Most global health authorities from the World Health Organization and the Centre for Disease Control and Prevention in the U.S. are projecting a vaccine for COVID-19 should be ready within 12 to 18 months, but even if that’s is the case, manufacturing and dispensing needs to be considered, according to one expert.
“We don’t have the facility to make it for everyone, even if we have the perfect vaccine ready to go in 12 to 18 months, we may not be able to get a hold of it,” said Dr. Natasha Crowcroft, Director of the Centre for Vaccine Preventable Diseases, Professor at the Dalla Lana School of Public Health at the University of Toronto.
While some officials are inclined to inject optimism to the public about when society could return to a new normal, the reality of tackling COVID-19 is not as simple, according to Dr. Crowcroft.
“People keep saying 12 to 18 months, I hope that's true, but I don’t think we know the answer. If it’s 18 months, we need to plan on not having it for a while, we have to have a way to manage the situation,” she said.
The three phases of testing for a viable vaccine which all take anywhere from three to six months include animal testing, safety testing and checking if the vaccine produces immune system activity in humans. Dr. Crowcroft, a 25-year-plus veteran of studying infectious diseases, understands that by providing the public with a particular date, it may offer comfort and calm the minds anxious citizens. However, she insists the timelines are largely a crap shoot.
“Anybody who says they have an answer to the question is being optimistic, the simple answer is we really don’t know, I’ve taken a position we need to be optimistic because of the time that we’re in,” she said.
The status of vaccines for COVID-19
As of late April, over 100 possible vaccines have been established, at least 77 vaccines are being tested globally, and a couple have started phase one of human trials. Researchers at Oxford University are overseeing human trials, with two patients already being injected with the potential vaccine.
“It has to work on people and it needs to be safe, to get through all the hurdles to get to that point, vaccines can fall at every hurdle,” said Dr. Crowcroft.
However, despite Dr. Crowcroft’s hesitancy around manufacturing and the timeline, she noted the global attention COVID-19 is receiving from so many scientists and political officials in terms of funding allows her some optimism.
“We have never had as much power to discover vaccines, science has moved forward so fast, we’ve never been in the position where scientists around the world have lined up to work on something in different ways." Dr. Natasha Crowcroft, University of Toronto
With so many minds focusing on the same goal, many taking different approaches, Dr. Crowcroft hopes they can find different methodologies which may all work.
“The more ways we try to solve it the more likely we are to find several solutions,” she said.
Worst-case scenario without a vaccine
While finding multiple vaccines or cures would be a reason to be enthusiastic, it is necessary to recall scenarios where vaccines or cures weren’t discovered. For decades, there has been better management for some viruses, but no vaccines for HIV, Epstein-Barr virus and the respiratory syncytial virus.
“It is possible that the vaccines won’t work, but is it probable? I think the number of ways that this is being approached, the chances they all fail is unlikely,” said Dr. Crowcroft.
While vaccines are necessary to find a cure for COVID-19, researchers in Germany and in the U.S. are already working on trying to create serology or antibody testing. The tests would be able to determine if someone had had COVID-19, by seeing if their immune system has produced antibodies against the infection.
However, as tests are underway, Health Canada’s website states that they are “not aware of a serological-based test that has been validated for diagnosis of COVID-19 to date.”
The combination of a no serology test or vaccine is a grim possibility in Dr. Crowcroft’s eyes, but still not completely devastating.
“The worst-case scenario is we have no way of antibody testing and we have no vaccine, the human race will survive this, it’s not an extinction event,” she said.
Serology testing an indicator of vaccine efficacy
With a global shortage of nasal swab test kits, the need and value of a serology test grows day by day as it allows health authorities a way to grasp how widespread infections are. But, as Dr. Crowcroft notes, even though companies and labs are announcing they’re working on an antibody test, there is still little to show.
According to Dr. Crowcroft it is still unclear how effective serology tests would be at allowing people to go back out into real life.
“With serological testing it’s like one step forward and two steps back, it seems like someone has the answer then it doesn't work, we’re not there yet,” she said.
Germany is the only country to begin widespread serology testing, as health authorities in the country will be testing 15,000 blood samples every two weeks, but the effectiveness and viability of the test is yet to be determined.
“The World Health Organization has said even if you test positive for the antibody test, it doesn’t mean you’re necessarily protected against infection — that is a huge issue,” she said.
The lack of a clear-cut antibody test that works is a major problem for trying to figure out if vaccines are effective.
“If you don’t have antibody tests that work it’s really hard to figure out if the vaccine is going to be successful,” said Dr. Crowcroft.
Could COVID-19 mutate into something different?
There are many iterations of coronavirus from SARS-CoV in 2003 to the current strain of SARS-CoV-2 which is causing the ongoing pandemic. However, as some people online have posed questions concerning a mutating virus, Dr. Crowcroft stresses it’s not a major concern for researchers working on vaccines.
“Coronaviruses don’t change as fast, they’re not like influenza, the current thinking is there may be some minor changes, it won’t be as rapid -- it’s not a huge issue,” she said.
Instead of being worried about a mutating virus, the importance of a vaccine which is viable for humans is the next key step in the process of testing.
“Mutation isn’t the concern with the vaccine, I think the concern with the vaccine is finding one that has long-lasting immunity and is safe in human beings,” she said.
However, even if COVID-19 is eradicated, this may not be the last time researchers are focusing on creating a vaccine for a virus causing a global pandemic, according to Dr. Crowcroft.
“There is a chance for there to be another coronavirus pandemic with a different coronavirus, so we are not out of the woods with this coronavirus,” she said.
With the increased globalization and proximity of our day-to-day interactions, Dr. Crowcroft notes that we are still set up to allow history to repeat itself.
“We still have all the ingredients for another coronavirus future pandemic in the future if we don’t change the fundamental ways we live in this world,” she said.
To be the change Dr. Crowcroft is hoping for, she stressed the importance of society to integrate better hygienic measures which include the uses of handwashing, face masks and physical distancing.
“We’re not going to carry on as we are right now, I think people will be more careful about hygiene probably and keeping their distance,” she said.