CORONAVIRUS VACCINES PASS SAFETY TRIALS BUT NO LEADER EMERGES Aina, Anushka, Josefin, Jesper

1. Scientific Concepts

1.1. Vaccine

1.1.1. Provides acquired immunity for a particular infectious disease

1.1.1.1. Acquired immunity - part of the immune system that allows for specialized defense against a particular pathogen

1.1.2. Contains an agent similar to the pathogen

1.1.3. Stimulates the immune system to recognize and react to any future threats from the pathogen

1.2. T cells

1.2.1. They are classified as lymphocytes, a subcategory of white blood cells (leukocytes) which are present in our blood.

1.2.2. T-cells are responsible for determining specific immune responses for antigens. To carry out this process, premature t-cells which originate in the bone marrow differentiate and specialize in different types of t-cells.

1.2.2.1. One example of these specialized t-cells are the t killer cells, who induce immune mediated cell death responses to directly kill virus infected cells as well as cancer cells.

1.3. How a vaccine is made

1.3.1. The general stages of the development cycle of a vaccine are: 1. Exploratory stage 2. Pre-clinical stage 3. Clinical development 4. Regulatory review and approval 5. Manufacturing 6. Quality control

1.3.2. Clinical development: Phase I: small groups of people receive the trial vaccine. Phase II: the vaccine is given to people who have characteristics similar to those for whom the new vaccine is intended. Phase III: the vaccine is given to thousands of people and tested for efficacy and safety.

1.3.2.1. The four vaccine candidates in the article has passed phase I and II trials. None of the vaccines so far has shown any serious side effects. However Large-scale efficacy trials (phase III trials) are needed to determine if the vaccine will prevent disease or infections.

1.3.2.1.1. Oxford’s vaccine is being tested for efficacy and the Moderna–NIAID vaccine is set to begin its phase III trial this month.

1.4. immunology

1.4.1. A branch of biology that studies the immune system

1.4.2. Especially relevant within the context of vaccines and disease

1.5. The spike protein

1.5.1. Protein spikes which cover the surface of the virus

1.5.2. Used to bind to and enter human cells

1.5.3. One of the developed vaccines mentioned in the article, harnessing a virus causing colds in chimpanzees, expresses this spike protein

1.5.4. RNA instruction for receptor binding domain from said spike protein also used within another vaccine

1.5.4.1. Thus the spike protein is seen to be crucial in inducing neutralizing antibodies when making a vaccine

1.6. Antibodies

1.6.1. Y shaped proteins able to recognize and bind to specific pathogens via its fragment antigen binding (Fab) variables

1.6.1.1. The Fab variables are specifically shaped to be able to bind to the antigens found on the surface of a pathogen

1.6.2. By binding to a pathogen, it can "tag" it to be neutralized by other immune cells, or it can directly neutralize it by inhibiting certain functions of the pathogen

2. Direct Stakeholders

2.1. Companies

2.1.1. Moderna (biotech company in Cambridge)

2.1.2. NIAID (National Institute of Allergy and Infectious Diseases)

2.1.3. University of Oxford

2.1.4. Imperial College of London

2.1.4.1. The employees - Scientists

2.1.4.2. The pressure on these companies/universities is very high. If they don´t come up with a vaccine-they will lose a lot of money.

2.1.5. CanSino Biologics (China)

2.1.6. AstraZeneca

2.1.7. BioNTech

2.2. Hospitals

2.2.1. Most hospitals are overwhelmed and the nurses/doctors have to work overtime

2.3. People affected by the virus

2.3.1. Many people, especially people in risk groups, can die or get very ill (hospitalized) without a vaccine.

3. Indirect stakeholders

3.1. General population

3.1.1. Society won´t go back to normal in a long time.

3.1.2. Many people are unemployed. People lose their jobs.

3.2. Governments

3.2.1. GDP/economy

4. Article Description

4.1. Coronavirus vaccine

4.1.1. First human trials

4.1.2. Different vaccine candidates

4.1.3. Issues with attempting to continue the research with making a vaccine

4.1.4. "Viral vectors" vaccines are being produced in which a genetically modified virus which normally causes colds in chimpanzees is being used.

4.1.5. Others are developing a RNA based vaccine containing instructions for the the 'receptor binding domain' of the spike protein

4.2. Immunologists suggest that many of these potential vaccines “may do the trick” however, the process of bringing the vaccine from the laboratory to the people would pose as a challenge.

4.3. Data derived from the preliminary trials cannot be compared as the same tests can return widely varied results due to changes in environment and people involved.

5. Article examples Issues at hand

5.1. Cannot compare the results of the different vaccines because of broad methodology. The same test can return widely different results.

5.1.1. Thus an issue in comparing creating a stop in developing the vaccine because of inability to compare such broad results

5.1.2. There is a greater focus on antibody neutralisation compared to identifying T cell responses, as it is harder to measure due to the need for large scale trials

5.2. Controlling the variables is difficult, because of different companies all developing the vaccine in a myriad ways, creating incomparable variables that have little in common

5.2.1. Again an issue that makes it difficult to compare the vaccine results and thus unable to continue developing

5.3. No stakeholders are stepping up to do this in a unified process to continue in developing a safe and efficient vaccine

5.3.1. No companies or clinics willing to step up or are so far capable of making enough vaccines for most of the world

5.4. T cells have received less attention due to difficulty in measuring, so it has been disregarded. However they play an important role in fighting the virus and protecting from it in the future.

5.4.1. This can become an issue with efficacy and efficiency of vaccine later on

6. Risks

6.1. No vaccine is produced because people cant compare whats best/incompentence

6.2. Companies rush to produce a vaccine.

6.2.1. A rushed process causes careless mistakes.

6.2.2. It might be hard to know the long-term effects of the vaccine when they continue to rush considering the importance and need of vaccines quick.

6.2.3. Can lead to companies keeping their results and progresses to themselves. Focusing more on creating some vaccine rather than a proper well made and safe vaccine

6.3. Biased testing methods, in thinking their vaccine being better

6.3.1. Altering their results to seem better compared to others

7. Potentials

7.1. Vaccine againt the coronavirus

7.1.1. Decreased infection rate

7.1.1.1. Society can go back to normal

7.1.1.1.1. Economy can be fixed

7.1.1.2. Less people die

7.2. Medical companies can make money

8. Research Questions

8.1. Biology

8.1.1. What is the vaccine immunogenicity period?

8.2. Chemistry

8.2.1. Which vaccine can be produced most efficiently?

8.3. Physics

8.3.1. Can statistical physics predict the long term effects of the vaccine on the infection rate of the virus?