Vaccines undergoing trials at Oxford University and in Germany are the most likely candidates to be ready this year, experts have said, but there are also candidates being tested in the US, Russia and China.
At a press conference on Monday, September 21, the Chief Scientific Officer for England, Sir Patrick Vallance, said "good progress" had been made on vaccines, and "several" were in the "very late stage of clinical testing".
The UK has got access to a number of these, he said, adding it was possible some would be made available this year, but more likely we would see them early next year. "In the meantime we have to get control of this... to make sure we can live with it."
A vaccine is important, because Sir Patrick noted that just "something under eight per cent of the population" have been infected and/or have antibodies. It may be higher in the cities, as high as 17 per cent, he said but added that the vast majority of us do not have immunity. What's more, even those who do have antibodies will probably see their immunity diminish over time.
Here's everything you need to know about what vaccines are being developed, the latest news, and when a jab might be ready.
What's the latest news in the hunt for a vaccine?
Oxford's vaccine trial – considered one of the most likely candidates for an effective vaccine – was halted on September 8 after a participant in the UK had an adverse reaction.
The vaccine, developed with AstraZeneca, cleared phases one and two human trials and progressed to the third phase where it was being tested on a larger number of participants.
Oxford University announced on September 12 that clinical trials of its coronavirus vaccine will resume in the UK.
But the adverse reaction experienced by the participant in the vaccine trial may not have been caused by the experimental vaccine itself, it has since been claimed.
However, human trials of the Oxford and AstraZeneca coronavirus vaccine are yet to resume in the US over concerns the jab may cause adverse reactions.
How has the search for a vaccine developed?
The huge task of developing a vaccine for the virus began in January when scientists decoded the genome of SARS-CoV-2.
Before the first case of coronavirus had been reported outside China, scientists had already sequenced the virus. On January 11, the genome of the coronavirus was posted to GenBank, an open-source database of nucleotide sequences maintained by the US federal government. On the same day, the Chinese government submitted the sequence to the World Health Organisation.
The Chinese Centre for Disease Control and Prevention announced a few weeks later that it was working on a vaccine and began testing it on animals in February.
On March 16, Moderna began trials on humans in the United States, testing 45 people in its first cohort. A few weeks later, the University of Oxford expressed hope that its team could develop a vaccine by September after testing on the first batch of humans.
On April 20, the UN General Assembly passed a motion urging international co-operation on access to vaccines.
US President Donald Trump told the media in May that he was confident a US-approved vaccine would be ready by the end of the year.
A few days later, trials of the Oxford/AstraZeneca were ramped up, testing over 3,000 participants in Brazil.
On June 28, China announced that it had developed a vaccine to be used by its military. The vaccine was given the green light for use by troops after trials proved it was both safe and effective, said CanSino Biologics, the biotech firm involved.
Russia claimed in August to have produced the world's first coronavirus vaccine - but scientists are wary that it has not been adequately tested.
Vaccines are currently being tested on thousands of people around the world with billions of orders waiting to be fulfilled – if the trials work.
How do vaccines work, how long do they take to make, and why?
A vaccine stimulates your body's immune system to produce antibodies and fight off a disease. It does this by introducing into your body the germs that cause disease. Your immune system then fights off these germs, developing the antibodies that then make you immune. Vaccines, therefore, can be potent weapons in preventing disease.
However, developing a vaccine is complicated. While researchers are confident that a vaccine could be ready by the summer of 2021, that would be the fastest humans have ever gone from seeing a brand new pathogen to developing a vaccine against it.
Here's the journey a vaccine takes, from initial development to approval:
- Before clinical testing: At this stage, scientists test the vaccine on cells and then give the virus to animals. If the vaccine produces an immune response – ie if antibodies are produced – it can move to the next stage
- Phase 1 testing: In these tests, also known as safety trials, the vaccine is tested on a small number of people. It is in this stage that scientists work out the dosage and if the jab produces an immune response in humans
- Phase 2: Now the vaccine is tested on a lot more people, with hundreds of participants split into groups, often by age. Sometimes, to speed up the process, phases 1 and 2 can be combined.
