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Where we are? The vaccine is far off, experts say

A vaccine to protect against coronavirus will be many things enclosed in a small vial: a harbinger of returning to normal, a scientific feat for centuries and, depending on when it arrives, a politically powerful symbol.

The timing for how long it will take to get that vaccine is a moving target and depends on who you ask – and when.

Dr. Anthony Fauci, the National Institutes of Health’s top infectious disease expert, has repeatedly said that he hopes that a vaccine will be available by late 2020 or early 2021.

President Donald Trump has promised that a vaccine will be ready later this year or January. A White House-led partnership, Operation Warp Speed, has earmarked nearly $ 1

0 billion for the effort, and $ 1.2 billion has already been promised on a single vaccine candidate.

Pharmaceutical giant AstraZeneca has promised to deliver at least 300 million doses to the United States as early as October 2020, probably even before a vaccine is approved.

In an effort to eliminate part of the hyperbole and get a realistic idea of ​​when a widely available vaccine will be available, USA TODAY has created a panel of nationally known experts in medicine, virology, immunology, logistics and supply chain issues for estimate how far we are from a widely available coronavirus vaccine. Each month, these experts will follow the progress and highlight inevitable setbacks.

If you think of it as a clock ticking from midnight (when the pandemic started) to noon (when the vaccines will be widely available in the U.S. and life returns to something close to normal), so starting in June, the panel says it’s around 4 in the morning.

“The sun hasn’t peeked over the horizon yet, but the horizon lights up in the east. We are no longer in the dark, “said Dr. Kelly Moore, associate director of immunization education with the Immunization Action Coalition.

The USA TODAY vaccine panel is designed to offer readers an objective and non-artisan understanding of how close we are to getting an effective vaccine distributed to the nation’s residents. We’re about a third of the way up, they say.

“I think we will have a vaccine by mid-next year,” said Paul Offit, director of the Vaccine Education Center at the Philadelphia Children’s Hospital.

Caltech University structural biologist Pamala Bjorkman agrees, although she believes one of the hardest parts – downsizing to make sufficient doses of vaccines – is still a big challenge for the future.

“I subtracted an hour from a third of how we estimate production and distribution problems,” he said via email.

The challenge isn’t just to create a new safe and effective vaccine: more than 11 possible candidates will be human tests this summer. But for a vaccine to end up in a pharmacy or doctor’s office near you, companies will have to produce hundreds of millions of doses and then deliver them across the country and ultimately the world.

It’s 4 in the morning: vaccines are coming

For June, ten experts answered our question on the timeline. Their responses fell between 2:00 and 6:00, with a median of 4:00 – the point where half of the responses were previous and half after.

Most said that actual progress in getting coronavirus vaccines has been a long way off, along with scientists working 24/7 on how to end the pandemic.

“The brightest minds in the world are in this struggle and move with an incredible sense of urgency,” said Dr. Michelle McMurry-Heath, President and CEO of the Biotechnology Innovation Organization, a commercial group for the biotechnology industry.

In a historical and global effort, basic science behind dozens of vaccine development efforts he mainly has was terminated in the six months following the appearance of the virus.

“Vaccine candidates are largely available,” said Dr. William Schaffner, professor of preventive medicine at Vanderbilt University.

The global effort has been stellar, said Florian Krammer, a virologist at Mount Sinai’s Icahn School of Medicine in New York City.

“I’ve never seen science move so fast,” he said.

Safety first and foremost in coronavirus vaccines

While the science of inventing candidate vaccines was difficult, it was not insurmountable given recent advances in genetics, virology and immunology.

“Science provided cutting edge technologies that were not possible ten years ago,” said Prakash Nagarkatti, an immunologist and vice president of research at the University of South Carolina.

Many of the vaccines in the pipeline are based on new technologies whose basic science is understood, although current techniques are still being developed.

Just having a vaccine for the United States won’t protect us, said Erica Ollmann Saphire, a structural biologist and professor at the La Jolla Institute of Immunology.

The important date is not when the first person in the United States can go to their doctor’s office and get the first shot. The important date is when we have enough coverage to prevent rebirth and recirculation among the human population, he said.

“We have seen very clearly this year that viruses can become viruses anywhere,” he said.

The biggest problems for these experts are always the messy and impossible to project real results: how safe and effective vaccines will prove when tested in people. Chemistry is a science of formulas. Biology is the very substance of life and as such it is almost impossible to predict.

The most difficult questions to answer are yet to come, they say. Will a vaccine provide lasting protection? Is it safe enough to supply billions of people? It can be produced quickly and reliably in large quantities quantities?

While the world is clamoring for a vaccine as quickly as possible, there cannot be brief security for economic or political interests, said Dr. Gregory Poland, director of the Mayo Vaccine Research Group and chief editor of Vaccine magazine.

Above all, he said, when the time comes to authorize vaccines for use.

“The Food and Drug Administration must demonstrate that it will not bow to political pressure and will do all the due diligence, safety tests and necessary reviews,” said Poland.

The way this work is presented to the public is crucial and the urgency has become a way of emphasizing the care that goes into the process, Schaffner warned.

“When we say we are” running, moving fast, etc. “What the public thinks is that we are cutting corners,” he said. “Messaging has been unfortunate.”

The goal must be to strengthen public confidence in all available vaccines “by showing our work openly and honestly,” said Moore. In order for the world to take sides when filming becomes available, researchers must “bring the public as partners in the process, as we have not done since the early days of the polio vaccine.”

In the end, no estimate can ever totally predict the unimaginable complexities of the body’s immune response to a new vaccine, so only these estimates remain. Assuming we can know the result is impossible.

“You have an unusual virus, a bat coronavirus that has unusual characteristics and we will meet it with vaccination strategies that have never been tested in large populations before.” What, “asked Offit,” could it go wrong? “

How we did it

The US TODAY has received responses from ten scientists, asking how far they think vaccine development has progressed since January 1, when the virus was first recognized internationally. These responses were then aggregated and the median was calculated.

The panelists of this month

Pamela Bjorkman, structural biologist at the California Institute of Technology

Dr. Florian Krammer, virologist at the Icahn School of Medicine of Mount Sinai in New York City

Dr. Michelle McMurry-Heath, president and CEO of the Biotechnology Innovation Organization (BIO)

Dr. Kelly Moore, associate director of Immunization Education, Immunization Action Coalition; former member of the CDC Advisory Committee on Vaccine Practices; Chair of the World Health Organization Advisory Committee for Immunization Practices

Prakash Nagarkatti, immunologist, vice president for research of the University of South Carolina

Dr. Paul Offit, director of the Vaccine Education Center and attending physician in the infectious disease division at the Philadelphia Children’s Hospital

Dr. Greg Poland, Mayo Clinic vaccine research team director, editor in chief, Vaccine

Dan Salmon, Johns Hopkins Bloomberg School of Public Health Institute for Vaccine Safety

Erica Ollmann Saphire, Structural biologist, professor at the La Jolla Institute of Immunology

Dr. William Schaffner, professor of preventive medicine, department of health policy and professor of medicine, division of infectious diseases, University of Vanderbilt

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