Current State of the First COVID-19 Vaccines

Abstract

SARS CoV-2 and its associated disease COVID-19 has devastated the world during 2020. Masks and social distancing could be efficient if done by large proportions of the population, but pandemic fatigue has decreased their efficacy. Economic shut downs come with large price tags and cannot be a long term solution either. The announcements by three vaccine manufacturers in November that their vaccines are 90% or more effective has given hope to at least those in the population who plan to get vaccinated as soon as a scientifically and medically sound vaccine becomes available. This review summarizes the underlying design strategies and current status of development of the nine vaccines that were in phase III trial on 8 November 2020. Contracts between vaccine manufacturing companies and governments aim at distributing the vaccine to a large part of the world population. Questions remain how the temperature sensitive mRNA vaccines will be transported and/or stored and how vaccination will be prioritized within each country. Additionally, current contracts do not cover all countries, with a serious gap in Africa and South America. The second part of this review will detail current distribution plans and remaining challenges with vaccine accessibility and acceptance.

Keywords: COVID-19; SARS CoV-2; phase III trial; vaccine development.

Figure 1

Time line of vaccine production and approval. BP, BioNTech/Pfizer; M, Moderna; AZ, Oxford/Astra Zeneca; J&J, Janssen/Johnson and Johnson; NV, Novavax; SPV, Sputnik V; CoV, CoronaVac; Ad5, Ad5-nCOV; BCG, Mycobacterium bovis. Blue arrows, phase I/II trials; green arrows, phase III trials; yellow arrows, roll out; purple star, (anticipated) approval date. Trial start dates were taken from http://www.clinicaltrials.gov. Approximate end dates of phase I/II trials are the publication dates. End points for unpublished trials a4re guesses by the author. For the last three vaccines, a guess for an approval date was not possible. Note that all start and end dates of trials, as well as approval dates are approximations.