Since coronavirus was first discovered to cause COVID-19, scientists have been racing to better understand the genetic makeup of the virus and unravel how to effectively treat infections. There is no cure, and medical specialists can only treat the symptoms of the disease. Many different treatment options have been suggested, and some older drugs seem to be associated with positive outcomes – but much more work is needed. The long-term strategy to combat COVID-19, which has spread to every continent on Earth in addition to Antarctica, is to develop a vaccine.
The development of new vaccines takes time, and they must be rigorously tested and safely confirmed through clinical trials before they can be used routinely in humans. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in the US, has often stated that a vaccine is at least a year to 18 months away. Experts agree that there is still a way to go.
Vaccines are incredibly important in the fight against disease. Vaccine development has allowed us to prevent a handful of viral diseases for decades. Yet there is confusion and inconvenience about their usefulness. This guide explains what vaccines are, why they are so important, and how scientists will use them to fight the corona virus. It also discusses the current treatment options used and which are promising in hospitals.
As more candidates appear and are tested we will add them to this list, so bookmark this page and come back for the latest updates.
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What is a vaccine?
A vaccine is a type of treatment that aims to stimulate the body's immune system to fight against infectious pathogens, such as bacteria and viruses. They are, according to the World Health Organization, "one of the most effective ways to prevent disease."
The human body is particularly resilient to disease in that it has developed a natural defense system against pesky pathogenic microorganisms such as bacteria and viruses. . The immune system – our immune system – consists of different types of white blood cells that can detect and destroy foreign invaders. Some gobble up bacteria, some produce antibodies that can tell the body what to destroy and get the germs out, and other cells remember what the invaders look like so that the body can respond quickly when they invade again.
Vaccines are a really smart fake. They make the body think that it is infected, so that it stimulates this immune response. For example, the measles vaccine makes the body think it has measles. When you are vaccinated against measles, your body generates a record of the measles virus. If you come into contact with it in the future, the body's immune system is ready and ready to beat it back before you can get sick.
The very first vaccine was developed in the late 18th century by a scientist named Edward Jenner. In a famous experiment, Jenner scraped pus from a milkmaid with cowpox – a type of virus that primarily causes disease in cows and is very similar to the smallpox virus – and introduced the pus to a young boy. The boy became a little ill and had a mild form of cowpox. Later, Jenner inoculated the boy with smallpox, but he did not get sick. Jenner's first injection of cowpox pus trained the boy's body to recognize the cowpox virus and because it is so similar to smallpox, the young man was able to fight it and not get sick.
Vaccines have come an incredibly long way since 1796. Scientists certainly do not inject pus from patients into other patients, and vaccines must meet strict safety requirements, multiple clinical testing rounds, and strict government guidelines before they can be adopted for widespread use.
What's in a vaccine?
Vaccines contain a handful of different ingredients depending on their type and how they want to generate an immune response. However, they all have an agreement.
The main ingredient is the antigen. This is the part of the vaccine that the body can recognize as foreign. Depending on the type of vaccine, an antigen can be molecules of viruses such as a DNA strand or a protein. It could instead be weakened versions of live viruses. For example, the measles vaccine contains a weakened version of the measles virus. When a patient receives the measles vaccine, their immune system recognizes and learns to fight a protein present on the measles virus.
A second important ingredient is the adjuvant. An adjuvant works to enhance the immune response to an antigen. Whether a vaccine contains an adjuvant depends on the type of vaccine it is.
Some vaccines used to be kept in reusable bottles and as such contained preservatives that allowed them to sit on a shelf without growing other pesky bacteria. One such preservative is thimerosal, which has received much attention because it contains traces of easily removable ethyl mercury. According to the CDC, it has not been shown to be harmful in vaccines. In places like Australia, single-use vials are now common and therefore preservatives like thimerosal are no longer needed in most vaccines.
When developing a vaccine for SARS-CoV-2, scientists must find a viable antigen that will stimulate the body's immune system to defend against infection.
Making a COVID-19 vaccine
The mid-outbreak pathogen, SARS-CoV-2, belongs to the family of viruses known as coronaviruses. This family is so named because they appear under a microscope with crown-like projections on their surface.
When developing a vaccine that targets SARS-CoV-2, scientists are looking closely at these projections. The projections allow the virus to enter human cells where it can multiply and make copies of itself. They are known as "spike proteins" or "S" proteins.and research suggests that they could be a viable antigen in any coronavirus vaccine.
That's because the S protein is common in coronaviruses that we have battled in the past – including the protein that caused the SARS outbreak in China in 2002-03. This has given researchers an edge in building vaccines against some of the S protein, and using animal models, they have shown that they can generate an immune response.
There are many companies around the world working on a SARS-CoV-2 vaccine, developing different ways to boost the immune system. Some of the most discussed approaches are those using a relatively new type of vaccine known as a "nucleic acid vaccine". These vaccines are essentially programmable and contain a small piece of genetic code to act as an antigen.
Biotech companies such as Moderna have been able to rapidly generate new vaccine designs against SARS-CoV-2 by taking a piece of the genetic code for the S protein and fusing it with fatty nanoparticles that can be injected into the body . Imperial College London is designing a similar vaccine using coronavirus RNA – the genetic code. Pennsylvania biotech company Inovio generates strands of DNA that it hopes will stimulate an immune response. While these types of vaccines can be made quickly, none have yet been put on the market.
Johnson & Johnson and the French pharmaceutical giant Sanofi are both working with the US Biomedical Advanced Research and Development Authority to develop their own vaccines. Sanofi's plan is to mix the coronavirus DNA with genetic material from a harmless virus, while Johnson & Johnson will attempt to deactivate SARS-CoV-2, essentially disabling the ability to cause disease and causing it to still stimulates the immune system.
March 30, Johnson & Johnson said that human tests of the experimental vaccine will begin by September. "We have a candidate who has a good chance of being successful against the Covid-19 virus," said Alex Gorsky, CEO of Johnson & Johnson, in an interview with NBC News' Today. "" Literally within a few days and weeks we will increase the production of these vaccines. "
DIOSynVax, a vaccine development company working at the University of Cambridge, is trying the traditional avenues of creating vaccines with a new platform. The company's approach uses computer modeling of the virus structure to identify vulnerabilities in the SARS-CoV -2 determine DNA – places it can target to trigger an immune response without harming the patient. "We end up with an imitation, a mirror image of part of the virus, but without the bad parts," Jonathan Heeney, CEO and founder of DIOSynVax, said in a statement. " What remains is essentially just the magic bullet to trigger the correct type of immune response. "
Some research organizations, such as Boston Children's Hospital, are investigating different types of adjuvants that will help enhance the immune response. This approach, according to the Harvard Gazette, is no longer aimed at the elderly who do not respond as effectively to vaccination We hope that by studying adjuvants to stimulate a vaccine, the elderly can be vaccinated with a mix of ingredients that would enhance their immunity.
When will a vaccine be available?
Fauci, of the Institute for Infectious Diseases, states that a vaccine is about a year and a half away, although we will likely have human trials within the next month or 2. According to a 60 minute interview with Fauci in March, a quick turnaround.
"The good news is that we did it faster than ever before," Fauci told 60 minutes. (Note: 60 minutes and CNET d and a common parent company, ViacomCBS.) "The sobering news is that it is not ready for prime time for what we are going through now."
Why is vaccine production taking so long? It involves many steps and many regulatory hurdles to jump through.
"To be able to sell any drug, it must undergo the standard clinical trial process, including Phase 1 [to] 3 trials," said Bruce Thompson, health counselor at Swinburne University in Australia. "We need to make sure the drug is safe, can do no harm and know how effective it is."
Scientists cannot assume that their vaccine design will work alone – they must test, test and retest. They have to recruit thousands of people to ensure the safety of a vaccine and how useful it will be. The process can be divided into six stages:
- Vaccine design: scientists study a pathogen and decide how they will get the immune system to recognize it.
