The coronavirus vaccines have shattered expectations

The vaccines represent a “stunning scientific achievement for the world … unprecedented in the history of vaccinology,” said Dan Barouch, an expert on virology and vaccines at Harvard, who worked on the Johnson & Johnson vaccine.

Details: Developing a vaccine takes an average of 10 years — if it works at all. Despite years of well-funded research, there are still no vaccines for HIV or malaria, for example.

• We now have multiple COVID-19 vaccines, all developed in less than a year.
• The Pfizer and Moderna vaccines are the world’s first successful mRNA vaccines — which, to oversimplify it, teach our bodies to generate an immune response without relying on weakened or inactivated viruses. It's a milestone that scientists have been working toward for 30 years.
• Moderna’s vaccine is the company’s first licensed product of any kind.

Most importantly, all the leading vaccines work extremely well.

• All four vaccines or vaccine candidates in the U.S. — from Pfizer, Moderna, AstraZeneca and Johnson & Johnson — appear to prevent coronavirus deaths, and to offer total or near-total protection against serious illness.
• Some of the vaccines are more effective than others at preventing mild or asymptomatic infections, but all of them significantly exceed the FDA’s threshold to be considered effective.

The catch: South Africa on Sunday halted distribution of the AstraZeneca vaccine because it appeared not to work against the dangerous variant discovered there — which is spreading across the world.

• The other vaccine makers have also said their products aren't as effective against the South African variant.

But that's a reason for the rest of the world to lean into the existing vaccines, not to be wary of them.

• Viruses can mutate when they spread widely. The best defense against widespread variants is to vaccinate as many people as possible and step up social distancing to contain the virus.
• Drugmakers may need to develop booster shots or new recipes to deal with variants, but waiting for a vaccine that addresses every variant will only leave the door open for more variants.

Our biggest problems are not with the vaccines, but rather the processes that surround them.

• Supplies need to increase; distribution needs to become far more efficient; we need to ensure that people get their second shots, when applicable; and people need to be willing to get vaccinated once they’re eligible.
• That’s a long and difficult to-do list, and getting those things wrong could drag the pandemic out for years. But if we can get the process right, the vaccines themselves are powerful enough to do the job.

“Once the history of this is written, they are going to be referred to as some of the greatest achievements of science,” Zeynep Tufekci, a University of North Carolina sociologist with a track record of prescience on the coronavirus, told The New York Times’ Ezra Klein.

• “It’s the kind of thing you would have national celebration and fireworks and church bells ringing and all of that,” she said.

This wasn’t a miracle, and it didn’t happen overnight. “What we’ve seen over the last year is the result and culmination of decades of scientific advances,” Barouch said.

• Researchers have been building toward mRNA-based vaccines for roughly 30 years, fueled by broader advances in genetic science.
• Those same advances have also greatly accelerated genetic sequencing — which is why researchers were able to map out COVID-19’s structure within weeks of discovering the virus, and to then begin working on potential vaccines.

What’s next: The vaccine race is one of the few areas of this entire pandemic where the U.S. and the world will be able to learn from our successes, rather than our failures.

• The breakthrough of successful mRNA vaccines will, scientists hope, pave the way for a new generation of products that are more effective and easier to develop than previous vaccines.
• Shoveling money at vaccine developers and establishing early, step-by-step communication with regulatory agencies also helped accelerate this process, and can help again in future pandemics.

The bottom line: “Good funding, great science and great collaboration with the regulatory agencies — that’s how they were able to do something that I didn’t think could be done in a year,” said Mark Slifka, an immunology professor at Oregon Health & Science University.