It shouldn’t but this is the world we live in now.
Setting up a bunch of ‘competing’ efforts to develop a vaccine is actually a more efficient use of time and expertise than just trying one vaccine after another; there are only so many people that can effectively work on a vaccine development, and until you get to Phase III clinical trials the amount of effort into any one vaccine is not taking opportunity cost away from developing others. But more crucially, this creates an infrastructure and develops experience for the rapid development of vaccines for future epidemics, so even those efforts that don’t produce a useful vaccine for SARS-CoV-2 are still useful as a ‘farm league’ for producing immunologists with specific experience in the practical aspects of vaccine development. This is going to be very important for the future so that we aren’t reliant upon the often limited funding to the NIAID and its partnerships with private companies who are necessarily interested in developments that generate a profit. Having a league of immunology labs able to crank out options for vaccines via different approaches is like having a standing military, and for the same reasons; you may not need it today, but when you do need it you don’t have time to train one up from green recruits.
It is hard to imagine a scenario where distributing an unproven vaccine (especially one that has not been demonstrated to be safe) is better than any other consequence. As shown above, an unsafe vaccine could actually increase the effective virulence of a pathogen by making people more sensitive and less resistant, in addition to any unexpected side effects not related to the disease itself.
The pathogen in the case of the Black Death (Yersinia pestis) is a bacterium, and so unlike viruses we have various different mechanisms to treat an infection. (Most anti-viral treatments aside from vaccination rely largely on supportive and suppressive treatments that lessen the effects but rely upon the immune system to ultimately defeat the viral pathogen, which is why HIV anti-virals can suppress the effects but not clear the virus from an infected patient.) While many bacteria are becoming naturally resistant to natural antibiotics there is ongoing work to develop targeted antibiotic and synthetic macrophage treatments to attack bacteria directly. Unlike bacteria, viruses are not active outside the infected cell, and so it is much more difficult to find a mechanism that inhibits them because they aren’t consuming any nutrients.
I don’t think that Ashtura was referring to Y. pestis itself, but to some hypothetical virus that’s just as bad as it. One can certainly envision a disease so bad that it’s prudent to push out even an untested vaccine, but this isn’t it.
Except there really isn’t. As discussed above, a defective vaccine could actually amplify the virulence of the virus. To deal with an epidemic as infectious as that described by Ashtura, we should do exactly what we are doing now, e.g. physical distancing and isolation, wearing masks and other protective equipment, improving public hygiene, and aggressively researching prophylactic drugs, effective treatment protocols, and multiple parallel efforts to produce a vaccine or (for bacterial pathogens) antibiotics and bacteriophage treatments.
Another question that has to be addressed is how long the immunity lasts. It is not clear what is going on, but some people have tested positive for Covid-19, then negative, then positive again. Now the middle test might have been a false negative or it is conceivable that even an actual recovered patient is immune for only a few weeks or months. In that case, good luck with finding a vaccine. But even if successful, the immunity might last only a year or two in which case frequent revaccination will be needed.
the immunity wasn’t strong enough, and they got re-infected by the same corona virus again.
the corona virus has mutated enough that immunity to Covid-19 doesn’t protect you from Covid-20, a new strain.
That 3rd option is the most scary!
And this corona virus is somewhat related to the common influenza virus, which mutates so fast that every year there are new strains going around. The typical flu shot is a quadravalent vaccine, meaning it protects against 4 strains of influenza, the 4 that experts predicted last spring would be the most common ones this winter. And some years they predict wrong, and it’s a bad year for the flu. (And this Corona virus is about 16-20 times more deadly than influenza. Let’s home it is less mutatable.)
Coronaviruses are no more related to the flu than they are to any other random virus. They happen to cause similar symptoms, but they’re not related.
And even if it’s possible for a recovered person to get re-infected, that’s fine as long as it’s rare. I mean, everyone knows that it’s “impossible” to get chickenpox twice, but my sister and I both did. But that doesn’t change the fact that most people won’t get chickenpox twice.
And if they got it even a tiny bit wrong, they would convince an even larger percentage of the population that “science” was worthless. Not a good outcome.
“140-Plus Coronavirus Survivors Retest Positive For Disease In South Korea, Raising Questions About Immunity.”
Forbes article today and other sources.
Are tests accurate?
Actual reinfection?
Some 90 tests are on the market, only 3 are FDA approved.
The immune response to coronavirus, including the duration of immunity,is “not yet understood,” says the United States Center for Disease Control and Prevention.
The FDA has given emergency approval to three antibody tests, which measure recovery from COVID-19, and are just becoming available, though experts have raised serious concerns about the available tests’ accuracy as they hit the market without rigorous clinical vetting.
One thing to keep in mind is that doctors and other medical folk have a maxim: Do no harm.
If a vaccine is sufficiently iffy that harm might be expected in a notable number of cases, then any ethical medically certified person wouldn’t administer it. That leaves a lot of people who would, but if your regular family doctor won’t give it, you should have second thoughts about getting it from a random person with little training and knowledge who doesn’t care if it may well hurt you.
Now and then, I don’t know how often, a vaccine will show side effects in clinical testing. I was a test subject in a trial of a vaccine for Clostridium difficil, a nasty infection that kills a bunch of people every year. C. diff is often acquired and transmitted in hospitals. The vaccine, C-diffense, was tested over a couple years, and the trial was abandoned when a larger-than-normal percentage of subjects developed cardiovascular problems. That’s an example of why vaccines must be found to be not only effective but also safe.
I wonder where shingles figures into that. I had chicken pox decades ago, and then an outbreak of shingles in December of last year. Does that count as a ‘recurrence’ of chickenpox?
No. From the article they are clearly talking about the fluid-filled blister phase as “recurrence.” No one would be surprised by occurrence of shingles decades after chicken pox. The article is talking about a surprising fact - recurrence of the blister phase.
Antigens exist in a range of immunogenicity - they’re not all the same. You need to find a chunk of the virus that provokes a strong immune response without being so strong that it accidentally flops over into some kind of autoimmune problem. I usually go to car metaphors to explain molecular biology for some reason. Imagine a virus is a car. The immune system recognizes various shapes on the car, and different shapes are more or less easily recognized. Perhaps the rear left door happens to work really well, but the lug nuts on the front wheels are really bad, and the battery is great, but it causes the immune system to attack all of the other batteries in the house, destroying all of your electronics.
All of this has to be determined experimentally, while accounting for the fact that there are 7+ billion humans on earth that will vary somewhat. There are at least hundreds of possible antigens that we can look at. We can take some lessons from previously developed vaccines (doors usually work better than wheels), but it all still has to be tested. And that’s just for the efficacy side. Once you have that, you then have to prove that it’s safe, which cannot be done overnight. You can’t just inject someone with your test vaccine, check back the next day, and say “yep! Still alive! We’re good to go!”
Neither “grassroots efforts” nor “gaining traction with politicians” is likely to have much sway in the scientific community. If these people want to volunteer, they should be volunteering for the actual medical trials to determine safety of the vaccines.
After the 12-18 month development and testing cycle, we have to face the production issues, which is what Gates wants to streamline.
Currently, the world produces ~165M doses of influenza vaccine. To inoculate the world against SARS-CoV-2 we will need 50 times that. 100 if it is a two dose vaccine like Shingrix.
A production cycle that could take another year or more.