How close are we to a coronavirus vaccine?

The fast-paced hunt by scientists and Drug companies for tools to control the worsening pandemic appears to be paying off. Moderna Inc. said its Covid-19 vaccine was 94.5% effective in a preliminary analysis of a large late-stage clinical trial. The positive readout comes just a week after a similar shot developed by Pfizer Inc. and BioNTech SE was found to be more than 90% effective in an interim assessment.

Both Moderna and Pfizer are expected to seek emergency-use authorization from US regulators if further study shows their vaccines are safe. AstraZeneca Plc and its partner, the University of Oxford, may also have preliminary results in the next few weeks.

Many questions remain about longevity of protection and how easily vaccines can be deployed. Still, the positive results are welcome at a moment when nations across the globe are imposing tougher restrictions as cases soar heading into winter. There has also been Progress with some potential treatments.

Vaccines

Vaccines give broad parts of the population some level of immunity and are considered crucial to ending the pandemic. They also take longer to develop, in part because they must be proven to be extremely safe since they're given to healthy people. There are currently more than 180 coronavirus vaccines in development, according to the World Health Organization. And while some researchers say a shot could be ready for emergency use by the end of the year, others say it could take far longer.

BioNTech SE, Pfizer Inc., Shanghai Fosun Pharmaceutical Group Co.

Name: BNT162b2

Progress: Phase 3

BioNTech's BNT162 program is a messenger RNA vaccine platform that the German company is developing with Pfizer. In China, BioNTech is co-developing vaccines with Shanghai Fosun Pharmaceutical Group.

The vaccine prevented more than 90% of infections in a study of tens of thousands of volunteers. The result paves the way for the company to potentially seek an emergency-use authorization from US regulators in November if further research shows the shot is also safe. The findings are based on an interim analysis conducted after 94 participants contracted Covid-19. The trial will continue until 164 cases have occurred. The partners have said they should be able to produce 1.3 billion doses by the end of 2021.

Moderna Inc.

Name: mRNA-1273

Progress: Phase 3

Moderna's mRNA-1273 uses messenger RNA to prompt the body to make a key protein from the virus, creating an immune response.

A preliminary analysis of data from more than 30,000 volunteers showed the shot prevented virtually all symptomatic cases of Covid-19, and also appeared to be effective in preventing the most serious infections. Moderna expects an emergency authorization to be based on a final analysis containing 151 cases, along with two months of safety follow-up data. The program is backed by $955 million from the US government, which separately reached a $1.5 billion deal for 100 million doses.

Oxford University, AstraZeneca Plc

Name: ChAdOx1 nCoV-19

Progress: Phase 3

The vaccine is made from a harmless virus that's been altered to produce the surface spike protein from SARS-CoV-2.

A US late-stage trial was resumed weeks after a pause that followed a volunteer's illness in a separate UK study. The British trial and others elsewhere had already restarted, and European regulators have begun a real-time review of the UK trial.

Johnson & Johnson

Name: JNJ-78436735

Progress: Phase 3

J&J is working on an unNamed adenovirus-based vaccine as well as two backups.

A late-stage trial of J&J's adenovirus-based vaccine was resumed after a pause when a volunteer became sick. The 60,000-person study is the first big US trial of an inoculation that may work after just one dose. The company has clinched supply deals with the US and the European Commission.

China National Biotec Group Co., Sinopharm

Name: Two unNamed candidates

Progress: Phase 3

Two subsidiaries at China's state-owned vaccine maker, one in Beijing and the other in Wuhan, have developed two shots from killed versions of the virus.

Hundreds of thousands of people, including frontline medical workers, have already received China National Biotec's shots under an emergency use authorization.The company is now testing the vaccines in final-stage trials in countries across the Middle East and South America, and expects the shots to be available in China as soon as end-2020.

Sinovac Biotech Ltd.

Name: CoronaVac

Progress: Phase 3

The vaccine uses inactivated virus, which can help the body develop antibodies to the pathogen without risking infection.

Brazil reversed its decision to suspend the final-stage trial of the vaccine, allowing tests to resume less than 48 hours after being halted amid criticism the initial pause was politically motivated.The shot had already been approved in China for emergency use for doctors, customs officials and other frontline workers, while simultaneously in Phase 3 trials in multiple other countries.

