Inside Canada’s risky race for a vaccine
IT CAN TAKE 10 YEARS TO DEVELOP A VACCINE. HOW DO YOU DO IT IN ONE?
“It’s been going on since February, so you need to sleep sometime, right? At least, I can’t just go on and on and on. We work sometimes 15, 16 hours a day. I’m not going to lie and say that’s every day, because that’s just not sustainable, at least not for me, anyway. Most of the people are working six, seven days a week. And it’s tiring; I’m not gonna lie about that either. It wears on you after a while, because it’s not just been, like, six weeks of working hard now. It’s been (he ticks off the months under his breath — February, March, April, May) four months, right?”
Dr. Darryl Falzarano is a vaccine hunter. Until the COVID-19 pandemic struck, his lab was focused on developing vaccines for camels against MERS. Today, Falzarano is leading a 12-member team at the University of Saskatchewan’s Vaccine and Infectious Disease Organization-international Vaccine Centre (Vido-intervac), which received nearly $1 million to expedite work on a COVID-19 vaccine, part of a $26.7 million research package from the federal government.
Recently, Falzarano’s lab reported that their experimental vaccine induced a strong immune response in ferrets which, like humans and cats, but unlike dogs, pigs, chickens and ducks, are highly susceptible to severe acute respiratory syndrome-coronavirus 2, or SARS-COV-2, the virus rattling the planet.
After receiving two doses of the vaccine, the ferrets were exposed to the virus. “One of the things we looked for after we vaccinated the animals was, do they have neutralizing antibodies — do they have antibodies that block the virus from infecting cells? And they do,” Falzarano said.
Ideally a vaccine is going to do two things: stop the virus from replicating in the lungs and making people severely ill, and stop people from shedding the virus and sharing it with other people.
The lab has now moved onto hamsters. The plan is to move into “first-in-human” studies in the fall, with a human-grade vaccine.
No one, Falzarano said, has ever developed a vaccine against coronaviruses in humans, which is why there is “no totally clear pathway forward as to what that really should be.” It also explains why there are 132 other vaccines in development, including 10 now being injected into humans. Dalhousie University researchers are awaiting research ethics board approval to lead the first Canadian trials in humans of a vaccine developed by Chinese manufacturer Cansino Biologics.
The University of Alberta, University of Manitoba and Western University of Waterloo are among other Canadian groups in the feverish sprint to a vaccine.
It normally takes 10 years to develop a vaccine. Everyone is trying to do this in about one. Even then, corners aren’t being cut, Falzarano said. Steps are being overlapped, but safety isn’t being compromised, he said. The same regulatory data is still required; it’s just being done in an accelerated way. “A vaccine that doesn’t work, maybe that’s not the end of the world. A vaccine that’s not safe that would be a huge problem. I think everyone is acutely aware of that risk.”
Vaccinating ourselves out of the COVID-19 mess may be our best hope at ending lockdowns permanently and substantially reducing deaths. “A lot of planning around returning to a fully open society rests on a lot of people getting this future vaccine,” said Maya Goldenberg, an associate professor of philosophy at the University of Guelph.
But as research teams around the world work at breakneck speed to deliver one, how accepting will we be? It depends on how much we trust political leaders and scientific bodies, said Goldenberg. “We’ll trust a vaccine to the extent that we trust the system that brought us the vaccine.”
There are already drumbeats of hesitancy. A survey by researchers in Carleton University’s School of Journalism and Communication, in partnership with Abacus Data, found that while a strong majority (73 per cent) of 2,000 Canadians surveyed would “definitely” or “probably” accept a COVID-19 vaccine, 10 per cent said they would definitely not, or likely not, get vaccinated, and 17 per cent were unsure.
Anti-vaccination forces are already marshalling and “seeding outlandish narratives,” Nature reports, including, that COVID-19 vaccines will be used to implant microchips into people. In May, a Youtube video claiming vaccines would “kill millions” received more than eight million views before it was deleted, Nature reported.
Goldenberg and others say health leaders need to start talking up vaccines, now. The newness of the vaccine, and a “break the glass” mentality in pushing
ANTI-VAX FORCES ARE ‘SEEDING OUTLANDISH NARRATIVES.’
them out could make people uneasy, said Dr. Paul Offit, professor of pediatrics at Children’s Hospital of Philadelphia and co-inventor of a vaccine against a rotavirus, the most common cause of severe diarrhea in babies and children worldwide. “I think we have the confidence of parents in this country. But you should be skeptical — I’m going to be skeptical about these vaccines when they come out,” Offit said this week in a livestreamed interview with JAMA editor-in-chief Dr. Howard Bauchner. “I want to see the data. Everyone should want to see the data.
I think there’s a lot at stake here.”
No amount of data will ever convince anti-vaccine conspiracy theorists, Offit said. “But I’m talking about the reasonable level of skepticism that anybody should have before putting something in their body.
“We better make sure that before we inoculate millions of people, tens of millions, many of whom are going to be healthy, young people who are unlikely to die from this virus, that we make sure we hold it to the highest standard of safety and efficacy before we put it out there.”
Goldenberg, an expert in vaccine hesitancy whose research, according to her bio, explores the “fundamental epistemic question, ‘How do we know what to believe?” said the race for a vaccine has become politicized, a “geopolitical fight between China and the USA” to be first. “There’s a global economic strength tied to being the first to have this vaccine,” she said.
“This is also going to be a big and difficult decision for people to make and everyone needs time to process it and everyone needs really good information.”
The public needs to be updated on the trials — which ones are going well, which ones aren’t. “We know already that there is a lot of spin,” she said, and science by opaque press release. Andrew Pollard, head of the Oxford Vaccine Group, said in a recent press statement that their human studies are “progressing very well.” Boston-based biotech firm Moderna was accused of overhyping results when it told CNN its vaccine produced protective antibodies in a small number of healthy volunteers during a safety trial. None of the data have been published in peer-reviewed journals.
Under “Operation Warp Speed,” U.S. President Donald Trump has set a target of having 300 million vaccine doses available by the end of 2020. For scientists and doctors and, arguably, the public, the idea of pushing any vaccine out into the population with “warp speed’ doesn’t inspire comfort, Dr. Brit Trogen, of NYU Langone and colleagues write in a new paper published by JAMA. In 1976, a U.S. campaign to vaccinate “every man, woman and child” against a feared swine flu pandemic that never came failed miserably, they wrote.
One manufacturer produced the wrong strain. The shots were blamed for a blip in Guillain-barré syndrome, a rare neurological disorder. Children developed high fevers, “or did not mount an immune response at all.” The fiasco damaged public trust and helped buoy the anti-vaccine movement.
“Good science requires rigour, discipline and deliberate caution,” the NYU authors wrote, and there will be only one shot at winning public acceptance of a COVID-19 vaccine.
Falzarano, at U of Saskatchewan, thinks the oneyear mark is bullish, but possible. However, “I don’t think you have a 100 million doses by then, and even if you had 100 million, that’s nothing.” Deciding who gets vaccinated first will be complicated, he said: “The country that has the most cases? Your country, regardless of how many cases you have?” Frontline workers first? The most susceptible? The lottery scene in the movie Contagion?
“I think that part becomes problematic,” Falzarano said.