By Stephanie Miceli

It normally takes 15 to 20 years to develop a vaccine, but due to the urgency of the COVID-19 pandemic, researchers are accelerating the vaccine development process.

During the most recent COVID-19 Conversations webinar, panelists agreed that a COVID-19 vaccine could be ready for emergency use by 2021. Health care workers and people with high-exposure jobs would likely be prioritized before the vaccine is made available to the general population, noted moderator Paul Offitt, who directs the vaccine education center at Children’s Hospital of Philadelphia.

“Some of the steps of vaccine development will need to happen in parallel,” said Richard Hatchett, CEO of the Coalition for Epidemic Preparedness Innovations (CEPI). For example, some companies may start manufacturing doses of the vaccines before the trials have finished. “This means we’re taking significant financial risks. But we do not want to take safety and efficacy risks,” he said. Safety is monitored throughout the vaccine development process, and companies will need to work with federal public health agencies well after a vaccine is licensed in the U.S.

Vaccine Development Mid-Pandemic — It’s Complicated

Currently, there are approximately 160 COVID-19 vaccines in development — a remarkable feat, considering researchers only learned about the novel coronavirus in late 2019, said John Mascola, director of the vaccine center at the National Institute of Allergy and Infectious Diseases.

Headlines about a single “winner” in the search for a COVID-19 vaccine are misleading, he cautioned. “We’ll need multiple wins. There are more than 300 million people in the U.S. alone, and a large segment of the population will need a vaccine. That isn’t going to be accomplished by one manufacturer.”

Mascola described several of the complications of developing a vaccine mid-pandemic. For example, in “normal” vaccine development circumstances, ideally, there are treatments available in case participants get sick, but there is no specific antiviral treatment for COVID-19. He also noted it’s important that studies feature a placebo component, so researchers can compare it with participants who received a vaccine. While vaccine trials generally start with healthy adults who have not been infected with the virus, researchers must also test special populations, particularly pregnant women and children. All of these considerations could impact the timeline.

Financing a Vaccine

Even if there are several safe, efficacious vaccines available, some countries may be left behind if they’re scrambling to finance a vaccine. It’s also important to monitor emerging COVID-19 hot-spots to inform vaccine distribution decisions, said Seth Berkley, CEO of Gavi, the Vaccine Alliance.

“COVID-19 was in 180 countries within three months,” said Berkley. “We don’t want a situation where one country has all of the vaccines while outbreaks are happening elsewhere. We’re not going to be safe from COVID-19 until we’re safe everywhere.”

Higher-income countries will likely finance their own vaccine programs, whereas programs in low- and middle-income countries (LMICs) would be donor-financed, said Berkley. Gavi is also working with countries to ensure LMICs are prepared for the storage, handling, and transport of a vaccine when it becomes available.

Countering Vaccine Misinformation

The search for a COVID-19 vaccine is also happening at a time when vaccine hesitancy is at an all-time high, said Kathleen Neuzil, professor in vaccinology and director of the University of Maryland’s Center for Vaccine Development and Global Health. Last year, for instance, the U.S. saw its highest number of measles cases since 1992, nearly costing the nation its elimination status.

Front-line health care workers — and trusted peers — will play a key role in encouraging people to receive a COVID-19 vaccine.

“Sometimes it’s not just an individual decision [to vaccinate.] Your mom in a nursing home probably isn’t going out and being exposed to COVID — it’s coming to her,” said Neuzil. “As health care professionals, we need to convey that vaccination is about preventing disease from spreading to our loved ones, and those who are immunocompromised.”

In a sense, vaccines are one of the world’s greatest tools for health equity, she added. Our best hope is education, and reminding people about the historical success of vaccines.

“It’s important to state the goal of vaccine development, whether that’s for COVID or any other disease. Are we trying keep people from dying from this disease? From getting infected? Are we trying to keep the population healthy and at work and functional? I think for COVID, we’d like to achieve all of these things.”

Further Reading

• Webinar recording
• Webinar transcript