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Khuroo MS, Khuroo M, Khuroo MS, Sofi AA, Khuroo NS. COVID-19 Vaccines: A Race Against Time in the Middle of Death and Devastation! J Clin Exp Hepatol 2020; 10:610-621. [PMID: 32837093 PMCID: PMC7286271 DOI: 10.1016/j.jceh.2020.06.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 06/05/2020] [Indexed: 12/12/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) has turned into a global human tragedy and economic devastation. Governments have implemented lockdown measures, blocked international travel, and enforced other public containment measures to mitigate the virus morbidity and mortality. As of today, no drug has the power to fight the infection and bring normalcy to the utter chaos. This leaves us with only one choice namely an effective and safe vaccine that shall be manufactured as soon as possible and available to all countries and populations affected by the pandemic at an affordable price. There has been an unprecedented fast track path taken in Research & Development by the World community for developing an effective and safe vaccine. Platform technology has been exploited to develop candidate vaccines in a matter of days to weeks, and as of now, 108 such vaccines are available. Six of these vaccines have entered clinical trials. As clinical trials are "rate-limiting" and "time-consuming", many innovative methods are in practice for a fast track. These include parallel phase I-II trials and obtaining efficacy data from phase IIb trials. Human "challenge experiments" to confirm efficacy in humans is under serious consideration. The availability of the COVID-19 vaccine has become a race against time in the middle of death and devastation. There is an atmosphere of tremendous hype around the COVID-19 vaccine, and developers are using every moment to make claims, which remain unverified. However, concerns are raised about a rush to deploy a COVID-19 vaccine. Applying "Quick fix" and "short cuts" can lead to errors with disastrous consequences.
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Affiliation(s)
- Mohammad S. Khuroo
- Medicine, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, India
- Digestive Diseases Centre, Dr. Khuroo's Medical Clinic, Srinagar, J&K(UT), India
| | | | - Mehnaaz S. Khuroo
- Pathology, Government Medical College, Srinagar, Kashmir, J&K (UT), 190010, India
| | | | - Naira S. Khuroo
- Gastroenterology and Liver Transplantation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Medical Imaging & Radiology, KFSH&RC, Riyadh, Saudi Arabia
- Digestive Diseases Centre, Dr. Khuroo's Medical Clinic, Sector 1, SK Colony, Qamarwari, Srinagar, Kashmir, J&K (UT), 190010, India
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52
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Chung YH, Beiss V, Fiering SN, Steinmetz NF. COVID-19 Vaccine Frontrunners and Their Nanotechnology Design. ACS NANO 2020; 14:12522-12537. [PMID: 33034449 PMCID: PMC7553041 DOI: 10.1021/acsnano.0c07197] [Citation(s) in RCA: 218] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/05/2020] [Indexed: 05/18/2023]
Abstract
Humanity is experiencing a catastrophic pandemic. SARS-CoV-2 has spread globally to cause significant morbidity and mortality, and there still remain unknowns about the biology and pathology of the virus. Even with testing, tracing, and social distancing, many countries are struggling to contain SARS-CoV-2. COVID-19 will only be suppressible when herd immunity develops, either because of an effective vaccine or if the population has been infected and is resistant to reinfection. There is virtually no chance of a return to pre-COVID-19 societal behavior until there is an effective vaccine. Concerted efforts by physicians, academic laboratories, and companies around the world have improved detection and treatment and made promising early steps, developing many vaccine candidates at a pace that has been unmatched for prior diseases. As of August 11, 2020, 28 of these companies have advanced into clinical trials with Moderna, CanSino, the University of Oxford, BioNTech, Sinovac, Sinopharm, Anhui Zhifei Longcom, Inovio, Novavax, Vaxine, Zydus Cadila, Institute of Medical Biology, and the Gamaleya Research Institute having moved beyond their initial safety and immunogenicity studies. This review analyzes these frontrunners in the vaccine development space and delves into their posted results while highlighting the role of the nanotechnologies applied by all the vaccine developers.
