Over one year after the first SARS-CoV-2 vaccines entered Phase 1 trials, vaccination campaigns are rolling out around the world. What did we learn from this unique journey?
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On December 31, 2019, the first case of COVID-19 was identified in Wuhan, China, according to the World Health Organization. Since then, the world has changed in a way never seen before. Every country in the world has been affected by this global pandemic, from crippling lockdowns, exponential case numbers, and isolation from the rest of the world. The millions of cases and deaths worldwide have caused immeasurable losses, but even in the hard times, the world was able to persevere and create something incredible. In under one year, the first vaccine for this disease was researched, developed, manufactured, and administered. A process that would normally take 10-15 years, as explained by History of Vaccines, was sped up and successfully completed in less than 10% of that time. The COVID-19 vaccine race is proportionate to the space race in dollars invested and high stakes, and it still isn’t over. Many large companies like Pfizer, Moderna, and Johnson & Johnson have become household names as millions have received their first and second doses. But these companies are only the tip of the iceberg that is the vaccine race. This article explores the timeline of vaccine trials and approvals around the world with a focus on what went well and what went wrong in Canada.
Timeline of Vaccine Trials and Approvals Around The World
Let’s go back in time to July 2021. It has been six months since the first case of SARS-CoV-2 was identified and hundreds of vaccine companies around the world have been working around the clock to develop and test a vaccine that works. In July, many vaccine companies that we now are receiving vaccines from like Moderna and Pfizer are starting their Phase 3 trials: the last trials before they can apply for government emergency use approvals. The following timeline shows many of the major vaccine trials and approvals across the world since July 21, 2020. Funding, vaccine deals, and registration of trials were not included. All information from the timeline was reported by the New York Times with data from clinicaltrials.gov and other federal sources.
July 2020
Oxford University and CanSino move to Phase 3 Trials
Moderna is expected to start Phase 3 trials
Pfizer and BioNTech starts combined Phase 2/3 trial
August 2020
🇨🇦 Calgary-based Providence Therapeutics has shown promising results from animal testing and is seeking funds from Canadian government
Russia approves Gamaleya Institute vaccine before Phase 3 trial beings
California-based Arcturus Therapeutics starts Phase 1/2 trials
AstraZeneca and Oxford University start Phase 3 trials
Cuba's Finlay Vaccine Institute starts Phase 1 trials
Taiwan-based Asimmune stars Phase 1 trials
China’s Sichuan University starts Phase 1 trials
Russia’s Gamaleya Institute starts Phase 3 trials of its already approved vaccine
China approves Sinovac’s vaccine for limited use
September 2020
Sanofi and GSK start Phase 1/2 trials
AstraZeneca halts global trials to investigate serious inflammatory syndrome in one volunteer
University of Hong Kong and Beijing Wantai Biological Pharmacy start Phase 1
AstraZeneca resume vaccine trials in the United Kingdom
Sinovac Biotech start Phase 1/2 trial on children
Johnson and Johnson start Phase 3 trials
Novavax starts Phase 3 trials
SpyBiotech starts Phase 1/2 trials
Vaxart starts Phase 1 trials
German Center for Infection Research starts Phase 1 trials
Thailand’s Chula Vaccine Research Center starts Phase 1
October 2020
AstraZeneca resume vaccine trials in Japan
Russia grants regulatory approval to EpiVacCorona vaccine before Phase 3 trials
ImmunityBio starts Phase 1 trials
Entos Pharmaceutical starts Phase 1 trials
India’s Bharat Biotech starts Phase 3 trials
Israel’s Institute for Biological Research starts Phase 1 trials
Cuba’s Finlay Vaccine Institute starts Phase 1 trials for their second vaccine
November 2020
🇨🇦 Canada’s Symvivo starts Phase 1 trials
India’s Zydus Cadila starts testing DNA-based skin patch vaccine
Turkey’s Erciyes University starts Phase 1 trials
💉 Pfizer-BioNTech vaccine was over 90% effective in preliminary Phase 3 trials
💉 Russian Direct Investment Fund announced their vaccine was 92% effective in preliminary Phase 3 trials
💉 Moderna vaccine was 94.5% effective in preliminary Phase 3 trials
Inovio starts Phase 2 trials
💉 Pfizer-BioNTech vaccine is 95% generally effective and 84% among people over 65 with no serious side effects after Phase 3 trials
China’s Academy of Medical Science and Anhui Zhifei Longcom start Phase 3 trials
