
The first human trial in Europe of a coronavirus vaccine has begun in Oxford - dustinmoris
https://www.bbc.co.uk/news/health-52394485
======
royletron
My partner is taking part in the trial in Oxford. So far there was a bit of an
anomaly on her blood work so they're bringing in her in for another round of
tests but I'm happy to ask her to share (or allow me to share by proxy) her
experience. Obviously she has no idea whether she is in the control group or
not.

~~~
robbyt
Are they receiving any compensation?

~~~
jjar
Here's the information sheet -
[https://www.covid19vaccinetrial.co.uk/participate-trial-
oxfo...](https://www.covid19vaccinetrial.co.uk/participate-trial-oxford)

> If you participate in the study until the end, you will receive a total
> payment of between £190-625, dependent on group.

My housemate hoped to take part but was not selected.

------
twic
The thing i like most about this vaccine is that it's a T-cell vaccine.

Very broadly speaking, the adaptive immune system has two arms.

One arm, humoral immunity, is about detecting foreign substances in the spaces
outside cells: B-cells make antibodies, antibodies inspect molecules floating
around, a match triggers the B-cells to proliferate and make more antibodies,
and then antibodies tell macrophages and various other brutal cells to destroy
and eat everything in sight, resulting in inflammation, but hopefully killing
the invader.

The other arm, cellular immunity, is about detecting foreign proteins inside
cells: T-cells make T-cell receptors, T-cell receptors inspect peptides
presented on the surface of cells through some amazing machinery culminating
in the MHC I protein, a match triggers the T-cells to proliferate, and the
T-cells themselves go round triggering self-destruction of cells presenting
the foreign peptides.

(I'm leaving out MHC II and helper T cells here, let alone T-regulatory cells,
gamma delta T cells and all sorts of other things i don't know about)

Both wings are useful in response to a viral infection, but ultimately, the
cellular immunity is key. Viruses commandeer and replicate inside cells, so to
stop an infection, you need to find and kill those cells. Cellular immunity
does that.

Vaccines based on injecting proteins or dead viruses can only develop humoral
immunity. Vaccines based on modified viruses, like this one, can also develop
cellular immunity.

In theory. So far, there are no T-cell vaccines.

~~~
krillln
so, we can say that B-Cell vaccines are good enough coz they have already been
working on other types of viral infection, right?

~~~
sudosysgen
They are likely good enough yes, presence of strong antibodies pretty much
means there's no way the virus can outpace the immune response, and it often
is neutralized so strongly you wouldn't even notice inoculation.

------
oli5679
There is a strong argument for doing a challenge trial, using young people, on
this candidate.

~~~
lbeltrame
I think it's ethically unacceptable. We're basically throwing everything we've
learned with drug safety out of the window.

~~~
nbabitskiy
It is absolutely unacceptable, that's why 2/3 answers to this comment so far
use martial metaphors. It violates not the liberty of young men, who have
every right to be reckless and volunteer, but integrity of the scientific
community.

If the Oxford researchers made trials on Syrian kids in a refugee camp, in
exchange for $100, I suppose more people would see a problem here.

~~~
tim333
I'd be willing to do it. It could save thousands or lives. Which part to you
object to? Enthusiastic volunteers being able to choose to take a risk? The
world has become far too nanny state and arse covering in my opinion.

I find the attitude puzzling that people are willing to value vague
abstractions like "integrity of the community" over thousands of lives.

~~~
nbabitskiy
I agree with everything you say. If a rogue MD in a nanny state will talk you
into a challenge trial, - by all means, let him do it and face the
consequences (hopefully, tough). But let's not pretend, that it would be an
informed consent.

The reason for the vaccine research protocol we're settled on, is the ubiquity
of wanna-be Pasteurs, and dearth of the real ones.

On a separate note. We have deprived ourselves of basic human rights under the
premise, that lives are worth any economic outcome of shut down. Where I live,
premeditated spreading of the Covid is considered by law an act of terrorism.
Officially vetted challenge trials just don't add up.

~~~
tim333
Yeah I'll give you you need informed consent and some common sense about the
whole thing.

------
gabipurcaru
WHO publishes a list of the vaccine landscape here -
[https://www.who.int/blueprint/priority-diseases/key-
action/n...](https://www.who.int/blueprint/priority-diseases/key-action/novel-
coronavirus-landscape-ncov.pdf)

As of April 20 2020, there were 5 in clinical evaluation and 71 in preclinical
evaluation. I'm a layperson, but very interesting to see the different
techniques and testing methodologies used.

------
notechback
I get that everyone like to put "we're the first" in their press release but
there are already a number of trials, eg house the day before a German company
was reportedly starting trials

[https://www.nytimes.com/reuters/2020/04/22/world/europe/22re...](https://www.nytimes.com/reuters/2020/04/22/world/europe/22reuters-
health-coronavirus-vaccine-biontech.html)