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Affiliation(s)
- Young Hun Chung
- Department of Bioengineering, University
of California San Diego, La Jolla, California 92093, United
States
| | - Veronique Beiss
- Department of NanoEngineering, University
of California San Diego, La Jolla, California 92093, United
States
| | - Steven N. Fiering
- Geisel School of Medicine, Dartmouth
College, Hanover, New Hampshire 03755, United
States
- Norris Cotton Cancer Center,
Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03766,
United States
| | - Nicole F. Steinmetz
- Department of Bioengineering, University
of California San Diego, La Jolla, California 92093, United
States
- Department of NanoEngineering, University
of California San Diego, La Jolla, California 92093, United
States
- Department of Radiology, University of
California San Diego, La Jolla, California 92093, United
States
- Moores Cancer Center, University of California
San Diego, La Jolla, California 92093, United
States
- Center for Nano-ImmunoEngineering,
University of California San Diego, La Jolla, California
92093, United States
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53
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Stanica IC, Moldoveanu F, Portelli GP, Dascalu MI, Moldoveanu A, Ristea MG. Flexible Virtual Reality System for Neurorehabilitation and Quality of Life Improvement. SENSORS (BASEL, SWITZERLAND) 2020; 20:E6045. [PMID: 33114272 PMCID: PMC7672612 DOI: 10.3390/s20216045] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/14/2020] [Accepted: 10/21/2020] [Indexed: 11/16/2022]
Abstract
As life expectancy is mostly increasing, the incidence of many neurological disorders is also constantly growing. For improving the physical functions affected by a neurological disorder, rehabilitation procedures are mandatory, and they must be performed regularly. Unfortunately, neurorehabilitation procedures have disadvantages in terms of costs, accessibility and a lack of therapists. This paper presents Immersive Neurorehabilitation Exercises Using Virtual Reality (INREX-VR), our innovative immersive neurorehabilitation system using virtual reality. The system is based on a thorough research methodology and is able to capture real-time user movements and evaluate joint mobility for both upper and lower limbs, record training sessions and save electromyography data. The use of the first-person perspective increases immersion, and the joint range of motion is calculated with the help of both the HTC Vive system and inverse kinematics principles applied on skeleton rigs. Tutorial exercises are demonstrated by a virtual therapist, as they were recorded with real-life physicians, and sessions can be monitored and configured through tele-medicine. Complex movements are practiced in gamified settings, encouraging self-improvement and competition. Finally, we proposed a training plan and preliminary tests which show promising results in terms of accuracy and user feedback. As future developments, we plan to improve the system's accuracy and investigate a wireless alternative based on neural networks.
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Affiliation(s)
- Iulia-Cristina Stanica
- Department of Engineering in Foreign Languages, University Politehnica of Bucharest, 060042 Bucharest, Romania;
- Computer Science and Engineering Department, University Politehnica of Bucharest, 060042 Bucharest, Romania; (F.M.); (A.M.)
| | - Florica Moldoveanu
- Computer Science and Engineering Department, University Politehnica of Bucharest, 060042 Bucharest, Romania; (F.M.); (A.M.)
| | - Giovanni-Paul Portelli
- Department 4, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Maria-Iuliana Dascalu
- Department of Engineering in Foreign Languages, University Politehnica of Bucharest, 060042 Bucharest, Romania;
| | - Alin Moldoveanu
- Computer Science and Engineering Department, University Politehnica of Bucharest, 060042 Bucharest, Romania; (F.M.); (A.M.)
