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A review on Promising vaccine development progress for COVID-19 disease
Revisión sobre el avance prometedor del desarrollo de vacunas frente a la enfermedad por COVID-19
Tafere Mulaw Belete
Corresponding author
mutafere@yahoo.com

Tell +251 918045943.
Department of Pharmacology, College of Medicine and Health Sciences, University of Gondar, P.o. box 196, Gondar, Ethiopia
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">Viruses have a great potential to become a dangerous life-threatening and cause irreparable loss to human beings&#46; Hardly the world learns to cope with one strain of virus when another emerges and poses a threat to the future of humanity&#46; A similar situation has emerged when a new strain of severe acute respiratory syndrome coronavirus 2 &#40;SARS-CoV-2&#41; that has not been previously known in human history&#46; Coronaviruses &#40;CoVs&#41; are nonsegmented&#44; enveloped&#44; single-strand&#44; positive-sense&#44; ribonucleic acid viruses belonging to the Coronaviridae family&#46; CoVs named due to their Sun&#39;s corona or crown-like surface projections&#46; CoVs are the largest group of host-specific RNA viruses infecting birds&#44; snakes&#44; bats&#44; and mammals including humans&#46; CoVs grouped into <span class="elsevierStyleItalic">Alphacoronaviruses</span> and <span class="elsevierStyleItalic">Betacoronaviruses</span> which mostly mammals like bats&#44; civets&#44; rodents&#44; and humans and <span class="elsevierStyleItalic">Gammacoronaviruses</span> and <span class="elsevierStyleItalic">Deltacoronaviruses</span> which are mostly found in birds&#46;<a class="elsevierStyleCrossRef" href="#bib0455"><span class="elsevierStyleSup">1</span></a> In the 21st century&#44; three CoVs outbreaks emerged from their reservoirs to cause disease in human&#46; Several members of the <span class="elsevierStyleItalic">Coronaviridae</span> family infect humans&#46; Humans are infected and developed upper respiratory tract diseases with different CoVs strains including 229E&#44; OC43&#44; NL63 and HKU1&#46; OC43 and 229E causes common cold mainly during winter with 4&#37;-15&#37; prevalence&#46; NL63 causes mild respiratory tract disease&#44; especially in children with a prevalence of 10&#37; of all respiratory diseases&#46; HKU1was isolated from a 71-year-old man with pneumonia&#46;<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The three CoVs that cause serious respiratory diseases are severe acute respiratory disease &#40;SARS-COV&#41; which emerged in late 2002&#44; Middle East respiratory syndrome &#40;MERS-COV&#41;&#44; which emerged in 2012&#44; and SARS-CoV-2 that causes COVID-19 disease emerged in China as a threat to the human lives and declared as a global health emergency by the World Health Organization &#40;WHO&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">4</span></a> According to Johns Hopkins&#8217; COVID-19 global case dashboard&#44; almost all countries are now facing the Corona Virus Disease 2019 &#40;COVID-19&#41; wave with 5&#44;518&#44;905 cases and 346&#44;700 total deaths reported on May 26<span class="elsevierStyleSup">th</span>&#44; 2020&#46; So&#44; there is an urgent need for an effective drug and vaccine for COVID-19 disease&#46;<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">5</span></a></p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Structure component of SARS-CoV-2 virus</span><p id="par0015" class="elsevierStylePara elsevierViewall">The SARS-CoV-2 virus has relatively a large genome structure about 30 &#40;26-32&#41; kb pairs&#46; The virus has several non-structural proteins &#40;NSP&#41; like&#44; NSP12&#44; NSP13&#44; NSP3 and NSP5 that are vital for their life cycle and pathogenesis&#46; Like other CoVs&#44; the SARS-CoV-2 virus has four structural proteins naming the S-spike Protein &#40;outer spiky glycoprotein&#41;&#44; envelope protein &#40;E&#41;&#44; Membrane glycoprotein &#40;M&#41;&#44; and nucleocapsid protein &#40;N&#41;&#44; that enhance the attachment&#44; transport and interferes with host immune response and other five accessory proteins &#40;ORF3a&#44; ORF6&#44; ORF8&#44; ORF7&#44; and ORF9&#41;&#46; These proteins help the corona virus-host cell interactions to create an optimal condition for viral replication&#44; modify host gene induction&#44; and neutralization of the host&#39;s antiviral defenses system&#46; These coronavirus&#8211;host interactions have a vital role in the viral disease pathogenesis&#46;<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The S protein is a transmembrane glycoprotein that promotes the entrance of the virus into host cells&#46; S protein is a major target for design of vaccines and inhibitors of viral entry&#46; The <span class="elsevierStyleBold">S</span> protein has two domains&#44; S1 and S2&#46; The S1 domains contain the receptor binding domain &#40;RBD&#41; that mediates attachment to the host receptor cell&#44; whereas the S2 domain facilitates the fusion of the virus to the host cell&#46; The Entry of SARS-CoV-2 into host cells initiated by binding of the RBD to