This is Jonas Salk in his laboratory at the University of Pittsburgh in April 1955,
perfecting America’s first vaccine against the poliovirus,
which killed or paralyzed about half a million people worldwide each year.
In the U.S. alone 58,000 new cases were reported in 1952, with over 3,000 fatalities .
The headlines screamed of the success of the Salk vaccine,
on the 10th anniversary of the death of history's
most famous polio patient, Franklin Delano Roosevelt.
So when news broke of a successful polio vaccine in 1955, there was widespread jubilation.
But just weeks later, those who received the vaccine produced by
a specific lab, Cutter Laboratories, reported polio infections.
In the haste to manufacture the vaccine at warp speed, 120,000
doses of the vaccine from this lab included the live poliovirus
instead of an inactivated version of the pathogen.
Because of this error, around 40,000 children
contracted a mild case of the disease, while
five died and 56 were paralyzed.
This moment in history redefined the way vaccines are developed and regulated.
The development of a vaccine is now
one of the most regulated aspects of the medical industry.
It typically takes more than 10 years
to create one, but there have been some exceptions.
The fastest vaccine created to date was for mumps,
which was licensed in 1967 after just 4 years of development.
In 2019, a vaccine for the Ebola virus
was approved in principle by the World Health Organization
after 5 years of development and trials.
Ultimately, vaccine makers are weighing the balance between safety and speed.
The development of a vaccine typically goes
through several phases the academic research,
pre-clinical stage, three phases of human trials,
regulatory approvals, scaling it for mass production, manufacturing and distribution.
In an accelerated model, these timelines are
compressed and may happen simultaneously.
For example, Microsoft billionaire Bill Gates is funding new
factories to manufacture seven promising vaccines,
even though some may not work, potentially wasting billions of dollars.
Within seven months of Covid-19 being declared
a pandemic by the World Health Organization,
more than 300 potential vaccines were being developed,
with a handful in final stage human trials.
Early frontrunners such as Russia and China
approved vaccines for public use without completing the traditional process leading
many experts to voice concerns about their safety.
There are so many unanswered questions about any potential vaccine.
Is it safe?
How does it get manufactured and distributed quickly?
Who gets first access, and what is the dosage?
As early as June 2020, Chinese media reported that
staff at state-owned companies could receive a Covid-19 vaccine before traveling abroad.
They were among the first in the world to receive a vaccine for emergency use,
which was produced by Chinese firm CNBG.
And then in August, Russia dropped a
bombshell with the announcement of its vaccine.
Vladimir Putin said the first Russian-produced vaccine for Covid-19
has received regulatory approval from the country's health ministry.
My favourite is that it's been approved even though it hasn't actually finished trials.
Easy come, easy go!
This was the first Covid-19 vaccine to be approved
albeit within its own borders and was heralded as the
country’s ‘Sputnik’ moment, a reference to the satellite
the Soviet Union launched into space in 1957.
The Soviet Union is launching the first Earth satellite.
Russia subsequently shipped its vaccine to the
United Arab Emirates and Belarus for clinical
trials while reaching supply agreements with countries
such as India and Brazil for millions of doses.
All vaccines aim to trigger the immune system
by delivering a protein that copies or contains a part of a virus.
The specific approach, however, can vary.
A key step is identifying how to deliver
the immunizing protein into the body, and
at least eight main methods are being tested.
For example, the vaccine produced by the leading
candidate in the United Kingdom, AstraZeneca, in partnership
with the University of Oxford, uses a weakened version
of the common cold virus found in chimpanzees.
Candidates that make it through the pre-clinical stage,
which may involve animal testing move on to three phases of human trials.
The first phase typically involves between 20 and 80 healthy people,
while the second involves a larger group of a
few hundred participants, including those at risk of contracting the illness.
The third and final phase can include thousands of people.
During these trials, researchers are watching out for the candidate vaccine’s effectiveness,
any potential side effects, and the dosage required.
After regulatory approvals and licensing, the logistical nightmare begins.
How can a vaccine be manufactured and distributed to 7.7 billion people worldwide?
The efficiency and efficacy of any vaccination program
also depends on how a vaccine should be stored and administered.
For example, a vaccine requiring multiple doses at different times
may complicate immunization efforts, while a vaccine administered orally
may lower the barriers to vaccination significantly.
The equipment needed to support this supply chain,
including billions of vials and syringes, will also be unprecedented.
Hindustan Syringes, one of the world’s largest manufacturers of the item,
has pledged to ramp up its production from 700 million a year to a billion by 2021.
Distribution companies like FedEx and UPS are also
preparing to meet this challenge by expanding their temperature-controlled supply chain.
This includes specialized warehouses, trucks and aircrafts with built-in freezers and
monitoring devices to ensure vaccines are stored
and transported at the required temperatures.
In August, UPS invested in 600 freezer farms
in the United States and the Netherlands.
Most of the Covid-19 vaccine candidates must
be stored at cold and specific temperatures, or they will spoil.
For example, Moderna’s vaccine requires a temperature
of –20 degrees Celsius while Pfizer’s vaccine
must be stored at –70 degrees Celsius.
In fact, a World Health Organization study found that more than
50% of vaccines are wasted through expiry, decay or leakages, among other issues.
According to the World Health Organization’s
global vaccine plan known as COVAX, the Covid-19 vaccine
should be distributed first to healthcare workers,
followed by the most vulnerable 20% of the population in participating countries.
Amid concerns over “vaccine nationalism” by richer nations,
a situation where countries prioritize their citizens first,
several world leaders have signed an open letter calling
for a “people’s vaccine”, demanding that it should be free of charge and available to all.
Mistrust of vaccines is another hurdle in the distribution process.
In France, 1 in 3 people disagree that vaccines are safe,
while only 50%of the Ukrainian public agree that vaccines are effective.
Many experts have reiterated that developing a vaccine is not a race
and decisions must be backed up by data.
The last time the U.S. government tried
to create a vaccine at “warp speed” in 1976, it ended in a fiasco.
The vaccine against a new strain of the swine flu virus
was developed in under a year, but it led to roughly 450 cases of a rare neurological disorder.
By the time the vaccination program was aborted, some 45 million out of some 200 million Americans had been inoculated.
The long shadow of the tainted polio vaccine in 1955 and the botched
vaccination program in 1976 still lingers today.
As governments and organizations are now racing to develop a new vaccine,
finding that delicate balance between safety, speed, and trust
is key in preventing future pandemics, including the greatest crisis of our generation.
Thank you so much for watching the video!
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