Via ABC Fact Check:
Russia has surprised the world with President Vladimir Putin announcing the first COVID-19 vaccine to win approval, sparking debate among scientists over whether the country has bypassed necessary safety checks. The World Health Organisation is reportedly calling for caution, citing a possible lack of appropriate clinical trials.
The Russian breakthrough is one of more than 160 potential COVID-19 vaccines in various stages of trials around the globe, with 150 nations committing funding to ensure universal access to a successful candidate.
At least 22 vaccines have entered phase one or two human trials, while another 139 are in preclinical stages, many on the brink of joining those currently ahead of the pack.
Three treatments developed in China, two in the US and one in the UK are showing promising early signs. All are in phase three human trials — the final hurdle which experts say is critical for ensuring public safety.
The Deputy Chief Medical Officer, Nick Coatsworth, says he is increasingly growing confident an effective vaccine will be found.
“We are everyday becoming more and more optimistic — cautiously optimistic — but optimistic nonetheless of a COVID-19 vaccine being produced,” Dr Coatsworth said in a press conference.
The Government has signed an agreement with UK-based drug company AstraZeneca to secure a potential COVID-19 vaccine developed by Oxford University, if its trials prove successful.
The science behind modern vaccination has evolved over hundreds of years. Put simply, it involves an intentional exposure to an inactive or weakened version of microbes that cause a disease.
The Journal of Global Infectious Diseases explains that introducing a non-dangerous version of the disease into the human body prepares a person’s immune system to recognise the virus and respond by producing protective antibodies.
But developing safe and effective vaccines requires intensive and long-term endeavour, usually over a decade or so.
With the world focused on a fast-tracked treatment for the novel coronavirus, RMIT ABC Fact Check takes a look at the history of vaccine development in the fight against some of the world’s most infectious diseases.
Smallpox
Smallpox was a contagious, often fatal disease causing severe skin rashes, fever and blindness estimated to have killed 500 million people in the last century alone.
The smallpox vaccine was the first successful vaccine to be developed.
Edward Jenner, an English doctor, became interested in the notion that being previously infected with a disease known as cowpox could protect a person from becoming ill with smallpox.
In 1796, he took matter from the lesions on the hands of a dairy maid who had cowpox and inoculated an 8-year-old boy.
A couple of months later, he inoculated the boy again — this time with smallpox. When the boy did not develop smallpox, Jenner concluded that the child was protected and published his findings in the same year.
Following initial skepticism, it took a further four years for the first public vaccination station to be opened in Britain in 1800.
Jenner was not the first person to practice inoculation, the introduction of a weak form of a disease into a person as protection against it. Before the discovery of vaccination, it was first practiced in Africa, India and China long before it was introduced into Europe in the 18th century.
In 1980, the World Health Organisation declared smallpox eradicated.
Polio
Poliomyelitis is a highly infectious disease primarily affecting children under the age of five. It attacks the central nervous system and can cause paralysis of the body, permanently disabling children and eventually preventing breathing.
In the 1950s, the spectre of polio triggered widespread fear throughout the developed world. Reminiscent of today’s lockdowns in response to COVID-19, escalating numbers of polio cases prompted the closure of schools, pools and theatres, as well as churches, which were forced to broadcast sermons over the radio.
Vaccine trials for polio first began in 1935 using children and monkeys, delivering mostly poor results. In 1953, American virologist John Salk produced the first effective polio vaccine. But it wasn’t until the early 1960s that mass immunisation of a more effective vaccine reduced transmission of the disease in developed countries.
In 1998, the World Health Organisation led a push to eradicate polio worldwide. Since then, cases have fallen by up to 99 per cent, saving an estimated 17 million children.
Today, cases of polio persist in countries such as Afghanistan, Pakistan, Cameroon and Chad.
Influenza
Influenza, or ‘flu’, is a highly contagious seasonal illness common throughout the world.
The virus was responsible for the global pandemic of 1918, dubbed the ‘Spanish Flu’, which killed an estimated 50-100 million people.
The 2009 ‘Swine Flu’ pandemic, which killed 18,449 people, was also a strain of influenza. The World Health Organisation estimates that between 290,000 and 650,000 deaths globally each year are associated with the flu.
As the 1918 pandemic worsened, scientists unsuccessfully scrambled to find a cure or vaccine. Experimentation with live vaccines began in the 1930s in the former Soviet Union.
However, outcomes were unpredictable and often induced mild fevers.
In 1935, Australian virologist Macfarlane Burnet discovered that influenza could be grown on the embryos of hen’s eggs. In the following five years, an inactive version of the disease was isolated and trialled in humans.
Mass scale studies into influenza vaccines began in 1942 in the UK and the US. Innovation has continued into the 2000s; however, a ‘universal vaccine’ suitable for all strains of the flu has yet to be developed.
