Inslee issues, extends proclamations related to COVID-19 – Access Washington

Inslee issues, extends proclamations related to COVID-19 – Access Washington

New Research: Lessons from immune response of most severe Covid patients – The Indian Express

New Research: Lessons from immune response of most severe Covid patients – The Indian Express

July 1, 2020

By: Express News Service | New Delhi | Updated: June 30, 2020 12:52:42 am Coronavirus test kits. T cells work alongside antibodies in trying to clear the virus and stopping the infection. (AP Photo: David J. Phillip)

A new study has found that even the sickest Covid-19 patients produce T cells that help fight the virus. T cells are a key component of the immune system and their roles include killing infected host cells, activating other immune cells, and regulating the immune response. The study cites its findings as further evidence that a Covid-19 vaccine (whenever developed) will need to elicit T cells to work alongside antibodies.

The new research was published in the journal Science Immunology on Friday.

The researchers followed 10 severely ill Covid-19 patients who were on ventilators at Erasmus University Medical Center, Netherlands. Two of the patients eventually died. An in-depth look at their immune system responses showed that all 10 patients produced T cells that targeted the SARS-CoV-2 virus. These T cells worked alongside antibodies in trying to clear the virus and stopping the infection.

The researchers note that these findings are in line with a recent study, published in Cell, that showed a robust T cell response in individuals with moderate cases of Covid-19. In both studies, the T cells in these patients prominently targeted the spike protein on SARS-CoV-2, according to La Jolla Institute for Immunology, researchers from which are involved in both studies. It is the spike protein that the coronavirus uses to enter human cells. The new study adds to growing evidence that the spike protein is a promising target. Accroding to La Jolla, it also confirms that the immune system can also mount strong responses to other targets on the virus.

This is good news for those making a vaccine using spike, and it also suggests new avenues to potentially increase vaccine potency, researcher Daniela Weiskopf, first author of the new study, said in a statement.

While the Cell paper followed San Diego residents, the new paper follows Dutch patientsand the T cell responses were consistent in both populations. This study is important because it shows this immune response in patients thousands of miles apart. The same observation has now been strongly reproduced in different continents and different studies, Weiskopf said.

Source: La Jolla Institute for Immunology

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Coronavirus: When will there be a COVID-19 vaccine? Therapeutic might come first – Deseret News

Coronavirus: When will there be a COVID-19 vaccine? Therapeutic might come first – Deseret News

July 1, 2020

Dr. Scott Gottlieb offered hope over the weekend for those worried over the coronavirus pandemic and the need for a vaccine.

Gottlieb said the U.S. and the world will likely see a successful vaccine in early 2021. Thats almost more than six months away.

In the meantime, Gottlieb said there are two things that can help stop the spread right now. One of those is a mask. Wearing a mask can help protect you and others from spreading the coronavirus pandemic.

But Gottlieb said theres hope for something coming in the fall that could help Americans.

2020 will be a hard year but then well more fully vanquish COVID with our technology. It will recede into a more manageable threat. Preserving things most central to our lives requires all of us to work together to reduce risks every day. Collectively we can stop these epidemics

A vaccine is probably an early 2021 event based on publicly available data. But dont lose sight of therapeutic antibodies. They should be available this fall and could be produced at scale by the end of the year. Theres a lot of technology in development in addition to vaccines.


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Bill Gates says he’s ‘not optimistic’ COVID-19 vaccines will successfully complete trials before end of the year – Fast Company

Bill Gates says he’s ‘not optimistic’ COVID-19 vaccines will successfully complete trials before end of the year – Fast Company

July 1, 2020

COVID-19 vaccine trials are well under way, but Bill Gates is not optimistic that phase III of these trials, which measures the efficacy and safety of a vaccine in a wide group of users, will be successful before the end of the year.

Gates spoke about the work toward a COVID-19 vaccine and how the coronavirus pandemic will continue to shape our future in a TED2020 live conversation with Chris Anderson on Monday. When asked about where we are in the quest for a vaccine, Gates mentioned three companies thatif they workare on track to have vaccines the earliest: Moderna, Johnson & Johnson, and AstraZeneca.

Those three will be gated by the safety and efficacy trial, he says. That is, well be able to manufacture thosealthough not as much as we wantbefore the end of the year. Whether the phase III will succeed, and whether it will be complete before the end of the year, I wouldnt be that optimistic about.

