COVID-19 Update: Vaccine and Antibody Developments
Dr. Steven Bishop returned to Facebook Live on Wednesday, May 20, to provide another weekly update on COVID-19.
Dr. Bishop kicked off this week with an update on vaccine and potential treatment developments. There's been a lot of encouraging news lately, but it is still very early days. While we don't want to get overly excited about a vaccine being ready in the near term, we are seeing good progress towards that goal.
To better understand the development of these new vaccines, it's important to take a step back and review vaccines in general.
Live Vaccine. In this type of vaccine, a small and weakened part of the live organism (bacteria or virus) is introduced into the body. Because the invasive organism is weakened, the body reacts and creates antibodies to protect from the disease without making the vaccinated person sick. Live vaccines work really well and produce a robust reaction. Examples of live vaccines include small pox and the first polio vaccines. The downside of live vaccines is that a small portion of the population who receive them do, in fact, develop the disease.
Recombinant Vaccine. Another type of vaccine, recombinant vaccines are products of genetic engineering, where a harmless agent such as yeast, is programmed to produce antigens of harmful pathogens. This vaccine uses a section of DNA from the virus or bacteria to stimulate an immune response in the body without causing sickness. Tetanus is an example of this type of vaccine.
mRNA Vaccine. An entirely new type of vaccine is being explored to fight coronavirus. Viruses multiple by hijacking the human body to create infectious proteins for the virus. The mRNA vaccine steals back this strategy by introducing synthetic mRNA into the body that mimics the virus. The proteins created through this process are solitary, so they do not assemble to form a virus. The immune system then detects these viral proteins and starts to produce a defensive response to them.
Initial testing for the mRNA vaccines have been very small and many more tests are needed to prove that the vaccine is both safe and effective.
Researchers are exploring treatment for coronavirus using antibodies. Also in the early stages of development, we are encouraged by the progress, but not ready to celebrate just yet.
An antibody is a protein produced by the body and used by the immune system to neutralize pathogens such as bacteria and viruses. Whole libraries of antibodies exist in storage within research laboratories. These libraries are being tested to see if any react to COVID-19. Those that do are being tested as a treatment or prophylactic for the disease.
Using antibodies in this manner is a well-established treatment type. Initial tests show a lot of promise as a "bridge treatment" for coronavirus until a vaccine is developed and deployed.
Because the antibodies are introduced into the individual, as opposed to the body manufacturing its own antibodies, the effect of the treatment eventually wears off. This is why a vaccine will still be necessary.
Read the Q&A recap below and watch the video for more detail.
Q & A
Dr. Bishop then opened the floor to answer your questions live.
When will PartnerMD resume physicals? Physicals are starting back up on a very limited basis. If you had a physical that had to be postponed, your care team will be in touch as soon as possible to get your physical rescheduled.
When do you expect a vaccine to be ready for mass distribution? Realistically, we are still looking at a 12 to 18 month window. Ensuring that a vaccine is both safe and effective takes time. We are hoping to have a good candidate for a vaccine by the end of 2020, with a rollout plan in place for 2021.
Will some groups be prioritized to get the vaccine first? This seems likely with higher risk groups going first. However, this really depends on the vaccine supply. If there's lots of vaccine available, there would be no reason for anyone to wait, but a phased rollout seems more likely.
Could the Sorrento Antibodies be a faster to market strategy? Sorrento Therapeutics has reported that its Covid-19 antibody was able to completely block the viral infection in-vitro. We know that these libraries of antibodies came from humans, so we already know these are compatible with the human body and generally safe. This means that these therapies require less safety testing. A reduction in the amount of safety testing could mean a shorter development process. Again, antibody treatments could be a bridge for us until there is a vaccine.
What vitamins should we be taking to help ward off illness? Both vitamin C and vitamin D are recommended for supporting the immune system. It's best to get these from natural sources rather than supplements. If you think you may need supplements, talk to your doctor, who can recommend how much of these vitamins you need and make sure that you are not taking any medications that might interact poorly with supplements.
What should we think about the South Korean study? The findings from a recent study in South Korea appear to indicate that some people who recovered from COVID-19 are testing positive for the virus again. One possibility is that these individuals are still shedding virus. Another theory is that the body has not yet fully flushed all remnants of the virus. Or, some interpretations suggest that the individuals were reinfected. It is unusual for a person to get sick multiple times in a row, so we just don't know what to make of these findings just quite yet.
What is the timing and likelihood of a second wave in the fall? We don't know. This depends on how and when governments release restrictions on the population. Unfortunately for Virginia, the second and third phases of reopening the economy coincide with the traditional onset of flu season. There is some concern that there could be a natural uptick in flu and COVID-19 in the fall. With social restrictions easing at the same time, we could potentially see a double bump in infections.
What's a reliable source for news in addition to the CDC and WHO websites? The Virginia Department of Health is a great source of information that is accurate and updated regularly. The American College of Physicians also has a ton of great information. This is a site for physicians, so expect to see more medical terminology, but definitely a good resource for anyone who wants to visit the site.
What can you tell us about false negative with COVID-19 testing? This really depends on the type of tests. The most common false negatives are looking for active cases and can be as high as 40% to 50% inaccurate. In fact, the longer you've been sick, the less accurate the swab test are. This is why PartnerMD uses a combination strategy testing for both active cases of COVID-19 and antibodies. Both test are more accurate together than each is alone.