The state of vaccine development

A primer on why recent vaccine news matters and what challenges remain.Vaccine news has moved fast in the past few weeks:

• Pfizer, Moderna Therapeutics, and AstraZeneca-Oxford are all in phase 3 of clinical trials.
• 450+ other clinical-stage vaccine programs are in development.

The VC firm a16z is providing excellent coverage on the latest vaccine progress (this 22-minute podcast is a great primer). Here are a few nuggets from their assessment:

Pfizer and Moderna results are important for 2 reasons

Preliminary efficacy for Pfizer (95%) and Moderna (94.5%) were both found in clinical settings. There is no guarantee that these results will translate to the real world, but there are 2 takeaways from the trials worth noting:

• Identifying a specific target: The vaccines for Pfizer and Moderna are targeting the same spike protein on the surface of the coronavirus. Whether or not these vaccines work more broadly, identifying the right target is crucial.
• A new vaccine-development platform: In the traditional vaccine process, you grow and administer doses of the weakened virus itself. Pfizer and Moderna are also both using mRNA technology, which gives the body instructions on what proteins to react to.

Rolling out a vaccine comes with many downstream challenges

If these vaccines clear all the medical and regulatory hurdles, the additional challenges can be summarized by the “4 D’s”:

• Durability: How long will the protection last?
• Dangers remaining: We don’t have data on long-term effects.
• Distribution: Many parts of the world don’t have the proper cold-chain infrastructure to distribute the vaccine. Also, which populations and demographics will get it first?
• Denialism: The vaccine is as effective as the number of people who take it. Many valid concerns will have to be addressed to ensure maximum uptake.

These challenges are befitting a process that has been compressed from the typical 10-15 years into a 12- to 18-month time frame.