angiotensin-converting enzyme 2 &#40;ACE2&#41;&#44; the main receptor for SARS-CoV-2 on the host cells surface and CD209L is another receptor with lower affinity&#46;<a class="elsevierStyleCrossRef" href="#bib0485"><span class="elsevierStyleSup">7</span></a> ACE2 receptors expressed in type II alveolar cells&#44; airway epithelial cells&#44; fibroblasts&#44; endothelial cells&#44; and in several immune cells&#46; S2 subunit has a domain that facilitates the fusion of the viral envelope with the host cell membrane&#46; These domains are internal membrane fusion peptide &#40;FP&#41;&#44; a membrane proximal external region &#40;MPER&#41;&#44; two 7-peptide repeats&#44; and a transmembrane domain &#40;TM&#41;&#46; The S glycoprotein has a key role in the induction of immunity during infection with SARS-CoV-2 by eliciting neutralizing-antibodies and T-cell responses&#46; Studies showed that the S protein has several immunodominant parts that do not induce neutralizing antibodies&#44; but the RBD in the S1 region is a potent inducer of neutralizing antibodies&#46; Thus&#44; full-length S glycoprotein&#44; the S1 subunit&#44; the RBD domain&#44; NTD&#44; and FP are proposed as the promising candidate to develop an effective vaccine against SARS-CoV-2&#46;<a class="elsevierStyleCrossRefs" href="#bib0485"><span class="elsevierStyleSup">7&#44;8</span></a> The M- membrane protein is a transmembrane glycoprotein that gives a definite shape to the virus structure&#46; It binds to nucleocapsid and organizes the virus assembly&#46; The M protein contains T cell epitope clusters that elicit a neutralizing antibody in SARS patients&#46; The E protein has a key role in the pathogenesis&#44; assembly&#44; and release of the virus&#46; The E protein Inactivation modifies the virulence of CoVs due to changes in morphology and tropism&#46; The <span class="elsevierStyleBold">N</span>-nucelocapsid protein &#40;which is within the phospholipid bilayer&#41; has a key role in complex formation with viral genome&#44; enhances M protein interaction during assembly&#44; and increases replication of the virus&#46; The E&#44; S&#44; and M proteins form the viral envelope&#46;<a class="elsevierStyleCrossRefs" href="#bib0490"><span class="elsevierStyleSup">8&#8211;10</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Current treatment strategies for COVID-19</span><p id="par0025" class="elsevierStylePara elsevierViewall">Currently&#44; no corona virus-specific therapeutic agent&#44; monoclonal antibodies&#44; or vaccine has been approved&#46; Thus&#44; there is an urgent need for effective medication and vaccine for COVID-19 disease to limit the transmission in the community&#46; Most treatment options for COVID-19 taken from previous experiences in treating SARS-CoV&#44; MERS CoV&#44; and other viral diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">11</span></a> Currently&#44; mechanical ventilation&#44; ICU admission&#44; and supportive care are the most important management strategy for severe cases&#46; According to WHO guidelines infected patients treated with supportive care like bed rest&#44; oxygen saturation&#44; adequate nutrition&#44; prevention of dehydration&#44; keeping electrolyte and acid-base balance&#44; antibiotics&#44; and isolation of patients suspected or confirmed for COVID-19&#46;<a class="elsevierStyleCrossRef" href="#bib0510"><span class="elsevierStyleSup">12</span></a> Several pre-existing and potential drug candidates&#44; including remdesivir&#44; chloroquine&#44; and others are considered&#46; the Therapeutic options that could be evaluated and used for COVID-19 include molecules binding to the virus&#44; inhibiting enzymes involved in viral replication and transcription&#44; inhibitors targeting helicase and proteases&#44; host cell protease inhibitors&#44; host cell endocytosis inhibitors&#44; anti-sense RNA and ribozyme&#44; neutralizing antibodies&#44; mAbs targeting host cell receptor or interfere with S1 RBD&#44; antiviral peptide targeting S2&#44; and natural products&#46;<a class="elsevierStyleCrossRef" href="#bib0515"><span class="elsevierStyleSup">13</span></a></p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Current Sars-Cov-2 Vaccines Platforms</span><p id="par0030" class="elsevierStylePara elsevierViewall">Effective SARS-CoV-2 vaccines are crucial for controlling the CoVs pandemic&#46; Vaccines decrease disease severity&#44; viral shedding&#44; and person to person transmission&#46; Currently&#44; no vaccine has been licensed to prevent SARS-CoV-2 infection&#46;<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">14</span></a> There are different vaccine development platforms against SARS-CoV-2&#44; including live attenuated virus&#44; viral vectors&#44; inactivated virus&#44; subunit vaccines&#44; recombinant DNA&#44; and protein vaccines&#46; Several studies are in progress&#44; but requires months to years to develop the vaccines for SARS-CoV-2&#46; Currently&#44; there may be many promising targets for SARS-CoV-2&#46; COVID-19 candidate vaccines under development include S protein or RBD subunit vaccines and replicating or non-replicating vector