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Coronavirus Vaccine List

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Vaccine development is a slow, painstaking process. First come the lab tests, then animal studies, and finally, a trio of human trial phases, each involving more people than the last.

Typically, that path to approval takes 10 to 15 years, but researchers are developing COVID-19 vaccines at a breakneck pace to combat the ongoing pandemic.

This coronavirus vaccine list highlights those in the final stretch of the development process: phase 3 clinical trials.

Moderna's RNA Vaccine (mRNA-1273)

Moderna's COVID-19 vaccine uses messenger RNA (mRNA) to instruct the body to produce antibodies against the novel coronavirus. This is a new technique for vaccines, which has never been used before, but if it works, would be easy to scale up.

In March, it became the first to reach the human trial stage, and a double dose of Moderna's vaccine prompted the creation of neutralizing antibodies in all 45 participants in the phase 1 trial, according to a preliminary report published on July 14.

In June, Moderna announced that it had fully enrolled a 600-person phase 2 trial, and on July 27, it officially launched a 30,000-person phase 3 trial that will test the vaccine's ability to prevent a COVID-19 infection.

For the trial, participants in the treatment group are receiving two 100-microgram doses of the vaccine, 28 days apart. During earlier trials, that dosage produced mild or moderate side effects, such as fatigue, chills, and headache, in all participants.

On November 16, Moderna announced the preliminary findings of the phase 3 trial, reporting that it appears to be 94.5% effective at preventing COVID-19 infections. It plans to submit a request for an EUA to the FDA within weeks, and if approved, the company says it could deliver 20 million doses to the U.S. before the end of 2020 — and produce an additional 500 million to one billion doses in 2021.

Pfizer's RNA Vaccines (BNT162B1 & BNT162B2)

Pharma giant Pfizer is developing BNT162-01, an mRNA-based coronavirus vaccine, in partnership with German company BioNTech and Chinese drugmaker Fosun Pharma.

In May, the group launched a combined phase 1 and 2 trial of two versions of the vaccine: BNT162b1 and BNT162b2. On July 1, it published the preliminary results of the trial, writing that the vaccine prompted the production of antibodies at levels exceeding those of coronavirus survivors.

On July 27, Pfizer and its collaborators announced the launch of a combined phase 2 and 3 trial that will involve 30,000 volunteers in the U.S., Brazil, and several other countries. This trial will focus on BNT162b2, as it was shown to produce significantly fewer side effects.

For the phase 2 and 3 trial, participants in the treatment group are receiving two 30-microgram doses of the vaccine, 21 days apart. During earlier trials, 75% of participants who received that dosage developed fevers after the second injection, but none reported severe side effects.

On November 9, Pfizer shared early results on the trials, reporting that the vaccine appears to be 90% effective at preventing COVID-19 infections. Less than 10 days later, it updated that figure to 95%, adding that the vaccine was more than 94% effective in trial participants over the age of 65.

Pfizer submitted its request for an EUA to the FDA on November 20. The review process is expected to take several weeks, but the firm previously announced that its goal is to produce 100 million doses of its vaccine in 2020 and 1.2 billion doses in 2021.

Oxford's Viral Vector Vaccine (ChAdOx1-S)

To create a viral vector vaccine, researchers from the University of Oxford and pharma company AstraZeneca added genetic material from the novel coronavirus's spike protein to a common cold virus (actually a chimpanzee adenovirus). The coronavirus genes should spark antibodies against COVID-19, while the harmless adenovirus lacks the tools to cause a real infection.

In April, after the vaccine showed promise in monkey studies, the group launched Europe's first clinical trial of a COVID-19 vaccine. In July, it reported that two doses of its vaccine prompted the creation of T cells and neutralizing antibodies in all trial participants.

On August 31, Oxford launched a 30,000-person phase 3 trial of its vaccine in the U.S. It also has phase 3 trials underway in Brazil and South Africa, and a combined phase 2 and 3 trial is ongoing in the U.K.

For the trials, Oxford is testing different sized doses, with some participants in the treatment group receiving just one dose and others two. During earlier trials, the vaccine produced no severe side effects, but more than half of participants did experience minor ones, such as headaches or fevers.

On November 23, Oxford shared interim trial data for two different dosing regimens. In one, the vaccine was 90% effective, and in the other, it was 62% effective, for an average efficacy of 70.4%. No one who received the vaccine developed a severe case of COVID-19.

Oxford is now submitting its data to regulators for approval. If granted, the developers say they could manufacture up to 3 billion doses of their vaccine in 2021. Unlike Pfizer's and Moderna's vaccines, ChAdOx1-S can be transported and stored at refrigerator temperatures, which could make it easier to distribute.