This echoes what leaders in the health tech industry think, according to a recent 300-person survey. Even though at least 90 vaccine candidates for COVID-19 are in development, seven of which had advanced to phase I trials by April, only 31% of the experts surveyed thought a vaccine would be broadly available by 2021.

Chinese officials did just approve a COVID-19 vaccine for use in its military, but the Chinese government is skipping phase III trials for this vaccine. Studies so far have shown this vaccine is safe and has some efficacy, according to Reuters, but phase III trials are a more robust consideration of a vaccines effects.

How helpful a vaccine is to curbing this pandemic still depends, ultimately, on how many people get the vaccine. Gates says that like mask wearing, vaccines have a huge community benefit. Getting a vaccine and wearing a mask are important to protect your community from the novel coronavirus, not only yourself.

In the U.S., mask wearing has become a point of political contention rather than something unilaterally adopted by the public as part of a collective effort to curb the viruss spread. Some have held onto the fact that the World Health Organization (WHO) initially did not advise people to wear masks. When asked if that was a terrible mistake the organization made, Gates replied, Yes.

The fact that the medical mask was a different supply chain than the normal mask, the fact that you could scale up the normal mask so well, the fact that it would stop that presymptomatic and never-symptomatic transmission, he says. Its a mistake, but its not a conspiracy. Its something that we now know more. And even now, our error bars on the benefit of masks are higher than wed like to admit, but its a significant benefit.

Looking forward to fall, Gates does not expect the COVID-19 pandemic to wane in the U.S., especially without widespread mask wearing, vaccines, or other drugs or innovative tools. While there is good progress on such tools, he says, theres nothing that would fundamentally alter the fact that this fall in the United States could be quite bad, and thats worse than I would have expected a month ago.

The degree to which shelter-in-place behavior has lapsed, the amount of people not wearing masks, and the presence of COVID-19 in cities it had not been in previously pose a challenge for the upcoming months.

Theres no case where we get much below the current death rate, which is about 500 deaths a day, but theres a significant risk we go back up to the even 2,000 a day that we had before because we dont have the distancing, the behavior change to the degree that we had in April and May, he says. We know this virus is somewhat seasonal, so that the force of infectionthrough temperature, humidity, more time indoorswill be worse as we get into the fall.


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The international race for a Covid-19 vaccine is on. Who will win? – HealthLeaders Media

The international race for a Covid-19 vaccine is on. Who will win? – HealthLeaders Media

July 1, 2020

Most Popular #1Fact check: Hospitals get paid more if patients listed as COVID-19, on ventilators

Sen. Scott Jensen, R-Minn., a physician in Minnesota, was interviewed by "The Ingraham Angle" host Laura Ingraham on April 8 on Fox News and claimed hospitals get paid more if Medicare patients are...

Confusion about lethality comparisons may be owing to "a knowledge gap" in how the CDC reports on seasonal influenza and COVID-19....

Healthcare created 346,000 new jobs in 2018, up from 284,000 jobs in 2017. The 2018 figures include 219,000 jobs in ambulatory services and 107,000 hospital jobs....

COVID-19, the illness caused by the novel coronavirus, is now the deadliest disease in the United States, killing more people per day than cancer or heart disease. According to a graph published...

Trump claims "BIG VICTORY for patients." The plaintiffs, led by the American Hospital Association, will appeal the ruling....


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2 doses of potential COVID-19 vaccine more effective than 1, study finds – WISHTV.com

2 doses of potential COVID-19 vaccine more effective than 1, study finds – WISHTV.com

July 1, 2020

INDIANAPOLIS (WISH) Two doses of is more effective than one, results from a preliminary study show.

The vaccine, AZD1222, was developed by Oxford University and tested in pigs at Britains Pirbright Institute. The results of the trial showed that pigs given an initial shot of AZD1222 followed by a booster shot 28 days later showed a higher immune response compared to pigs who only received one injection.

These results look encouraging that administering two injections with the same vaccine boosts antibody response that can neutralize the virus, Dr. Bryan Charleston, director of the Pirbright Institute, said in a news release.

Specifically, researchers saw an increase in neutralizing antibodies. Neutralizing antibodies are a powerful immune response because they not only bind to foreign agents that invade the body, but they attach in a way that blocks the infection from spreading. Neutralizing antibodies are highly effective in protecting against future infections.

