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COVID-19 Vaccines: Current Perspective and Future Development

Dr Rajan Bajracharya

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Today’s Agenda
• Vaccines: current understanding and history

• Types of Vaccines

• COVID-19 infection and vaccine development

• A video on COVID-19 vaccine platforms

• Take home message

 Vaccines: Basics
Vaccine: A material containing live attenuated or inactivated (killed) microorganisms,
or constituents of microorganisms, capable of eliciting protection against infection.

Vaccination: Inoculation with a vaccine for the purpose of inducing immunity in the
control of infectious diseases.

Immunization: A process by which a person becomes protected against a disease

through vaccination.

Vaccination is one of the great public health achievements of human history. Each
year, vaccines prevent more than 2.5 million child deaths globally.
 Vaccines: History
Edward Jenner, a British physician, is generally
credited with ushering in the modern concept of
vaccination.
In 1796 he used matter from cowpox pustules to
inoculate patients successfully against smallpox,
which is caused by a related virus
(Berkeley, Gloucestershire)
Louis Pasteur developed rabies vaccine (rabies
antitoxin) in 1885.
In 1979, WHO officially declared smallpox eradicated
In 1974, WHO launched the Expanded Programme
on Immunization (EPI), with the goal of dramatically
increasing vaccination rates among children in the
developing countries
Types of vaccines
 Vaccine effectiveness vs safety
Vaccine effectiveness: The probability that a vaccine, when used in the field
under routine vaccination circumstances, confers immunity in a population.
Expressed as a percent. e.g. 2 doses of Measles vaccine is 97% effective at
preventing measles.

Vaccines are not completely risk-free and adverse events will occasionally
result from vaccination. Although most adverse events are minor (e.g. redness
at injection site, fever), more serious reactions (e.g. seizures, anaphylaxis) can
occur albeit at a very low frequency.

Vaccines are given to healthy persons to prevent disease; so a higher standard

of safety is expected of immunizations compared with medications that are used
to treat people who are sick.
 Why we use vaccines?
 Vaccines can prevent infectious diseases. Examples of vaccine
preventable diseases are: measles, polio, hepatitis B, influenza
and many others.

 When most people in a community are vaccinated against a

disease, the ability of the pathogen to spread is limited. This is
called ‘herd’ or ‘indirect’ or ‘population’ immunity.

 When many people have immunity, this also indirectly protects

people who cannot be vaccinated, such as very young babies and
those who have compromised immune systems.
SARS-CoV2 (Corona virus)
 COVID-19 Vaccine platforms
Viral vector
Consists of harmless viruses (e.g. aden-
ovirus) that have been modified so that
they contain antigens from the target
pathogen. The modified viruses act as de-
livery
system that display the antigens to the
immune cells. Replicating viral vectors
make extra copies of themselves in the
body’s cells. Non-replicating viral vectors
do not. Ebola vaccine (2019)
DNA
Consists of DNA molecules which are
converted into antigens by the body’s
cells (via RNA as an intermediate step).
As with RNA vaccines, the antigens are
subsequently detected by the immune
cells.
No licensed vaccines
RNA
Consists of messenger RNA which code
for parts of the target pathogen that are
recognised by the immune system ('anti-
gens'). Inside the cells, the RNA mole-
cules are converted into antigens which
are
then detected by the immune cells.
No licensed vaccines

Virus like particles Protein subunit

Consists of virus like particules which mimic the
native structure of the virus and can induce an
immune response. However, they lack core
genetic material which makes them
non-infectious and unable to replicate.
No licensed vaccines
Consists of the key antigenic part from the
target pathogen that are recognised by the
immune system. Adjuvants can be added to
enhance the immune response.
Hepatitis B, HPV, acellular pertussis
 Video

https://www.youtube.com/watch?v=KMc3v
L_MIeo&t=2s
 COVID-19 Vaccines
47 candidate vaccines in clinical evaluation; 155 in preclinical evaluation
10 candidate vaccines currently undergoing Phase 3 clinical trials
 COVID-19 Vaccines
Vaccines currently undergoing Phase 3 clinical trials
 BCG vaccine against COVID-19
There is no evidence that the Bacille Calmette-Guérin vaccine (BCG)
protects people against infection with COVID-19 virus (WHO)

There are clinical studies currently being conducted in the USA, Australia,
and the Netherlands actively evaluating the potential protective benefits
from BCG vaccination related to COVID-19 disease.
 Till the
vaccines
become
available