- Animal Studies: A new vaccine has been tested in animal models for disease to demonstrate that it works and has no extreme adverse effects.
- Clinical Trials (Phase I): These represent the first tests in humans and test the safety, dose and side effects of a vaccine. These studies enroll only a small cohort of patients.
- Clinical Trials (Phase II): This is a deeper analysis of how the drug or vaccine works biologically. It encompasses a larger cohort of patients and assesses the physiological responses and interactions with the treatment. For example, a coronavirus study can assess whether a vaccine stimulates the immune system in a particular way.
- Clinical Studies (Phase III): In the final phase of studies, an even larger number of people are tested over a long period of time.
- Legal Approval: The final hurdle is that regulatory agencies, such as the US Food and Drug Administration, the European Medicines Agency and the Australian Therapeutic Goods Administration, are reviewing available evidence from experiments and trials and conclude whether a vaccine should be given. all-clear as a treatment option.
Traditionally, therefore, it can take a decade or more for a new vaccine to go from design to approval. In addition, once regulatory processes have concluded that a vaccine is safe, pharmaceutical companies must overdrive production so that they can produce enough of the vaccine to boost immunity in the wider population.
With SARS-CoV-2, the process is accelerated in some cases. As STATnews reports, the vaccine under development by Moderna has passed from design directly to phase I clinical trials of the mRNA vaccine, skipping tests in animal models. Those tests will take place at the Kaiser Permanente Washington Health Institute in Seattle and patients are now enrolled.
First US COVID-19 Vaccine Trials In Humans
In the US, Moderna's modern Phase I clinical trials began on March 16 in collaboration with NIAID, the US National Institutes of Health and KPWHRI. It is the first human test for the mRNA vaccine and a total of 45 healthy adult volunteers between the ages of 18 and 55 will be enrolled.
"This phase 1 study, which started at record speed, is an important first step towards achieving that goal," Fauci said in a statement.
Moderna's approach, explained in the Vaccines section above, is particularly unique in its speed. . Because the biotech company was already researching ways to tackle the coronavirus that causes respiratory syndrome in the Middle East, they were able to adapt their methodology and vaccine design for SARS-CoV-2. The experimental vaccine, called mRNA-1273, contains genetic material from the spike protein contained in SARS-CoV-2 embedded in a lipid nanoparticle.
Production costs were supported by the Coalition for the Epidemic Preparedness Innovations.
The trial will have patients receive two injections of the mRNA-1273 28 days apart. The 45 patients are divided into three groups of 15 and are given different doses: 25 micrograms, 100 micrograms or 250 micrograms. Safety assessments will be made after the first four patients have received the lowest and middle doses and again before all patients receive their injection. Another safety assessment of the data will be performed before injecting the 15 patients seeking the highest dose.
Even if the vaccine has been proven to be safe and promising as protection against COVID-19, it can still take a year away – at least.
The US NIH has added a second site to the Moderna vaccine clinical trial from March 27. Emory University in Atlanta is now enrolling healthy adult volunteers between the ages of 18 and 55 in a Phase I trial. This will be an extension of the trial conducted in Seattle – and the ultimate goal is to enroll 45 entrants in the two states.
You can visit the NIAID website for all information about the trial.
Australian Ferret Fix
The Australian Commonwealth Scientific and Industrial Research Organization (CSIRO) has begun testing two promising candidate vaccines in preclinical studies – conducted in animals. In collaboration with the Coalition for Epidemic Preparedness Innovations, CSIRO will test candidates produced by the University of Oxford and by the American pharmaceutical company Inovio in ferrets.
"We know that the ferret has the specific receptor on cells in its lungs so that the virus can infect it," said Trevor Drew, director of the Australian Animal Health Laboratory where preclinical trials are taking place. Drew refers to ACE2, a protein that uses the SARS-CoV-2 virus to invade human cells. Drew says the similarity between ferrets and human ACE2 receptors makes the slinky mustelid a great animal model for testing the immune response.
