What We Know—And Don't Know—About A Possible COVID-19 Vaccine

In nearly every article we read about what to expect as we move forward through the COVID-19 pandemic, the final outcome, the “resolution,” hinges on the assumption that we will develop an effective vaccine. If we have a vaccine, we can open the country back up. Take off our masks. See our friends again. Send our kids back to school. (Please for the love of god let us send our kids back to school.) In short, a vaccine is our hope for a true return to normal without sacrificing at-risk members of our population.

Even if a COVID-19 vaccine ends up being something like the flu vaccine, requiring an updated version every year in response to a slowly mutating virus (though it appears COVID-19 mutates slower than flu), we could do this. We could tolerate this.

But is a vaccine really the thing we should hang our hopes on? When headlines across the internet parrott Dr. Fauci’s “18-month” timeline, is this a realistic goal? How close are we, really? And what goes into making an effective vaccine anyway?

We don’t always succeed at creating vaccines.

It should be noted that just because a virus exists, doesn’t mean we’re able to create a vaccine for it. Although we have been able to develop vaccines for flu, smallpox, polio, yellow fever, and even Ebola, some viruses are more elusive and difficult to create vaccines for. HIV/AIDS has had millions upon millions of dollars poured into efforts at coming up with a vaccine, to no avail. That’s because of the nature of the virus—it mutates rapidly inside its host even as it cripples their immune system.

Dengue fever is a virus that infects up to 400,000 people per year and does not have a vaccine despite massive efforts to develop one. With dengue, it was found that a vaccine actually exacerbated the disease, worsening its symptoms. We also don’t have vaccines for most common rhinoviruses and adenoviruses—the viruses that, along with other known coronaviruses, cause the common cold.

With COVID-19, we have reason to be optimistic.

But we have reason to hope for a COVID-19 vaccine. The team at the University of Oxford’s Jenner Institute so far seems closest to developing one, mainly because they had a jump on other labs thanks to having already proven that previous inoculations they’d developed for other coronaviruses did not harm humans. Oxford scientists are saying they may have a working vaccine by as early as this September. Scientists at the National Institutes of Health’s Rocky Mountain Laboratory in Montana confirm this possibility. They have found that rhesus macaque monkeys are proving immune to COVID-19 after being administered the vaccine developed at the Jenner Institute.

A Chinese company called SinoVac is reporting similar success with rhesus macaques and a vaccine they’re developing and has begun a clinical trial with 144 participants. Pfizer has also begun human trials.

Of course, when it comes to developing a COVID-19 vaccine, the paramount concern is safety. Whatever scientists come up with will be administered to a massive percentage of the human population. So it absolutely must be safe. And that requires testing—lots and lots of testing.

Extensive testing is required to get a vaccine to market—and that takes time.

According to the CDC, there are normally three phases of clinical trials involved in getting a virus to market, each phase requiring an ever-increasing number of human test subjects to demonstrate efficacy and safety. This is after pre-clinical stages of research and exploration including the testing of animals whose immune systems are close to humans, like the rhesus macaque monkeys previously mentioned.

But in the case of a COVID-19 vaccine, some are advocating for an accelerated clinical stage. The Journal of Infectious Diseases recently published an article in support of allowing young, healthy people to voluntarily participate in “human challenges.” “Human challenge” means deliberately exposing human subjects to the SARS-CoV-2 virus. Some would have received the candidate vaccine, and others—a control group—would have no protection whatsoever. So there are definitely risks involved, and study participants would have to be fully aware of and willing to accept those risks.

The article’s authors argue that despite the risks, “such studies, by accelerating vaccine evaluation, could reduce the global burden of coronavirus-related mortality and morbidity.” They point out that the risks to a young, healthy population submitting to voluntary COVID-19 exposure for the purpose of expediting a vaccine would likely come at far less human cost than if many more months passed without a vaccine. And they make it clear that participants would have to be well-informed of the risks involved. Because, as we know, even young, healthy people infected with COVID-19 do sometimes die.

But can we trust a vaccine?

As with anything to do with the COVID-19 virus, conspiracy theories abound. One thing we can definitely trust is that antivaxxers will be on a coronavirus vaccine like vultures on a rotting carcass. We’re already witnessing the spread of false news. Recently, a WordPress site intentionally spread the false news that the first Oxford volunteer to be injected with the trial COVID-19 virus had died. The Guardian, among other news organizations, reported that the woman, Dr. Elisa Granato, is in fact alive and well. The university of Oxford even put up its own brief message urging people “not to give [false reports] any credibility and not to circulate them.”

What we can count on is that scientists truly want to develop a vaccine to prevent COVID-19, and they desperately do not want to fuck this up. The best minds in the world are working on this and are well aware that they are under the glare of the spotlight, and that whatever they do under that spotlight will endure the scrutiny of future historians. Because of this pressure (which often manifests as much-needed government funding), because of the brilliance of the minds at work, because of how far science has come when it comes to our understanding of vaccines and the human immune system, it is not irrational to put our hope in the possibility of a COVID-19 vaccine becoming a reality.

But will a vaccine happen soon?

It depends how you define “soon.” Even once a vaccine is proven effective, scaling up to the levels needed to vaccinate an entire population will be no easy undertaking. The team at Oxford says maybe by September. But even if that happens—and it would require literally everything going exactly right—it would still take time to produce and distribute the vaccine at the scale necessary to stop the spread of COVID-19.

In the meantime, we need to continue to social distance and wear masks when and if we have to go out. We did flatten the curve, but it took millions of people staying in their homes to make that happen. Now, as states begin to open up and attempt some variation of “normal,” complacency is not the direction we want to go. The virus is still a very real threat, and if we’re smart, we’ll continue to socially distance as much as possible as we wait for scientists to do their jobs.