Since it was first discovered to be the causative agent of the new disease, scientists have been trying to better understand the genetic makeup of the virus, how it infects cells and how it can be treated effectively. There is no cure and specialists can only treat the symptoms of the disease. Many different treatment options have been suggested and some older medications seem to have positive results – but much more work is required. However, the long-term strategy to combat COVID-19, which has spread to all continents alongside Antarctica, is to develop a vaccine.
It takes time to develop new vaccines, and they must be rigorously tested and clinically confirmed to be safe before they can be routinely used in humans. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in the United States, has often stated that a vaccine is at least a year to 18 months away. Experts agree that there is still a long way to go.
Vaccines are incredibly important in the fight against diseases. Due to vaccine development, we have been able to keep a handful of viral diseases at bay for decades. Still, there is confusion and discomfort about their usefulness. This guide explains what vaccines are, why they are so important, and how scientists will use them to fight the coronavirus. It also discusses the treatment options currently in use and those that are promising in hospitals.
When more candidates appear and are tested, we will add them to this list. So bookmark this page and check for the latest updates again.  You can jump to any segment by clicking the links below:
What is a vaccine?
A vaccine is a type of treatment that is designed to stimulate the body's immune systemto fight infectious agents such as bacteria and viruses. According to the World Health Organization, they are "one of the most effective methods of disease prevention".
The human body is particularly resistant to diseases because it has developed a natural defense system against evil disease-causing microorganisms such as bacteria and viruses. The immune system – our immune system – consists of different types of white blood cells that can recognize and destroy foreign invaders. Some devour bacteria, others produce antibodies that can tell the body what to destroy and remove the germs, and other cells memorize what the intruders look like so the body can respond quickly when they re-enter.
Vaccines are a really clever fake. They make the body think that it is infected so that it stimulates this immune response. For example, the measles vaccine pretends the body that it has measles. If you are vaccinated against measles, your body will make a record of the measles virus. If you come into contact with it in the future, your body's immune system is prepared and ready to fight it back before you can get sick.
The very first vaccine was developed in the late 18th century by a scientist named Edward Jenner. In a famous experiment, Jenner scratched pus from a milk maid with cowpox – a type of virus that mainly causes disease in cows and is very similar to the pox virus – and introduced the pus to a boy. The young man got a little sick and had a slight case of cowpox. Jenner later vaccinated the boy with smallpox, but he didn't get sick. Jenner's first injection of cowpox pus trained the boy's body to recognize the cowpox virus, and because it is so similar to smallpox, the young man was able to fend it off and not get sick.
Vaccines have come an incredibly long way since 1796. Scientists certainly do not inject patient pus into other patients, and vaccines must adhere to stringent safety regulations, multiple rounds of clinical testing, and strict regulatory guidelines before proceeding to a broad one Application can be taken over.
What does a vaccine contain?
Vaccines contain a handful of different ingredients, depending on their type and how they are supposed to trigger an immune response. However, there are some similarities between all of them.
The most important component is the antigen. This is the part of the vaccine that the body can recognize as foreign. Depending on the type of vaccine, an antigen can be molecules from viruses such as a strand of DNA or a protein. Instead, they could be weakened versions of live viruses. For example, the measles vaccine contains a weakened version of the measles virus. When a patient receives the measles vaccine, his immune system recognizes a protein present on the measles virus and learns to ward it off.
A second important component is the adjuvant . An adjuvant enhances the immune response to an antigen. Whether a vaccine contains an adjuvant depends on the type of vaccine.
Some vaccines were previously kept in vials that could be used multiple times and, as such, contained preservatives which ensured that they could sit on a shelf without other nasty bacteria growing in them. One such preservative is thimerosal, which has received a lot of attention because it contains traces of easy-to-clean ethyl mercury. According to the CDC, it has been shown that inclusion in vaccines does no harm. Disposable vials are now common in countries like Australia, which is why preservatives like thimerosal are no longer required in most vaccines.
When developing a vaccine against SARS-CoV-2, scientists need to find a viable antigen that stimulates the body's immune system to fight infection.
Production of a COVID-19 vaccine
The pathogen at the center of the outbreak, SARS-CoV-2, belongs to the family of viruses known as coronaviruses. This family is called because they appear under the microscope with crown-like projections on their surface.
When developing a vaccine against SARS-CoV-2, scientists deal intensively with these projections. The projections allow the virus to enter human cells, where it can replicate and make copies of itself. They are known as "spike proteins" or "S" proteins.and research suggests that they could be a viable antigen in any coronavirus vaccine.
