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Why We Might Not Get A Coronavirus Vaccine: Support The Guardian
Why We Might Not Get A Coronavirus Vaccine: Support The Guardian
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Coronavirus outbreak
Vaccines are simple in principle but complex in practice. Photograph: Sean Elias/PA
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Why we might not get a coronavirus vaccine | Coronavirus outbreak | The Guardian 2020-05-25, 12:30 PM
10,950
But while trials have been launched and manufacturing deals already signed
– Oxford University is now recruiting 10,000 volunteers for the next phase of
its research – ministers and their advisers have become noticeably more
cautious in recent days.
This is why.
Vaccines are simple in principle but complex in practice. The ideal vaccine
protects against infection, prevents its spread, and does so safely. But none
of this is easily achieved, as vaccine timelines show.
More than 30 years after scientists isolated HIV, the virus that causes Aids,
we have no vaccine. The dengue fever virus was identified in 1943, but the
first vaccine was approved only last year, and even then amid concerns it
made the infection worse in some people. The fastest vaccine ever
developed was for mumps. It took four years.
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Why we might not get a coronavirus vaccine | Coronavirus outbreak | The Guardian 2020-05-25, 12:30 PM
Covid-19 patients and found that levels of IgG antibodies – those responsible
for longer-lasting immunity – rose steeply in the first month of infection but
then began to fall again.
Last week, scientists at Rockefeller University in New York found that most
people who recovered from Covid-19 without going into hospital did not
make many killer antibodies against the virus.
The genetic stability of the virus matters too. Some viruses, such as
influenza, mutate so rapidly that vaccine developers have to release new
formulations each year. The rapid evolution of HIV is a major reason we have
no vaccine for the disease.
This means scientists will have to check extremely carefully for signs of
dangerous side-effects. During the search for a Sars vaccine in 2004,
scientists found that one candidate caused hepatitis in ferrets. Another
serious concern is “antibody-induced enhancement” where the antibodies
produced by a vaccine actually make future infections worse. The effect
caused serious lung damage in animals given experimental vaccines for both
Sars and Mers.
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Why we might not get a coronavirus vaccine | Coronavirus outbreak | The Guardian 2020-05-25, 12:30 PM
“We don’t even know if a vaccine can produce an immune response which
would protect against future infection,” says David Heymann, who led the
response of the World Health Organization (WHO) to the Sars epidemic.
Early results from two frontrunner vaccines suggest they might have some
use.
The US biotech firm Moderna reported antibody levels similar to those found
in recovered patients in 25 people who received its vaccine.
Another vaccine from Oxford University did not stop monkeys contracting
the virus, but did appear to prevent pneumonia, a major cause of death in
coronavirus patients.
If humans react the same way, vaccinated people would still spread the
virus, but be less likely to die from it.
How well a vaccine works determines how it is used. Armed with a highly
effective vaccine that protects for several years, countries could aim for herd
immunity by protecting at least two-thirds of the population.
Coronavirus patients pass the virus on to three others, on average, but if two
or more are immune, the outbreak will fizzle out. That is the best-case
scenario.
More likely is we will end up with a vaccine, or a number of vaccines, that are
only partially effective.
Vaccines that contain weakened strains of virus can be dangerous for older
people, but might be given to younger people with more robust immune
systems to reduce the spread of infection.
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Why we might not get a coronavirus vaccine | Coronavirus outbreak | The Guardian 2020-05-25, 12:30 PM
Meanwhile, older people might get vaccines that simple prevent infections
progressing to life-threatening pneumonia. “If you don’t have the ability to
induce immunity, you’ve got to develop a strategy for reducing serious
outcomes of infection,” says McCauley.
But partially effective vaccines have their own problems: a vaccine that
doesn’t stop the virus replicating can encourage resistant strains to evolve,
making the vaccine redundant.
Hopes for eliminating the virus start with a vaccine but do not end there. “If
and when we have a vaccine, what you get is not rainbows and unicorns,”
says Larry Brilliant, CEO of Pandefense Advisory, who led the WHO’s
smallpox eradication programme. “If we are forced to choose a vaccine that
gives only one year of protection, then we are doomed to have Covid become
endemic, an infection that is always with us.”
The virus will still be tough to conquer with a vaccine that lasts for years.
“It will be harder to get rid of Covid than smallpox,” says Brilliant. With
smallpox it was at least clear who was infected, whereas people with
coronavirus can spread it without knowing. A thornier problem is that as
long as the infection rages in one country, all other nations are at risk.
Or as Brilliant puts it, the virus will “ping-pong back and forth in time and
geography”.
One proposal from Gavi, the vaccine alliance, is to boost the availability of
vaccines around the world through an “advance market commitment”. And
Brilliant believes some kind of global agreement must be hammered out
now. “We should be demanding, now, a global conference on what we’re
going to do when we get a vaccine, or if we don’t,” he says.
“If the process of getting a vaccine, testing it, proving it, manufacturing it,
planning for its delivery, and building a vaccine programme all over the
world, if that’s going to take as long as we think, then let’s fucking start
planning it now.”
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Why we might not get a coronavirus vaccine | Coronavirus outbreak | The Guardian 2020-05-25, 12:30 PM
At restaurants, tables will have to be shielded from each other and serving
staff will follow strict rules to prevent spreading the virus. “In our Hong Kong
perspective, the diligent and correct use of reusable masks is the most
important measure,” he says.
We might become blase about Covid-19 deaths when life resumes and the
media move on, but the seriousness of the illness will make it harder to
ignore, she says.
Heymann says it is too soon to know how the pandemic will pan out. “We
don’t understand the destiny of this virus,” he says. “Will it continue to
circulate after its first pandemic? Or will it, like some other pandemic
viruses, disappear or become less virulent? That we do not know.”
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Why we might not get a coronavirus vaccine | Coronavirus outbreak | The Guardian 2020-05-25, 12:30 PM
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Why we might not get a coronavirus vaccine | Coronavirus outbreak | The Guardian 2020-05-25, 12:30 PM
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