Waiting for Covid-19 Vaccine

Vladimir and Estragon from Samuel Beckett’s absurdist play are stuck eternally waiting for Godot, but we still have time to think through and carefully plan for Covid-19 vaccine’s eventual arrival.

If you listen to some of the Trump administration’s spokesmen or the White House briefings alone, you may think that a Covid-19 vaccine is just around the corner, an eventuality that is a matter of months.

Depending on the day of the week and who’s talking, we hear “by the end of the year” or “well into” 2021, the latest estimate from the lead U.S. immunologist Anthony Fauci. 

“We are going to make sure we’re going to have a vaccine by the end of the year for emergency use,” Treasury Secretary Steven Mnuchin said at the White House last week.

Most healthcare officials and private companies agree that this would be our best-case scenario, and would take a “revolutionary” feat of science to produce a vaccine in under five years, which is how long it normally takes.

In reality the timeline of this vaccine’s development, with all the domestic political pressure and global competition to get it, is far from certain. What’s also not certain is how it will be distributed, who’ll be able to access it, and whether that amount of people will be sufficient enough to stabilize the spread of Covid-19 overall.

Most of these questions are the same for countries around the world. What’s striking about the American experience with Covid-19 is that while half the country is counting days till the miracle vaccine will allow things to go back to normal, the other half of the country has no intention of ever vaccinating themselves or is on the fence about it. And this makes our prospects for going back to normal even murkier and complicated.

The Associated Press study with researchers at University of Chicago conducted in May found that only 49% of Americans plan to get vaccinated. While 20% said “no, thank you” and 31% weren’t sure. 

These numbers are in line with normal flu vaccinations, but the politicized climate around wearing masks and other CDC guidelines suggests that questions and misinformation around vaccines will only get more polarizing.

Meanwhile, scientists around the globe are racing to come up with the miracle vaccine. Globally, over 160 labs are working on vaccine development. The vaccine development includes exploratory, pre-clinical, clinical, regulatory review, manufacturing and quality control, according to CDC. 

And there are now at least 24 coronavirus vaccines in the human testing phase, with 18 more expected to enter this phase later this year according to estimates by Business Insider.

As governments are looking to expedite these steps, many are raising concerns about the safety, efficacy of the vaccine developed under these conditions as well as the track records of the companies receiving millions in government funding.

The leader of one of these frontrunner companies, Merck CEO Kenneth Frazier said officials are doing a “grave disservice” to the public by talking up the potential for vaccines later this year.

“We've seen in the past, for example, with the swine flu, that that vaccine did more harm than good,” he warned. “We don't have a great history of introducing vaccines quickly in the middle of a pandemic. We want to keep that in mind.”

He noted that in the last quarter century, there have been only seven new vaccines developed globally. 

Bureaucratic agencies are struggling to expedite the trial phase. Companies are trying to use “plug-and-play” technologies that worked with previous outbreaks. Moderna, for example, is using a vaccine development platform previously used to produce influenza virus and Zika virus vaccine candidates.

And before these phases are even completed, companies are looking to the manufacturing stage of Covid-19 vaccines to be able to quickly accommodate millions of doses needed.

But there is no “plug-and-play” for the global scenario we’re experiencing now. Countries are paying billions of dollars, scientists are competing with each other, private companies are fighting off cyberattacks from hostile governments, and the scientific community is dealing with political pressure to deliver results and mistrust from the public.

It will be an incredible scientific accomplishment when we get it, but it will be a true miracle when any group of people will be able to overcome these obstacles that are unlikely to dissipate anytime soon.

"I would be extremely happy to be wrong, but I don't really see how a vaccine can get put together in time to help out with the likely course of this current outbreak," Derek Lowe, author of the industry blog In The Pipeline, told Business Insider's Andrew Dunn.

Once we do get it, there is a question of who will get it first.

Companies like AstraZeneca, for example, took U.S. federal funding and also have signed contracts with hostile countries like Russia, which is working to develop its own vaccine.

There is the so-called “vaccine nationalism” factor and then the global corporations deciding how much they feel comfortable profiting from the global pandemic. 

Bioethicist Ruth Faden says one constant in pandemics is that the “poorest and least powerful in society” are usually the most vulnerable. If Covid-19 response in the U.S. is any indication, this trend will likely continue.

“In the U.S., we've seen that happening in this pandemic with people of color, who are experiencing disproportionately high rates of infections and deaths for reasons rooted in longstanding structural injustices,” she noted. “There is an important conversation to be had about whether, as a part of the much overdue racial reckoning in the U.S., we should consider putting people of color high on the list for vaccine priority in the early days.”

Yet the AP study with University of Chicago showed that Black Americans are the least excited about getting vaccinated, with only a quarter of the Black respondents saying they plan to get a vaccine.

Before the vaccine is developed and brought to market, there is still time to do proper due diligence and, critically, educate the public about this vaccine’s merits and safety, especially the most vulnerable segments of the population. 

When the vaccine does arrive, another key factor will be the political environment and Trump response to the 2020 presidential election’s results.

In either scenario, the speed of development is a concern for many about how safe the vaccine will be.

“I am not an anti-vaxxer,” Melanie Dries of Colorado Springs told AP. But, “to get a COVID-19 vaccine within a year or two ... causes me to fear that it won’t be widely tested as to side effects.”

As Fauci and others have noted, it’s going to take a significant majority for it to make a difference.

“If we could vaccinate the overwhelming majority of the population -- we could start talking about real normality again," Fauci told CNN last week. "But it is going to be a gradual process."

Still, tens of thousands of people have already signed up as volunteers for the new vaccines, and you can volunteer here for the clinical trials run by the National Institutes of Health.

With this much distrust of the healthcare and scientific community, we are not in good shape if the miracle cure of a vaccine arrived tomorrow. That’s the real concern.

The words of the CEO who’s leading one of the vaccine efforts deserve more attention, not just for this Covid-19 outbreak but for any future pandemics to come.

“No matter where you are in the world, you should have access to this vaccine because it is a global pandemic. And my view is unless all of us are safe, none of us are safe,” he said. “When you think about the world that we live in with climate change, with ecosystem disruption, with populations moving around the way they do with human mobility the way it is, this pandemic is just the first of many that we could experience as a species because those conditions are only going to get worse going forward.”

While we’re waiting for the miracle cure to arrive, we should think long and hard about what kind of country we want to live in: a divisive, corrosive state where everyone only cares about themselves or a nation where scientific knowledge is respected, with proper checks and balances but without political overreach.