~~~
punnerud
And trials started weeks ago in Norway as well:
[https://www.regjeringen.no/en/aktuelt/who-global-corona-
stud...](https://www.regjeringen.no/en/aktuelt/who-global-corona-study-starts-
in-norway/id2695532/)

~~~
egao1980
Or Russia -
[https://ria.ru/20200411/1569898745.html](https://ria.ru/20200411/1569898745.html)

~~~
remarkEon
(I don't speak Russian, yet)

Given how politicized this has gotten, in general for treatment of this virus,
I'm not optimistic that we'll be sharing information. Praying I'm wrong.

~~~
egao1980
Basically on 11 of April they started a trial. Up to today WHO approved for
trial 9 potential vaccines made in Russia.

------
Gatsky
Maybe there will be a vaccine for SARS-CoV-2, but the one lesson to take away
from all this is that if a truly terrible pandemic hits (eg more contagious
than SARS-CoV-2 but with a 10%+ mortality rate) a vaccine won’t save us. I’m
not sure what will. Relying on the source country to quickly identify an
outbreak and raise the alarm obviously isn’t going to work...

~~~
bibabaloo
I'm not any epidemiologist, so if someone knows more please correct me, but I
read that viruses with a high mortality rate are much easier to contain.
Mainly because the virus more naturally dies out as it kills its hosts. That
was one of the reasons that SARS didn't reach pandemic scale with its 10%
mortality rate.

I have to wonder if Covid-19 is in the 'sweet spot' of dangerousness, as it
has a mortality rate that doesn't hamper its ability to spread but still kills
a lot of people.

~~~
amelius
I suppose that if the incubation period is long enough the virus can have an
arbitrary mortality rate and still spread.

~~~
gridlockd
Incubation period and lethality are usually correlated, afaict.

~~~
ignoramous
Or, imagine a HIV-esque virus. Super long incubation period, lethal in that it
attacks your immune system, and super different than anything we've seen
before to effectively find a cure or a vaccine faster than usual.

Now imagine if such a virus was airborne and was already spreading... Who'd
know?

------
chrisandchips
I don’t know much about the subject - when one of these institutions discovers
a vaccine, do the rest just give up and settle the loss of having come second
in the race? Do the private companies then automatically switch to producing
as much of the successful vaccine as possible to meet demand and turn a
profit?

~~~
egwor
I imagine they keep going since side effects could be better, or it could be
more effective.

~~~
mattkrause
A handful of the first SARS vaccines “worked” (in that they led to antibody
production), but also had nasty side effects.

~~~
dehrmann
It's like how there's a cure for HIV that you really don't want.

~~~
djsumdog
You mean death? Or am I missing something?

~~~
mattkrause
I would assume they mean the CCR5 stem cell/bone marrow thing.

A handful of patients (2?) have undetectable viral loads after being treated
for leukemia. In these cases, the bone marrow or stem cells were from donors
with a mutation in _CCR5_ that confers some resistance to HIV. The mechanism
isn't completely understood, AFAIK, since people with the CCR5 delta32
mutation have partial, but not complete, resistance to HIV normally.

It's not a very viable treatment yet: the transplant procedure is brutal (a
friend went through it) and you need to be unlucky enough to need a
transplant, yet lucky enough to find a donor that has the right mutations
(which again, are not completely known) AND is otherwise compatible with the
patient.

Still, very exciting for a possible mechanism, but also probably not coming to
a hospital near you this decade.

Here's one of the studies:
[https://www.nejm.org/doi/10.1056/NEJMoa0802905](https://www.nejm.org/doi/10.1056/NEJMoa0802905)

------
jdalgetty
The comments on that article are something else!

~~~
bartread
There used to be a website dedicated to the ludicrous nature of BBC Have Your
Say comments (of which these are the contemporary equivalent), but
unfortunately I can't remember what it was called . They've always been ...
out there. I can't deal with reading them because I can literally feel the
brain cells dying off when I do.

~~~
boristhespider
[http://web.archive.org/web/20150121193235/http://ifyoulikeit...](http://web.archive.org/web/20150121193235/http://ifyoulikeitsomuchwhydontyougolivethere.com/)

------
Madmallard
They tried corona virus vaccines already after the first SARS outbreak. When
patients were re-exposed to the virus they had severe auto-immune lung
pathologies. Sounds super problematic.