Over 100 COVID-19 vaccines are currently being tested worldwide, but this study raises the question: Will a vaccine against the coronavirus grant lifelong immunity? Or, will the protective effects weaken over time? In an interview with Belgian radio station, Bel RTL, AstraZeneca CEO Pascal Soriot was quoted as saying the companys vaccine will last about one year.

Pigs have been used in the past to develop vaccines against the flu. The animals are more physiologically similar to humans in terms of body weight and metabolic rate, Pirbright researchers said in a statement. Positive research outcomes in pig trials are highly predictive of positive outcomes in human trials, they add.

Human clinical trials to test AZD1222 are underway, and scientists hope to have results available to the public in the coming months.

With updated information from the Indiana Department of Health on June 24, this timeline reflects updated tallies of deaths and positive tests prior to that date.


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Summer may decide fate of leading shots in COVID-19 vaccine race | News, Sports, Jobs – Lock Haven Express

Summer may decide fate of leading shots in COVID-19 vaccine race | News, Sports, Jobs – Lock Haven Express

July 1, 2020

AP Photo/Siphiwe SibekoIn this Wednesday, June 24 file photo, a volunteer receives a COVID-19 test vaccine injection developed at the University of Oxford in Britain, at the Chris Hani Baragwanath hospital in Soweto, Johannesburg, South Africa.

People on six continents already are getting jabs in the arm as the race for a COVID-19 vaccine enters a defining summer, with even bigger studies poised to prove if any shot really works and maybe offer a reality check.

Already British and Chinese researchers are chasing the coronavirus beyond their borders, testing potential vaccines in Brazil and the United Arab Emirates because there are too few new infections at home to get clear answers.

The U.S. is set to open the largest trials 30,000 people to test a government-created shot starting in July, followed about a month later with another 30,000 expected to test a British one.

Those likely will be divided among Americans and volunteers in other countries such as Brazil or South Africa, Dr. Anthony Fauci of the National Institutes of Health told The Associated Press.

While hes optimistic, weve been burned before, Fauci cautioned.

Multiple successes, in multiple parts of the world, are vital.

This isnt a race of who gets there first. This is, get as many approved, safe and effective vaccines as you possibly can, Fauci said.

Vaccine experts say its time to set public expectations. Many scientists dont expect a coronavirus vaccine to be nearly as protective as the measles shot.

If the best COVID-19 vaccine is only 50% effective, thats still to me a great vaccine, said Dr. Drew Weissman of the University of Pennsylvania.

We need to start having this conversation now, so people wont be surprised, he added.

And for all the government promises of stockpiling doses in hopes of starting vaccinations by years end, heres the catch: Even if a shot pans out and its one that your country stockpiled only some high-risk people, such as essential workers, go to the front of a very long line.

Will you and I get vaccinated this year? No way, said Duke University health economist David Ridley.

The home stretch

Vaccines train the body to rapidly recognize and fend off an invading germ. About 15 experimental COVID-19 vaccines are in various stages of human studies worldwide.

And while theres no guarantee any will pan out, moving three different kinds into final testing offers better odds especially since scientists dont yet know just how strong an immune reaction the shots must spark to protect.

Measuring that with the first proven vaccine will really help us understand for all the other vaccines in development, do they also have a chance? said Oxford University lead researcher Sarah Gilbert.

Only China is pushing out inactivated vaccines, made by growing the new coronavirus and killing it. Vaccines by Sinovac Biotech and SinoPharm use that old-fashioned technology, which requires high-security labs to produce but is dependable, the way polio shots and some flu vaccines are made.

Most other vaccines in the pipeline target not the whole germ but a key piece the spike protein that studs the surface of the coronavirus and helps it invade human cells. Leading candidates use new technologies that make shots faster to produce but havent yet been proven in people.

Oxfords method: Genetically engineer a chimpanzee cold virus so it wont spread but can carry the gene for that spike protein into just enough cells to trick the immune system that an infections brewing.

Another vaccine made by the NIH and Moderna Inc. simply injects a piece of the coronavirus genetic code that instructs the body to produce harmless spike copies that the immune system learns to recognize.

CHASING THE VIRUS

Researchers must test thousands of people not where COVID-19 is surging because then its too late but where its smoldering, Fauci said.

Only if the virus starts spreading through a community several weeks after volunteers receive either a vaccine or a dummy shot time enough for the immune system to rev up do scientists have the best chance at comparing which group had more illness.

