It took researchers five years to develop an Ebola vaccine, and that was a record at the time. Researchers are now on the precipice of blowing that record away.
Current projections anticipate having a potential vaccine to protect against COVID-19 by the spring of 2021.
Dr. Dawn Nolt is the medical director for infection prevention at OHSU Doernbecher Children's Hospital.
OHSU
“Usually it takes a lot of money and a lot of time to move the vaccine through development,” said Dr. Dawn Nolt, medical director of infectious disease prevention at OHSU Doernbecher Children’s Hospital. “But for the COVID-19 vaccine, given the immediacy of the need, this process has been accelerated.”
She spoke with OPB’s Geoff Norcross.
Norcross: “When are we going to get those shots?”
Nolt: “We can reasonably expect any COVID-19 vaccines, I think it’s safe to say, by spring of 2021. Optimistically, maybe some folks in high-risk groups could get vaccines by the end of the year. But let’s underpromise and overdeliver. How’s that?”
Norcross: “Well, that’s interesting, because the CDC asked states to be ready to distribute a vaccine as soon as late October. What’s going on there?”
Nolt: “Yeah, there’s no way that was going to happen by the end of October. The vaccine researchers haven’t even finished getting all the people they want to study, and then they still have to analyze the data and the results. And so this announcement about a vaccine by late October or early November was not scientifically based.”
Norcross: “Where are we in the process, though?”
Nolt: “Right now, I think we’re doing quite well. We have a number of candidates that are in fairly advanced human trials. And so I’m really hoping that we can get a nice batch of effective vaccines by spring 2021.”
Norcross: “So we’re talking about the possibility of a vaccine within a year after COVID-19 became a pandemic. That’s huge, isn’t it?”
Nolt: “Oh, it’s so exciting! Usually the time it takes for a vaccine to go from a twinkle in someone’s mind to being available for the general population, historically that’s taken 10 to 15 years. We’re doing this at breakneck speed.”
Norcross: “How is that happening?”
Nolt: “Usually it takes a lot of money and a lot of time to move the vaccine through development. And scientists really want to make sure something they have is safe for patients to use and something that will work. And so it’s been a very linear process. Historically, vaccine candidates are tested in the lab and then in animals and then tested in groups of humans. But for the COVID-19 vaccine, given the immediacy of the need, this process has been accelerated, so that a lot of the steps are being done in parallel. Animal trials are being done at the same time as subjects are being recruited. Scientists now are using fancy new technologies to more quickly generate some potential vaccine before we can test them. So really, these changes are making the timeline for development of the COVID-19 vaccine to be as little as two years.”
Norcross: “I think I heard you say once before that the Ebola vaccine was created in five years and that was a record.”
Nolt: “That’s absolutely true. And really, that vaccine used some very new technologies to get something that was very effective that could go into patients during an Ebola outbreak. So now to consider that during an ongoing epidemic, to have a vaccine that could curb this pandemic would be great.”
Norcross: “You mentioned the fact that this is an ongoing epidemic. Does that have something to do with it? I mean, the fact that COVID-19 is very active and doesn’t show any signs of becoming less active anytime soon.”
Nolt: “Yes. You know, when there’s a new epidemic or pandemic, there’s a lot of interest, a lot of effort gets exerted by the scientists. There’s a lot of money that comes in. But when the vaccine development has been so prolonged, as in the past, by the time the vaccine comes out, it’s likely that the outbreak has already kind of abated. Therefore, money goes away and the vaccine development just sort of halts. So in some ways, having an ongoing outbreak continues to stimulate effort and money. And in some ways, the vaccine gets developed quicker.”
Norcross: “Let’s step back a little bit here. What do vaccines actually do?”
Nolt: “Vaccines are a way to generate an immune response to a specific germ, such as the SARS-CoV-2 virus, without that person having to suffer the actual COVID-19 disease. And then this immune response is available when the person actually encounters the virus, so then that virus is eliminated or illness becomes less severe because of the protection from the vaccine.”
Norcross: “So you’re tricking your body into thinking you have it when you don’t.”
Nolt: “That’s correct.”
Norcross: “By the time we actually get this vaccine, even if it is early next year, what’s the likelihood that the virus will have changed? That it will have mutated into something else and we’re not protected anymore?”
Nolt: "That’s certainly a question that we are worried about. We know that all germs, including viruses, can evolve during mutation. There are some different strains of measles and chickenpox that are circulating, but vaccines have been inducing lifelong protection. On the flip side, influenza changes so much that they have to redesign a new vaccine every year.
“Particularly about the coronavirus, we know that they could mutate a lot, which accounts for the ability of some of the coronaviruses to jump animal species. We’re not entirely sure about COVID-19 or what it’s going to do in the future, but we hope the vaccine will have lifelong protection.”
Norcross: “How is it going to work when we actually have the vaccine available to give to people? Are we going to get shots? Are we going to get more than one? What’s the inoculation procedure going to be like?”
Nolt: “Currently, the tested regimens include two doses. The first dose is given to kind of prime the immune system, get it to recognize that it needs to do something. And that immune response may kind of settle out a little bit. Then we give it a second shot, usually about a month later, to make sure that the immune system really understands what it’s going through and that sort of immune response sticks around until the actual virus comes around. So at this time, it’s a two-dose regimen.”
Norcross: “And just to underscore this because many people are still asking: best-case scenario, pie-in-the-sky, a vaccine available by spring of next year?”
Nolt: “Yes.”
Norcross: “But we have to be careful here because we don’t know how likely that actually is going to be right now, right?”
Nolt: “That’s right. I think what you’re trying to get me to say, which I will of course say, is that until we get a vaccine and until we know that vaccine is effective, we should continue to protect ourselves by washing our hands, wearing our masks and practicing physical distancing.”
To listen to the entire conversation, use the audio player at the top of this story.