Meet the leading COVID-19 Vaccine Candidates: Dr. Offit with CHOP says immunogenic response will be the key metric of success (safety comes second).

In an article published in the Journal of American Medical Association (JAMA), Dr. Paul Offit, and others, in affiliation with the Children’s Hospital of Pennsylvania (CHOP), outlined the leading COVID19 vaccine candidates.

The authors explain two of the five candidate vaccines are based on mRNA methodology. Moderna’s vaccine, mRNA-1273, is a lipid nanoparticle-encapsulated mRNA vaccine that encodes a full-length, prefusion stabilized spike (S) protein of SARS-CoV-2.

Pfizer, in partnership with BiBioNTech, a German company, is developing an mRNA platform that is also focused on lipid nanoparticle-encapsulated mRNA that encodes for SARS-CoV-2 spike (S) protein.

For the second type of vaccine, Merck Sharp & Dohme is partnering with the International AIDS Vaccine Initiative to develop recombinant vesicular stomatitis virus-vectored vaccine (rVSV–vector) using spike (S) protein as an antigenic target.

Johnson and Johnson and AstraZeneca are using a third strategy involving replication-defective recombinant adenoviral vectors. Unlike the rVSV-vectored vaccine by Merck, which uses a replication-competent  virus as a vector, J&J and AstraZeneca’s candidates use either a replication-defective simian adenovirus or replication-defective human adenovirus type 26.

All of that is a scientific mouthful. What’s important for you to know, dear reader, is what the authors tell you at the end of the article about the key metric (i.e., priority) with all of these vaccine candidates. Consider:

With all these vaccines, efficacy—as defined by robust and durable immunogenic response—will be the key metric of success. Without long-lasting immunity that persists season to season, the capacity of any candidate vaccine to effect community transmission will be limited. In addition, safety will be an equally important second metric. All 5 candidates are undergoing rigorous investigation of their safety profile, inclusive of unintended adverse events. In the setting of accelerated vaccine development timelines, robust safety monitoring will be crucial in setting a foundation of public trust in the ultimately successful candidate vaccine. JAMA

Safety being an equally important but second metric. How exactly is something second but equally important? That defies logic. Clearly, a robust and durable immunogenic response is the first priority and safety is the second. Safety, or the perception of safety, is needed to set a foundation of public trust. Actual safety for the entire population that will receive the vaccine does not need to be proven.

We’ve explained why it is important to “follow the money” with Big Pharma because profitability and finances come first and safety comes second. The tail of money wags the dog of safety. Big Pharma knows the money is in the efficacy (the robust and durable immune response), where safety need not be proven over time to the total population receiving the vaccine (e.g., medically fragile children).

The authors reported no conflicts of interest. 

Be safe and knowledgeable with whom you build a foundation of trust.

Meet the leading COVID-19 Vaccine Candidates: Dr. Offit with CHOP says immunogenic response will be the key metric of success (safety comes second).
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