vaccines expressing mainly S protein or the RBD&#46; Several studies showed that viral S protein subunit vaccines displayed higher neutralizing antibody titers and protection than live-attenuated SARS-CoV&#44; full&#44; and DNA-based S protein vaccines&#46; Collectively&#44; S protein&#47;gene is the preferred target site in SARS vaccine development&#44; and the same strategy can be potentially useful in developing SARS-CoV-2 vaccine&#46;<a class="elsevierStyleCrossRefs" href="#bib0520"><span class="elsevierStyleSup">14&#44;15</span></a></p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Live-Attenuated Vaccines</span><p id="par0035" class="elsevierStylePara elsevierViewall">Live attenuated vaccine &#40;LAV&#41; is the most immunogenic vaccines that do not require adjuvant to gain optimal response due to its effectiveness to provoke immunity mimic to the natural infection&#46; The LAV contain viable but attenuated live virus with low virulence property that does not cause disease in a person with normal immune systems&#46; They reproduce slowly&#44; and thus remain a continuous source of antigen for a long period after Single immunization&#44; reducing the need for booster dose&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">16</span></a> Several LAVs are found in the market to protect various disease including mumps&#44; rubella&#44; measles and varicella vaccines&#46; LAV produced by passing virus in cell cultures&#44; in animals or at suboptimal temperatures&#44; allowing less virulent strains selection or by mutagenesis&#44; or deletion of the viral genes that give virulence&#46; LAV is not suitable for infants&#44; immune-compromised patients&#44; and elderly people due to the risk of reversion to virulent strain&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">17</span></a> Currently&#44; several pharmaceutical companies isolated the virus strains of SARS-CoV-2 and started relevant vaccine development&#46; Codagenix <span class="elsevierStyleItalic">Biotec</span> Inc collaboration with the Serum Institute of India Ltd developing a live-attenuated SARS-CoV-2 vaccine in which the sequence of the target gene of interest has been changed by swapping its optimized codons with non-optimized ones&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">18</span></a></p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Inactivated Whole-Virus Vaccine</span><p id="par0040" class="elsevierStylePara elsevierViewall">Inactivated whole-virus comprises the entire disease-causing virion which is inactivated physically &#40;heat&#41; or chemically&#46; It has several antigenic parts to the host and can induce diverse immunologic responses against the pathogen&#46; Inactivated whole-virus has several advantages&#44; including low production cost&#44; safe&#44; and does not involve genetic manipulation&#46; IWV is conventional vaccines with mature technology and may become the first SARS-CoV-2 vaccine put into clinical use&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">19</span></a> There are three inactivated whole-virus vaccines against SARS-CoV-2 reached phase 1&#47;2 clinical trial&#46; These phase 1&#47;2 clinical trials are done by the Beijing Institute of Biological Products &#40;ChiCTR2000032459&#41;&#44; Sinovac &#40;NCT04352608&#41; and Wuhan Institute of Biological Products &#40;ChiCTR2000031809&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">20</span></a></p><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Subunit Vaccines</span><p id="par0045" class="elsevierStylePara elsevierViewall">Subunit vaccines contain pathogen-derived proteins &#40;antigens&#41; with immunogenicity that can elicit the host immune system&#46; Subunit vaccine is safe and easily manufactures by recombinant DNA techniques but requires adjuvant to enhance a immune response&#46; So far&#44; many research institutions initiated the SARS-CoV-2 subunit vaccine&#44; and use the spike glycoprotein S&#44; and its fragments&#44; such as S1&#44; S2&#44; RBD&#44; and nucleocapsid protein as a prime target antigens as shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">21</span></a> Novavax&#44; Inc&#46; developed a candidate vaccine based on S protein&#46; So far&#44; Clover Biopharmaceuticals constructed a SARS-CoV-2 S protein trimer vaccine &#40;S-Trimer&#41; by using its patented Trimer-Tag&#169; technology&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">22</span></a> Since the RBD of S protein directly bind with the ACE2 receptor on host cells&#44; RBD immunization induces specific antibodies that may block this recognition and effectively prevent the invasion of the virus&#46; Most of SARS-CoV-2 subunit vaccines currently under development use RBD as the antigen&#46; In a study in monkeys&#44; recombinant RBD protein was used to successfully reduce viral loads in the lungs and oropharynx and to prevent MERS-CoV pneumonia&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">23</span></a> Similar to RBD&#44; the N-terminal domains &#40;NTD&#41; of the S protein&#44; E&#44; M&#44; N&#44; and NSPs proposed carbohydrate receptor-binding activity&#46; For example&#44; the