All stakeholders be it governments, private companies, non-government organizations, are accelerating their efforts to develop a vaccine against COVID-19.
As the world waits for a coronavirus vaccine, tens of thousands of people could die.
Hopes are very high that soon we have a very effective vaccine against COVID-19. But, let us think about another scenario. And this is a worst-case possibility. Imagine that no vaccine against Covid-19 is ever developed.
Then we will have to option but to live with it.
Cities would slowly open and some freedoms will be returned, but on a short leash, if experts’ recommendations are followed. Testing and physical tracing will become part of our lives in the short term, but in many countries, an abrupt instruction to self-isolate could come at any time. Treatments may be developed — but outbreaks of the disease could still occur each year, and the global death toll would continue to tick upwards.
No vaccine scenario is a possibility that is being talked about very seriously by many experts. Because it’s happened before. Several times.
“There are some viruses that we still do not have vaccines against,” says Dr. David Nabarro, a professor of global health at Imperial College London, who also serves as a special envoy to the World Health Organization on Covid-19. “We can’t make an absolute assumption that a vaccine will appear at all, or if it does appear, whether it will pass all the tests of efficacy and safety.
“It’s absolutely essential that all societies everywhere get themselves into a position where they are able to defend against the coronavirus as a constant threat, and to be able to go about social life and economic activity with the virus in our midst,” Nabarro says.
Although many experts are confident that a vaccine will be developed soon, bringing it to fruition in a year or two will be a feat never achieved before.
“We’ve never accelerated a vaccine in a year to 18 months,” Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, tells CNN. “It doesn’t mean it’s impossible, but it will be quite a heroic achievement.
“We need plan A, and a plan B,” he says.
No vaccine against HIV Virus
HIV virus is nowhere near under control. Though the infection rate has declined 47 percent since its peak in 1996, last year 1.8 million people became newly infected with HIV around the world, and 37 million people are currently living with it. About 1 million people die of AIDS every year, making it the fourth biggest killer in low-income countries.
In 1984, the US Secretary of Health and Human Services Margaret Heckler announced at a press conference in Washington, DC, that scientists had successfully identified the virus that later became known as HIV — and predicted that a preventative vaccine would be ready for testing in two years.
Nearly four decades and 32 million deaths later, the world is still waiting for an HIV vaccine.
In 1997, President Bill Clinton challenged the US to come up with a vaccine within a decade. Fourteen years ago, scientists said we were still about 10 years away.
The difficulties in finding a vaccine began with the very nature of HIV/AIDS itself. “Influenza is able to change itself from one year to the next so the natural infection or immunization the previous year doesn’t infect you the following year. HIV does that during a single infection,” explains Paul Offit, a pediatrician and infectious disease specialist who co-invented the rotavirus vaccine.
We don’t have an effective vaccine for dengue fever either
The Food and Drug Administration in May 2019 approved the first vaccine against dengue fever, one that protects against a common disease but has generated significant controversy due to evidence it can increase the risk of severe infection in some people.
The agency ruled that Dengvaxia, manufactured by Sanofi Pasteur, can only be used in individuals aged 9 to 16 living in parts of the United States where the dengue virus is endemic — in other words, where it circulates on an ongoing basis.
After Sanofi announced its findings, the Philippines — the only country to have used the vaccine broadly to date — suspended use of Dengvaxia and ultimately revoked its license. Prosecutors have charged Sanofi, a half-dozen of its employees, and several current and former Philippines health officials over a series of deaths it alleges are linked to use of the vaccine.
Based on the company’s findings, experts who advise the World Health Organization on vaccine policy recommended that Dengvaxia only be given to people who are known to have had a previous infection.
Similarly, it’s been very difficult to develop vaccines for the common rhinoviruses and adenoviruses — which, like coronaviruses, can cause cold symptoms. There’s just one vaccine to prevent two strains of adenovirus, and it’s not commercially available.
Human trials are already underway at Oxford University in England for a coronavirus vaccine made from a chimpanzee virus, and in the US for a different vaccine, produced by Moderna.
A number of treatments are likewise being tested for Covid-19, as scientists hunt for a Plan B in parallel to the ongoing vaccine trials, but all of those trials are in very early stages. Till then, we will have to learn to live with the disease