West China Hospital and Sichuan University start Phase 2 trials
💉 AstraZeneva and Oxford vaccine was 90% effective depending on dosage in preliminary Phase 3 trials
💉 Russian Direct Investment Fund revise their claim and confirm their vaccine is 90% effective
Italy’s ReiThera ends successful Phase 1 trials
California’s biomedical research institute City of Hope starts Phase 1 trials
Cuba’s Center for Genetic Engineering and Biotechnology’s nasal spray and injection vaccine starts Phase 1 trials
December 2020
United Kingdom gives Pfizer-BioNTech vaccine emergency use authorization
South Korea’s SK Bioscience starts Phase 1 trials
Australia’s University of Queensland abandons vaccine after entering clinical trials
💉 🇨🇦 Canada gives full approval to Pfizer-BioNTech vaccine
UAE gives full approval to Beijing Institute vaccine
The United States gives Pfizer-BioNTech vaccine emergency use authorization
Chinese Academy of Medical Sciences starts Phase 3 trials
India’s Gennova Biopharmaceuticals and Seattle’s HDT Bio start Phase 1/2 trials
Gamaleya Research Institute announces Sputnik V vaccine has 91.4% efficacy rate
CureVac starts Phase 3 trials
Japan’s Shionogi stars Phase 1/2 trials
South Korea's GeneOne starts Phase 1/2 trials
China’s Clover Biopharmaceuticals starts Phase 2/3 trials
Russia’s Vector Institute starts Phase 3 trials
France’s Valneva starts Phase 1/2 trials
Vietnam’s Nanogen Biopharmaceuticals starts Phase 1 trials
The United States gives Moderna vaccine emergency use authorization
Cuba’s Soberna 2 vaccine starts Phase 2 trials
The European Union gives Pfizer-BionTEch vaccine conditional approval
💉 🇨🇦 Canada gives Moderna vaccine approval
Iran’s government vaccine starts Phase 1 trials
AstraZeneca and The Russian Gamaleya Institute start Phase 1 trials of their combination vaccine
Russia approves Sputnik V vaccine for people over 60
Kazakhstan’s government vaccine starts Phase 3 trials
Novavaz starts Phase 3 trials
💉 China approves Sinopharm’s vaccine with 79.34% efficacy rate
United Kingdom gives Oxford-AstraZeneca vaccine emergency use authorization
The World Health Organization gave Pfizer and BioNTech’s vaccine emergency validation
January 2021
India’s Zydus Cadila starts Phase 3 trials
India gives Oxford-AstraZeneca emergency use authorization
India gives Bharat Biotech emergency use authorization
Egypt approves Sinopharm’s vaccine for emergency use
Israel gives Moderna vaccine emergency use authorization
Taiwan’s Medigen starts Phase 2 trials
European Union gives Moderna vaccine conditional marketing authorization
Arcturus Therapeutics starts Phase 2 trials
🇨🇦 Vaccine and Infectious Disease Organization (VIDO) at the University of Saskatchewan start Phase 1/2 trials
💉 Sinovac vaccine CoronaVac confirmed efficacy rate of just over 50%
ImmunityBio starts second Phase 1 trial in South Africa
Israel’s Institute for Biological Research starts Phase 2 trials
Turkmenistan registers Russia’s Sputnik V vaccine
Brazil gives Oxford-AstraZeneca vaccine emergency use authorization
Turkey’s Erciyes University starts Phase 2 trials
Merck abandons vaccines developed with Themis and IAVI
Medigen and Dynavax start Phase 2 trials
🇨🇦 Canada's Providence Therapeutics start Phase 1 trials
💉 Novavax was 89.3% effective in United Kingdom trials and below 50% effective in South Africa trials
💉 Johnson and Johnson was 72% effective in the United States, 66% in Latin America, and 57% in South Africa
February 2021
ImmunityBio starts Phase 1 trial of an oral version of the vaccine.
China’s Clover Biopharmaceuticals cancels Phase 2/3 trial with GSK adjuvant and will move forward with Dynavax adjuvant trials
💉 Russia’s Sputnik V vaccine has a 91.6% efficacy rate
Cuba’s Abdala vaccine starts Phase 2 trials
Mexico gives Russia’s Sputnik V vaccine emergency use authorization
AstraZeneca vaccine is protective against the variant in Britain with 84% efficiency
South Africa stops plans for AstraZeneca vaccine rollout due to mutation prevalence
Iran's second vaccine starts Phase 1 trials
SK Bioscience starts Phase 1/2 trials
Takis Biotech and Rottapharm start Phase 1 trials
India’s Bharat Biotech’s nasal spray starts Phase 1 trials
China’s Shenzhen Kangtai starts Phase 2 trials
Russia approves Chumakov Center vaccine for early use
Sanofi starts Phase 2 trials for a stronger formulation of their vaccine
Thailand's Mahidol University starts Phase 1 trials
Brazil, Guyana, Egypt, Honduras and Guatemala approves Russia’s Sputnik Vaccine
Bahrain gives Johnson & Johnson shot emergency use authorization
China approves CanSino and Sinopharm vaccines for general use
💉 🇨🇦 Canada grants Oxford-AstraZeneca vaccine emergency use authorization
US grants Johnson & Johnson’s vaccine emergency use authorization
March 2021
VBI Vaccines starts Phase 1/2 trials.