Gamaleya Research Institute

Name: Sputnik V

Progress: Phase 3

Gamaleya's candidate is a viral vector vaccine based on human adenovirus—a common cold virus—fused with the spike protein of SARS CoV-2 to stimulate an immune response.

The developer of Russia's flagship vaccine said it shows a 92% efficacy rate in preventing cases of the illness. The preliminary Phase 3 findings are based on results from 20,000 volunteers who were given the first dose, including more than 16,000 who also received a second injection.

CanSino Biologics Inc.

Name: Ad5-nCoV

Progress: Phase 3

CanSino, working with the People's Liberation Army, splices the virus's spike protein into a safe, nonreplicating version of a human adenovirus.

CanSino's viral vector candidate is being tested in Russia, Pakistan and other countries in Phase 3 testing that seeks to enroll 40,000 people. The shot has already received special authorization to be used by China's military.

Inovio Pharmaceuticals Inc.

Name: INO-4800

Progress: Phase 2

Inovio's experimental vaccine uses DNA to activate a patient's immune system.

Inovio says an early trial showed positive immune responses but investors complained about a lack of detail. In September, a phase 2/3 study was put on partial hold by the US Food and Drug Administration before dosing could be started. The agency had questions about the device to be used to deliver the shot.

Novavax Inc.

Name: NVX-CoV2373

Progress: Phase 2

Novavax's vaccine consists of synthetic spike proteins grown in armyworm moth cells.

Novavax has received $1.6 billion from the US government as it prepares for a final-stage study this fall. A first look at phase 1 results was viewed positively on immune responses. In August, phase 2 trials began in the US and elsewhere.

Arcturus Therapeutics Holdings Inc., Duke-NUS Medical School

Name: LUNAR-COV19

Progress: Phase 2

Arcturus and Duke-NUS are developing a single-dose messenger RNA vaccine.

Arcturus Therapeutics dosed its first cohort of patients with its experimental mRNA vaccine in early August. The California biotechnology company has supply agreements in Israel and Singapore. Arcturus's shot may work at lower doses than other mRNA vaccines, making it easier to manufacture in bulk. Results from a phase 1 studay are expected in the fourth quarter.

Sanofi, GlaxoSmithKline Plc

Name: UnNamed candidate

Progress: Phase 2

Sanofi is working on a vaccine using technology already employed in one of its flu vaccines, which could speed development and production.

In September, Sanofi and Glaxo launched human studies at sites across the US Operation Warp Speed has agreed to provide as much as $2.1 billion to the companies to support clinical trials and manufacture an initial 100 million doses, with an option for another 500 million shots. The EU and UK have also clinched deals.

Merck & Co.

Name: V591, V590

Progress: Phase 1

Merck's two vaccine candidates employ exisiting technology behind a measles virus vector platform discovered by the Institut Pasteur and its own Ebola shot, respectively.

Merck's candidate that uses a measles virus vector platform began human trials in September. Its other experimental vaccine, using technology employed in its Ebola shot, will go into human studies imminently. Merck says it doesn't want to have the first available shot, but the one with the greatest global impact.

Imperial College London

Name: UnNamed candidate

Progress: Phase 1

When injected, the RNA vaccine candidate delivers genetic instructions to muscle cells to make the "spike" protein on the surface of the coronavirus.

Researchers have received UK funding and have begun human trials. In July, Imperial College London announced it was expanding its trial to additional sites.

CureVac

Name: UnNamed candidate

Progress: Phase 1

Like those from Moderna, Pfizer and BioNTech, CureVac's shot packages coronavirus-fighting messenger RNA in tiny particles that look to the body like cholesterol.

The German government bought a $344 million stake in the biotech company in June, after speculation the US was looking to buy the business or its technology. Soon thereafter, CureVac launched a phase 1 trial in 168 patients in Belgium and Germany. In August, it announced preliminary plan to supply up to 405 milion doses to EU states.

Sichuan Clover Biopharmaceuticals Inc., Dynavax Technologies Corp., GlaxoSmithKline Plc.

Name: SCB-2019

Progress: Phase 1

Clover Biopharmaceuticals, of Chengdu, China, in collaboration with GlaxoSmithKline, grows proteins resembling the virus's spike protein in a mammalian cell culture and injects them into muscles to trigger an immune response.

