Response to Covid19 has seen a huge variety of different types of vaccine research in many countries around the world and here is a sample of the types of research to date:
You’ve heard of Pfizer, Moderna and AstraZeneca, but what about Medigen and Zydus Cadila?
In the race to vaccinate the world and in the face of supply issues and sanctions, some countries have developed homegrown vaccines.
There are geopolitics and vaccine nationalism at play, but the pandemic has seen a flurry of vaccine development – from the first-ever DNA vaccine to one grown on leaves.
While a lot of these vaccines sound new, the science and technologies they’re built on have been around for a long time.
As ANU virologist David Tscharke notes, vaccine development is a tough business – in the past, if a vaccine already existed for a disease it was difficult to break through with a new idea.
But the pandemic has blown the field wide open.
“Nobody knew who was going to be first, nobody knew if the first one would work,” Professor Tscharke said.
“So there was an enormous push into all of these really interesting vaccine technologies.”
But they all basically work in the same way – telling the body to build up an immune response, so if they ever get infected with the virus, the body knows what to do.
The world’s first DNA vaccine
India has often been called the pharmacy of the world, but it’s not just manufacturing vaccines — it’s researching and developing them too.
The homegrown vaccine from Zydus Cadila stands out for a bunch of reasons — it’s the world’s first DNA vaccine, and it’s also needle-free.
It carries the genetic code for the coronavirus spike protein, which the body can then read and generate an immune response.
The vaccine, called ZyCoV-D, was approved on August 20 and is delivered via a jet injector, sometimes called a gene gun.
It uses a high-pressure stream of fluid to blast it into the cells of the skin.
Some other DNA vaccines being developed are delivered by a patch, which is embedded with hundreds of tiny needles coated in the vaccine.
DNA vaccines don’t need to be stored at low temperatures like mRNA vaccines such as Pfizer and Moderna.
ZyCoV-D has a reported efficacy of 67 per cent — lower than some other vaccines but still above the World Health Organization’s 50 per cent threshold. It requires three doses.
Citing sanctions, Iran goes it alone with COVIran Barekat
Iran has been the worst-hit country in the Middle East and was battling a fifth wave that appeared to peak at 50,000 daily cases and 700 daily deaths last month.
In January this year, Iran’s supreme leader banned the import of Pfizer and AstraZeneca, saying he didn’t trust the US- and UK-made jabs.
Later, Iran did end up importing AstraZeneca that was manufactured in other countries, such as Russia or South Korea, and the new government last week approved the single-dose Johnson & Johnson.
But in the meantime, the country developed its own vaccine — COVIran Barekat — which was approved for emergency use in mid-June, before phase three trials were complete.
Early phases in clinical trials reported an efficacy of more than 90 per cent, but results have not yet been peer-reviewed.
It’s an inactivated vaccine, meaning it’s made by growing the virus, then killing or inactivating it. It’s a similar type to China’s Sinopharm vaccine — which has been the most administered in Iran.
Iran has also said US sanctions have hindered their efforts to get vaccines, but it can access them through COVAX.
“There are some countries that are under quite a lot of sanctions. So Iran is a country where it’s quite difficult for them to access things depending on what the political situation is,” Professor Tscharke said.
Although the US sanctions do not include medicines, in practice they have deterred international banks from financial transactions involving Iran — something that the Human Rights Watch in the past has said can have knock-on effects for Iranians’ access to health care.
Rebuffing Chinese vaccines, Taiwan makes Medigen
Taiwanese President Tsai Ing-wen made a soft-power move last month when she got her first vaccine — a home-grown variety called Medigen.
Taiwan was upheld as a poster child early on in the pandemic, keeping the virus largely under control for more than a year.
But a spike in infections in May this year highlighted the island’s low vaccination rates, with only about 1 per cent vaccinated against COVID-19 at the start of that outbreak.
Taiwan refused Chinese vaccines like Sinopharm and Sinovac and instead accepted donations of AstraZeneca from Japan and Moderna from the US.
Medigen is a subunit protein vaccine, like Novavax, and its Chinese name means “high end”.
The President said she wasn’t nervous when she received her jab, but Medigen hasn’t undergone phase three trials — due to be tested in Paraguay.
It was granted emergency approval in July amid criticism from the opposition that its approval was rushed.
National pride in Cuban vaccines
Cuba has approved three vaccines for emergency use — the Abdala vaccine, Soberana 2 and single-dose Soberana Plus, and the country has another two jabs in development.
All are protein subunit vaccines, like Medigen or Novavax, and Soberana Plus can work as a booster shot.
Soberana Plus, according to the New York Times, is also tailored for those who have had COVID-19 before, in what was described as a world first.
Cuba, which is renowned for its healthcare system and has a long history of developing vaccines, has injected some national pride in its vaccine names.
Abdala is named after a poem by young revolutionary and independence hero Jose Marti, while Soberana 2 means “sovereign”.
Earlier this month, Cuban authorities began inoculating toddlers as young as two years old with Soberana 2.
It has also been approved for use in Iran, while Abdala has now been approved in Vietnam.
Can vaccines grow on trees?
The majority of the world’s flu vaccines are grown in chicken eggs, but Canada-based Medicago is opting for plants for its COVID-19 vaccine.
Professor Tscharke said while protein for vaccines often is grown in fermenters or vats in factories, it’s possible to use a plant instead, which can be quick and inexpensive.
The idea behind this one is that it contains proteins that mimic the structure of the virus, but does not contain genetic material.
The vaccine is grown in a wild species indigenous to Australia and is related to tobacco, and the company is partially funded by cigarette maker Philip Morris International.
The plant-based vaccine is still ultimately injected, but Professor Tscharke says the broader idea of growing vaccines on plants is another platform given a push during the pandemic.
There have also been high hopes for further development of oral and edible vaccines, he said.
“People have liked the idea that you could eat your vaccines … I remember somebody who wanted to have a polio vaccine in the banana.”
Barriers to vaccine equity remain
Vaccine nationalism and supply issues have partly fuelled the creation of new jabs but barriers remain, according to Deborah Gleeson, a public health expert at La Trobe University.
High-income countries bought up the bulk of the world’s projected vaccine supply for 2021, “leaving only crumbs for low-income countries,” she said.
Many countries are relying on COVAX for the equitable distribution of vaccines, but of the 2 billion doses hoped for by the end of the year, fewer than 300 million have been distributed so far.
“The underlying problem is the limited global supply of vaccines due to the exclusive rights held by a handful of companies, which most people can probably name,” she said.
Those exclusive rights are governed by the WTO’s Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS).
“The TRIPS waiver was first proposed in October 2020 and almost 12 months later, some rich countries are still refusing to support it,” she said.
But she added momentum is shifting, with Australia moving to support the TRIPS waiver earlier this month.
“Vaccinating the world as quickly as possible is in all our interests, as variants emerging in areas of uncontrolled transmission will continue to threaten the world’s recovery from the pandemic until we achieve it,” Dr Gleeson said.
The issue is which vaccine is the best; if there is a best, or even a list of better ones, and how do we determine it?
Some reluctant people are treated as Anti-vaxers and the question is is this really an honest assessment; or is the fear and the lack of disclosure concerning the pandemic the driving force of the reluctance. In all medical procedures it is required that informed consent is given by the patient and when the information is not detailed and there seems to be a panic in the community in the manner that the various governments have responded; some would say reluctance is really the order of the day.
Perhaps the Governments of the world should stop the way they are doing things and being more trusting with the information that they have. Conspiricies feed on scanting information and unanswered questions –
It is time for governments answer all the questions!
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