Microsoft co-founder and billionaire philanthropist Bill Gates is working to support the development of vaccines against infectious diseases before the outbreak of the new coronavirus,media reported. In his latest blog post, Gates argues that the only way to end the current new corona epidemic is to vaccinate 7 billion people around the world. However, no new coronavirus vaccine has been approved for widespread use and could take up to 18 months to develop. Gates said more than 100 different new coronavirus vaccines are being developed, and eight to 10 of them look particularly promising.
The following is the full text of Gates’ blog post:
One of the most frequently asked questions these days is, when will the world be able to return to where it was before the outbreak? My answer is always the same: when we have a near-perfect new coronavirus drug, or when almost everyone on the planet is vaccinated against the new coronavirus. The former is unlikely to happen any time soon. We need a magic cure that is at least 95% efficient to stop the outbreak. Most of the drug candidates are far less powerful these days, and while they can save many lives, they are not enough to restore us to normality.
This is when vaccines need to work. Humans have never had a more urgent task than developing broad immunity to new coronaviruses. Realistically, if we are to return to normalcy, we need to develop a safe and effective vaccine. We need to make billions of doses of vaccines, we need to ship them all over the world, and we need to do all of this as soon as possible. It sounds daunting, and it does. Our foundation is the world’s largest fund sponsor of vaccine research and development, an effort that dwarfs any previous effort. This will require unprecedented efforts of global cooperation. But I knew there would be results, because there was no other option at all.
The world is developing a new corona vaccine at the fastest time in history
Dr Anthony Fauci has said he believes it will take about 18 months to develop a new coronavirus vaccine. I agree with him that although it may be as short as nine months, it may be as long as two years. While 18 months may sound like a long time, it will be the fastest time scientists can develop a new vaccine. It usually takes about five years to develop a vaccine. Once you’ve chosen a disease as your target, you have to develop a vaccine, test it on animals, and start testing safety and efficacy in humans.
Safety and efficacy are the two most important goals for each vaccine. Safety is just like it sounds: Is it safe to vaccinate? Some minor side effects, such as mild fever or pain at the injection site, are acceptable, but you don’t want to give people a vaccine that will make them sick. Effectiveness measures the effectiveness of vaccineprotection stoain stoains. Although ideally we would like the vaccine to be 100% effective, this is not the case. This year’s flu vaccine, for example, is about 45%.
In order to test for safety and efficacy, each vaccine is tested in three stages:
1) The first stage is a safety test. A small number of healthy volunteers will be the first to be vaccinated. You can try different doses to produce the strongest immune response at the lowest effective dose without serious side effects.
2) Once a formula has been determined, it will move on to the second phase, which tells you how effective the vaccine is in the person who intends to vaccinate. This time, hundreds of people will be vaccinated. This group should include people of different ages and health conditions. ‘
3) In the third phase, thousands of people will be vaccinated. This is usually the longest stage for testing because it occurs in so-called “natural disease conditions”. It needs to be inoculated to a large group of people who may already be at risk of being infected by a target pathogen and wait to see if the vaccine reduces infection rates.
After the vaccine has passed all three stages of testing, construction of the plant to produce it begins, and it is then submitted to the World Health Organization and various government agencies for approval. Most vaccine development and rollout requires this process, but the current normal development schedule is clearly not good enough. In saving lives and reducing trillions of dollars in economic losses, the day we need to reduce this process will make a huge difference to the world.
In traditional processes, the steps to resolve critical and unknown issues take place in order. This can help mitigate financial risks, as developing a new vaccine is often very expensive. Many candidate experiments have failed, which is why companies wait until they know the next step is successful.
For the new corona virus, funding development is clearly not a problem. Governments and other organizations, including our foundation and a non-profit organization called the Alliance for Vaccine Innovation, have made it clear that they will support the search for vaccines at all costs. As a result, scientists can save time by completing several development steps at once. For example, the private sector, governments and our foundations will begin building facilities to produce different potential vaccines. If some of these facilities end up idle, that’s fine. In order to lead production, it is only a small price.