carbohydrate-binding properties of IBV M41 strain related to the NTD of the S protein&#46; Thus&#44; this domain is a candidate antigen for the development of the vaccine&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">24</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">mRNA Vaccines</span><p id="par0050" class="elsevierStylePara elsevierViewall">mRNA carries instruction from the protein-encoding DNA to the proteins translating ribosomes&#46; There are two types of mRNA vaccines platform&#58; non- replicating mRNA and self-amplifying mRNA that encodes not only the required antigen but also the viral replication machinery&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">mRNA vaccines mimic the natural infection of the virus&#44; but they retain only a short synthetic viral mRNA which encodes only the required antigen&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">25</span></a> mRNA vaccine is a promising alternative to traditional vaccine approaches due to their safety&#44; potency&#44; quick vaccine-development time&#44; and low-cost production&#46; The procedures to develop the mRNA vaccine include the screening of antigens&#44; the optimization of sequences&#44; modified nucleotides screening&#44; delivery systems optimization&#44; evaluation safety&#44; and immune response&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">26</span></a> mRNA vaccines strongly induce both cellular and humoral immune responses&#46; It is relatively safe and effective because it is only a transient carrier of message that does not interact with the host genome and it also does not need the whole virus&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">27</span></a> Currently&#44; no mRNA based vaccine entered the market&#46; So far&#44; a SARS-CoV-2 mRNA vaccine &#40;mRNA-1273&#44; encoding S protein&#41; developed by Moderna&#47;NIAID&#44; launched Phase 1 &#40;NCT04283461&#41; clinical trial as shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">28</span></a> Bluebird Biopharmaceutical Company is developing mRNA vaccine candidates using two different approaches&#46; The first is to use mRNA to express the virus S protein and RBD domain and the second is to express virus-like particles in vivo&#46; Duke-NUS Medical School and Arcturus Therapeutics partnered to develop a self-replicating mRNA vaccine candidate&#44; currently in a preclinical trial&#46; BioNTech and Pfizer are collaborating to co-develop mRNA-based vaccine candidate BNT162&#46;<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">28&#44;29</span></a></p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">DNA Vaccine</span><p id="par0060" class="elsevierStylePara elsevierViewall">DNA vaccines &#40;DVs&#41; have a plasmid into which a particular gene incorporated that encodes the antigens that identified from the pathogenic microorganism&#46; The bacterial plasmid carrying the desired gene delivered into the host and translated the antigenic protein that stimulates the immune system normally activated by the pathogenic microorganism&#46; DVs elicit both the cell-mediated and humoral immune system&#46; DVs induce long-lasting immunity that defends the diseases effectively in the future&#46; DVs are very stable&#44; can be produced within weeks because they does not need culture or fermentation&#59; instead used synthetic processes and began clinical trial within monthes&#46; Currently&#44; DNA vaccine not approved for the market&#46;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">30</span></a> Several pharmaceutical companies have advanced DNA platforms for COVID-19 vaccine discovery&#46; Most DVs candidates encode the S protein or the S1 domain to prevent attachment to the human ACE2 receptor&#44; a receptor for viral entry&#46; The DNA translating S protein stimulates antibodies and elicits cell-mediated immune response in mice&#44; macaques&#44; and camels&#46; When the immunized macaques were challenged with MERS-CoV&#44; characteristic clinical symptoms including pneumonia were mitigated&#46; So far&#44; two SARS-CoV-2 DVs are under development&#46;<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">31</span></a> Inovio Pharmaceuticals developed a DVs candidate termed INO-4800&#44; which is in phase 1 &#40;NCT04336410&#41; clinical trial&#46; Takis&#47;Applied DNA Sciences&#47;Evvivax and Zydus Cadila are developing a DVs candidate for COVID-19 disease which is now in preclinical studies&#46;<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">32</span></a></p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Viral Vector-Based Vaccine</span><p id="par0065" class="elsevierStylePara elsevierViewall">Viral vector vaccine works by carrying a DNA express or antigen&#40;s&#41; into host cells&#44; thereby eliciting cell-mediated immunity in addition to the humoral immune responses&#46; Viral Vectors Vaccines characterized by strong immunogenicity and safety&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">33</span></a> Several viral vectors are available for vaccine development including vaccinia&#44; modified vaccinia virus Ankara &#40;MVA&#41;&#44; adenovirus &#40;Ad&#41;&#44; adeno-associated virus &#40;AAV&#41;&#44; retrovirus&#47;lentivirus&#44; alphavirus&#44; herpes virus&#44; Newcastle disease virus&#44; poxvirus&#44; and others&#46; Viral vectors can be replicating or non-replicating viruses&#46;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">34</span></a> Adenovirus and modified vaccinia virus Ankara &#40;MVA&#41; are the most common viral vectors used in vaccine developments as shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; There are over 50 subtypes of human Ad&#44; with Ad serotype 5 &#40;Ad5&#41; is a stable&#44; non-replicating virus that used in several vaccine development&#46; This virus allows the insertion of large segments of foreign DNA &#40;&#8764;8<span class="elsevierStyleHsp" style=""></span>kb&#41; into its genome&#46; But&#44; pre-existing immunity against human Ad5 is widespread&#44; hampering its use as a vector for vaccine development&#46;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">35</span></a> Chimpanzee adenovirus &#40;ChAdOx1&#41; represents an alternative to the human Ad vector due to its safety and lack of preexisting immunity in humans&#46;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">36</span></a> Mice immunized with the Ad5 vector encoding the S protein-induced systemic neutralizing antibodies and mucosal T-cells immunity&#46; Ad5 vectors encoding the S1 domain of the S protein displayed stronger neutralizing antibody responses than that encoding the full length&#44; suggesting the effect of immune focusing&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">37</span></a> Currently&#44; Can Sino Biological Inc&#46; and the Beijing Institute of Biotechnology are developing Ad5- vector COVID-19 vaccine candidate in Phase 1&#40;ChiCTR2000030906&#41;&#46; Another adenovirus vectored vaccine developed by Chen Wei group entered in phase 1 clinical trial &#40;NCT04313127&#41;&#46; Johnson &#38; Johnson is developing an adenovirus vectored vaccine using AdVac&#174;&#47;PER&#46;C6&#174; vaccine platforms&#46; Shenzhen Geno-Immune Medical Institute also developing two lentivirus vector based vaccine candidates named COVID-19&#47;aAPC and LVSMENP- DC&#46; Recombinant MVA&#44; Newcastle disease virus &#40;NDV&#41;&#44; and poxvirus used as a viral-vector vaccine candidate due to their safety&#44; efficacy&#44; and decent immunogenicity&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">38</span></a></p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Synthetic Peptide or Epitope Vaccine</span><p id="par0070" class="elsevierStylePara elsevierViewall">Synthetic Peptide vaccines have chemically produced from fragments of antigens that elicites the immune response&#46; These vaccines are inexpensive&#44; easy for preparation&#44; and quality control&#46; But display low immunogenicity&#44; thus antigen modification and adjuvant required during formulation&#46; Fragments of antigen has B&#95; and&#47;or Tepitope activity&#44; which affect the specificity of the immune response&#46; Currently&#44; a set of B and T cell epitopes isolated from S and N proteins of SARS-Cov&#44; these epitopes are highly conserved in SARS-CoV-2 and may assist efforts to develop vaccine for covid-19 disease&#46;<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">39</span></a> Several pharmaceutical companies like Generex Biotechnology developing peptide based vaccines against SARS-CoV-2 viruses by producing synthetic peptides that mimic crucial antigens from a virus that is chemically bonded to the 4-amino acid Ii-Key to ensure robust immune system activation&#46;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">40</span></a></p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Virus-Like Particles Based Vaccine</span><p id="par0075" class="elsevierStylePara elsevierViewall">Virus-like particles &#40;VLPs&#41; are&#8220;hollow-core&#8221; virus particles formed by the viral structural component with self-assembly character into nanostructure&#46; VLP mimic the structure of the whole virus&#46; VLPs can elicit innate immunity response via pathogen recognition receptors&#46; VLPs represent advanced subunit vaccine with increased immunogenicity because they contain the structural protein of the virus&#46; VLPs have a noninfectious and non-replicative property due to lose of genomic component&#46; VLPs help to develop safer and cheaper vaccine candidates&#46;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">41</span></a> VLPs can be synthesized by encoding the viral structural proteins&#46; In general&#44; the VLPs-based vaccine is similar to the whole inactivated virus vaccine&#44; but it does not require the viral inactivation step which may affect the immunogenicity of a viral protein&#46; Because no live virus is involved in the production process&#44; VLPs can be easily generated in a low-containment production environment&#46;<a class="elsevierStyleCrossRefs" href="#bib0430"><span class="elsevierStyleSup">41&#44;42</span></a> So far&#44; VLP-based vaccines produced for greater than 30 different viruses including GlaxoSmithKline&#39;s Engerix&#174; &#40;hepatitis B