New from the @EmoryCSHH News Team: Measles surge due to vaccine inequities and hesitancy, experts debate Ozempic use for pre-diabetes, STIs in decline for second year, ChatGPT outperforms doctors in providing diagnoses
By: Vivian Tsao
Now that the COVID-19 pandemic has taken hold of more than 209 countries, and has taken the lives of over 126,000 individuals, anti-vaxxers seem to have stayed awfully quiet – and hopes of a vaccine continue to rise. As there seems to be no indication of controlling the outbreak in the upcoming weeks, people have turned their hopes towards a vaccine as the only way to successfully halt the pandemic. Eye-catching phrases such as “A Potential Coronavirus Vaccine Might Have Been Discovered” have been dominating news headlines to provide a sliver of hope in between the articles updating us on daily infection rates and projected death tolls, but they may be creating the false illusion of a magic bullet.
If a vaccine is found, how long will it take for it to be mass distributed? How effective will it be? Will countries have a strong enough health infrastructure in place to accept a vaccine program with open arms? These questions are key to predicting how much of an effect a vaccine will make on the pandemic on a realistic scale. With these questions in mind and by exploring the biological, economical, and political aspects of the pandemic, we will gain some insight into what a world with a COVID-19 vaccine looks like.
The situation also produces an ethical dilemma – how do we get the vaccine to everyone and if there isn’t enough? Who gets it first?
Coronaviruses are not a newly emerging family of viruses. The world has seen two major coronavirus epidemics before: the 2002-2004 severe acute respiratory syndrome (SARS) epidemic in China, and the 2012 Middle East respiratory syndrome (MERS) epidemic that started in Saudi Arabia. In both of these cases, the epidemics were contained before the vaccines for them were fully developed. These vaccines are now being repurposed for the development of a COVID-19 or Sars-CoV-2 vaccine, which moves the process much faster towards human trials. As history shows, coronaviruses are a rising threat to the global community; therefore, research and development in this area will likely prove to be beneficial for streamlining a faster healthcare response for potential outbreaks.
Around 80 companies worldwide have been racing to produce a COVID-19 vaccine, and as of April 6, at least five of them have begun clinical trials and testing on human subjects. Though this seems like good headway, Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases (N.I.A.I.D), warned the public that “a vaccine that you make and start testing in a year is not a vaccine that’s deployable.” He further explains that the earliest possible date will be at least a year to a year and a half, even considering the fast track process.
Fauci’s pessimistic viewpoint comes from the reasoning that testing the efficacy and safety of a vaccine takes a tremendous amount of time. A vaccine must pass certain tests reviewed by the Food and Drug Administration (FDA) before it is approved for use. It must first pass a preclinical trial, which normally takes years but is fast tracked in times of emergencies. An example can be seen in U.S based bio-technology company Moderna’s trial, where it has skipped animal trials and is going directly into human testing. Even with this extremely fast-tracked process, the timeline of development, clinical trials, and finally market level production would take at least 12 to 18 months. A vaccine may not come in time for it to be the answer to ending the pandemic, but it could be a solution to keeping COVID-19 cases low once the outbreak is already controlled.
Once a vaccine passes the dreadfully long process of proving its safety and efficacy, the situation becomes less of a biological obstacle and turns into an economic and political one – the mass production of the COVID-19 vaccine. The companies and organizations that are currently racing towards a vaccine do not have the capacity for producing the vaccine in such a high quantity that it could be supplied on a global scale. The incentives put in place for a biotechnology or pharmaceutical company to create a treatment are also the barriers for these companies to create the quantities the world desperately needs. These patents and incentives promise the company a patent that can ensure that their efforts pay off, but do not allow other companies to help produce it. An alternative solution would have to be for companies outside of the U.S that do not fall under the purview of the United States patent infrastructure to produce the vaccine.
The situation also produces an ethical dilemma – how do we get the vaccine to everyone and if there isn’t enough? Who gets it first? Countries will have to look into past examples to see which strategies to adopt. The UK, for example, plans to prioritize their medical staff and children as well as pregnant mothers for vaccinations during potential influenza pandemics. Each outbreak is different, and in the case of COVID-19, the people with the highest risk are healthcare workers, people with pre-existing medical conditions, and people 65 years and older. These guidelines will have to be formed in a situation where limited vaccine supply occurs.
Even if the vaccine does not come around in time, the COVID-19 pandemic will only get the world one step closer to preparing for the next one. As experts heed the public to stay rational and not be over-reliant on waiting for a vaccine, our best bet is to stay at home and practice proper social distancing…all the while remembering to wear a mask.
References
Hu, Ben et al. “Bat Origin Of Human Coronaviruses.” Virology Journal 12.1 (2015): n. pag. Web. 19 Apr. 2020.
https://www.theguardian.com/world/2020/apr/06/when-will-coronavirus-vaccine-be-ready
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