Don’t just wait on a vac­cine

It’s not too late to launch a na­tional plan to mit­i­gate and con­tain the novel coro­n­avirus.

The Washington Post - - THURSDAY OPINION -

VAC­CINE OP­TI­MISM is un­der­stand­able in these days of anx­i­ety about the virus. Al­most ev­ery day, there are up­beat re­ports about a vac­cine start­ing a new phase of clin­i­cal tri­als, and the world­wide re­search ef­fort spans tech­nolo­gies old and new. Surely a safe and ef­fec­tive vac­cine must ar­rive be­fore too long — as promised, in “warp speed,” such as later this year or early next?

A dose of re­al­ism would be pru­dent. Vac­cines are truly re­mark­able medicine and have proved ef­fec­tive in stop­ping dis­eases such as measles and po­lio. But they are not sim­ple to dis­cover, man­u­fac­ture or dis­trib­ute. Many re­search ef­forts fail. The first clin­i­cal trial for an HIV vac­cine was in 1987, and there still isn’t one, de­spite much hard work. As Carolyn Y. John­son re­ported in The Post on Mon­day, once a vac­cine is found to be safe and ef­fec­tive, the process will be at the be­gin­ning, not the end. Vac­cines must be man­u­fac­tured to ex­act­ing stan­dards. Dis­tribut­ing the vac­cine fairly to peo­ple in the United States and around the world will strain health net­works, the sup­ply chain, pub­lic trust and global co­op­er­a­tion. This may take months or, quite likely, years.

An­other rea­son for cau­tion is that the vac­cine timeline de­pends on hu­man phys­i­ol­ogy. It may take a while to build up the an­ti­bod­ies to fight the novel coro­n­avirus. A sec­ond in­oc­u­la­tion may be re­quired. Im­mu­nity could be short-lived or par­tial. Also, it is pos­si­ble that the first vac­cines to win ap­proval may not be per­fect, and not work all the time on ev­ery­one. As Ms. John­son points out, the measles vac­cine is one of the best, 98 per­cent ef­fec­tive at pre­vent­ing dis­ease, but the in­fluenza vac­cine is 40 to 60 per­cent ef­fec­tive most years, be­cause it must be re­cal­i­brated to take into ac­count shift­ing strains. Ideally, a vac­cine would pre­vent the dis­ease, but it is pos­si­ble one will emerge that lessens sever­ity of symp­toms. For all these rea­sons, it is vi­tal that the in­tegrity of vac­cine devel­op­ment, test­ing and pro­duc­tion not be thrown into doubt by haste or po­lit­i­cal in­ter­fer­ence that could erode pub­lic trust.

It is hard to imag­ine, but next year — or four years from now — we could still be wait­ing for a vac­cine.

Pres­i­dent Trump ab­di­cated lead­er­ship and shunted pan­demic re­sponse to the states. Now, as his White House task force co­or­di­na­tor, Dr. Deb­o­rah Birx, stated on CNN over the week­end, the virus is “ex­traor­di­nar­ily wide­spread.” We need to start anew with a na­tional ef­fort to mit­i­gate and con­tain the pan­demic in the United States. The hour is late, but not too late. We need sig­nif­i­cant quan­ti­ties of per­sonal pro­tec­tive equip­ment and high-speed di­ag­nos­tic test­ing equip­ment and sup­plies — and if the mar­ket can’t sup­ply them, the gov­ern­ment must step in. Once ram­pant com­mu­nity spread is brought un­der con­trol, then plen­ti­ful test­ing, trac­ing and other mea­sures will be nec­es­sary, as well as face masks and so­cial dis­tanc­ing for a long while to come.

Let’s sup­pose it is sum­mer of 2022, and there is still no vac­cine. What would we wish we had done to­day? Let’s do it.

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