The world is coming to terms with COVID-19 and establishing a “new normal” for continuing with everyday life. Naturally, many people — especially in countries hardest hit like the United States — are wondering if there is an end in sight to the pandemic. The two main possibilities are herd immunity or the development and widespread distribution of a vaccine. Since the duration of immunity to the coronavirus after infection is not yet widely understood, widespread herd immunity as an end to the pandemic is highly unlikely. That leaves a vaccine as another option to return to the lives we once knew – and banking on a vaccine that will be ready by December has become a source of optimism in these dark times. But this expectation is incredibly misguided and does no good in the end. Instead, we owe it to ourselves to be honest about the realities of the pandemic: It is not going away any time soon, and we must prepare to wait for at least another year before the COVID-19 vaccine is ready.
When the coronavirus gained the public’s attention early this year, the science of virology and vaccination was thrust into the spotlight as well. Typically, vaccine development requires extensive initial research into its viability as a safe and effective vaccine candidate. This is followed by pre-clinical studies in non-human models, i.e. animal testing, in order to show initial promise in its vaccine candidacy. Next, clinical trials begin, and progress through three phases. Phase I involves a small number of subjects and is mainly designed to measure the vaccine’s safety. Similarly, Phase II tests for safety but with multiple groups of subjects. Finally, Phase III involves widespread testing for efficacy of the vaccine. After these phases, the vaccine is reviewed by the Food and Drug Administration and, if approved, its manufacturing process can begin. However, the COVID-19 vaccine timeline is far less linear; many stages of its development are happening concurrently due to its expedited status by multiple biopharmaceutical companies pursuing their own COVID-19 vaccines like Moderna, BioNTech and Zydus Cadila. The multiple distinct stages necessary for the successful production of any vaccine demonstrate that no vaccine manufacturing process can be speedy – and COVID-19 is no exception.
Vaccines for other specific infectious diseases went through years-long processes of development. For example, the vaccine for typhoid fever took 13 years to create, and the polio vaccine’s road to development stretched into decades. Often, the search for a vaccine would take so long because vaccine candidates turned out to either be ineffective or have side effects that were too dangerous for widespread use. Indeed, clinical trials, especially for vaccines, can and must be paused if unanticipated side effects spring up. In the case of typhoid,some of these issues were due to the researchers’ limited abilities and knowledge at the time, but this is not always the case. Sometimes, a vaccine cannot be developed even with advances in science because the virus is extremely complex. For example, there is still no HIV/AIDS vaccine despite decades put into its research and development. Of course, the duration of a vaccine’s research depends on the virus that it protects against. Depending on the complexity of the virus that the vaccine targets, development often takes between 10 and 15 years, so there is no guarantee for how long it will take to create an effective COVID-19 vaccine.
Despite the long process required to produce a successful vaccine, many still cling to the hope of the arrival of one for COVID-19 by the end of the year. This pandemic has done nothing but take from us – opportunities, jobs and lives. To think it might all be over by December is pleasant, but this is not realistic even when considering the projects currently in the works. The leading vaccine candidate, created by AstraZeneca, was temporarily suspended after a research participant suffered an extreme complication – a spinal cord injury – after administration of the vaccine. Although experts at the University of Oxford have determined that the reaction was most likely not caused by the vaccine, the halt on the vaccine’s development was still necessary as a precaution. Furthermore, Johnson and Johnson’s vaccine candidate trial was also paused on Oct. 12 after one of the study subjects sustained an injury, also apparently not caused by the vaccine itself. These two trials have recently resumed, but a month and a half is a long time to make no research and development progress, especially for a drug as urgently needed as a COVID-19 vaccine. Every day that the trial was suspended was another day that the virus was able to spread further. Additionally, adverse events during clinical trials are even more discouraging when there are so many vaccine skeptics already.
It is no surprise that many have unrealistic expectations of the timeline for vaccine creation and distribution, since government officials have often given conflicting reports of when a vaccine will be coming. Last month, President Trump promised that there will be enough coronavirus vaccines for every American by April 2021. This contradicts the timeline proposed by actual health officials. The Centers for Disease Control has projected that widespread coronavirus vaccination will only be possible by the third quarter of 2021 at the earliest, months off from Trump’s predictions. By that time, the pandemic will have lasted for almost two years, and even then, this is a hopeful estimate.
There is also the question of who would get the vaccine first once it is successfully created. Trump previously said that doses of the coronavirus vaccine could be ready for the general public as early as October or November of this year. Even if this were true, given that supplies would be limited at first, the vaccine would most likely be allocated to seriously at-risk groups and healthcare workers on the frontline, as it should be. Most experts project that doses of the vaccine will be made available to non-frontline and non-at-risk Americans much later.
The most important objective throughout this whole process is ensuring that the vaccine is safe and effective. The last thing the world needs is a vaccine that ends up making people get sicker or suffer injuries. Delays in vaccine production are frustrating, especially when they seem so close to completion. The AstraZeneca trial was in Phase III, one of the last phases of development, before the participant’s spinal cord injury shut down the study for further investigation. This incident serves as a lesson that time, energy and effort must be put into eliminating detrimental effects from the distributed vaccine, especially since this vaccine will likely be offered to the majority of the world’s population. Delays are part of the process, and we must collectively recognize and prepare for this.
While a vaccine is not likely to arrive soon, we still have a responsibility to minimize the spread of the virus through our actions: wearing a mask, social distancing and washing our hands. The talk of “flattening the curve” that started back in April still applies today, despite how much the pandemic has evolved since then. Rather than passively wait for a vaccine, we should take individual precautions, and derive hope from our own ability to affect the outcome of the pandemic.
Rachael Schmidt ’21 can be reached at rachael_schmidt@brown.edu. Please send responses to this opinion to letters@browndailyherald.com and op-eds to opinions@browndailyherald.com.
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