The Telegram (St. John's)

Scientists hunt pandemic hotspots in race to test vaccines

Success of lockdown, social distancing policies could mean few candidates to test vaccines

- KATE KELLAND JULIE STEENHUYSE­N REUTERS REUTERS • STEVE PARSONS

LONDON — The first wave of the COVID-19 pandemic may be waning. For vaccine developers, that could be a problem.

Scientists in Europe and the United States say the relative success of draconian lockdown and social distancing policies in some areas and countries means virus transmissi­on rates may be at such low levels that there is not enough disease circulatin­g to truly test potential vaccines.

They may need to look further afield, to pandemic hotspots in Africa and Latin America, to get convincing results.

“Ironically, if we’re really successful using public health measures to stamp out the hot spots of viral infection, it will be harder to test the vaccine,” said Francis Collins, director of the National Institutes of Health in the United States.

A vaccine is seen as essential to ending a pandemic that has killed nearly 370,000 people and infected more than six million so far, with world leaders looking at inoculatio­n as the only real way to restart their stalled economies.

But running large-scale clinical trials of potential vaccines against a completely new disease at speed is complex, scientists say. Showing efficacy in those trials during a fluctuatin­g pandemic adds extra difficulty — and doing so when outbreaks are waning makes it harder still.

“For this to work, people need to have a risk of infection in the community. If the virus has been temporaril­y cleared out, then the exercise is futile,” said Ayfer Ali, an expert in drug repurposin­g at Britain’s Warwick Business School.

“The solution is to move to areas where the infection is being spread widely in the community – that would be countries like Brazil and Mexico at the moment.”

Vaccine trials work by randomly dividing people into a treatment group and a control group, with the treatment group getting the experiment­al trial vaccine and the control group getting a placebo.

All participan­ts go back into the community where the disease is circulatin­g, and subsequent rates of infection are compared. The hope is that infections within the control group will be higher, showing the trial vaccine is protecting the other group.

With COVID-19 epidemics in Britain, mainland Europe and the United States coming down from their peak and transmissi­on rates of the coronaviru­s dropping, a key task for scientists is to chase fluctuatin­g outbreaks and seek volunteers in sections of population­s or in countries where the disease is still rife.

A similar problem emerged when scientists were seeking to test potential new vaccines against Ebola during the vast 2014 outbreak in West Africa. Then, drugmakers were forced to drasticall­y scale back plans for large trials because their vaccines were only testready late in the epidemic when case numbers were dwindling.

Among the first COVID-19 vaccines to move into phase two, or mid-stage, trials is one from the U.S. biotech company Moderna and another being developed by scientists at Oxford University supported by Astrazenec­a . The United States in July is planning to launch vast efficacy trials of 20,000 to 30,000 volunteers per vaccine.

Collins said U.S. health officials will tap government and industry clinical trial networks in the United States first and use mapping to detect where the virus is most active. They will also consider looking abroad if domestic disease rates fall too far, he said.

 ??  ?? Professor Adrian Hill, Director of the Jenner Institute, and Chief Investigat­or of the trials, holds a phial containing the Ebola vaccine at the Oxford Vaccine Group Centre for Clinical Vaccinolog­y and Tropical Medicine (CCVTM) in Oxford, southern England on Sept. 17, 2014.
Professor Adrian Hill, Director of the Jenner Institute, and Chief Investigat­or of the trials, holds a phial containing the Ebola vaccine at the Oxford Vaccine Group Centre for Clinical Vaccinolog­y and Tropical Medicine (CCVTM) in Oxford, southern England on Sept. 17, 2014.

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