Source: Faculty of Medicine and Health Sciences Alumni and Friends
When will we have a COVID-19 vaccine? It’s the big question on everyone’s mind that prompted infectious disease epidemiologist and vaccinologist Nicole Basta and her team to create an interactive online COVID-19 vaccine tracker, which provides real-time updates on progress in developing a safe and effective vaccine.
“You see a lot of reporting in the popular press and press releases about vaccine development. But there is so much misinformation. Our goal with the vaccine tracker is to help the public hone in on reliable information, improve understanding about the vaccine testing process, and manage expectations about when a vaccine may be available,” says Basta, an associate professor in the Department of Epidemiology, Biostatistics and Occupational Health at McGill’s new School of Population and Global Health in the recently renamed Faculty of Medicine and Health Sciences.
“We want to make sure the public are very informed consumers and that they can have all their questions answered. Increasing transparency about COVID-19 vaccine development can increase knowledge and improve trust in vaccines. We are aiming to be ahead of the curve by addressing valid questions with accurate, reliable and unbiased information, which will help with public acceptance and uptake once safe, effective vaccines are available locally and globally.”
Launched in late August, the vaccine tracker features weekly, real-time updates to monitor progress on each of the more than 30 vaccines currently in human trials; behind the scenes, the team is tracking more than 140 vaccines in development around the world. Each vaccine candidate has its own card, with a goal thermometer showing whether the vaccine is in phase 1, 2 or 3 of clinical trials or approved, and information about the developers, countries involved, and vaccine type, such as RNA-based, protein subunit, or inactivated virus. Quebec-based Medicago, for example, where another faculty member, Professor Brian Ward, MDCM’80, PGME’92, is medical officer, is using its innovative plant-based technology to develop a vaccine.
Users from any country can submit their own questions about COVID-19 vaccines. A colour-coded map also updates the number of vaccine candidates, registered vaccine trials, and highest trial stage for each country.
The community immunity tool simulates the spread of an imaginary disease and how vaccines can protect the entire community. To see the impact of vaccination, users can choose the percentage of the population to vaccinate and watch what happens to the numbers of people healthy, sick, recovered, and dead in different scenarios. If 30% are vaccinated, for example, users will see a graph of the typical curve and how the numbers of infections and deaths climb dramatically, while at 90% infections and deaths plummet.
As a vaccine epidemiologist, Basta is applying her expertise and experience in public education, deployment and use of other vaccines in the United States and African countries such as Mali and Uganda to develop public health vaccination strategies against COVID-19. “Developing vaccines is the first step, but my research also picks up where clinical trials leave off by focusing on the best way to target vaccines in the population in Canada, the U.S. and around the world,” explains Basta, who came to McGill from the University of Minnesota in January.
Public health education matters in making licensed vaccines more effective in preventing the spread of infectious diseases, whether it be seasonal flu or COVID-19. In a study in the journal Vaccine, Basta showed that the willingness of Minnesota adults to get a flu shot increased by 7.3 percentage points after being educated about the community immunity benefits of vaccination.
“Educating people about how getting vaccinated not only protects them personally but also helps others in the community made them much more likely to get the flu vaccine,” Basta says.
Through a field project in Uganda, Basta helped determine how to provide more equitable access and improved human papillomavirus (HPV) vaccine coverage for adolescent girls in low-income, rural areas. “People have many questions when a vaccine is being launched. In Uganda, we identified ways to increase the uptake and optimize the impact of HPV vaccination among adolescent girls including by ensuring that teenage girls not attending school also had access to the vaccine,” says Basta, whose epidemiology work in Mali showed a new meningitis vaccine could provide longer-lasting protection for 400 million people in Africa’s meningitis belt during yearly, dry season outbreaks.
Basta was motivated to become a vaccine epidemiologist after she got involved in preparing for a possible avian flu epidemic as a young outbreak investigator for the Florida Department of Health from 2005 to 2007. “I’ve always been impressed with how vaccines are such a powerful tool for prevention. The experience that influenced me was planning for a possible pandemic after outbreaks of avian flu in Southeast Asia, which were very deadly. If the virus had spread widely, the world would have been in dire straits. We worked on prevention plans for a global pandemic and of all the mitigation strategies, mass vaccination made the biggest difference,” says Basta, a Princeton University graduate, who earned a master’s in epidemiology at University of Cambridge as a Gates-Cambridge Scholar and a PhD in epidemiology from University of Washington.
The vaccine tracker’s second phase will add a new component focusing on the ethics and challenges of equitably distributing COVID-19 vaccines in a global pandemic when there is limited supply.
“We know that when a vaccine or vaccines are approved, there won’t be eight billion doses available on day one. It’s important to learn from past mistakes and have informed conversations on a global scale to ensure vaccines are distributed equitably and effectively to reduce transmission risk and protect the most vulnerable people,” says Basta, who developed the tracker with a team that includes McGill biostatistician and Associate Professor, EBOH, Erica Moodie, as well as other researchers and trainees from McGill, University of Minnesota, and University of Toronto.
Looking at past efforts to develop new vaccines also can be useful in managing expectations about realistic timelines for a safe, effective vaccine. Basta is collaborating with biomedical ethicist Jonathan Kimmelman, a James McGill Professor in the Biomedical Ethics Unit/Social Studies of Medicine, on a second project, supported by M14 Emergency COVID-19 Funding, which uses historic success rates for viral vaccine development to provide publicly accessible, evidence-based projections for when a COVID-19 vaccine might be available.
“We found that except for new influenza vaccines, the shortest timeline from phase 2 to an approved candidate was five years for the Ebola vaccine and the success rate was less than 5%. If we can successfully make a safe, effective vaccine available in a year to 18 months, it will be a huge historic achievement,” says Kimmelman.
COVID-19 vaccine candidates are being developed on an accelerated timeline, with the aim and hope that the unprecedented funding, advances in vaccine technology, diverse approaches and international cooperation will produce one or more safe, effective vaccines much faster than ever before. Basta and Kimmelman caution that high standards of scientific rigour must be maintained in developing and evaluating COVID-19-vaccines despite the strong political and financial pressures to speed up, or relax standards, for regulatory approvals.
Basta argues that informed public scrutiny and greater transparency about the strengths and limitations of vaccine candidates are vital to building rather than undermining public trust in vaccines. “With the vaccine tracker, we’re trying to inform people about what’s happening with each of the vaccines now as they’re being developed. People are eager to ask questions. They want to be confident in the vaccine and have access to information in an unbiased way. Because everyone in the world is paying attention, I hope this will raise the standards of transparency in the regulatory process for approval, licensing, and widespread distribution of COVID-19 vaccines,” she says.
Managing expectations about what vaccines can do is also critical to the success of a global effort to prevent and stop the spread of COVID-19. “I’m very optimistic that we’ll have several vaccine candidates licensed within the next year or two. But even after a vaccine is available, it won’t be a magic bullet,” says Basta. “The vaccine will be a very powerful tool that needs to be used along with physical distancing, masks, testing, and new treatments because COVID-19 is such a serious global threat.”
September 9 2020