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A handful of the dozens of experimental Covid-19 vaccines in human testing have reached the last and biggest hurdle - looking for the needed proof that they really work.
AstraZeneca announced Monday its vaccine candidate has entered the final testing stage in the US. The Cambridge, England-based company said the study will involve up to 30,000 adults from various racial, ethnic and geographic groups.
Two other vaccine candidates began final testing this summer in tens of thousands of people in the US One was created by the National Institutes of Health and manufactured by Moderna Inc., and the other developed by Pfizer Inc. and Germany's BioNTech.
"To have just one vaccine enter the final stage of trials eight months after discovering a virus would be a remarkable achievement; to have three at that point with more on the way is extraordinary," Health and Human Services Secretary Alex Azar said in a statement.
NIH Director Francis Collins tweeted that his agency "is supporting several vaccine trials since more than one may be needed. We have all hands on deck."
AstraZeneca said development of the vaccine known as AZD1222 is moving ahead globally with late-stage trials in the UK, Brazil and South Africa. Further trials are planned in Japan and Russia. The potential vaccine was invented by the University of Oxford and an associated company, Vaccitech.
Meanwhile, a US advisory panel was expected to release a draft plan Tuesday for how to ration the first doses of vaccine. The National Academies of Science, Engineering and Medicine will solicit public comments on its plan through Friday.
There's a good reason so many Covid-19 vaccines are in development.
"The first vaccines that come out are probably not going to be the best vaccines," Dr Nicole Lurie, who helped lead pandemic planning under the Obama administration, said at a University of Minnesota vaccine symposium.
There's no guarantee that any of the leading candidates will pan out - and the bar is higher than for Covid-19 treatments, because these vaccines will be given to healthy people. Final testing, experts stress, must be in large numbers of people to know if they're safe enough for mass vaccinations.
They're made in a wide variety of ways, each with pros and cons. One problem: Most of the leading candidates are being tested with two doses, which lengthens the time required to get an answer - and, if one works, to fully vaccinate people.
Another: They're all shots. Vaccine experts are closely watching development of some nasal-spray alternatives that just might begin the first step of human testing later this year - late to the race, but possibly advantageous against a virus that sneaks into the airways.
For now, here's a scorecard of vaccines that already have begun or are getting close to final-stage tests:
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