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When a new pathogen emerges,
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our bodies and healthcare systems
are left vulnerable.
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In times like these,
there’s an urgent need
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for a vaccine to create widespread
immunity with minimal loss of life.
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So how quickly can we develop vaccines
when we need them most?
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Vaccine development can generally be
split into three phases.
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In exploratory research, scientists
experiment with different approaches
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to find safe and replicable
vaccine designs.
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Once these are vetted in the lab,
they enter clinical testing,
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where vaccines are evaluated
for safety, efficacy,
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and side effects across a variety
of populations.
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Finally, there’s manufacturing,
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where vaccines are produced
and distributed for public use.
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Under regular circumstances, this process
takes an average of 15 to 20 years.
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But during a pandemic, researchers
employ numerous strategies
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to move through each stage
as quickly as possible.
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Exploratory research is perhaps the
most flexible.
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The goal of this stage is
to find a safe way
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to introduce our immune system
to the virus or bacteria.
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This gives our body the information it
needs to create antibodies
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capable of fighting a real infection.
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There are many ways to safely trigger
this immune response,
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but generally, the most effective
designs are also the slowest to produce.
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Traditional attenuated vaccines create
long lasting resilience.
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But they rely on weakened viral strains
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that must be cultivated in non-human
tissue over long periods of time.
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Inactivated vaccines take a much
faster approach, directly applying heat,
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acid, or radiation to weaken the pathogen.
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Sub-unit vaccines, that inject harmless
fragments of viral proteins,
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can also be created quickly.
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But these faster techniques produce
less robust resilience.
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These are just three of many vaccine
designs,
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each with their own pros and cons.
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No single approach is guaranteed to work,
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and all of them require
time-consuming research.
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So the best way to speed things up is for
many labs
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to work on different models
simultaneously.
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This race-to-the-finish strategy
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produced the first testable
Zika vaccine in 7 months,
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and the first testable COVID-19 vaccine
in just 42 days.
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Being testable doesn’t mean these
vaccines will be successful.
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But models that are deemed safe
and easily replicable
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can move into clinical testing while other
labs continue exploring alternatives.
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Whether a testable vaccine is produced
in four months or four years,
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the next stage is often the longest and
most unpredictable stage of development.
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Clinical testing consists of three phases,
each containing multiple trials.
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Phase I trials focus on the intensity of
the triggered immune response,
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and try to establish that the vaccine
is safe and effective.
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Phase II trails focus on determining
the right dosage and delivery schedule
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across a wider population.
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And Phase III trials determine safety
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across the vaccine’s primary
use population,
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while also identifying rare side effects
and negative reactions.
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Given the number of variables and
the focus on long-term safety,
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it’s incredibly difficult to speed up
clinical testing.
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In extreme circumstances, researchers
run multiple trials
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within one phase at the same time.
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But they still need to meet strict
safety criteria before moving on.
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Occasionally, labs can expedite this
process by leveraging
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previously approved treatments.
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In 2009, researchers adapted the seasonal
flu vaccine to treat H1N1 –
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producing a widely available vaccine
in just six months.
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However, this technique only works
when dealing with familiar pathogens
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that have well-established
vaccine designs.
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After a successful Phase III trial,
a national regulatory authority
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reviews the results and approves
safe vaccines for manufacturing.
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Every vaccine has a unique blend
of biological and chemical components
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that require a specialized pipeline
to produce.
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To start production as soon as the
vaccine is approved,
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manufacturing plans must be designed
in parallel to research and testing.
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This requires constant coordination
between labs and manufacturers,
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as well as the resources to adapt
to sudden changes in vaccine design –
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even if that means scrapping
months of work.
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Over time, advances in exploratory
research and manufacturing
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should make this process faster.
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Preliminary studies suggest that future
researchers
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may be able to swap genetic material
from different viruses
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into the same vaccine design.
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These DNA and mRNA based vaccines
could dramatically expedite
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all three stages of vaccine production.
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But until such breakthroughs arrive,
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our best strategy is for labs around the
work to cooperate and work in parallel
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on different approaches.
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By sharing knowledge and resources,
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scientists can divide and
conquer any pathogen.