Cuba’s Soberana 2 starts Phase 3 trials
💉 🇨🇦 Canada authorizes Johnson & Johnson vaccine
Bavarian Nordic starts Phase 1/2 trials
China’s Academy of Military Medical Sciences starts Phase 2 trials
Nanogen Biopharmaceutica starts Phase 2 trials
European Union grants Johnson & Johnson conditional marketing authorization
Denmark, Iceland, and Norway pause Oxford-AstraZeneca vaccine rollout due to concerns of blood clotting
💉 Novavax vaccine 96% effective against original coronavirus and 86% against British variant
Sanofi and Translate Bio starts Phase 1/2 trials
China authorizes Anhui Zhifei Longcom and the Institute of Microbiology of Chinese Academy of Sciences' vaccine
Germany, France, Spain, Italy, the Netherlands, and Ireland halt Oxford-AstraZeneca vaccine rollout for concern about blood clotting
🇨🇦 Canada’s Medicago and GSK start Phase 3 trials
Meissa Vaccines’ intranasal vaccine starts Phase 1 trials
Iran’s Ministry of Defence’s new vaccine starts Phase 1 trials
Brazil grants full approval to Oxford-AstraZeneca vaccine
Cuba’s Abdala vaccine starts Phase 3 trials
💉 AstraZeneca is 79% effective at preventing symptomatic COVID-19 and 100% effective against critical disease
Daiichi Sankyo and the University of Tokyo start Phase 1/2 trials
China’s Zhongyianke Biotech's vaccine starts Phase 2 trials
💉 AstraZeneca revises results, saying their vaccine is 76% at effective at preventing symptomatic COVID-19
🇨🇦 Health Canada updated the Oxford-AstraZeneca vaccine label to include side effects of very rare reports of blood clots
Turkey’s Middle East Technical and Bilkent University start Phase 1 trials
Pfizer-BioNTech vaccine is highly effective in adolescents aged 12 to 15
April 2021
Walter Reed Army Institute of Research starts Phase 1 trials
Japan’s KM Biologics starts Phase 1/2 trials
Turkey’s Koçak Farma starts Phase 1 trials
Akston Biosciences's vaccine starts Phase 1/2 trials
Cuban Soberana Plus's vaccine for COVID-19 survivors starts Phase 2 trials
U.S. health agencies pause the use of Johnson & Johnson vaccine after six women developed a rare disorder involving blood clots
Denmark permanently stops use of AstraZeneca vaccine
Philippines give Johnson & Johnson emergency use authorization
Philippines give Bharat Biotech emergency use authorization
China’s Shenzhen Kangtai starts Phase 3 trials
Iran’s Shafa Pharmed Pars starts Phase 3 trials
France's Valneva starts Phase 3 trials
Iran’s Razi Vaccine and Serum Research Institute start Phase 2 trials
Baylor College of Medicine and Texas Children’s Hospital start Phase 3 trials
China’s Sinopharm's third vaccine starts Phase 1/2 trials
The Scientific and Technological Research Council of Turkey starts Phase 1 trials
May 2021
Elixirgen Therapeutics starts Phase 1/2 trials
Denmark stops use of Johnson & Johnson vaccine
China’s Lanzhou Institute of Biological Products, Beijing Zhong Sheng Heng Yi Pharmaceutical Technology and Zhengzhou University start Phase 1/2 trials
Russia approves Gamaleya vaccine’s one-dose version “Sputnik Light” which has a reported 79.4% efficiency
The World Health Organization grants Sinopharm vaccine emergency use authorization
The United States authorizes Pfizer-BioNTech vaccine for children 12 to 15
💉 🇨🇦 Canada approves Pfizer-BioNTech vaccine for children 12 and up
France’s OSE Immunotherapeutics starts Phase 1 trials
China gives Shenzhen Kangtai’s vaccine emergency use authorization
China's Stemirna Therapeutics starts Phase 1 trials
Pennsylvania-based VaxForm starts Phase 1 trials
France’s Sanofi starts Phase 3 trials
June 2021
The West China Hospital of Sichuan University starts Phase 3 trials
China’s Academy of Military Medical Sciences starts Phase 3 trials
The Republic of the Congo, Belarus, Mauritius, Nicaragua, Palestine, and Venezuela approve the Russian one-dose "Sputnik Light" vaccine
America's National Institute of Allergy and Infectious Diseases start a booster shot trial of Moderna, Pfizer, and Johnson & Johnson vaccines
University of Washington and Icosavax starts Phase 1/2 trials
Australia’s Vaccine starts Phase 2 trials
💉 Novavax vaccine’s Phase 3 trials show it has 90.4% efficacy
Iran gives Shafa Pharmed Pars vaccine emergency use authorization
Vietnam’s Nanogen starts Phase 3 trials
💉 CureVac has 47% efficiency rate at the recent trial
Kazakhstan’s second vaccine starts Phase 1/2 trials
💉 Cuba's Abdala vaccine has a reported efficacy rate of 92%
Turkey’s Erciyes University's vaccine starts Phase 3 trials
Iran’s Ministry of Defence's vaccine Fakhravac starts Phase 2 trials
Altimmune abandons Phase 1 trial of their nasal spray vaccine
Iran gives Cuba’s Soberana 2 vaccine emergency use authorization
Iran’s Baqiyatallah University of Medical Sciences starts Phase 1 trials
July 2021
Zydus Cadila’s vaccine has 66.6% efficacy.
