More Dakka for Coronavirus: We need immediate human trials of many vaccine-candidates and simultaneous manufacturing of all of them

Our best chance to fight CV is to cre­ate a vac­cine as soon as pos­si­ble. The irony is that we prob­a­bly already have a vac­cine but we can’t prove that it works, un­til an­i­mal safety test, 1 and 2 stage of the clini­cal tri­als, which will take 12-18 months at least. How we could ac­cel­er­ate the cre­ation of the vac­cine?

There are sev­eral ideas, which are mostly in­spired by the re­search of anti-ag­ing drugs, which suffer from the same prob­lem: the need for very long clini­cal tri­als. See More Dakka post by Sara Con­stantin.

  1. Im­me­di­ate hu­man tri­als. If we have the vac­cine in 3 months, not 18 months, we will save mil­lions of lives. So, based on the trol­ley prob­lem logic, we may risk the health of a few thou­sand peo­ple to achieve these goals, es­pe­cially if they were vol­un­teers. Thus we need to start a hu­man test of the vac­cine can­di­dates im­me­di­ately, even be­fore the end of an­i­mal tri­als, which are still needed. here we get ac­cel­er­a­tion by perform­ing in par­allel the ac­tions which are typ­i­cally done se­quen­tially.

  2. Test safety and effi­ciency si­mul­ta­neously. We also should com­bine 1 stage and 2 stages oа tests, that is safety and effi­ciency, by giv­ing the vac­cine to peo­ple who are already un­der po­ten­tial ex­po­sure to CV, like nurses, or old peo­ple in nurseries.

  3. Test on large groups. We should test a vac­cine on a large group of peo­ple, like 10 000, so any find­ing will quickly get statis­ti­cal sig­nifi­cance. If the num­ber of in­fec­tion will de­cline rel­a­tive to the con­trol group, we could see it in one month.

  4. Test all vac­cine can­di­dates. All said above in 1-3 should be done with each of a dozen vac­cine-can­di­dates which are cur­rently un­der de­vel­op­ing. As a re­sult, in one month we could know which vac­cine can­di­date is the strongest and safest.

  5. Man­u­fac­tur­ing in ad­vance. Si­mul­ta­neously, we should start large scale pro­duc­tion of all vac­cine-can­di­dates, if it is pos­si­ble. After the best (maybe 3 or 5) vac­cine-can­di­dates are val­i­dated, the stock­pile of failed vac­cine-can­di­dates is de­stroyed, and the best vac­cines are de­liv­ered to the pop­u­la­tion. This will help to fight the pro­duc­tion de­lay.

  6. Give peo­ple differ­ent best vac­cines. There is still could be long-term detri­men­tal effects of some of the vac­cines, so it may be bet­ter not to give ev­ery­body just one best vac­cine—what if it makes ev­ery­body will be­come ster­ile in 1 year?

  7. Com­bine best vac­cines. To in­crease pro­tec­tion, we could give each per­son a com­bi­na­tion of sev­eral (but not all to en­sure point 6) of the best vac­cines. Here I as­sume that detri­men­tal in­ter­ac­tion be­tween vac­cines is typ­i­cally un­likely, but more tech­ni­cal anal­y­sis is needed.

  8. Estab­lish bio­mark­ers of a good vac­cine (e.g. an­ti­bod­ies). Bio­mark­ers are im­por­tant to check effi­ciency of a clini­cal trial be­fore the fi­nal out­come is known.

  9. Try other ap­proaches, like DRACO, dis­tanc­ing, co­conut oil, a large dose of vi­tamin C etc and test them in the same ac­cel­er­ated way.

Sev­eral hu­man tri­als already started: In China mil­i­tary vol­un­teers are test­ing an ex­per­i­men­tal vac­cine, and there are clini­cal tri­als of Moderna vac­cine in the US.