When Money is No Object

When Money is No Object

By Debra Johnston, M.D.
 
I’ve been spending a lot of time talking with patients about the COVID-19 vaccine. Sometimes we celebrate being fully vaccinated. Some patients are skeptical about how serious COVID-19 infections actually were. And others are not convinced they can trust the vaccine.
 
When I talk to the first group, we chat about our plans to reunite with people and activities we love. With the second group, I share stories of my firsthand experiences as a doctor during this crisis. We talk about interpreting death rates, how death certificates are filled out, or how health care is reimbursed.
 
I particularly enjoy the conversations with the third group, many of whom share some of the same questions I had. I did not believe, at the beginning of the pandemic, we could possibly have a vaccine by the end of 2020. How could a vaccine for a brand-new disease be developed so quickly?
 
There are two lessons beautifully illustrated by the lightning-fast development of the COVID-19 vaccines. The first is what can happen when money is no object. The typical process of drug development involves a relatively small investment for initial testing, investing a little more only if those results are encouraging, rinse and repeat. With the COVID-19 vaccines, all needed funding was available almost immediately.
 
The second lesson is the importance of past research. Other coronaviruses caused outbreaks of SARS (severe acute respiratory syndrome) in 2003, and MERS (Middle East respiratory syndrome) in 2012. Researching these deadly infections taught us how coronaviruses invaded human cells, so we knew that the spike protein was a good target for a vaccine. Developing a vaccine for Ebola taught us how to safely edit the genes of a less harmful virus and use it to teach our immune systems to fight a more serious infection. Thirty years of mRNA research led to clinical trials of mRNA-based cancer therapies, and investigation of mRNA vaccines for influenza, rabies, and Zika. All this research and technology was used in COVID-19 vaccine development.
 
Chinese scientists published the genetic code for the virus in January 2020. Within days, using all that previous knowledge, researchers began production of vaccines. When the clinical trials began, the pandemic was raging, and many trial participants were exposed to COVID-19 over a short period of time. Trials could proceed faster than usual because when lots of people are getting sick, it doesn’t take as much time to determine if a therapy, including a vaccine, is effective.
 
Were the COVID-19 vaccines developed in record time? Yes. Because money was no object, and because 30 years of scientific research and development left us poised to succeed.
 
Debra Johnston, M.D. is part of The Prairie Doc® team of physicians and currently practices family medicine in Brookings, South Dakota. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPB most Thursdays at 7 p.m. central.