April 22, 2020

expert comment on COVID-19 vaccine development

There have been questions from journalists about vaccine trials and the global race to produce a vaccine for COVID-19.

Dr Ohid Yaqub, Senior Lecturer at the Science Policy Research Unit at the University of Sussex, said:

“Before vaccines and drugs can enter clinical trials, they need to be registered, so from that we can see what sort of questions the study is interested in, and how they plan to answer them. 

“This particular trial is a phase I/II, so they are mostly checking for safety but also checking a little bit for efficacy. The vaccine they are testing is a small part of the covid virus, packaged inside a delivery vector, neither of which can cause disease but may be successful in triggering an immune response. 

“This is a typically cautious approach to vaccine development. Even so, the trial will mostly be looking for any problems or severe adverse reactions. There will very likely be none, so the trial is also designed to enable us to learn a little bit about efficacy at the same time. They will of course be looking at how many vaccinated people get infected (so called breakthrough cases) as compared to a control group. But they will also be looking for how much of an immune reaction the vaccine managed to elicit in terms of cellular and antibody responses. Lastly, they will look to see whether giving some people a boost (two doses instead of one) makes a difference, but this will not have a control group so it is a lower order priority.

“In terms of broader policy context, this is extremely early days. In my view, public policy should continue to support vaccine development as best it can, and there are a number of ways it can continue to do that, but at the same time policymakers should continue to assume that a vaccine will not be available any time soon. We should be careful not to tempt people working on vaccines into estimating or making optimistic predictions about when a vaccine will be ready. There is a long history of over-optimistic vaccine predictions. 

“Even if a vaccine unexpectedly becomes available, it is too early even to speculate whether it will have high efficacy or low efficacy. A low efficacy vaccine will have different policy implications in terms of how it should be rolled out. I therefore think public policy attention should continue to focus on testing and on healthcare system capacity, and should focus on lockdown and managing the social costs of (partial) lockdown for as long as possible.

“Few scientists will be thinking in terms of a global national race. They will be keen to publish and share their results and share them with the world. Some firms might be thinking in terms of racing to secure patent and distribution rights before they make further investments, but others will not.

“Given that this is not even a phase III trial, this is like talking about who might win a race before the preliminary qualifying heats have even begun.”

All our previous output on this subject can be seen at this weblink: www.sciencemediacentre.org/tag/covid-19

Declared interests

None received.