Understanding the Oxford COVID-19 Vaccine
by Rasa Audejaitis
Overview
Living in the midst of a pandemic is a truly unprecedented experience.
With the abundance of news and ever changing headlines, it can be difficult to tune into information. Understanding this information becomes and even greater task when most of it is put out in scholarly articles that are difficult to read and comprehend.
The following will provide a clearer and simpler description of the Oxford COVID-19 Vaccine development. There will also be reflection questions to help think about this project.
Background on COVID-19 Vaccine Development
Vaccine: A suspension of killed, weakened, or fragmented microorganisms/toxins/antibodies that are given to prevent disease.
Corona Viruses: Most corona viruses only cause cold like symptoms, and even in immunocompromised individuals severe illness is rare. For this reason, there has been limited attention towards human corona viruses by researchers. More is known about animal corona viruses because of the need to protect commercially important animals. The SARS and MERS outbreaks also sparked some research into this group of viruses, but this slowed down after those outbreaks were contained.
Reflection Questions:
Why are vaccines important?
Should more attention be put into researching virus groups that are considered "not severe?"
COVID-19: Scientifically referred to as SARS-CoV-2, COVID-19 is a more aggressive strain of the corona virus. It causes a variety of symptoms but the most common are cough, fever, and shortness of breath. It turns deadly when respiratory and cardiac failure occur. The impact it has had on society shows that there is a critical need for countermeasures, such as vaccines. If a vaccine is developed, it has the possibility to diminish the effects and lower transmission of the virus, end the pandemic, and possibly prevent its return.
Structure of COVID-19: COVID-19 is roughly 120 nanometers wide; for comparison a human hair is 80,000-100,000 nanometers wide. It is made up of proteins, a lipid membrane, and viral RNA. The spike protein (S protein) looks like a crown, therefore the name "corona." The other proteins are the envelope (E protein), membrane (M protein), and nucleocapsid (N protein).
S protein: Allows for the virus to enter into cells through attachment and membrane fusion
E protein: Stimulates the curvature of the membrane
M protein: Interacts with other proteins to coordinate the virus assembly
N protein: Binds to viral genome and helps with the incorporation into the virus
Reflection Questions:
What measures besides a vaccine can society take to limit the negative impact of COVID-19?
Why are some countries more affected than the others by the virus?
Why do some face coverings work better than others?
The Oxford Vaccine
Background:
The team working on their vaccine consists of scientists from the Jenner Institute and the Oxford Vaccine Group. Both of these teams have a lot of experience in vaccine development. They also have experience in during outbreaks; they helped respond to the Ebola outbreak of 2014. The vaccine that they are working on is called ChAdOx1. They have used the same technology from that vaccine to produce other vaccines that fight against the flu, Zika and MERS. They have extensively researched and prepared the technology for ChAdOx1 in preparation for "Disease X;" COVID-19 has become "Disease X."
How ChAdOx1 Works:
The first question to ask is what does ChAdOx mean? When you break down the name of the vaccine Ch stands for Chimpanzee, Ad stands for Adenovirus, and Ox stands for Oxford. The Adenovirus that they are using causes the common cold in many chimpanzees.
The Oxford team has altered it so the virus can not grow in the human body. This makes it a very safe vaccine for those with weaker immune systems. Chimpanzee Adenovirus vaccines have been used in individuals 1 week old to 90 years old for 10 diseases. Another pro of this type of vaccine is that Adenoviruses are very well studied and have been used on thousands of subjects and have been deemed very safe.
The scientists at Oxford altered the spike protein on the Adenovirus to match the COVID-19 spike protein (S protein on Figure 1). When this Adenovirus is put into the human body the COVID-19 spike proteins are displayed and an immune response is triggered in response to that spike protein (Figure 2) . When this happens the body creates antibodies and T Cells for COVID-19. This way, if the person gets infected with the actual virus, the body can fight it faster and with less symptoms appearing.
