A COVID-19 Vaccine in Record Time Is Going to Require a Lot of Knowledge of History and a Lot of Cooperation, and Much More Patience

I was interviewed the other day about the work being done on the COVID-19 pandemic in general and the pandemic coronavirus vaccine in particular. The reporter wanted to know if it was possible to have a viable vaccine before the end of this year (2020) as the President keeps predicting. I told him that it was possible, but it is also highly improbable. The record for vaccine development right now stands at around 4 years from the discovery of the virus that causes a disease to the development of a vaccine against it. In 1945, the virus that causes mumps was isolated in the lab, and it wasn’t until 1948 that the vaccine was developed. It would be almost 20 years before an even better vaccine for mumps came along.

This record stands only if you start the timer at the point in which the mumps virus is isolated. Mumps has been known as a disease for much longer than that. If you start the clock on a vaccine from the time that the disease is first identified, then the record goes to Ebola. Ebola was “discovered” in the 1970s. (Discovered in a sense that it was first described as a disease on its own to the scientific world.) The vaccine for it came in the last couple of years. That’s about forty years. Another disease that has been known about for forty years is HIV/AIDS, and a vaccine for that particular virus has been very elusive.

This is not to say that we should not be hopeful that a vaccine against this pandemic coronavirus is going to take a very long time, with millions more dead or injured from the disease (COVID-19) in the meantime. Now, more than ever in history, there is plenty of technological know-how to create vaccines. Scientists like Dr. Peter Hotez in Texas worked on a SARS vaccine back in the early 2000s. (SARS is also caused by a coronavirus.) So scientists know what causes the disease, how to grow the virus in the lab, what kind(s) of immune response(s) it the virus triggers, how to look for the antibodies made in response to exposure to the virus, and how to test the public for infection. These are all things that need to come together for a vaccine to be developed.

Consider, for example, the history of the polio vaccine. Like mumps, polio was known about for centuries, but it wasn’t until the 1950s that a series of incremental discoveries allowed Dr. Jonas Salk and Dr. Albert Sabin to work with their teams on a safe and effective polio vaccine. In 1793, Dr. Michael Underwood publishes a book on the diseases that affect children and clearly describes polio as its own disease apart from others that cause similar symptoms. Between 1840 and 1890, neurologists describe the abnormal anatomy and physiology of nerves affected by the disease. In the early 1900s, polio is found to be infectious from person-to-person, and epidemics are more clearly identified and described in the scientific literature. In 1910, the antibodies that monkeys and humans create against polio are identified, making laboratory testing for exposure and infection something that could be done to know who is exposed and who is not.

In 1921, Franklin Delano Roosevelt contracts polio while on a family retreat. He was 39 at the time, and his resolve to rid himself of the disease and keep others from getting it created the foundation we now know as the March of Dimes. That’s where the funding came for more research into polio. Then, in the 1930s and 1940s, two bright women studied and understood that the poliovirus multiplied in the digestive system of monkeys (paving the way for Sabin’s vaccine) and that the virus could be inactivated effectively with formalin and still trigger an immune response as if an actual infection had happened (paving the way for Salk’s vaccine). By the mid-1950s, with all the money raised through FDR’s encouragement, and centuries of knowledge coming together, a safe and effective polio vaccine was tried on thousands of children across the United States, with parents waiting for hours in the hot sun to give their children a chance at not catching the terrible disease.

Now think of all the advancements in science since the 1950s. We now have genetic technology that demystifies the genetic sequence of every living thing, including viruses. We have powerful computers to process millions and millions of data points gathered from laboratories all over the world, and those laboratories are talking to each other in real time. (When Pasteur presented his rabies vaccine findings, he had to do so at a large gathering of French scientists, and then the information was wired days later to the New York Times.) And there is a worldwide race to a vaccine that will end the pandemic before it is allowed to run its natural course.

It is just going to take some time. As a result, one of the biggest assets in this race is patience. Elected leaders and public health authorities need to be able to shepherd the rest of the public through a very turbulent time and help the people practice patience before the vaccine is available. This is very difficult to do, and it has triggered a record number of resignations from public health officials who have been threatened with violence because of the science and evidence-based recommendations they have given to mitigate the effects of the pandemic.

If Edward Jenner and Louis Pasteur could figure out vaccines against smallpox and rabies without ever seeing the viruses that caused those diseases — without ever knowing the genetic sequences of those viruses or the antibodies produced by the human body in response — then, surely, the millions of bright minds working on stopping the COVID-19 pandemic will come up with something sooner rather than later.

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Author: René F. Najera, DrPH

I am the editor of the History of Vaccines site, an online project by the College of Physicians of Philadelphia. All opinions expressed on these blog posts are not necessarily those of the College or any of my employers. Check out my professional profile on LinkedIn: https://www.linkedin.com/in/renenajera Feel free to follow me on Twitter: @EpiRen

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