Over the past two decades, three human coronaviruses (SARS-CoV, MERS-CoV, and SARS-CoV-2) have emerged worldwide and there is still no approved vaccine for any of them.

Greedy nations race each other in a drug-ridden CoVID Olympics, spending billions to find the gold medal vaccine.

Yet we are told the greatest elite performer on earth – a  CoVID-19 vaccine — is almost on the starting blocks. Let the games begin…. As of 1 June 2020, 157 vaccine candidates are undergoing development by academic labs and industry.

Creating a truly effective vaccine is a tricky business and there are a lot of contenders trialling a range of approaches. The most traditional and proven effective candidate is a live but attenuated (weakened) virus. This type of vaccine was used successfully to eradicate smallpox and more recently polio. A live-virus formulation appears to be a gold medal contender in the vaccine Olympics, but this approach is not without hurdles.  As with the polio vaccine, a live virus can go “wild” and infect a new generation.  Another problem with live viruses is that, rather than protect against a virus, they can enhance the activity of the virus and make the sickness worse (as has been found with Zikka and Dengue vaccines).

A solution has been to only use a part of the live virus genome – a subunit, which results in safer and fewer side effects. However, both these live virus approaches require precise refrigeration for transport – not only to ensure viability but also to prevent inadvertent inoculation due to poor safety measures. Because of these issues, such vaccines are unlikely to medal in the vaccine Olympics next year.

Finding enough refrigeration units to transport the vaccine may be the biggest hurdle for them. WHO reported that 2.8 million vaccines were lost in five countries due to cold chain failures, and fewer than 10% of countries had effective vaccine management practices.

Inactivated vaccines, which are made up of killed viruses, are another alternative and have been used widely in preschool and school vaccination programs. They are safer but require multiple doses to establish protection, which would require larger production batches. They also need to be kept temperature controlled. Apart from these problems, it is difficult to see how a population divided and somewhat suspicious about wearing masks would be open to have repeated vaccinations. Another approach that is not likely to finish strong in the vaccine Olympics.

Vaccines that are made up of just the master genetic code (DNA) or the intracellular code (RNA) are now very much in vogue because they are supposed to be safer, speedier, more stable and easier to scale up for production. Unfortunately, they have yet to be proven effective and though they have been tried to fight a number of infections, to date there is no licensed DNA or RNA vaccine. Such vaccines are unlikely to make it past the Youth Olympic Games.

Timely, sufficient production and transportation of vaccines are not the only problems. There is the issue of how to get the vaccine to work in the right place in the body. Some researchers are trialling using other viruses, for example the Chimpanzee adenovirus, that are not toxic to humans (supposedly they don’t jump between species to humans as the coronavirus does) to get the vaccine inside us and help the immune system. There are no examples of these types of vaccines on the market, their safety may come into question. May be disqualified.

To date, the production and trialling of CoVID vaccines has been largely unregulated and greedy nations continue to race each other in a drug-ridden CoVID Olympics, spending billions to find the gold medal vaccine. Accommodating regulatory agencies, such as the   FDA  have loosened their guidance about appropriate trials. Unfortunately, little is really known about how you can prove that a preventive activity, such is vaccination, is effective without putting lots of unvaccinated people at risk. Even if finalists emerge, the stakes are great and there are bound to be challengers, ensuring that the gold medal will be in doubt for some time to come.