Atlas

Loooong thread - 138 tweets ~8000 words.
TLDR: 40 current vaccine candidates in progress across many different methods (lots experimental) in many different regions. Rollout will be very decentralized.
Normal vaccine lifecycle: ~15 years
Cov2 - many steps were done already e.g we already knew a lot about coronaviruses. "Fiddling around was skipped and antigen was plugged into existing tech."
This acceleration shouldn't be expected to compromise safety.
40 vaccines currently in development, 10 in Phase 3 trials. And can be licensed under "Emergency Use Authorization."
Several ways to make a vaccine
- Classic: Grow virus in cell culture, isolate it, concentrate it, then kill it "chemically or physically". No EU/US companies currently using this approach.
- Live attenuated - more advanced - genetically modifying live virus and infecting people so their body fights a weakened version and develops antibodies. Only 3 of 40 currently use this method & progress "far behind".
- Modern - no live infectious disease involved - antigens are grown in cells. Well tested - used for flu, Hep B & HPV already. Novavax (Author's recommended candidate) using this method in UK.
- Other methods: Replication Incompetent Viral Vectors (trigger strong t cell response but can be problematic for immunocompromised people).
- Completely New Methods:
- DNA ("Current progress seems slow").
- RNA ("Absolute new kid on the block") - impressive technology. Two western frontrunners (Moderna & Pfizer) using this approach - won't work in lower income regions as they need to be stored frozen.
Authors recommendation for which one to take: Pfizer or Novavax

Florian Krammer