With a combination of optimism and fear—optimism that a fast response is possible and fear that the next pathogen might not succumb so easily—pandemic preparedness has taken on a renewed urgency.
In September, US president Joe Biden announced a plan to prepare for the next pandemic, with an initial outlay of $15 billion and a total investment of $65.3 billion over the next 10 years. The first goal is to “design, test, and approve a safe and effective vaccine against any pathogenic human virus within 100 days following the identification of an emergent viral pandemic.
One advantage of the mRNA vaccine platform, according to Moderna’s CSO Andrea Carfi, is that different mRNAs can be combined to target more than one pathogen or, in the case of SARS-CoV-2, more than one variant. Moderna has already announced that it has preclinical data on a combination flu and COVID-19 vaccine, which will be going into clinical trials next year, and it has plans for multivalent vaccines against SARS-CoV-2 variants beta and delta.
Although other mRNA and protein nanoparticle vaccines are multiplexing to get breadth of protection, Simpson thinks that won’t be necessary with their VLPs. “If they look and smell like viruses, the body will react,” he says.
In response to the current epidemic, the group has put $200 million dollars on the table to start the race towards broadly protective vaccines both against SARS-CoV-2—this call ended in September, and applications are under review—and one for beta-coronaviruses more generally, which closed on 1 October 2021.
The groups practiced on various viruses, but then in 2019, halfway through the program, they were confronted with the real-life challenge of SARS-CoV-2. Crowe says that he and Jenkins contemplated whether they were ready to tackle this, especially as, early on, patient samples were unavailable. But as soon as a US patient was identified in January 2020), they decided to go for it. The first step—identifying an antibody—was achieved in roughly a week by AbCellera, followed by Vanderbilt.
Pain points The P3 groups collectively demonstrated that antibodies can be isolated and deployed quickly, not just for treatment but also for prevention, and that this can be done even from scratch in a few months, faster than for typical vaccines. And although the RNA vaccines were also put into arms in amazingly short order, a vaccine-induced immune response can take weeks to months to develop.
Adagio Therapeutics, which was spun out of the antibody engineering company Adimab in 2020 to fight the pandemic, has an engineered fully human mAb that reacts with all known SARS-CoV-2 variants now in phase 2/3 trials for both disease treatment and prophylaxis. Tillman Gerngross, Adagio’s founder and CEO, took a gamble that the pandemic was not going to go away quickly and embarked on a program of antibody design that would capture all the known and potentially unknown variants of SARS-CoV-2.
More recently Vir researchers and collaborators have identified a number of antibodies with unique properties, among them broadly neutralizing activity targeting a cryptic epitope in the RBD, and a narrow escape profile .
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