Coronavirus vaccine: 7 insights from former US Science Envoy

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Former US Science Envoy Dr. Peter Hotez is spearheading coronavirus vaccine development in his position as co-director of Texas Children’s Hospital Center for Vaccine Development. His team is working on developing a COVID-19 vaccine specifically for low- and middle-income countries.

Dr. Hotez, who served as an envoy in the Obama administration from 2015 to 2016, tells Al Arabiya English the COVID-19 vaccine will not be ready before one year; there will likely be different vaccines produced for different groups of people; and the vaccine will likely not be needed annually.

Here are Dr. Hotez’s answers to 7 questions:

Q: When would be the earliest that we can expect a COVID-19 vaccine to be on the market?

DR. HOTEZ: The aspirational goal is a year to 18 months. That’s going to be tight. The world’s record is four or five years so we have to break the world’s record. It really depends on how the clinical testing goes.

Here’s the problem: we can develop a number of vaccines fairly quickly, but they still have to all go through the same pipeline to show that the vaccine actually works in people in an area where transmission is underway, and also that the vaccine is safe. Those timelines are tough to accelerate.

Q: Once a vaccine is created would people most at-risk - such as the elderly or health care workers - be the first ones in line to get this vaccine?

DR. HOTEZ: There may be different COVID-19 vaccines for different populations. Maybe different vaccines for older individuals, or those with underlying chronic conditions, or for healthcare providers. I don’t think it’s going to be a situation where it will be one vaccine that emerges. I’m predicting there will be at least three or four vaccines that will be out and may vary depending on use and local needs.

Q: How often will we have to get a COVID-19 vaccine - every year? Every 3 years? Once in a lifetime?

DR. HOTEZ: We don’t know for sure. Part of the thinking is COVID-19 probably won’t be like influenza where the virus changes and we have to create a new vaccine every year. I don’t think we’ll be in that kind of situation. I’m hoping that if we vaccinate and maybe boost, that may be all you need for a long time. We’ll have to see how long the vaccine lasts and if the virus comes back - but I’m not envisioning it will be an annual vaccine.

Q: Your team at the Texas Children’s Center for Vaccine Development is working on a vaccine for COVID-19. Where in the process is your vaccine, as well as others in development?

DR. HOTEZ: There are probably going to be a dozen vaccines that move into clinical testing over the next few weeks and months. The reason we are testing so many different vaccines is we want to have at least two or three that could be ready for licensure in as quick a period of time as possible.

Our group - the Texas Children’s Center for Vaccine Development, part of the National School of Tropical Medicine at Baylor College of Medicine - has had a coronavirus vaccine program for the last decade and one of the vaccines that will hopefully go into clinical trials might be ours. Vaccines are usually a pretty long timeline, many years often, but we are hoping to get something out pretty quickly.

Q: What is unique about the vaccine you are developing?

DR. HOTEZ: It uses a very old and established technology - it's a recombinant protein technology that is the same technology used for the Hepatitis B vaccine that is used all over the Middle East and North Africa region.

Our vaccine is specifically tailored for global health because it's a low cost vaccine, one that’s easily affordable and accessible so this would be a great vaccine especially for parts of the Middle East that would have trouble affording it. Who’s going to make the vaccine for Yemen, Sudan, Iraq and Syria? We’re hoping ours will be able to be used in these countries.

There’s also a lot of capability to manufacture our vaccine locally in many parts of the world. Right now there’s only modest capacity for making vaccines in the Middle East but maybe that would be a possibility as well. We have a lot of good collaborations with scientists in Saudi Arabia. Could this be something that’s made in Saudi or in the United Arab Emirates? This is also something we would like to explore.

Q: Once a vaccine is available, will our world go back to normal? There are groups of people who are anti-vaccination, for cultural, religious or other reasons. If these groups of people don’t get vaccination, will there still be a huge risk of another pandemic breaking out?

DR. HOTEZ: If we don’t develop adequate herd immunity globally, this will be a virus that will stay around for a long time. Look at measles - we have had the measles vaccine for decades. It's safe and highly effective. But it’s very fragile in that when the use of the vaccine declines, as we’ve seen in the past few years in places like the Philippines or in Madagascar, then the virus returns. We’ll have to maintain our vigilance with vaccinating.

Q: What are some challenges to vaccine development in the Middle East?

DR. HOTEZ: During my time serving as US science envoy in the Obama administration from 2015-2016, I was tasked with helping to build vaccine development across the Middle East and North Africa. We helped build some infrastructure in Saudi Arabia with universities there, so we’re hoping we can build on that because there’s an urgent need to create vaccines locally.

Almost no vaccines are produced in the Middle East from start to finish. That’s a huge vulnerability because there’s so many diseases. We’re talking about COVID-19 today, but there are a lot of diseases that are arising out of the collapsed healthcare infrastructure of places like Iraq, Syria and Yemen. A country like Saudi Arabia, in the middle of it all - there’s an extreme vulnerability there. I think there’s a great need to build local capacity for vaccine development.

The Middle East is such a vital region for the world and we can’t allow its population to live in that kind of vulnerability. If there is insecurity in the Middle East, it translates to insecurity globally.