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Sharma O, Sultan AA, Ding H, Triggle CR. A Review of the Progress and Challenges of Developing a Vaccine for COVID-19. Front Immunol 2020; 11:585354. [PMID: 33163000 PMCID: PMC7591699 DOI: 10.3389/fimmu.2020.585354] [Citation(s) in RCA: 288] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 08/31/2020] [Indexed: 12/11/2022] Open
Abstract
A novel coronavirus, which has been designated as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first detected in December 2019 in Wuhan China and causes the highly infectious disease referred to as COVID-19. COVID-19 has now spread worldwide to become a global pandemic affecting over 24 million people as of August 26th, 2020 and claimed the life of more than 800,000 people worldwide. COVID-19 is asymptomatic for some individuals and for others it can cause symptoms ranging from flu-like to acute respiratory distress syndrome (ARDS), pneumonia and death. Although it is anticipated that an effective vaccine will be available to protect against COVID-19, at present the world is relying on social distancing and hygiene measures and repurposed drugs. There is a worldwide effort to develop an effective vaccine against SARS-CoV-2 and, as of late August 2020, there are 30 vaccines in clinical trials with over 200 in various stages of development. This review will focus on the eight vaccine candidates that entered Phase 1 clinical trials in mid-May, including AstraZeneca/Oxford's AZD1222, Moderna's mRNA-1273 and Sinovac's CoronaVac vaccines, which are currently in advanced stages of vaccine development. In addition to reviewing the different stages of vaccine development, vaccine platforms and vaccine candidates, this review also discusses the biological and immunological basis required of a SARS-CoV-2 vaccine, the importance of a collaborative international effort, the ethical implications of vaccine development, the efficacy needed for an immunogenic vaccine, vaccine coverage, the potential limitations and challenges of vaccine development. Although the demand for a vaccine far surpasses the production capacity, it will be beneficial to have a limited number of vaccines available for the more vulnerable population by the end of 2020 and for the rest of the global population by the end of 2021.
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Affiliation(s)
| | - Ali A. Sultan
- Department of Microbiology and Immunology, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
| | - Hong Ding
- Departments of Medical Education and Pharmacology, Weill Cornell Medicine-Qatar, Education City, Doha, Qatar
| | - Chris R. Triggle
- Departments of Medical Education and Pharmacology, Weill Cornell Medicine-Qatar, Education City, Doha, Qatar
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Goldman RD, Marneni SR, Seiler M, Brown JC, Klein EJ, Cotanda CP, Gelernter R, Yan TD, Hoeffe J, Davis AL, Griffiths MA, Hall JE, Gualco G, Mater A, Manzano S, Thompson GC, Ahmed S, Ali S, Shimizu N. Caregivers' Willingness to Accept Expedited Vaccine Research During the COVID-19 Pandemic: A Cross-sectional Survey. Clin Ther 2020; 42:2124-2133. [PMID: 33067013 PMCID: PMC7532744 DOI: 10.1016/j.clinthera.2020.09.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/11/2020] [Accepted: 09/22/2020] [Indexed: 01/01/2023]
Abstract
Purpose This study determined the predictors of caregivers' willingness to accept an accelerated regulatory process for the development of vaccines against coronavirus disease 2019 (COVID-19). Methods An international cross-sectional survey was administered to 2557 caregivers of children in 17 pediatric emergency departments (EDs) across 6 countries from March 26, 2020, to June 30, 2020. Caregivers were asked to select 1 of 4 choices with which they most agreed regarding a proposed COVID-19 vaccine–approval process, in addition to questions regarding demographic characteristics, the ED visit, and attitudes about COVID-19. Univariate analyses were conducted using the Mann–Whitney U test for comparing non–normally distributed continuous variables, an independent t test for comparing normally distributed continuous variables, and a χ2 or Fisher exact test for categorical variables. Multivariate logistic regression analysis was used for determining independent factors associated with caregivers' willingness to accept abridged development of a COVID-19 vaccine. A P value of <0.05 was considered significant. Findings Almost half (1101/2557; 43%) of caregivers reported that they were willing to accept less rigorous testing and postresearch approval of a new COVID-19 vaccine. Independent factors associated with caregivers' willingness to accept expedited COVID-19 vaccine research included having children who were up to date on the vaccination schedule (odds ratio [OR] = 1.72; 95% CI, 1.29–2.31), caregivers' concern about having had COVID-19 themselves at the time of survey completion in the ED (OR = 1.1; 95% CI, 1.05–1.16), and caregivers' intent to have their children vaccinated against COVID-19 if a vaccine were to become available (OR = 1.84; 95% CI, 1.54–2.21). Compared with fathers, mothers completing the survey were less likely to approve of changes in the vaccine-development process (OR = 0.641; 95% CI, 0.529–0.775). Implications Less than half of caregivers in this worldwide sample were willing to accept abbreviated COVID-19 vaccine testing. As a part of an effort to increase acceptance and uptake of a new vaccine, especially in order to protect children, public health strategies and individual providers should understand caregivers' attitudes toward the approval of a vaccine and consult them appropriately. Half of caregivers accept an abridged process for rapid COVID-19 vaccine approval. Seeking fast approval associated with caregiver’s gender, intent to vaccinate child. Concern about own COVID-19 infection associated with preferring expedited approval.