The candidate vaccines are injected into ferrets either through the nose or directly into the muscle. CSIRO will investigate the immunity of the lungs where the virus is multiplying by comparing vaccinated animals with unvaccinated controls.
The vaccine candidate developed by Oxford University uses a different type of virus – an adenovirus – to deliver a small piece of the genetic sequence of SARS-CoV-2 into the body. This type of vaccine has proven safe and effective in the past, but much work remains to be done to ensure that it is safe and effective in COVID-19 patients.
The second candidate is a DNA vaccine developed by Inovio, a Pennsylvania-based pharmaceutical company. Using proprietary technology, Inovio's vaccine candidate, INO-4800, is injected into the body to stimulate a certain type of immune cell – a T cell – and antibodies to the coronavirus.
Drew says the vaccines are delivered to single-dose ferrets before being challenged with the SARS-CoV-2 virus. He expects to see the first results of the preclinical trials in June.
How do you treat COVID-19?
The best way to prevent disease is to avoid exposure. Those tips are below.
First, antibiotics, drugs designed to fight bacteria, will not work on SARS-CoV-2, a virus. If you are infected, you will be asked to isolate yourself for 14 days to prevent further spread of the disease. If symptoms escalate and you experience shortness of breath, high fever and lethargy, get medical attention.
The treatment of hospital cases of COVID-19 is based on the most appropriate treatment of the patient's symptoms. For patients with severe disease affecting the lungs, doctors place a tube in the airway so that they can be connected to ventilators – machines that help control breathing.
There are no specific treatments for COVID-19 yet, although a number are in the works, including experimental antivirals, which can attack the virus, and existing drugs targeting other viruses such as HIV, which have shown some promise in the treatment of COVID-19
Remdesivir, an experimental antiviral drug made by biotech company Gilead Sciences, has garnered much of the spotlight. The drug has been used in the US, China and Italy, but only on a & # 39; compassionate basis & # 39; – In essence, this drug has not received approval, but it can be used outside of a clinical trial in critically ill patients. Remdesivir is not specifically designed to destroy SARS-CoV-2. Instead, it works by disabling a specific piece of machine in the virus, known as "RNA polymerase," which many viruses use to replicate. It has been shown to be effective in human cells and mouse models in the past.
Its effectiveness is still being debated, and much more rigorous study will be needed before it becomes a general treatment for SARS-CoV-2, if at all .
Gilead, the manufacturer received "orphan status" for remdesivir on March 23, which is usually reserved for the development of drugs to diagnose or treat "rare diseases or conditions" affecting less than 200,000 people. The rating gives Gilead a number of incentives, including tax breaks and expensive fee waivers, and is intended to accelerate the development process. It also prevents other generic competitors from selling the drug. However, on March 25, Gilead asked for status to be revoked after a significant backlash from public and presidential candidate, Bernie Sanders.
During a White House briefing session on April 29. The data from the trial was not released at the time, leading some experts to speculate that it was too early to say how effective remdesivir will be in treating COVID-19. On the same day, Gilead Sciences published results of a small study of the safety of the medicine over five and ten-day treatment regimens and a study in China that was terminated prematurely, showing no significant benefits for patients receiving the medicine.
What it boils down to? Remdesivir has shown promise, but there is much more science to do.
Encouraging clinical trials in Wuhan and Shenzhen with more than 300 patients of the Japanese flu drug favipiravir were reported by Chinese scientists in The Guardian on March 18. The drug seemed to shorten the course of the disease, with patients receiving treatment clearing the virus after just four days, while those who didn't took about 11 days to clear it up.
The drug is manufactured by Fujifilm Toyama Chemical, but the company declines to comment on the allegations. Favipiravir, also known as Avigan, is an antiviral and is designed to target RNA viruses, including coronaviruses and influenza viruses. The drug is thought to disrupt a pathway that helps these viruses to replicate in cells. According to the Guardian, a source within the Japanese Ministry of Health suggests the drug is not effective in patients with severe symptoms.
