Herd immunity without a vaccine is unethical (WHO Dr. Tedros). Dr. Atlas has pushed the herd immunity approach without a vaccine and posits that we only need 20% to get there. “Herd immunity has been universally discredited by anyone with credibility” – Dr. Michael Osterholm. “That 20% number is the most amazing combination of pixie dust and pseudoscience I’ve ever seen…It’s 50% to 70% minimum…our goal is to get as many people protected with vaccines.”
𝐒𝐢𝐦𝐩𝐥𝐲 𝐩𝐮𝐭 – 𝐰𝐞 𝐧𝐞𝐞𝐝 𝐚 𝐯𝐚𝐜𝐜𝐢𝐧𝐞. Let’s talk about that in a few pictures. Each of these pictures will be a separate post – so, today is just a 30,000 foot summary to get us started. (Pictures 1 and 2 are from the NYT COVID-19 vaccine tracker site. This is a great site to read!)
𝐏𝐈𝐂𝐓𝐔𝐑𝐄 𝟏 – Vaccines usually requires years and years of testing and research from animals to humans in several phases. This is a nonpartisan, legit and rigorous scientific process to make sure the vaccines (to be given to millions) are safe. That nonpartisan process has been in place for a long time and patience is required.
𝐏𝐈𝐂𝐓𝐔𝐑𝐄 𝟐 – We now have 11 vaccine candidates in Phase 3 trials. These are the ones that have deemed safe in the smaller trials and are are now being tested in a lot of people (30,000-40,000+). You’ve heard of some of these in the news: Pfizer, Moderna, Johnson & Johnson, AstraZeneca and others.
𝐏𝐈𝐂𝐓𝐔𝐑𝐄 𝟑- There are different types of vaccines being developed: Vaccines made with inactivated or weakened virus, viral-vector vaccines (examples are the Ebola vaccine that was recently approved), nucleic-acid vaccines (DNA and RNA-based), protein-based vaccines, and a few others. The NATURE article below gives a great, detailed description of each of these types, including how easy/hard they are to manufacture, test, etc. We’ll talk about these in a different post too.
𝐏𝐈𝐂𝐓𝐔𝐑𝐄 𝟒 – “Wait, doesn’t it take 20 years to develop these? How can you be sure they are safe?” We all understand this caution. Here’s how it is happening: – In summary, our technology is better and we know more now than we did 20 years ago – so, the vaccine pipeline timeline has shifted but the rigorous safety precautions are still in place.
The technology to quickly test and develop vaccines has improved in terms of efficiency. Also, “vaccine and biotech companies have been investing heavily in approaches” that can be “readily adapted to new pathogens” – NEJM article. In other words, the early development stuff (the foundational aspects) needed for vaccines can go much quicker now than it used to – same safety protocols in place when it reaches human phases- but quicker development and manufacturing with better technology.
Another aspect that is different now than years ago is new platforms for vaccine development: namely, DNA- and RNA-based platforms. That means the vaccines on these platforms can be developed quickly (without needing fermentation or culture which historically take a while). The same safety protocols to test these platforms are in place – but, the technology to get to the human testing phase and manufacturing when they are deemed safe for wide-spread use is better.
Another aspect that is different now than years ago is the organization,, the Coalition for Epidemic Preparedness Innovation (CEPI), a nongovernmental international organization of key countries to develop vaccines against 5 pathogens on the WHO priority list. As soon as COVID-19 was identified in the Wuhan outbreak, CEPI went to work. We’ll talk about this again – if you want to read more about it, look at the NEJM article below. In short, the foundational groundwork on the vaccine development front for potential pandemics were already being put in place.
Lastly, developing a vaccine in the middle of a pandemic follows the pandemic paradigm (as seen in Picture 4). We saw similar speed-work during the Ebola outbreak which worked.
𝐂𝐎𝐍𝐂𝐋𝐔𝐒𝐈𝐎𝐍: Many, many, many scientists have been all-hands-on-deck since January regarding a vaccine. That’s why we saw so many vaccine candidates being developed at once. Some will fail (that’s just science), but some won’t. We are seeing several emerge in Phase 3 testing and anticipate seeing more of the main results in the coming weeks. Am I hopeful? Yes! Will I get a vaccine? Yes, if Dr. Fauci, Dr. Osterholm, and the other science-avengers I talked about in yesterday’s post say to get one.
𝐀 𝐧𝐨𝐭𝐞 𝐚𝐛𝐨𝐮𝐭 𝐯𝐚𝐜𝐜𝐢𝐧𝐞-𝐦𝐲𝐭𝐡𝐬: In the coming posts, we’ll talk about safety and the nuances of the new vaccines. I know many of you have questions about that and I understand those. What I want to ask you to do is not believe the pseudo-science about vaccines being micro-chipped, the 5G myths, and other weird stuff you’re probably already hearing on social media. There’s some fancy-smancy fake-data/news around vaccines being touted through videos or memes that can look legit- If you don’t hear it from the real experts though (science avengers), just don’t believe it. If it sounds funky (like weird microchips or 5G – #facepalm), it probably is. Even if the videos use fancy data points and sound smart – be cautious and use wisdom. Listen to the experts (i.e science avengers) on this. That will be the next myth-busting anti-science discussion to be had.
We’ll get into the weeds on all of these posts in the coming days, including info on what’s in the vaccines and how they work, who are included in the trials (ages, underlying conditions, etc), the potential need for boosters, and how will the vaccines be distributed to lots of people. Until then, keep wearing your masks and distancing and washing your hands.
-Friendly neighbor epidemiologist
Dr. Michael Osterholm response to Dr. Atlas: https://thehill.com/homenews/sunday-talk-shows/521605-infectious-disease-expert-calls-white-house-advisers-herd-immunity
Picture 3: NATURE article: https://www.nature.com/articles/d41586-020-01221-y