- Phase 3: In the third phase of testing, the vaccine is delivered to thousands of people. The vaccine runs alongside a placebo. This phase is extremely important because it simulates mass adoption of the vaccine; the larger sample size of participants means that the trial can find out rare potential side effects of the vaccine that might not be present in smaller groups. The Oxford and Imperial vaccines are currently at this stage.
- Approval: If the vaccine passes through these stages, it can be approved by national regulators. Then it can be distributed. Scientists would continue to monitor people who receive the vaccine, in case it is not safe. However, researchers have expressed concern that approval could be rushed without adequate scrutiny – as with China and Russia's vaccines – or that emergency authorisation of a coronavirus vaccine could be dangerous. Approval is also subject to political pressures, such as President Trump's hope to get a vaccine distributed to Americans before he faces the polls on November 3.
Having to satisfy the safety criteria in each of these stages is why developing a vaccine is such a long and complicated process.
What's the latest on Oxford?
The Oxford/AstraZeneca vaccine suffered a setback in September after a participant reported adverse effects.
Before that, testing had been positive. The full results of the Oxford trials, published on July 20, showed that initial trials on 1,077 British adults found that the vaccine induced strong antibody and T-cell responses, which may improve further after a booster jab.
The discovery is promising because separate studies have suggested that antibodies may fade away within months while T-cells can stay in circulation for years.
Clinical teams at the University of Oxford's Jenner Institute and Oxford Vaccine Group began work in January to develop a Covid-19 vaccine. The team progressed to human trials on April 23.
The Oxford vaccine was considered the clear frontrunner in the global race.
But trials have been paused twice after two participants, both British women, sequentially developed transverse myelitis, an inflammation of the spinal cord that can cause paralysis.
Oxford University announced on September 12 that clinical trials of its coronavirus vaccine will resume in the UK.
Oxford said the pause had given time for a "review of safety data by an independent safety review committee, and the national regulators".
It added: "Globally, some 18,000 individuals have received study vaccines as part of the trial. In large trials such as this, it is expected that some participants will become unwell, and every case must be carefully evaluated to ensure careful assessment of safety."
Trails of the vaccine have since been restarted in Brazil, India and South Africa, but are still on pause in the US where the legal and historical context means regulators tend to take a tougher stance.
What about the Imperial College vaccine?
Researchers at Imperial have developed a candidate which, when injected, will deliver the genetic instructions to muscle cells to make the SARS-CoV-2 spike surface protein. This should provoke an immune response and create immunity to the virus.
Rather than giving people a weakened form of the illness, the Imperial vaccine instead uses synthetic strands of genetic code based on the virus' genetic material.
Another vaccine candidate is being developed by the University of Cambridge which hopes to start clinical trials in the autumn after it received £1.9 million in funding from the British government.
The Cambridge candidate, DIOS-CoVax2, is DNA based. Computer-generated antigen structures are encoded by synthetic genes, which can then re-programme the body’s immune system to produce antibodies against coronavirus.
What deals has Britain signed and will Britons get first access to a vaccine?
On September 14, the Government announced that it had secured the supply of 60 million doses of a Covid-19 vaccine candidate being developed in France.
Valneva SE, a specialist vaccine company, announced a "major partnership" with the UK worth around £433 million. The doses will be provided in the second half of 2021.
There is an option for the Government to access a further 130 million doses between 2022 and 2025, the company said.
Britain had already signed deals for more than 340 million doses of a vaccine. The total stockpile means that — if the vaccines all work — there will be enough for every person in Britain to have five doses. Most of the vaccines require two to be effective.
Britain is preparing to revise laws to allow the emergency use of any effective coronavirus vaccine before it is fully licensed — but only if it meets required safety standards.
The UK has also joined Covax, the UN scheme pooling funds from wealthier countries and non-profits to develop two billion doses of an effective, approved and equally distributed vaccine by the end of the 2021.
The UK had previously announced £48 million to finance Covax vaccines for lower-income countries. The World Health Organisation said last month that 172 countries and multiple candidate vaccines were engaged in talks about joining the initiative.
