Corona virus continues its relentless march around the world.
As of last night, there have been 14.3 million cases and 602,000 deaths from COVID-19. WHO is currently registering more than 260000 new cases every day. These figures are likely to be a considerable underestimate of the true number. The COVID-19 epidemic has killed more people than any other epidemic infection in recent decades.
The New England Journal of Medicine this week published a report of the Phase One trial of the first SARS-CoV-2 (COVID-19) vaccine. The study involved 45 volunteers (aged 18-55) who were divided into three groups who were given different amounts of antigen. The dose was repeated after 4 weeks.
This vaccine is an entirely new concept in vaccine development. “The vaccine is a modified messenger RNA (mRNA) based vaccine that encodes the SARS-CoV-2 spike (S)8 glycoprotein stabilized in its prefusion conformation.”[1] The S glycoprotein (spike protein) is required for the virus to latch onto and enter the human host cell. The mRNA tricks the body’s DNA in the cells nucleus to make the spike protein. The body then produces neutralising antibodies against the spike protein and the virus is defeated. The really clever part is to produce an mRNA that only encodes one protein – this cannot act as a virus and so humans are safe.
Technically it is a very difficult process. It has never been done before. Traditionally the best vaccines have been made by injecting protein into the body. The idea behind the mRNA vaccine is that after 2 doses of the vaccine the body will continue to produce the antigen protein resulting in in long lasting immunity.
Sounds good in theory. Let’s hope it works and is safe for all ages and for long term use. If this trial doesn’t work the WHO has a list of 120 candidate vaccines to trial.
Don’t hold your breath. Most vaccines take years to develop.
The article is available free on the NEJM Home page together with supplementary material, including the detailed protocol. Certain propriety information has been redacted.
- Jackson, L.A.; Anderson, E.J.; Rouphael, N.G.; Roberts, P.C.; Makhene, M.; Coler, R.N.; McCullough, M.P.; Chappell, J.D.; Denison, M.R.; Stevens, L.J., et al. An mRNA Vaccine against SARS-CoV-2 – Preliminary Report. N Engl J Med 2020, 10.1056/NEJMoa2022483, doi:10.1056/NEJMoa2022483.
Colin Binns, MBBS, PhD
Editor-in-Chief, Asia-Pacific Journal of Public Health
School of Public Health, Curtin University, Perth, Australia
Wah Yun Low, PhD
Managing Editor, Asia-Pacific Journal of Public Health
President, Asia-Pacific Academic Consortium for Public Health
Deputy Executive Director, Asia Europe Institute
University of Malaya, Kuala Lumpur, Malaysia
Victor Hoe Chee Wai, MBBS, PhD
Webmaster, Asia-Pacific Academic Consortium for Public Health
Department of Social and Preventive Medicine, Faculty of Medicine
University of Malaya, Kuala Lumpur, Malaysia
