The Centre for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota has released the Coronavirus Vaccines Research and Development Roadmap (CVR) – a major global strategy to develop broadly protective vaccines against continually emerging SARS-CoV-2 variants and the threat of new coronaviruses that may cause pandemics in the future.
The report, developed with funding from The Rockefeller Foundation and the Bill & Melinda Gates Foundation, is the product of an international collaboration of 50 scientific experts from around the world who forged a unified strategy to make these critically-needed vaccines a reality.
“The Covid-19 pandemic marks the third time in just 20 years that a coronavirus has emerged to cause a public health crisis,” says Michael Osterholm, PhD, MPH, CIDRAP director, University of Minnesota Regents Professor and McKnight Presidential Endowed Chair in Public Health. “The Covid-19 pandemic taught us the hard lesson that we must be better prepared. Rather than waiting for a fourth coronavirus to emerge – or for the arrival of an especially dangerous SARS-CoV-2 variant – we must act now to develop better, longer-lasting and more broadly protective vaccines. If we wait for the next event to happen before we act, we will be too late.”
The emergence of SARS-CoV-2 in 2019 was preceded by an epidemic in 2003 caused by a different coronavirus called SARS-CoV. Then, in 2012, the Middle East respiratory syndrome coronavirus, or MERSCoV, emerged. Coronaviruses can carry a high risk of death: for MERS-CoV, about one third of infections result in death, and approximately one in 10 for SARS-CoV, although neither spreads easily from person to person.
In contrast, SARS-CoV-2, the virus that caused the Covid-19 pandemic, has a much lower fatality rate but, because it is so highly infectious between people, it had caused more than 650-million confirmed cases and 6,6-million deaths worldwide by the end of 2022. Even more concerning is the threat of a new coronavirus in the future that could be both highly transmissible and highly lethal. In addition, the emergence of new SARSCoV-2 variants may further jeopardise the significant protection provided by current vaccines against severe disease and death.
The CVR confronts these extraordinary threats with a detailed, comprehensive, and coordinated plan to accelerate the development of long-lasting, broadly protective coronavirus vaccines capable of preventing severe disease and death, and potentially protect against infection and transmission. The CVR further emphasises the goal that future broadly protective vaccines must be suitable for all regions worldwide, including remote areas and low- and middle-income countries.
“We may want to be done with coronaviruses, but coronaviruses are not done with us. At this point in history, complacency is our greatest enemy,” says Linfa Wang, PhD, professor with the Emerging Infectious Diseases Programme at Duke-NUS Medical School and executive director of the Programme for Research in Epidemic Preparedness and Response, Singapore. “It is critical that we start now to develop vaccines that are future-ready for coronaviruses circulating in animals now that might infect humans and cause pandemics in the future as SARS-CoV-3 and beyond.”
The report highlights different paths to success. One approach could involve a stepwise process, starting with vaccines to protect against variants of SARS-CoV-2. Another approach could focus on vaccines capable of protecting against multiple types of coronaviruses, including those likely to spill over from animals to humans in the future.
The CVR summarises key barriers and gaps and outlines specific goals and milestones for advancing broadly protective coronavirus vaccines.
The work is organised into five topic areas:
* Virology. Developing broadly protective coronavirus vaccines requires learning more about the global distribution of coronaviruses circulating in animal reservoirs that have the potential to spill over to humans.
* Immunology. Scientists need to learn more about human immunology, including research that will expand the breadth and durability of immune protection from vaccines and natural infection. Improved understanding of mucosal immunity may unlock new strategies to block infection.
* Vaccinology. Identifying key preferred product characteristics will inform priorities and strategies for vaccine R&D and accelerate discovery. Leveraging new technologies and identifying the best methods to assess vaccine efficacy will further catalyse critical advancements.
* Animal and human infection models for vaccine research. The limited availability of a range of suitable animal models is a key barrier to developing broadly protective coronavirus vaccines. Additionally, work is needed to explore the potential role for the safe and effective use of controlled human infection models in coronavirus vaccine research.
* Policy and financing. The successful development and global distribution of broadly protective coronavirus vaccines will require reinvigorating and sustaining a high level of political commitment and long-term investment in vaccine R&D and manufacturing.
“Time and time again, we have seen that investment in science brings solutions: The Covid-19 pandemic galvanised the research community and advanced vaccine R&D efficiently and through broad collaborations,” says Bruce Gellin, MD, MPH, chief of global public health strategy at The Rockefeller Foundation. “The Coronavirus Vaccines R&D Roadmap charts a path to aggressively get ahead of new and emerging threats by prioritising the development of vaccines that provide long-lasting immunity against a broad range of coronaviruses and are equitably available to all.”
“Now is not the time to sit back,” says Dan Barouch, MD, PhD, William Bosworth Castle Professor of Medicine at Harvard Medical School and director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center. “It is a time to aggressively build on the science and networks forged during the Covid-19 pandemic to develop improved, next-generation coronavirus vaccines.”
“The vaccines that we currently have for Covid-19 are the most important tool that we have in our battle against the pandemic,” says Charlie Weller, PhD, head of Prevention, Infectious Diseases, at the Wellcome Trust. “But we can do better – by developing vaccines that give us broader protection – protection against new variants, protection from coronaviruses that have not yet emerged, but might cause the next pandemic. We can discover new ways to deliver vaccines, such as skin patches or intranasal vaccines – and maybe even vaccines that could block transmission. This roadmap creates the structured plan that will give us the tools we need to better protect ourselves, our families, and our communities around the world.”