Perspective: Finding the fastest pathway to COVID-19 vaccine development

When seeking the fastest pathway to a vaccine to prevent coronavirus disease 19 (COVID-19), defining the stakes and potential hurdles is critical, says Barney Graham in this Perspective. Because the human population is naïve to the virus that causes coronavirus disease 19 (COVID-19), the consequences of repeated epidemics will be unacceptably high, he writes. Therefore, the benefit of developing an effective vaccine is very great, and even greater if it can be deployed in time to prevent repeated or continuous epidemics.

Finding the fastest pathway to vaccine availability includes the avoidance of safety pitfalls, with lessons learned from history. Although the potential risk of vaccine-induced antibody or T cell responses leading to adverse responses to natural SARS-CoV-2 infection should be carefully evaluated, Graham says, there is also a risk of delaying clinical trials in favor of prolonged evaluation of vaccines in animal models that do not fully recapitulate the pathogenesis of disease in humans. This happened with the respiratory syncytial virus vaccine, Graham notes. Judicious evaluation of candidate vaccines in healthy adults, in parallel with vaccine studies in animal models and coincident process development to scale-up production capacity, provides a path forward with minimal risk, and potentially tremendous benefit, to human subjects, he says.