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3335060/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3335060/)
[https://jvi.asm.org/content/85/23/12201](https://jvi.asm.org/content/85/23/12201)
[https://www.newscientist.com/article/dn23563-threatwatch-
cou...](https://www.newscientist.com/article/dn23563-threatwatch-could-a-mers-
vaccine-make-people-sicker/)

~~~
tinus_hn
Note that in the reports mentioned, the ‘patients’ are mice and ferrets.

------
neuronic
So 2 days ago, we received the news that the first human trials on a vaccines
by a biotech firm from Mainz have gotten approval by the Paul Ehrlich
Institute [1] as well in Germany. Good news, let's all work together to kick
this things ass!

Source [German News]: [https://www.sueddeutsche.de/gesundheit/coronavirus-
impfstoff...](https://www.sueddeutsche.de/gesundheit/coronavirus-impfstoff-
deutschland-biontech-1.4884844)

Main source [PEI, English]: [https://www.pei.de/EN/newsroom/press-
releases/year/2020/08-f...](https://www.pei.de/EN/newsroom/press-
releases/year/2020/08-first-clinical-trial-sars-cov-2-germany.html)

[1] a federal institute for vaccines

------
djsumdog
How exactly are vaccines made? Like how do you make a brand new one? For
smallpox, the first vaccine came from cowpox (or possibly horsepox). People
didn't know what viruses were, but horsepox happened to be similar enough to
generate the same antibodies, but not kill people.

But I've never seen a good documentary on how vaccines are made for diseases
today. YouTube just seems to be filled with professor's lectures from
introclasses. Are live viruses used and, if so, how are they made inert yet
cause the immune system to generate the same antibodies?

Anyone have a documentary with the technical details of any of the modern
vaccine generation techniques?

~~~
HillRat
Basically, there are three primary approaches to safely introducing antigens
to the immune system: you can inactivate (or kill) a virus through methods
such as heat treatment; you can attenuate it (make it less well-adapted to
humans) by introducing it into foreign hosts until its adaptive mutations make
it safe for humans; or you can synthesize molecular antigenic subunits and
introduce those on a viral carrier or with chemicals to stimulate an immune
response. Experience with inactivated SARS vaccines suggests that protection
is incomplete and, worse yet, the vaccines trigger immunopathic responses that
can cause serious damage. Most focus is on subunit vaccines, but s-protein-
based vaccines in feline coronavirus have been shown to actually worsen the
effects of reinfection, so researchers are understandably cautious.

------
LandR
I'm about far from anti-vaxer stance as its possible to be, so please don't
think this is where this is coming from, but isn't this crazy quick compared
to how long vaccines usually take?

Is the long time to create vaccines not usually to make sure they are safe?
What is different now that it can be done quicker? Is it just the sheer amount
of effort and cash being thrown at it?

~~~
fuckknows
So according to In The Pipeline[1] they essentially modified their existing
MERS vaccine so that it worked for SARS-COV-2. Their original vaccine had
already gone through phase 1 trials and had shown efficacy and no harmful side
effects.

[1]
[https://blogs.sciencemag.org/pipeline/archives/2020/04/23/a-...](https://blogs.sciencemag.org/pipeline/archives/2020/04/23/a-close-
look-at-the-frontrunning-coronavirus-vaccines-as-of-april-23)

~~~
mcarmichael
Derek Lowe is terrific in communicating complex ideas in the field to
concerned lay observers like me; he's been a great resource for reliable
information about the science of this thing.

Just to clarify; the ChAdOx1 MERS prospect hasn't proceeded to a trial
demonstrating efficacy in human subjects (as yet).

That's a particularly important distinction here, given the nature of the
novel delivery mechanism[1] and prior observation of complications in SARS-
CoV-1 vaccine development[2]

[1]
[https://en.wikipedia.org/wiki/Viral_vector#Adenoviruses](https://en.wikipedia.org/wiki/Viral_vector#Adenoviruses)

[2]
[https://www.hkmj.org/abstracts/v22n3%20Suppl%204/25.htm](https://www.hkmj.org/abstracts/v22n3%20Suppl%204/25.htm)

~~~
ignoramous
> _Just to clarify; the ChAdOx1 MERS prospect hasn 't proceeded to a trial..._

Looks like it has (for SARS-CoV-2 instead):
[https://www.genengnews.com/news/astrazeneca-joins-u-of-
oxfor...](https://www.genengnews.com/news/astrazeneca-joins-u-of-oxford-and-
spinout-to-develop-covid-19-vaccine/)

------
hans_castorp
Germany started trials on April 22nd using a vaccine named BNT162. Apparently
with non-infected people first.

------
twomoretime
If one had strong reasons to suspect a mechanism by which a vaccine could
actually be deadly or fatal, but this mechanism had not been verified
explicitly in literature, would they be ethically obligated to warn
participants in advance?

~~~
chemeng
If there is reason to believe it presents a material risk to their health and
well-being. Yes.

------
SCAQTony
COVID-19 is a retrovirus, much like HIV. They both have similar s-protein as
well. When discovered in 1983 that HIV is the sole cause of AIDS, it took
12-years for an antiviral to reach the market. In the past 37-years, no
vaccine has panned out against HIV. As for COVID-19 "Houston, we have a
problem."

~~~
cherpa12
I believe you are correct. I believe COVID 19 IS in the category of RNA based
retroviruses. No one here is saying it is the same thing as AIDS! That's
silliness. But tests being rolled out on COVID 19 contain a reverse
transcriptase polymerase chain reaction (RT-PCR). I believe the virus does
fall into the retrovirus category; like malaria, AIDS and ebola.