Lacking a crystal ball, the NIH has vaccine testing networks in the U.S., South America and South Africa on standby while finalizing decisions on the summer tests.

Were going to be doing it in multiple sites with a degree of flexibility so researchers can rapidly shift as the virus moves, Fauci said. Nothing is going to be easy.

The Oxford shot, with a 10,000-person study underway in England, already encountered that hurdle. Gilbert told a Parliament committee last week that theres little chance, frankly of proving the vaccines effectiveness in Britain after infections plummeted with the lockdown.

So her team looked abroad. In addition to the planned U.S.-run study, Brazil last week began a last-stage test of the Oxford shot in 5,000 health workers, the first experimental COVID-19 vaccinations in South America. In another first, South Africa opened a smaller safety study of the Oxford shot.

With few new infections in China, Sinovac next month will begin final tests in 9,000 Brazilian volunteers. And SinoPharm just signed an agreement with the United Arab Emirates; that studys size isnt clear.

EXPECT

IMPERFECT PROTECTION

Animal research suggests COVID-19 vaccines could prevent serious disease but may not completely block infection. One study that dripped the coronavirus into monkeys showed vaccinated animals avoided pneumonia but had some virus lurking in their noses and throats. Whether it was enough to spread to the unvaccinated isnt known.

Still, that would be a big win.

My expectations have always been that well get rid of symptomatic disease. From what weve seen of the vaccines so far, thats what they do, said Penns Weissman.

The initial vaccines might be replaced with later, better arrivals, as historically happens in medicine, noted Dukes Ridley.

And while shots in the arm are the fastest to make, those for respiratory diseases require virus-fighting antibodies to make their way into the lungs. Gilbert said Oxford eventually will explore nasal delivery.

WARNING AGAINST

SHORTCUTS

Some U.S. lawmakers worry about pressure from the Trump administration to push out an unproven shot during the fall election season.

We want a vaccine, not a headline, Sen. Jack Reed, a Democrat from Rhode Island, said at a recent Senate committee hearing.

Dr. Stephen Hahn, commissioner of the Food and Drug Administration, pledged to a House committee last week that any decision would be based on science.

Different countries have different rules about when to release a vaccine. For the U.S., Fauci insisted there will be no safety shortcuts, a key reason NIH is investing in such huge studies.

Regardless of how and when a vaccine arrives, each country also will prioritize whos first in line as doses become available. Presumably theyll start with health workers and those most vulnerable to severe disease as long as each shot is proven to work in at-risk groups such as older adults.

Because each vaccine works differently, which population group it will protect, we dont know yet, said Dr. Mariangela Simao of the World Health Organization, which is advising countries on how to choose.

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Historically Black Meharry Medical College Joins the COVID-19… – Diverse: Issues in Higher Education

Historically Black Meharry Medical College Joins the COVID-19… – Diverse: Issues in Higher Education

July 1, 2020

June 30, 2020 | :

by B. Denise Hawkins

Meharry Medical College has joined the COVID-19 Vaccine Trials Network and will be enrolling community members in studies of a handful of vaccine candidates, announced the Nashville, Tennessee-based historically Black institution on Tuesday.

I am excited given the importance of minority communities taking part in COVID-19 vaccine trials, said Meharrys president and CEO Dr. James E. K. Hildreth, referring to the disproportionate number of African Americans hit by the virus.

The vaccine trials will be conducted as a part of Operation Warp Speed, a public-private partnership the White House formed to fast track the development, testing and manufacturing of a vaccine to prevent the disease caused by the novel coronavirus and therapeutic drugs to treat those infected with COVID-19.

White House officials told the media on Tuesday that the COVID-19 vaccine, once available, will be distributed according to priorities, with the most vulnerable people ahead in line.

Globally, more than 100 coronavirus vaccinesare being studied, but fewer than a dozen are being tested on humans. Operation Warp Speed has narrowed its current list down to seven vaccine candidates, National Public Radio reported on June 12. South Africa, which has the highest number of cases of coronavirus in Africa, began vaccine testing in the country last week. In the U.S., the federal governments goal is to have a COVID-19 vaccine ready by January 2021.

Dr. James E. K. Hildreth

Since the pandemic, Hildreth, a renowned infectious disease expert, has expressed skepticism that a vaccine can safely be developed and approved in a year, which is considered an extremely short window by most in the scientific community. Then he is reminded that the need for a drug to halt the spread of the highly infectious novel coronavirus that causes COVID-19 is unprecedented and urgent, especially for people of color.