This is because the S protein is widespread in corona viruses that we have fought in the past – including those that caused the SARS outbreak in China in 2002-03. This has given the researchers a head start in building vaccines against part of the S protein and has shown on the basis of animal models that they can trigger an immune response.
There are many companies around the world that are working on a SARS-CoV-2 vaccine that develops various ways to stimulate the immune system. Some of the most discussed approaches are those that use a relatively new type of vaccine known as a "nucleic acid vaccine". These vaccines are essentially programmable and contain a small piece of genetic code that acts as an antigen.
Biotech companies like Moderna were able to quickly develop new vaccine designs against SARS-CoV-2 by fusing part of the genetic code for the S protein with fatty nanoparticles that can be injected into the body. Imperial College London is developing a similar vaccine using coronavirus RNA – its genetic code. Pennsylvania biotech company Inovio is producing strands of DNA that it hopes will stimulate an immune response. Although these types of vaccines can be made quickly, none have yet been launched.
Johnson & Johnson and the French pharmaceutical company Sanofi both work with the United States' Biomedical Advanced Research and Development Authority to develop their own vaccines. Sanofi's plan is to mix coronavirus DNA with harmless virus genetic material, while Johnson & Johnson will attempt to deactivate SARS-CoV-2, essentially eliminating its disease-causing ability while ensuring that it does the immune system continues to be stimulated.
Some research institutions, such as the Boston Children's Hospital, are investigating various types of adjuvants that contribute to enhancing the immune response. According to Harvard Gazette, this approach is aimed more at older people who do not respond so effectively to vaccinations. It is hoped that by studying adjuvants to promote a vaccine, older people can be vaccinated with a mixture of ingredients that will boost their immunity.
When will a vaccine be available?
Fauci of the Institute for Infectious Diseases assumes that a vaccine is approximately one and a half years away, although we will likely see trials with people within the US starting next month or two. According to a 60 minute interview with Fauci in March, this is a quick process.
"The good news is that we did it faster than ever before," said Fauci for 60 minutes. (Note: 60 Minutes and CNET share a parent company, ViacomCBS.) "The sobering news is that it's not ready for prime time for what we're going through."
Why does vaccine production take so long? There are many steps and many regulatory hurdles to overcome.
"For a drug to be sold, it must go through the standard clinical trial process, including Phase 1 [to] 3 trials," said Bruce Thompson, Dean of Health at Swinburne University in Australia. "We need to make sure the medicine is safe, does no harm, and knows how effective it is."
Scientists cannot assume that their vaccine design will work simply – they have to test, test and test again. You need to recruit thousands of people to ensure the safety of a vaccine and how useful it will be. The process can be divided into six phases:
- Vaccine design: Scientists examine a pathogen and decide how to get the immune system to recognize it.
- Animal testing: A new vaccine is tested for disease in animal models to show that it works and has no extreme adverse effects.
- Clinical studies (phase I): These are the first tests on humans and test the safety, dose and side effects of a vaccine. These studies only cover a small cohort of patients.
- Clinical trials (Phase II): This is a more detailed analysis of the actual biological effects of the drug or vaccine. It includes a larger group of patients and assesses the physiological responses and interactions with the treatment. For example, a coronavirus study can assess whether a vaccine stimulates the immune system in a particular way.
- Clinical studies (phase III): In the last phase of the studies, an even larger number of people are tested over a long period of time.
- Regulatory Agency: The final hurdle is that regulators such as the United States Food and Drug Administration, the European Medicines Agency and the Australian Therapeutic Goods Administration are reviewing the evidence available from experiments and studies and concluding whether a vaccine should be administered All-clear as a treatment option.
Traditionally, it can take a decade or more for a new vaccine to be approved for design. Once regulatory processes come to the conclusion that a vaccine is safe, pharmaceutical companies need to ramp up production so that they can produce enough vaccine to increase immunity in the wider population.
With SARS-CoV-2, in some cases the process is accelerated. As STATnews reports, the vaccine being developed by Moderna has moved from design directly to phase I clinical trials of its mRNA vaccine and has skipped tests in animal models. These tests will take place at the Kaiser Permanente Washington Health Institute in Seattle, and patients are currently being enrolled.
First US COVID-19 vaccine studies in humans
In the United States Moderna's Phase I clinical studies began in March 16 in collaboration with NIAID, the US National Institutes of Health, and KPWHRI. It is the first human mRNA vaccine test involving a total of 45 healthy adult volunteers between the ages of 18 and 55.
"This phase 1 trial, which was started at record speed, is an important first step towards achieving this goal," said Fauci in a statement.
