Imagining future coronavirus vaccines leads to questions: How far away are we from finding a successful vaccine? If and when we find an appropriate vaccine candidate, how do we distribute it in order to ensure herd immunity — or society-wide resistance to the virus? What if people refuse to take it?
That last question might sound odd, given the current situation, but even in the pandemic, the anti-vaccination movement is thriving.
The Observer talked with Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Children's Hospital and dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston, about progress being made toward a vaccine and Texas' outlook once one is discovered.
Hotez helped lead research into a vaccine for SARS that withered on the vine thanks to lack of funding in 2016. His team is one of several around the world working to develop a vaccine for the novel coronavirus.
One of the big fears as Texas sits, reopening in fits and starts but not approaching anything that one would consider normal, is that the vaccine is actually just a MacGuffin. It doesn't exist now and it might not ever exist. After all, coronaviruses have been floating around the world's population for centuries and scientists have never successfully developed a vaccine for one.
It's a worrying thought, but one Hotez dismisses, although he does believe that getting an effective vaccine to the public will take longer than some of the more aggressive predictions about a potential vaccine, some of which have said a vaccine could be available as soon as early 2021.
The reason no vaccine for a coronavirus exists, the doctor says, isn't because one couldn't have been made.
"We'll get a vaccine. It may not be as soon as we like, but I think that, toward the end of next year we'll have some pretty interesting vaccine candidates, or just one candidate, but I think we will have a vaccine," Hotez says. "It's not that difficult to target COVID-19 virus, you just need a good immune response to the spike protein."
"It's not that difficult to target COVID-19 virus, you just need a good immune response to the spike protein." — Dr. Peter Hotez
Once scientists find an effective candidate or candidates, according to Hotez, it should be available to the public quickly. Manufacturers will be equipped to make a lot of it thanks to the U.S. Department of Health and Human Services' National Vaccine Program.
"We're going to make a lot of vaccines to scale, knowing that a number of them are not going to work," Hotez says.
Money will be spent on vaccines that eventually get thrown away, Hotez says, but the right vaccine should be ready to go when it's suitable for the general public.
Previous attempts at creating a coronavirus vaccine have stalled, Hotez said, because there wasn't a big enough desire for them.
"We've made several coronavirus vaccines that we think looked really good, but then no one wanted to invest in clinical trials for them," Hotez says. "That's what we do at Texas Children's Baylor — we make the vaccines that no one else wants to make because there's no (market for them). It's a market failure rather than a science failure."
While Hotez thinks there will eventually be a vaccine, he's already worried about how the public, Texans especially, will react when it comes time to get their inoculations. The anti-vaccine movement is already showing signs that it could sabotage the whole project.
According to a Reuters/Ipsos poll published Thursday, a quarter of all Americans have little or no interest in taking a COVID-19 vaccine.
"You've got a very aggressive anti-vaccine movement (in Texas), plus you've got a lot of mixed messaging coming out of the White House," Hotez says. "Even if the vaccine is available, it may not work because not enough Americans have taken it to avoid transmission."
Over the past several years, Texas has seen a declining vaccination rate at its public schools and an increase in diseases, like measles, that had previously been thought to be eradicated.
"The problem is no vaccine is 100% so you need to develop herd immunity," Hotez says. "We're probably going to need at least 70% or more of the population vaccinated to actually stop (COVID-19) transmission, and I think, because of the anti-vaccine movement and terrible messaging, I think we may not actually get there ... I've been pushing the White House and the (National Institutes of Health) to develop a vaccine communication program, but they don't see the urgency for it yet."