The Economist - USA (2020-11-13)

Leaders 11

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inelongyearselapsedbetweentheisolationofthemeasles

virus in 1954 and the licensing of a vaccine. The world waited

for 20 years between early trials of a polio vaccine and the first

American licence in 1955. Marvel, then, at how the world’s scien-

tists are on course to produce a working vaccine against sars-

cov-2, the virus that causes covid-19, within a single year.

And not just any vaccine. The early data from a final-stage

trial unveiled this week by Pfizer and BioNTech, two pharma

companies, suggests that vaccination cuts your chances of suf-

fering symptoms by more than 90%. That is almost as good as for

measles and better than the flu jab, with an efficacy of just

40-60% (see Briefing). Suddenly, in a dark winter, there is hope.

Not surprisingly, Pfizer’s news on November 9th roused the

markets’ bulls. Investors dumped shares in Clorox, Peloton and

tech firms, which have all benefited from the coronavirus, and

instead switched into firms like Disney, Carnival and Interna-

tional Consolidated Airlines Group, which will do well when the

sun shines again (see Finance section). The oecd, a club of main-

ly rich countries, reckons that global growth in 2021 with an early

vaccine will be 7%, two percentage points higher than without.

There is indeed much to celebrate. Pfizer’s result suggests that

other vaccines will work, too. Over 320 are in development, sev-

eral in advanced trials. Most, like Pfizer’s, focus on the spike pro-

tein with which sars-cov-2 gains entry to cells.

If one vaccine has used this strategy to stimulate

immunity, others probably can, too.

Pfizer’s vaccine is also the first using a pro-

mising new technology. Many vaccines prime

the immune system by introducing inert frag-

ments of viral protein. This one gets the body to

make the viral protein itself by inserting genetic

instructions contained in a form of rna. Be-

cause you can edit rna, the vaccine can be tweaked should the

spike protein mutate, as it may have recently in mink. This plat-

form can be used with other viruses and other diseases, possibly

including cancer, BioNTech’s original focus.

So celebrate how far biology has come and how fruitfully it

can manipulate biochemical machinery for the good of human-

ity (there will be time later to worry about how that power might

also be abused). And celebrate the potency of science as a global

endeavour. Drawing on contributions from across the world, a

small German firm founded by first-generation Turkish immi-

grants has successfully worked with an American multinational

company headed by a Greek chief executive.

Yet despite the good news, two big questions stand out, about

the characteristics of the vaccine and how fast it can be distri-

buted. These are early results, based on 94 symptomatic cases of

covid-19 from among the 44,000 volunteers. Further answers

must wait until the trial has gathered more data. It is, therefore,

not clear whether the vaccine stops severe cases or mild ones, or

whether it protects the elderly, whose immune systems are

weaker. Nor is it known whether inoculated people can still

cause potentially fatal infections in those yet to receive jabs. And

it is too soon to be sure how long the beneficial effects will last.

Clarity will take time. In the next few weeks the trial should be

declaredsafe,thoughfurthermonitoringofthevaccinewillbe

needed. The companies predict that immunity will last for at

least a year. The 90%-plus efficacy is so high that this vaccine

may offer at least some protection to all age groups.

While the world waits for data, it will have to grapple with dis-

tribution. Vaccine will be in short supply for most of next year.

Although rnajabs may prove easier to make at scale than those

based on proteins, Pfizer’s requires two doses. The company has

said that it will be able to produce up to 50m doses in 2020 and

1.3bn next year. That sounds a lot, but America alone has over

20m first responders, medical staff, care-home workers and ac-

tive-duty troops. Perhaps a fifth of the world’s 7.8bn people, in-

cluding two-thirds of those over 70, risk severe covid-19. Nobody

has ever tried to vaccinate an entire planet at once. As the effort

mounts, syringes, medical glass and staff could run short.

Worse, Pfizer’s shots need to be stored at temperatures of

-70°C or even colder, far beyond the scope of your local chemist.

The company is building an ultra-cold chain, but the logistics

will still be hard. The vaccine comes in batches of at least 975

doses, so you need to assemble that many people for their first

shot, and the same crowd again 21 days later for a booster. No-

body knows how many doses will be wasted.

So long as there is too little vaccine to go around, priorities

must be set by governments. A lot depends on

them getting it right, within countries and be-

tween them. Modelling suggests that if 50 rich

countries were to administer 2bn doses of a vac-

cine that is 80% effective, they would prevent a

third of deaths globally; if the vaccine were sup-

plied according to rich and poor countries’ pop-

ulation, that share would almost double. The

details will depend on the vaccine. Poor coun-

tries may find ultra-cold chains too costly.

The domestic answer to these problems is national commit-

tees to allocate vaccine optimally. The global answer is covax, an

initiative to encourage countries’ equal access to supplies. Ulti-

mately, though, the solution will be continued work on more

vaccines. Some might survive in commercial refrigerators, oth-

ers will work better on the elderly, still others might confer lon-

ger protection, require a single shot, or stop infections as well as

symptoms. All those that work will help increase supply.

Only when there is enough to go around will anti-vaxxers be-

come an obstacle. Early reports suggest the jab causes fevers and

aches, which may also put some people off. The good news is that

an efficacy of 90% makes vaccination more attractive.

The tunnel ahead

The next few months will be hard. Global recorded death rates

have surged past their April peak. Governments will struggle

with the logistics of vaccination. America is rich and it has

world-class medicine. But it risks falling short because the virus

is raging there and because the transition between administra-

tions could lead to needless chaos and delays. Squandering lives

when a vaccine is at hand would be especially cruel. Science has

done its bit to see off the virus. Now comes the test for society. 7

Suddenly, hope

Scientists have managed to create a vaccine for covid-19. Getting enough people vaccinated will be even harder

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