Moderna's approach, which was explained in the section on vaccines above, is particularly unique in its speed. As the biotech company was already looking for ways to fight the coronavirus that causes respiratory syndrome in the Middle East, they were able to adapt their methodology and vaccine design for SARS-CoV-2. The experimental vaccine, called mRNA-1273, contains genetic material from the spike protein that is present in SARS-CoV-2 and is embedded in a lipid nanoparticle.
Manufacturing costs were supported by the coalition for innovations to prepare for epidemics.
In the study, patients received two injections of mRNA-1273 at 28-day intervals. The 45 patients are divided into three groups of 15 patients each and dosed differently: either 25 micrograms, 100 micrograms or 250 micrograms. Safety checks are performed after the first four patients have received the lowest and medium doses and before all patients have been shot. A further safety check of the data is performed before the 15 patients receiving the highest dose are injected.
Even if the vaccine has been shown to be safe and promising to protect against COVID-19, it could take a year away – at least.
You can visit the NIAID website for all information about the study.
How do you treat COVID-19?
The best way to prevent disease is to avoid exposure. These tips are below.
First: antibiotics, a drug to fight bacteria, do not work with SARS-CoV-2, a virus. If you are infected, you will be asked to isolate yourself for 14 days to prevent the disease from spreading further. If the symptoms escalate and you experience shortness of breath, high fever and lethargy, you should see a doctor.
Treatment of COVID-19 cases in hospitals is based on the best possible treatment of patient symptoms. For patients with severe diseases that affect the lungs, doctors insert a tube into the airways so that they can be connected to ventilators – machines that support breath control.
There are still no specific treatments for COVID-19, although a number are in the works, including experimental antivirals that can attack the virus and existing medications for other viruses such as HIV that are promising in the treatment of COVID -19 .
Remdesivir, an experimental antiviral drug from the biotech company Gilead Sciences, has gained much of the spotlight. The drug has been used in the United States, China, and Italy, but only on a "compassionate basis" – essentially, this drug has not received approval, but can be used outside of a clinical trial in critically ill patients. Remdesivir was not specifically designed to destroy SARS-CoV-2. Instead, a certain machinery in the virus is switched off, known as "RNA polymerase", which many viruses use for replication. It has been shown in the past to be effective in human cells and mouse models.
Its efficacy is still under discussion, and much more rigorous studies are required before this becomes general treatment for SARS-CoV-2, if it is at all .
Gilead, the manufacturer, was awarded "Orphan Status" for remdesivir on March 23, which is normally reserved for the development of drugs to diagnose or treat "rare diseases or conditions", less than 200,000 of which People are affected. The classification provides Gilead with a range of incentives, including tax breaks and expensive exemptions, and is designed to speed up the development process. It also prevents other generic competitors from selling the drug. On March 25, however, Gilead called for status to be lifted after the public and presidential candidate Bernie Sanders were subjected to significant backlashes.
On March 18, Chinese Guardian scientists reported encouraging clinical trials in Wuhan and Shenzhen involving more than 300 patients with the Japanese influenza drug favipiravir. The drug appeared to shorten the course of the disease in patients who received treatment to get rid of the virus after only four days, while those who did not last about 11 days.
The drug is manufactured by Fujifilm Toyama Chemical, but the company has refused to comment on the allegations. Favipiravir, also known as Avigan, is an antiviral and has been developed to target RNA viruses, including coronaviruses and influenza viruses. The drug is believed to interfere with a pathway that helps these viruses replicate in cells. According to the Guardian, a source from the Japanese health ministry suggests that the drug is not effective in patients with severe symptoms.
Other Treatment Options
An HIV drug, Kaletra / Aluvia, was used in China to treat COVID-19. AbbVie, an Illinois-based pharmaceutical company, said the treatment was provided as an experimental option for Chinese patients in the "early days" of fighting the virus. The company proposes to work with global health agencies, including the Centers for Disease Control and Prevention and the World Health Organization.
On March 18, a randomized, controlled trial evaluated the effectiveness of the HIV drug. The results published in the New England Journal of Medicine show that adults with severe COVID-19 infections do not appear to benefit from drug treatment and there was no clinical improvement over standard care. The authors suggest that additional studies should be done because treatment can reduce serious complications, such as acute kidney injury or secondary infections, when administered at a certain stage of the disease.
The problem with chloroquine
A drug that has chloroquine has been used to treat malaria for about 70 years and is a potential treatment candidate. It appears to be able to block the binding of viruses to human cells and their replication. It also stimulates the immune system. A letter to the editor in the journal Nature on February 4 showed that chloroquine was effective in combating SARS-CoV-2. A Guangdong-based Chinese study reports that chloroquine improves patient outcomes and could "improve the success rate of treatment" and "shorten hospitalization."
