Smallpox, which caused as many as 300 million deaths in the twentieth century alone, stopped being a threat to humanity in 1979. Its eradication was the fruit of a globally coordinated vaccination programme. Today, over 170 teams of scientists around the world are working on a similar effort to extirpate Covid-19.
While the number of experimental vaccines under clinical investigation has quintupled to 31 (compared to our previous report on the discovery effort; see WiC492), Chinese firms are still apparently the frontrunners. As of August 26, the country had produced three of the six candidates in their final stage of trials, meaning that their vaccines’ efficacy and safety will be tested across thousands of people, according to the World Health Organisation.
Leading the field is China National Biotec Group, a subsidiary of state-owned Sinopharm. CEO Liu Jingzhen told Guangming Daily on August 18 that its vaccines will be ready for public distribution by the end of December.
His expectation is based on Phase III trials of its two candidates taking about three months to complete. Tests of the earliest batch of vaccines started on 15,000 volunteers in late June in Abu Dhabi, and additional trials also gained approvals in Bahrain, Peru, Morocco and Argentina this month.
What makes the product launch a stronger near-term possibility is that Sinopharm has already readied its production facilities in Beijing and Wuhan with an investment of Rmb2 billion ($290 million). Together they are designed to produce 220 million doses a year. Two jabs, costing less than Rmb1,000, will yield 100% protection against Covid, Liu has suggested, claiming to have received the inoculations himself.
Sinovac’s CoronaVac is another leader in the race. Since July 21 the Beijing-based company has been conducting various Phase III trials overseas too. The tests in Brazil, in collaboration with the publicly-funded Butantan Institute, have enrolled 9,000 healthcare professionals working at different Covid-19 specialised facilities. Early this month Sinovac started working with the International Centre for Diarrhoeal Disease Research in Bangladesh to test its potential vaccine on 4,200 more people, and with Bio Farma, Indonesia’s only vaccine manufacturer, in a 1,600-person trial in Bandung in West Java.
In an interview with CGTN, a state broadcaster, Sinovac’s chairman and CEO Yin Weidong noted that CoronaVac could provide worldwide protection against Covid-19, despite the various mutations of the virus. In April when China saw a spike in imported cases, the company obtained 20 different strains of SARS-CoV-2 from patients around the world, and claims that its vaccine’s immune serum can neutralise all of them, regardless of their types.
Similar to its state-backed peer, Sinovac is also primed for mass production. Back in April it secured low-interest loans from a local bank as well as a large plot of land from the Daxing district government in Beijing for a new production plant capable of churning out 300 million doses every year.
“This capacity can meet both domestic and foreign demand. Hence, we’ve promised some countries that they could enjoy the same priority as China,” Yin said.
Both Sinopharm and Sinovac are adopting a relatively traditional approach to vaccine-making, using viruses grown in petri dishes that are then ‘inactivated’ for use on humans.
Their main competitors – Moderna in the US and BioNTech in Germany (it is partnered with Shanghai-based Fosun) – both launched 30,000-people trials at the end of July 27. They are trying out a revolutionary method known as messenger ribonucleic acid (mRNA).
Theoretically, this works by injecting carefully-edited genomic sequences into human cells that then hatch the exact proteins that researchers want the body to recognise as a threat. In the case of SARS-CoV-2, this is the protruding spike proteins, according to research published by Nature, a medical journal.
In short, the Chinese frontrunners present an ‘inactivated’ version of the real virus to the human body, whereas the Western firms are relying on synthetic genetic codes. Champions of the novel approach tout its cell-free process, which could speed up manufacturing time. Proponents of the older technique see merits in exposing the body to most or all of the virus because that gives the immune system a broader choice of potential targets.
Standing between the two approaches is the deployment of adenoviral vectors, which is the focus of scientists at the UK’s University of Oxford. This style of research has concentrated on genetic modification of a common cold virus typically suffered by chimpanzees – while not replicating it will counter the SARS-Cov-2 spike protein.
Results of the candidate’s Phase III trials – now underway in the US, Brazil, South Africa and India – are expected to come out in November. The university’s commercial partner AstraZeneca will produce 2.4 billion doses; while the Serum Institute in India has promised to produce up to one billion doses.
A close challenger to Oxford is CanSino, a Tianjin-based biotech company. Its potential vaccine differs by using adenovirus type 5, which typically causes the common cold among humans, as a vector. Phase III trials are expected to take place in Saudi Arabia, Russia and Latin America, although CanSino has been giving doses of its vaccine to soldiers of the People’s Liberation Army since late June. The project’s lead developer is Chen Wei, an infectious disease expert heading the Academy of Military Medical Sciences (see this week’s “Red Star”).
In fact, other Chinese officials also began administering experimental vaccines to frontline workers under an “emergency use” protocol more than a month ago. This is intended to protect people facing the highest risk of infection by the virus, according to the National Health Commission. Frontline health workers, public service workers and border officials were among the first to go onto the immunisation programme.
Acknowledgement of the fledgling vaccination scheme, which came despite an avalanche of international criticism of the Russians for their own perceived haste in licencing an under-trial vaccine, indicates the sense of optimism in Chinese officialdom that its vaccines are going to work.
As countries around the world scramble to secure vaccine stock for their people, Chinese Premier Li Keqiang also promised on Wednesday to give Myanmar, Laos, Thailand, Cambodia and Vietnam early priority in accessing some of China’s forthcoming Covid-19 vaccines.
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