Like the coronavirus pandemic continues to spread all over the world, the best hope for having it really under control is a vaccine that protects people from COVID-19 contraction. Scientists in the United States, China, the United Kingdom and elsewhere are rushing to develop a vaccine and there have been some promising signs that one of the many candidate vaccines in development could prove effective against the virus.
In the United States, president Donald Trump predicted the arrival of a vaccine before the end of the year. Dr. Anthony Fauci, director of the National Institute for Allergies and Infectious Diseases of the National Institutes of Health said it is “When and not if”
With COVID-19 taking lives and crushing economies around the world, stopping the spread would provide enormous relief. But the progress of science is characterized more by failure than success. Researchers are working on nearly 200 potential vaccines for this coronavirus, and there is no guarantee that none of them will ever work, let alone one that is ready for extensive use in a few months.
Create a safe, effective vaccine which would quickly be unprecedented. Furthermore, no one has ever attempted to do so produce a new vaccine, distribute it for every corner of the world and carry out an immunization campaign on this scale and with so much speed.
To better understand the challenges facing vaccine researchers, HuffPost spoke with Vincent Racaniello, professor of microbiology and immunology at the Vagelos College of Physicians and Surgeons of Columbia University in New York.
Is it realistic to expect a vaccine for the new coronavirus later this winter?
No, I think it is unrealistic to expect a vaccine by the end of 2020. We haven’t had any vaccines in such a short time. It would be a year from January, when we first saw circulation in the United States. Eighteen months is optimistic. What would be more realistic, in my opinion, would be next summer. You know, vaccines can take 5 to 10 years and more. The polio vaccine took 50 years to develop. Of course, we have advanced our technology so that we can do it faster now, but I would say no, the end of this year is not entirely feasible, in my opinion. However, I would like to be surprised.
How would a SARS-CoV-2 vaccine work to prevent people from getting sick?
What the vaccines do is that they are introduced into you – they can be injected, or they can be taken orally or through any number of other ways – and turn on your immune system to respond to the virus in question, in this case SARS- CoV-2, without making you sick. So you have an immune response and most importantly, your immune response comes with a wonderful feature called “memory”, so remember what it encountered so that every time it reviews that agent, it will respond. This is what a vaccine tries to do: it tries to produce immune memory without any of the pathogenic or pathological consequences of a real infection.
Is it similar to what the human immune system does when it fights infections?
Absolutely. If you have the flu or a common cold virus or any other virus – if you survive, of course – then you have immune memory and therefore every time you meet the virus again, you should create a good response and completely prevent the infection. You won’t even know you’ve encountered the virus.
What are the main challenges for developing new vaccines for any disease?
There are many, but the main one is to understand what is needed to protect you from infections. We have talked a lot in general about the immune response but, in fact, there are different components. There are cells and proteins involved, so we need to know which one is important for the particular virus. This is one of the reasons why it took 50 years to get a polio vaccine, because people had to understand what was important. Now, for this new virus, we don’t have the time to do it, so we’re making a lot of assumptions about what’s important and hopefully they’re right.
How do governments, pharmaceutical companies, academic institutions and scientists decide how to prioritize vaccine development for some diseases over others?
I hate to say that this is very sad and this is an indictment for the entire vaccine production system, but the main priority is profit.
The companies that produce vaccines are all for-profit companies and must see that they can profit from their vaccine. So all the vaccines we have are there because many, many people are infected with viruses such as flu, measles, mumps, rubella, shingles and polio. They infect many people and companies can make money from them.
However, there are many diseases out there that are far less common but still kill people. Companies are not interested in making vaccines for these diseases because they don’t make a profit. I think it’s a fatal flaw with our vaccine system that needs to be fixed which is why we don’t have a vaccine ready for this particular virus. We could, but no company was interested. The same goes for antiviral drugs. That’s why we are in this situation in which we find ourselves now.