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Affiliation(s)
- Ran D Goldman
- The Pediatric Research in Emergency Therapeutics Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
| | - Shashidhar R Marneni
- Department of Pediatric Emergency Medicine, Children's Medical Center of Dallas, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Michelle Seiler
- Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland
| | - Julie C Brown
- Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Eileen J Klein
- Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | | | - Renana Gelernter
- Pediatric Emergency Medicine Unit, Shamir Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tyler D Yan
- The Pediatric Research in Emergency Therapeutics Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Julia Hoeffe
- Division of Pediatric Emergency Medicine, Inselspital University Hospital of Bern, Bern, Switzerland
| | - Adrienne L Davis
- Division of Pediatric Emergency Medicine, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Mark A Griffiths
- Division of Pediatric Emergency Medicine, Children's Healthcare of Atlanta, Emory School of Medicine, Atlanta, GA, USA
| | - Jeanine E Hall
- Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Gianluca Gualco
- Pediatric Emergency Department, Pediatric Institute of Italian Part of Switzerland, Ticino, Switzerland
| | - Ahmed Mater
- Division of Pediatric Emergency Medicine, Jim Pattison Children's Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sergio Manzano
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Graham C Thompson
- Division of Pediatrics and Emergency Medicine, Alberta Children's Hospital and University of Calgary, Calgary, Alberta, Canada
| | - Sara Ahmed
- Department of Emergency Medicine, Mary Bridge Children's Hospital, Tacoma, WA, USA
| | - Samina Ali
- Department of Pediatrics, Faculty of Medicine and Dentistry, Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Naoki Shimizu
- Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan
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56
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Spinola SM, Zimet GD, Ott MA, Katz BP. Human Challenge Studies Are Unlikely to Accelerate Coronavirus Vaccine Licensure Due to Ethical and Practical Issues. J Infect Dis 2020; 222:1572-1574. [PMID: 32845303 PMCID: PMC7499586 DOI: 10.1093/infdis/jiaa457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 07/21/2020] [Indexed: 01/05/2023] Open
Affiliation(s)
- Stanley M Spinola
- Department of Microbiology and Immunology, Indiana University School of
Medicine, Indiana University, Indianapolis, Indiana, USA
- Department of Medicine, Indiana University School of Medicine, Indiana
University, Indianapolis, Indiana, USA
- Department of Pathology and Laboratory Medicine, Indiana University School of
Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Gregory D Zimet
- Department of Pediatrics, Indiana University School of Medicine, Indiana
University, Indianapolis, Indiana, USA
| | - Mary A Ott
- Department of Pediatrics, Indiana University School of Medicine, Indiana
University, Indianapolis, Indiana, USA
- Center for Bioethics, Indiana University School of Medicine, Indiana
University, Indianapolis, Indiana, USA
| | - Barry P Katz
- Department of Biostatistics, Indiana University School of Medicine, Indiana
University, Indianapolis, Indiana, USA
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Russo G, Reche P, Pennisi M, Pappalardo F. The combination of artificial intelligence and systems biology for intelligent vaccine design. Expert Opin Drug Discov 2020; 15:1267-1281. [PMID: 32662677 DOI: 10.1080/17460441.2020.1791076] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION A new body of evidence depicts the applications of artificial intelligence and systems biology in vaccine design and development. The combination of both approaches shall revolutionize healthcare, accelerating clinical trial processes and reducing the costs and time involved in drug research and development. AREAS COVERED This review explores the basics of artificial intelligence and systems biology approaches in the vaccine development pipeline. The topics include a detailed description of epitope prediction tools for designing epitope-based vaccines and agent-based models for immune system response prediction, along with a focus on their potentiality to facilitate clinical trial phases. EXPERT OPINION Artificial intelligence and systems biology offer the opportunity to avoid the inefficiencies and failures that arise in the classical vaccine development pipeline. One promising solution is the combination of both methodologies in a multiscale perspective through an accurate pipeline. We are entering an 'in silico era' in which scientific partnerships, including a more and more increasing creation of an 'ecosystem' of collaboration and multidisciplinary approach, are relevant for addressing the long and risky road of vaccine discovery and development. In this context, regulatory guidance should be developed to qualify the in silico trials as evidence for intelligent vaccine development.
