An Effective COVID-19 Vaccine Unlikely to Act as a Silver Bullet

While the world holds its breath for the development of a coronavirus-stopping vaccine, no successful vaccine is likely to act like a silver bullet, stopping the pandemic in its tracks.

According to a group of leading scientists, even with an effective coronavirus vaccine, life is unlikely to get back to normal in spring.

People should be “realistic” about what a vaccine can do, and about the timeline, said researchers brought together by the Royal Society.

“Vaccines have the potential to end the COVID-19 pandemic but it may be some time before they can make a major difference,” according to Data Evaluation and Learning for Viral Epidemics (DELVE), a multi-disciplinary group convened by the Royal Society.

Many challenges remain despite progress on COVID-19 vaccines

Many have been hoping that a vaccine would stop the pandemic dead in its tracks, and all over the world, there is now a rush to produce an effective vaccine.

“Huge progress has been made through international collaboration with 200 vaccines in development and a number in trials that look promising,” the Society said.

But it noted that the initial vaccines “might be only partially effective, might not be effective for some groups, might provide only short-lived immunity, and may have many problems to be solved around rapid scale-up in manufacture, distribution and acceptability.”

Dr Fiona Culley of the National Heart and Lung Institute at Imperial College London and one of the lead authors of the report said: “Planning now for the different scenarios that might play out will give us the best chance of taking rapid advantage of any vaccines that are proven to be safe and effective.”

“A vaccine offers great hope for potentially ending the pandemic, but we do know that the history of vaccine development is littered with lots of failures,” Dr Culley said.

The group said restrictions may need to be “gradually relaxed” as it could take up to a year to roll the vaccine out.

Although there is still some optimism, including from UK government scientific advisers, that a mass vaccination may be ready at the start of the year, the report from the Royal Society warns it will be a long process.

However, the Royal Society report warns it will be a long process.

THE ROYAL SOCIETY

The origins of the Royal Society lie in a 1660 ‘invisible college’ of natural philosophers and physicians. The Society was founded following a lecture by Sir Christopher Wren, at Gresham College, London on 28 November. King Charles II was its patron.

Centuries later, the Royal Society it is now the UK’s national science academy and a Fellowship of some 1,600 of the world’s most eminent scientists.

The Royal Society’s motto ‘Nullius in verba’ is taken to mean ‘take nobody’s word for it’. According to the Society’s website, it is an expression of the determination of Fellows to withstand the domination of authority and to verify all statements by an appeal to facts determined by experiment.

“Even when the vaccine is available it doesn’t mean within a month everybody is going to be vaccinated, we’re talking about six months, nine months… a year,” said head of chemical engineering at Imperial College London, Prof Nilay Shah.

KEY ISSUES

The report says there are still “enormous” challenges ahead. Key issues identified in the Royal Society report include:

• Potential differences in the ability of vaccines to protect against transmission and disease
• Differences in the effectiveness of vaccines for some sections of the population, such as the elderly
• Possible short half-life of immunity provided by vaccines, meaning multiple doses or boosters might be needed to achieve immunity 
• Vaccines providing only partial immunity will require higher vaccination rates to achieve the same levels of protection in a population
• The logistical challenges of manufacturing and delivering a global immunization programme are enormous and some of the most promising vaccine candidates (such as RNA vaccines like the one being developed at Imperial College, London) are using technologies that have not been manufactured at scale before
• Public trust in a vaccine programme will have to be established and maintained.

There are also concerns about raw materials — both for the vaccine and glass vials — as well as refrigerator capacity, with some vaccines needing storage at minus 80C.

The report concludes that, should effective and safe vaccines be developed, global coordination of vaccine purchase, production and distribution will be needed.

In addition, availability, uptake, effectiveness and long term safety will need to be closely monitored; financial support must be maintained for the development of a second generation of vaccines, and the SARS-CoV-2 virus must be closely monitored for vaccine-escape mutations;.

Looking ahead, the report states that global collaboration in investing in research training and the infrastructure to deliver vaccine programmes needs to be maintained to ensure preparedness for future pandemics.