By now a dozen vaccine candidates have been dropped, five appear to offer minimal protection, and the rest are still in too early a stage of testing to tell. Regardless of how they ultimately turn out, it’s looking less and less likely that a vaccine will be ready by the end of 2021.
To add to the frustration, COVID-19 maintains a tenacious grip on the United States. While countries like Germany, France, Japan, and New Zealand have successfully suppressed the pandemic and gotten back to life as usual, in the U.S. outbreaks keep popping up, getting beaten back, and popping up somewhere else. Amazingly, it’s still hard to get enough testing kits and even PPE.
Rosa and the rest of her team start a new trial, this time with a combination of vaccines: their own inactivated vaccine and another candidate that also proved only weakly effective in trials. This one is a so-called “viral vector” vaccine that implants spike-protein mRNA into a virus that normally infects chimpanzees. The chimp virus can’t replicate in humans, but it gets the mRNA into the human cells, where it can be translated into spike protein. When registration begins for Phase III volunteers, Rosa adds her name to the list.
June 2021: Breakthrough
A particularly severe wave of the pandemic swells and retreats, leaving the U.S. death toll at north of half a million. The shared trauma has not unified Americans behind the science that could save them, but fractured it. As she’s arriving at work one morning, Rosa finds a picket line of shouting, unmasked protesters. One carries a sign that reads: “Vaccine = Mind Pollution.” Rosa has no idea what that’s supposed to mean. As she pushes through, one of the protesters screams, “Bill Gates lies!” and deliberately coughs on her.
Her mask filters out two-thirds of the virus-laden particles, but thousands get through and settle inside her mouth and throat. That evening the first generation of infected cells is bursting, seeding millions of virions up and down her respiratory tract. The next morning, she wakes up feeling meh. She checks her temperature: 99 degrees. Not enough to stay home from work. Only weeks later, when she goes to have her blood drawn as part of the trial, will she learn that her inoculation helped her beat a case of COVID-19.
Rosa’s case isn’t statistically significant. But taken together with what is happening to the hundreds of other volunteers, it is a point in a compelling picture. Taken in combination, these two vaccines work.
A series of conference calls between CEPI, WHO officials, and government regulators turns into a flurry of Zoom meetings and group chats with pharmaceutical companies, manufacturers, logistics specialists, and NGOs. With growing excitement, the community realizes that a consensus has emerged. The time has come.
The groundwork has been well laid out. For months factories filled with giant tanks of growth medium, the solution used to grow microorganisms, have been running flat out. The regulatory playbook has been torn up and patched back together a third of the time. Officials have reviewed the study data, checked plant blueprints, assessed production standards. The chance that things could go terribly wrong is much higher than normally would be deemed acceptable. But the upside is too huge to pass up.
Calls go out. The next morning, Rosa is standing in Times Square when the alert scrolls across the news crawl:
EFFECTIVE NEW COVID-19 VACCINE APPROVED WORLDWIDE.
Although hundreds of millions of doses have already been manufactured in anticipation of this moment and stockpiled around the globe, that still only covers a tiny fraction of those who need to be protected. So it will be administered in tranches: first to front-line health care workers, then the elderly and ill, then essential-industry workers, then children, then adults with compromising medical conditions, and finally healthy adults.