Other Treatment Options
An HIV drug, Kaletra / Aluvia, has been used in China to treat COVID-19. According to a publication by AbbVie, an Illinois-based pharmaceutical company, the treatment was offered as an experimental option for Chinese patients during "the first days" of fighting the virus. The company suggests it works with global health authorities, including the Centers for Disease Control and Prevention and the World Health Organization.
On March 18, a randomized, controlled study assessed the effectiveness of the HIV drug. The results, published in the New England Journal of Medicine, show that adults with severe COVID-19 infections do not appear to benefit from the drug treatment and that there was no clinical improvement from standard care. The authors note that additional studies need to be conducted because treatment can reduce serious complications – such as acute kidney injury or secondary infections – if given at a certain stage of the disease.
Problems with chloroquine and hydroxychloroquine
A drug that has been used to treat malaria for about 70 years, chloroquine has been identified as a potential candidate for treatment. It seems to be able to prevent viruses from binding to human cells and getting into them to multiply. It can also boost the immune system. A letter to the editor in the journal Nature on February 4 showed that chloroquine was effective in fighting SARS-CoV-2. A Chinese study from Guangdong reports that chloroquine improved patient outcomes and "could improve treatment success rates" and "reduce hospitalization."
Tesla and CEO of SpaceX Elon Musk and US President Donald Trump have both touted chloroquine as a potential candidate for treatment. Chloroquine phosphate is widely available, but it is not without side effects, and health officials warn against self-medication. It can cause headache, diarrhea, rash, itching and muscle problems. It is also used as an additive in aquarium cleaner. Rarely, it seems to strongly affect the heart muscle and can lead to abnormalities or heart failure. Health officials in Nigeria have reported cases of chloroquine poisoning, and on March 23, a man in his sixties and his wife became seriously ill after self-medicating with chloroquine phosphate from an aquarium cleaner. The man later died, and his wife was placed in intensive care.
A recent correspondence in the journal Nature, on March 18, suggests that "hydroxychloroquine" – a less toxic derivative of the drug – may be effective in inhibiting SARS-CoV-2 infection. That derivative is widely available for the treatment of diseases such as rheumatoid arthritis, and Chinese researchers have conducted at least seven clinical trials of hydroxychloroquine to treat infections.
The combination of hydroxychloroquine with the antibiotic azithromycin has also been reported to have positive patient outcomes, but many experts question its legitimacy.
Doctors in Marseille, France, conducted a low-power study in a small number of patients (36) and suggested that the combination of hydroxychloroquine and azithromycin may be effective in reducing the number of viruses found in a particular part of the body . The study is widely cited and even Trump suggested it could be a "game changer" . However, many scientists have questioned whether or not the design and methods of the study are up to date.
"The results are disputed and the clinical studies are inconclusive," said Gaeten Burgio, a medical researcher at Australian National University. "To date, there is no clear evidence that chloroquine or hydroxychloroquine is a treatment option. Additional clinical studies will tell us whether hydroxychloroquine or chloroquine are viable options for COVID-19 treatments."
Burgio does not recommend storing hydroxychloroquine because the drug is critical for the treatment of patients with the autoimmune disease Lupus. Elisabeth Bik, a microbiologist and science adviser who manages the Science Integrity Digest blog, examined the study in detail and discovered conflicts of interest, an accelerated peer review process, and a handful of inconsistencies in the reporting. The International Society for Antimicrobial Chemotherapy, which publishes the journal in which the Marseille study appeared, made a statement on April 4 stating that "the article does not meet the Society's expected standard."
Stephen Hahn, Commissioner of the Food and Drug Administration, discussed the investigations into chloroquine during a White House briefing on March 19. "That's a drug the President has instructed us to take a closer look at if a more comprehensive approach can be taken to see if it would benefit patients," said Hahn. Trump announced that the FDA on March 19 said chloroquine approved for use on the basis of 'compassionate use'.