Phase 1:
In April of 2020, the Oxford vaccine had been developed and clinical trials began. Roughly 1000 people from four cities in England received the vaccine. Participants were randomly assigned their vaccine or a control vaccine called MenACWY. The majority of the group was given one dose of the vaccine, however, a smaller 10 person group was given two doses four weeks apart (Figure 3).
Phase 2:
This phase will be used to see if the vaccine will affect varying age groups in different ways. This group will include a small number of adults and children. The children will be recruited later, after the vaccine is deemed safe for adults. The adults in this trial will be 50 years old and older and the children will range from 5-12 years old.
Phase 3:
Phase 3 is a larger scale trial that will confirm and expand on safety and effectiveness results from the previous trials. This is the only trial that will be conducted both inside and outside of the United Kingdom. They are enrolling 30,000 patients in this trial; this is way more than their previous two trials and will be more accurate due to an increase in the number of people they are getting data from. All of the people in this trial will be 18 years or older.
Reflection Questions:
Why is it important to build factories right as clinical trials start?
Why is it important to test the vaccine on children? Do you think this is ethical?
Why are control groups necessary?
Early Results:
The early results have been very promising. There are no early safety concerns and the vaccine creates a strong response from the immune system. The only negative side effects reported were pain in the injection site and flu like symptoms for the first 24 hours after the vaccination. This is similar to other Adenovirus vaccines.
Within 14 days the T cell response is provoked and white blood cells begin to attack the virus. Within 28 days the antibody response occurs and they neutralize the virus so that it cannot infect cells when the actual virus is contracted later on. All participants had antibodies, but the strongest response was from those who received the second doses. All the participants had antibodies 56 days after vaccination, which means there is potential for a long term antibody response. This data has given the scientists working on the vaccine increased confidence that the vaccine will work.
Plans to Mobilize the Vaccine:
There is an agreement with Oxford and AstaZeneca that they will be prepared to produce a vaccine right away if the trials are successful. All of the UK population should be able to get vaccinated as well as those in countries that are experiencing the worst effects of the pandemic. AstraZeneca commits to supply more than 2 billion vaccines. Oxford scientists have stated that the best case scenario is that multiple companies and research groups come up with a viable vaccine so that everyone can get vaccinated.
Reflection Questions:
Should governments fund vaccines?
Who should get vaccinated first?
Updates on All Vaccine Trials:
Click here and then hit download to view the current phases of all the vaccines in development to fight against COVID-19 .
Interactive Model:
Works Cited:
About. (2020). COVID-19. https://covid19vaccinetrial.co.uk/aboutAbout the Oxford COVID-19 vaccine. (2020, July 19). Research | University of Oxford. https://www.research.ox.ac.uk/Article/2020-07-19-the-oxford-covid-19-vaccineNew study reveals Oxford coronavirus vaccine produces strong immune response. (2020, July 20). Research | University of Oxford. https://www.research.ox.ac.uk/Article/2020-07-20-new-study-reveals-oxford-coronavirus-vaccine-produces-strong-immune-response
Oxford’s ChAdOx1 nCoV-19 clinical trials. (2020, July 19). Research | University of Oxford. https://www.research.ox.ac.uk/Article/2020-07-19-oxford-covid-19-vaccine-trials
Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomised controlled trial. (2020, July 20). The Lancet. https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2931604-4
The Challenges of Vaccine Development against a New Virus during a Pandemic. (2020, May 13). PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7219397/
Thompson, S. A. (2020, July 15). How Long Will a Vaccine Really Take? Https://Www.Nytimes.Com/#publisher. https://www.nytimes.com/interactive/2020/04/30/opinion/coronavirus-covid-vaccine.html
Vaccine Product Approval Process. (2018, January 30). U.S. Food and Drug Administration. https://www.fda.gov/vaccines-blood-biologics/development-approval-process-cber/vaccine-product-approval-process
Acknowledgements:
I would love to thank Claudia Ludwig and Rachel Calder who helped us have this wonderful opportunity in the middle of a pandemic. I would also love to thank my mom and dad who were beyond excited to hear I got to be a part of this project and who helped me stay motivated along the way.
