When Can We Really Hope to Have a COVID-19 Vaccine?

Female worker at pharmaceutical factory operating control panel of the pharmaceutical machine.

With talks about the road to recovery, return to work, and reopening gaining speed, hopes that a vaccine for COVID-19 will be available by the end of this year were stoked by comments over the weekend that “we’re going to have a vaccine much sooner than later,” along with the launch of a project to have 300 million doses available by January 2021.

Under a program called “Operation Warp Speed,” the administration has reportedly identified 14 potential coronavirus vaccines for expedited testing. Officials said the goal is to have three to four cleared for use early next year.

There is further cause for optimism. Pfizer and German pharmaceutical company BioNTech began trials of a potential coronavirus vaccine on Monday, saying that, if successful, they could have production quantities available for emergency use as soon as September. Pfizer and BioNTech will test the vaccine on 360 healthy volunteers in the first stage of the study, expanding to up to 8,000 volunteers by the end of the second stage, which usually takes at least three months. Other pharmaceutical firms are reportedly nearing field tests with similar genetically engineered vaccines and the National Institutes of Health last month said there were more than 100 potential therapeutics for COVID-19 in the works.

That’s the good news.

coronavirus, covid19, patient isolation

The more sobering side is that developing a vaccine that is safe, effective, has no serious side effects and can be used on a large percentage of the population is devilishly difficult.

The Mayo Clinic notes that there are three basic approaches to vaccines being pursued. Live vaccines, in which a live virus is used, have historically been the most effective preventative but they require extensive safety testing and risk being transmitted to people who aren’t immunized. Activated vaccines, which use a dead version of the virus, generally provide less protection and require multiple doses, if they work at all. Genetically engineered vaccines of the type being developed by Pfizer and BioNTech, have never before been licensed for human use.

Even under ideal conditions, the Clinic says, “it’s unlikely that a COVID-19 vaccine will become available sooner than six months after clinical trials start. Realistically, a vaccine will take 12 to 18 months or longer to develop and test in human clinical trials.”

That’s if a vaccine can be developed at all. A more chilling scenario outlined by CNN is that it takes decades or longer to develop effective prevention. CNN recalls that despite U.S. government predictions in 1984 that a vaccine for HIV would be available within two years, none has ever proven successful. Likewise, the world still lacks an effective vaccine for dengue fever, which infects as many as 400,000 people a year.

If that pessimistic scenario plays out, it doesn’t mean that people will live in lockdown for a generation. The effects of HIV were eventually mitigated with antivirals to the extent that hundreds of thousands of people who are at risk of contracting the disease are now protected by taking a daily preventative pill. A similar solution is possible with the coronavirus. 

Treatments could also help. The U.S. Food and Drug Administration is considering making remdesivir available to treat infected patients based on signs it could speed up recovery. Therapeutics could make it possible to control the coronavirus by relieving pressure on healthcare systems enough to permit infected patients to be treated, lower death rates and gradually reopen economies.

treatment Shot of an elderly woman looking at products in a pharmacy

“If a vaccine can’t be produced, life will not remain as it is now. It just might not go back to normal quickly,” CNN says, hopefully. The transition would require citizens to take personal responsibility for quarantining themselves and reporting contact with infected people. The scenario also presupposes the widespread availability of rapid and effective tests.

Another key variable in the recovery process is the confidence of people. For example, public opinion polls show that the majority of U.S. citizens are uncomfortable about shopping at a retail clothing store or sitting down in a restaurant. Absent a vaccine, the question of when life can return to something resembling normal will turn on how quickly those attitudes change.