Sinopharm's Inactivated Vaccine

Some vaccines provide protection against disease by introducing the body to an inactivated version of a virus or bacteria — that is, one that can no longer make a person sick, but can still prompt an immune response.

The first inactivated coronavirus vaccine to make it to phase 3 trials is co-developed by Chinese state-owned company Sinopharm and the Wuhan Institute of Biological Products.

In June, Sinopharm reported that the vaccine produced antibodies in every participant in a combined phase 1 and 2 trial. The following month, it launched a phase 3 trial in the United Arab Emirates (UAE), which is now ongoing.

For that trial, participants in the treatment group are receiving two doses of the vaccine, three weeks apart. In earlier trials, no serious adverse effects were reported.

Sinopharm's goal is to have the vaccine ready to enter the market by the end of 2020 or in early 2021.

On August 22, Chinese health officials announced via state-controlled media that the nation has begun inoculating high-risk residents with the vaccine on July 22.

On September 14, the UAE announced that it had also approved the vaccine for healthcare workers at high risk of contracting COVID-19.

Sinopharm's Other Inactivated Vaccine

Sinopharm is also collaborating on an inactivated coronavirus vaccine with the Beijing Institute of Biological Product.

A combined phase 1 and 2 trial of that vaccine, BBIBP-CorV, launched in April, and Sinopharm is now testing it on 5,000 people in a phase 3 trial in the United Arab Emirates.

On August 22, Chinese health officials announced via state-controlled media that the nation has begun inoculating high-risk residents with the vaccine on July 22.

On September 14, the UAE announced that it had approved the vaccine for healthcare workers at high risk of contracting COVID-19.

Sinovac Biotech's Inactivated Vaccine (CoronaVac)

Chinese biotech firm SinoVac has also developed an inactivated coronavirus vaccine — CoronaVac — and in August, the company secured an emergency use approval from the nation to begin dosing high-risk populations with the vaccine.

The path to that started in April, when the firm launched a combined phase 1 and 2 trial of the vaccine, and according to the preliminary results published in June, it prompted the production of neutralizing antibodies in more than 90% of participants within 14 days.

In mid-July, SinoVac launched a phase 3 CoronaVac trial involving 9,000 doctors and healthcare workers in Brazil. Initial results of that trial are expected to arrive in October.

For that trial, participants in the treatment group are receiving two doses of the vaccine, 14 days apart. None of the participants in the earlier trials experienced any severe adverse reactions.

SinoVac hasn't said when it expects CoronaVac to be available to the public, but it is ready to manufacture 100 million doses.

The Tuberculosis Vaccine (Bacillus Calmette-Guerin)

One of the COVID-19 vaccines currently in phase 3 trials is not like the others — because it was actually developed a hundred years ago to protect against an entirely different disease.

Every year, doctors use the Bacillus Calmette-Guerin (BCG) vaccine to inoculate more than a million children against tuberculosis. But some researchers suspect that the vaccine may have an "off target" effect: protection against COVID-19.

Murdoch Children's Research Institute is one of several groups putting that theory to the test.

In March, it launched a phase 3 trial during which 10,000 healthcare workers will receive either the BCG vaccine or a placebo. The researchers will then follow up to see whether the vaccine appears to prevent or decrease the severity of coronavirus infections.

CanSino's Viral Vector Vaccine (Ad5-nCoV)

Chinese company CanSino Biologics's candidate is another unique addition to this list of coronavirus vaccines because it had already received limited government approval before reaching the phase 3 trial stage.

On June 25, CanSino announced that it had received special approval to distribute Ad5-nCoV to members of China's military for one year.

The following month, the company reported that the vaccine prompted the creation of both antibodies and T cells in most phase 2 trial participants. However, it didn't appear as effective in people who already had immunity to the harmless cold virus it uses to transport the coronavirus's genetic material.

In an early trial, the majority of patients (81%) had at least one adverse effect, including pain at the injection site (54%), fever (46%), fatigue (44%), headache (39%), muscle pain (17%), and vomiting or diarrhea (13%). The study, published in The Lancet, reported, "Most adverse reactions were mild or moderate in severity," but a handful of participants (mostly in the high-dose group) did report severe fever (over 101.3 F), fatigue, or muscle or joint pain.

Initially, CanSino had trouble finding a nation willing to host a phase 3 trial. But in August it announced plans to conduct trials in both Saudi Arabia and Pakistan.

If the vaccine proves effective in those trials, CanSino is ready to produce up to 200 million doses of it annually starting in early 2021.

