The First Covid Vaccines May Not Prevent Covid Infection

Desperation for a way to keep economies from collapsing under the weight of Covid-19 could mean settling for a vaccine that prevents people from getting really sick or dying but doesn’t stop them from catching the coronavirus.

Although a knock-out blow against the virus is the ultimate goal, early vaccines may come with limitations on what they can deliver, according to Robin Shattock, an Imperial College London professor leading development of an experimental shot.

“Is that protection against infection?” Shattock said. “Is it protection against illness? Is it protection against severe disease? It’s quite possible a vaccine that only protects against severe disease would be very useful.”

As countries emerge warily from lockdowns, leaders are looking to a preventive shot as the route to return to pre-pandemic life. Fueled by billions of dollars in government investment, vaccines from little-known companies like China’s CanSino Biologics Inc. and giants like Pfizer Inc. and AstraZeneca Plc are in development.

At least one of the fastest-moving experimental shots has already advanced into human trials after showing an impact on severe disease -- but less so on infection -- in animals. Experts say such a product would probably be widely used if approved, even if that’s as much as it contributes, until a more effective version comes to market.

“Vaccines need to protect against disease, not necessarily infection,” said Dennis Burton, an immunologist and vaccine researcher at Scripps Research in La Jolla, California.

There are drawbacks, though. While holding the potential to save lives, such vaccines might lead to complacency in lockdown-weary nations, said Michael Kinch, a drug development expert who is associate vice chancellor at Washington University in St. Louis.

“My guess would be that the day after someone gets immunized, they’re going to think, ‘I can go back to normal. Everything will be fine,’” he said. “They’re not going to necessarily realize that they might still be susceptible to infection.”

Covid-19 is already thought to be spread by people without symptoms, and a symptom-preventing vaccine may create even greater numbers of them.

Vaccines are among the most effective weapons against infectious disease, and prevent up to 3 million deaths a year, according to the World Health Organization. Yet few, if any, are 100% effective in all people who get them. For example, about 3% of people who get measles vaccine develop a mild form of the disease, and can spread it to others.

In their attempts to confront a rapidly growing threat, developers are turning to technologies that have never been used successfully in humans. More than 130 shots are in the works for Covid-19 prevention, according to the World Health Organization.

Vaccines work by presenting the immune system with a form of a germ -- or a key part of it -- preparing the body to respond when a real exposure occurs. When that happens, immune proteins called antibodies glom onto the virus, halting its entry to cells. Sometimes vaccines ramp up immune T-cells, which don’t do as much to prevent infections, but can slow and eventually stop their progression.

A common approach to raising levels of antibodies is with injection of a virus that’s been inactivated or killed. About nine of these are in experimentation: One, made by China’s Sinovac Biotech Ltd., led to high levels of Covid-targeted antibodies in monkeys.

Another shot developed at the University of Oxford uses an innovative approach in which Covid genes are inserted into a different, harmless virus. Those make proteins that are recognized by the immune system, which raises defenses against a real infection.

About a quarter of the experimental shots listed by the WHO, including two already in human studies, follow the same approach as the Oxford vaccine. One of the advantages of the technology is its speed. AstraZeneca, which is partnering with Oxford, has said it will begin delivering doses for the U.K. as soon as September, and will have doses for the U.S., which helped fund development, the following month.

On Saturday, AstraZeneca and four European Union countries said they reached an agreement to distribute hundreds of millions of doses of the vaccine. Beijing-based Sinovac Biotech also said over the weekend that results from testing its coronavirus shot in humans support advancement to final-stage studies.

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