Traditionally vaccine development occurs over a timescale of ten to fifteen years. This is split in to three stages: exploratory research, clinical testing and finally manufacture and distribution. Generally, the manufacture of a vaccine is designed in the final year of two of the process. The urgency of the current global situation means that multiple groups and governments have committed to funding the manufacture of vaccines ‘at risk’, at the same time as their testing, not knowing how effective or safe they are. In itself this is not a bad thing. If a given vaccine does pass clinical trials, then it will be ready for use immediately. This could potentially save thousands of lives and speed up the global recovery process.
“This could potentially save thousands of lives”
However, earlier this month Russia licenced a vaccine ahead of its phase three clinical trials. Named Sputnik V, it aims to show a similar display of power to the world as its namesake, Sputnik I, did when it was launched in 1957 by the USSR as the world’s first artificial satellite. The breach of protocol associated with its lack of testing, likely exacerbated by Western mistrust of Russia, was met with outrage by the world’s scientific community.
‘At risk’ development is possible because governments and other funds are underwriting the risk. Governmental funding makes explicit the fact that vaccines are inherently political. In 2010 Heidi Larson set up the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine. In 2015 they developed a vaccine confidence index. This investigated the extent to which groups of people believed vaccines to be safe, important and effective. It found that those most likely to vote for a populist party were also the people most likely to disagree that vaccines were safe, important or effective.
“Vaccines cannot escape their political and social backdrop”
The meaning of this? Vaccines cannot escape their political and social backdrop because they are the domain of governments and big businesses – two institutions fundamentally lacking in public trust. A report published by the COCONEL Group in May indicated that any vaccine against SARS-CoV-2 is going to be subject to intense public scrutiny and it urged public authorities to “communicate early and transparently on these processes to avoid vaccines becoming part of political debates”.
President Trump can be accused of politicising America’s quest for a vaccine. He has repeatedly asserted that a vaccine might be available “right around” 3rd November, the day of the forthcoming presidential election. America’s leading infectious disease expert, Anthony S Fauci, has claimed that the FDA will not let political pressures compromise the safety of a vaccine. But Trump’s words, “I’m rushing it. I am. I’m pushing everybody.” undermine public trust in any vaccine. In turn, this risks reducing uptake and compromising public safety.
It emerged last week that Russia has been in direct discussions with the WHO and that phase three clinical trials overseen by a foreign research body of its vaccine will now go ahead. This apparent change of heart may come after a realisation by the Russian government that their vaccine is of limited power if it is not perceived to be safe.
Producing a successful Covid-19 vaccine is going to bring its creators a degree of power because of the current worldwide demand. But for the most part, those scientists around the world searching for a vaccine have collaborated with each other in the knowledge that this global issue requires as global response. Spearheaded by institutions such as the WHO, CEPI and Gavi, there are multiple initiatives aimed at providing equitable access to successful vaccines. One can only hope that the loss of public trust caused by the politicisation of a vaccine does not undermine the efforts of these organisations to limit the loss of life across the globe.
Image: National Institute of Allergy and Infectious Diseases via Creative Commons