Could a universal coronavirus vaccine be the silver bullet that will end this pandemic — and the next?

First-generation vaccines were not the panacea hoped for in the early days of COVID-19. Also, herd immunity didn’t come in to save the day.

Could a so-called ‘pan-coronavirus’ vaccine be the long-awaited silver bullet that will end the COVID pandemic — and the next one too?

Answer: It’s complicated.

“The term pan-coronavirus vaccine needs an asterisk next to it,” Dr. Stuart Ray, vice president of medicine for data integrity and analytics at Johns Hopkins’ Department of Medicine, Fortune.

Such a vaccine could target all coronaviruses, named for their crown-like appearance under a microscope. Or it could focus on COVID-19 and its myriad variants. Or it could tackle the four long-standing coronaviruses that circulate as the common cold — or a combination of them.

It could also protect against SARS (Severe Acute Respiratory Syndrome), a coronavirus that emerged in 2002 and killed hundreds, and MERS (Middle Eastern Respiratory Syndrome), another coronavirus that emerged in 2012 and killed hundreds.

Aside from the possibility of ending the current coronavirus pandemic, it could even be able to crush the next one once it starts.

“Coronaviruses are jumping into the human population,” says Dr. Duane Wesemann, Harvard Medical School professor and principal investigator in Brigham and Women’s Hospital’s Division of Rheumatology, Immunology, and Allergy. He is leading a team of researchers working on a pan-coronavirus vaccine with funding from the US National Institutes of Health.

“I do not know when” [the next will]† Maybe not in our lifetime. But it will probably happen someday. Is there a way to develop a vaccine that will be available to us in the setting of SARS-CoV-3?”

Whatever form such a vaccine may take, it is a worthy goal, Dr. Bruce Walker — director of the Ragon Institute of MGH, MIT and Harvard, a medical institute focused on disease eradication, and co-leader of the Massachusetts Consortium on Pathogen Readiness —said Fortune

But it can forever remain that: a goal.

“I think we need to be ambitious in pushing for a pan-coronavirus vaccine, but it won’t be an easy task,” Walker warned. “There is no clear path forward.”

Work in progress – and possibly years of work ahead

However pie-in-the-sky the goal is, there’s no shortage of work to achieve it. A universal coronavirus vaccine is a top priority for nonprofits, government agencies and vaccine makers, according to an April article in Nature.

Among entities with a version in development: Moderna, Duke University, and countless biotech companies.

Clinical trials are underway for US military and CalTech efforts, Dr. Amesh Adalja, a senior scientist at the Johns Hopkins Center for Health Security, Fortune.

Such a vaccine could indeed serve as a ‘silver bullet’, he said: ‘That would be the way you take this threat off the table – not just SARS-CoV-2, but all coronaviruses. And to ward off 30% of colds would be a really good thing.

But these things take time, he said. A striking example: the flu vaccine.

“We don’t have a universal flu vaccine yet, although people have been working on that for a while,” he said. “There are some versions of a universal flu vaccine in clinical trials, but it’s not something that’s believed to be efficacious and last through multiple flu seasons with multiple strains.”

Another: HIV.

“We’ve been working on vaccines for some pathogens like HIV for decades,” Wesemann said. “Some scientists thought a few decades ago, ‘Gosh, it’ll only be a few years before we have an HIV vaccine,’ but many decades later, we’re still finding out that we need to learn more about how to do this.”

Wesemann said he is more optimistic about developing a pan-coronavirus vaccine, “but we have learned a lot of humility from other pathogens.”

“We don’t understand our immune system as well as it takes to sit down and design the best vaccine,” he said.

Making a universal coronavirus vaccine available to the general public will require additional research, animal studies and early-stage human studies, all of which could take years, Dr. Dan Barouch — a professor of medicine at Harvard Medical School and the director of the Center for Virology and Vaccine Research — told Fortune

And the process isn’t taking place on the accelerated Operation Warp Speed ​​timeline that the original COVID vaccines were on, Adalja noted.

“It will probably be a while before a pan-coronavirus vaccine will be available to the general public,” Barouch said. “I don’t think anyone will go this fall to get this at CVS.”

Promising, but not impenetrable

Even if — or if — a universal coronavirus vaccine is available, it probably won’t be bulletproof, experts warn.

While a pan-coronavirus vaccine has the potential to “help end the pandemic” — at least by halting serious illness and death — its success would depend on enough individuals around the world to get the shot, said Dr. Daniel Kuritzkes, chief of the Infectious Diseases Division at Brighman and Women’s Hospital and professor of medicine at Harvard Medical School.

Otherwise, the virus could even learn to evade a universal COVID vaccine.

“That’s definitely a possibility,” Kuritzkes said.

“As long as the virus continues to circulate among a significant number of people, there is a possibility for continued adaptations of the virus,” he added. “If a variant emerged that had acquired mutations that could evade the immune response of the presumed pan-coronavirus vaccine, the virus could jump into the vaccinated population and re-emerge.”

There are two goals vaccines can pursue, Ray said: to prevent infection altogether, or just prevent severe illness and disruption, as current COVID vaccines do.

A pan-coronavirus vaccine can prevent serious illness and disruption of all variants and sub-variants of COVID-19, theoretically eliminating the need for boosters.

But such a vaccine could still allow the spread of infection, as current vaccines do, experts warn.

“My guess is that if we’re designing a vaccine that has to be as broad as possible, we’re going to have to give up some potency,” Wesemann said.

The concept of the pan-coronavirus vaccine may just be too good to ever materialize, Ray warned, but he hopes such a development “can hit that sweet spot to be truly protective and sustainable.”

“One of the things that keeps us up at night is that if we do things that don’t control its spread, it will continue to evolve and find a hole in our armor,” he said.

One possible gap: Long COVID, a potentially debilitating condition that could affect up to 23 million Americans who have survived an infection, according to federal officials.

Research shows that “even mild to moderate COVID-19 can have long-term consequences for cardiovascular and mental health outcomes,” Ray said. “We might find that we can prevent the severe first few weeks of the disease, but see a build-up of damage from relatively mild infections.”

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