Each spring, when the cherry blossom season arrived, Ren Chao would be busy receiving tourists visiting the campus of Wuhan University in Hubei Province, central China. But this year, the 36-year-old’s work has changed dramatically. When the novel coronavirus disease (COVID-19) broke out in the city of Wuhan, he began to work on prevention and control on campus. Besides that, he also volunteered to transport medical workers to and from hospitals around the city as public transport came to a standstill. On March 17, a friend sent him a message asking if he would be interested in a different kind of volunteering and he signed up. He was to be a test subject for the first-phase clinical trials of a COVID-19 vaccine. Volunteers extraordinaire “In the past months, we, the people in Hubei, received support and care from all over the country. Now it’s time to reciprocate,” Ren told Beijing Review. On March 20, he was given a shot of a recombinant subunit vaccine, a preparation containing a minuscule part of the virus to create an immune response in the body. Currently, he is under medical observation. Zhu Aobing, a 27-year-old soldier studying at the Hubei University of Technology, also in Wuhan, is another volunteer. Coming from a family of soldiers, Zhu said he felt duty-bound to help. Before the clinical trials, he was volunteering in a local community since late January. He received a low-dose vaccine shot on March 19. Several teams are working simultaneously in China to develop COVID-19 vaccines, and most of them are expected to complete preclinical trials and begin human tests in April, Wang Junzhi, a drug and vaccine development expert, said at a press conference on March 17. The vaccine development programs are among the world’s front-runners, he added. The clinical trials, approved by the National Medical Products Administration, are being carried out by the Institute of Biotechnology, Academy of Military Medical Sciences in collaboration with CanSino Biologics, a biological vaccine manufacturer in Tianjin near Beijing. The first phase, being carried out in two medical facilities in Wuhan, recruited 108 healthy adults aged between 18 and 60. They were chosen from around 5,000 applicants. After health checkups, they were divided into three groups, each one receiving a different dose of the vaccine. For 14 days, they will be under medical observation and their body temperature will be monitored constantly. All 108 will receive a series of follow-up examinations to see if their bodies have generated antibodies against the virus. The clinical trials will be completed by December 31. “I was a little nervous when receiving the vaccination, but now I feel good,” Ren told Beijing Review on March 25. All volunteers, he said, were fully informed of the risks before being vaccinated. “The scientists explained to us the purpose of the trials, possible adverse reactions and countermeasures to be taken, and I trust them,” he said. Several volunteers like Ren and Zhu are now sharing their experience on Chinese social media platforms such as Weibo and micro video-sharing platform Douyin as many people are keen to know about the progress of the study. Some netizens called the volunteers pathfinders for taking part in an experiment that might save countless lives. However, Ren said they are mere followers. In his eyes, the scientists and researchers racing against the clock to develop the vaccine are the real pathfinders. A five-pronged approach On March 2, President Xi Jinping visited the Academy of Military Medical Sciences and the School of Medicine at Tsinghua University in Beijing to inspect COVID-19 prevention work, where he urged speeding up vaccine research and development and tracking the progress of similar research overseas for early clinical trial and application of the vaccines. Chinese scientists are focusing on five ways to develop COVID-19 vaccines, Wang said. One is creating an inactivated vaccine consisting of virus particles grown in the laboratory that have lost their disease-producing capacity but can help a person produce antibodies. Another is genetic engineering subunit vaccines, where a gene is modified in the laboratory to create anti-viral properties. A third is making a vaccine with adenovirus, a virus that causes colds and other infections, after modifying it to make it safe for humans. The fourth is the nucleic acid vaccine, which the World Health Organization has called a revolutionary treatment. It means introducing the DNA or RNA of the virus into the recipient’s body to create immunity. The fifth is using attenuated or reduced influenza virus. These serve as vectors, carrying the infection in a mild form to the recipient and creating immunity. The vaccine under trial, a genetic engineering subunit vaccine, was developed by a research team led by senior bioengineer Chen Wei. Chen told China Central Television it has been developed in accordance with international norms and can be mass produced once the preparatory work is complete. Chen had also led a research team that developed an Ebola vaccine in 2017, making China the third country in the world to successfully do so following the U.S. and Russia. The vaccine underwent clinical trial in Sierra Leone, which suffered an Ebola outbreak in 2014. Chinese researchers have also developed animal models to identify the transmission routes of the novel coronavirus and ensure the vaccines and drugs are safe and effective. Qin Chuan, a researcher from the Institute of Laboratory Animal Sciences under the Chinese Academy of Medical Sciences (CAM), said at a press conference that eight vaccines are under evaluation at CAM. Efforts elsewhere By March 8, about 64 vaccine projects were underway around the world. China has individually undertaken and cooperated with other countries in 36 projects, China Newsweek reported. The U.S. National Institute of Allergy and Infectious Diseases (NIAID) announced on March 16 the beginning of a clinical trial for an experimental nucleic acid vaccine. The vaccine was jointly developed by NIAID scientists and their collaborators in U.S. biotechnology company Moderna, Inc. The first of the study’s 45 subjects received the vaccine on that day. The company began to develop the vaccine two days after China shared the genetic sequence of the novel coronavirus on January 11. But despite the efforts, there is still a long way to go before the vaccines can be provided for the public since the work has to be meticulous to guarantee safety. According to Dan Nicolau, an associate professor at the Queensland University of Technology in Australia, it will take at least one year before any vaccine is put into circulation.