30 Apr 2020

Covid-19 vaccine strategy needed, scientists say

From Nine To Noon, 9:08 am on 30 April 2020

There are urgent calls for the government to develop a national vaccine strategy, and someone to lead it, amid fears New Zealand could be at the back of the queue for any potential Covid-19 vaccine.

Most infectious disease experts agree any Covid-19 vaccine is at best 12 to 18 months away.

3D print of a spike protein of SARS-CoV-2, in front of a 3D print of a SARS-CoV-2 virus particle. The spike protein (foreground) enables the virus to enter and infect human cells.

3D print of a spike protein of SARS-CoV-2, in front of a 3D print of a SARS-CoV-2 virus particle. The spike protein (foreground) enables the virus to enter and infect human cells. Photo: National Institute Of Allergy And Infectious Diseases, NIH

Around 40 teams of scientists globally are working on coronavirus vaccines and some 80 vaccines are in early-stage development.

But it is complicated. There are at least five different technologies to work with, from tried and tested inactivated methods, as used for seasonal influenza, to new genetic or RNA vaccines, none of which exist yet.

There's a six-phase process to go through, including trials to determine dosage, formulation, side effects, adverse effects and overall effectiveness.

Adding to the difficulty is a lack of reference material, since no human ever encountered Covid-19 before December 2019.

Not only that, there is no vaccine against any type of coronavirus yet.

Immunologist Ian Frazer from the University of Queensland, who worked on the HPV vaccine, says a vaccine being available in up to a year and a half is feasible, but the science is challenging.

“The critical issue with all of the vaccines is to demonstrate safety, and safety is something that can only be done through clinical trials and they of course take time.

“The track history for coronavirus vaccines is that some of them have been tested in animals, and if the animal subsequently encounters the virus it gets sicker than if the vaccine hadn’t been given,” Frazer said.

Trials could be sped up if healthy volunteers were willing to have the vaccine administered and then be exposed to the virus itself, he said.

A globally-coordinated response would then be needed to distribute the vaccine, Frazer said.

“It would be very unfortunate that the vaccine were only available in the limited number of countries making it for themselves.

“The biggest challenge is scaling up any vaccine that we do discover that will work to the level necessary to deliver a vaccine into a population of 8 billion people across the planet.”

Now is the time to think about delivery so when we do have a vaccine we’re ready, Frazer said. But we shouldn’t assume a vaccine will be successfully developed.

“Despite all the good stories to date we might never have a vaccine, we’ve been trying for vaccines for coronavirus for a long time and haven’t yet got one that’s out there, so we don’t want to put all of our eggs in the basket of a vaccine.

“We want to also look for possible treatments for people who are already infected, and we want to realise that we may not get either of these.

“Assuming that we can get a vaccine that will work then the critical thing in all of that is to make sure this isn’t a vaccine for Australia or for New Zealand or for any particular country - it’s a global vaccine to control a global pandemic.”

Professor Graham Le Gros, who heads biomedical research at the Malaghan Institute, says relying on other countries for a vaccine is the wrong approach. He's working on a New Zealand-made vaccine.

“We’re in a privileged position in New Zealand in that we can learn from some of the vaccine developments occurring elsewhere.”

If we sit on our hands nothing will happen and all New Zealand will have to offer the rest of the world is money, he said

“We have globally-recognised vaccine production, we make great animal vaccines, we can turn that to making human vaccines.”

He has no doubt a vaccine could be made here.

“We can do it, of course we can, we’ve made vaccines. There’s no reason why we can’t make something like a protein vaccine and put it into people and test it. We’ve got some of the best clinicians in the world … we can do it.”

Being part of a global response, particularly when it comes to procurement, will require a joined-up national strategy, University of Otago infectious disease specialist Professor David Murdoch says.

“We’re a rich country and we’re a small rich country in the Southern Hemisphere with responsibility over quite a few countries in the South Pacific, so it is a legitimate concern … we certainly will not be a high priority, but we need to be in the game in terms of how we get access at the right time.”

Doctors are adding their concerns about Covid-19 vaccine availability, if one is developed.

Two open letters, signed by international and national organisations, have been sent to the Minister of Health and Minister of Trade urging them to address concerns that WTO intellectual property trade rules could prevent our ability to secure affordable access to medical supplies, including vaccines and potential medicines to treat Covid-19.

“There is the possibility effective medicines may be developed for Covid-19 but New Zealand as a smaller country, without a manufacturing capability of its own, ends up at the end of the queue,” Dr George Laking, a medical oncologist from Doctors for Healthy Trade told Nine to Noon.

We have seen this unfold with PPE, he said, and it might be necessary to break with WTO rules on intellectual property by taking advantage of a compulsory licence which suspends the monopoly effect of a patent and allows others than the patent holder to produce and supply a product.

The Ministry of Health was approached by Nine to Noon for comment and gave this statement.

“The development of a safe and effective vaccine is a crucial tool in the eradication of Covid-19 world-wide.

“The government is currently investigating how to ensure research efforts here connect to global research, so there is a co-ordinated strategy on finding a COVID-19 vaccine. More information will be available on this soon.

“New Zealand is currently developing a vaccine strategy that will bring together the key players in a coordinated approach. The vaccine strategy will form part of a broader immunisation strategy.

“Health sector agencies involved include the Ministry of Health which is responsible for designing and implementing national immunisation programmes, Medsafe, the regulatory agency responsible for assessing the safety and quality of medicines, and Pharmac, the Crown entity that decides which medicines and medical devices are funded in New Zealand. 

“These agencies are working closely with the Ministry of Business Innovation & Employment (MBIE), which is the agency responsible for the science and innovation system, the research and science community, and potential New Zealand-based vaccine manufacturers.”