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One thing is certain: It won’t be just another flu vaccine.
Medical researchers worldwide are working toward a single goal: to develop a vaccine, or vaccines, to protect us from the novel coronavirus and the disease it causes, COVID-19. The crucial puzzle piece? Ensuring it is effective in the most at-risk population — older adults.
As we age, our immune systems become less efficient and, as a result, vaccines are less effective — the 2017–2018 flu vaccine, for example, was 38 percent effective in the general population but less than 20 percent effective in people over 65. So a standard antibody-producing vaccine, while helpful, may not be the preventive resource we need.
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Antibodies are key to a second goal, too: finding a treatment that doctors can use to mitigate the worst symptoms and outcomes of the disease when people do get it.
A winding road forward
Once you’re exposed to a virus, a race begins between the virus and the body’s immune system; which one will overwhelm the other? “If we can give the immune system a head start, instead of the body starting from zero, we get it to a stronger position,” says Paul Duprex, director of the Center for Vaccine Research at the University of Pittsburgh. “How do we do that? We expose people to fragments of the virus before the real virus comes along. That is the process of vaccination in the simplest sense.”
Over the past several months, you’ve probably read dozens of stories of promising new vaccines, including trials being conducted on people 50 and older. Anthony Fauci, M.D., our national beacon of medical hope through this crisis, made headlines in early June when he said that we should have “a couple of hundred million doses” of a candidate vaccine by the beginning of 2021.
But here’s the problem with all that news, Duprex says. In a Zoom video call, he holds up a stapled sheaf of papers that has lists and details printed on both sides. “This is the World Health Organization’s master list of candidate vaccines. Look at all these.” He shows me: There are scores, if not hundreds. “These are in clinical development. Only a few have gone to phase one clinical trials. It’s important for your readers to understand: We don’t have a vaccine. Even if it’s in phase one, it’s not a vaccine. It’s a candidate vaccine. It’s not a vaccine until it’s a product. A product of millions and millions of doses. That’s when it matters.”
And that’s why even Fauci can’t say whether all those millions of doses he’s talking about will even be effective. In essence, every scientist in the world is trying to turn a marathon into a sprint. Here’s how that final product, or products, will most likely happen.
Step one: Identify the target
Back in March, researchers from the University of Texas and the National Institutes of Health revealed the first three-dimensional atomic map of the novel coronavirus’ spike protein, the part of the virus that binds to and infects human cells. The spike proteins look exactly as they sound: the spikelike structures we see sticking out of the ubiquitous spherical renderings of the virus.