The Vaccine Question

Between anti-vax myths and the profit-driven practices of Big Pharma, there is much to contend with in the vaccine debate. As Eoghan Ó Ceannabháin argues, we must fight on both fronts to put health before profit.

US President Trump recently made the outlandish claim that a COVID-19 vaccine would be available in the US by October, contradicting the scientists who have been working in the area. The assertion came a month after Russian president Vladimir Putin announced that Russia had become the first to approve a vaccine for widespread use.

Both announcements were met with global condemnation by scientists who argue that rushing the roll-out of a vaccine could be extremely dangerous. Mass vaccination without a properly tested vaccine could result in negative health implications, as well as undermining confidence in vaccines among the general population.

In Trump’s case, there fear among the scientific community that he could give an Emergency Use Authorization (EUA) for a COVID-19 vaccine. While there are some justifications for EUAs, their use for vaccines is a major risk. 

Moreover, Trump’s record with EUAs does not inspire confidence. The FDA revoked the EUA for Trump’s pet drug, hydroxychloroquine, back in June, determining that the legal criteria for administering it was no longer met. Last month he provided an emergency authorisation for convalescent plasma for COVID-19 despite infectious disease experts saying that the treatment only yielded “incremental improvement” at best. The day before, he went on the offensive in an effort to undermine the FDA, tweeting:

“The deep state, or whoever, over at the FDA is making it very difficult for drug companies to get people in order to test the vaccines and therapeutics”.

Trump’s wild pseudo-scientific claims have been a major feature of the COVID-19 pandemic, and behind these interventions lie a certain logic that is driven by imperialist competition. Trump and other leaders are pushing for a vaccine in order to beat out their competitors and to reboot their national economies as soon as possible. It is this same logic that has Putin claiming that his own daughter has taken the Gameleya vaccine without presenting any evidence to suggest this is true.

Outside of the scientific milieu, Trump and Putin’s stunts have been widely mocked, with many satirical cartoons appearing on various news outlets.

Race for a Vaccine

While these are probably the most blatant examples of vaccine hype we have seen since the beginning of the pandemic, they are not the first. Various pharmaceutical companies have declared their progress on a vaccine on numerous occasions – usually triggering a spike in their stock price and often securing pre-orders from countries who wish to be first off the mark in vaccinating their populations.

Novavax saw their share price spike 15% back in May after announcing that they were beginning human trials on a vaccine in Australia, despite the fact that results would not be available until July at the earliest. More recently three Korean companies, Genexine, Gene One Life and SK Bioscience have seen their stock soar after reports of potentially reaching local trials within the year.

As a whole, shares in companies researching a COVID-19 vaccine have soared since the pandemic started. The “race for a vaccine” is not simply an attempt to develop a vaccine as quickly as possible. It is a race to get there first and to beat competitors to the massive profits that will be made from the resulting sales.

The neoliberal mantra of the last few decades has been that profit-driven competition is what spurs on development and progress. Yet the area of vaccine development is one of the sharpest examples where even a cursory examination topples this myth.

AstraZeneca, Pfizer, Moderna, GSK, Johnson & Johnson are just some of the pharmaceutical companies currently hiring groups of scientists to work in silos, competing with one another to develop a vaccine and jealously guarding whatever breakthroughs they achieve. This is not the fault of the scientists themselves, of course, but of the companies who seek to profit from their research.

Competition is an Obstacle

It is impossible to know how much faster a vaccine could be developed if the science was being shared and new discoveries were freely available to all, but having disparate groups of researchers working independently on the same issue will certainly prolong the process.

Moreover, this is not the first time that the profit-driven system has held back progress on a vaccine. During the 2003 SARS and 2012 MERS epidemics, both beta coronaviruses closely related to SARS-COV2 (COVID-19), scientists argued in favour of developing a vaccine for both diseases, and also predicted that any breakthrough would be beneficial for future similar epidemics.[efn_note]Hotez, P. J., Bottazzi, M. E., Tseng, C. T. K., Zhan, B., Lustigman, S., Du, L., & Jiang, S. (2014). Calling for rapid development of a safe and effective MERS vaccine.[/efn_note] 

While some limited research was carried out, pharmaceutical companies largely refused to engage with it because the populations concerned were considered to be too small. When the epidemics subsided, the research was largely abandoned. 

Evidence now suggests that if a SARS vaccine had been developed it may have been effective in protecting 30-40% of people from COVID-19 due to the similarities between the two viruses. Much of the research on SARS and MERS vaccines sought to target spike proteins and RING proteins that are used to infect cells. Given the similar structure of COVID-19, which has related proteins that trigger cell infection, any progress on a SARS or MERS vaccine would have meant a headstart on a COVID-19 vaccine.[efn_note]Boudjelal, M., Nehdi, A. and Islam, I., Why Do SARS-COV Vaccines Not Exist? The Pharma Scientific Intelligence and Business Model Must Be Revisited!.[/efn_note]

A vaccine is likely to be developed eventually, but the negative impact of capitalist competition on public health does not stop at the problems described above. Once a vaccine is available, the question of how to administer it to a large enough proportion of the global population will become a major challenge.

A rush for vaccines has already begun, with wealthier countries having pre-ordered over 2 billion doses from various companies. The US has purchased 800 million doses of at least 6 vaccines that are being developed, with an option to purchase around 1 billion more. The UK has secured 340 million doses – approximately 5 doses for every citizen. Both Japan and the EU countries have secured hundreds of millions of doses each.

Vaccine Nationalism

Public health experts have decried this competitive scramble and are urging that vaccines be fairly distributed across the world. Director of the World Health Organisation Tedros Adhanom Ghebreyesus warned against “vaccine nationalism”, saying that:

“While there is a wish amongst leaders to protect their own people first, the response to this pandemic has to be collective. This is not charity. We have learned the hard way that the fastest way to end this pandemic and to reopen economies is to start by protecting the highest risk populations everywhere, rather than the entire populations of just some countries”.

Yet international solidarity and cooperation have been hard to come by throughout the duration of the COVID-19 pandemic. Instances of medical equipment destined for one country being withheld by another, or of medicines being hoarded rather than directed to jurisdictions in need, have been all too common. In June, for example, the US bought up the world’s entire supply of Remdesivir, a key drug for improving COVID-19 outcomes.

Profit-driven competition is playing itself out in the medical sphere and is having severe repercussions for public health. Meanwhile, efforts to secure cheap vaccines for poorer countries are struggling to gain traction. The main international effort to do so is COVAX, a joint fund led by Geneva-based Gavi, CEPI and the WHO. COVAX aims to secure 2 billion vaccines, half of which will be given to low- and middle-income countries at little to no cost. The other half will be for higher income countries, who will pay for the supply.

However, while COVAX have already put in an order of 300 million vaccines from AstraZeneca, they are falling far short of the estimated $18 billion needed to meet their target. There is a real danger that when vaccines are finally developed, the richer countries will hoard supply, vaccinate their own populations and leave the poorer countries to fend for themselves. The pharmaceutical companies will also hold everyone over a barrel for supply in order to generate massive profits for themselves.

Vaccine Scepticism

All of the problems arising from Big Pharma and a profit-driven approach to medicine are driving the scepticism that could become a major stumbling block to vaccinating enough people in due course. An understandable distrust of the pharmaceutical industry has led many people to throw the baby out with the bathwater and to dismiss science and medicine as a whole.

Far-right forces and conspiracy merchants across the world have seized upon this distrust and amplified it, so that there is a broad range of conspiracies surrounding a COVID-19 vaccine – from the claim made in the video Plandemic that a vaccine would “kill millions”, to the belief that Bill Gates wishes to use the vaccine to implant traceable microchips in the population.

Beyond some of the more outlandish claims made by the conspiracists, there are some genuine concerns that need to be addressed if we are to win some of these people to the need for vaccination. 

One such concern is that of potential adverse effects of vaccines. The anti-vax movement has made claims about the damaging effects of vaccines over the years. The most famous example is the claim that vaccines cause autism – first put forward in 1998 in a fraudulent study by Andrew Wakefield. Despite his research being debunked and withdrawn from Lancet due to deliberate falsification, his claims nevertheless were damaging.

Measles, a disease that used to claim the lives of millions of children annually before a vaccine was found was declared eradicated in the United States in 2002. Yet between January and September of 2019 there were 1,241 individual cases of Measles confirmed across 31 states.[efn_note]Patel M, Lee AD, Clemmons NS, et al. National Update on Measles Cases and Outbreaks — United States, January 1–October 1, 2019. MMWR Morb Mortal Wkly Rep 2019;68:893–896.[/efn_note]

It would be wrong to suggest that there are simply never any negative side effects when it comes to vaccines. However, adverse effects generally happen much less frequently after vaccinations than they do for other types of commonly used medications, S.S.R.Is (anti-depressants) being a prime example. It is also the case that because vaccines are given out to much larger populations than other medicines, the instances of ill-effects can seem higher.

There are also major fears that a COVID-19 vaccine would become mandatory. Indeed, one of the arguments conspiracy theorists make around masks is that the government is seeking to train people into compliance so that they will accept a vaccine. Introducing a mandatory vaccine at a time when levels of distrust are dangerously high is therefore likely to to be counterproductive. Once a safe vaccine has been developed, the Left should argue for education and voluntary, rather than compulsory, vaccination.

Solidarity, not Capitalist Competition

Though the pharmaceutical industry is currently racing to develop a vaccine, vaccine research has been significantly hindered by a lack of interest because it was often viewed as unprofitable. Vaccination is one of the rare examples of solidarity in medicine under capitalism – the public’s health at large is looked after, rather than the atomised, individualistic approach that allows those with deep pockets to stay healthy and leaves everyone else behind.

Indeed, this spirit of solidarity is something shared by past scientists such as Jonas Salk, who developed the first polio vaccine along with his team. Asked in 1955 who “owned” the new vaccine, he said, “Well, the people I would say. There is no patent, could you patent the sun?”

Salk’s words stand in sharp contrast to the greed of Big Pharma, the race to develop a vaccine first in order to gain massive profits, and the likely price-gouging that occurs once this happens. 

It is in this spirit that we must fight on several fronts. We must confront the anti-science arguments of the right and defend public health against their relentless campaigns of misinformation. 

We must also fight against the profit-driven, bad scientific practices of Big Pharma: the commercially-driven secrecy, the reluctance to publish negative trial data, the jealous guarding of scientific discoveries, and the price-gouging. 

All of this could lay the groundwork for the democratisation of science, for a system where knowledge is freely shared for the public good, and where public health is put before profit.

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