The people's vaccine for global health

The Texas Children’s Hospital Center for Vaccine Development (Texas Children’s CVD) and Baylor College of Medicine have developed a vaccine for everyone called Corbevax¹. It is the first Covid-19 vaccine designed specifically for global health. It is a milestone for global vaccine equity. It can be mass-produced at a low cost, using a well-established technology that is easily transferred to countries with limited assets. It was developed without taxpayer money, with no funding from Project Warp Speed (a public and private partnership that was started by the United States Government to facilitate and accelerate the development, manufacturing, and distribution of Covid-19 vaccines, therapeutics, and diagnostics). It’s a model for developing a potent vaccine without substantial public funding1. In the last week of 2021, India’s drug regulation agency authorized the distribution of Corbevax. The U.S. International Development Finance Corporation (DFC) and Biological E. (BioE) announced that they are expanding BioE’s vaccine manufacturing facility in Hyderabad, India². This will increase the company’s capacity to produce Covid-19 vaccines. The central government of India has already ordered 300 million doses. Another 100 million or more doses per month will be produced starting in February. In addition, BioE plans to deliver more than one billion additional doses to other countries. This includes low- and middle-income countries in Africa, Asia, and Latin America, where vaccine availability has generally been very low². It took longer to develop than mRNA vaccines, but it is poised to save many more lives. It is a good example of the benefits of slow medicine³. It’s also an amazing example of how many good people are not motivated by personal profit, but by the public good. They care about the needy – not the greedy. In contrast, major producers of currently used Covid-19 vaccines resist efforts to remove patent protection despite receiving billions of dollars of taxpayers’ money.

Corbevax is made by microbial fermentation in yeast, similar to the process used to produce the recombinant hepatitis B vaccine that many countries with limited resources already make and give to their people². This will enable local manufacturing of this vaccine. Texas Children’s CVD and Baylor have already licensed the vaccine technology to companies in Indonesia and Bangladesh and have licensed it for production in African countries such as Botswana. Vaccines can and should be produced locally and widely in countries in the Global South using simple technology and licensing agreements.

Two years into the pandemic and with the Omicron variant killing millions of people, Corbevax is the first Covid-19 vaccine designed specifically for global health. It is a great accomplishment for global vaccine equity. It may also help overcome vaccine hesitancy, and serves as a blueprint for how to develop a potent vaccine for pandemic use in the absence of substantial public funding.

It is possible that the world might have been vaccinated by now if Texas Children’s CVD had received just a fraction of the support given to biotech and multinational companies. We could have prevented the emergence of the deadly and highly transmissible variants. So, they continue to ask the government of the USA and G7 nations for assistance to co-develop the vaccine with new partners in other low-resource countries. This includes safely advancing them to the Covax sharing facility for global distribution. During this next year, they hope to partner with the World Health Organization and other United Nations agencies to finally vaccinate the world. This low-cost, safe and effective vaccine is easy to store and distribute. It might help us to achieve global vaccine equity and overcome vaccine hesitancy and refusal¹.

Corbevax does not use the entire spike protein as its antigen, as do other vaccines, including the mRNA vaccines from Moderna and Pfizer/BioNTech⁴. This is very important because the Omicron variant has over 30 mutations in the spike protein. This makes it resistant to the immune systems of many people, including those who have been vaccinated and have received booster shots. Instead, Corbevax uses just the receptor-binding domain (RBD) of the spike protein as the antigen and an optimum adjuvant consisting of Dynavax (DVAX) CpG^2,5-7. Corbevax is made with technology that has been used worldwide for decades. So, the manufacturing processes are already well-known and won’t require a steep learning curve that is needed for the scale-up of new technologies such as mRNA, adenovirus, and protein particle vaccines¹.

Like the recombinant hepatitis B vaccine that is made using the same technology, Corbevax has an excellent safety profile¹. In phase 3 clinical trial conducted in India, Corbevax produced mainly mild adverse events, making it perhaps one of the safest Covid-19 vaccines in use. When compared with doses of the AstraZeneca–University of Oxford vaccine manufactured by the Serum Institute of India, Corbevax also produced a higher amount of neutralizing antibodies against the Delta and Beta variants of the SARS-CoV-2 virus that causes Covid-19. They expect to have Omicron data soon. Corbevax provided more durable and lasting protection. It can be stored using simple refrigeration. And like the hepatitis B vaccine, this Covid vaccine has one of the lowest costs of any available to date. No patents have been filed on the vaccine technology, and Texas Children’s CVD is assisting and co-developing the vaccine alongside BE and other vaccine producers in the Global South. This helps keep the cost low. Hundreds of millions of people have already been vaccinated with the recombinant hepatitis B vaccine over multiple generations. It is anticipated that people will readily accept Corbevax and similar recombinant protein Covid vaccines, including for pediatric use. Clinical trials in children are also underway in India. Parents may even be more willing to accept Corbevax than vaccines made with newer technology. If there was ever a Covid vaccine that might triumph over vaccine hesitancy and refusal, this could be the one. Remarkably, Texas Children’s CVD did this with no major federal or G7 support, instead of relying almost exclusively on private philanthropy based in Texas, New York, and elsewhere¹.

Even though the global elite seems to be insane and addicted to over-consumption, the vast majority of the world’s people are not. They are quite willing to make personal sacrifices for the good of society as a whole. There is a long history of abolitionists fighting slavery and injustice⁸. In my opinion, there is still hope for humanity.