Tracking the vaccine race

Tracking the
vaccine race

A look at the vaccines in development to fight COVID-19.

The race to create vaccines against the novel coronavirus is entering a critical stretch, with several candidates that were first out of the gate beginning to release late-stage trial data and possibly seeking early regulatory approval. Multiple “winners” are likely to make it to market, and success will depend on a number of factors reflected in this tracker.

Vaccine scorecard

A sampling of the leading vaccine candidates and some new technologies to watch, listed in alphabetical order by company or group, and by current development phase.

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Trial Phase
I
II
III
Prior Licensed Vaccine
No
Yes
Latest results
Earlier
Recent
Approval Status
Review
Limited
Advance orders
No
Yes
Earliest Delivery
Later
Sooner
Arcturus Therapeutics-Duke NUS
AstraZeneca-Oxford
CanSino Biologics
CureVac AG
Gamaleya Research Institute
Inovio-CEPI
Johnson & Johnson-BARDA-Janssen
Medicago-GSK-Dynavax
Merck-IAVI-BARDA
Merck-Themis
Moderna-NIAID
Novavax
Pfizer-BioNtech
Sanofi-GSK
Sinopharm-Beijing Inst.of Biological Products
Sinovac-Instituto Buntantan

Track record

Vaccines that don’t demonstrate overall safety in small phase 1 and 2 trials will not go any further. Some of the leading coronavirus candidates have the advantage of being based on familiar, time-tested formulas, including candidates containing a viral protein or inactivated whole virus, with or without an immune-boosting adjuvant. Other contenders represent newer technologies, including those based on RNA, DNA or virus-like particles, but even some of these approaches have already led to licensed vaccines against other diseases or at least gone through prior human trials. And they have a few advantages of their own, such as fast manufacture or smaller dose requirements.

Viral vectors are both old and new, having been long in development for other applications and already used in some licensed vaccines. This design reliably provokes an immune response, but the vaccines may also share a potential problem: the harmless viruses that serve as a “vector” to ferry genetic instructions into cells may already be recognized by the human immune system, which can reduce vaccine effectiveness and require higher dosages. Another worry is that a first vaccine shot could create immunity to the vector that weakens the effect of a second shot. For vaccine designers, “it is a risk to be mitigated,” Nathalie Garçon, CEO and CSO of BIOASTER and former chief of GSK Biologicals’ Global Adjuvant Center for Vaccines told Reuters. Large-scale trials will reveal if the risk is serious and if vaccine designers can find a way around it.

Vaccine timeline

Vaccine development normally takes years, starting with preclinical laboratory work. But most pandemic vaccines are being tested in overlapping trial phases to compress the timeline. In Phases 1 and 2, safety and early immune responses are assessed. In Phase 3, researchers will also look at vaccine efficacy: does it protect, who does it protect, and how well? Regulators will use that data in approval decisions. A handful of vaccines are in production already, so as to be ready for rapid distribution when approved.

Clinical trials

pre-clinical

Phase 1

Phase 2

Phase 3

approval

production

Clinical trials

pre-clinical

Phase 1

Phase 2

Phase 3

approval

production

Clinical trials

approval

production

Phase 1

pre-clinical

Phase 2

Phase 3

Regulators aprove

Animal trial

Safety trial

Large group trial

Efficacy trial

Clinical trials

pre-clinical

Phase 1

Phase 2

Phase 3

approval

production

Safety trial

Large group trial

Efficacy trial

Regulators aprove

Animal trial

Trial results

Whether a pandemic vaccine requires one dose or two, and how far apart shots must be given, can impact how practical it will be to distribute and how much it costs. Phase 3 trials–which typically include tens of thousands of volunteers with a greater diversity of backgrounds and a wider age range than early safety trials–will also reveal a vaccine’s efficacy: how much of the population it is likely to protect, and to what degree.

The race for a vaccine against SARS-CoV-2 is challenging the vaccine industry at every level, Garçon said. Vaccine designers are not only trying to make a single vaccine meant to protect 2 billion people or more, they’ve been doing it without knowing what immune responses equate with protection against this new virus. As a proxy, many compared responses in early trial volunteers to those seen in recovered COVID-19 patients. In phase 3, researchers can begin to see who resists infection in the real world. Experts project the leading candidates might protect roughly 70% of vaccinated people against infection or against severe COVID-19 if they are infected. The U.S. FDA has set a minimum threshold of 50% efficacy to even consider a vaccine for approval. Still not clear is how long that protection will last, but it could be as little as a year, AstraZeneca CEO Pascal Soriot said last June and BioNTech chief executive Ugur Sahin echoed in November.