Closely-held Clover started testing a vaccine in mid-June. Initial results from the 150-person study are expected by September, according to collaborator Dynavax Technologies Corp. A late-stage efficacy study is targeted for year-end.

Antivirals

Antiviral Drugs work by stopping the virus from replicating or infecting cells. They can include everything from complex biotechnology therapies to older generics. Other examples of antivirals include many HIV Drugs, treatments for hepatitis C, and the influenza treatment Tamiflu.

Gilead Sciences Inc.

Drug: Veklury (remdesivir)

Progress: Authorized

Veklury targets genetic material called RNA and is meant to stop SARS-CoV-2 from replicating. Tried without success as an Ebola Drug, it's complex to manufacture and for now has to be given intravenously.

Remdesivir became the first US-approved therapy in October after early data showed that it sped up patients' recoveries. The company has said the Drug may have a mortality benefit, though a World Health Organization study casts doubt on that.

Regeneron Pharmaceuticals Inc.

Drug: REGN-COV-2

Progress: Phase 3

Regeneron's antibody cocktail consists of two antibodies that bind to spike protein that the coronavirus uses to infect cells. Regeneron used special mice to generate numerous antibodies, and it selected the most potent ones.

Regeneron has three big trials ongoing, both for prevention and treatment, and President Donald Trump has touted its antibody cocktail. In September, early-stage results showed the biotech's therapy cut virus levels in the blood and reduced symptoms in patients being treated outside the hospital. The company is seeking an emergency use authorization in the US

Eli Lilly & Co, AbCellera Biologics Inc., Junshi Biosciences

Drug: LY-CoV555

Progress: Authorized

Lilly is testing a monoclonal antibody against the coronavirus that was discovered using AbCellera's lab-on-a-chip technology for rapidly scanning through numerous Covid-19 antibodies to find the most potent. It's also testing an antibody cocktail with Junshi Biosciences.

The FDA authorized the experimental treatment, called bamlanivimab, for use against mild-to-moderate Covid-19 in adults, including those who are 65 and older, and pediatric patients. The emergency-use clearance gives doctors an option for tackling the virus in high-risk patients before they're sick enough to require hospitalization.

GlaxoSmithKline Plc, Vir Biotechnology Inc.

Drug: VIR-7831 (also called GSK4182136)

Progress: Phase 3

The two companies have been collaborating since April to test multiple monoclonal antibodies against the coronavirus; VIR-7831 is the most advanced candidate, but a second is exepected to move into efficay trials this year.

On August 31, Glaxo and Vir launched a 1,300-patient trial in early Covid-19 to see whether the antibody can prevent hospitalization in high-risk patients. Initial results may be available before the end of the year.

AstraZeneca Plc

Drug: AZD7442

Progress: Phase 1

AstraZeneca's antibody cocktail consists of two antibodies researchers at Vanderbilt University Medical Center derived from convalescent patients that were optimized by AstraZeneca.

AstraZeneca began a phase 1 trial of the antibody combination in 48 healthy patients in August.

Merck & Co., Ridgeback Biotherapeutics LP

Drug: MK-4482

Progress: Phase 2

The antiviral Drug discovered at Emory University inhibits the replication of multiple RNA viruses.

Preclinical studies found the Drug induced mutations causing a range of coronaviruses to make catastrophic errors when they replicate. Merck CEO Kenneth Frazier told Bloomberg it has the potential to be easier to use than Gilead's remdesivir. The companies are launching large, late-stage studies in September.

Takeda Pharmaceutical Co., and the CoVIg-19 Plasma Alliance

Drug: CoVIg-19

Progress: Preclinical

A hyperimmune globulin or a concentrated form of blood plasma from recovered Covid-19 patients, which can contain infection-fighting antibodies that can be used against the illness. Similar treatments have shown promise in treating other serious infections.

The Japanese Drugmaker Takeda and a handful of other companies are developing and distributing a concentrated form of blood plasma from recovered Covid-19 patients. US studies will be done with the NIH.

Zhejiang Hisun Pharmaceutical Co.

