These are, no doubt, tense times, largely due to the general elections. Everyone is watching the polls and who will be our next president. However, we cannot afford to lose focus on another issue; some may argue an even bigger one – the coronavirus. I just know you are sick of hearing it by now, and I understand. I am too. The greatest nightmare of a medical doctor is seeing people die, and the coronavirus has claimed the lives of over 230,000 Americans. That’s sad.
One of the most common questions that I hear people ask is, ‘when will a vaccine be ready?’ Some don’t even believe one will ever be ready. There’s some good news in that regard, and at times like this, let’s cling to every form of good news we have. The good news is that there are several vaccine candidates in the late stages of testing. And by several, I mean over 200, 213 precisely. However, only four of those are considered front-runners. They are from Johnson and Johnson, BioNtech and Pfizer, AstraZeneca and the University of Oxford, and finally, Moderna and the National Institutes of Health.
These four front-runners are in phase 3 clinical-stage, and that is great news, considering we have only known about the virus for close to a year now. Naturally, vaccines take lots of years to develop. Lots and lots of years, and even then, they may not be 100% effective. In fact, the probability of the vaccines eliminating the coronavirus anytime soon is closer to zero than you can imagine. So, don’t think the coronavirus will be gone in the next one, two, or even ten years. I have a better shot at winning the presidential election than a coronavirus vaccine eliminating the coronavirus in a few years. Only one infectious disease has been totally eradicated, the smallpox, and guess how many years it took – 200!
Notwithstanding, the vaccines are progressing at a relatively rapid rate. The third stage of the clinical trial is about the fourth stage overall in developing a vaccine. The first is the preclinical analysis, followed by Phase I, II, and III clinical trials, then the regulatory review, and, lastly, the approval and manufacturing of the vaccine in large quantities.
At the third stage of the clinical trial, which the four leading candidates are right now, the vaccine is tested in thousands of people. Johnson and Johnson is planning on testing on about sixty thousand people, for BioNtech, about forty-four thousand people will get the vaccine, while AstraZeneca and Moderna will enroll close to thirty thousand participants. The volunteers are usually people most susceptible to getting the virus, which are people above 65, and people with other medical conditions, and some other minorities.
These four vaccines don’t have the same mechanism of action. Look, the development of a vaccine is not a simple one at all. Pharmaceutical companies spend hundreds of millions and even billions of dollars in research and development, so I won’t go too much into the details of their production. Even I don’t fully understand them. However, what you need to know is that Johnson and Johnson, and AstraZeneca, plan on using adenoviruses. The former uses one that with some genetic modifications while the latter is made from a chimpanzee adenovirus that is nonreplicating in nature. The other two front-runners use mRNA, a fairly new model of vaccine development.
That’s on the vaccines we have now. As to when the vaccines will be developed, there is no definite answer. Unsurprisingly, vaccines take time to make because any mistake in its development will significantly affect its safety and can lead to worse effects than what it is treating. The FDA has to approve the vaccines before they can be manufactured in large quantities. And to get approval, the vaccines have to pass all clinical trials and review stages. Efficacy is crucial, but so is safety. So, it makes sense that vaccines take time. Averagely, they take about ten years to make.
That doesn’t mean we have to wait ten years for a vaccine, though. The nature and circumstances surrounding the coronavirus mean a vaccine has to be developed faster than usual. Reports are suggesting 2021 or, although much more unlikely, the end of 2020. Even if a vaccine is developed this year, it will still take about eight months or so before it can be distributed across the country. But we first have to get an approved one.
Some weeks ago, there was a setback when two of the front-runners, Johnson and Johnson, and AstraZeneca, had to pause developments due to complications. The trials have resumed now, but it just goes to show how delicate the whole process is. After the vaccine is made, it’d likely be distributed first to health workers, high-risk patients before it gets to the rest of the population. The pharmaceutical companies do not determine who gets it first; the CDC does, and it has begun releasing plans on how the vaccine will be distributed. But that’s not the river in front of us now.
On a closing note, the development of a vaccine does not mean a deviation from safety rules, like wearing masks, social distancing, and regular hand-washing. Please do all of these. Please.