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Affiliation(s)
- Giulia Russo
- Department of Drug Sciences, University of Catania , Catania, Italy
| | - Pedro Reche
- Department of Immunology, Universidad Complutense De Madrid, Ciudad Universitaria , Madrid, Spain
| | - Marzio Pennisi
- Computer Science Institute, DiSIT, University of Eastern Piedmont , Italy
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Sharpe HR, Gilbride C, Allen E, Belij-Rammerstorfer S, Bissett C, Ewer K, Lambe T. The early landscape of coronavirus disease 2019 vaccine development in the UK and rest of the world. Immunology 2020; 160:223-232. [PMID: 32460358 PMCID: PMC7283842 DOI: 10.1111/imm.13222] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 12/13/2022] Open
Abstract
Since the first World Health Organization notification on 31 December 2019, coronavirus disease 2019 (COVID‐19), the respiratory disease caused by the coronavirus severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), has been responsible for over four million confirmed infections and almost 300 000 deaths worldwide. The pandemic has led to over half of the world's population living under lockdown conditions. To allow normal life to resume, public health interventions will be needed to prevent further waves of infections as lockdown measures are lifted. As one of the most effective countermeasures against infectious diseases, an efficacious vaccine is considered crucial to containing the COVID‐19 pandemic. Following the publication of the genome sequence of SARS‐CoV‐2, vaccine development has accelerated at an unprecedented pace across the world. Here we review the different platforms employed to develop vaccines, the standard timelines of development and how they can be condensed in a pandemic situation. We focus on vaccine development in the UK and vaccines that have entered clinical trials around the world.
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Affiliation(s)
- Hannah R Sharpe
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Ciaran Gilbride
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Elizabeth Allen
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Cameron Bissett
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Katie Ewer
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Teresa Lambe
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Kis Z, Kontoravdi C, Dey AK, Shattock R, Shah N. Rapid development and deployment of high-volume vaccines for pandemic response. ACTA ACUST UNITED AC 2020; 2:e10060. [PMID: 33977274 PMCID: PMC7361221 DOI: 10.1002/amp2.10060] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/01/2020] [Accepted: 06/01/2020] [Indexed: 12/12/2022]
Abstract
Overcoming pandemics, such as the current Covid‐19 outbreak, requires the manufacture of several billion doses of vaccines within months. This is an extremely challenging task given the constraints in small‐scale manufacturing for clinical trials, clinical testing timelines involving multiple phases and large‐scale drug substance and drug product manufacturing. To tackle these challenges, regulatory processes are fast‐tracked, and rapid‐response manufacturing platform technologies are used. Here, we evaluate the current progress, challenges ahead and potential solutions for providing vaccines for pandemic response at an unprecedented scale and rate. Emerging rapid‐response vaccine platform technologies, especially RNA platforms, offer a high productivity estimated at over 1 billion doses per year with a small manufacturing footprint and low capital cost facilities. The self‐amplifying RNA (saRNA) drug product cost is estimated at below 1 USD/dose. These manufacturing processes and facilities can be decentralized to facilitate production, distribution, but also raw material supply. The RNA platform technology can be complemented by an a priori Quality by Design analysis aided by computational modeling in order to assure product quality and further speed up the regulatory approval processes when these platforms are used for epidemic or pandemic response in the future.
