When Ebola exploded across West Africa in 2014, it took more than five years to get a vaccine approved by drug regulators.

Fast forward to 2020, and researchers were able to develop multiple protective coronavirus vaccines and get them authorised within 12 months of the virus being discovered.

It’s a spectacular and unparalleled scientific achievement — and promises to help bring the pandemic under control.

But it’s left some people wondering: if vaccines normally take years to develop, just how did we get here so fast?

Previous research and pandemic prep Years of research and new vaccine technologies meant we were already a few steps ahead.(ABC: Edwina Seselja)

It can be tempting to think that COVID-19 vaccine development kicked off when the pandemic did. In reality, scientists had spent years building vaccine technologies that could be quickly adapted to emerging viral threats — sometimes known as ‘Disease X’.

Thanks to funding bodies like the Coalition for Epidemic Preparedness (CEPI), researchers at Oxford University had been working on a vaccine that could be quickly tweaked to target COVID-19.

The technology involves using a harmless common cold virus (that infects chimpanzees) and engineering it to carry proteins of other viruses you want to protect against.

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The research meant that as soon as the genetic sequence of SARS-CoV-2 (the virus that causes COVID-19) became available, the Oxford team was able to use the virus’s genetic blueprint to modify their vaccine and begin testing it in clinical trials.

Similarly, development of a different vaccine approach, using mRNA technology — used in both Pfizer’s and Moderna’s COVID-19 vaccines — allowed researchers to work much faster than if they had relied on traditional vaccine methods, such as using weakened or inactivated parts of the virus.

Like the Oxford vaccine, the mRNA vaccines could be made fast because they only required the genetic sequence of SARS-CoV-2, and not a sample of the actual virus.

Billions of dollars in funding Extra resources and financial gambles allowed research and manufacturing to begin quickly.(ABC: Edwina Seselja)

Vaccine research costs money — a lot of money — and often this can be difficult to secure.

Less so in a pandemic, it turns out, and in the face of widespread social and economic devastation.

Thanks to billions of dollars from governments, the private sector, and funding bodies like CEPI, researchers had access to immediate and substantial funding for COVID-19 vaccines.

This meant multiple clinical trials were launched quickly, and pharmaceutical companies were able to manufacture and stockpile vaccines before they even knew if they were effective.

In normal circumstances, drug companies never hedge their bets like this — it would be too costly if their vaccine failed and the doses had to be scrapped.

But in a pandemic, having the right infrastructure in place and vaccine doses ready to go is critical, so governments assumed bigger financial risks.

Less bureaucracy, and back-to-back trials Vaccine research is expensive, which means clinical trials are usually slow to progress.(ABC: Edwina Seselja)

One of the reasons vaccine development normally takes so long is because the testing process itself — specifically, the time in between the different phases of clinical trials.

First, the vaccine needs to be tested in cells in the lab, and then it must be shown to be safe and protect against infection in animals. Next, researchers have to get approval to study the vaccine in humans, and secure funding to start the first of three phases of human trials.

Phase 1: Testing in a small number of humans. This part is about making sure the vaccine is safe.Phase 2: More testing in humans — does the vaccine trigger strong immune responses?Phase 3: Testing in a larger number of humans to confirm its efficacy and safety.

Each phase usually involves writing grant applications and recruiting hundreds if not thousands of people.

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At each stage, pharmaceutical companies also want to assess the data and work out if the vaccine is worth pursuing. All of this can take years.

While the COVID-19 vaccines have gone through the same rigorous safety checks, the clinical trials have been prioritized, so there’s been little waiting around.

Thanks to significant funding injections and lots of people willing to take part in research, scientists have been able to run clinical trials in parallel — e.g. recruiting for phase 3 while they’re still finishing phase 1 — rather than do things sequentially (and slowly).

This, in addition to getting data to drug regulators earlier, has shaved months if not years off the process. Most importantly, it hasn’t compromised the safety of the vaccines.

A bit of luck that it was a coronavirus The scientists working on COVID-19 vaccines had experience with other coronaviruses.(ABC: Edwina Seselja)

Before 2020, most of us had never heard of the word ‘coronavirus’. But for people in the health and science community, the term was nothing new.

Coronaviruses are a well-known family of viruses, thought to be behind up to a third of all common colds, and responsible for the SARS epidemic in 2003, and MERS outbreak in 2012.

Previous work on SARS-CoV, MERS-CoV, and other common human coronaviruses meant researchers weren’t totally starting from scratch with SARS-CoV-2.

They already had some understanding of the virus’s biology, including its all-important spike protein.

Previous research had demonstrated the spike protein was essential to the virus gaining a foothold in the body, and a ripe target for an effective vaccine.

For expert input into this article, we thank: Dr Kylie Quinn, vaccine expert, RMIT University; Dr Kirsty Short, virologist, University of Queensland.

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