How does Russia's vaccine work?
Vladimir Putin has announced that Russia has approved the world’s first coronavirus vaccine.
Moscow has hailed the speedy development of the vaccine as evidence of its medical prowess, but scientists have raised concerns about a lack of testing and transparency.
According to a study in the Lancet, Russia’s “fast-track” Covid-19 vaccine is safe and produces two forms of immune response against the virus. However, the new study of two early-phase trials reveals that the drug has so far only been tested on a total of 76 people - and not by the most rigorous of methods.
The vaccine has been named “Sputnik V”, drawing comparisons to the Cold War space race.
The Telegraph has revealed that Britain is likely to reject a vaccine from Russia, amid serious concerns over its trial processes.
Is there vaccine research being done in the US?
Donald Trump has said the US would start mass production of any vaccines developed before they are fully approved so that they can be quickly distributed once rubber-stamped.
The president has accused the US Food and Drug Administration (FDA) of preventing pharmaceutical companies from finding people to test coronavirus vaccines on. Mr Trump suggested "deep state" elements at the FDA wanted to delay a vaccine until after the election.
Only half of Americans are now willing to take a vaccine for Covid-19, a significant drop due to growing concerns the approvals process will be rushed.
The US has already signed contracts worth billions of dollars to distribute the vaccine.
Moderna's vaccine trial showed promising early results after the candidate reportedly produced protective antibodies in a small group of healthy volunteers. A third trial involving thousands of people started in July. Even if the trials are successful Moderna's vaccine would not be available until between January and June 2021.
On August 11, Mr Trump said his government will purchase 100 million doses of Moderna’s experimental vaccine.
Some scientists have expressed concerns that the FDA, which would need to approve any potential vaccine, could be pressured by the White House into clearing an unproven drug before election day on November 3.
Is China working on a vaccine?
China has moved up a gear in the pivotal area of vaccine diplomacy, with a string of positive announcements from Beijing.
China is pulling ahead in what could be the final leg of the global coronavirus vaccine race. Of the nine candidates in phase three trials, four are Chinese.
However, some are concerned about the quality of the vaccines and that they are being used to gain political leverage.
Beijing was so confident in its homegrown inoculations that authorities had been administering vaccines for more than a month before clinical studies conclude, authorities revealed at the beginning of September.
The Chinese government has provided sparse details on which vaccines are being given to people, and how many have been vaccinated, leading to concerns participation may be forced and not voluntary.
Experts are starting to wonder whether China's strategy of focusing on "old school" vaccine technologies may eventually prove to be more prudent.
China National Biotec Group (CNBG), a state-run vaccine company, said in mid-September that early data from its phase three trials showed that its two leading immunisations were effective in preventing volunteers contracting Covid-19 – the first time a claim of efficacy has been made.
Dexamethasone & other treatments being trialled
The world's first coronavirus treatment that significantly reduces the risk of death is being given to NHS patients following groundbreaking trials by British scientists.
In a breakthrough described by Boris Johnson as a "remarkable achievement", the common steroid dexamethasone was shown to radically improve the chances of survival for the most ill patients.
On June 16, the Prime Minister hailed the result as the "biggest breakthrough yet" in the treatment of coronavirus, both in Britain and globally.
The Government has been stockpiling dexamethasone since March in case the trials were successful. There are already supplies for 200,000 patients, and enough to cope with any second wave of the virus.
The drug – commonly used to treat arthritis, severe allergies and asthma – costs just £5 for a full course of treatment and is expected to have a major impact on the pandemic.
Alongside vaccine development, doctors are trialling existing drugs for viruses such as Ebola, malaria and HIV. Early results seem promising but, until full clinical trials have been concluded, doctors cannot be certain that the drugs are effective.
AstraZeneca has started a Phase 1 clinical trial of its drug AZD7442, a combination of two monoclonal antibodies, for the prevention and treatment of Covid-19. The trial, funded by the US Government, will include up to 48 healthy participants in the UK aged 18 to 55.