virus&#41; and Cervarix&#174; &#40;human papillomavirus&#41;&#44; and Merck and Co&#46;&#44; Inc&#46;&#8217;s Recombivax HB&#174; &#40;hepatitis B virus&#41; and Gardasil&#174; &#40;human papillomavirus&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0440"><span class="elsevierStyleSup">43&#44;44</span></a> Currently&#44; several VLP expression systems available like recombinant vaccinia virus&#44; mammalian cells &#40;293T&#44; CHO&#41;&#44; baculovirus and yeast expression systems&#46; The RBD domain based VLP vaccine candidate &#40;RBD-CuMVTT&#41; derived from cucumber mosaic virus induced significant levels of antibodies in mice which can inhibit the binding of S protein to ACE2 receptor and effectively neutralized the SARS-CoV-2 virus in vitro&#46;<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">45</span></a></p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">The most promising vaccines</span><p id="par0080" class="elsevierStylePara elsevierViewall">The COVID-19 outbreak is rapidly increasing in the number of cases&#44; deaths&#44; and countries affected&#46; Pharmaceutical companies are searching to develop an effective vaccine for controlling the COVID-19&#46; Currently&#44; several countries and Research institutions are developing vaccine against SARS-CoV-2&#46; However&#44; vaccine development could not be done overnight&#46; After vaccine design and preparation&#44; it will undergo safety and efficacy evaluation before entering clinical trials&#46; Generally&#44; three phases of clinical trials undertaken to evaluate the safety&#44; efficacy and immunogenicity of the vaccine&#46; Phase 1 done for studing safety and immunogenicity of the vaccine&#44; and later&#44; phase 2 and phase 3 studies done for both safety and efficacy&#46; Typically&#44; a novel vaccines development takes 10&#8211;20 years and less than 10&#37; success rate even for a vaccine that enters clinical trials&#46; In the past 30 years&#44; FDA approved around 3&#44;000 clinical trials applications for vaccine development but less than 20 vaccines approved&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Currently&#44; there are no effective vaccines for the prevention of COVID-19&#46; But&#44; few candidates moved into clinical trial&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">CanSino Biologicals started Phase 2 clinical trial in China &#40;NCT04341389&#41; for Ad5- nCoV which showed safe&#44; tolerable and immunogenic in phase 1 clinical trial&#46; Moderna Announces Positive Interim Phase 1 Data for mRNA-1273 vaccine&#46; The vaccine elicited virus- neutralizing antibodies at the levels displayed in convalescent sera and showed full protection against viral replication in the lungs in a mouse model&#46; The vaccine candidate mRNA-1273 also showed safe and well tolerated&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Inovio Pharmaceutical developed INO-4800 which is in phase 1 trials showed safe and protective immunity&#46; LV- SMENP- DC from Shenzhen Geno-Immune Medical Institute &#40;phase1&#41; may offer promising vaccines against COVID-19&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">University of Oxford developed a vaccine based on Chimpanzee Adenovirus Vector &#40;ChAdOx1&#41; which is immunogenic in mice&#46; The vaccine candidate entered phase I&#47;II &#40;NCT04324606&#41; clinical trial in April 2020 to study its safety&#44; tolerability and immunogenicity in 510 volunteer&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Abbreviations</span><p id="par0105" class="elsevierStylePara elsevierViewall">Ad5&#44; Ad serotype 5&#44; AAV&#44; adeno-associated virus&#44; ACE2&#59; angiotensin-converting enzyme 2&#44; CoVs&#59; Coronaviruses&#44; ChAdOx1&#59; Chimpanzee adenovirus&#44; DVs&#59; DNA vaccines&#44; MVA&#44; modified vaccinia virus Ankara&#44; SARS-CoV-2&#59; severe acute respiratory syndrome coronavirus 2&#44; WHO&#59; World Health Organization&#44; S protein&#59;Spike Protein&#44; RBD&#59; receptor binding domain&#44; VLPs&#59;Virus-like particles&#44; NDV&#59; Newcastle disease virus</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Funding</span><p id="par0110" class="elsevierStylePara elsevierViewall">No funded</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflict of interests</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interests&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The emergence of the strain of coronavirus SARS-CoV-2 &#40;severe acute respiratory syndrome coronavirus 2&#41; that causes corona virus disease 2019 &#40;COVID-19&#41; and its impact on in the world have made imperative progress to develop an effective and safe vaccine&#46; Despite several measures undertaken&#44; the spread of this virus is ongoing&#46; So far&#44; more than 1&#44;560&#44;000 cases and 1000&#44;000 deaths occurred in the world&#46; Efforts have been made to develop vaccines against human coronavirus &#40;CoV&#41; infections such as MERS and SARS&#46; However&#44; currently&#44; no approved vaccine exists for these coronavirus strains&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Such Previous research efforts