Hydroxychloroquine has also received an emergency use authorization from the FDA as of April 3, but many questions remain regarding optimal doses and treatments related to COVID -19
Op 24 maart kondigde de Amerikaanse FDA aan dat het toegang zou geven tot "herstellend plasma" voor patiënten met ernstig of onmiddellijk levensbedreigend COVID-19 infecties. Bij deze vorm van therapie wordt een fractie van het bloed van herstelde COVID-19-patiënten ingebracht in het lichaam van zieke patiënten.
Zoals we hierboven hebben uitgelegd, is het immuunsysteem de verdedigingskracht van het lichaam. Wanneer een virus binnenvalt, zendt het een leger cellen uit, inclusief witte bloedcellen, om het te bestrijden. Die cellen geven antilichamen af, die blijven hangen in het vloeibare deel van het bloed, bekend als "plasma". Als een patiënt COVID-19 overleeft, hebben ze waarschijnlijk een enorme voorraad antilichamen in hun plasma opgebouwd. Het idee is om een deel van hun voorraad op te nemen in ernstig zieke patiënten, in de hoop dat de antilichamen het immuunsysteem van de patiënt stimuleren om het virus te vinden en te vernietigen.
Dit is niet de eerste keer dat zo'n therapie zou worden gebruikt; eerdere uitbraken van SARS, MERS en de H1N1-grieppandemie zagen allemaal het gebruik van herstellend plasma om patiënten te behandelen. In feite strekt het gebruik van herstellend plasma zich uit tot de grieppandemie van 1918.
Een rapport van Chinese wetenschappers gepubliceerd in het tijdschrift The Lancet Infectious Diseases in februari suggereerde dat de behandelingsoptie levensvatbaar zou kunnen zijn in de strijd tegen SARS-CoV-2 en anekdotisch bewijs uit China heeft enig succes laten zien, met 91 van de 245 patiënten in een proef die verbetering liet zien, volgens Xinhua.
In de VS heeft de New Yorkse gouverneur Andrew Cuomo aangekondigd dat New Yorkse artsen in een proef herstellende plasmatherapie gaan testen vanaf eind maart.
Hoe kun je jezelf nu beschermen tegen coronavirus?
Het is geen goed idee om te vertrouwen op een vaccin om de verspreiding van coronavirus te stoppen, want dat is nog vele maanden verwijderd. De beste manier om de verspreiding op dit moment te stoppen, is door te gaan met het beoefenen van goede persoonlijke hygiëne en door de interactie met anderen te beperken. "Het beste wat je kunt doen, zijn de simpele dingen zoals handen wassen en handdesinfectie", zei Thompson.
Deze uitbraak is ongekend en veranderend gedrag is absoluut essentieel om de verspreiding te stoppen.
Er zijn een groot aantal bronnen beschikbaar van de WHO om jezelf te beschermen tegen infectie. Het is duidelijk dat het virus zich van persoon tot persoon kan verspreiden en dat overdracht in gemeenschappen over de hele wereld heeft plaatsgevonden. Bescherming komt neer op een paar belangrijke dingen:
- Handen wassen: gedurende 20 seconden en niet minder! U kunt hier enkele .
- Sociale afstand bewaren: probeer minstens 1 meter afstand te houden van iedereen die hoest of niest.
- Raak uw gezicht, ogen niet aan of mond: Een ongelooflijk moeilijke taak, maar zo komt het virus in eerste instantie in het lichaam terecht.
- Hygiënische maatregelen voor de luchtwegen: Hoesten en niezen in je elleboog.
- Als je een locatie hebt bezocht waar COVID-19 zich verspreidt , daarna 14 dagen lang zichzelf isolerend.
Voor veel meer informatie,
gaan. Oorspronkelijk gepubliceerd in maart en voortdurend bijgewerkt als er nieuwe informatie beschikbaar komt.