As illness and death linked to the new coronavirus accelerate across the U.S., federal officials are looking to existing and new treatments to battle the disease.

The first coronavirus vaccine trial got underway Monday in Seattle when four volunteers received a version of a vaccine to prevent the disease, which as of Friday in the U.S. had killed more than 200 and been linked to over 14,000 confirmed cases.

It marked the start of an all-out effort by thousands of scientists worldwide working to create vaccines against the new coronavirus, in what in research terms is a blindingly fast response to the global threat. As of last week, the World Health Organization had posted a list of 41 possible vaccine candidates on its site.

Still, no one will be lining up this summer for vaccinations. It will be at least a year to 18 months before any vaccine is ready for large-scale use, according to most estimates. Before being deployed, vaccines must go through multiple rounds of testing to make sure they are safe, effective and don’t have unintended consequences.

Researchers are not starting from scratch. Work on two previous coronaviruses, Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) provide a road map for how to create an immune response to SARS-CoV-2, the virus that causes the illness COVID-19.

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The process was immensely sped up by the decision of professor Yong-Zhen Zhang at the Shanghai Public Health Clinical Center in China to publish the virus' genome on Jan. 10.

Early financial support from the Oslo-based Coalition for Epidemic Preparedness Innovations (CEPI), a nonprofit global partnership to develop vaccines, also has been crucial.

While no one knows who will cross the finish line with a vaccine first, several companies and groups are off to strong starts, particularly those already working on SARS and MERS vaccines. Here are some of the noteworthy efforts underway:

Moderna

This Boston-based company already was working on RNA therapies and vaccines. It began working with the National Institutes of Allergy and Infectious Disease in February to create an experimental SARS-CoV-2 vaccine. It began testing its first vaccine candidate on humans Monday. A group of four people was given the vaccine and researchers will first study its safety. If after several weeks it appears to be safe, another round of testing will begin to see whether it stimulates their immune system to make antibodies against the virus. It was one of three groups that received funding for the effort Jan. 23 from the CEPI.

University of Queensland, Australia

The Australian research group was working on “molecular clamp” vaccines against MERS for several years and had a version showing results in animal studies. It got funding from CEPI and retooled its research for SARS-CoV-2 in February. The “clamp” method uses a sequence of amino acids to lock down the spikes SARS-CoV-2 uses to infect cells, allowing the immune system to target it before the virus can activate itself. Testing of the trial vaccine in mice is underway and the group is hoping to begin human trials by mid-year.

Inovio

This Pennsylvania-based biotech company also received one of the early CEPI grants. Inovio, was working on a DNA-based vaccine against MERS. The company president said it designed a COVID-19 vaccine candidate in three hours after the genetic sequence was published by the Chinese. The company plans to begin human trials in April.

CureVac

This German-based company was in the news last week after reports surfaced President Donald Trump suggested the U.S. might buy access to its vaccines only for Americans. CureVac, which was mainly working on anti-cancer vaccines, uses messenger RNA to make vaccines. It signed a development agreement with CEPI on Jan. 31 to work on SARS-CoV-2. The company hopes to have a possible vaccine ready to test within several months.

Novavax

Maryland-based Novavax was working on vaccines against SARS and MERS. On March 10 it announced a $4 million award from CEPI to work on a SARS-CoV-2 vaccine. It hopes to begin testing in late spring.

Oxford University

A team at Oxford's Jenner Institute in Britain is creating SARS-CoV-2 vaccine seed stock in conjunction with Italian medical product manufacturer Advent. The Jenner Institute was working on a vaccine against MERS and currently has a trial underway in Saudi Arabia.

EU Horizon 2020 consortium

A large consortium of European research universities and biotech companies is working on a vaccine for SARS-CoV-2. The effort received nearly $3 million in European funding on March 9 and includes German, Dutch and Danish universities and biotech companies.

GlaxoSmithKline

This United Kingdom-based company is one of the world’s largest vaccine producers. It has signed an agreement with CEPI to bring GSK’s adjuvant system into the SARS-CoV-2 mix. Adjuvants can be added to vaccines to boost the immune response they produce. This could decrease the amount of vaccine (once one becomes available) needed per dose, allowing more doses to be produced more quickly.

Academy of Military Medical Sciences

Researchers at the Chinese academy are working with scientists at CanSino Biologics, a Hong Kong-based biotech company that licensed a vaccine for the Ebola virus in 2017. According to China's clinical trial registration database, the experimental COVID-19 vaccine is in the early stages of safety testing and tests were approved to begin as soon as March 17.