As of Tuesday, COVID-19 has claimed more than 126,000 lives in the U.S., according to Johns Hopkins Universitys coronavirus tracker. The latest data reveals a continued uneven toll among people of color, especially among African Americans. While overall mortality rates from COVID-19 are climbing for all racial and ethnic groups in the country, an APM Research Lab study called Color by Coronavirus found that African Americans continue to experience the highest overall mortality rates and the most widespread occurrence of disproportionate deaths.

Hildreth, who pushed hard to deliver mobile testing to Black communities in Nashville, Tennessee, opened a center on the Meharry campus in early April. Hes now pushing to ensure that those most impacted by this coronavirus have access to COVID-19 vaccines and clinical trials.

Thats what we want and need to happen, said Dr. Namandj Bumpus, a professor and chair of the Department of Pharmacology and Molecular Sciences at the Johns Hopkins University School of Medicine.

African Americans are consistently underrepresented in clinical trials for diseases ranging from diabetes to heart disease to HIV, despite being disproportionately affected by many of them. Among people of color, only about 10% enroll in clinical trials. In her award-winning research, Bumpus studies genetic differences in how people metabolize leading HIV drugs, providing evidence that responses are different in African Americans who are disproportionately infected by the disease.

Clinical trials, said Bumpus, are the only way that researchers will know if a new COVID-19 vaccine will be effective in African Americans who have been hard-hit by the disease.

Having Meharry in the forefront on recruitment in the Black community is a really positive move, Bumpus said about Mondays announcement that the college has joined the COVID-19 Vaccine Trials Network. Black representation among researchers and those administering the tests, she added, also goes a long way to build trust in Black communities and increase participation.

In fact, in May, Hildreth told a virtual convening of the House Ways and Means Committee that Black medical colleges like Meharry are best prepared to tackle the disproportionate impact of the COVID-19 pandemic on African Americans.

Meharry and Meharrians are trusted in the communities we serve, which have a history of abuse at the hands of Americas medical establishment. We understand the subtle, yet critical cultural differences that have long been overlooked by mainstream providers, creating deep fear and distrust. We can deploy quickly, we know where to go, and we will be welcomed,

But Meharry is one institution. All those conducting COVID-19 vaccine trials around the country must be intentional about enrolling African Americans and other people of color, said Johns Hopkins Bumpus.

My hope is that Meharrys efforts will keep this need top of mind for people.


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Historically Black Meharry Medical College Joins the COVID-19... - Diverse: Issues in Higher Education
Bill Gates on COVID-19 vaccine: Getting people to take it may be hard – Business Insider – Business Insider

Bill Gates on COVID-19 vaccine: Getting people to take it may be hard – Business Insider – Business Insider

July 1, 2020

The final roadblock to distributing a coronavirus vaccine will be ensuring that enough people actually take it, Bill Gates said in a recent interview with CNN. The billionaire philanthropist and cofounder of Microsoft has contributed millions toward coronavirus research.

"You'll have a choice of whether you take the vaccine or not," Gates said to CNN's Anderson Cooper and Dr. Sanjay Gupta in a Coronavirus Town Hall. "So there's that final hurdle."

Three-quarters of Americans said they would take a coronavirus vaccine if they were assured it was safe, according to a Reuters/Ipsos poll published in May. About 40% of American adults surveyed said they would take if after it was approved by the Food and Drug Administration, while 38% said they would take it after extensive peer-reviewed clinical trials. Thirty-eight percent of respondents also said they would wait until much of the public had taken the vaccine before taking it themselves.

More than 28,000 people have also joined an organization called 1Day Sooner, which runs human challenge trials to help test vaccines and treatments for COVID-19, according to The Washington Post.

There are more than 140 vaccine projects in development, according to The World Health Organization. Although research is moving quickly, there are still many challenges around gathering data to show that a vaccine would work and ramping up the necessary production, as Business Insider's Andrew Dunn has reported.

The US Department of Health and Human Services is aiming to deliver 300 million doses of a coronavirus vaccine by January 2021 as part of its broader strategy around the development and distribution of COVID-19 vaccines and treatments.

The urgency of the coronavirus pandemic, which has killed 489,922 people around the globe and infected 9.6 million according to Johns Hopkins University, means it could be challenging for scientists to spend a lot of time trialing vaccines with various age ranges and populations.

