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Accelerating Vaccine Development

Summary:
How can deployment of a Sars Cov2 vaccine be speeded up ? One important step is to make a lot of candidate vaccines while testing for effectiveness. Usually, there is testing, approval than producing. Since producing a lot then testing makes no business sense, it is a project for states or charities. Unsurprisingly the Gates foundation is on it committing to mass produce 6 candidate vaccines. A remaining problem is that proof of effectiveness takes a long time (and a huge sample). Fortunately, even without a vaccine, most people, even in the highest risk occupations, don’t get Covid 19. Therefore it is hard to prove that vaccinated people do even better. An effectiveness trial will take time. The most advanced candidate is the Oxford made

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How can deployment of a Sars Cov2 vaccine be speeded up ?

One important step is to make a lot of candidate vaccines while testing for effectiveness. Usually, there is testing, approval than producing. Since producing a lot then testing makes no business sense, it is a project for states or charities. Unsurprisingly the Gates foundation is on it committing to mass produce 6 candidate vaccines.

A remaining problem is that proof of effectiveness takes a long time (and a huge sample). Fortunately, even without a vaccine, most people, even in the highest risk occupations, don’t get Covid 19. Therefore it is hard to prove that vaccinated people do even better. An effectiveness trial will take time.

The most advanced candidate is the Oxford made adenovirus based vaccine. Because a very similar vaccine against (I forget) MERS or Sars Cov1 is known to be safe, they can go straight to testing effectiveness. A phase 1/2 trial is recruiting volunteers. A phase III (yhat means very big) trial is being organized.

The phase 1/2 trial has estimated primary completion date May 2021. One step in the trial is follow the subjects for 6 months to see if they catch Covid 19. I am citing the entry at clinicaltrials.gov

One basically clearly unethical shortcut is to vaccinate then challenge with the virus. The hope is that the experimental subjects won’t be killed. Acting on such hope is no longer allowed (nor should it be). I am willing to volunteer to participate (a safe offer because it won’t happen and they would use young volunteers if it did).

Of course most people have few qualms about doing this with animals and there is already a vaccine (good old killed virus vaccine) known to protect Rhesus monkeys.

I think another approach would be to vaccinate then test serum. One thing would be to test if the serum blocks infection in vitro, that is contains neutralizing antibodies. It is know that the serum of (most) people who have had Covid 19 contains such neutralizing antibodies.

Another would be a trial of serum of vaccinated people as therapy for people with Covid 19. Serum from people who have recovered is being used. It is in short supply. A theraputic trial of serum from unexposed people, from vaccinated people, and from people who have recovered from Covid 19 as therapy for people with Covid 19 makes sense. As we have seen, theraputic trials don’t have to take very long (the course of the disease is within 28 days the course of not catching the disease has been all of time until now).

Serum of recovered patients has not been proven to be effective, so this trial would be legal.

Robert Waldmann
Robert J. Waldmann is a Professor of Economics at Univeristy of Rome “Tor Vergata” and received his PhD in Economics from Harvard University. Robert runs his personal blog and is an active contributor to Angrybear.

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