How can we develop a COVID-19 vaccine quickly?

A vaccine would be an incredibly powerful tool to slow down the coronavirus pandemic. This is how vaccine development needs to change to get to a COVID-19 vaccine.

A biologist takes coronavirus DNA sample from the freezer.

Credit: Pedro Vilela / Stringer / Getty Images

A COVID-19 vaccine could be developed in 12-18 months but this will require significant investment, global collaborations and a new model for vaccine development.

Vaccines are one of the most important tools in combatting infectious disease. But they come at a cost – development is a lengthy and expensive process.

Vaccines are given to healthy people to prevent illness, so the rigour to which testing and safety are held is much higher than for treatments given to people who are already sick. This translates into years of clinical trials. And the failure rate is high – to produce a safe and effective vaccine, researchers test multiple candidates over many years, or sometimes decades.

An effective, affordable and widely available vaccine is the only way we can overturn the COVID-19 pandemic. We need a vaccine much faster – which is why it needs to be done differently.

What developing a vaccine typically looks like

All licensed vaccines currently available have been made using a traditional vaccine development model. Because of the high costs and failure rate, this usually follows a linear sequence of steps.

There are five stages to the process:

  1. Discovery research takes 2-5 years and involves lab-based research looking to find ways to induce an immune response at a molecular level.
  2. The pre-clinical stage takes 2 years and involves testing in animals to assess the safety and suitability of potential vaccines for humans.
  3. Clinical development involves testing potential vaccines in humans and has three phases:
    • Phase I – testing for safety – takes 2 years and requires 10-50 people to take part in trials.
    • Phase II – understanding the immune response – takes 2-3 years and requires hundreds of people to take part in trials.
    • Phase III – assessing if the vaccine candidate protects against the disease – takes 5-10 years and requires thousands of people to take part in trials.
  4. Regulatory review and approval involves submitting data and information to regulators to gain approval for vaccines and can take 2 years.
  5. Manufacturing and delivery require specialist facilities that are highly regulated and expensive to develop.

Following this model, a traditional vaccine could take more than 10 years to be developed and cost between $200 and $500 million.

This is not fast enough for a COVID-19 vaccine.

The five stages of vaccine development

What needs to change to develop a COVID-19 vaccine at speed

Developing a vaccine as quickly and safely as possible requires a new model – with a fast start and many steps executed in parallel, before knowing what works and what doesn’t.

Preparing multiple stages at the same time will require huge investment – initially, at least $2 billion is needed for vaccine development and $1 billion for distribution. This funding must be secured urgently. Some of this investment will fail, but the cost of not investing enough in what could be a critical tool to solving the pandemic is much higher.

To develop a COVID-19 vaccine quickly, researchers, developers and funders must work together to:

  1. streamline the vaccine development process – this means doing different stages of development and production at the same time, to get to a vaccine faster.
  2. fund as many vaccine candidates as possible using a wide variety of approaches – we don’t know where a COVID-19 vaccine will come from so we need to try as many different innovations and technologies as possible to find one that works.
  3. create clinical trials in sites across the world, not just in high-income countries – this will give us the best chance of finding a vaccine that is safe and effective for everyone.
  4. build global manufacturing capacity – we will need billions of doses of a COVID-19 vaccine. To meet this demand, we have to:
    • invest in manufacturing sites now, before clinical trials are completed, to make sure that production can begin as soon as a vaccine is approved.
    • create new manufacturing sites instead of repurposing existing ones, as these are still needed to produce routine immunisations such the MMR or polio vaccine. The world must keep up routine immunisation where possible to avoid a double burden of outbreaks. Also, large-scale manufacturing has never been done before for some of the novel vaccine technologies that are being tried for COVID-19 – we have to build these production facilities without knowing if the vaccine candidate is viable.
    • make sure the production sites are geographically distributed – if a vaccine is developed, it should be manufactured and distributed equitably to communities across the world, not only richer nations.
  5. continue developing the most promising candidates, even if the current pandemic were to end – we should work towards a point at which successful vaccines can be stockpiled and ready for trials and emergency authorisation for future outbreaks, even if we manage to stop the current one without a vaccine.

Developing a COVID-19 vaccine at speed

Developing a COVID-19 vaccine is a monumental task, and no single institution or organisation can create a vaccine by themselves. To succeed, we’ll need to rapidly build new models of collaborative science and global manufacturing and distribution partnerships.

These will not be possible without significant investment and public, private and philanthropic collaboration on a never-before seen level.