Philly vaccine pioneer: We can’t rush a coronavirus vaccine | Q&A
At a White House news conference Tuesday, Anthony Fauci, the head of the
National Institute of Allergy and Infectious Disease, told President Donald
Trump a coronavirus vaccine would likely not be available within the next year
or two. Trump responded: “I like the sound of a couple of months better.”
But a vaccine is not going to be available in the next couple of months, and
according to Dr. Paul Offit, that’s appropriate. Offit, director of the Vaccine
Education Center at Children’s Hospital of Philadelphia, is the co-developer of
the rotavirus vaccine. It took roughly 26 years to perfect that protection
against a disease that, according to the Centers for Disease Control and
Prevention, was the leading cause for severe diarrhea in children before the
vaccine’s introduction in 2006.
Why is it unrealistic to expect a vaccine for coronavirus in a few months?
Nobody’s ever seen this virus before. Therefore, if you’re interested in making
a vaccine, you first had access to that virus only a couple months ago. That’s
not long.
[To make a vaccine] you first need to make a decision as to what approach you
want to take. Then you have to do extensive animal model testing to make sure
that the approach that you’ve taken is safe in animals, and that it induces an
immune response which would likely be protective. Then you gradually do studies
in people to make sure it’s safe, and then to make sure that it induces an
immune response. That takes time, a lot of time, typically years. Then and only
then, are you ready to put it into people to see whether or not it works in an
outbreak situation.
In 2018, after the World Health Organization declared an Ebola outbreak in the
Democratic Republic of Congo, there was an experimental vaccine very quickly.
I think people got fooled by Ebola. When the outbreak occurred in West Africa
and we had a vaccine pretty much that rolled off shelf within weeks, people
thought, Ha! That’s easy.
But what they didn’t realize is people have been working on an Ebola vaccine
for 20 years. They’ve done the animal model testing. They’ve done the testing
to make sure that the vaccine was safe and was immunogenic.
But that’s not true here. This is a new virus. So we’re starting from scratch.
What is it about this virus that makes people confident that a vaccine will be
available?
I don’t know. You know, I’d say about 15% to 20% of the respiratory infections
that we see in our hospital in the winter months are [types of] coronavirus.
This is a virus that has been around for 50 years.
But here are these three newer strains of coronavirus — MERS, SARS, and now
this COVID-19. The first two viruses, SARS and MERS, have come and gone.
I think this [COVID-19] virus likely will come back because it’s different. If
you were infected with SARS or MERS viruses, you were sick. And it’s very easy
to tell who was sick and who wasn’t. You could then quarantine those people —
put a moat around them, if you will — so that they wouldn’t infect others. So
those infections quickly died out. This virus is more like flu. It spreads in a
similar manner to flu by respiratory droplet. It’s about as contagious as flu.
It has the same set of symptoms as flu. And I think in the end, frankly, it’s
going to have the same mortality rate as flu.
There are certainly human studies showing that if you’re infected with a
coronavirus — meaning one of the typical coronaviruses — you can have immunity
to that strain for at least a year and probably longer. That’s encouraging. If
natural infection can protect you, then it’s encouraging that it can produce an
immune response which is protective and which you should be able to mimic with
vaccination.
Vaccine development is tightly regulated. How much of that is about safety vs.
red tape?
If you’re going to be testing this in otherwise healthy people who are very,
very unlikely to die from this infection, you better make sure it’s safe. So
you want those regulations in place.
An example is the dengue vaccine. When it was tested in Latin America and
Philippines, it was found to actually increase your risk of dengue shock
syndrome. Children who were less than 9 years of age, who had never been
exposed to the virus before, were actually more likely to be hurt by the
vaccine than helped by it. Now, you only knew that from doing large clinical
trials with tens of thousands of people.
The history of medical breakthroughs is littered with tragedy. You want to make
sure that things are safe.
What do you think is behind the apparent willingness to skirt the rules to rush
a vaccine?
I think that because we falsely overrate, or incorrectly rate, what the
mortality rate is, we’re willing to accept that things will be rushed through.
In fact, coronavirus doesn’t have a high mortality rate.
There’s a virus that the CDC currently estimated has killed between 20,000 and
45,000 people in the United States -- influenza. But only half the country gets
that vaccine.
There’s only 14 deaths [in the U.S., as of Friday afternoon] from COVID-19, but
everybody would get a vaccine now.
The point being: We’re not very good at assessing risk.
https://www.inquirer.com/health/coronavirus/coronavirus-covid-19-vaccine-trump-paul-offit-20200306.html
Gerry
........................................................................
_______________________________________
http://www.okiebenz.com
To search list archives http://www.okiebenz.com/archive/
To Unsubscribe or change delivery options go to:
http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com
