Coronavirus: Turning a marathon into a sprint: the race for a COVID-19 vaccine

At most recent count, there was more than 100 potential candidates in the race to develop a vaccine against SARS-CoV-2, the virus that causes COVID-19.

The Coalition for Epidemic Preparedness Innovation has confirmed 78 as active, three of which have already moved to testing on humans.

But while there are dozens of potential vaccines, using several different technologies to target the virus in different ways, the real race is against the clock - the world won't go back to the normal we once knew until there is a vaccine.

And there's no guarantee there will be a vaccine at all.

"Unlike pandemic influenza, where the strategy was to control and contain until the vaccine came, because we knew the vaccine would come, we don't know if and when a vaccine will come with this virus," Chief Medical Officer Brendan Murphy said last week.

"If it does, that's a beautiful way out."

While Professor Murphy has moved to manage expectations about the likelihood a vaccine could allow the world "a way out" of the fight against COVID-19, the experts asked by The Canberra Times all said it was fair to talk about "when" not "if" a vaccine will be available.

The collaboration within the science community, advances in science and technology and the sheer pace and number of vaccine candidates give those at the coalface confidence an answer will come.

"We are in a new space," says Dr Rob Grenfell, Health Director of the Health and Biosecurity Business Unit at CSIRO, where two vaccine candidates are already in pre-clinical trials.

A vaccine for the Zika virus was developed within 18 months, Grenfell says, the fastest development of a vaccine for a new agent that he has seen. While a vaccine for SARS couldn't be developed, the world has changed since then.

"Since SARS in the early 2000s, there's been a lot of advances in science, in particular areas in genetic science, protein science, even the science of cells, and also there's been considerable advances in a lot of the tools and techniques that we actually need to make these new proteins, but also the way to test vaccines and how they're working."

Failure in scientific endeavour rarely makes headlines, but successful discoveries are littered with disproven theories, leads that reached dead ends and questions left unanswered.

"Failure is in fact a very common occurrence when trying to build a vaccine for a new agent," Grenfell says, which is precisely why it's vital that there are dozens of potential vaccines being developed - the world isn't putting all its eggs in one basket.

Where many will fail, others could make the distance.

It's one of few times competitors in a race don't mind if they cross the finish line first, or make it there at all.

"From the scientific community, we're agnostic about which vaccine is going to get there first," says Professor Trent Munro, whose team at the Rapid Response Vaccine Pipeline at the University of Queensland has moved onto pre-clinical trials of a vaccine for coronavirus already.

"With the number of programs we have going across the globe for COVID we have a really good shot at finding something."

The variety in the type of vaccines being developed also puts scientists at an advantage - the vaccine eventually developed could be made more effective by what is learnt in other trials.

"One of the really great things about there being so many different people trying different things is that we'll have a pretty good idea about how to make sure that we not only get good immunity, but we get the right flavour of good immunity," says Professor David Tscharke, the head of immunology and infectious disease at the Australian National University's John Curtin School of Medical Research.

"I've never seen anything like this before, from lots of fronts," says Munro, who points out the commonly cited time frame of 12 to 18 months for a vaccine has researchers working at speeds they have never done before.

Professor Munro is part of one of the Australian teams at the forefront of vaccine development for COVID-19, and even as part of an organisation designed to be able to react quickly to a new disease, he says it is hard to convey to the general public just how unusual it is to see such speed, collaboration and planning.

"Everything from how fast information is getting published, from how fast experiments are happening and then scientists sharing that information. That started way back when then scientists in China were able to publicly give out the DNA sequence of the virus, that's unprecedented speed and its just accelerated from there."

At the CSIRO, a 24/7 roster is keeping scientists in the laboratory well beyond what would normally be expected.

"Easter will happen next year," according to Grenfell, who said the staff he is leading have been working at that pace since January as part of preparations to be ready for pre-clinical trials.

In a sporting competition, it would be laughable for opposition coaches to have a meeting during play to swap notes, explain whether key players are match-fit, and what strategies they would attempt next.

But that is exactly what is happening among scientists. Munro says he has already participated in telephone meetings with other researchers working to develop vaccines, hosted by the World Health Organisation, giving all scientists the same data.

"All of the developers ... talked openly about what they're doing, you don't normally see that in other competitive areas," he said.

Collaboration isn't just between the scientists - universities, agencies like the CSIRO and big pharmaceutical companies are all in talks about how a potential vaccine may be manufactured en masse so that it may be distributed more widely.

Work taking place at the CSIRO in Geelong is emblematic of Australia's contribution to the global race for a vaccine - partnering with international researchers, two vaccine candidates are starting pre-clinical trials using the government science agency's platform, while others are lining up to be able to take part.

At the University of Queensland, the Rapid Response Vaccine Pipeline received funding from the Coalition for Epidemic Preparedness Innovation little more than 12 months ago, giving it the ability to answer the call to develop a vaccine when it came in January.

A partnership with Dutch bio-pharmaceutical company Viroclinics Xplore has allowed the vaccine currently under development to power ahead.

Other universities in Australia are also developing vaccine candidates, and the work of the Doherty Institute in Melbourne had been world-leading, the first laboratory to grow and share COVID-19 from a patient sample.

There are five stages a vaccine must go through before it becomes available to the public. The first is pre-clinical development, where a candidate vaccine is researched and developed, and tested on animals with similar traits to humans. For example, ferrets are being used in one of the trials at the CSIRO as the protein on the outside of their lungs is similar to that in humans.

If that stage is successful, there are three phases of human trials, first in a small group of between 10 and 100 people, testing if the vaccine is safe, if it induces a strong immune response and what the optimal dose could be.

Out of the dozens of trials worldwide, just three have moved on to testing in humans.

In the following phases of human trials the groups tested get larger, up to 10,000 people, to continue to test if the vaccine is safe in a larger and more varied population and if it is effective at preventing the disease.

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Once those hurdles are crossed, the vaccine moves into the implementation phase - licensing and large scale manufacture.

At the University of Queensland, the vaccine under development targets the surface of the virus, which it uses to make its way into other cells in the body. By using the DNA sequence of that part of the virus, removing the need to use a live version of the virus, the vaccine uses similar technology to other protein-based drugs like insulin or other antibodies.

"We're able to give that as a vaccine and that tricks your immune response to think that it's been infected by a virus, it just knows there'a foreign object and it's able to mount a fight," Munro says.

Combining that reaction with molecular clamp technlogy developed at the university is the unique, and possibly winning element of the vaccine under development.

"It actually makes the protein in a form which makes a much stronger immune response than otherwise would be possible."

The risks associated with getting it wrong are high.

"A vaccine is a very unique type of medical product, because it's a product that you give to somebody who is not sick," says Tscharke.

"And despite what some people out there will say, what that means is that the tolerance for adverse events is incredibly low."

Added to the scientific challenge of finding something that works, is finding something that doesn't accidentally swing and miss - accidentally making people more vulnerable to end up with a worse form of the disease.

"The last thing you want to do is to educate the immune system with your vaccine to make it more likely to take that wrong track and make the wrong flavour of immune response. And this has happened in the past with another respiratory virus," says Tscharke.

It's this risk that weighs heavily on the minds of those working in trials.

For Dr Ron Grenfell and his team at the CSIRO, it's why their work is fast, but not rushed.

"We are not taking any short cuts on the quality and the safety of the work that actually needs to be done. We're well aware these that things need to be addressed for a successful vaccines to actually make it for use in humans."

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