July 1, 2020
There was a scare at the Tehran American Dependent’s School in 1955. One of the teachers came down with polio. We children were all rushed downtown to the Army Hospital to be injected with a brand new vaccine so that we could return to school safely.
Vaccines are where many of us place our hope these days. And this makes sense. Only a few generations ago parents lived in fear of losing children to infectious diseases like polio, diphtheria, smallpox, whooping cough, or the random bite of a rabid dog. Older people rely on vaccines as well, to protect them from afflictions like pneumonia, influenza, and shingles. In between are the healthy adults protected by their immunological vigor and the fact that they are no longer surrounded by infectious diseases.
Until a new one comes along. History gives us a vivid example in the devastating effect of diseases that sixteenth-century Europeans brought to the Americas, including small pox, influenza, measles. More recently the world has been threatened by viruses with pandemic potential–new influenza viruses, retroviruses, and coronaviruses. A vaccine hasn’t always come forth to save us.
Actually, I think our prospects for a vaccine look good this time. The global effort is unprecedented. More than 100 companies are currently working on vaccines, including pharmaceutical companies in the U.S., U.K., Germany, France, India, and China. Last week Dr. Anthony Fauci told Congress that we may have a vaccine by the end of 2020 or early in 2021. (See the DHHS Fact Sheet on Operation Warp Speed below). Other experts have estimated that a vaccine might not be ready until the end of 2021, a year later.
The fact that 9 vaccines are already in clinical trials is encouraging (see Forbes article below). Clinical trials are human trials conducted in three phases: phase 1 to verify safety, phase 2 to test doses for safety and efficacy, and phase 3 is a double-blind test on a population large enough to include a range of ages and immune competency. These trials require a large investment of time, expertise, and money. The fact that so many companies have the confidence to take their vaccines this far is very promising.
My big concern right now is keeping expectations realistic. From the beginning we have had the impression that lockdowns were for a few weeks, that opening up meant conditions were under control, that “normalcy” was just around the corner. Who can blame people for planning weddings in June or beach weekends in July? Yet the reality is that we still have a fast-spreading virus whose effects range from zero to death and we are still debating how we want to handle it.
So let’s look for a minute at possible areas of disappointment with a vaccine:
- What does “available” by the end of the year mean? Available when and to whom?
- The vaccine may not guarantee protection. 50% efficacy may have to be enough to start with.
- How long will the protection last? 6 months, a year, longer?
- The first available vaccine may not be the best. Fortunately there are a lot of vaccines under development simultaneously and they aren’t all approaching immunity the same way.
- Vaccines need to be available worldwide both for humanitarian and economic reasons: think trade, tourism, family visits, conferences, concerts, Olympic Games, international competitions such as soccer and tennis. Right now many of us can’t even visit other states, let alone other countries.
The ultimate disappointment would be a long delay or no vaccine. It happens. So far there is no vaccine for HIV/AIDS, which is still a pandemic. Other diseases with no vaccine include malaria, Ebola, West Nile virus, Lyme disease, and RSV (respiratory syncytial virus). What do we do then? For diseases carried by mosquitoes, we put efforts into vector control. We focus on treatment and management as we do with chronic diseases and cancers. For infectious diseases, like COVID-19, we use familiar epidemiological methods like quarantine and contact tracing to limit their spread.
Actually I am optimistic. I think we have reason to be hopeful about a vaccine for COVID-19. But with this particular disease it’s wise to temper our hopes with caution and patience.
Today’s Notable Headlines
“US STOCKS-Vaccine optimism, improving data lift Wall Street,” Reuters, July 1, 2020. https://finance.yahoo.com/news/us-stocks-vaccine-optimism-improving-185117750.html
“Covaxin: India to hold human trial of coronavirus vaccine in July,” BBC, June 30, 2020. https://news.yahoo.com/coronavirus-human-trial-india-vaccine-041541741.html
“What the AIDS crisis can teach us about the coronavirus pandemic,” NBC News, June 29, 2020. https://www.nbcnews.com/now/video/what-the-aids-crisis-can-teach-us-about-the-coronavirus-pandemic-86379077865
“FDA says a coronavirus vaccine would have to be at least 50% effective to be approved,” USA Today, updated July 1, 2020. https://www.usatoday.com/story/news/2020/06/30/fda-coronavirus-vaccine-would-have-least-50-effective/5349964002/
“We’re one-third of the way to a widely available coronavirus vaccine, experts say,” USA Today, June 30, 2020. https://news.yahoo.com/were-only-one-third-way-130020789.html
“9 Pharmaceutical Companies Racing For A COVID-19 Vaccine,” Forbes, June 16, 2020. https://www.forbes.com/sites/moneyshow/2020/06/16/9-pharmaceutical-companies-racing-for-a-covid-19-vaccine/#7a3d840a76ad
“Fact Sheet: Explaining Operation Warp Speed,” Dept. of Health and Human Services, June 16, 2020. https://www.hhs.gov/about/news/2020/06/16/fact-sheet-explaining-operation-warp-speed.html
“What happens if a coronavirus vaccine is never developed? It has happened before,” CNN, May 4, 2020. https://www.cnn.com/2020/05/03/health/coronavirus-vaccine-never-developed-intl/index.html
Why am I doing this?
The coronavirus pandemic will be indelibly written on our memories just as the Great Depression or the Battle of Britain left their mark on past generations. It is my intention to journal the events of these days from three perspectives: as a retired medical technologist, a historian (Ph.D., 2014), and an ordinary person living through an extraordinary crisis.
You are on History’s Edge.