Advance orders

All the unknowns have not stopped governments and international organizations, including the WHO through its COVAX initiative, from pouring funding into a handful of candidates to speed their development and regulatory review. A fierce international competition to lock in billions of dollars’ worth of purchase commitments has also been underway for months, and some companies will soon start delivering millions of doses.

Initial doses ordered by country


Other vaccines
Moderna and Pfizer/BioNTech

Now, the vaccine candidates must prove themselves. We’re tracking the candidates closest to producing results and a few that represent promising new technologies to watch.

Vaccine details

Information about individual vaccine candidates' technology and latest reported results.

Phase 1/2

ARCT-021

Arcturus Therapeutics-Duke NUS

United States

RNA

LATEST RESULTS

Not yet reported


Age range:

21-55, 56-80

Doses trialed:

1

Immune response:

Not yet reported

Side effects:

Not yet reported

OTHER DETAILS


Prior licensed vaccines:

No

Prior trials:

No

Technology:

Self-replicating RNA + LNPs

Advance orders: Israel, Singapore

Concurrent Phase 1/2; 2/3

AZD1222

AstraZeneca-Oxford

United Kingdom

Viral vector

LATEST RESULTS

Nov. 23; Phase 3


Age range:

18+

Doses trialed:

2 ("at least one month apart")

Immune response:

62%-90% efficacy

Side effects:

Mild

OTHER DETAILS


Prior licensed vaccines:

No

Prior trials:

MERS, Chikungunya, Flu, Hep B, Malaria, RSV, TB, Zika, Prostate cancer

Technology:

Nonreplicating chimpanzee adenovirus vector

Advance orders: Australia, Brazil, Canada, COVAX, Ecuador, EU, France, Germany, India, Israel, Italy, Japan, Morocco, Netherlands, Panama, Spain, UK, U.S.

Phase 2/3

Ad5-nCov

CanSino Biologics

China

Viral vector

LATEST RESULTS

July 20; Phase 2


Age range:

18+

Doses trialed:

1

Immune response:

High

Side effects:

9% severe

OTHER DETAILS


Prior licensed vaccines:

Ebola

Prior trials:

Technology:

Nonreplicating adenovirus vector

Advance orders: Mexico

Phase 1/2

CVnCoV

CureVac AG

Germany

RNA

LATEST RESULTS

Nov. 2; Phase 1


Age range:

18-60

Doses trialed:

1 or 2 (0 and 29 days)

Immune response:

Moderate

Side effects:

Mild to moderate

OTHER DETAILS


Prior licensed vaccines:

No

Prior trials:

Rabies

Technology:

mRNA + LNPs

Advance orders: COVAX, EU

Phase 3

Sputnik V

Gamaleya Research Institute

Russian Federation

Viral vector

LATEST RESULTS

Sep 4; Phase 2


Age range:

18-60

Doses trialed:

2 (0 and 21 days)

Immune response:

Moderate

Side effects:

Mild

OTHER DETAILS


Prior licensed vaccines:

Ebola

Prior trials:

MERS, Flu

Technology:

Nonreplicating adenovirus vectors

Advance orders: Bahia, Brazil; Egypt; India; Mexico; Nepal; Uzbekistan; Vietnam

Concurrent Phase 1/2; 3

INO-4800

Inovio-CEPI

United States

DNA

LATEST RESULTS

Not yet reported


Age range:

Not yet reported

Doses trialed:

1

Immune response:

Not yet reported

Side effects:

Not yet reported

OTHER DETAILS


Prior licensed vaccines:

No

Prior trials:

Ebola, Flu, Lassa, MERS

Technology:

DNA plasmid

Advance orders: COVAX

Concurrent phase 1/2; 3

Ad26 SARS-CoV-2

Johnson & Johnson-BARDA-Janssen

United States

Viral vector

LATEST RESULTS

Sept. 25; Phase 1/2


Age range:

18-55, 65+

Doses trialed:

1 or 2 (0 and 58 days)

Immune response:

Moderate

Side effects:

Mild

OTHER DETAILS


Prior licensed vaccines:

Ebola

Prior trials:

HIV, RSV, Zika

Technology:

Nonreplicating adenovirus vector

Advance orders: Canada, COVAX, EU, UK, U.S.

