GSK makes vaccine platform available as coronavirus spreads

The Coalition for Epidemic Preparedness Innovations (CEPI) and healthcare company GSK have announced a new collaboration aimed at helping the global effort to combat the Wuhan coronavirus (2019-nCoV) — a move which will see GSK make its established pandemic vaccine adjuvant platform technology available to enhance the development of an effective vaccine.

GSK is a leader in the development of innovative vaccines using different adjuvant systems. An adjuvant is added to some vaccines to enhance the immune response, thereby creating a stronger and longer lasting immunity against infections than the vaccine alone. The use of an adjuvant is of particular importance in a pandemic situation since it can reduce the amount of antigen required per dose, allowing more vaccine doses to be produced and made available to more people.

“As a leader in science and innovation, we believe we can help to contribute to the fight against 2019-nCOV with one of our advanced vaccine adjuvant systems,” said Thomas Breuer, Chief Medical Officer, GSK Vaccines. “Our adjuvant technology has previously been used successfully in the pandemic flu setting. It enables using only small quantities of the vaccine antigen which allows the production of more doses of the vaccine — a crucial advantage in a pandemic.”

“Gaining access to GSK’s world-leading adjuvant technology is a huge step forward in developing a vaccine against the novel coronavirus 2019-nCoV,” said CEPI CEO Dr Richard Hatchett. “Coupling GSK’s adjuvant systems with the pioneering platform technology we are funding has the potential to make more vaccine available more rapidly — by decreasing the dose of vaccine antigen required to protect each individual. This ‘antigen-sparing’ effect makes a given supply of vaccine go farther, increasing the number of people who can benefit.”

CEPI will coordinate engagements between GSK and entities funded by CEPI who are interested in testing their vaccine platform with GSK’s adjuvant technology to develop effective vaccines against 2019-nCoV. One such arrangement is being formalised between GSK and The University of Queensland (UQ), which recently entered a partnering agreement with CEPI to develop a ‘molecular clamp’ vaccine platform to enable targeted and rapid vaccine production against multiple viral pathogens. CEPI has extended this funding to work on a 2019-nCoV vaccine candidate, and access to the GSK adjuvant technology will now support this early-stage research.

“At GSK we believe in the value CEPI can bring to responding to outbreaks like 2019-nCOV,” said Roger Connor, President, GSK Vaccines. “We are proud to contribute to cutting-edge research from scientists at The University of Queensland, and we are open to working with other partners who have a promising vaccine platform that could be used together with our adjuvant.”

This announcement complements four prior CEPI programs of work relating to 2019-nCoV vaccine development already announced by CEPI, in partnership with CureVac, Inovio, UQ, and Moderna, and the US National Institute of Allergy and Infectious Diseases. These partnerships seek to improve the scientific understanding of the novel coronavirus, and to develop vaccines against it. These programs will leverage rapid response platforms already supported by CEPI with the aim of advancing 2019-nCoV vaccine candidates into clinical testing as quickly as possible.

The news comes as new modelling research, published in The Lancet, estimates that up to 75,800 individuals in Wuhan may have been infected with 2019-nCoV as of 25 January — significantly more than the ~24,000 cases that have been reported worldwide. The new estimates also suggest that multiple major Chinese cities might have already imported dozens of cases of 2019-nCoV infection from Wuhan, in numbers sufficient to initiate local epidemics.

In the study, researchers from the University of Hong Kong used mathematical modelling to estimate the size of the epidemic based on officially reported 2019-nCoV case data and domestic and international travel (ie, train, air, road) data. They assumed that the serial interval estimate (the time it takes for infected individuals to infect other people) for 2019-nCoV was the same as for severe acute respiratory syndrome (SARS). The researchers also modelled potential future spread of 2019-nCoV in China and internationally, accounting for the potential impact of various public health interventions that were implemented in January 2020 — including use of face masks and increased personal hygiene, and the quarantine measures introduced in Wuhan on 23 January.

The researchers estimate that in the early stages of the Wuhan outbreak (from 1 December 2019 to 25 January 2020), each person infected with 2019-nCoV could have infected up to 2–3 other individuals on average, and that the epidemic doubled in size every 6.4 days. During this period, up to 75,815 individuals could have been infected in Wuhan. Additionally, estimates suggest that cases of 2019-nCoV infection may have spread from Wuhan to multiple other major Chinese cities as of 25 January, including Guangzhou (111 cases), Beijing (113), Shanghai (98) and Shenzhen (80). Together, these cities account for over half of all outbound international air travel from China.

“If the transmissibility of 2019-nCoV is similar nationally and over time, it is possible that epidemics could be already growing in multiple major Chinese cities, with a time lag of one to two weeks behind the Wuhan outbreak,” said lead author Professor Joseph Wu. “Large cities overseas with close transport links to China could potentially also become outbreak epicentres because of substantial spread of pre-symptomatic cases unless substantial public health interventions at both the population and personal levels are implemented immediately.”

While the estimates suggest that the quarantine in Wuhan may not have the intended effect of completely halting the epidemic, further analyses suggest that if transmissibility of 2019-nCoV could be reduced by 25% in all cities nationally with expanded control efforts, both the growth rate and size of local epidemics could be substantially reduced. Moreover, a 50% reduction in transmissibility could shift the current 2019-nCoV epidemic from one that is expanding rapidly to one that is slowly growing.

“It might be possible to reduce local transmissibility and contain local epidemics if substantial, even draconian, measures that limit population mobility in all affected areas are immediately considered,” said study co-author Dr Kathy Leung. “Precisely what and how much should be done is highly contextually specific and there is no one-size-fits-all set of prescriptive interventions that would be appropriate across all settings. On top of that, strategies to drastically reduce within-population contact by cancelling mass gatherings, school closures and introducing work-from-home arrangements could contain the spread of infection so that the first imported cases, or even early local transmission, does not result in large epidemics outside Wuhan.”

The authors point to several limitations of their study, including that the accuracy of their estimates depends on their assumption about the zoonotic source of infection in Wuhan. They also highlight that the models assume travel behaviour was not affected by disease status and that all infections eventually have symptoms — so it is possible that milder cases have gone undetected, which could underestimate the size of the outbreak. Lastly, they note that their epidemic forecast was based on inter-city mobility data from 2019 and might not reflect mobility patterns in 2020, particularly in light of the health threat posed by 2019-nCoV.

Image credit: ©stock.adobe.com/au/zilvergolf

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