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Affiliation(s)
- Zoltán Kis
- Centre for Process Systems Engineering, Department of Chemical Engineering, Faculty of Engineering Imperial College London London UK
| | - Cleo Kontoravdi
- Centre for Process Systems Engineering, Department of Chemical Engineering, Faculty of Engineering Imperial College London London UK
| | - Antu K Dey
- International AIDS Vaccine Initiative (IAVI) New York New York USA
| | - Robin Shattock
- Department of Infectious Disease, Faculty of Medicine Imperial College London UK
| | - Nilay Shah
- Centre for Process Systems Engineering, Department of Chemical Engineering, Faculty of Engineering Imperial College London London UK
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Abstract
The world awaits a SARS-CoV-2 virus (i.e., COVID-19 disease) vaccine to keep the populace healthy, fully reopen their economies, and return their social and healthcare systems to “normal.” Vaccine safety and efficacy requires meticulous testing and oversight; this paper describes how despite grandiose public statements, the current vaccine development, testing, and production methods may prove to be ethically dubious, medically dangerous, and socially volatile. The basic moral concern is the potential danger to the health of human test subjects and, eventually, many vaccine recipients. This is further complicated by economic and political pressures to reduce government oversight on rushed vaccine testing and production, nationalistic distribution goals, and failure to plan for the widespread immunization needed to produce global herd immunity. As this paper asserts, the public must be better informed to assess promises about the novel vaccines being produced and to tolerate delays and uncertainty.
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Khan K, Dimtri F, Vargas C, Surani S. COVID-19: A Review of Emerging Preventative Vaccines and Treatment Strategies. Cureus 2020; 12:e8206. [PMID: 32577324 PMCID: PMC7305574 DOI: 10.7759/cureus.8206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
COVID-19, which was first detected in the Hubei province of China, has become a global phenomenon. The effects and devastation on both health and economy have been global. At present, there is a substantial amount of research being done to discover suitable treatment modalities. Efforts have been made on the development of potential efficacious vaccines. The development of a vaccine can be complex, expensive as well as time-consuming. Currently, various ongoing clinical trials are in progress that are investigating either pharmacologic therapies or vaccines against this virus. We, in this brief review have tried to address the process and current development efforts of vaccine in progress.
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Affiliation(s)
- Kashmala Khan
- Internal Medicine, Corpus Christi Medical Center, Corpus Christi, USA
| | - Francis Dimtri
- Cardiology, Corpus Christi Medical Center, Corpus Christi, USA
| | - Carlos Vargas
- Internal Medicine, Corpus Christi Medical Center, Corpus Christi, USA
| | - Salim Surani
- Internal Medicine, Corpus Christi Medical Center, Corpus Christi, USA.,Internal Medicine, University of North Texas, Dallas, USA
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McHugh KJ. Employing drug delivery strategies to create safe and effective pharmaceuticals for COVID-19. Bioeng Transl Med 2020; 5:e10163. [PMID: 32440566 PMCID: PMC7235503 DOI: 10.1002/btm2.10163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 12/28/2022] Open
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63
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Abu-Farha RK, Alzoubi KH, Khabour OF. Public Willingness to Participate in COVID-19 Vaccine Clinical Trials: A Study from Jordan. Patient Prefer Adherence 2020; 14:2451-2458. [PMID: 33363361 PMCID: PMC7754261 DOI: 10.2147/ppa.s284385] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 11/20/2020] [Indexed: 12/28/2022] Open
Abstract
PURPOSE The development and production of novel vaccine to prevent COVID-19 is an international imperative to human lives. For that purpose, clinical trials have to be carried out as per international ethical standards. The current study was undertaken to examine the willingness to participate in COVID-19 vaccine clinical trials and to determine factors that might affect their decision to participate. PATIENTS AND METHODS A cross-sectional survey study was carried out among the public in Jordan. During the study period, a convenience sample of adults (aged 18 years or above) were asked to participate via an online self-administered survey that was designed to evaluate the willingness to participate in COVID-19 vaccine clinical trials and to determine factors affecting their decision to participate. RESULTS Results showed that, among participants (n=1,287), 36.1% reported to be willing to participate in clinical trials of the vaccine. Additionally, a lower percentage (18.1%) were willing to allow their children to participate. Motivators that encourage participation were the desire to return to normal life (73.2%), followed by the desire to help in finding a treatment for COVID-19 infection (68.1%). Barriers towards the participation were not wanting to be challenged by the virus (54.7%), fear (40.7%), lack of time (40.4%), and mistrust in pharmaceutical companies (38.9%). Finally, results showed that higher educational level was associated with lower willingness to participate (P=0.001), whereas having a previous participation in clinical studies is associated with a significantly higher willingness to participate in COVID-19 vaccine clinical trials (P<0.001). CONCLUSION A good portion of Jordanians are positive regarding participation in clinical studies of COVID-19 vaccine. Educational level and previous participation in clinical studies were among the determinants of such willingness. In addition, fear and lack of time were among the barriers of participation.
