Dr Yousuf Ali Al mulla
With coronavirus cases increasing around the world and economies continuing to be hampered, countries are not only competing for the first vaccine, but the coronavirus vaccine train has not stop yet at a fixed station so far. It is still roaming across a number of countries in the different continents, which are still testing their potential vaccine to repel the virus attack. However, we do recognize that it usually takes several years, sometimes decades to develop a vaccine for a new disease. Hence trying to develop a vaccine for COVID-19 within one year is unprecedented in history of vaccine science.
Although COVID-19 is a new disease, researchers have previous experience in developing candidate vaccines for other coronaviruses such as SARS and MERS. Off course vaccine artificially stimulates the immune system to make antibodies and conferring immunity without getting the disease. Interestingly, there are currently more than 145 coronavirus candidates being tested worldwide, but only two vaccines have entered the final third stage trial, one form China and one from United kingdom, with possible USA-German alliance as a third competitor entering this race!
Oxford University was able to quickly move to stage of human experiments, as the team previously used similar technology to develop MERS vaccine, which already shown that is safe for humans, with ultimate great progress lately expressed with its trials.
Moreover, we know that immune system has two arms of immunity, the humeral immunity and its antibodies and the other one is cellular immunity with T cells. Remarkably the Oxford University vaccine does stimulate both immunities and factually this surprised me and gives us much hope that we could have a vaccine. However, we have to be very cautious, because there has never been vaccine against coronavirus and they may never been one?. Also, there is no expectation that can be done! , as we know that no vaccine yet for Malaria or HIV and these disease we know well.
Definitely such news updated from Oxford is encouraging. Although the success of the vaccine in the formation of these cells constitutes a major breakthrough, it will not be reliable until the results of the experiments are announced in its third stage trial within coming weeks, in order to ensure its efficacy and the absence of side effects.
On other hand, with such points about Oxford vaccine and what lately spread by media about its affectivity in stimulating both immunities. Truly in think it has not yet showed really if it prevent infection or disease. What it is done shows us till now, that such vaccine has generated immune response and hopefully that’s what the next phase of clinical trial has to show us. Actually in the next phase, the study of the vaccine will be more with large number of people, simply because large numbers means you have more confidence in the data. However, numerous reports had claimed that clinical trial for Russian vaccine had been completed, knowing also that second and clinical trial are supposed to be completed in August 2020 , while no clarity over phase 3 trial ! Understanding that phase 3 trials, tests the efficacy and safety on hundreds or thousands of people.
Of course, people will be wondering how it was approved? I could say here that if the vaccine showed a strong responds in phase 2 trials, it might be approved for emergency use without full phase of trial 3 as such, or could be that such trials speed up through combined trial where several phases are run simultaneously. On other wards this claim can be, but completely skipping over phase 3 would be risky. Yet, if you could agree with me, that a vaccine which causes rare side effects may be acceptable for older people who would likely suffer worse complications from the infection itself. Surprisingly, one of the countries has been recently accused for hacking and targeting COVID-19 vaccine developer and its data. Looking to that, with such race for a vaccine between different nations, I think each research Centre is individualized and seem to be no cooperation or collaboration at least now with such catastrophic pandemic. It is really sad if such centers or most of them just seeking prestige or Nobel Prize, looking who will first invent the vaccine and ignoring the necessity of collaboration in order to get the vaccine soon as possible for whole world. Otherwise are we in a vaccine production cold war, with possible attempt to tarnish the reputation of coming vaccine?
Dramatically, as we have observed in last weeks and after reducing the strict measures related to isolation, social distancing and mobility, it sadly leads to increase cumulative infections again and mostly due to the incomplete what so called herd immunity, which might be completed either in 2021 or 2022 in the absence of vaccine production. Keeping in mind also that, if coronavirus mutated significantly this can lead to potentially dangerous results for vaccine development; however we are fortunate that no mutation as such was detected yet!
However, still many people are asking if we could possibly see a vaccine ready to go this year?! In fact about the timeline with hope that the vaccine might be ready in coming months or at least by end of year 2020, I am not as optimistic that we can have it sometime this fall, still I am looking for early or mid-year 2021, but I would obviously love to be proved wrong about that! Unfortunately, if we could not get the vaccine, the herd immunity if developed, will not be enough mostly to eradicate the virus and it will come back in small waves over several years, urging us to learn how to live with the virus for some time!
At end, until the optimal vaccine is determined, the next challenge for us as individual and society is to continue with the commitment toward physical distance, wearing face masks, hand washing and adhering to other health guidelines. In addition continue to be alert to any changes in the state of the virus, as it is able to respond to everything we do to control it...If we make a vaccine it will try to avoid it and if we stay at home, I am afraid it will know how to stay longer!
Dr.Yousuf Ali Al Mulla is a physician, medical innovator & educator.m
