One of the few positives that emerged from the bin fire of 2020 was the speed at which not one, but three, effective and safe vaccines were developed, trialled and approved in the UK. They offer hope for a more optimistic 2022 and a route out of the pandemic. However, as with other projects involving big pharma and national governments, many people are skeptical about the speed at which vaccines have become available.
In non-plague times, vaccine development is a long process. It is multi-staged and complex, involving scientific research, preclinical trials, three phases of clinical trials, and regulatory approval, which can all take over ten years. Between dealing with clinical trial bureaucracy, recruiting participants, accumulating trial cases, evaluating efficacy, more trials, collecting data over long follow ups, assessing if the vaccine has worked once the trial finishes, compiling and submitting the data to regulators, scaling up manufacturing and agreeing distribution with countries, vaccine development is slow and stop-start at the best of times.
The Pfizer-BioNTech, Moderna, and Oxford-AstraZeneca vaccines however, completed this process within a year. The rapidity of their development and deployment has understandably raised a few eyebrows. But what’s been cut from the process to achieve this?
Fortunately,none of the science. No company wants to be the one that develops an unsafe vaccine. Like all vaccines, these three went through preclinical testing, smaller trials in healthy people, and larger trials with 10,000s of participants across the globe.
Companies and countries are still collecting long-term efficacy and safety data beyond a year, of course, but otherwise trial lengths and sizes are similar to what we’d expect for most vaccines.
What accelerated the timescales? Money, political will, and the right technologies, combined with a raging pandemic through the summer, helped vaccine trials blast through all but the most optimistic timelines. Across Europe, North America and Asia we’ve witnessed a vaccine space race. Countries bought millions of doses before trial results were known and the US gave out $2.5 billion through Operation Warp Speed. Alongside governments, vaccine regulators also pitched in. Later stage trials were planned as early stage trials were run.
Companies submitted data on a rolling basis rather than at the end of all trials, ensuring data was scrutinised while minimising delays. This level of financial and regulatory assistance is lacking when there’s no global pandemic.
That’s only part of the story. The Oxford-AstraZeneca and the Pfizer-BioNTech and Moderna vaccines were quick to start because of their technology. The Oxford team were already working on a vaccine for MERS (Middle Eastern Respiratory Syndrome, a more deadly but less transmissible form of coronavirus) when SARS-CoV-2 emerged, giving them a huge head-start. The vaccines developed by BioNTech and Moderna rely on short chunks of the virus’s genetic code rather than slower traditional techniques, so putting together a candidate was much faster than normal: just 63 days, in fact.
The front runner vaccines are a testament to what can be achieved when governments and international organisations cannot ignore the need for urgent action (providing powerful lessons for addressing the climate emergency).
There are still a lot of negatives however: many areas of Africa and the Global South will struggle to achieve widespread access to vaccines until 2022 or later, and companies are raking in enormous profits on human misery, which is morally wrong.
But the vaccines themselves have been rigorously tested and given the known, awful risks of Covid-19, we should be encouraging everyone to get vaccinated if they can.