"It's understandable that because of the urgency of this, the amount of time that you'll be out looking at it is just going to be less," Gates said when asked about the issue of vaccine hesitancy. "And so even for scientists really understanding, 'Ok, were the trial populations accounting for all of these different groups? How low does the age range go? . . . How do you feel about pregnant women in it, what about the elderly? It's a challenge to get that safety database to build up the confidence."

Gates and his wife Melinda have contributed $250 million toward developing treatments, testing, and vaccines for COVID-19 through the Bill & Melinda Gates Foundation. The funds will also contribute toward coronavirus relief efforts in low and middle-income countries.

Overall, Gates believes that "a lot of people" will be willing to take the vaccine and herd immunity could be achieved if between 70% and 80% of people do so.

"It really could then exponentially drop the numbers," Gates said. "But we need that for the entire world if we're going to go back and have people taking vacations, international students, international sports events. So it'll take a while until we get this thing finished off on a global basis."


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USA Today explores when a COVID-19 vaccine might be ready – KARE11.com

USA Today explores when a COVID-19 vaccine might be ready – KARE11.com

July 1, 2020

It's a simple way to take a look at when a panel of experts predict the U.S. will see a widespread vaccine.

Author: kare11.com

Published: 6:45 PM CDT June 30, 2020

Updated: 6:43 PM CDT June 30, 2020


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COVID-19 Vaccine in 2020 Highly Unlikely, Experts Caution – Duke Today

COVID-19 Vaccine in 2020 Highly Unlikely, Experts Caution – Duke Today

July 1, 2020

DURHAM, N.C. -- Speculation that a vaccine for COVID-19 might be widely available by the end of this year is overly optimistic, three Duke experts said Wednesday.

While there may be substantial scientific progress by the end of 2020, there will still be significant manufacturing hurdles to clear before a vaccine is available to most people, the experts said during a briefing for media.

Below are excerpts from the briefing:

David Ridley, health economist

Dr. Fauci is quite optimistic. I think optimism is good. I think optimism has a really important role. We need people within these companies being optimistic. If everyone sits back and talks gloom and doom nothings ever going to get done. So I respect that optimism.

But will you and I get vaccinated this year? No way. Its possible a vaccine will be approved this year. But not at scale. We wont have a lot of doses of this.

We might have some people vaccinated this year. But the average person wont be vaccinated this year.

Thomas Denny, chief operating officer, Duke Human Vaccine Institute

If youre going into a tough game, you need a coach thats getting the team revved up. We may have some good science by the end of the year and think we have some leading candidates. But manufacturing them to have it all administered, thats a tall order to be ready by the beginning of 2021.

Ooi Eng Eong, deputy director, Emerging Infectious Diseases Programme, Duke-NUS Medical School in Singapore

Once we get to the efficacy phase and ask the question of whether this vaccine will work to prevent infection, that depends on how common the infection is at that time. If the situation still goes on as it is, we shouldnt have any problem testing efficacy."

But if for whatever reason the prevalence of the disease goes down, it will take us a much longer time to assess efficacy.

Were not going to get rid of the coronavirus in a hurry. Its going to stay with us. Even if we can vaccinate people, protect them from infection the question is how long will immunity last?

If we think about using vaccines in stages, potentially we could get one, possibly at the soonest to me, about this time next year. Anything sooner than that is extremely optimistic. Others have said we could get it by the end of this year. Im an optimistic person, but Im not that optimistic.

David Ridley

Were preparing to manufacture at scale. Fortunately, some of these vaccine makers are already manufacturing now. Sanofi said theyre going to be able to make 100 million doses this year and a billion doses next year. Thats really unprecedented. Usually youd wait to see if your vaccine is having some success. If you think theres a 1-in-8 chance that youre going to get on the market, and youre already spending tens of millions, hundreds of millions of dollars, thats kind of crazy. But thats the crazy world we live in and I salute them for it.

Usually it takes years to manufacture. You want to be sure you got a good vaccine before you begin making it at scale. Typically this is going to take four or five years. Maybe now we can do it in one or two years. Part of this is going to depend on the appetite of these manufacturers to start building something now that they probably will never use.

My guess is this will take longer than people will assume because there will be a little bit of foot-dragging. If you drag your feet a little bit longer and make sure its a good vaccine, that its going to work before you make the huge investments in manufacturing, you can save a lot of money.