Fortunately, compressing the test schedule is not the only way to complete a process that typically takes five years in 18 months. Another way we’re going to do this is to test many different methods at the same time.
More than 100 vaccine candidates are under development.
As of April 9, 115 different new coronavirus candidate vaccines are under development. I think eight to ten of them look particularly promising. The most promising candidate vaccines take a variety of methods to protect the body from the new coronavirus. To understand what this means, it is important to remember how the human immune system works.
When the disease pathogen enters the body, your immune system produces antibodies to respond. These antibodies attach to a substance called antigens on the surface of a microorganism, which signals an attack to your body. Your immune system records every microbe it has ever beaten, so it can quickly identify and destroy an intruder before it makes you sick.
Vaccines bypass this process by teaching your body how to fight pathogens without getting sick. The two most common methods are inactivated vaccines and live vaccines. Inactivated vaccines contain dead pathogens, while live vaccines are made from live pathogens that have weakened (or detoxified). They are very effective, but are more prone to side effects than inactivated drugs of the same kind.
Inactivated vaccines and live vaccines are what we consider to be “traditional” methods. There are many of these two types of new coronavirus candidate vaccines being developed for good reason because they are both mature technologies and we know how to test and manufacture them. The disadvantage is that making them is time-consuming. Each dose of vaccine contains a lot of substances, and most of these materials are biological, which means you have to nurture it. Unfortunately, this will take time.
That’s why I’m particularly excited about two new approaches to some of the candidate vaccines: RNA and DNA vaccines. If one of these new methods succeeds, we are likely to deliver the vaccine to the world more quickly. For the sake of simplicity, I only explain the RNA vaccine. DNA vaccines are similar in that they use different types of genetic material and administration methods.
For nearly a decade, our foundation has been supporting the development of RNA vaccine platforms. We originally planned to use it to develop vaccines for diseases that affect the poor, but now it looks like one of the most promising options for dealing with the new coronavirus. The first candidate vaccine to begin human trials was an RNA vaccine developed by a company called Modern na.
The RNA vaccine works like this: Instead of injecting the pathogen’s antigen into your body, it gives your body the genetic code it needs to produce the antigen itself. When antigens appear outside your cells, your immune system attacks them and learns how to defeat future intruders in the process. This basically turns your body into its own vaccine manufacturing plant.
Because RNA vaccines allow your body to do most of the work, they don’t need much material, which makes them much faster. However, there is a problem: we are not sure whether RNA is a viable vaccine platform. Since the new coronavirus will be the first target for rna vaccines, we must demonstrate that the platform itself is effective and that it creates immunity. It’s kind of like building a computer system and the first piece of software at the same time.
Even if rna vaccines continue to show hope, we must continue to pursue other options. We don’t yet know what the new coronavirus vaccine will look like. Before we do that, we have to try our best in as many ways as possible.
It may not be a perfect vaccine, but that’s okay. The smallpox vaccine is the only one that wipes out all the diseases on Earth, but it’s also brutal. It leaves a scar on the arm of anyone who gets it. One in three people has serious side effects that they cannot go to school or work. A small number of people even have a more serious reaction. The smallpox vaccine is far from perfect, but it does the job. The new coronavirus vaccine may be similar.
If we are designing a perfect vaccine, we will hope that it is completely safe and 100% effective. It should be a single dose of vaccination that will provide you with lifelong protection, and it should be easy to store and transport. I want the new coronavirus vaccine to have all these qualities, but given our schedule, it’s likely that all of these benefits won’t be achieved.
As I mentioned earlier, the two priorities are safety and effectiveness. Since we may not have time for years of research, we will have to conduct a broader Phase I safety trial and ensure that we have good real-world evidence that the vaccine is fully safe to use.
We have more leeway in terms of efficacy. I suspect that an effective vaccine of at least 70% will be enough to stop an outbreak. A vaccine that is 60% efficient is available, but we may still see some localized outbreaks. Any vaccine that is less than 60% effective is unlikely to produce enough group immunity to stop the virus.
