Vaccine libraries will give us a head start on the next Disease X
Creation of vaccine libraries will help the world develop vaccines against the next Disease X in 100 days.
Developed in record time, multiple safe and effective vaccines against COVID-19 are now saving lives around the globe: this scientific achievement is one bright spot to emerge from the darkness of the pandemic. But this remarkable success has not come out of the blue, and the story of how it happened points towards a future in which humankind has a head start on tackling emerging infectious diseases.
In many ways, COVID-19 is a proof of concept for the ‘prototype vaccine’ approach to rapidly developing vaccines against new viral threats, which sees preliminary versions of vaccines developed against representative viruses which can then be swiftly adapted to tackle other related pathogens.
For several years before the emergence of SARS-Cov-2 – the virus which causes COVID-19 – scientists were already working on vaccines against MERS and SARS, pathogens from the same virus family as COVID-19. What those scientists learned enabled them to pivot quickly and respond at lightning speed when COVID-19 emerged, laying the groundwork for the record-breaking effort to develop COVID-19 vaccines.
COVID-19 will not be the last time the world is faced with a novel pathogen, or Disease X, so we need to be ready to respond as soon as it emerges even if we don’t know what that Disease X will be. To speed up this process we can replicate the approach to COVID-19 for other pathogens by developing prototype vaccines against the different virus families that infect humans.
These prototype vaccines will be based on rapid response platforms such as mRNA, which can be adapted in a matter of weeks once a new virus has been identified. They will form a ‘library’ of vaccine candidates that are ready to be pulled off the shelf and swiftly adapted next time Disease X emerges. That way, we don’t lose valuable time creating a new vaccine from scratch when a new viral threat is already upon us.
Enabling the 100 days mission
This vaccine library will be a critical enabler of CEPI’s mission to help the world compress vaccine development to 100 days. Vaccines in the library will be advanced through preclinical and early-stage clinical testing to build vital knowledge about the safety and immunogenicity of both the platform and the antigens they are targeting, giving the world a significant head start once a new threat emerges.
Against a closely related pathogen, a candidate vaccine from the library could itself be useful, while against more distantly related viruses, it would serve as a template for rapid vaccine development. This echoes the way mRNA and viral vector MERS vaccines—like the one developed by Oxford University and supported by CEPI—served as templates for some of the first vaccines developed against COVID-19.
But if we don’t know what Disease X is going to be, how do we select which vaccines to put in the library?
Today we know of approximately 260 viruses that infect humans, coming from roughly 25 families of viruses. It’s not possible to develop vaccines against every single potential virus, but vaccine libraries can be created for each of the virus families to be used or rapidly adapted if related viruses emerge.
Building vaccine libraries is a mammoth task requiring major investment, so we anticipate it being a shared global project with CEPI playing a pivotal leadership and connecting role.
At CEPI, we’re prioritising the development of vaccine libraries for up to 10 virus families that pose the greatest risk to public health, by working with leading experts to systematically rank each family based on its Disease X potential. To do this, we’re looking at potential for outbreak transmission or zoonotic spillover, ability to mutate, mode of transmission, and other factors.
For each virus family selected, we’ll create vaccine candidates for as many as 10 to 15 different viruses depending on the complexity of the family. Our aim is to establish clinical proof of concept for vaccine libraries against multiple virus families over the next five years.
Tackling Disease X – no matter where it emerges
As COVID-19 has shown with terrible clarity, viruses do not respect borders. Vaccines can only control outbreaks before they become pandemics if they are made available to those who need them most, regardless of where they live.
CEPI’s investments will, therefore, be focussed on maximising global equitable access to the vaccines in our library—particularly for people in low-income and middle-income countries—so that if and when a Disease X outbreak should occur, the vaccines we’ve developed can be deployed to help contain it, wherever it is in the world.
Find out more about the 100 days mission here.