The development of new Covid-19 vaccines is proceeding at a breakneck pace, which is good news for the world. We already have two phase 3 vaccines in the United States and Europe; each of these trials that will vaccinate several thousand people and then wait and see how many of them get infected. If the vaccines work, then in a few months we can start large-scale production.
But we don’t have to wait. These two vaccines (from Moderna and Oxford University / Astra Zeneca) have already been shown, in phase 1 trials, to be safe and probably effective. That’s why companies are going ahead and giving each vaccine to 30,000 more people – they know vaccines are safe. the New York Times reports that 3 other Covid-19 vaccines are also in phase 3 trials: one from BioNTech and Pfizer, and two from Chinese companies, Sinopharm and Sinova Biotech.
So why not start giving millions of doses now? We should.
In fact, an Indian vaccine maker is already making progress in large-scale production. The Serum Institute, run by Indian billionaire Adar Poonawalla, manufactures hundreds of millions of doses of the Oxford vaccine, before getting final approval, invests its own money, and takes the risk that the vaccine will work.
Why don’t we do the same in the United States and in Europe? In my opinion, two things are holding us back:
1. Money. Making hundreds of millions of doses of a vaccine is expensive, and if the vaccine fails in Phase 3 trials, that money will have been wasted. I can see why the private companies that conduct these trials might not be able to do full-scale production. This is where the government can step in: just buy the vaccines in advance! We’re already doing this on a fairly large scale anyway: the United States recently announced that it is paying Novavax $ 1.6 billion to cover all stages of its clinical trials plus manufacturing 100 million doses, long before the vaccine is approved.
Given that the United States alone has already spent well over $ 3 trillion (or 3,000 times a billion, for those who matter) to bail out the economy, with at least $ 1 trillion more to come, a few billion dollars more to make vaccines – even if vaccines don’t work, it seems like a great investment.
2. Prudence excessive. The normal vaccine testing and approval process requires 3 phases. In phases 1 and 2, we carefully test for safety and try to determine the best dose. Although a vaccine may seem to work after these phases, the number of people tested is small and we need more to be sure the vaccine works. This is what phase 3 tells us.
So the current phase 3 plans for these vaccines work like this: identify a large number of people (30,000 in at least one of the trials) and give them half the vaccine, and give the other half a placebo. Then wait a few months and see how many people contract Covid-19. If the vaccine works, then we will see that far fewer people in the vaccinated group get sick.
Awesome. We absolutely should, and we are.
But we are in the midst of the worst pandemic since 1918. The step-by-step vaccine approval regime was not designed for a global emergency, in which every day of delay means that thousands of people die.
We already know the vaccines in Phase 3 trials are safe – otherwise, it would be unethical to give the vaccine to 30,000 people, as these trials do. We must immediately increase production, using public funds rather than private funds, and then offer these vaccines free to all who want them.
Of course, we’ll have to let anyone who wants the vaccine know that we’re not sure if it works. No one will be forced to accept it, but I guess millions of people will be eager to try. And yes, there is a chance that the vaccines don’t work very well, and maybe that will create more distrust when we end up getting a good vaccine. But it is a risk we must take, given the greater damage caused by the delays. The evidence for these trial vaccines is already better than most of the treatments we give people – and most importantly, we know they are safe.
So let’s start vaccinating millions of people now, as soon as we can increase production. I will be the first to try the Moderna or Oxford vaccine, as soon as it is ready.