The next generation of Covid-19 vaccines could be a pill or a spray



The next generation of Covid-19 vaccines in development could come in pill or nasal spray form and be easier to store and transport than the current handful of vaccines that form the backbone of the global effort. vaccination.

These new vaccines, from US government laboratories and companies, including Sanofi AT,

Altimmune Inc.

and Gritstone Oncology Inc.,

also have the potential to provide longer lasting immune responses and be more potent against new and multiple viral variants, which could help prevent future pandemics, according to the companies.

Vaccines currently authorized in the United States by Pfizer Inc.

and its partner BioNTech SE, as well as Moderna Inc.,

must be transported and stored at low temperature and require two doses given weeks apart.

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The new vaccines could “be some improvement” on these limitations and more easily adapt to vaccination efforts in rural areas, said Gregory Poland, professor and vaccine researcher at the Mayo Clinic in Rochester, Minnesota. “You’ll see second-generation, third-generation vaccines,” he said.

According to the World Health Organization, 277 Covid-19 vaccines are in development around the world, 93 of which have entered human testing. Most vaccines in clinical trials are injected, but there are two oral formulations and seven nasal spray formulations.

Altimmune is developing its Covid-19 vaccine in the form of a nasal spray.


Photo:

Ting Shen for the Wall Street Journal

Many new generation vaccines are in the early to mid-phase of human testing, which means they may not be available until later in 2021 or 2022. There is no guarantee that the vaccines will be available. vaccines will succeed in testing, and some of the companies that develop them, such as Altimmune and Gritstone, have never put a vaccine on the market.

If proven to safely protect people against Covid-19, the new vaccines could serve as a booster in the United States, where a majority of the adult population is expected to be inoculated by the summer with the vaccines. currently licensed from Pfizer, Moderna and Johnson & Johnson..

Infectious disease specialists increasingly expect that periodic boosters will be needed to extend the duration of protection against the novel coronavirus and to build defenses against the variants. They are also investigating whether giving a person doses of two different vaccines can improve their effectiveness.

New vaccines could also be used as primary vaccinations in countries lagging behind in mass vaccination campaigns.

“It is extremely important in the future to have vaccines that are easier to handle and have better cold chain characteristics,” said John Mascola, director of the Center for Vaccine Research at the National Institute of Allergy and Disease. Infectious diseases.

Altimmune, of Gaithersburg, Md., Is developing a Covid-19 vaccine that is given as a nasal spray, similar to AstraZeneca PLC’s FluMist influenza vaccine which is a popular choice for children for seasonal flu vaccination.


“It is extremely important in the future to have vaccines that are easier to handle and have better cold chain characteristics.”


– John Mascola, Director of the Center for Vaccine Research at the National Institute of Allergy and Infectious Diseases

“It’s a very simple and effective way to deliver the vaccine,” said Scot Roberts, Scientific Director of Altimmune. “You don’t need needles and syringes.”

The vaccine uses a modified version of a harmless virus called adenovirus, which is designed to carry a genetic code that instructs cells in the body to make the spike protein from the coronavirus. This induces an immune response, including the production of antibodies in the blood, building a defense against the real virus.

The design is similar to the injected Covid-19 vaccines from Johnson & Johnson and AstraZeneca. But since the Altimmune vaccine is given as a nasal spray, it could also induce a type of immune response known as mucosal immunity, which could help clear the virus from the airways, helping to reduce transmission. of the virus by vaccinated people, according to Dr. Roberts.

“Having this mucosal immunity that can both block infection as it enters and neutralize it when it is on the way out could be very important from a public health perspective,” he said.

By mid-year, the company is awaiting the results of a preliminary study to determine whether the vaccine safely induces the desired immune response.

Altimmune says its Covid-19 nasal spray vaccine could induce a type of immune response that could help clear the virus from the airways.


Photo:

Ting Shen for the Wall Street Journal

Vaxart Inc.

of South San Francisco, California, is developing a Covid-19 vaccine in tablet form that can be swallowed. A small, early-stage study showed that it triggered immune responses against the virus and had the potential to protect against variants, the company said in February.

Vaxart plans to begin a mid-stage, or phase 2, study of the tablet vaccine by mid-year, a spokesperson said.

Sanofi and GlaxoSmithKline PLC are jointly exploring potential vaccines against new variants, while also testing a modified version of their original injected Covid-19 vaccine candidate, which studies have shown failed to induce a sufficient immune response in patients. the elderly.

Pfizer and Moderna are also looking for second-generation clichés, including those aimed at variants, as well as new formulations that improve storage and shipping. Their first-wave vaccines, cleared by the Food and Drug Administration in December and over 90% effective in preventing Covid-19, are generally safe, but require two doses as well as low-temperature transport and storage, and have a limited shelf life. life once thawed.

Government and academic researchers are also working on new snapshots, including at the Walter Reed Army Institute of Research and NIAID.

WRAIR recently began a clinical trial of its investigational Covid-19 vaccine which may offer broader protection against variants. Ultimately, U.S. military researchers hope to make a vaccine to protect against all types of coronavirus in one shot, said Dr Kayvon Modjarrad, director of the emerging infectious diseases branch institute.

This goal is shared by Drew Weissman, professor and immunologist at the University of Pennsylvania who has carried out crucial research into the technology behind the Pfizer and Moderna vaccines. Dr Weissman is concerned that new pandemics will arise in the coming years involving pathogens even more dangerous than the coronavirus behind Covid-19, known as SARS-CoV-2.

“It is almost certain that we will have more pandemics in the future,” he said.

Dr Weissman is also working on a vaccine to protect against all coronaviruses, including those that cause the life-threatening illnesses of SARS and MERS. The vaccine showed evidence of protecting mice against the disease, he said.


“It is almost certain that we will have more pandemics in the future.”


– Drew Weissman, professor and immunologist at the University of Pennsylvania

Another approach to next-generation vaccination is to study whether the combination of several existing Covid-19 vaccines is more effective than a single vaccine.

Government scientists hope to learn how to use different booster vaccines to improve the duration of protection while protecting against dangerous variants of the virus, says John Beigel, associate director of clinical research in the division of microbiology and infectious diseases at NIAID , which is part of the effort.

Scientists, in collaboration with academic partners, hope to start the study in the coming months and have answers this summer. The University of Oxford is conducting another study involving the mixing of vaccines.

Nelson Michael, director of the Center for Infectious Diseases Research at WRAIR, calls it the “Cocoa Puffs / Trix” government experiment.

“It’s about looking at what’s on the shelf, taking a little of this first, then a little of that afterwards, an approach like a kid would with cereal,” he says.

As more and more American adults receive their Covid-19 vaccines, various side effects are appearing. WSJ’s Daniela Hernandez talks with an infectious disease specialist about what’s common, what isn’t, and when to see a doctor. Photo: Associated Press

Write to Peter Loftus at [email protected]m and Gregory Zuckerman at [email protected]

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