Let’s Talk About the COVID-19 Vaccine

We won’t have it in 2020 and, when it happens, it’ll be hard to find it in Venezuela, where there’s already a dramatic shortage of vaccines we’ve used for decades.

Photo: BBC, retrieved.

Vaccines are wake up calls for the immune system. The process to make them is very similar to that of drug development: First, you need to find a molecule that triggers the immune system. Once you isolate it, you try it on animals and, if it’s safe, in humans. The last stages of this process are clinical trials, which are divided into three phases. Only in phase III trials is the vaccine tested in large numbers of sick patients.

This is usually a very long process. The malaria vaccine started development in the late ‘80s, phase III trials just concluded in 2014 and the vaccine turned out to be less effective than expected. So don’t expect a COVID-19 vaccine anytime this year. 

Nonetheless, there’s hope. COVID-19 is a viral disease and viruses are relatively simple organisms. The SARS-coV-2 has five proteins, and vaccine development has concentrated in only two of them, making the process much more straightforward. Considerable research has already been done in SARS-coV-1 and MERS-coV, two closely related viruses that caused severe diseases in 2003 and 2012, respectively. That means that it probably won’t take us 30 years to get a coronavirus vaccine, although it’s unlikely we’ll get one in less than 18 months.

It probably won’t take us 30 years to get a coronavirus vaccine, although it’s unlikely we’ll get one in less than 18 months.

35 different companies around the world are working on it and three will start clinical trials in the coming days, but most of the candidates that enter the vaccine development process won’t make it til the end. Either they’re shown to be unsafe or they’ll fail to produce a long-lasting response in humans. We’ll be lucky if at least one of the current candidates proves to be effective and even at that point, there’s another huge obstacle to overcome. 

To actually stop transmission of COVID-19, any vaccine will have to be administered to millions of people in a relatively short time, many in underdeveloped countries that won’t be able to afford them. 

This is an important aspect to consider in Venezuela, a country that can’t even keep up with pre-existing vaccination programs and lacks the infrastructure to develop a large scale vaccination campaign. The limited impact that humanitarian aid distributed by the Venezuelan Red Cross has had in the country also suggests that other organisms, perhaps NGOs and the Pan American Health Organization (PAHO), will have to be actively involved in the process. Another concern is how to prevent a potential vaccine from being exploited as yet another segregation mechanism by Maduro’s regime.

In any case, we still have time to think about these details before a vaccine is available in the country.

Juan Carlos Gabaldón

Medical doctor from Merida, currently studying Medical Parasitology at the London School of Hygiene and Tropical Medicine