Johnson & Johnson announced their vaccine provides durable protection against the Delta variant
Bharat Biotech’s vaccine has 77.8% efficacy against symptomatic COVID-19, 93.4% against severe COVID-19, 63.6% against asymptomatic COVID-19, and 65.2% against the Delta variant
Tetherex Pharmaceuticals starts Phase 1 trials
Thailand’s Baiya Phytopharm starts Phase 1 trials
Cuba authorizes the Abdala vaccine for emergency use
CyanVac starts Phase 1 trials
Focus on Canada: Successes and Failures
Domestic production
The transmissibility of the coronavirus wasn’t the only reason countries hunkered down and slowed international trade. Many countries realized that although a vaccine would benefit us all, it would benefit those who could make one domestically first. Canada’s neighbour, the United States, has some of the best R&D facilities and manufacturing plants in the world so it's no surprise they were able to pull off their ambitious mass vaccination campaign ahead of the deadline, as written by Bloomberg vaccine tracker. Canada, on the other hand, was not as successful. A CBC article explained that at the start of the pandemic, we didn’t have a manufacturing facility that could be used to produce the viral vector or mRNA products needed for COVID-19 vaccines. We were completely reliant on imported supplies that were at times not able to meet domestic demand. Having a domestic production supply would have put Canada on the same level as the USA and the UK on rollout capabilities. In hindsight, the government is acting to prevent this from happening again with a $415 million dollar Sanofi vaccine production facility in Toronto, according to Global News. The facility will be completed by 2027 and will mainly create flu shots, but the effort is a little late.
AstraZeneca
CBC News explains that in late February, Health Canada approved the AstraZeneca vaccine for adults 18+ saying it provided a 62% protection against COVID-19. At the time, they said there were no serious health concerns and although the efficacy was less than Pfizer and Moderna, it was good enough to protect Canadians. Later, after seeing cases of rare-blood clotting due to the vaccine, the Government of Canada issued a label change to the vaccine to add the rare side effect “may cause blood clots”. However, CBC News also wrote that in March, Quebec, Ontario, Alberta, Saskatchewan, Manitoba, Newfoundland and Labrador and Prince Edward Island stopped the use of the vaccine, for anyone under 55, claiming the risk of blood clots outweighed the protection provided for the age group. Later in May, Ontario and Alberta stopped giving out the AstraZeneca vaccine altogether, according to Reuters. Currently, there is still mixed delivery of this vaccine across the provinces and the health risks and benefits have not been properly communicated.
Approval for youth aged 12-15
On May 5, 2021, Health Canada approved the Pfizer-BioNTech vaccine for children ages 12-15. On December 9, 2020, the vaccine had been approved for those 16 and up. Making sure children are vaccinated is crucial to the reopening of schools and daycares. As we move towards a return to normal, this is a first two to full population vaccination.
Final Message
As we reach the “light at the end of the tunnel,” we can look back at the progress, mistakes, and successes accomplished over the last year and critique it all we like. However, after being faced with a pandemic of proportions never before seen in human history, there is no doubt that we have done many great things. The world saw revolutionary scientific breakthroughs that will hopefully protect us if any similar threat were to rise again.
Article Author: Ria Patel
Article Editors: Victoria Huang, Valerie Shirobokov