WEBVTT 00:00:07.553 --> 00:00:09.894 How do we develop a new vaccine? 00:00:09.894 --> 00:00:14.394 After lots of laboratory work, how do we know it is ready to get tested in humans? 00:00:14.695 --> 00:00:17.002 And then, how do we know whether or not it works? 00:00:17.639 --> 00:00:22.950 We test new vaccines in clinical trials to determine that they're both safe and effective 00:00:22.950 --> 00:00:25.249 before they get licensed in the US. 00:00:25.589 --> 00:00:27.901 Stick with us, this is going to be interesting. 00:00:28.521 --> 00:00:31.600 And, although this applies to all kinds of drugs and vaccines, 00:00:31.600 --> 00:00:36.522 we're going to focus here on vaccines used for prevention of a specific type of infection. 00:00:37.292 --> 00:00:41.152 The first thing to know is that a lot of testing is done before a vaccine 00:00:41.152 --> 00:00:42.890 ever gets tested in humans. 00:00:42.890 --> 00:00:45.783 There is a long process of development in a laboratory, 00:00:45.783 --> 00:00:49.600 and testing, both for safety and for protection, in animal studies. 00:00:50.160 --> 00:00:54.602 After we have a vaccine that looks both safe and promising in preventing infection 00:00:54.602 --> 00:00:57.724 in a laboratory, we begin testing in humans. 00:00:59.094 --> 00:01:02.074 Because we don't know whether or not the vaccine will work, 00:01:02.074 --> 00:01:05.834 we begin a very structured set of studies called clinical trials. 00:01:05.834 --> 00:01:10.804 These studies involve healthy volunteers, who are told in detail about how and why 00:01:10.804 --> 00:01:14.550 this vaccine is being tested, and about any potential harm. 00:01:15.390 --> 00:01:19.545 This educational process is a process called informed consent, 00:01:19.545 --> 00:01:22.276 and goes on before and during the trial. 00:01:23.016 --> 00:01:26.189 There's a continual discussion that happens between the researchers 00:01:26.189 --> 00:01:27.776 and the study volunteers. 00:01:27.776 --> 00:01:31.917 Describing the study, informing the volunteers about any new information 00:01:31.917 --> 00:01:34.317 that happens at any time during the study, 00:01:34.317 --> 00:01:37.267 and answering all questions that the volunteers have. 00:01:38.207 --> 00:01:42.209 The study staff also determine whether the volunteer meets all the eligibility 00:01:42.209 --> 00:01:46.879 criteria to participate, which involves physical exams and blood tests. 00:01:48.969 --> 00:01:53.082 Next, we start what is called a ramdomized, double-blinded clinical trial. 00:01:53.082 --> 00:01:57.440 What that means is that after volunteers enrol in a study, 00:01:57.440 --> 00:02:00.786 a computer randomly decides whether they will get the vaccine 00:02:00.786 --> 00:02:02.832 or whether they will get the placebo, 00:02:02.832 --> 00:02:05.131 which is usually just salt water. 00:02:05.521 --> 00:02:09.462 We do this to be able to separate outside effects that are due to the vaccine 00:02:09.462 --> 00:02:13.424 from those that are just happening to people in a community at the same time, 00:02:13.505 --> 00:02:16.397 like the rate of cold symptoms, or headaches. 00:02:17.301 --> 00:02:21.928 And, we double-blind, meaning neither the participant nor the study staff 00:02:21.928 --> 00:02:24.846 know who is getting which type of injection. 00:02:25.606 --> 00:02:30.277 That prevents both the volunteers and the staff from over or under reporting symptoms. 00:02:30.277 --> 00:02:34.158 We advise participants to tell us about everything that is happening to them. 00:02:35.038 --> 00:02:39.253 Before a vaccine is licensed by the US food and drug administration, 00:02:39.253 --> 00:02:42.409 it usually goes through 3 phases of clinical trials, 00:02:42.409 --> 00:02:44.739 each of which has a specific purpose. 00:02:45.829 --> 00:02:48.779 Phase 1 trials, which can last up to 2 years, 00:02:48.779 --> 00:02:52.841 compare the safety - does the vaccine cause any side effects, 00:02:52.841 --> 00:02:57.711 and tolerability - does the injection hurt, and for how long? 00:02:58.211 --> 00:03:02.264 In this phase of studies, scientists are also gathering information about 00:03:02.278 --> 00:03:04.819 the body's immune response to the vaccine, 00:03:04.829 --> 00:03:09.073 to see whether it is a promising approach to preventing this specific infection. 00:03:09.623 --> 00:03:14.561 Phase 1 trials do not determine whether or not the study product is actually doing 00:03:14.561 --> 00:03:15.733 what we hope it will do. 00:03:16.983 --> 00:03:20.303 Phase 2 trials, which can last longer than 2 years, 00:03:20.303 --> 00:03:23.843 will confirm the safety in a larger group of volunteers, 00:03:23.843 --> 00:03:28.099 and focus on the best dose and the best timing of vaccinations to produce 00:03:28.099 --> 00:03:29.904 the strongest immune response. 00:03:31.444 --> 00:03:35.435 Promising vaccines that are safe and generate a strong immune response 00:03:35.435 --> 00:03:37.715 move into phase 3 trials. 00:03:37.715 --> 00:03:42.592 These are the largest trials, and compare the rate of infection in the vaccine and 00:03:42.592 --> 00:03:43.676 placebo groups. 00:03:44.606 --> 00:03:47.448 This will tell us whether the vaccine is able to prevent infection, 00:03:47.448 --> 00:03:53.225 and, if so, if it is effective in all of the volunteers, or only a sub-group, 00:03:53.225 --> 00:03:55.488 like younger volunteers, or women. 00:03:56.798 --> 00:04:01.168 Along with the safety data that is collected in all phases of vaccine studies, 00:04:01.168 --> 00:04:07.049 this efficacy data is used by the FDA to decide if the vaccine should be licensed, 00:04:07.049 --> 00:04:09.940 and, if so, for whom it is recommended. 00:04:11.960 --> 00:04:16.549 In the best case scenario, it could take 6-10 years for a promising vaccine to move 00:04:16.549 --> 00:04:20.040 from phase 1 testing to real world distribution. 00:04:20.040 --> 00:04:21.894 Often it takes longer. 00:04:22.904 --> 00:04:26.342 The clinical trials are absolutely necessary to determine that a vaccine 00:04:26.342 --> 00:04:29.512 is safe and effective in preventing new infections. 00:04:31.212 --> 00:04:35.032 This video has been provided to you by Youreka science, in collaboration with 00:04:35.032 --> 00:04:36.326 BridgeHIV. 00:04:36.326 --> 00:04:39.152 To stay in touch with Youreka science, like us on Facebook, 00:04:39.152 --> 00:04:42.892 follow us on Twitter, or subscribe to this YouTube channel, or visit us at 00:04:42.892 --> 00:04:44.402 YourekaScience.org 00:04:44.402 --> 00:04:45.426 Thank you for watching!