Scientists are under pressure to deliver a vaccine soon. When can we expect it and will it be safe?
Emilija Manevska/Getty

The unprecedented swiftness with which medical science is developing a vaccine for COVID-19 is one of the most inspiring stories in this historic chapter. Vaccine candidates emerged only weeks after scientists identified SARS-CoV-2 and sequenced its genetic code. Universities and Big Pharma formed teams to develop vaccine candidates in short order. But just as quickly, the search for a vaccine became a political issue, and the sad result is that while the chances of an effective vaccine are rising, so is public distrust.

That's too bad, because the medical and scientific task of developing a COVID-19 vaccine is not the only critical ingredient to a successful vaccination campaign. Public buy-in is essential, because a vaccine is only effective when people agree to be inoculated. The political spectacle surrounding the vaccine efforts is undermining the public trust. Conflicting messages that seem likely to continue for the next two months of the presidential campaign will complicate efforts by doctors and public health officials in communicating, just as the threat of an autumn wave of infections approaches.

The race for a vaccine took shape early on. By July, Moderna, the Massachusetts drug company, moved the vaccine candidate that it was developing with nearly $1 billion dollars from the U.S. National Institutes of Health (NIH) into phase 3 clinical trials. Phase 3 is the gold standard in medicine, the final leg of testing a new vaccine has to complete before the Food and Drug Administration decides if its benefits are sufficiently large and its risks sufficiently small to justify releasing it to millions—perhaps billions—of otherwise healthy people. To persuade the FDA and the rest of the medical community, Moderna will enroll 30,000 people, give some of them the vaccine and the rest a placebo, and wait until 150 of them come down with COVID-19.

Russia's Gamaleya Research Institute wasn't far behind Moderna in the race to be first out with a vaccine. But in August, as Moderna was beginning the vast logistical operation of enrolling participants for its trial, Russia decided to authorize use of its vaccine even though it hadn't yet published the results of its phase 1 and 2 trials, which are used to gather data on toxicity and effectiveness from a small number of close-monitored participants. Russia was releasing a vaccine that had been tested on only 76 people.

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Scientists denounced the move as “reckless,” “foolish,” “unethical” and potentially “disastrous.” If the vaccine turned out to be unsafe or ineffective, it could undermine public trust in vaccines across the globe, at a time when persuading people to accept vaccination is important to containing COVID-19.

Undaunted by the example of Russia—or perhaps emboldened by it—President Trump earlier this month began suggesting that the U.S. might authorize its own vaccine before the election on November 3. “We remain on track to deliver a vaccine before the end of the year and maybe even before November 1st,” he said at a news conference. “We think we can probably have it sometime during the month of October.” He has repeated the claim.

Pushback came from many directions. Democratic candidates Joe Biden and Kamala Harris were quick to attack Trump for mixing politics and science. “I would not trust Donald Trump and it would have to be a credible source of information that talks about the efficacy and the reliability of whatever he's talking about,” Harris told CNN. Scientists also objected. Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, said a vaccine before the end of the year was “not impossible” but “unlikely.” Francis Collins, the director of the NIH, told Senators at a hearing that any decision to release a vaccine would be made on scientific grounds. “I just hope Americans will choose to take the information they need from scientists and not from politicians,” he said.

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