Phase 3 trials are here. How close is the US to getting a safe and effective COVID-19 vaccine?

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The U.S. government has invested billions of dollars in the race for a COVID-19 vaccine. It’s part of Operation Warp Speed, the federal program that’s aiming to deliver more than 300 million vaccine doses to Americans by January. 

Some recipients of this money are reporting promising results. The company Moderna is looking to enroll 30,000 people in its phase three trial. Pfizer and AstraZeneca are also getting a lot of attention for their progress. 

KCRW talks about the current status of vaccine research and development with Victoria Jaggard, Executive Editor for Science at National Geographic.

KCRW: It usually takes years to bring a vaccine to market, but some companies are trying to fast-track it for COVID-19. What are they doing now?

Victoria Jaggard: “What a lot of companies are doing is … start with technologies that are fairly well proven. And so we've already got some sense that maybe they're going to work, and they're going to be effective. And sort of smush some of these trial phases together and do some of these tests in tandem, using some of the early data to be able to push forward a little bit faster.” 

There are phase three vaccine trials now. What does that mean? 

“Phase three is one of the latest stages of clinical trials. This is when you're really leveling up to thousands of human volunteers, being willing to try out a vaccine. Because we have gone through those initial phase one and phase two trials of seeing what are the right doses for provoking an effective immune response, and at the same time, not having any bad side effects that would make … the cure worse than the disease. 

So when something gets to phase three, they've already gone through those checks. And what they're trying to do is make sure that they can really scale it up, that they've narrowed in on the dose that they want, and that this is going to be something that's going to work for a broad spectrum of the public.”

Whether people will take this vaccine has a lot to do with trust, and in particular, trust in the Trump administration. Trump's false statements while in office have been well documented, and Facebook and Twitter just removed a video today where Trump claimed that children are almost immune to COVID-19, which isn’t true. How does that complicate the rollout of a potential vaccine?

“Public communication is a major part of making sure that a vaccine is rolled out in a safe and effective way. If people are not willing to take the drug in the first place, that's obviously a problem because the more people who are willing to be vaccinated, the better protection we're providing for the public at large. And we've already seen quite a history in this country of people being skeptical of vaccines. 

And I think one of the dangers of moving too quickly is maybe we'll develop a vaccine that is relatively effective, and it has minor side effects. But if we'd really taken our time, and we've got so many vaccine candidates in trials right now, that if we'd really taken our time to get the right one developed the right way, it would be more effective, and it would have fewer side effects potentially. Which means that there'd be less likelihood that people taking it would be experiencing bad effects or still getting sick, and therefore continuing to be hesitant or reluctant to want to get involved with vaccines at all." 

Moderna has gotten a lot of attention. How does their vaccine work and how far along is this?

“Moderna is such a fascinating example in all of this. Their vaccine is what is known as an mRNA vaccine. So it's using snippets of the virus' genetic code to insert that into people, and then create the proteins that will trigger an immune response. 

So you're not getting even a weakened or dead version of the whole virus. You're just getting these little itty bitty snippets so that you're less likely to get sick, but you are going to be exposed to the proteins that tell your body to start mounting that defense. 

… It is a system that can be scaled up really easily, but at the same time, it's a system that is not entirely proven. If Moderna is successful — and I believe also Pfizer is another company that is in late stages with an mRNA vaccine — if Moderna or Pfizer are successful, they would be the first ever mRNA vaccine approved for use in humans.” 

Is AstraZeneca creating the vaccine in a more traditional model?

“AstraZeneca is actually working in partnership with the University of Oxford in the United Kingdom. And they are working on what's called a viral vector vaccine. This is a more typical version of a vaccine like the kinds we already have. 

… This is where we're taking the spike protein, which is the bit on the SARS-CoV-2 virus that gives it that halo of spikes all around it. That's the bit that helps the coronavirus actually invade our human cells. So they take that spike protein, and they insert it into a weakened version of what's known as an adenoviruses. This is … one of the many viruses actually that typically causes a common cold. So it's nothing to be super worried about in the first place. You take that coronavirus bit, you insert it into the adenovirus, and then you introduce the adenovirus into the human body. It acts like a Trojan horse. It delivers those same proteins that trigger the immune response in the body.” 

What about the money factor?

“Cost to the vaccine is clearly going to affect things like who gets the vaccine once it's ready, right? So accessibility is going to be a huge part of this problem as well. If a vaccine is priced very highly, then that's going to very seriously affect whether it reaches some of the communities that are most at risk. … It's an issue that I think needs to be taken into account when we're talking about the ethics of a vaccine rollout. 

… University of Oxford and AstraZeneca have stated … that they plan, if their vaccine is successful, to sell it at cost. Not clear yet what that cost was going to be.” 

Is a safe and effective vaccine inevitable at this point, or are we getting our hopes up? 

“I agree with Dr. Fauci. I like to remain cautiously optimistic. I think there are more than 150 candidates in play. I really hope one of them is going to work. I just hope that we take the time to find the right one and roll it out in the right way.”

— Written by Amy Ta, produced by Angie Perrin