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Affiliation(s)
- Rana K Abu-Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
- Correspondence: Rana K Abu-FarhaDepartment of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman11931, JordanTel +96265609957 ext 1496Fax +9625232899 Email
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid22110, Jordan
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid22110, Jordan
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Pincinato EC, Costa EFD, Lopes-Aguiar L, Nogueira GAS, Lima TRP, Visacri MB, Costa APL, Lourenço GJ, Calonga L, Mariano FV, Altemani AMAM, Coutinho-Camillo C, Chone CT, Ramos CD, Altemani JMC, Moriel P, Lima CSP. GSTM1, GSTT1 and GSTP1 Ile105Val polymorphisms in outcomes of head and neck squamous cell carcinoma patients treated with cisplatin chemoradiation. Sci Rep 2019; 9:9312. [PMID: 31249357 PMCID: PMC6597539 DOI: 10.1038/s41598-019-45808-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 06/14/2019] [Indexed: 01/09/2023] Open
Abstract
Cisplatin (CDDP) combined with radiotherapy (RT) is employed in head and neck squamous cell carcinoma (HNSCC) with variable toxicities and clinical response. Glutathione S-transferases (GSTs) participate in CDDP excretion from cells, and genes encoding GSTs, GSTM1, GSTT1and GSTP1, are polymorphic in humans. This prospective study aimed to evaluate the roles of GSTM1, GSTT1, and GSTP1 Ile105Val polymorphisms in outcomes of HNSCC patients treated with CDDP chemoradiation. Ninety patients were genotyped by multiplex PCR. Urinary CDDP measurements were performed by HPLC. Treatment side effects and response were analysed by conventional criteria. Patients with GSTT1 genes showed 7.23- and 5.37-fold higher likelihood of presenting vomiting and ototoxicity, lower glomerular filtration rate (GFR), and lower elimination of CDDP in urine relative to patients with deleted genes. Patients harbouring the GSTP1 IleVal or ValVal genotypes showed 4.28-fold higher likelihood of presenting grade 2 or 3 vomiting and lower GFR with treatment than those harbouring the IleIle genotype. In multivariate Cox analysis, patients with the GSTP1 105ValVal genotype had 3.87 more chance of presenting disease progression than those with the IleIle or IleVal genotype (p < 0.01). Our findings provide preliminary evidence that inherited abnormalities in CDDP metabolism, related to GSTT1 and GSTP1 Ile105Val polymorphisms, alter outcomes of HNSCC patients treated with CDDP and RT.
