It’s a big month for the Walter Reed Army Institute of Research in Silver Spring, Maryland. Last week, after getting FDA clearance, scientists there began a phase one trial on humans of their new coronavirus vaccine.
This isn’t just any vaccine.
It’s one that Dr. Kayvon Modjarrad, founding director of the institute’s emerging infectious disease program and lead on the trial, hopes can work against any and all variants of the current coronavirus, and even the SARS-1 virus that fueled a deadly outbreak in 2002 and 2003.
Modjarrad is part of a growing movement of researchers who are trying to create “variant-proof” vaccines that, if successful, would provide strong, lasting immunity against all strains of the coronavirus, and even other types of coronaviruses.
He described his lab’s approach as taking a Swiss Army knife to the virus: “You can put lots of different things into them, you can put different parts of different coronaviruses all into one vaccine,” he said.
He and others are also searching for the Achilles’ heel of the entire family of coronaviruses, which share some common traits, just like in human families.
“You look at a family, and they all have kind of the same nose, or maybe even more apt here is a vulnerability,” he said. “So, there are vulnerable sites, or parts of a coronavirus that’s common to all coronaviruses that we can target in the development of vaccines that will be applicable to all known coronaviruses.”
“And if the patterns hold,” he added, “it should be applicable to future coronaviruses that haven’t made a jump into human populations yet.”
Modjarrad’s research, which uses a new nanoparticle platform, is in the very early stages. Phase one will involve just a few dozen trial participants. The aim is to first see if the immune response induced in animals and in the lab translates to people, and if the vaccine is safe.
Still, the effort is ambitious. The quest for a universal coronavirus vaccine is a big task.
“It behooves society to look at this in a really serious way. ... We can’t afford as a society to go through this [kind of pandemic] again.”
“It behooves society to look at this in a really serious way,” said Wayne Koff, a longtime HIV vaccine researcher and director of the Human Vaccines Project. “We can’t afford as a society to go through this [kind of pandemic] again.”
“I don’t think anyone has any illusions,” Koff said. “It’s going to be a stepwise approach.”
Koff thinks that despite this all being in its very early stages, in general, it’s feasible. While the coronavirus does mutate, it’s more stable than viruses such as HIV. Scientists today have an unprecedented technological advantage, too.
It takes merely hours now to sequence an entire virus, which wasn’t possible a 10 years ago. “The reason we were not able to do this a decade ago is we didn’t have the advances in the biomedical, AI [artificial intelligence], and machine learning space,” Koff said.
Labs across the US — like in California, Georgia, North Carolina, Texas and Washington — are now working on this. A few groups in Europe are, too. That includes those who’d already been working on a universal flu vaccine.
Yet, no one single lab can crack this universal code. Many stress that it needs to be a global effort.
“The patterns of disease that we are seeing with SARS-CoV-2 are different in different parts of the world, and we don't know what the drivers of that are."
“The patterns of disease that we are seeing with SARS-CoV-2 are different in different parts of the world, and we don't know what the drivers of that are,” said Gagandeep Kang, a scientist at the Christian Medical College in Vellore, in southern India.
Kang is known by some as the "vaccine queen" and as India’s top vaccine scientist because of her groundbreaking work on rotavirus and cholera. She said that to develop a truly universal coronavirus vaccine, scientists need to better understand immune responses to the virus. It means understanding why some people around the world get really sick from COVID-19 and others don’t.
That will require a lot more collaboration in ways that historically have not happened in low- and middle-income countries. This is because of what she describes as “helicopter” research: “You drop into a country, you collect the samples, and you leave with the samples. And the population, and the scientists, and the doctors that contributed — you know, those patients — get nothing out of it.”
Kang said now is the time to change this and put resources in place to make these efforts truly global. She co-chairs the Coalition for Epidemic Preparedness and Innovations, or CEPI, which just announced a $200 million investment in the development of broadly protective vaccines.
Kang sees an urgency around this. Adult immunization campaigns are challenging, she said. For example, much of the world isn’t able to deliver annual flu shots, much less something as crucial as a vaccine for the coronavirus.
“You know, it's hard enough to think about how the first wave of [coronavirus] vaccines is going to reach the whole world. Can you imagine doing this every three years? We’d have to reshape the world entirely,” she said.
Past vaccine campaigns and outbreaks offer plenty of lessons.
Efforts to develop a vaccine for the original SARS, and then the related MERS viruses lost momentum after the outbreaks peaked. Then there was H1N1, Zika, and Ebola. Then the spotlight moved. Now, it’s SARS-CoV-2, a virus that has killed millions of people.
“Do we just forget about it and move on with our lives, like we did to a large extent with Zika, and to some extent, Ebola?"
“Do we just forget about it and move on with our lives, like we did to a large extent with Zika, and to some extent, Ebola?” said Modjarrad, who worked at the World Health Organization during the Ebola outbreak in West Africa, and currently serves on the group’s vaccine advisory committee.
“In that way, these efforts aren’t just about SARS-CoV-2 or even coronaviruses,” Modjarrad said. “It’s about building systems for whatever might come next. ... So, when an outbreak occurs, we don’t pat ourselves on the back for so quickly having a vaccine within a year, despite hundreds of thousands of people or millions of people succumbing already,” Modjarrad said.
“But instead, we have a vaccine in place, or maybe people even vaccinated already against something that hasn’t come out yet.”