to develop a coronavirus vaccine in the years following the 2003 pandemic have opened the door for the scientist to design a new vaccine for the COVID-19&#46; Both SARS-CoV and SARS-CoV-2 has a high degree of genetic similarity and bind to the same host cell ACE2 receptor&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">By using different vaccine development platforms including whole virus vaccines&#44; recombinant protein subunit vaccines&#44; and nucleic acid vaccines several candidates displayed efficacy in vitro studies but few progressed to clinical trials&#46; This review provides a brief introduction of the general features of SARS-CoV-2 and discusses the current progress of ongoing advances in designing vaccine development efforts to counter COVID-19&#46;</p></span>"
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">platform&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">developer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Phase of study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Drosophila S2 insect cell expression system VLPs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ExpreS2ion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S protein&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">WRAIR&#47;USAMRIID&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S-Trimer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Clover Biopharmaceuticals Inc&#46;&#47;GSK&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peptide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaxil Bio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S protein&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AJ Vaccines&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ii-Key peptide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generex&#47;EpiVax&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S protein&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EpiVax&#47;Univ&#46; of Georgia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S protein &#40;baculovirus production&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sanofi Pasteur&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Full length S trimers&#47; nanoparticle &#43; Matrix M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Novavax&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">gp-96 backbone&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Heat Biologics&#47;Univ&#46; Of Miami&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Molecular clamp stabilized Spike protein&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">University of Queensland&#47;GSK&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S1 or RBD protein&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Baylor College of Medicine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Subunit protein&#44; plant produced&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">iBio&#47;CC-Pharming&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VIDO-InterVac&#44; University of Saskatchewan&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adjuvanted microsphere peptide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">University of Saskatchewan&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Full-length Spike&#44; S1&#44; RDB&#44; nucleocapsidFormulated with adjuvants &#47;or fused with Fc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;Novavax&#44; Phase III&#41; recombinant S protein &#40;Vaxine Pty Ltd&#44; Australia&#44; Phase I&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Protein Subunit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S protein &#40;adenovirus production&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Johnson &#38; Johnson &#40;Jansen&#41;&#58; In partnership with Biomedical Advanced Research and Development Authority &#40;BARDA&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2440572.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Vaccines under development based on Protein Subunit for COVID-19 according to the WHO as of April 20&#44; 2020 &#40;adapted from &#40;20&#41;&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Type of candidate vaccine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">developer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">stage of clinical evaluation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LNP-encapsulated mRNA&#40;mRNA-1273&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">USA &#40;Moderna&#47;NIAI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Phase 2&#40;NCT04283461&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LNP-encapsulated mRNA cocktail encoding VLP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fudan University&#47; Shanghai JiaoTong University&#47;RNACure Biopharma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">mRNA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">China CDC&#47;Tongji University&#47;Stermina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">mRNA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Arcturus&#47;Duke-NU&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">mRNA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BioNTech&#47;Fosun Pharma&#47;Pfizer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">saRNA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Imperial College London&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">mRNA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Curevac&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">preclinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2440573.