The vaccination was fast. Here’s how to do it even faster

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The most advanced vaccine use in history promises to stop a pandemic that has already reached 1.67 million lives, but what if a vaccine for COVID-19 had been available more quickly, say so early March?

A question raised by Florian Krammer, PhD, a microbiologist at the Icahn School of Medicine at Mount Sinai in New York City. In a statement published directly in the journal Cell, reflects on the loss of life and says that vaccines will now have a significant impact on ending the pandemic, but that they were needed much earlier.

His lab recently discovered that SARS-CoV-2, the virus that causes COVID-19, was circulating in New York City as early as February, even though it was not first case report to March 1. Krammer has since turned his attention to another timeline and is evaluating how to speed up vaccine delivery.

in the Cell column, he writes, “While vaccines are unlikely to have stopped the virus from spreading globally, a well-prepared infrastructure would be able to deliver vaccines for 3-4 months. into exit (in March or April) has saved many lives and it would seem that they have normalized the situation in many areas now. “

The U.S. Food and Drug Administration has already issued an emergency use permit for the Pfizer-BioNTech vaccine in the near future, and a second vaccine from Moderna is expected to be approved soon. Operation Warp Speed ​​is living up to its moniker and so far it is on track to deliver 300 million doses of vaccines to Americans in the coming months, but the director of the CDC who is Going out still claims that this is “the most difficult time in public health. history of this country. “

It’s a grim prospect that seemed unbelievable last year when the Global Health Security Index highlighted the number of United States in the world for its ability to respond to a major health crisis. With high-quality laboratories and scientific staff, a strategic national collection of equipment and emergency and communications reconnaissance plans, the United States was ready to lead an international pandemic response, but struggled initially to reduce full capacity.

Race against the virus

The race for vaccination began in January when a Chinese scientist made the genetic sequence of SARS-CoV-2 openly available.

It’s a race that David Wang, PhD, is well acquainted with; worked as part of the team that uncovered the world’s first major acute respiratory syndrome (SARS) back in 2003 during that revolution and helped establish the scientific work for this one.

Wang was in a dock post when CDC scientists were confronted with the mysterious pathogen imported from China’s Guangdong province that affected a patient, then handed over to health workers and other patients in hospitals who suffer from their close ties, while the disease has moved into the wider space. community.

If that situation feels familiar, the drill is more like the same scientist has responded this year.

Wang’s advisor at the time, Joseph DeRisi at the University of California San Francisco, entered into a call with the CDC and found out if the genomic method from his lab could help. The cornerstone of the strategy is a long-acting oligonucleotide DNA microarray capable of detecting hundreds of viruses simultaneously. His team had already used random PCR amplification in conjunction with microarray to detect several viruses in human respiratory samples and included them to test for a CDC sample of the secretory pathogen.

It didn’t take long before his team had answers: Detection of a novel coronavirus (SARS-CoV) in patients with SARS. Phylogenetic analysis and order comparisons showed that this virus was not closely related to any of the previous coronaviruses. So far. SARS-CoV-2 is genetically linked and more potent; the first SARS virus was deadly, but escaped after public health mitigation measures.

To date, all pathogen outbreaks are from wildlife to humans – from SARS in 2003 to H1N1 bird flu in 2009, MERS in 2012, the 2014 Ebola outbreak, Zika in 2016 to COVID-19 – has kept the scientific community under guard.

Germ hunters come together

But what if, instead of an eleven-hour sword to study an unknown pathogen, a network of scientists was summoned to jump in?

That’s the goal of a new network launched in August by Anthony Fauci, MD, director of the National Institute of Allergies and Infectious Diseases. Named the Centers for Research on Emerging Infectious Diseases (CREID), it has a team of scientists strategically located around the world in key centers, with others based on the margins of human settlement where hunters and farmers may be exposed to novel pathogens; near villages where person-to-person transmission begins; and where unusual cases of fever, encephalitis, and sudden death begin to develop.

The network has been funded by $ 82 million over 5 years. Wang, now a professor at the University of Washington School of Medicine in St. Louis, is a professor. Louis, over the Asia-East Africa region.

New $ 82 Million Pandemic Network

The organization is gaining experience in dealing with incidents more quickly by “pivoting to work together,” said Jean Patterson, chief program officer for the CREID network..

Researchers can use a prototype pathogen approach to study how and where infectious diseases come from wildlife to jump into humans. Reporting from 10 institutions in the U.S. and 28 other countries, scientists are developing diagnostic, therapeutic and vaccine families that can be targeted and deployed more quickly the next time “Pathogen X “into the world.

Krammer, who did not respond to interview requests, has speculated that new vaccines could be developed just 3 weeks after the discovery of a new virus, and could be used immediately in a phase 3 test – skipping on level 1-2 tests. “Since a production correlation has been tested for a closely related virus, the correlation can be used to measure vaccine efficacy,” he writes.

Then, results from the clinical trial could be available almost 3 months later. And while clinical trials are underway, production may have increased globally and pre-activated distribution chains, so at that 3-month mark, transmission may Vaccination start immediately, he recommends.

New world records would be set. And in the event that the emerging virus is identical or virtually unrecognizable by one of the modified vaccines, the existing stocks could be used for stage 3 testing, purchased even more time.

But how fast is it too fast?

Wang states that it is uncertain whether it would be appropriate to conduct a number of stage 1 and 2 tests for viruses in connection with an initial screening for a new agent vaccine.

More investment in understanding the immune response to a wide range of viruses will certainly help inform future vaccine development, but the timeline proposed for phase 3 testing would be a very ideal scenario, he says. “And it largely depends on the level of infection at the sites selected for the vaccine studies,” he says, recalling that there were early concerns in Oxford AstraZeneca’s studies as to whether cases enough to gather evidence with the low level of infection in the UK over the summer.

“For a virus that does not spread as effectively as SARSCoV-2, it may take much longer for enough events to occur in the vaccine population to assess efficacy,” Wang said.

Allison Shelley is executive editor for Medscape Medical News reporting on COVID-19 pandemic. For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.