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9 reasons you can be optimistic that a vaccine for COVID-19 will be widely
available in 2021

  August 20, 2020 8.19am EDT
  [39]William Petri, University of Virginia

Author

   1. [40]William Petri
      Professor of Medicine, University of Virginia

Disclosure statement

  William Petri receives research grant funding from the NIH and the Bill
  and Melinda Gates Foundation.

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  Cartoon of a Covid 19 vaccine. Experts are confident that there will be
  a vaccine next year. [46]PenWin /iStock / Getty Images Plus
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  As fall approaches rapidly, many are wondering if the race for a
  vaccine will bear fruit as early as January 2021.

  [53]I am a physician-scientist and infectious diseases specialist at
  the University of Virginia, where I care for patients and conduct
  research into COVID-19. I am occasionally asked how I can be sure that
  researchers will develop a successful vaccine to prevent COVID-19.
  After all, we still don’t have one for HIV, the virus that causes AIDS.

  Here is where the current research stands, where I think we will be in
  five months and why you can be optimistic about the delivery of a
  COVID-19 vaccine.

1. Human immune system cures COVID-19

  In [54]as many as 99% of all COVID-19 cases, the patient recovers from
  the infection, and the virus is cleared from the body.

  Some of those who have had COVID-19 may have low levels of virus in the
  body for up to three months after infection. But in most cases these
  individuals can [55]no longer transmit the virus to other people 10
  days after first becoming sick.

  It should therefore be much easier to make a vaccine for the new
  coronavirus than for infections such as HIV where the immune system
  fails to cure it naturally. SARS-CoV-2 doesn’t mutate the way that HIV
  does, making it a much easier target for the immune system to subdue or
  for a vaccine to control.

2. Antibodies targeting spike protein prevent infection

  A vaccine will protect, in part, by inducing the production of
  antibodies against the spike protein on the surface of SARS-CoV-2, the
  virus that causes COVID-19.
  [56]Y-shaped antibody bound to the spike protein. When a Y-shaped
  antibody (green) binds to the spike protein (blue and brown) of the
  SARS-CoV-2, the coronavirus is unable to infect cells.
  [57]vdvornyk/iStock/Getty Images Plus

  [58]The virus needs the spike protein to attach to and enter human
  cells to reproduce. Researchers have shown that antibodies, like those
  made by the human immune system, bind to the spike protein, neutralize
  it and prevent the coronavirus from infecting cells in laboratory
  culture.

  Vaccines in clinical trials have been shown to raise [59]anti-spike
  antibodies that block virus infection in cells in the lab.

  [60]At least seven companies have developed [61]monoclonal antibodies,
  laboratory-manufactured antibodies that recognize the spike protein.
  These antibodies are entering clinical trials to test their ability to
  prevent infection in those who are exposed, for example, through a
  household contact.

  Monoclonal antibodies may also be effective for treatment. During an
  infection, a dose of these monoclonal antibodies could neutralize
  virus, giving the immune system a chance to catch up and manufacture
  its own antibodies to combat the pathogen.

3. Spike glycoprotein contains multiple targets

  The spike protein has [62]many locations where antibodies can bind to
  and neutralize the virus. That’s good news because with so many
  vulnerable spots, it will be difficult for the virus to mutate to avoid
  a vaccine.

  Multiple parts of the spike would need to mutate to evade neutralizing
  anti-spike antibodies. Too many mutations to the spike protein would
  change its structure and render it incapable of binding to ACE2, which
  is key to infecting human cells.

4. We know how to make a safe vaccine

  Safety of a new COVID-19 vaccine is improved by researchers’
  understanding of potential vaccine side effects and how to avoid them.

  One side effect seen in the past was [63]antibody-dependent enhancement
  of infection. This occurs when antibodies don’t neutralize the virus
  but instead allow it to enter into cells via a receptor intended for
  antibodies. Researchers have found that by [64]immunizing with the
  spike protein, high levels of neutralizing antibodies can be produced.
  This lessens the risk of enhancement.

  A second potential problem posed by some vaccines is an allergic
  reaction that causes inflammation in the lung, as was seen in
  individuals who received a [65]respiratory syncytial virus vaccine in
  the 1960s. This is dangerous because inflammation in the lung air
  spaces can make it difficult to breathe. However, researchers have now
  learned [66]how to design vaccines to avoid this allergic response.

5. Several different vaccines in development

  The U.S. government is supporting the development of several different
  vaccines via [67]Operation Warp Speed.

  The goal of Operation Warp Speed is to deliver 300 million doses of a
  safe and effective vaccine by January 2021.

  The U.S. government is making a major investment, committing [68]US$8
  billion to seven different COVID-19 vaccines.

  By supporting multiple COVID-19 vaccines, the government is hedging its
  bets. Only one of these vaccines needs to prove safe and effective in
  clinical trials for a COVID-19 vaccine to be made available to
  Americans in 2021.

  [Get the best of The Conversation, every weekend. [69]Sign up for our
  weekly newsletter.]

6. Vaccines passing through phase I and II trials

  Phase I and phase II trials test if a vaccine is safe and induces an
  immune response. Already the [70]results to date from three different
  vaccine trials are promising, triggering the production of anti-spike
  neutralizing antibodies levels that are two- to four-fold higher than
  those seen in people who have recovered from COVID-19.

  [71]Moderna, [72]Oxford and [73]Chinese company CanSino have all
  demonstrated the safety of their vaccines in phase I and phase II
  trials.
  Phase III trials for a COVID-19 vaccine are underway in multiple
  countries. [74]ER Productions Limited/Getty Images

7. Phase III clinical trials are underway

  During a phase III trial, the final step in vaccine development
  process, the vaccine is tested on tens of thousands of individuals to
  determine if it works to prevent infection with SARS-CoV-2, and that it
  is safe.

  [75]The vaccine produced by Moderna and NIH and the [76]vaccine from
  Oxford-AstraZeneca began phase III trials in July. Other COVID-19
  vaccines will be starting phase III within weeks.

8. Accelerating vaccine production and deployment

  Operation Warp Speed is paying for the production of millions of doses
  of vaccines and supporting vaccine manufacturing at an industrial scale
  even before researchers have demonstrated vaccine efficacy and safety.

  The advantage of this strategy is that once a vaccine is proven safe in
  phase III trials, a stockpile of it will already exist and it can be
  distributed immediately without compromising full assessment of safety
  and efficacy.

  This is a more prudent approach than that of [77]Russia, which is
  vaccinating the public with a vaccine [78]before it has been shown to
  be safe and effective in phase III.

9. Vaccine distributors are being contracted now

  McKesson Corp., the largest vaccine distributor in the U.S., has
  already been [79]contracted by the CDC to distribute a COVID-19 vaccine
  to sites – including clinics and hospitals – where the vaccine will be
  administered.

  I believe that it is realistic that we will know sometime in late 2020
  whether some COVID-19 vaccines are safe, exactly how effective they are
  and which ones should be used to vaccinate the U.S. population in 2021.
    * [80]Medicine
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    * [88]COVID-19
    * [89]SARS-CoV-2
    * [90]Spike protein
    * [91]ACE2

Want to write?

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