Health
COVID-19 vaccine has been nearly 20 years in the making
The claim: The COVID-19 vaccine was developed in less than a year, but there are no vaccines against viruses and diseases that have existed for far longer
It is approaching a year since the World Health Organization declared COVID-19 a pandemic, and on Dec. 8, Britain was the first Western country to begin vaccination against the virus. The rollout was followed by the U.S. Food and Drug Administration’s emergency authorization of Pfizer-BioNTech’s COVID-19 vaccine on Dec. 11 and Moderna’s on Dec. 18.
Given the quick scientific response to the newly emerging virus, one Instagram post is calling foul, questioning why vaccines for equally debilitating diseases, predating the pandemic, have not yet been developed.
The Nov. 30 Instagram post from author Boyce Watkins shares a screenshot of a Facebook comment alleging countless years of research effort have yielded no vaccine.
“40 years worth of research…no vaccine for HIV (sic) At least 100 years research…no vaccine for cancer (sic) Ongoing research…no vaccine for the common cold (sic) Less than a year for a covid (sic) vaccine? Thanks but a hard pass on that shot…” claims “Lee Morin” in the comment.
“This does make you wonder: How did you come up with this so fast, but you can’t vaccinate against viruses that have been harming people for centuries?” asks Watkins. The post has received over 13,800 likes and comments agreeing with Watkins’ charge.
“Come on. You have 7 BILLION customers. No other virus/cancer/ailment has that many customer. Follow the money,” writes Instagram user borzirtc.
Other social media users have posted the same or a similar claim, as recently as Jan. 13.
USA TODAY has reached out to those who posted the claim for further comment.
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It began with chickens
Operation Warp Speed, the private-public partnership initiated by the White House during the pandemic, may give the impression the COVID-19 vaccine developed overnight, but in actuality, it depends on research dating back nearly 100 years.
Coronaviruses were first encountered in April 1930, when a strange respiratory disease ravaged poultry farms across North Dakota and Minnesota, killing tens of thousands of baby birds, The Scientist reports. Unsure of what exactly this illness was, veterinarians Arthur Schalk and Merle Hawn of North Dakota Agricultural College, now North Dakota State University, called it “infectious bronchitis of baby chicks,” the viral agent later named infectious bronchitis virus.
Further scientific research into IBV and recognition that it was not like influenza A, a flu virus known to cause bronchitis, would transpire over the next 30 years. In November 1968, a group of scientists wrote to the journal Nature asking for IBV, and viruses resembling it like mouse hepatitis virus discovered in 1947, to be classified as coronaviruses, a name derived from its appearance — the spike proteins casting a halo around the surface, much like the sun’s corona — on electron microscope imaging.
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SARS was the first attempt at a human coronavirus vaccine
While coronaviruses could cause a variety of fatal diseases in animals, the two known to infect humans were not a grave concern, as they only caused the common cold. This belief was challenged in November 2002 with the emergence of a new respiratory illness in Guandong Pprovince, China, that would infect over 8,000 people worldwide and claim 774 lives.
In less than a month, researchers decoded the enormous genome of the new virus, which caused a disease called severe acute respiratory syndrome. Researchers concluded it was a coronavirus, likely to have jumped from animals to humans because it was only somewhat related to other known coronaviruses. (It took over 15 years of search to identify bats as the potential animal source.) By July 2003, thanks to isolating and quarantining patients, the World Health Organization declared SARS officially contained.
Nevertheless, fears of future seasonal SARS outbreaks called for a vaccine. SARS-CoV’s spike protein was an obvious choice for a target. Prior research found the spike protein was critical in determining which species a coronavirus infected, where it preferred to hunker down — called organ or cell tropism — and disease severity. The spike protein had even been proposed as a vaccine target for canine coronavirus in 1991.
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A number of vaccines targeting the spike protein were designed, tested in animal models and found to be quite promising against SARS and other coronavirus illnesses like Middle East respiratory syndrome, which appeared in 2012. But further testing reached an impasse when funding declined steadily in the years following the 2003 outbreak, said Dr. Peter Hotez, a vaccine scientist and dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, whose team collaborated with Galveston National Laboratory to create a SARS vaccine in 2016.
“We manufactured a really great SARS 1 vaccine in the lab. We actually had a manufacturer at Walter Reed, but then we couldn’t raise the money to do all the clinical testing,” he told USA TODAY.
