Shirley de Villiers FM features editor & columnist
A health worker injects a person during clinical trials for a Covid-19 vaccine at Research Centers of America in Hollywood, Florida. Picture: Eva Marie Uzcategui/Bloomberg
A health worker injects a person during clinical trials for a Covid-19 vaccine at Research Centers of America in Hollywood, Florida. Picture: Eva Marie Uzcategui/Bloomberg

US President Donald Trump has never been one to let the truth get in the way of his personal ambition. So, faced with the very real risk of being a one-term president, it’s unsurprising that he’d try pin his political salvation on a coronavirus vaccine — or, at least, on the promise of one.

“You could have a very big surprise coming up ... The people of the world will be happy,” Trump told journalists on Monday. “We’re going to have a vaccine very soon, maybe even before a very special date. You know what date I’m talking about.”

It’s not the first time he’s raised hopes that a vaccine will be rolled out before the November 3 election either. On Friday, he reportedly said a vaccine could be ready “maybe even before November 1” or “sometime in the month of October”. And the Centers for Disease Control (CDC) informed state authorities last week that they should be ready to distribute a vaccine by November 1.

Only, it’s probably all wishful thinking.

As Dhruv Khullar notes in the New Yorker, Larry Corey, who is co-ordinating clinical trials for federally-backed vaccines, puts the timeline at about seven months from July – so February next year. Optimistically, it could be December.

Moncef Slaoui, head of the improbably named “Operation Warp Speed” vaccine programme, says there’s a “very, very low chance” of approval before election day.

And, of nine companies rushing to roll out a vaccine in the US, only Pfizer has suggested it may have results from late-stage tests in October, Ed Silverman writes on health news site Stat. But even that is far from certain. And, needless to say, those results are still a substantial step behind distribution of any vaccine.

So it’s Shrodinger’s vaccine: at once ready to roll, and not.

It’s also vintage Trump: should a drug be ready ahead of the election, he’ll claim all the credit. If not, he’ll lay the blame at the feet of the regulatory authority. He’s already laid the groundwork for that: in yet another unhinged tweet last month, he accused the “deep state” Federal Drug Administration (FDA) of intentionally slowing vaccine approval until after the election.

It is, of course, cynical politicking, but it also raises the fear that political expediency is trumping public safety.

As Stat reports, a new poll by the Kaiser Family Foundation shows 62% of Americans believe the FDA will rush to approve a vaccine due to political pressure. This follows a survey by Stat and The Harris Poll last month, which found that 78% of Americans believe politics — not science — is driving the vaccine process.

It’s no wonder there’s disquiet about actually taking a vaccine — only 41% of people who responded to the Kaiser poll would get a free vaccine if it were approved before November.

Big Pharma’s pandemic pledge

On Tuesday, Big Pharma weighed in.

In an unprecedented move, nine vaccine-makers, pledged publicly that they would not seek regulatory approval without extensive data on safety and effectiveness.

It’s clear from Silverman’s article in Stat that this is about business: Big Pharma cannot afford to have its reputation impugned every time Trump takes to Twitter.

Besides, a vaccine will already be a hard sell to a population that’s distrustful of political influence in science.

Unfortunately, AstraZeneca didn’t display quite this same commitment to transparency when it announced the temporary suspension of its vaccine trial due to a “suspected adverse event”.

Detail on this “event” only really emerged after a private conference call between CEO Pascal Soriot and three investors on Wednesday.

As Stat reports here, a woman in the UK who had taken the vaccine, not the placebo, developed suspected transverse myelitis, a “serous spinal inflammatory disorder”. It also emerged, during that call, that this is the second time AstraZeneca has halted its vaccine trial (the first was due to an unrelated multiple sclerosis diagnosis).

It’s apparently not unusual to halt drug trials. And, as this article on the Conversation Australia website explains, it won’t reflect on the safety of the vaccine, if and when it’s approved.

If anything, voluntarily pressing pause shows AstraZeneca’s commitment to protocol. But it would be nice, given swirling misinformation around Covid and vaccines, to feel corporates are playing open cards, as Stat’s Silverman writes in this open letter to Soriot.

Beyond a vaccine

In any event, there’s likely going to be more to our Covid response than a vaccine.

As Khullar writes in the New Yorker, a “silver bullet” vaccine is unlikely.

First, there’s the fact that perfect vaccines — along the lines of the one for polio — are rare. Then you have to factor in distribution challenges — and whether sufficient people will take the vaccine to ensure herd immunity.

“Unless you have a perfect vaccine, which very few are, you’ll always have people who end up getting sick,” National Institute of Allergy & Infectious Diseases director Anthony Fauci tells Khullar. “We’re going to need other treatments.”

To that end, Khullar offers a fascinating view into the alternative treatments that are under development, and the progress being made. These include antivirals, to “build barriers against infection for at-risk people”; antibody treatments, “to prevent the newly infected from getting worse”; and immunomodulators — “interventions that target the sickest and give them a fighting chance”.

“By surrounding the virus in this way, we can make it less contagious and lethal, changing the character of the pandemic,” he writes.

It’s heartening to read, after months of overwhelming helplessness.

Of course, all these medical alternatives, once available to the market, still require public buy-in — which in turn requires a belief in the sometimes plodding but objective methodology of science.

That the White House is home to an inveterate liar who cosied up to anti-vaxxers to get elected — and who seems happy to prioritise politics over public safety to get re-elected — doesn’t bode well.

*De Villiers is the features editor of the FM​

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