I’m a virologist & investor... & I’m hearing people say it’s impossible to make covid vaccine b/c we haven’t been able to make one to any coronaviruses. Not true. We have veterinary vaccines for dog & cow strains. Human one’s not been investment worthy, until now. here’s why...
There are 4 coronavirus strains that circulate amongst humans causing nothing more than mild colds in most people. They stimulate a modest immune response- enough to get over an infection and leave you protected for about a year, maybe more. But eventually antibodies wane...
And that’s when you become susceptible to reinfection by same virus. So why haven’t we developed a vaccine against these 4 coronavirus strains? We could take it every year and protect ourselves against colds, right? That’s a nice idea but most colds are caused by other viruses...
Our four standard human coronaviruses only cause 20% of colds. Colds are mostly caused by rhinoviruses, RSV, parainfluenza virus (not same as influenza), and other viruses we haven’t even identified yet. They are all so different that each would require a different vaccine.
So while we could have made a coronavirus vaccine (which really would have had to be four vaccines, one for each strain), the trouble is that it would have only helped protect you against 20% of the viruses that cause colds.
It would be difficult and expensive to run a clinical trial that showed that the coronavirus vaccine worked because even if it reduced your risk of suffering a coronavirus-mediated cold by 75%, that would cut the risk of any cold by only 15% (75% of 20%).
It would be a large trial so that this 15% reduction would be statistically significant. But it’s doable. Bigger problem is the marketing message of 15%. Adults get 2-4 colds a year, so a 15% reduction doesn’t even add up to 1 fewer cold per year. Not very compelling, right?
The commercial product people want is not a coronavirus common cold vaccine. They want a COMMON COLD vaccine that protects them against most of their risk. For that, vaccine would have to protect against most cold viruses (and we don’t even know what causes 30% of colds).
And some viruses require vaccines to have multiple components (antigens) to be effective. All these components would require their own development and optimization. We’re not talking about inventing one product...
we’re talking about inventing over a dozen, each of which would be useless along but all of which would be needed just to get what may be a commercially viable product people would MAYBE want to take. Why do I say maybe?
Because 1) it’s just a cold, 2) your insurance would probably make you pay a copay to nudge you into not taking it, 3) people have needles, and here’s the clincher...
Anti-vaxxers would tell you that it causes horrors. Some people would get diagnosed with, let’s say, MS or cancer a few days after they got the vaccine simply because that happens to some people by chance at random... it’s a coincidence but anti-vaxxers would blame the vaccine.
It won’t be true and data will show its not true, but that won’t matter, because many people will think “why risk it, I’ll get over a cold”. Investors look at all this and see a multi-billion dollar sinkhole of risk that will probably be as unrewarding as...
as the Lyme vaccine GSK developed, launched, & pulled off the market after a few years for same reasons I just listed. (And we really need a Lyme vaccine b/c ticks are spreading & carry a host of horrors. But that’s a slower, quieter pandemic we can talk about another time.)
But Covid is different. It’s serious, more so than the flu. So we’ll develop a vaccine for it just as we have for the flu and dog/cow coronaviruses. It might cost a few billion dollars across a dozen different programs, but there will be a market.
Just as Sanofi, GSK, & several others companies compete on price & still make billions each year supplying the world with a constantly evolving yet affordable flu vaccine (usually $10-20), similarly industry can develop & supply world w/ a covid vaccine.
Maybe even mix it w/ annual flu shot for convenience. — By the way, I’ve heard people say that industry doesn’t even care to make a universal flu vaccine. That’s also not true. There have long been efforts and investors willing to fund credible projects, but this is really hard.
Despite decades of failure, there are still biotech companies toiling on a universal flu vaccine (would protect us against most strains w/ one shot every 5-10 years). It’s hard, yet I think doable. By comparison, covid is simple. It definitely ain’t herpes (simplex is misnomer).
Covid is so technically doable we already have vaccines for dog & cow coronaviruses. We’ll definitely make one for covid, trials will be simple since we’ll be specifically trying to prevent Covid, which is only caused by SARS-CoV-2 (not by dozen different viruses), and...
insurance will pay for it just as it pays for the flu vaccine, in many cases without a copay. For those without insurance (shame on us, America!), there are free flu shot clinics. Google “free flu shot near me”. Similarly, there will be affordable covid vaccines for everyone...
because this is a serious public health problem. America can be heartless in its poor coverage of many medicines, eg insulin (I wrote a book about drug affordability and how to fix our system) but America is pretty good about making vaccines affordable.
Btw, if you’re interested in learning more about the drug industry, why medicines aren’t affordable for some, & what we need to change to make innovation work for all, then do read my book. You’ll never see healthcare the same. thegreatamericandrugdeal.com
I’ll leave you with following insight from flu & what it means for covid vaccine development. Vaccine is like a mugshot of criminal you show to police so they know who to look out for. As we get older, our immune systems become weaker & vaccines don’t work as well.
You show our immune systems the mugshot, &’it doesn’t react very strongly. Biotech industry is working on vaccines that compensate, essentially illuminating better mugshots so more immune cells notice them. We’ll need that advanced technology for covid since it’s hell on elderly.
Until then, we’ll need younger people to get vaccinated to provide herd immunity for older folks. It’s a travesty that 10k-60k/year die of flu (mostly old folks) & more hospitalized b/c the young don’t think they need vaccine for themselves. Vaccinate for others if not yourself!
I should add that when I say “investors” have been hesitant to invest in common cold vaccine, I don’t mean just billionaires. I mean people who manage money on behalf of pension funds, endowments; eg ordinary Americans rely on mutual funds not to make unprofitable investments.
It would be wrong for fund managers to fund development of drug they know will be a commercial flop b/c America isn’t willing to pay for it. You can donate to such a cause, & gov can fund it w/taxes (eg Barda) but investment professionals can’t waste people’s savings on it.
That’s key reason we don’t have more antibiotics. Current ones work so well there is only a small (terrifying though) need for new ones, & hospitals resist paying high price for the few patients who need them. Small market, small incentive, little investment, few new antibiotics.
Since I wrote this tweet, I sent another tweet thread out on the topics with link to article I wrote:
