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Dr. Lynda Stuart, a leading vaccine expert at the Bill & Melinda Gates Foundation, said she is optimistic that a COVID-19 vaccine could be available as soon as 14 months from now. At that time, the vaccine would ideally go to healthcare workers, the elderly and people who are considered most vulnerable.
“Once we have done that, it’s a very big thing that will change the equation very significantly,” added Stuart, speaking at an ICFJ webinar. Vaccines for the rest of the population would be rolled out over the following year, she said.
The 80 or more labs working on finding vaccines have a daunting challenge, Stuart said. First, they need to develop a safe vaccine as soon as possible. At the same time, a vaccine needs to be cheap, reliable and easy to mass produce for billions of people. She predicted that there may be several different vaccines circulating around the world.
Stuart, the deputy director of Vaccines & Human Immunobiology at Gates Foundation, estimated that the price of a vaccine would fall between US$1 and US$15 per dose. “If we get to that point we will likely be able to get it to everybody who needs it,” she said.
Here are other key quotes from the conversation:
On expediting the timeline
As part of its US$250 million COVID-19 response, the Gates Foundation is investing in several promising ideas for finding and mass producing a vaccine to stomp out COVID-19, including ramping up manufacturing capacity while vaccines are still being tested.
“We're really trying to identify the ones that we think have promise and start building the manufacturing capacity early so that if they work, we're not waiting a long period of time before the vaccine is actually deliverable in the billions and millions of doses,” Stuart said.
On the development process
The two main challenges to developing a COVID-19 vaccine are time and scale, Stuart said. A huge number of doses are needed — quickly.
“Some vaccine approaches are very quick, and some vaccine approaches are able to get to the billion-dose scale,” she said. Gates is pursuing both avenues in parallel.
“At the end of the day, if we get a vaccine that's very fast, but we only can give it to 10 people, that's not going to help us. And if we get a vaccine that we give to millions of people, but it takes us 10 years, that's also not the right solution.”
About 80 to 100 labs are beginning to work on a search for the vaccine. Of those, she said, about 30 are “actually beginning to test specific vaccines.”
On global coordination
During the Ebola crisis, there was no central organization body coordinating the global response. “So after that chaos, I think there was a decision made that we needed to be a bit better prepared,” she said. The global health community created the Coalition for Epidemic Pandemic Preparedness and Innovation, which she said is working closely with the World Health Organization. “They've already taken the lead in bringing together the key partners.”
On vaccine safety
“Our number-one concern when we're making a vaccine is that it is safe. And the first sets of studies are always looking at safety. So all of these approaches would never go forward if we didn't think they were safe, at least in small groups of people.”
On vaccine hesitancy
“It's growing and it's concerning. But I’m optimistic about this because often people don't understand quite what a vaccine is protecting you from,” she said. However, “If you have children who died of measles or you've seen people with polio or you’ve had members of your family with meningitis, your view of the value of a vaccine and the risk benefits is very different.”
“I'm optimistic that those with vaccine hesitancy will understand more about the value of having a vaccine. Now they see the impact of not having one,” she said. “We will try and address that through education.”
On natural and herd immunity
“Natural immunity is the idea that once you've been infected, you're now immune and you can't get re-infected,” Stuart said. “We do not yet know whether that is indeed true. There are loads of infections out there where you can get it again. Maybe you won't get it as severely again, but you can get it. So we do not yet know if natural immunity is sterilizing.”
“The idea of herd immunity is that either through natural immunity or through vaccine-induced immunity, you get people to high enough levels that you can interrupt this transmission cycle. If you're doing it through infection...there's a cost to pay,” Stuart said. “A very large number of people would die on the path to herd immunity through natural infection. So personally, my opinion, the best way to get the herd immunity is for us to get a vaccine to get us there.”