It is December 27, 2020 and I have just signed, as my father’s legal guardian, the consent for the covid-19 vaccine to be administered. This minimal act is the key to culminating, in the person of an 86-year-old elderly man interned in a residence, a process that began almost a year ago and that, without fear of exaggeration, can be considered a true scientific feat, most likely the biggests of the history.
The final goal has not yet been reached. A long road full of threats lies ahead. Billions of people need to be vaccinated, and difficulties may still arise. There are those who, for different reasons, prefer not to.
We do not yet know what the scope of the vaccination campaigns will be, if they will reach the last corners of the planet or when they will arrive. We do not know how long it will take manufacturers to produce the billions of doses that will be needed, or how many of the thousands of people who will die or become seriously ill within days or weeks before receiving the vaccine. We do not know if the genetic variants of SARS-CoV-2 that arise will confer defenses against the vaccines that are administered. Nor if vaccines, in addition to protecting those who receive them, will also prevent them from infecting others. And finally, we don’t know if they will have any serious side effects when millions of people are vaccinated.
But none of these threats, no matter how real, can tarnish the achievement of vaccination, with the maximum guarantees that can be offered, of millions of people in the first months of 2021, one year after the start of the worst pandemic to that humanity has faced for a century.
By size, not by character or motivation, we can cite two antecedents of this company. The first is the Manhattan project. It allowed the Americans to have, in a few years, the atomic bomb. During its development (1942-1947), it involved 130,000 people and the equivalent of 70 billion current dollars was dedicated to it, although only 10% of that amount was allocated to the development and production of weapons.
The second, more technological than scientific, was the Apollo program, thanks to which human beings stepped on the lunar surface on six occasions. The program lasted for more than a decade (1961-1972) and involved an investment of 170 billion dollars.
The short history of the COVID-19 vaccine began on December 31, 2019, when health officials in Wuhan, China, reported 27 cases of unknown pneumonia. On the following January 8, it was reported that the cause was a new coronavirus. Two days later, its genomic sequence had already been made public. In February, several pharmaceutical companies launched vaccine projects. In China, the first were CanSino Biologics, Sinovac Biotech and the state company Sinopharm; in the United States, Moderna and Inovio Pharmaceuticals; in Europe, BioNTech, a German biotech company, developed a candidate that it would later share with Pfizer; a group from the University of Oxford created a vaccine that was joined by AstraZeneca; Janssen and Sanofi Pasteur also launched their own projects.
In mid-April it became known that the SinoVac Biotech vaccine was effective in monkeys. On the 20th of that same month, five companies were already testing their vaccines in clinical trials, and there were more than 70 candidates in preclinical development. In late July, Moderna and Pfizer-BioNTech’s vaccines, both based on messenger RNA, began efficacy trials. The Chinese projects, paradoxically, lost the lead due to the success with which the pandemic was contained in that country, which forced the recruitment of volunteers in others.
During the month of November, it was announced that a few vaccines were more than 90% effective. All the deadlines, from the appearance of pneumonia cases in December 2019 to the authorizations, by regulatory agencies, of the vaccines in December 2020, have been the shortest, by far, that there have ever been.
Since the outbreak of the disease was announced, thousands of scientists, biomedical and other areas, from around the world began to investigate issues related to covid-19, sharing information to a degree never seen before. Cooperation has occurred, for the most part, using informal networks, without the need for formal agreements between countries or institutions.
The results of this research activity have been reflected in the publication, until the beginning of December, of 84,180 scientific articles related to covid-19 (at a rate of 260 daily).
To give this figure the meaning it deserves, let’s make a comparison: the total number of those published since scientific journals on lung cancer have existed is approximately 350,000; AIDS-HIV, 165,000; flu, 135,000; and 100,000 on malaria. In just eleven months, a volume of articles on covid-19 equivalent to almost 60% of all articles published on influenza has been published.
The number of signatories (sole authors) of the articles on covid-19 amounts to 322,279, a figure that triples in just 11 months that of the participants in the Manhattan project after five years. If we limit ourselves to those who have been involved in the development of vaccines, and since there are currently 162 candidates (of which 52 are in clinical trials), a conservative estimate gives a number of 65,000 participants (scientific and health personnel ) worldwide, which is equivalent to half of all personnel involved in the Manhattan project.
The economic effort has also been enormous. The US administration alone has allocated more than 10 billion dollars to pharmaceutical companies for the design and production of vaccines. If to that amount we add the resources invested by China, Japan, Russia, the United Kingdom and the European Union, the total amount would perhaps approximate the investment made in the Manhattan project, although only 10% of that was destined to design and production of armament.
On the shoulders of giants
In addition to the financial investments and dedication of hundreds of thousands of people, the SARS-CoV-2 vaccine has benefited from some favorable circumstances that I summarize below.
Research a few years ago to develop vaccines against SARS-CoV-1 and MERS-CoV has made it possible to skip preliminary steps. Phase I and II trials began almost simultaneously by adapting existing procedures. Phase III studies began after intermediate analysis of the results of the previous ones, covering stages of parallel clinical trials.
Several vaccines began to be produced on a large scale, assuming the risk that they would ultimately be ineffective and the investment would be lost. And the public drug agencies, meanwhile, have been making a continuous evaluation of these vaccines to have all the guarantees of efficacy and safety.
An extraordinary conjunction of factors has allowed this scientific endeavor to proceed with astonishing speed. Never have so many vaccines been developed against the same pathogen at the same time. Never have so many people been involved in a great scientific project in such a short time. Such a degree of collaboration has never been achieved, even between competitors. Never have so many clinical trials been developed at once to test the efficacy of so many vaccines. And never before have so many resources and so much intelligence been devoted to fighting a disease in such a short space of time.
Without such a great effort, the situation in which we find ourselves today would not have been reached. And yet such an effort was not, by itself, a guarantee of success. In 1971, the then President of the United States, Richard Nixon, signed the so-called National Cancer Act, a law that sought to end cancer and allocated the equivalent of about 10 billion current dollars to that goal. 50 years have passed since then.
The reason Nixon’s so-called “war on cancer” fell far short of its goals is that there were fundamental aspects of cancer cell biology that were still unknown. The same had not happened with the Manhattan project or with the Apollo program, because in both cases they had the basic knowledge necessary to tackle them.
That same factor, basic science, has been key in the development of the covid-19 vaccine. Since the structure of DNA was unveiled in 1953, a huge volume of research has made it possible to understand the structure and behavior of viruses, unravel the functioning of the human immune system, and develop powerful biotechnological techniques, among other essential ingredients of this achievement.
This is an important lesson for the future: basic research may be an essential requirement to face dangers to our own survival that are unknown to us today.
In the days or weeks to come, my father will be vaccinated and, with him, thousands of other residents in social and health centers. Later we will be vaccinated by others, until a large part of the world population has been immunized. Doubts remain, problems will arise and new obstacles will emerge to overcome, but humanity as a whole – thousands of millions of people – will benefit from the fruits of a collective scientific endeavor without equal.
Juan Ignacio Pérez Iglesias, Professor of Physiology, University of the Basque Country / Euskal Herriko Unibertsitatea
This article was originally published on The Conversation. Read the original.