The biggest challenge will be to ensure that vaccines are effective in older persons. The older you get, the less effective the vaccine will be. Your immune system ages like the rest of your body, and it is slow to identify and attack intruders. This is a big problem for the new coronavirus vaccine, as older people are the most vulnerable. We need to make sure they are protected.
The shingles vaccine (also for the elderly) fights this by increasing the intensity of the vaccine. We may do something similar to the new coronavirus vaccine, although it may bring more side effects. Health facilities can also require people over a certain age to increase vaccination doses.
In addition to safety and effectiveness, there are several other factors to consider:
1) How many injections do I need? A one-time vaccine is easier and faster to deliver. But we may need a multi-dose vaccine to be effective enough.
2) How long does the effect last? Ideally, the vaccine will provide you with lasting protection. But we may end up with only a vaccine that will keep you from getting sick for a few months. If this happens, short-term vaccines may be used when we study more durable vaccines.
3) How do I store it? Many common vaccines are kept at 4 degrees Celsius, which is about the temperature of a normal refrigerator, so it is easy to store and transport. But RNA vaccines need to be stored at lower temperatures (as low as minus 80 degrees Celsius), which will make it more difficult to reach some parts of the world.
I hope that after 18 months we have the vaccine as close as possible to “perfection”. Even if not, we will continue to work hard to improve. After that, I think the new coronavirus vaccine will be part of the routine immunization program for newborns.
However, once we have a vaccine, we still have a lot of problems to solve. That’s because we need to make and distribute at least 7 billion doses of vaccine. To stop the spread of the epidemic, we need to make vaccines available to almost everyone on the planet. We have never sent anything to any corner of the world before. And, as I mentioned earlier, the manufacture and storage of vaccines is particularly difficult.
Until we know exactly what we’re doing, we can’t figure out many things about making and distributing vaccines. For example, can we use existing vaccine plants to produce new coronavirus vaccines?
What we can do now is build different kinds of vaccine factories to prepare in advance, because each vaccine type requires a different type of plant. We need to have facilities in which we can produce each vaccine so that we can start producing the final vaccine (or multiple vaccines) as soon as possible. That would cost billions of dollars. Governments need to quickly find a mechanism to fund this. Our foundation is currently working with CEPI, WHO and governments to address financing issues.
Part of the discussion focused on who would vaccinate when. The reality is that not everyone can get vaccinated at the same time. Producing 7 billion doses of the vaccine can take months or even years. In the case of multiple doses of vaccine, 14 billion doses may be required, and we should start distributing them as soon as the first vaccines are ready. Most people agree that health workers should give priority to vaccination. But who’s the next batch of vaccinators? Elderly? Teacher? Workers in needy jobs?
I think low-income countries should be one of the first to receive this treatment because the risk of death in these places is much higher. New coronaviruses will spread faster in poor countries, as measures such as keeping safe physical distances are more difficult to implement. More people are in poor basic health, which makes them more prone to complications, and weak health systems will make it harder for them to access the care they need. Promoting vaccines in low-income countries could save millions of lives. The good news is that we already have an organization with expertise in the GavI on how to do this.
For most vaccines, manufacturers sign agreements with the country where their plant is located so that the country can be the first to obtain the vaccine. It is unclear whether this will occur in the new corona outbreak. I hope we can find a way to spread the vaccine to the world on a fair basis. Once we have a better understanding of what we are doing, WHO and national health agencies will need to develop distribution plans.
Ultimately, we’re going to scale up so that everyone can get vaccinated. Then we will be able to get back to normal and hopefully make a decision to prevent us from falling into this situation again. It may be hard to see the end result now, but there is a hint of Sugon at the end of the tunnel. We are doing the right thing to get vaccinated as soon as possible. At the same time, I urge people to continue to follow the guidelines set by local governments. Whether we can get through this outbreak as quickly as possible will depend on whether everyone is doing their part to keep each other safe. (Small)