Although more than 40 organizations are developing the COVID-19 vaccine, only three have made it to human testing.

Leading the way is Kaiser Permanente Washington Research Institute in Seattle, which began testing 45 healthy adult volunteers earlier this month. The other two front-runners are the Beijing Institute of Biotech and CanSino Biologics, and the University of Oxford in the United Kingdom. 

University of Washington vaccinologist Deborah Fuller. (GeekWire Photo / Todd Bishop)

“With all these vaccines, people become confused and say, ‘Well, which one is it going to be?’” said Deborah Fuller, vaccinologist and professor of microbiology at the University of Washington School of Medicine. “We’re going to need multiple vaccines to be able to fully stop the pandemic.”

One reason is that patients will react to the vaccine differently, Fuller said. For example, a vaccine that works well in young adults may not be as effective among older populations or for people with underlying health conditions. 

As of Monday, the virus has infected more than 1 million people worldwide and killed over 74,000 people, including nearly 11,000 in the U.S., according to Johns Hopkins University.

Politics will play a role once a vaccine is developed, Fuller said. If the United States is the first to roll out a vaccine, it would likely be distributed in the U.S. before negotiating licenses and costs with other countries. Same goes for China or other parts of the world that may develop their vaccines first. 

Ideally, the vaccines will be free to the American public and covered by insurance companies, much like flu vaccines, Fuller said. The more vaccines make it to market, the greater chance for lower costs. 

“I think that’s going to be really important for the population, but especially for developing countries, that the cost of vaccines be as low as possible,” Fuller added. 

Fuller’s lab at the University of Washington is one of many across the U.S. developing vaccines or drug therapies for COVID-19. Her most promising RNA vaccine is being tested on monkeys and may soon advance to clinical testing. 

A research team led by Kaiser Permanente’s Lisa Jackson is the first in the U.S. to study the effectiveness of Boston-based biotech Moderna’s mRNA-1273 vaccine. Phase I of the clinical trial uses an inactive fragment of messenger RNA, a genetic code that can help trigger an immune response and fight infection.

“Even though that vaccine came from Boston, it’s the researchers and scientists in Seattle who are getting to study it for the first time,” Fuller said. “So, I think Seattle is evolving. It might end up being the epicenter for future pandemic preparedness.”

Prior to the pandemic, it typically takes at least three to four years to go from discovering a vaccine to beginning clinical trials, Fuller added. 

Since Moderna was already developing a vaccine for other infectious diseases, including some in the coronavirus family, the company modified its existing technology platform to include SARS-CoV-2 that causes the novel coronavirus. 

Researchers hope to have the mRNA-1273 vaccine ready as early as fall 2020 for vulnerable groups, especially health care workers. Phase I of the study is projected to be done by June 2021.

Apart from vaccines, other promising treatments in the U.S. include using cell-based therapy to make use of natural killer cells, which play a key role in the body’s natural defense against viral infections. Seattle’s Infectious Disease Research Institute and a New Jersey company called Celularity were cleared by the Food and Drug Administration last week to begin their trials.

Other treatments being tested include antiviral remdesivir, developed by Gilead Sciences, and the anti-malaria drug hydroxychloroquine.

Internationally, the Beijing Institute of Biotech and CanSino Biologics are the second to bring a vaccine to human trials. The Ad5-nCoV vaccine uses a virus that has been engineered to remove infectious properties and potentially create a strong immune response. A similar vaccine was used to treat Ebola.

Phase I of testing is being conducted at the Hubei Provincial Center for Disease Control and Prevention on 108 healthy adult volunteers who will receive one of three doses. Officials hope to conclude safety testing by December 2020, and all testing by 2022.

The University of Oxford is the third to bring its vaccine into human trials. The ChAdOx1 vaccine uses a non-infectious virus made up of genetic material found in the novel coronavirus. Officials are recruiting 510 health volunteers, and hope to complete testing by May 2021.

“It’s a race to find a cure, but not a race against each other,” Fuller said. “So, when you hear all these reports about all these vaccines started and all of these clinical trials, that’s a really, really good thing.”

Hear more from Deborah Fuller on this recent episode of the GeekWire Health Tech podcast.

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