Drug: Favipiravir

Progress: Authorized

Favipiravir is a flu medicine that is branded and sold as Avigan by FujiFilm Holdings Corp. in Japan. Favipiravir also targets viral RNA to stop the spread of the virus.

An early study of favipiravir found potential benefits. Russia has shipped a version to hospitals across the country. A US trial is underway to test the Drug in mild cases of the disease.

Generic Drugs made by Teva Pharmaceutical Industries Ltd., Mylan NV, Sanofi, Novartis AG, Bayer AG and others

Drug: Hydroxychloroquine, chloroquine

Progress: Revoked

Hydroxychloroquine and chloroquine are anti-malarial Drugs that have been tested in other viral outbreaks, generally without success. Years old, they're available as lower-cost generics.

Once touted by President Donald Trump, hydroxychloroquine has suffered a series of trial failures. The FDA has pulled its US authorization for use against the virus.

Indirect therapies

These therapies don't directly treat or prevent the virus, but can help patients who have fallen ill by mitigating the disease's effects, such as difficulty breathing or severe inflammatory responses. Such treatments, including a promising generic steroid, could help some of the sickest hospitalized patients.

Generic Drugs made by Mylan NV, Hikma Pharmaceuticals Plc and others

Drug: Dexamethasone

Progress: Phase 3

The low-cost steroid is already widely used to treat a range of ailments including rheumatism, asthma and allergies. It's among a number of anti-inflammatories being studied to help patients cope with a powerful overreaction of the immune system, sometimes called a cytokine storm.

The 60-year-old medicine reduced deaths among patients needing breathing assistance, according to University of Oxford researchers.

Regeneron Pharmaceuticals Inc. and Sanofi; Roche Holding AG

Drug: Kevzara; Actemra

Phase 3Rheumatoid arthritis Drugs that target a pathway known as interleukin-6 or IL-6 can affect inflammation.These medicines could help very sick Covid-19 patients in respiratory distress.

Regeneron and Sanofi stopped a study in patients who needed mechanical ventilation when it became clear Kevzara didn't work any better than placebo. Meanwhile, July results for Roche's Actemra showed it failed to extend the lives of Covid-19 patients with pneumonia. In October, an observational study showed those who got Actemra were 30% less likely to die. The company continues to study the medicine as a treatment for the disease in combination with antivirals.

Incyte Corp., Novartis AG; Eli Lilly & Co.

Drug: Jakafi; Baricitinib

Progress: Phase 3

Jakafi, or Jakavi as it's called outside the US, belongs to a class of Drugs known as JAK inibitors that target inflammation and repress cellular proliferation. Baricitinib, marketed by the brand-Name Olumiant, also belongs to the class of Drugs.

In April, Incyte and Novartis started a trial of Jakafi to address a potential deadly reaction to the disease, in which a patient's immune system kicks into dangerous overdrive. Lilly and the NIH are studying baricitinib with remdesivir in hospitalized patients. A late-stage Lilly-sponsored study started enrolling patients in June to test barictinib on its own in such patients.

Kiniksa Pharmaceuticals Ltd., I-Mab, Humanigen Inc., Roivant Sciences Inc., Sanofi

Drug: Mavrilimumab, lenzilumab, others

Progress: Phase 2

To mitigate the complications of cytokine storm, companies are developing antibodies against human granulocyte-macrophage colony stimulating factor or GM-CSF, a cytokine responsible for inflammation. Some of these medicines are also being developed for rheumatoid arthritis.

Various studies are underway after earlier results showed some patients treated with mavrilimumab had their fevers resolve and did not need mechanical ventilation. Humanigen is furthest along and expects late-stage datafor  lenzilumab in 300 patients the fourth quarter. If results are positive they may be enough for an emergency authorization, the company said after talking to US regulators.

Bristol Myers Squibb Co., Pfizer Inc.

Drug: Heparin, Eliquis

Phase 3Blood thinners may stop some of the potentially fatal effects of blood clots seen in Covid-19 patients, like strokes or heart attacks.

The NIH said in September that trials were underway to test the blood thinner heparin in hospitalized patients. Bristol and Pfizer's Eliquis will be tested in outpatients against aspirin or a placebo in a separate trial. Researchers hope to have results in the coming months.

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Disclaimer: This article first appeared on bloomberg.com, and is published by special syndication arrangement.