Funding was not the only issue. Testing whether a vaccine can prevent disease requires the disease to still be around. Since there have been no major outbreaks of SARS since 2003, testing vaccine efficacy was difficult. But more instrumental is interest: Few SARS or MERS cases meant pharmaceutical companies were less inclined to invest in a likely rarely used vaccine.
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Laying the groundwork
Typically, the road to creating new vaccines is long, with many steps: Finding and developing a vaccine target (exploratory), testing it in tissue- or cell-cultures and animal models (preclinical) followed by three phases of clinical trials with human volunteers.
If a vaccine proves its mettle, its developers have to seek and gain approval from the FDA before manufacturing. Lastly, in phase four, quality control monitors for any possible vaccine side effects.
For vaccines to be effective, a specific target is needed. This vaccine target, also called an antigen, is typically a fragment of the disease-causing agent that instructs the immune system on how to recognize and destroy it upon contact. Searching for a suitable antigen can be an arduous process but prior coronavirus research made it all the more easier.
“When the Chinese put up the COVID-19 sequence on bioRxiv in January, our community of scientists looked at it and said, ‘Yeah, we got this because we know how to do it.’ It was all about plug and play based on all that experience,” said Hotez.
Having a running start does not mean the testing process was accelerated, however. Hotez, whose recombinant protein subunit COVID-19 vaccine is undergoing clinical trials in India, stated the vaccine still underwent testing among a large group of human volunteers, even more than a typical trial with over 30,000 to 60,000 people.
What accelerated the vaccine process was manufacturing.
“The two accelerants are doing the manufacturing of risk (scaling up manufacturing based on the assumption the vaccine will work, also called at-risk manufacturing) and manufacturing the vaccine in parallel with clinical trials. That’s new because we usually wait for the phase three results,” he said.
More:Fact check: The US saw more deaths in 2020 than in 2019, driven by the COVID-19 pandemic
So why is there no vaccine for HIV, cancer or the common cold?
Human immunodeficiency virus, the culprit behind acquired immunodeficiency syndrome, commonly known as AIDS, is a tricky virus. Much like the novel coronavirus, HIV binds to a protein on the surface of T cells, a type of white blood cell, to enter. Once inside, HIV integrates its genetic material with its host cell’s DNA, using the host’s DNA replication machinery to create new viruses, which blast off to infect and kill other T cells.
Finding a specific and effective vaccine target is therefore difficult, especially since HIV mutates frequently in order to mask itself from the immune system. According to the National Institute of Allergy and Infectious Disease, common vaccine approaches using inactivated or live HIV forms have either not been “effective in eliciting immune responses in clinical trials” or are too dangerous to use.
The same goes for the common cold, which is caused by a smorgasbord of viruses including over 150 different types of rhinovirus, a common troublemaker.
“It’s hard to create a vaccine when you have so many different viruses causing similar symptoms. To make a universal vaccine against all of them is probably pretty daunting, it might be doable, but it’s daunting,” explained Hotez.
Cancer, an abnormal growth of the body’s own cells due to unchecked genetic mutations, is no virus, but the struggle in finding a suitable vaccine target is not any easier.
“The challenge is getting antigen targets and also access, because a lot of the antigens, or cancer proteins, are first inside the cell. They may not be presented to the immune system so these are much more complicated targets,” said Hotez.
Advances in messenger RNA-based vaccine technology in recent years may help fast-track some cancer vaccines, he acknowledged. The platform, which provides the body the equivalent of a genetic assembly instruction booklet for manufacturing target-specific antibodies, has been used for rabies, influenza and Zika and is considered an attractive approach for its low cost, speed of manufacturing, potency and versatility, Nature reported.
Many cancer vaccines using mRNA are in the works, like Moderna’s personalized cancer vaccine, mRNA-4157, which is being tested in patients with metastatic common epithelial cancer. The Boston-based pharmaceutical company also announced on Jan. 11 it was working on a mRNA HIV vaccine with phase I clinical trials expected sometime in 2021.
Our ruling: Missing context
We rate this claim MISSING CONTEXT because without additional context it might be misleading. Vaccines require specific targets against which they train the immune system. COVID-19’s spike protein was identified nearly 20 years ago as a potential vaccine target during the development of the SARS vaccine, following the 2003 SARS outbreak. This has helped expedite the vaccine process, given that vaccine platform technologies have advanced in recent years, as well. Another accelerant was the commercial-scale production of COVID-19 vaccine doses prior to FDA clearance, called at-risk manufacturing, when early results appeared promising. Finding suitable vaccine targets for HIV, cancer and the common cold has been more difficult in comparison as these diseases have either elusive or highly variable targets.
