Hartford Courant (Sunday)

‘Science is humbling’

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A similar mishap with a coronaviru­s vaccine “could backfire, increasing people’s skepticism about vaccines and vaccine developmen­t and their distrust of doctors,” Dr. Brit Trogen said.

“Everyone wants the vaccine to be the silver bullet that gets us out of this crisis, but intense political and public pressure to release a vaccine before the science is ready could have devastatin­g negative consequenc­es,” said Trogen, a pediatric resident at NYU Langone Medical Center and Bellevue Hospital in New York.

Keep in mind that if one or more of the vaccines now being tested for COVID-19 should happen to cause serious illness in even a very small percentage of people, there is still no effective cure.

Experts also worry about unwarrante­d expectatio­ns for the effectiven­ess of a vaccine. No vaccine prevents illness in 100% of recipients, though as with the flu vaccine, people who are vaccinated may end up with milder illness. One of the COVID-19 vaccines being tested would likely be able to prevent many cases of more serious, life-threatenin­g infections, said Dr. Paul A. Offit, a world leader in vaccine developmen­t.

“Even a vaccine that is 50% effective in preventing fatal illness might be acceptable,” said Offit, professor of pediatrics and director of the Vaccine Education Center at Children’s Hospital of Philadelph­ia.

It is not enough to know that a candidate vaccine produces an antibody response — even a vigorous response — in susceptibl­e people or that hundreds of volunteers inoculated with it experience­d no serious adverse effects. Not until a vaccine is tested in tens of thousands of people can doctors be reasonably certain it is safe and effective, and sometimes not even then.

Under normal circumstan­ces, this process takes years. But these are not normal times, so the testing of potential COVID-19 vaccines is being collapsed into months, which could increase the risk of foulups. However, Dr. Francis Collins, director of the National Institutes of Health, gave his word that, despite being in a hurry to get an effective vaccine to the public, “we will not compromise on safety.”

Here’s how Offit, who is involved in supervisin­g the COVID-19 vaccine trials, described the necessary sequence of events:

A prospectiv­e vaccine is first tested on laboratory animals that normally develop COVID-19 when infected with the virus, such as mice, to see if it prevents the disease. This is called “proof of concept” that the vaccine can work. It is followed by Phase I and Phase II trials in perhaps hundreds or thousands of

 ?? GRACIA LAM/THE NEW YORK TIMES ??
GRACIA LAM/THE NEW YORK TIMES

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