None of the scientists I spoke to for this story were at all surprised by either outcome — all said they expected the vaccines were safe and effective all along. Which has made a number of them wonder whether, in the future, at least, we might find a way to do things differently — without even thinking in terms of trade-offs. Rethinking our approach to vaccine development, they told me, could mean moving faster without moving any more recklessly. A layperson might look at the 2020 timelines and question whether, in the case of an onrushing pandemic, a lengthy Phase III trial — which tests for efficacy — is necessary. But the scientists I spoke to about the way this pandemic may reshape future vaccine development were more focused on how to accelerate or skip Phase I, which tests for safety. More precisely, they thought it would be possible to do all the research, development, preclinical testing, and Phase I trials for new viral pandemics before those new viruses had even emerged — to have those vaccines sitting on the shelf and ready to go when they did. They also thought it was possible to do this for nearly the entire universe of potential future viral pandemics — at least 90 percent of them, one of them told me, and likely more.
As Hotez explained to me, the major reason this vaccine timeline has shrunk is that much of the research and preclinical animal testing was done in the aftermath of the 2003 SARS pandemic (that is, for instance, how we knew to target the spike protein). This would be the model. Scientists have a very clear sense of which virus families have pandemic potential, and given the resemblance of those viruses, can develop not only vaccines for all of them but also ones that could easily be tweaked to respond to new variants within those families.
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According to Florian Krammer, a vaccine scientist at Mount Sinai, you could do all of this at a cost of about $20 million to $30 million per vaccine and, ideally, would do so for between 50 and 100 different viruses — enough, he says, to functionally cover all the phylogenies that could give rise to pandemic strains in the future. (“It’s extremely unlikely that there is something out there that doesn’t belong to one of the known families, that would have been flying under the radar,” he says. “I wouldn’t be worried about that.”) In total, he estimates, the research and clinical trials necessary to do this would cost between $1 billion and $3 billion. So far this year, the U.S. government has spent more than $4 trillion on pandemic relief. Functionally, it’s a drop in the bucket, though Krammer predicts our attention, and the funding, will move on once this pandemic is behind us, leaving us no more prepared for the next one. When he compares the cost of such a project to the Pentagon’s F-35 — you could build vaccines for five potential pandemics for the cost of a single plane, and vaccines for all of them for roughly the cost of that fighter-jet program as a whole — he isn’t signaling confidence it will happen, but the opposite.
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If we do all that, he says, the entire timeline could be compressed to as few as three months. The production and distribution of a vaccine adds considerable cost, bureaucracy, and even some chaos, as we’re likely about to see. But three months from the design of the Moderna vaccine was April 13. The second and third surges, the return to school and the long-dreaded fall, 225,000 more deaths and 50 million more infections — all of that still lay ahead. Shave another month off somehow and you’re at March 13, the day the very first person in New York City died.
The “Beau Biden Cancer Moonshot“ authorized $1.8 billion over seven years for cancer research in 2016, don’t know what he’s planning on doing as president but this would be an excellent use of research money, Wouldn’t say no to both though.
Brinens and Things 