The history of the influenza vaccine poses the troubling possibility that the current iterations of potential COVID-19 vaccines could be ineffective against future strains. If COVID-19 was to mutate in similar fashion to influenza strains, it could continue to cycle through communities on a seasonal basis.
Although more data is needed, studies have shown that COVID-19 has mutated, but at a much slower rate than influenza.
MMR
MMR is a combination vaccine protecting against measles, mumps and rubella. These viral diseases can all display severe symptoms such as rashes, fevers, swelling and infections.
Rubella, in particular, poses a significant risk during pregnancy, increasing the chances of miscarriage and serious birth defects.
The MMR vaccine was produced by Maurice Hilleman and first became available in 1971. Its development represented the culmination of research spanning 20 years.
In 1998, British ex-physician Andrew Wakefield sparked controversy by publishing a study in the Lancet purporting to show a link between the MMR vaccine and autism.
Although promptly and widely discredited by the scientific community, it led to pervasive myths about vaccination that still exist.
Ebola
Ebola was discovered in 1971 and reached epidemic levels in West Africa between 2013 and 2016 resulting in the deaths of 11,300 people.
Causing vomiting, diarrhea, rashes, bleeding and impaired organ function, the fatality rate varies significantly across outbreaks — from 25 per cent to 90 per cent, with an average of 50 per cent.
Research into an Ebola vaccine began in the late 1970s but failed to attract commercial interest or funding due to its relative rarity and ability to be contained.
After an explosion of cases in Africa, several vaccine candidates were fast-tracked in 2014.
The same year, human trials of the experimental Everlo vaccine began. The vaccine was conditionally approved by the European Commission and backed by the World Health Organisation in 2019 for use in high-risk areas.
The speed with which the Ebola vaccine was developed is held up as a beacon of hope in the global push for a COVID-19 vaccine.
SARS
Severe acute respiratory syndrome (SARS) is a viral respiratory illness in the coronavirus family. Foreshadowing the current SARS-COV-19 pandemic, SARS was identified in China in 2003 and spread to North America, South America and Asia, flagging the risk of infectious diseases being transmitted via airline travel in an increasingly globalised world.
Almost 8,100 cases of SARS were identified, killing 774 people, before it was contained later that year.
The Future Virology Journal shows that during, and soon after, the pandemic of 2003, a wave of funding from governments, pharmaceutical companies and foundations fuelled research that uncovered at least four vaccine candidates that appeared to induce protective antibodies in animals.
However, side effects causing harmful immune responses hindered initial human trials. Although promising developments have been made, a lack of commercial application is thought to have deterred further funding.
COVID-19
As of August 2020, there have been more than 21 million cases of COVID-19 globally, resulting in almost 770,000 deaths. With economies crippled by extensive lockdowns and curbed social interaction, an effective vaccine appears to be a key to bringing an end to the crisis.
Russia’s vaccine is expected to be rolled out from mid-October. Named ‘Sputnik V’, a likely nod to the Cold War-era space race, its emergence has some experts concerned that its development has been rushed.
Vaccines expert Terry Nolan, of the Murdoch Children’s Research Institute, told the ABC that it did not appear that sufficient trials of the vaccine had been conducted.
‘It’s clear there have not been phase three studies; that is, studies which have looked at the impact on infection, and there probably hasn’t even been phase two studies,” he said.
Researchers at Oxford University, in collaboration with UK company AstraZeneca, have concluded phase one and two studies of their vaccine, publishing promising early signs in the Lancet.
Phase three clinical trials are under way and set to conclude in September.
In the US, frontrunners Moderna and Pfizer have both recently announced phase three trials in 30,000 people which they hope will pave the way to approval of their vaccine candidates by the end of the year.
China-based biopharmaceutical company Sinovac, the Wuhan Institute of Biological Products and Beijing Institute of Biological Products, in collaboration with pharmaceutical company Sinopharm, have also all entered phase three trials for their vaccine candidate.
In January 2020, Australia played an early role in COVID-19 vaccine development when researchers at the Doherty Institute were the first to grow the virus in a cell culture outside of China, allowing for global expert analysis.
In early July, The University of Queensland began phase one human trials for a vaccine.
In South Australia, researchers at Flinders University, in collaboration with Adelaide-based company Vaxine, announced positive results from early phase one trials and are claiming to be on track to deliver a vaccine by the end of the year.
Amid criticism from Labor that he was too slow to act, Health Minister Greg Hunts aid the Government was in ‘advanced negotiations’ with companies to produce a vaccine in Australia.
While there is increasing hope for an effective COVID-19 vaccine, history shows there is by no means a guarantee of an immediate or silver-bullet solution. Even if a successful candidate is found, overcoming the political and logistical challenges of production and global uptake could further delay efforts.
