Claire Felter
Governments, multilateral organizations, and private firms have spent billions of dollars to develop effective vaccines for the new coronavirus within one year.
Close to a dozen vaccines—including ones by Pfizer and BioNTech, Moderna, and Sinopharm—are already being distributed, with hundreds of millions of people inoculated so far.
Vaccines go through rigorous testing for safety and effectiveness before they are approved for public use, a process that typically takes years.
Introduction
A year into the pandemic of the COVID-19 coronavirus disease, the global effort to develop and distribute an effective vaccine has already produced several promising options. The accelerated development of multiple vaccines is unprecedented; the process typically takes eight to fifteen years.
Now, the immunization of a critical mass of the world’s population—which is crucial for getting the pandemic under control—is up against a new set of challenges, including dangerous new strains of the virus, global competition over a limited supply of doses, and public hesitation about the vaccines.
What is the status of COVID-19 vaccine distribution?
Several vaccines have been approved for general or emergency use in countries including China, Russia, the United Kingdom, and the United States. As of February 2021, over two hundred million doses had been administered worldwide. Several countries—such as Israel and the United Arab Emirates—are making swift progress immunizing their citizens, while the vast majority have either vaccinated only small fractions of their populations or are yet to start.
How does a vaccine work?
Traditionally, vaccines are dead or weakened virus molecules—known as antigens—that trigger defensive white blood cells in the immune system to create antibodies that bind to the virus and neutralize it.
There are four main types of conventional vaccines:
live vaccines use a weakened form of the virus to prompt the creation of antibodies;
inactivated vaccines use a dead version of the virus;
toxoid vaccines use toxins made by the virus to produce immunity to the part of the virus that causes disease; and
subunit, recombinant, polysaccharide, and conjugate vaccines use proteins or other pieces of the virus.
There are also several new types of vaccines that use the virus’s genetic material—DNA or RNA—to prompt the body to create antibodies. More than a dozen of the COVID-19 vaccine candidates that have gone to clinical trials are genetic-based, including those by U.S. pharmaceutical giant Pfizer and partnering German firm BioNTech and by U.S.-based Moderna. No vaccine of this kind had ever been approved for commercial use in humans before the COVID-19 pandemic.
When most of a population has been vaccinated and is immune to a particular disease, even those who are not immune are considered protected because the likelihood of an outbreak is small. This is known as herd immunity. Chicken pox, measles, mumps, and polio are all examples of diseases for which the United States has achieved herd immunity due to vaccines. Scientists are divided about how much of a population must have COVID-19 antibodies to prevent new outbreaks, with estimates ranging from less than half to over 80 percent.
Who is involved in vaccine development?
Vaccines are frequently collaborative efforts across sectors of society, with private pharmaceutical firms teaming up with public health agencies or university labs. Here are snapshots of some of the major players in the COVID-19 vaccine field.
Governments. Public health agencies have played critical roles in supplying funds to develop COVID-19 vaccines. In the United States, President Donald J. Trump’s administration launched Operation Warp Speed, a project aimed at developing an effective vaccine and manufacturing enough doses for all three hundred million Americans. The effort, which pledged billions of dollars to companies with promising candidates, brought together several agencies within the Department of Health and Human Services—including the Centers for Disease Control and Prevention, the National Institutes of Health (NIH), and the Food and Drug Administration (FDA)—and the Department of Defense. The European Commission has also funded several candidates; at a virtual summit in May 2020 hosted by the European Union, world leaders, organizations, and banks pledged $8 billion for vaccine research. In China, the government has closely overseen efforts on its territory, with state-owned firms such as Sinopharm making up about two-fifths of the country’s vaccine industry.
International institutions. The World Health Organization (WHO) and other multilateral institutions such as the World Bank are focused on financing and manufacturing COVID-19 vaccines for global use, in particular to ensure fair allocation among all countries. Also at the forefront of multilateral efforts is the Coalition for Epidemic Preparedness Innovations (CEPI), a global alliance that was founded by Norway, India, the Bill & Melinda Gates Foundation, the UK-based Wellcome Trust, and the World Economic Forum. Gavi, the Vaccine Alliance—also founded by the Gates Foundation—is a public-private partnership focused on improving vaccine access for lower-income countries. In June 2020, the WHO, CEPI, and Gavi launched COVAX, a global initiative aiming to distribute two billion vaccine doses by the end of the following year. By February 2021, COVAX had begun its deliveries, sending doses first to West Africa.
Private sector. The pharmaceutical industry has been driving much of the push. Companies ranging from biotech start-ups to giants such as U.S.-based Johnson & Johnson shifted their research and development efforts to focus on COVID-19. While early research into a vaccine candidate typically receives government funding, such as NIH grants in the case of the United States, the bulk of financing for clinical development generally comes from private sources.
Research institutions and nonprofits. Many of the COVID-19 vaccine candidates have involved a university or college assisting in preclinical research or clinical trials. In the case of the University of Oxford’s candidate, the research team was already working on vaccines for an unknown disease that could cause a pandemic; then, in January 2020, the group zeroed in on COVID-19. The Gates Foundation has been the leading nonprofit funding COVID-19 vaccine efforts.
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