Athens-born Dr. Constantinos Kyriakis is one of the dedicated researchers around the world who is currently working on developing a vaccine for the Covid-19 coronavirus. Kyriakis, an Assistant Professor of Virology at the College of Veterinary Medicine, at Auburn University, is collaborating with the University of Georgia, and hopes to begin preclinical animal trials soon so that they can proceed to the next stage of the vaccine development process.
Kyriakis received his Doctor Of Veterinary Medicine (DVM) at the Aristotle University of Thessaloniki and his PhD in virology and vaccinology at Ghent University in Belgium.
Upon completion of his PhD, the young researcher held several positions in Greece, including Technical Director at Animal Health Division of Medical Products Ltd, based in Athens, and Lecturer of Veterinary Medicine at the University of Thessaly.
Kyriakis’ research has primarily focused on influenza viruses and novel vaccine technologies for more than a decade.
Greek Reporter managed to catch up with Kyriakis to discuss his potentially crucial work in the fight against the coronavirus, his thoughts on the current situation, and the controversial “Herd Immunity” policy which has been widely discussed across the globe since the start of the pandemic.
“We quite simply will not have a vaccine ready for some time,” Kyriakis states to Greek Reporter bluntly. “When we had the SARS-CoV-1 and MERS-CoV outbreaks a few years ago, we did not go as far as we should have with regards to vaccine studies. They did do some preclinical studies in animals, but only one vaccine was tested in humans, which ultimately means we have no research or platform to work from.”
“So when you want to create a vaccine you begin by choosing your technology, and deciding on the type of vaccine that is most suited,” Kyriakis explains. “Is it better to produce an inactive vaccine, which is what most vaccines are, a “subunit” vaccine, or a live vaccine, and then you would conduct your tests, and begin your studies,” the researcher states.
“This is just the pre-clinical trial stage; there are a further three stages to conduct if this initial stage is successful, and you can only progress to the clinical trials if the initial tests don’t cause any major side effects and are deemed safe to test on humans,” he explains.
“Phase 1 of clinical trials requires 50 to 100 volunteers. You provide all of them with the vaccine, and measure the appropriate responses.” Kyriakis states. “When we have determined the vaccine is safe, and the immune responses are positive, with minimal side effects, you move to Phase 2, which requires roughly 500 -1000 people.
At this phase, only half of the volunteers will receive the vaccine, and the other half a placebo. This phase provides you with much more solid conclusions than the first and allows you to confidently move onto Phase 3, quite obviously the most important of all,” Kyriakis adds.
He then goes on to say that “Phase 3 requires around 2,000 – 3,000 people, but the difference between these volunteers and the volunteers in Phase 1 & 2 is that these volunteers have to be a true representation of the population. Young, old, people with pre-existing health conditions, etc. Phase 1 & 2 we only use healthy volunteers to reduce the risk.”
“Phase 3 is also double-blinded and random, neither the person who provides the vaccine or the person receiving it will know whether they have had the vaccine or placebo. This adds further legitimacy to the results, and allows us to be sure that the vaccine is effective.”
However, this painstaking process does not stop there.
“If these clinical trials are successful, you have to go to the relevant medical authorities — the FDA in the US and the European Medicines Agency in the EU — to apply for a license, so you can then begin production of the vaccine on a mass scale,” Kyriakis states.
Each phase of the clinical trials is expected to take 2-3 months if there are no issues or anomalies, and it is not yet certain how quickly manufacturers can produce the vaccine even when one is approved.
The concept of herd immunity has been the subject of heated debate around the world in recent months. When two senior government officials in the UK announced it as a key aim in the fight against the virus, it prompted widespread alarm and was quickly denied by the Health Secretary.
Despite this skepticism and pushback, though, several countries are implementing the policy, or still considering it.
“As a vet, I am very familiar with herd immunity; the clue is in the name, it is used widely in the veterinary world. You would accept that your flock will be exposed to the pathogen and potentially lose 5% of your animals — it would not be a disaster,” Kyriakis calmly explains to Greek Reporter.
“The recovery of the remaining 95% of the herd would cause a much stronger immune response against any future outbreaks. History tells us (and that does not mean this will happen) but in pandemics, you usually have several waves, the first and second causing the most problems, and the third you will have built herd immunity. This happened with the 1918 Spanish flu,” Kyriakis adds.
“I think it has had mixed responses from scientists around Europe because we do not know the full severity of this virus yet. It is the broad understanding that the virus affects the older population more severely but we have also seen cases of very young people with no pre-existing conditions contracting and succumbing to the virus, so herd immunity is very high risk,” the researcher admits.
“You also need healthcare systems that can cope with the increased number of people contracting the virus, and I am not sure how many countries, if any, in the world have the level of infrastructure and discipline required to implement herd immunity,” he states.
Our conversation turns to prevention, response, and future-proofing. Kyriakis smiles and takes a deep breath.
“In one word, ‘transparency.’ The world needs to be more transparent about outbreaks and report them immediately to the relevant organizations so the world can immobilize and start to put processes in place earlier, preventing spread,” Kyriakis states firmly.
“The world’s response, when it was correctly notified, has been pretty impressive. Scientists had the full gene sequence of this virus in weeks! In the case of SARS-CoV-1, it took months!” Kyriakis says emphatically. “That was very important,as we were able to produce genetic molecular diagnostic methods that were reliable enough to identify the virus accurately.”
“There are also so many clinical drugs in trials at the moment, some of which are novel (new), some of which are already licensed and on the market but could be repurposed to fight the virus. This again shows a very rapid response. We did not have this response in the past.
“And even the fact we are testing vaccines so quickly is impressive. This shows the rapid advancement of technology in the scientific world,” the researcher states in a promising tone.
Kyriakis further illustrates his point by displaying a portable sequencer which is no larger than the average smartphone and looks very light; it actually requires just a few additional parts and a power source. The device allows researchers to identify pathogens on the spot in the field, identifying issues quickly and effectively.
“Look, scientists have been talking about the possibility of a pandemic transmitted from animals for years. We know that any pandemic in the future will come from animals — there is no doubt about that — and we are pretty aware of any pathogens circulating in the human population, but what caught 90% of scientists off guard was that we were all expecting an influenza pandemic,” he explains.
“There are so many different possible combinations of influenza that can spill over to humans, I am almost sure that the next pandemic will be influenza. This is what happened in 2009.”
“Had this been an influenza pandemic we would have been more prepared. Why? We have antiviral drugs against influenza and we know they work, they are licensed, tested, everything, we could have had them deployed immediately. Secondly, we have decades of old influenza vaccine technology. A vaccine against an influenza pandemic is possible within three months, no exaggeration.”
“The reason that COVID-19 is causing so much disruption is that healthcare systems around the world were completely unprepared, nobody expected we would need so many ventilators, or intensive care units,” he explains.
“To future proof, we need a serious intensification of surveillance on the animal population, get them analyzed and sampled in the lab, so we have a platform of data that allows us to scale up the production of vaccines more effectively in the future.”
He continues, saying “the combination of these things, increased surveillance, giving us earlier warning signals, and research will help us be more efficient in creating a vaccine.”