You could think of creative ways to get around this. Governments can be involved, for sure. We are hindered in this country by our government’s political paralysis and its reluctance to invest fully in science, so this is hindered. Now, since this SARS-CoV-2 emerged, new nonprofit organizations have emerged that have said, “We will finance the development of the vaccine.” In the end, it’s just someone who raises money and there is a lot of money out there to do it. Think about the money we are spending on recovery in the United States – trillions. If a fraction of that money had been spent on developing a vaccine, we would have been without this problem.
There are no vaccines available for any coronavirus strain, including the one causing COVID-19. Because?
After SARS-1 in 2003, it went away. We managed to stop it. The virus has disappeared. So most companies said, “We are not interested in making a vaccine. There is no market.” But some academics went on and did an experimental SARS vaccine, but it never went further because there is no financial support.
It is not difficult. In fact, it wouldn’t have been very difficult to create a vaccine that can protect against many coronaviruses that come out of bats. But again, no financial support for this and, even more so, no research reports. In the United States, the NIH was unwilling to support that type of fundamental research because its budget is too limited.
There are many new candidates for the coronavirus vaccine in development. What will determine which, if any, are used?
Unfortunately, mostly I’m not even in phase 1 in people. A handful is in phase 1 and a couple in phase 2. Those have been pushed and those will be the ones who will finish first, so they will have an advantage. Now, whether they work or not is obviously important, so if they don’t work, this is the end and the others will have to recover.
The rest of them aren’t even out of the lab. Some of these may never leave the laboratory. You may find that there are too many problems developing them. Others might, but because companies see that other companies have an advantage, they may decide not to add resources because they will lose money. Many of these companies have never made vaccines before. Very few companies have, and I think that’s a factor. If you haven’t done a vaccine, you’ll have more problems because you don’t know what you’re doing.
All these things are factors, and therefore obviously production is a factor. I hope we have more than two vaccines because I don’t see how 7 billion doses of vaccine can be made with just two companies. I think we need at least 10 vaccines to be able to cover the whole planet.
What are the potential disadvantages of distributing rapidly developed vaccines during an emergency such as the SARS-CoV-2 pandemic?
We could take a lesson from the polio vaccine in the 1950s. It was only about 50% effective, but that’s what they had, so they moved on. This meant that many children whose parents had lined them up for the shots were unprotected. It also meant that companies had accelerated production. Indeed, many children received polio from that early vaccine because it was not properly produced. You might imagine these early SARS-CoV-2 vaccines because they are rushed through, they are not as optimal as they could be and will not be as effective. In most cases, the vaccine candidates are not infectious, so I’m not too worried about them causing the real disease.
If you try to increase vaccine production by hundreds of millions of doses, things may go wrong. Normally, we take a long time to do it. Everyone is assured that we are doing things safely, but I think there is still room for things that go wrong when things rush.
People say, “Well, if they’re rushing, I’m not going to take it,” and I think it’s a valid concern. What I often say is that if you rush a vaccine and there is a problem and you hurt people, then you will never be able to get them hired for many years. Once there is a negative view of a vaccine due to some side effects, people are very reluctant to take it. We have to make sure it’s safe. We cannot create shortcuts. We need to test it in enough people – thousands of people – to make sure there are no side effects.
If a new coronavirus vaccine were developed, what would have happened to be distributed widely and safely?
You need a lot of doses, first of all, because I don’t want it to be distributed only in rich countries. This is not the point of vaccines. Developed nations are producing the vaccine, but they must understand that they must share it with everyone, and I hope it will happen here. This is my main concern.
You have to do enough. If we only have one vaccine that works, it will be really difficult to make enough doses for everyone. Another problem is that these vaccines will have to be cold, probably frozen and not everywhere they have this ability. Finally, what about delivery? Most of these vaccines need to be injected. This means that you need at least 7 billion needles. I don’t even know if we have 7 billion needles in the world, so I hope someone is thinking about it in advance. And you need people to inject them. You can’t do it alone. You need a qualified healthcare professional who is not available everywhere.
Has a vaccination campaign of this magnitude ever been attempted?
Never. We never had to immunize everyone. We have always had select groups, as for the childhood diseases in which we carry out mass campaigns. There is no precedent for this, for having to immunize every person on the planet.
This transcription has been modified for length and clarity.
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