The Race for A COVID-19 Vaccine
The COVID-19 pandemic has forever changed the way we view and depend on science and medicine. It has united nations around the world, by joining top scientists together to fight a common enemy. To date, confirmed cases worldwide total over several million and continue to grow. Scientists look for answers to slow down the spread of the disease as the entire world watches, feeling both hopeful and fearful at the same time.
The COVID-19 virus is part of a group of viruses called coronaviruses. This same class includes severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). COVID-19 is similar to the virus that caused the SARS global outbreak in 2003. Research has already been done on a vaccine for SARS in the past, so scientists are not necessarily starting with a blank slate.
The COVID-19 pandemic is a race of sorts, …but are we sprinting in search of an answer for treatments and a vaccine? Have we paced ourselves in this race, or are we going to burn out too quickly in the run, compromising safety, efficacy, or medical ethics?
A new poll from The Associated Press-NORC Center For Public Affairs Research stated that only about half of Americans would get a vaccine if available. Why is this number so low? Upon further examination, the most cited reason for not vaccinating was “concerns of safety” or “side effects” of the vaccine. Also, around 30% were not against vaccination, but instead marked “undecided.” Based on this information, it seems that we need more information and time.
The COVID-19 Vaccine and Immunity
Individuals receive immunity from disease through one of two ways. Either by getting the disease itself (natural immunity) or by receiving a vaccination. A vaccine offers protection of both the individual and the community by herd immunity. Herd immunity is group or community protection that occurs when a majority of the population is vaccinated. It protects those who have not been vaccinated or are more likely to become infected such as individuals who have compromised immune systems. Experts are still uncertain about how many individuals would need to be vaccinated with the COVID-19 vaccine to achieve this herd immunity. You can read more about herd immunity here.
Coronavirus Vaccine Research
One of the biggest challenges we face in the development of a vaccine is time. Scientists look to develop a solution as quickly as possible, and at the same time ensuring safety and efficacy.
According to the Trump administration in mid-May, Americans can expect to see a COVID-19 vaccine by the end of this year.
Typically, the development of a vaccine from the minute it is discovered in a lab to when it is given to a patient is measured in years, sometimes decades. Even the search for a vaccine for polio, a devastating disease that infected close to 60,000 children in its worst year (1952), took about a decade to be researched, tested, and widely distributed to the American public.
Why does it take so much time? Science and our current understanding of health have changed dramatically since the 1950s- when even your family physician might have smoked. To understand this, you need to appreciate the steps a new drug or health intervention goes through before it can be given to the public.
Vaccine Development Timeline
Clinical development of a vaccine can be separated into three stages after it is tested in animals. Vaccines go through the same procedure needed to bring a new drug to the market.
· Phase I - the vaccine is tested in a small group of individuals to look for side effects and determine the ideal amount of vaccine to give
· Phase II - the vaccine is given to a much larger group of people. Scientists try to keep characteristics, such as age or health status, as similar to the population for whom the vaccine is intended.
· Phase III - the vaccine is given to thousands of people to test for safety and efficacy
Sometimes vaccines go through further testing, even after the vaccine is approved and licensed, called Phase IV or post-marketing analysis.
Controversy Regarding COVID-19 Vaccine
Some researchers favor the use of “human challenge trials” to speed up the vaccine development process. This type of “challenge” trial muddies the ethical waters. In it, healthy volunteers are given the vaccine then purposely infected with COVID-19. Usually, during the testing of a vaccine, researchers wait until the person contracts the virus naturally.
Also, since so much is unknown about how exactly the new coronavirus works, it is impossible to know all of the risks associated with participating in a trial. Participants would be unable to give valid informed consent, which is an essential part of the clinical design process.
While this is not happening in the United States, it is happening in other countries.
Current Status of a COVID-19 Vaccine
There are more than 100 projects around the world focused on the search for a COVID-19 vaccine. As of the middle of May, eight potential vaccine candidates are currently under investigation and being tracked by the World Health Organization. Presently, there is very little data available with only one vaccine candidate having moved to phase II where it is being studied in humans.
The Bottom Line
The best way to fight this disease right now is to follow established guidelines on social distancing and hand hygiene. This race of science vs. the COVID-19 pandemic needs to be a paced marathon rather than a quick sprint to ensure safety and efficacy.