THE GREAT VACCINE HYPE
By Richard Davis
Listening to news reports one might think that the only way that we can move from pandemic mode to some degree of post-pandemic normalcy is to have a vaccine to rid us of COVID 19. Any vaccine that is developed will not magically make COVID 19 go away. It might help a little, but a magic bullet cure is unlikely.
The sound bite, short-attention span world is not suited to explaining complex issues such as how vaccines are developed and how they work. Instead, the world sees hope when a lab developing a vaccine sends out premature press releases of success so their stock value can increase.
There are well established scientific protocols in place for vaccine development and they all require years of trials and research. Sometimes vaccine development efforts are successful and sometimes they are not. When a vaccine is developed and made available to the public it takes years for us to see the big picture of how the vaccine works.
The COVID 19 pandemic has made politicians more impatient than usual and they want to speed up the process for developing a vaccine. It would be a good thing to develop a vaccine quickly, but we have to look at the tradeoffs. You don’t have to be a virologist to know that a vaccine that is put on the market after a year or less of trials will not tell us if people will develop long-term immunity or if the vaccine will remain effective after a year.
Vaccines work by activating the immune system without causing disease. There are a number of ways that vaccines are made and they include using: weakened viruses, inactivated viruses, proteins from a virus, a viral protein grafted onto an innocuous virus or the mRNA that encodes a viral protein.
Keep in mind the fact that vaccine-induced immunity is usually weaker than immunity that develops after an infection. As the first generation of vaccines are in development researchers believe these vaccines may decrease the severity of the disease but not stop it from spreading. They may work in a manner similar to flu shots. For a vaccine to be approved by the FDA it has to prevent or reduce severe disease in at least 50 percent of people. Not exactly a high bar.
Current vaccines in development have shown the ability to induce antibodies that neutralize the coronavirus. Of course, we will not have any long-term data that would tell us if that kind of neutralization is permanent.
Vaccine manufacturers are moving into phase three trials which usually take years but are now being done in months. The information that is gained from these trials will be less than what is needed to effectively move to a world in which COVID 19 is less of a threat. Speeding up phase three also means that we will have a shorter window in which to look for rare and long-term side effects.
If a vaccine is put on the market and it proves to be of marginal benefit or if it turns out that life-threatening side effects become apparent after more than a year after its use we will be in much worse shape than if we were patient and followed a more thorough and lengthy vaccine development process.
There are many other issues related to accelerated vaccine development and we have to realize that whatever becomes available after a shortened development phase may end up making life worse for a lot of people.
Then there are issues of distribution and cost of the vaccine. With dysfunctional leadership and a lack of a national pandemic response I fear that it may be years before this country is able to be a little freer from the shadow of COVID 19.