The Great And Desperate Race Of The Vaccine Hunters .
In science every attemp to find a new vaccine or drug is an open question.We never know until the last yards what the answer will be. That’s the lure and the curse of scientific method.The vaccine hunters have a lot of scientific methods and skills to win the game in their favor, but they are always at the mercy of the shuffler of the cards.
In a record time of just a few months, more than one hundred and fifty vaccines have entered to development, several of which have already begun to be tested on humans.
The discovery of new vaccines is a process between scientific technology and pure creativity. We do not really know what to expect at the end of the process. There are no guarantees. The development of new vaccines is much more like the creation of the new Hollywood blockbuster than the new mobile engine and code or the construction of a brand new car. We move inside fog.
Maybe it is more difficult than a flight to Mars or to create a new CERN reactor. Both are measurable projects and we can use to achieve our mega goal our minds and tools.
Both could use well established scientific equations, technical principles and mathematical formulas. It has been a huge and grueling effort, but at least the researchers have clear scientific maps and mathematical compasses to guide them. The engineers know with certainty how far the Earth is from Mars and how much energy is needed to get there.
In contrast, the central challenge in the development of a new vaccine — the trial-and-error screening of an immense number of drug candidates — is a task that is not based on known equations or formulas. While an engineer knows whether his machine will finally work, a vaccine hunter has no clear idea of how a certain vaccine will work until a human actually takes it.
This is how Donald R. Kirsch describes it in his inspiring book “The Drug Hunters”:
“There are still no clear scientific laws, technical principles or mathematical formulas that can guide a budding drug hunter from idea to product. Although there have been a number of advances that make various components of the drug hunt process more efficient, such as receptor theory, rational design, recombinant DNA technology, pharmacokinetic tests (which evaluate how a drug is processed by the body from ingestion to excretion), modelling of transgenic animal diseases (genetic modification of an animal’s DNA to mimic an aspect of a human disease so that the drug can be tested on animals rather than humans), high-throughput screening (the ability to rapidly evaluate thousands of compounds) and combinatorial chemistry (the ability to generate thousands or even millions of different chemical compounds in a single process for use in testing) — this is more akin to complicated cinema technology -IMAX projectors, surround sound and enhanced vision than a blueprint for drug development.”
The formal history of vaccination from a scientific point of view traditionally dates back to Edward Jenner’s groundbreaking experiments with cowpox in 1796, although it would take almost a century for the practice to get its name, an honor bestowed on Jenner posthumously by his most famous scientific advocate, Louis Pasteur.
Legend has it that Mithridates VI, King of Pontus at Black Sea in Asia Minor, consumed sublethal doses of poison daily for decades in order to build up his tolerance to such substances. Although this behavior was probably motivated by a suspicion of his imminent assassination bordering on paranoia, it may have been justified; his mother killed his brothers and possibly murdered her father, King Mithridates V, in their attempt to seize the throne. It did not help that he was also a terrible enemy and therefore a target of Roman Empire. But the strategy may have worked; when he was finally defeated by Pompey and “wanted to die by poison, he was not able to”, most likely because of the acquired resistance Mithridates’ preparation of plant oils and resins became later the basis for the universal antidotes Mithridatium and Theriac .
Throughout history, various other forms of vaccination have been practiced. In the seventh century Buddhists in India are said to have ingested snake venom to protect themselves from its deadly effects. In 16th-century China, at least four methods of variation were probably in use: healthy children were given cotton soaked with either pus or scab from lesions in their nostrils; powdered scab was blown into the nostrils with a thin silver tube; and healthy children were clothed in clothing worn by those infected with smallpox. In the middle of a measles epidemic in Edinburgh in 1758, the Scottish doctor Francis Home tried to vaccinate healthy people with skin lesion material from infected people. Using a mixture of blood and infected skin, he inoculated a small group of children, resulting in a clinically debilitated disease and protection from wild type measles.
We currently use about 30 vaccines against human infectious diseases. Their effect is well documented worldwide, but most clearly in developed countries, where many of these infections have become experiences from the distant past.
Where Are We Now?
So where do we stand after 10 months? What is new in the desperate game of vaccine hunters?
-The 2 vaccines from Sinopharm: Recently it was announced that the UAE has begun emergency approval of a vaccine from Sinopharm. No results have been published yet.
-The third vaccine from China, Sinovac Coronavac, is expected to be ready by the end of September. No results have been published yet.
These vaccines were approved for emergency use in China together with the CanSino vaccines. Coronavac, for example, is said to have been administered to 24,000 people in China with very rare side effects. The 2 Sinopharm vaccines are said to have been used by hundreds of thousands of people.
China Vaccine Regulators have announced that they will be 50% effective, but prefer at least 70% (standards that meet the US and European standards).
-For the BNT/Pfizer vaccine from Germany and the NIH/Moderna vaccine from the USA, a final efficacy evaluation is expected to be completed by the end of October.
-For the Vaccines Oxford and AstraZeneca, the III phase was relaunched (in the UK and Brazil, but not at the other three geographic locations). It is estimated that 47,000 people will participate and it is reported that 18,000 volunteers have already received the vaccine. A lot of scientific anxiety is happening here, because two volunteers had serious neurological problems.
-Finally there is Sputnik 5, the Russian vaccine. But the protocol is missing a lot of things to be secure.
The questions of the experts are decisive:
Many public health experts and scientists disagree with emergency vaccination licenses, regardless of the country or authority issuing them.
If we remain sympathetic and believe that there are no political implications behind the approval of a drug or vaccine, why do we need an emergency license?
But what will the process of collecting additional efficiency data look like after its publication? Will randomized trials be continued in populations not covered by the license?
How will such a license affect other vaccines that are in development and may be better? And how will this vaccine license affect the collection of additional data needed to support the broader use of a vaccine? Care must be taken not to fall into a state of inactivity where testing is impossible but data is insufficient.
When it comes to pandemic management and in particular the issue of vaccines, everything must be subject to transparent control, and everything is a question of balance and risk management. A vaccine with low effectiveness and therefore low uptake will not provide sufficient protection for a community. However, even if the effectiveness is not optimal and the side effects are high, this is a problem, even for a vaccine that “works”.
If the efficacy is high, then the short-term symptoms are tolerable as an individual side effect.
The Two Mantras Of The Vaccine Hunters
It is clear now why It is a strange and unpredictable race. Similar to a poker game .The vaccine hunters have a lot of scientific methods and skills to win the game in their favor, but they are always at the mercy of the shuffler of the cards.
Now we need super speed and consistency at the same time.
Usain Bolt, is widely regarded as the greatest sprinter of all time. His achievements as a sprinter have earned him the nickname “Lightning Bolt”.
There are better starters than me, but I am a stronger finisher used to say.
Eliud Kipchoge, the most decorated marathon runner in the world, is a man of immense self-discipline. At 5:00 a.m., he rolls out of bed for his morning run. He divides his time between his home in Eldoret, Kenya, where he lives with his wife and three children, and a training camp up in the hills, 8,000 feet above sea level, where he shares tasks with his teammates.
Kipchoge is the long distance running version of Usain Bolt.
He once wrote down a formula:
Motivation + Discipline = Consistency
These are the ruling mantras of the vaccine hunters also.