Thomas Denny

The duration of immunity post-vaccination is a major scientific issue were trying to understand. Were also trying to understand right now whats the duration of immunity after natural infection. That will help us probably understand how well or how well not vaccines will work for us.

One of the approaches were taking at the vaccine institute, were also exploring the potential development of a pan-coronavirus vaccine.

If we can develop a vaccine that would cover protection to all types of coronaviruses that may be a threat to us we think that would be a big benefit. Thats a longer-term goal for ours. Its 18 months to two years out. I dont think there are many playing in that space currently. Most are looking at the short-term COVID-19 pathogen and trying to get a rapid vaccine developed for that one.

Ridley

Its very common for the second product, a later product to be better than the first. Lipitor was fifth to market for cholesterol drugs and was arguably better than the previous four.

Its reasonable to expect that later entrants will be better. Assuming the virus is still with us and still a threat, Id expect other companies to continue product development.

Ooi Eng Eong

Obviously theres pressure. Theres pressure from the demand from the public for a solution so they can go back to some level of normality in their lives. Theres pressure from colleagues in the hospitals saying we need to deal with this.

Theres also competition from other groups working on vaccines. I think competition is good. It forces us to think harder to come up with better, more innovative ways of doing things. There is pressure but I think at some level of pressure is good to really push the boundaries.

Ridley

We need a lot of materials in this process. Some are very simple. Gowns and masks are pretty simple things. Swabs for diagnostics are pretty simple things. Rubber stoppers, medical glass sound pretty simple. But we really have a high standard for those because anytime we have something coming into contact with the vaccine thats going to go straight into your blood stream, we have a really high standard for sterility.

Sterile water always seems to be in shortage. Water should be easy to make. But it has to be sterile because its going straight into the bloodstream. We cant underestimate the importance of all these products along the line.

We might be a little concerned about hoarding. Theres cost to scaling up PPE. Theres cost to scaling up medical glass and rubber stoppers. Someone might hoard those. One of the vaccine manufacturers, one of the hospitals might try to grab those materials. Theres all sorts of parts in this process and if one of them breaks down, it slows the process of getting the vaccine to people."

Ridley

None of the major vaccine manufacturers will charge ridiculous prices. Theyre in this game to try to do good, to try to impress their employees, to try to impress their shareholders. Theyre not going to do that by charging ridiculous prices.

Ooi Eng Eong

Were testing (our vaccine) as a preventative vaccine. But is an intriguing possibility. Our fight against the virus relies on the body to recognize first of all its infected with the virus. It triggers a series of processes. So it is entirely possibly theoretically that because were using an RNA vaccine, the vaccine will trigger the processes that will allow the (body) to fight an RNA pathogen.

Weve only had this virus for seven months now. Theres a lot we dont know about this virus.

Think about it like a thief breaking into your house. If this person is very skilled at overcoming your alarm, they will be able to break into your house. If you have another system that can activate the alarm while the break-in is in process, you would actually trap the thief. So it is something that is possible.

Denny

Those with underlying medical conditions, and first-line responders. Hospital workers, theyre the highest priority. If we cant keep those folks going, were in trouble.

Faculty participants

Thomas N. DennyThomas Dennyis chief operating officer of the Duke Human Vaccine Institute, a professor of medicine and an affiliate member of the Duke Global Health Institute. His administrative oversight includes a research portfolio of more than $400 million. Denny has served on numerous committees for the NIH over the last two decades.thomas.denny@duke.edu

Ooi Eng EongOoi Eng Eongis a professor of medicine and deputy director of the Emerging Infectious Diseases Programme at Duke-NUS Medical School in Singapore. He also co-directs the Viral Research and Experimental Medicine Centre at the SingHealth Duke-NUS Academic Medical Centre (ViREMiCS), which studies therapies and vaccines against viral infections.engeong.ooi@duke-nus.edu.sg

David RidleyDavid Ridleyis a professor of the practice at Dukes Fuqua School of Business, where he is faculty director of the Health Sector Management program.He was lead author of the paper proposing a review program to encourage development of drugs for neglected diseases that became U.S. law in 2007.david.ridley@duke.edu

---Duke experts on a variety of other topics related the coronavirus pandemic can be found here.


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COVID-19 Vaccine in 2020 Highly Unlikely, Experts Caution - Duke Today