The development of new Covid-19 vaccines is proceeding at a furious pace, which is good news for the world. We already have two vaccines in phase 3 trials in the United States and Europe; each of these tests that will vaccinate many thousands of people, and then wait to see how many will be infected. If the vaccines work, we will be able to start large-scale production in a few months.
But we don’t have to wait. Both these vaccines (from Moderna and Oxford University / Astra Zeneca) have already proven, in phase 1 tests, to be safe and probably effective. That’s why companies are advancing and giving every vaccine to 30,000 more people: they know that vaccines are safe. The New York Times reports that 3 other Covid-19 vaccines are also in Phase 3: one from BioNTech and Pfizer and two from Chinese companies, Sinopharm and Sinova Biotech.
So why not start giving millions of doses right now? We should.
Indeed, an Indian vaccine manufacturer is already proceeding with large-scale production. The Serum Institute, run by the Indian billionaire Adar Poonawalla, is producing hundreds of millions of doses of the Oxford vaccine, before obtaining final approval, investing its own money and risking that the vaccine will work.
Why aren’t we doing the same thing in the U.S. and Europe? In my view, there are two things that hold us back:
1. Money. Making hundreds of millions of doses of a vaccine is expensive and if the vaccine fails in phase 3 studies, the money will be wasted. I can understand why private companies that perform these processes may not be able to proceed with large-scale production. This is where the government can intervene: just buy vaccines in advance! We are already doing this on a large scale in any case: the United States recently announced that it was paying $ 1.6 billion Novavax to cover all stages of its clinical trials in addition to producing 100 million doses, long before the vaccine was approved.
Given that the United States alone has already spent well over $ 3 trillion (or 3,000 times a billion, for those who matter) to save the economy, with at least another 1 trillion dollars to come, a few billion dollars more for making vaccines, even if vaccines don’t work, seems like a big investment.
2. Excessive attention. The normal vaccine testing and approval process requires 3 steps. In steps 1 and 2, we carefully test safety and try to determine the best dose. Although a vaccine may seem effective after these stages, the number of people tested is small and we need more people to make sure the vaccine works. This is what Phase 3 tells us.
So current Phase 3 plans for these vaccines work like this: identify a large number of people (30,000 in at least one of the studies) and give half the vaccine to them, and give the other half to a placebo. So wait a few months and see how many people get Covid-19. If the vaccine works, we will see that significantly fewer people in the vaccinated group get sick.
Great. We absolutely have to do it, and we are.
But we are in the midst of the worst pandemic since 1918. The careful step-by-step vaccine approval regime was not designed for a global emergency, where every day of delay means that thousands of people die.
We already know that the vaccines in phase 3 studies are safe, otherwise it would not be ethical to administer the vaccine to 30,000 people, as these studies are doing. We should immediately increase production, using government funds rather than private money, and therefore offer these vaccines free to anyone who wants them.
Obviously we will have to educate anyone who wants the vaccine that we don’t know for sure if it works. Nobody will be forced to take it, but I suppose millions of people will be eager to try. And yes, there is a possibility that vaccines don’t work very well, and perhaps this will create greater distrust when we eventually have a good vaccine. But this is a risk we should take, given the greater damage caused by the delays. The evidence for these test vaccines is already better than most of the actual treatments that we are offering people and, above all, we know they are safe.
So let’s start vaccinating millions of people now as soon as we can increase production. I will be the first in line to try the Modern or Oxford vaccine as soon as it is ready.