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">vaccine candidates based on RNA platform for COVID-19 according to the WHO as of April 20&#44; 2020 &#40;adapted from &#40;20&#41;&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Platform&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Type of candidate vaccine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">developer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">stage of clinical evaluation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non-replicating Viral Vector&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ad5 Vector&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CanSino Biological Inc&#46; and Beijing Institute of Biotechnology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Phase 2ChiCTR2000031781Phase 1ChiCTR2000030906&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Modified Vaccina Ankara &#40;MVA&#41; encoded VLP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">GeoVax&#47;BravoVax&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ad26 &#40;alone or with MVA boost&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Janssen Pharmaceutical Companies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pre-Clinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ChAdOx1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">University of Oxford&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Phase 1&#47;2NCT04324606&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ad-based Naso VAX expressing SARS2-CoV spike protein&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Altimmune&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pre-clinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ad5 S &#40;GREVAX&#8482;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Greffex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pre-clinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Oral Vaccine platform&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaxart&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pre-clinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Replicating Viral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Full-length Spike or S1Vector used&#58; ChAd or &#40;Modified Vaccina Ankara&#41; MVA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Zydus CadilaInstitut Pasteur&#47;ThemisTonix Pharma&#47;Southern Research&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Phase I&#40;NCT03399578&#44;NCT03615911&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Replicating Viral Vector&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Measles Vector&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Zydus Cadila&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pre-clinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Measles Vector&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Institute Pasteur&#47; Themis&#47; Univ&#46; of Pittsburg Center for Vaccine Research&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pre-clinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Horse pox vector expressing S protein&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tonix Pharma&#47;Southern Research&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pre-clinical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">dendritic cells modified with lentiviral vector expressing synthetic minigene based on domains of selected viral proteins&#59; administered with antigen- specific CTLs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ShenzhenGeno- ImmuneMedical Institute&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Phase I&#40;NCT04276896&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">artificial antigen- presenting cells modified with lentiviral vector expressing synthetic minigene based on domains of selected viral proteins&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ShenzhenGeno- ImmuneMedical Institute&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Phase I&#40;NCT04299724&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Vaccine developments by using Non-Replicating Viral Vector platform for COVID-19 according to the WHO as of April 20&#44; 2020 &#40;adapted from &#40;20&#41;&#46;</p>"
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    ]
    "bibliografia" => array:2 [
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46;Y&#46; Yong"
                            1 => "H&#46;K&#46; Ong"
                            2 => "S&#46;K&#46; Yeap"
                            3 => "K&#46;L&#46; Ho"
                            4 => "W&#46;S&#46; Tan"
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos