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Protecting Ourselves from the Next Pandemic

This year’s coronavirus pandemic begins and ends with fear. In less than 90 days, more than 100,000 people on nearly every continent have been infected with a virus that previously was unknown, and several thousand have died. Though few facts comfort us right now, we can take solace in the knowledge that the most effective way to control this and future pandemics exist: 21st-century vaccines.

Vaccines, as we know them today, are insufficient. To protect against challenging infections like the new coronavirus, we need a significant shift in research and innovation. The COVID-19 pandemic may finally provide the motivation to build on and accelerate advancements in vaccinology that help us overcome current limitations.

One major advance in the design of modern vaccines has enabled scientists to harness a deeper knowledge of genetics and molecular biology to design vaccines that more closely mimic the way the body usually encounters and responds to viral infections. This new generation of vaccines is made from nucleic acids, the building blocks of genes, rather than from proteins. Indeed, the first vaccine that has been introduced to clinical trials against the current pandemic is a nucleic-acid vaccine.

Vaccinology research has also yielded a transformative portfolio of immune-boosting molecules known as “adjuvants” that increase the quality of the immune response. Adjuvants are used in vaccinations against hepatitis, whooping cough, tetanus, human papillomavirus, tuberculosis and malaria. More recently, a new class of adjuvants has successfully boosted the effectiveness of a vaccine against shingles (a recurrence of chickenpox) from 50 percent to 95 percent; others are showing great promise in HIV vaccines. Most relevant to our current pandemic, vaccines containing adjuvants can be protective even when genetic mutations render vaccines with no adjuvant useless. These vaccines are more potent, so we can administer smaller doses and immunize more people, and we can store them safely for years between pandemics.

Yet these crucial adjuvants are not being harnessed to create effective vaccines against the current coronavirus. The obvious question is why? First, the companies making the only approved vaccine adjuvants are having difficulty producing enough because they are sourced from limited natural products. Second, the current climate of vaccine safety skepticism prompts some to fear the addition of adjuvants to make vaccines more potent. Finally, there are too few adjuvants in the public domain that can be used to augment the effectiveness of new vaccines for pandemics.

President Trump has indicated that a vaccine against the current coronavirus is a high priority and could be available “relatively soon.” Whether that will be soon enough to protect vulnerable citizens from COVID-19 remains to be seen, but in the meantime, several steps should be taken immediately to address gaps in vaccine availability for the current and future potential pandemics:

Invest in research and development. We can use this pandemic as motivation to fund initiatives that help us understand the optimal design, selection and production of modern vaccine adjuvants for pandemic infections. A concerted effort at investigating and creating new vaccines will lead to a faster and more effective response to future outbreaks. Similarly, nucleic-acid vaccines are showing enormous potential and need to be tested and deployed widely. We also need to invest in and facilitate the testing, monitoring and analysis of adjuvanted-vaccine safety.

Create strategic stockpiles. Adjuvants that have been proven safe and can be produced cheaply, rapidly and in large quantities from widely available synthetic materials exist today. Unfortunately, they are not widely used nor stored in sufficient quantity in our nation’s warehouses. We must create a stockpile to allow these lifesaving compounds to be ready for this and all future pandemics.

Reduce barriers to innovations in modern vaccines. The fear of vaccine side effects has dramatically hindered the ability to develop new vaccines. We must develop tools to disseminate knowledge learned about safety and side effects widely to the public. Overcoming our fears of the coronavirus pandemic is vital to stimulating the development of a secure, flexible, rapidly deployable and affordable vaccine portfolio to address the current epidemic.

We know that with infectious diseases, history inevitably repeats itself. Let’s not make the same mistakes of the past by missing this opportunity to assure more stability and security for future pandemics with 21st-century vaccines.

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