Phase 2

CoVLP

Medicago-GSK-Dynavax

Canada

Virus-like particle

LATEST RESULTS

Nov. 6; Phase 1


Age range:

18-55

Doses trialed:

2 (0 and 21 days)

Immune response:

Moderate-High

Side effects:

Mild to moderate

OTHER DETAILS


Prior licensed vaccines:

No

Prior trials:

Flu

Technology:

VLP + adjuvant

Advance orders: Canada

Phase 1/2

V591

Merck-IAVI-BARDA

Multinational

Viral vector

LATEST RESULTS

Not yet reported


Age range:

18-55; 60+

Doses trialed:

2 (0 and 57 days)

Immune response:

Not yet reported

Side effects:

Not yet reported

OTHER DETAILS


Prior licensed vaccines:

Ebola, Marburg, Lassa

Prior trials:

HIV

Technology:

Replicating vesicular stomatitis virus vector

Advance orders:

Phase 1/2

TMV-083

Merck-Themis

Multinational

Viral vector

LATEST RESULTS

Not yet reported


Age range:

18-55; 60+

Doses trialed:

1 or 2

Immune response:

Not yet reported

Side effects:

Not yet reported

OTHER DETAILS


Prior licensed vaccines:

No

Prior trials:

Chikunguya, Ebola, HIV, Lassa, West Nile, Zika

Technology:

Replicating measles vector

Advance orders: COVAX

Concurrent phase 1; 2; 3

mRNA-1273

Moderna-NIAID

United States

RNA

LATEST RESULTS

Nov. 16; Phase 3


Age range:

56-70, 70+

Doses trialed:

2 (0 and 28 days)

Immune response:

94.1% efficacy

Side effects:

Mild to moderate

OTHER DETAILS


Prior licensed vaccines:

No

Prior trials:

Cytomegalovirus, Zika

Technology:

mRNA + LNPs

Advance orders: Canada, COVAX, EU, Israel, Japan, Netherlands, Qatar, UK, U.S.

Concurrent phase 1/2; 3

NVX-CoV2373

Novavax

United States

Protein subunit

LATEST RESULTS

Sep 2; Phase 1/2


Age range:

18-59

Doses trialed:

2 (0 and 21 days)

Immune response:

High

Side effects:

Mild

OTHER DETAILS


Prior licensed vaccines:

No

Prior trials:

RSV, Flu, Ebola, HPV, VZV

Technology:

Antigen + adjuvant

Advance orders: Australia, Canada, COVAX, Japan, UK, U.S.

Concurrent phase 1/2; 2/3

BNT162

Pfizer-BioNtech

Multinational

RNA

LATEST RESULTS

Nov. 18; Phase 3


Age range:

18-55 , 65-85

Doses trialed:

2 (0 and 21 days)

Immune response:

95% efficacy

Side effects:

Mild to moderate

OTHER DETAILS


Prior licensed vaccines:

No

Prior trials:

Flu

Technology:

mRNA + LNPs

Advance orders: Bahrain, Canada, Chile, Ecuador, EU, Israel, Japan, Mexico, Netherlands, Panama, Peru, Spain, Switzerland, UK, U.S.

Phase 1/2

S protein (baculovirus production)

Sanofi-GSK

Multinational

Protein subunit

LATEST RESULTS

Not yet reported


Age range:

18-49; 50+

Doses trialed:

1 or 2 (0 and 21 days)

Immune response:

Not yet reported

Side effects:

Not yet reported

OTHER DETAILS


Prior licensed vaccines:

Flu

Prior trials:

Multiple

Technology:

Antigen + adjuvant

Advance orders: Canada, EU, UK, U.S.

Concurrent phase 1/2; 3

BBIBP-CorV

Sinopharm-Beijing Inst.of Biological Products

China

Inactivated virus

LATEST RESULTS

Aug 13; Phase 1/2


Age range:

18-59

Doses trialed:

2 (0 and 14 or 21 days)

Immune response:

Moderate

Side effects:

Mild to moderate

OTHER DETAILS


Prior licensed vaccines:

N/A

Prior trials:

N/A

Technology:

Inactivated virus + adjuvant

Advance orders: Morocco

Concurrent Phase 1/2; 3

CoronaVac

Sinovac-Instituto Buntantan

China/Brazil

Inactivated virus

LATEST RESULTS

Nov. 17; Phase 1/2


Age range:

18-59

Doses trialed:

2 (0 and 14 days)

Immune response:

Low

Side effects:

Mild

OTHER DETAILS


Prior licensed vaccines:

Multiple

Prior trials:

SARS-CoV-1

Technology:

Inactivated virus

Advance orders: Brazil, Indonesia

Sources

Reuters reporting, companies, Vaccine Centre at the London School of Hygiene and Tropical Medicine, WHO

Reporting and writing by Christine Soares

Graphics, design and development by Travis Hartman

Illustrations by Ally Levine