Tesla and SpaceX CEO Elon Musk and US President Donald Trump both have advertised chloroquine as a potential treatment candidate. A recent correspondence in Nature magazine on March 18 suggested that hydroxychloroquine – a less toxic derivative of the drug – effectively inhibited SARS-CoV-2 infection. This derivative is widely used to treat diseases like rheumatoid arthritis, and Chinese researchers have conducted at least seven clinical trials with hydroxychloroquine to treat infections.
The combination of hydroxychloroquine with the antibiotic azithromycin has also been associated with positive patient results. Doctors in Marseille, France, conducted a low-performance study on a small number of patients (36) and suggested that the combination treatment could be effective in reducing the amount of virus found in a particular part of the body. The study is frequently cited and even the President of the USA suggested that it could be a "game changer" . Whether this leads to better clinical results – ie. whether patients recover faster – is still being discussed.
"The results are controversial and the clinical studies are inconclusive," says Gaeten Burgio, a medical researcher at the Australian National University. "So far, there is no clear evidence that chloroquine or hydroxychloroquine are a treatment option. Additional clinical studies will show us whether hydroxychloroquine or chloroquine is suitable for COVID-19 treatments."
Burgio advises against storing hydroxychloroquine because the drug is of crucial importance for the treatment of patients with the autoimmune disease lupus.
Food and Drug Administration Commissioner Stephen Hahn discussed the chloroquine investigation during a briefing at the White House on March 19. "This is a drug that the President has instructed us to examine more closely to see if it is an extended-use approach. This could actually be tested to see if it benefits the patient," said Hahn. Trump announced that FDA-approved chloroquine will be used for "compassionate use" on March 19.
There is also another problem with the use of chloroquine.
Chloroquine phosphate, which is widely used, is not without side effects and health officials warn against self-medication. It can cause headaches, diarrhea, rashes, itching and muscle problems. It is also used as an additive in aquarium cleaners. In rare cases, it appears to severely affect the heart muscle and can lead to abnormalities or heart failure. Health officials in Nigeria have reported cases of chloroquine poisoning. On March 23, a man in his sixties and his wife became seriously ill after self-medication with chloroquine phosphate, which comes from an aquarium cleaner. The man later died and his wife was placed in intensive care.
Convalescent Plasma Therapy
On March 24, the United States FDA announced that it would provide patients with severe or directly life-threatening COVID-19 infections access to "convalescent plasma". With this form of therapy, part of the blood from restored COVID-19 patients is infused into the body of sick patients.
As explained above, the immune system is the body's defenses. When a virus invades, it sends out an army of cells, including white blood cells, to fight it off. These cells release antibodies that remain in the liquid part of the blood known as "plasma". If a patient survives COVID-19, they are likely to have built up a large pool of antibodies in their plasma. The idea is to take part of their inventory and infuse it into critically ill patients in the hope that the antibodies will stimulate the patient's own immune system to find and destroy the virus.
This is not the first time that such therapy would be used; Previous outbreaks of SARS, MERS, and the H1N1 influenza pandemic used convalescent plasma to treat patients. In fact, the use of convalescent plasma dates back to the 1918 influenza pandemic.
A report by Chinese scientists published in February in The Lancet Infectious Diseases magazine suggested that the treatment option for combating SARS-CoV-2 and anecdotal evidence could be viable, according to Xinhua, of 91 with 245 out of 245 patients in China Study showed some success.
In the United States, New York Governor Andrew Cuomo announced that New York doctors will begin testing convalescence plasma therapy in a trial beginning in late March.
How can you protect yourself against corona virus now?
It is not a good idea to rely on a vaccine to stop the spread of coronavirus, as it is still many months away. The best way to stop the spread is to continue to practice good personal hygiene and limit interactions with others. "The best thing to do is do the simple things like hand washing and hand disinfection," said Thompson.
This outbreak is unprecedented, and behavioral changes are absolutely critical to stopping the spread.
The WHO provides a variety of resources to protect against infections. It is clear that the virus can spread from person to person and the transmission has taken place in communities around the world. Protection boils down to a few important things:
- Washing your hands: 20 seconds and no less! Here you will find some .
- Maintaining social distance: Try to keep at least 1 m away from people who cough or sneeze.
- Don't touch your face, eyes, or mouth: an incredibly difficult task, but that's how the virus gets into the body first.
- Hygiene measures for the respiratory tract: coughing and sneezing in the elbows.
- If you visited a place where COVID-19 spreads, isolate yourself for 14 days.
For more information
. Originally published in March and constantly updated as new information becomes available.