Russia's Viral Vector Vaccine (Sputnik V)

Another outlier on this list is a viral vector vaccine developed by Russia's Gamaleya Research Institute.

After less than two months of human testing, President Vladimir Putin announced on August 11 that the vaccine, officially Gam-Covid-Vac Lyo but called "Sputnik V," had been approved, with mass vaccinations expected to begin in October.

Russia had yet to release the detailed results of the vaccine's phase 1 or 2 trials at the time of the announcement, and a small phase 3 trial was ongoing, leading many in the scientific community to question the vaccine's efficacy and safety.

On August 20, Russia said the vaccine's approval was actually a "conditional registration certificate" and announced plans to expand the phase 3 trial from 2,000 volunteers to 40,000.

A few weeks later, on September 4, the Gamaleya researchers did publish the data from their phase 1 and 2 trials in the Lancet, reporting that it produced only mild side effects and prompted an antibody response.

On September 7, Enrico Bucci, an adjunct professor in systems biology at Temple University, published an open letter calling into question the reliability of Russia's data. An additional 37 scientists have since signed it.

On November 24, the developers reported a second interim analysis of their trial, which had by then enrolled more than 18,000 people. Based on 39 cases of COVID-19, the vaccine was 91.4% effective at preventing infection.

Johnson & Johnson’s Adenovirus Vaccine (JNJ-78436735)

On September 23, healthcare giant Johnson & Johnson announced that its COVID-19 vaccine had reached the critical phase 3 stage of human testing.

While three vaccines have already hit that milestone in the U.S., this one may have several advantages over the others.

For one, Johnson & Johnson's vaccine is designed to deliver protection with just one shot, not two. It can also be stored in a refrigerator, unlike the vaccines developed by Moderna and Pfizer, which need to be stored at below-freezing temperatures. That could make it easier to distribute.

Johnson & Johnson's phase 3 trial is also the largest to date, with up to 60,000 volunteers across three continents — but it hit a snag on October 12 when the company announced a study pause due to a patient exhibiting an "unexplained illness". The company was cleared to resume the trial on October 23.

Johnson & Johnson initially reported that it could begin distributing the vaccine as soon as early 2021 — no word yet on how this pause in the trial might affect that timeline.

Novavax's Recombinant Vaccine (NVXCoV2373)

Maryland-based Novavax has yet to successfully bring a vaccine to market, but on September 24, the company joined the ranks of those to launch a phase 3 trial of a COVID-19 vaccine.

Novavax's vaccine prompts an immune response by introducing the body to a coronavirus protein housed within microscopic particles — the same tried-and-true approach taken by existing vaccines for HPV and shingles.

In monkey studies, the vaccine provided protection against COVID-19, and in small human trials, volunteers exhibited high levels of antibodies after receiving the vaccine.

Novavax plans to enroll up to 10,000 volunteers in the U.K. in its newly launched phase 3 trial. A U.S. phase 3 trial is expected to follow in October. Half the volunteers will receive two doses of the vaccine, delivered three weeks apart, while the others receive a placebo.

If the vaccine proves effective and secures regulatory approval, Novavax expects to be able to produce 2 billion doses of it annually by mid-2021.

The Vector Institute's Peptide-Based Vaccine (EpiVacCorona)

On October 14, Russian President Vladimir Putin announced the approval of the nation's second COVID-19 vaccine: EpiVacCorona.

Siberia's Vector Institute developed the vaccine, which contains small bits of proteins from the coronavirus called peptides. The vaccine has yet to be put to the test in a phase 3 trial, and the results of earlier-stage human trials have yet to be published.

According to Russian news agency TASS, a phase 3 trial involving 30,000 people is expected to begin in November or December.

Anhui Zhifei Longcom Biopharmaceutical's Subunit Vaccine

Biopharmaceutical company Anhui Zhifei Longcom has partnered with the Chinese Academy of Medical Sciences to develop a recombinant subunit vaccine candidate for COVID-19.

“The vaccine involves protein so it doesn’t require a high biosafety level production facility (as needed for inactivated vaccines)," CAS researcher Yan Jinghua explained. "The production process is very safe, which guarantees accessibility to the vaccine."

On November 20, the group launched a phase 3 trial of the vaccine in China. Trials in Uzbekistan, Indonesia, Pakistan, and Ecuador are expected to follow shortly, with the goal of enrolling 29,000 adults in the trial.

We'd love to hear from you! If you have a comment about this coronavirus vaccine list or if you have a tip for a future Freethink story, please email us at [email protected].

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