Seeing the light at the end of the tunnel

By Noralyn O. Dudt

The adage, "NECESSITY is the mother of invention" comes to mind when we pause to take stock of where we are in this COVID-19 era and see that 11 vaccines are currently in use worldwide.  Certainly, a technological feat, as it has only been barely a year when the World Health Organization declared the coronavirus a pandemic.

Those 11 vaccines are being successfully injected into people's arms but they are not enough to fulfill the global need in the short term. According to Science News, only about 1.9 percent of the world's more than 7 billion people have been fully vaccinated against the coronavirus as of April 5^th. As the Pfizer and Moderna vaccines need to be stored in freezers, transporting them to far-flung areas can be logistically challenging. The necessity for other types of vaccines that would not require refrigeration has spurred scientists to think "outside the box."  To reach herd immunity around the globe we need as many different types of vaccines—the types that can reach everyone without the complexities of transporting and storage.

Things are looking good as some vaccines are getting close to the finish line. Novavax, a scientific research lab in Gaithersburg, Maryland may soon request emergency use authorization for its vaccine in the United States and other countries. Another 250 Covid-19 vaccines are at some stage of development, with 60 of them far enough along to be tested in people.

As mentioned in my previous articles, vaccines have to go through clinical trials that involve healthy volunteers. The Pfizer and Moderna vaccines that are already in use have set a high bar as they have been proved to be about 90 percent effective in real-world situations. That said, finding people willing to participate in clinical trials in which they might get a placebo instead of a vaccine could be tough, especially in countries where other authorized vaccines are available.

However, the new vaccines would have an edge over the Pfizer’s and Moderna’s if they don't require freezers to store them. They will have a better chance of being used in rural or remote areas that lack the resources to buy and maintain freezers. Another advantage would be their ability to handle emerging variants of the coronavirus that may be more infectious, more deadly or both.

While both Pfizer and Moderna utilized the mRNA technology for their vaccines, and AstraZeneca and Johnson & Johnson contained engineered adenoviruses, other vaccine makers are using novel ways in their approach.

Vaxart—based in San Francisco came up with a pill (an oral vaccine) which can be stored at room temperature and does not need trained medical workers or equipment to administer.  Vaxart engineered a common cold virus called adenovirus to carry into human cells the instructions for making two coronavirus proteins. There, the proteins can be made to prime the immune system to later fend off the virus. Vaxart's founder and chief scientific officer says that previous animal research suggests that taking the vaccine orally may produce more of an immune response in the mucus membranes that line the nose, mouse, throat and digestive tracts than injected vaccines do. As this vaccine would be in pill form, it will have a wider reach; it can be easily sent through the mail to remote areas where freezers may not be available to keep the vaccines cold.

Vaxxinity, formerly Covaxx, just completed phase 1 testing for safety and ability to rev up the immune system in 60 adults. Vaxxinity used several proteins from SARS-CoV-2, the virus that causes COVID-19, to design peptides that look like pieces of those proteins. These peptides then mimic important structures within the coronavirus proteins, including the part of the spike protein that the virus uses to latch onto cells. When injected into the body, the lab-made peptides prod the immune system to build antibodies and gear up other immune cells to attack the coronavirus should the vaccinated person encounter it later.

Valneva is the France-based company that is producing a vaccine with an inactivated or "killed" version of SARS-CoV-2. The virus used in the vaccine was isolated from a patient in Italy. The vaccine virus is grown in monkey cells and then chemically inactivated and mixed with two adjuvants, substances that enhance the body's immune response.

Inovio has produced a vaccine that has a different delivery method—DNA instructions for building the coronavirus spike protein are injected just under the skin with multiple tiny needles and then zapped into cells in the body via a handled device that releases a split-second pulse of electricity.  From there, cells produce the spike protein and cue the immune defenses. No other vaccine has this method of delivery. An added advantage is the fact that the vaccine can be stored for a year at room temperature, and for five years in a refrigerator.

All of these and many others are in the pipeline—some are already in phase 2 of the clinical trials while others are further along and awaiting approval. It is truly a remarkable achievement given the fact that it was only a year ago when we were all kept in the dark, not knowing exactly how to keep ourselves from getting infected by the virus.

With COVID-19, the old proverb " necessity is the mother of invention " has a new lease on life. The saying has often been ascribed to Plato who in 325 B.C. wrote the “Republic”, a widely-read dialogue about justice and philosophy. Humans from the very beginning have always had to face adversity in one form or another.  Fortunately, we have not been left alone; we are endowed by our Creator with brains and minds to come up with ingenious solutions to address those challenges. COVID-19 has had us in a dark "tunnel" for a year now, but the ingenuity of the human mind that God had gifted His creation is enabling us to see "the light at the end of the tunnel."  Thank God for those brains and those minds who were willing to think "outside the box", we are finally seeing the beginning of the end to the pandemic, we are about to be liberated… we will be well and be at HOME again.

 

Noralyn Onto Dudt, an avid reader of everything readable especially scientific journals and historical narratives, lives just a few miles from the North Interstate – 270, technology "corridor" of Maryland. Already retired, she goes back and read those medical/scientific reports that she edited for her MD. Ph.D. students at the National Institutes of Health when she feels nostalgic.