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Affiliation(s)
- Eder C Pincinato
- Clinical Oncology Service, Department of Internal Medicine, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
- Health and Biological Science Center, Faculty of Pharmacy, Mackenzie Presbyterian University, São Paulo, São Paulo, Brazil
| | - Ericka F D Costa
- Clinical Oncology Service, Department of Internal Medicine, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Leisa Lopes-Aguiar
- Clinical Oncology Service, Department of Internal Medicine, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Guilherme A S Nogueira
- Clinical Oncology Service, Department of Internal Medicine, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Tathiane R P Lima
- Clinical Oncology Service, Department of Internal Medicine, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Marília B Visacri
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Anna P L Costa
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Gustavo J Lourenço
- Laboratory of Cancer Genetics, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Luciane Calonga
- Department of Ophthalmology and Otolaryngology, School of Medical Sciences, University of Campinas, University of Campinas, Campinas, São Paulo, Brazil
| | - Fernanda V Mariano
- Department of Pathology, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Albina M A M Altemani
- Department of Pathology, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | | | - Carlos T Chone
- Department of Ophthalmology and Otolaryngology, School of Medical Sciences, University of Campinas, University of Campinas, Campinas, São Paulo, Brazil
| | - Celso D Ramos
- Department of Radiology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - João M C Altemani
- Department of Radiology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Patrícia Moriel
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Carmen S P Lima
- Clinical Oncology Service, Department of Internal Medicine, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.
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Rolling KE, Hayney MS. The vaccine development process. J Am Pharm Assoc (2003) 2018; 56:687-689. [PMID: 27836129 DOI: 10.1016/j.japh.2016.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 09/29/2016] [Indexed: 01/05/2023]
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Jairaj A, Shirisha P, Abdul MSM, Fatima U, Tiwari RVC, Moothedath M. Adult Immunization - Need of the Hour. J Int Soc Prev Community Dent 2018; 8:475-481. [PMID: 30596036 PMCID: PMC6280562 DOI: 10.4103/jispcd.jispcd_347_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 10/16/2018] [Indexed: 11/15/2022] Open
Abstract
Immunization is the process of making individuals immune. Childhood immunization is a common process for various aliments, but adult immunization in the Indian scenario is obscure. Officially, India has been declared polio-free, which is an achievement despite cultural, political, economic, geographic, and so many other factors. The changing demographics of adult, geriatric population and growing cost of health-care maintenance are a concern in developing countries like India. Thus, promoting healthy lifestyle needs prevention, early detection, and management of various diseases and disorders. Certainly, prevention in adults is yet to be tapped completely, so that goal of 100% prevention can be achieved. Various fraternities of medical association have come up with guidelines for adult immunization schedules in India. The present paper reviews infectious diseases such as anthrax, chikungunya, cholera, dengue, influenza, and malaria in this section of the review. We humbly request all health-care professionals and educators to educate the mass for adult immunization. So that, cost involved for treatment and workforce for the management of diseases can be better utilized in some other needed areas.
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Affiliation(s)
| | - P Shirisha
- Department of Humanities and Social Sciences, IIT Madras, Chennai, Tamil Nadu, India
| | | | - Urooj Fatima
- Skin and Laser Care Centre, Dr. Sulaiman Al Habib Hospital, Riyadh, Saudi Arabia
| | - Rahul Vinay Chandra Tiwari
- Department of Oral and Maxillofacial Surgery and Dentistry, Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala, India
| | - Muhamood Moothedath
- Department of Public Health Dentistry, College of Applied Health Sciences in Ar Rass, Qassim University, Buraydah, Saudi Arabia
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Meningococcal Vaccines: Current Status and Emerging Strategies. Vaccines (Basel) 2018; 6:vaccines6010012. [PMID: 29495347 PMCID: PMC5874653 DOI: 10.3390/vaccines6010012] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 02/21/2018] [Accepted: 02/23/2018] [Indexed: 12/13/2022] Open
Abstract
Neisseria meningitidis causes most cases of bacterial meningitis. Meningococcal meningitis is a public health burden to both developed and developing countries throughout the world. There are a number of vaccines (polysaccharide-based, glycoconjugate, protein-based and combined conjugate vaccines) that are approved to target five of the six disease-causing serogroups of the pathogen. Immunization strategies have been effective at helping to decrease the global incidence of meningococcal meningitis. Researchers continue to enhance these efforts through discovery of new antigen targets that may lead to a broadly protective vaccine and development of new methods of homogenous vaccine production. This review describes current meningococcal vaccines and discusses some recent research discoveries that may transform vaccine development against N. meningitidis in the future.
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