The genetic sequence of SARS-CoV-2, the coronavirus that causes COVID-19, was published on 11 January 2020, triggering intense global R&D activity to develop a vaccine against the disease, writes Nature. The scale of the humanitarian and economic impact of the COVID-19 pandemic is driving evaluation of next-generation vaccine technology platforms through novel paradigms to accelerate development, and the first COVID-19 vaccine candidate entered human testing with unprecedented rapidity on 16 March 2020.
The Coalition for Epidemic Preparedness Innovations (CEPI) is working with global health authorities and vaccine developers to support the development of vaccines against COVID-19. To facilitate this effort, we have developed and are continuously maintaining an overview of the global landscape of COVID-19 vaccine development activity. Our landscape database includes vaccine development programmes reported through the WHO’s authoritative and continually updates list, along with other projects identified from publicly available and proprietary sources. The landscape provides insights into key characteristics of COVID-19 vaccine R&D and serves as a resource for ongoing portfolio management at CEPI. We have also shared our landscape information with others in the global health ecosystem to help improve coordination in the COVID-19 outbreak response and enable global resources and capabilities to be directed towards the most promising vaccine candidates.
As of 8 April 2020, the global COVID-19 vaccine R&D landscape includes 115 vaccine candidates (Fig. 1), of which 78 are confirmed as active and 37 are unconfirmed (development status cannot be determined from publicly available or proprietary information sources). Of the 78 confirmed active projects, 73 are currently at exploratory or preclinical stages.
The most advanced candidates have recently moved into clinical development, including mRNA-1273 from Moderna, Ad5-nCoV from CanSino Biologicals, INO-4800 from Inovio, LV-SMENP-DC and pathogen-specific aAPC from Shenzhen Geno-Immune Medical Institute. Numerous other vaccine developers have indicated plans to initiate human testing in 2020.
A striking feature of the vaccine development landscape for COVID-19 is the range of technology platforms being evaluated, including nucleic acid (DNA and RNA), virus-like particle, peptide, viral vector (replicating and non-replicating), recombinant protein, live attenuated virus and inactivated virus approaches. Many of these platforms are not currently the basis for licensed vaccines, but experience in fields such as oncology is encouraging developers to exploit the opportunities that next-generation approaches offer for increased speed of development and manufacture. It is conceivable that some vaccine platforms may be better suited to specific population subtypes (such as the elderly, children, pregnant women or immunocompromised patients).
Of the confirmed active vaccine candidates, 56 (72%) are being developed by private/industry developers, with the remaining 22 (28%) of projects being led by academic, public sector and other non-profit organisations. Although a number of large multinational vaccine developers (such as Janssen, Sanofi, Pfizer and GlaxoSmithKine) have engaged in COVID-19 vaccine development, many of the lead developers are small and/or inexperienced in large-scale vaccine manufacture. So, it will be important to ensure coordination of vaccine manufacturing and supply capability and capacity to meet demand.
Most COVID-19 vaccine development activity is in North America, with 36 (46%) developers of the confirmed active vaccine candidates compared with 14 (18%) in China, 14 (18%) in Asia (excluding China) and Australia, and 14 (18%) in Europe. Additional vaccine development efforts have been reported for China, and CEPI is in dialogue with the Chinese Ministry of Science and Technology to confirm their status.
Lead developers of active COVID-19 vaccine candidates are distributed across 19 countries, which collectively account for over three-quarters of the global population.
However, there is currently no public information on vaccine development activity in Africa or Latin America, although vaccine manufacturing capacity and regulatory frameworks exist in these regions. The epidemiology of COVID-19 might differ by geography, and it is likely that effective control of the pandemic will require greater coordination and involvement of the southern hemisphere in vaccine R&D efforts.
The World Health Organisation (WHO) has announced that at least 70 possible candidates for vaccines – of which three are in clinical evaluation and 67 in pre-clinical evaluation.
The WHO published a comprehensive blueprint document on 11 April 2020, tabling the various companies racing towards an approved vaccine.
Several drug manufacturers, big and small, started the process of working towards the first vaccine. While lockdown measures around the globe are imposed to help flatten the curve of new infections, it is not nearly enough to curtail the spread of COVID-19. Among the listed companies are the Chinese biotech company CanSino and US biotech start-ups Inovio Pharmaceuticals and Moderna.
Larger companies working hard towards a vaccine are Johnson & Johnson, Sanofi and Pfizer.Full Health24 report WHO blueprint document Nature report