Coronavirus vaccines shattered expectations

No matter how hard you squint or from what angle you look at it, coronavirus vaccines are a triumph. They save lives today; they will help end this pandemic eventually; and they will pay scientific dividends for generations.

The big picture: The pandemic is not over. There are still big threats ahead and big problems to solve. But despite all that has gone wrong over the past year, the vaccines themselves have shattered even the most lofty expectations.

Vaccines represent an “amazing scientific achievement for the world… unprecedented in the history of vaccinology,” said Dan Barouch, a virology and vaccine expert at Harvard who worked on the Johnson & Johnson vaccine.

Details: Development of a vaccine takes an average of 10 years – if it works at all. Despite years of well-funded research, there are still no vaccines for HIV or malaria, for example.

• We now have several COVID-19 vaccines, all developed in less than a year.
• The Pfizer and Moderna vaccines are the world’s first successful mRNA vaccines – which, to put it simply, teach our bodies to generate an immune response without relying on weakened or inactivated viruses. This is a milestone towards which scientists have been working for 30 years.
• Moderna’s vaccine is the first licensed product of any kind.

More important again, all major vaccines work extremely well.

• The four vaccines or vaccine candidates in the United States – from Pfizer, Moderna, AstraZeneca and Johnson & Johnson – appear to prevent coronavirus deaths and offer full or near total protection against serious illness.
• Some of the vaccines are more effective than others at preventing mild or asymptomatic infections, but all of them significantly exceed the FDA threshold to be considered effective.

The catch: South Africa halted distribution of the AstraZeneca vaccine on Sunday because it did not appear to work against the dangerous variant found there – which is spreading around the world.

• Other vaccine makers also said their products were not as effective against the South African variant.

But that’s a reason for the rest of the world to look at existing vaccines, not to be suspicious of them.

• Viruses can mutate when they spread widely. The best defense against the widespread variants is to vaccinate as many people as possible and step up social distancing to contain the virus.
• Drugmakers may need to develop booster shots or new recipes to treat the variants, but waiting for a vaccine that addresses each variant will only leave the door open to other variants.

Our biggest problems are not with vaccines, but rather with the processes around them.

• Supplies must increase; distribution must become much more efficient; we need to make sure people get their second injection, if they have one; and people must be ready to be vaccinated once they are eligible.
• It’s a long, difficult list of things to do, and getting it wrong could lead to the pandemic for years to come. But if we can get the process done, the vaccines themselves are powerful enough to do the job.

“Once the story is written, they will be considered some of the greatest achievements of science, ”said Zeynep Tufekci, a sociologist at the University of North Carolina with foreknowledge of the coronavirus, told Ezra Klein of the New York Times.

• “It’s the kind of thing you would have a national celebration, fireworks and church bells and all that,” she said.

It wasn’t a miracle and it did not happen overnight. “What we have seen over the past year is the result and culmination of decades of scientific advancement,” said Barouch.

• Researchers have been turning to mRNA-based vaccines for about 30 years, fueled by broader advances in genetic science.
• These same advancements also dramatically speeded up genetic sequencing – which is why researchers were able to map the structure of COVID-19 weeks after the virus was discovered, and then start work on potential vaccines.

And after: The vaccine race is one of the few areas in this entire pandemic where the United States and the world can learn from our successes, rather than our failures.

• The breakthrough of successful mRNA vaccines will pave the way, scientists hope, for a new generation of products that are more effective and easier to develop than previous vaccines.
• Shoveling money from vaccine developers and establishing early, step-by-step communication with regulators has also helped speed up this process and may help again in future pandemics.

The bottom line: “Good funding, great science and great collaboration with the regulators – that’s how they were able to do something that I didn’t think I could do in a year,” said Mark Slifka, professor at immunology at Oregon Health & Science University.