An effective coronavirus vaccine makes it more likely that people can gather in large numbers, the Illinois economy can reopen safely, and hospitalization rates can go down.
In an article for the Illinois Council of Health-System Pharmacists (ICHP) newsjournal, Roosevelt University professor Jason Alegro and two PharmD candidates review the most promising COVID-19 vaccines.
“Our goal in writing this article was to educate the pharmacists, students, and technicians in our state on a topic that is on everyone’s mind and a potential game-changer in this pandemic,” said Jason Alegro, assistant professor of clinical sciences.
Alegro also serves as clinical pharmacy specialist in infectious disease at Mount Sinai Hospital. He added, “By doing so, we can all become better informed with the science and clinical data of COVID-19 vaccine development, especially as our patients and loved ones look to us for answers.”
Professor Alegro wrote the review with Chelsea Manaligod and Kristen Martinez, current PharmD candidates at Roosevelt University. The College of Pharmacy offers the only three-year Doctor of Pharmacy program in Illinois.
The top COVID-19 vaccine candidates
As of August 20, more than 30 vaccines have entered human trials. The review by Alegro, Manaligod and Martinez focuses on two promising COVID-19 vaccines: an adenovirus type 5 (Ad5) vector vaccine from CanSino Biologics, and an mRNA vaccine from Moderna.
The team’s hope was to educate others in pharmacy about the importance and strategies of these COVID-19 vaccines.
“With the opportunity to work on this article with Dr. Alegro and my colleague Kristen Martinez, I was able to gain more knowledge about the different challenges and potential solutions in the prevention of COVID-19,” said Manaligod. “I have been able to foster skills that most second year pharmacy students don’t get a chance to.”
The CanSino vaccine uses an adenovirus (another common virus) to deliver COVID-19 genes into the patient’s cells. The human cells create viral proteins, which triggers an immune response, which will help the patient fight off COVID-19.
The adenovirus, as the Roosevelt pharmacists explain, is attractive because it can safely infect a broad range of cell types, it’s stable, and it has the potential to elicit a strong immune response. But if patients are immune to the adenovirus from past illnesses, like colds or pink eye, it might not trigger as strong of an immunologic response.
CanSino Biologics is currently running a Phase 3 trial in Saudi Arabia, which will test the vaccine on thousands of patients. In their review, the Roosevelt pharmacists note that the trial needs to explore the effectiveness and side effects of the vaccine in older patients, who are especially susceptible to severe cases of COVID-19.
Novel vaccine technologies
The Moderna vaccine, now in Phase 3 trials, and might be the vaccine that is “garnering the most interest” according to the review. Developed in collaboration with the National Institute for Allergy and Infectious Diseases, the vaccine uses messenger RNA (mRNA) to deliver coronavirus genes to cells and trigger the patient’s immune system.
Because the vaccine uses mRNA, producing it won’t require live, infectious organisms, which lowers the risk of accidental contamination or bioterrorism. The novel design has “the potential for rapid, cost-effective, large-scale production,” according to the Roosevelt professor and students.
However, their review did express some concerns about the safety of the virus. Studies have shown the potential for severe inflammatory responses, and the innovative mRNa design has seen issues with stability and degradation.
Moderna provided initial data on May 18 via press release. The vaccine went through Phase 2 trials on 600 participants, and the multisite Phase 3 trial, which began in late July, is expected to enroll 30,000 Americans.
“As a Hispanic, first-generation college student with no previous experience in research, I feel very lucky to have been a part of the ICHP article,” said Martinez. “This pandemic has brought forth stress and fear for many people, and the spread of misinformation is a serious concern.”
Many questions remain
As the Roosevelt pharmacy team makes clear in their review, many questions remain about the vaccines undergoing trial.
How effective and long-lasting are these vaccines? Are there still concerns about short- and long-term safety? Will the vaccine work for all demographics, especially the seniors most vulnerable to the disease? And how will vaccines work as the coronavirus evolves?
As the group notes, “It will only be once a successful vaccine is approved and marketed that we will be able to see its true effect on the population, hopefully leading to an effective post-pandemic reality.”
Read the full article on the ICHP website.