What if a COVID-19 vaccine doesn’t work?
If other viruses are anything to go by, we may not be able to rely on a vaccine to eradicate COVID-19. But how likely is it that we won’t find a workable vaccine? And how else can we manage coronavirus?
Recent weeks have been full of uplifting news stories about progress in COVID-19 vaccine trials, and how close we might be to a ‘solution’ to this pandemic. With logistical problems to face even if a vaccine is created [link to 25], there is reason to be cautious.
There are some notable vaccine success stories
We know that vaccines have been very effective against measles and childhood diseases. Smallpox, a highly contagious disease caused by the variola virus, was actually declared by the WHO to have been eradicated by a vaccine in 1980. However, this is the only disease to receive this notable distinction.
But there are still killer diseases we have no cure for
There are incredibly prevalent diseases for which there is no vaccine despite years of research by hordes of specialists. For example, 1.7 million people were diagnosed with the HIV virus worldwide last year; 33 million lives have been claimed by AIDS by AIDS. There is no vaccine and it continues to spread. Efforts are ongoing, but it’s clear that there won’t always be an easy, quick answer to preventing complex diseases.
We haven’t eradicated Hepatitis B, but the vaccine is considered effective
Hepatitis B vaccines are 80% to 100% effective in preventing infection or clinical hepatitis in those who receive the complete vaccine series. This is still considered successful, which should be comforting to know as the COVID-19 vaccines that look most likely to be rolled out soonest - from Pfizer, Moderna and Oxford University - are at leats 75% ‘effective’ as things currently stand.
Sars-COV-2 appears to be more contagious and more severe than flu viruses
Because of some similar symptoms, people often compare COVID-19 to the flu, which many people are vaccinated against annually. Flu jabs are hard to produce, because the virus mutates, meaning a new variation of the vaccine needs to be produced every year. Jabs are generally only advised to those in vulnerable groups, and the CDC reports effectiveness rates of 40 to 60%. It’s been as low as 3% effective in the past.
Most COVID-19 vaccine developers aim to prevent symptoms, not infection
As the FT notes, [preventing infection] has never been achieved for other coronaviruses or strains of influenza; the “pragmatic goal” of stopping symptomatic COVID-19 infections “is the stated objective of the AstraZeneca, Moderna, Pfizer/BioNTech and J&J vaccines.” This would ideally mean a reduction in people dying or being admitted to hospital. But, as noted in the British Medical Journal, none of the trials from 2020 are testing for that.
As the likelihood of hospitalisation or death from COVID-19 is still quite low, “None of the trials currently underway [as of October 2020] are designed to detect a reduction in any serious outcome such as hospital admissions, use of intensive care, or deaths. Nor are the vaccines being studied to determine whether they can interrupt transmission of the virus.” They are just testing for something that appears to stop symptoms, and are hoping that something very effective on mild symptoms will be equally or more effective on severe symptoms.
Moai can help us to manage life with COVID-19
It seems like life ‘without’ COVID-19 is a pretty distant vision. At Moai, we have developed an approach - centred around unique privacy-preserving technology - to manage and better understand the spread of the disease, so that life can get back to ‘normal’ as far as possible. Without compromising privacy, the Moai app helps with contact tracing and learning more about the factors that contribute to COVID-19 transmission in public life.