Our fact-check sources:
- World Health Organization, March 11, 2020, “WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020“
- USA TODAY, Dec. 8, 2020, “‘V-Day’: A year after COVID-19 pandemic began in China, UK is first in West to start vaccinations“
- U.S. Food & Drug Administration, Jan. 12, “Pfizer-BioNTech COVID-19 Vaccine“
- U.S. Food & Drug Administration, Jan. 12, “Moderna COVID-19 Vaccine”
- U.S. Department of Health and Human Services, Dec. 21, “Fact Sheet: Explaining Operation Warp Speed”
- The Scientist, Sept. 1, 2020, “Coronavirus Closeup, 1964“
- Prairie Public News, Dec. 16, 2020, “A Coronavirus in 1930“
- Nature, Nov. 16, 1968, “Virology: Coronaviruses”
- Laboratory Animals, Dec. 13, 1996, “Enterotropic mouse hepatitis virus”
- Medical Microbiology, accessed Jan. 14, “Chapter 60 Coronaviruses“
- Centers for Disease Control and Prevention, April, 26, 2013, “CDC SARS Response Timeline“
- Nature Reviews Microbiology, Dec. 1, 2003, “SARS – beginning to understand a new virus”
- Science, May 30, 2003, “The Genome Sequence of the SARS-Associated Coronavirus“
- Nature, Dec. 1, 2017, “Bat cave solves mystery of deadly SARS virus — and suggest new outbreak could occur”
- World Health Organization, July 5, 2003, “SARS outbreak contained worldwide”
- The National Academies Learning from SARS: Preparing for the Next Disease Outbreak, accessed Jan. 14, “Coronavirus Research: Keys to Diagnosis, Treatment, and Prevention of SARS”
- Virology, Oct. 12, 2000, “Coronavirus Spike Proteins in Viral Entry and Pathogenesis”
- Nature Reviews Microbiology, Feb. 9, 2009, “The spike protein of SARS-CoV — a target for vaccine and therapeutic development“
- Google Patents, April 25, 1991, “DNA encoding the Canine coronavirus spike protein“
- Journal of Biomedical Science, Dec. 20, 2020, “Coronavirus vaccine development: from SARS and MERS to COVID-19“
- Centers for Disease Control and Prevention, Aug. 2, 2019, “Middle East Respiratory Syndrome (MERS)”
- NBC News, March 5, 2020, “Scientists were close to a coronavirus vaccine years ago. Then the money dried up.“
- Medscape, May 28, 2020, “COVID-19 Data Dives: Why Don’t We Have a Vaccine for SARS or MERS?“
- Infectious Diseases and Therapy, April 23, 2020, “Vaccines for SARS-CoV-2: Lessons from Other Coronavirus Strains“
- George Washington Online Public Health, March 6, 2019, “Producing Prevention: The Complex Development of Vaccines“
- Baylor College of Medicine News, Nov. 16, 2020, “Biological E. Limited and Baylor COVID-19 vaccine begins clinical trial in India“
- Transfusion Medicine and Hemotherapy, May 9, 2016, “Human Immunodeficiency Virus (HIV)“
- National Institute of Allergy and Infectious Disease, May 17, 2018, “Infographic — Progress Toward an HIV Vaccine”
- Mayo Clinic, April 20, 2019, “Common cold“
- National Institute of Health, Feb. 9, 2015, “What is Cancer?”
- Lancet, July 25, 2017, “Safety and immunogenicity of a mRNA rabies vaccine in healthy adults: an open-label, non-randomised, prospective, first-in-human phase 1 clinical trial“
- Vaccine, May 31, 2019, “mRNA vaccines against H10N8 and H7N9 influenza viruses of pandemic potential are immunogenic and well-tolerated in healthy adults in phase 1 randomized clinical trials“
- Clinical Trials, Aug. 22, 2019, “Safety, Tolerability, and Immunogenicity of Zika Vaccine mRNA-1893 in Healthy Flavivirus Seropositive and Seronegative Adults“
- Nature, Oct. 16, 2019, “Unlocking the potential of vaccines built on messenger RNA“
- BioSpace, Nov. 11, 2020, “Moderna’s Personalized Cancer Vaccine Shows Promise in Early-Stage Trial“
- Moderna, Jan. 11, “Moderna Provides Business Update and Announces Three New Development Programs in Infectious Disease Vaccines“
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