A vaccine for Covid sounds like the title of a Hallmark romance movie. A science fiction movie might be more appropriate.
The virus has been with us for half a year, and it is spreading around the world, disrupting life as we knew it pre-Covid. Control is limited to simple and basic public health. We need a therapeutic agent and a vaccine if we are to halt this scourge. What does history tell us about the possibilities of a pharmacological solution? It is not encouraging.
Smallpox has ravaged mankind since the dawn of history. There is evidence of the disease in Egyptian mummies dating to 300 BC. Chinese physicians began vaccination efforts 500 years ago and the practice spread to Europe.
Cotton Mather started a program of variolation in Boston in 1721. The practice worked but the anti-vaxers were livid. George Washington used the technique in treating the Continental Army in 1777 and saved the troops from the disease. William Jenner, in 1796, proposed using cowpox for vaccination and it became the treatment of choice around the world.
In 1980, the WHO declared Smallpox eradicated, one of the only disease entities to be eliminated. That was 200 years after George Washington saved his army. It took time.
Polio was the disease my parents worried about during my childhood. In 1932, we elected a president who was crippled by Polio. FDR began the March of Dimes to develop treatment including a vaccine. In 1955, the Salk vaccine was declared safe and effective, and President Eisenhower embraced a massive and rapid program of vaccination.
Unfortunately, one of the companies given the production license made a terrible error and that led to a small epidemic of the disease we were trying to prevent. Safety in the development, production and distribution of a vaccine is critical.
Developing a vaccine at “Warp Speed” sounds good, but history tells us, that biology moves at the speed of biology. No matter how you try to speed biology up, it still takes nine months to have a baby.
So where are we now, some six months into this pandemic? There are some 200 labs, around the world working on a vaccine. Early trials are being conducted and some results are encouraging.
We need to understand the effectiveness and the safety of the vaccine and we need to plan on how to produce and distribute the vaccine to the 330 million Americans and the 8 billion souls on this planet.
We will not have a vaccine that satisfies these criteria in 2020, and perhaps not in 2021. We will, eventually, learn to co-exist with this virus as we have with other pathogens such as tuberculosis, flu and measles. In the meantime, social distancing, masks and hand-washing are the best we can do.
Leonard Kirschner MD, MPH
Editor’s note: Mr. Kirschner served as commander of the hospital at Luke Air Force Base from 1983-85 and AHCCCS director from 1987-93. He also is past president of AARP Arizona.