Coronavirus Vaccine Dreams
I find myself fantasizing about a Covid-19 vaccine that will get us back to living our lives. About a triumphant announcement that the trial was a resounding success, and science has won, that there is a safe effective vaccine in production, and that we should all line up to get our shots — a vaccine that will give us back freedom of association, freedom of travel, freedom from the various kinds of worry, anxiety and fear that are filling our news cycles and our minds. It’s a comforting fantasy, but for now it’s just a fantasy.
Caught in this endless nonstop news swirl, many people — parents and others — can probably understand what it’s like to be hoping — and waiting — and maybe even praying — for a vaccine. It’s a moment that should connect us with our not-too-distant history, and maybe make us wonder whether we’ve lost some valuable perspective.
In 1955, when the first clinical trials showed that Jonas Salk’s new polio vaccine was “safe, effective and potent,” it was front-page headline, above-the-fold news. The New York Times offered this: SALK POLIO VACCINE PROVES SUCCESS; MILLIONS WILL BE IMMUNIZED SOON; CITY SCHOOLS BEGIN SHOTS APRIL 25.
“It was a remarkable moment when an entire nation breathed a sigh of relief that this hideous childhood disease could be prevented,” said David Oshinsky, a professor of medicine at N.Y.U. Langone Health, and the author of “Polio: An American Story.” “When that announcement was made, church bells chimed, factory whistles went off, adults ran into the street and began hugging each other.”
Can you imagine the sigh of relief when there’s an effective coronavirus vaccine? Given the intensity of the news cycle right now, it’s not actually so hard to imagine we might have an international moment like the one that came when the Salk trial results were announced: banner headlines, church bells ringing. A medical V-Day, where V meant both vaccine and victory, over a feared and previously deadly enemy.
For most of us alive now, it’s a new experience to be longing for a vaccine. The success of the Ebola vaccine (approved by the Food and Drug Administration in 2019) was a great and speedy achievement, but I’m not sure that the general public in the United States was profoundly aware of it, or profoundly relieved. And the vaccines that have been added into the schedule in recent years work wonderfully, but it’s not clear that people were living in fear, waiting and hoping for an HPV vaccine, or even a meningitis vaccine. One vaccine that many people wished for urgently — but that never arrived — was an H.I.V. vaccine, which is still not close.
Yes, there was powerful advocacy by people whose children’s lives had been destroyed by meningitis (the so-called meningitis vaccine actually specifically works against one very particular bacteria, Neisseria meningitidis, so named for its propensity to cause meningitis). But it wasn’t something that had the general public terrorized, as polio terrorized parents in the 1930s and 1940s and 1950s.
“Right after the vaccine was described as safe, potent and effective, Jonas Salk was invited to the White House,” to meet President Eisenhower, Dr. Oshinsky said. “And for the first time in anyone’s memory, Ike really choked up, thanked him for saving the children of the world, and that really is just a high moment in science, it’s hard to imagine the gratitude people felt.”
If we get a vaccine for the coronavirus, it will immediately make our world a safer, easier, more reassuring place once again. Science will have solved a problem, so that we can once more walk (and fly and sail) more comfortably through the world — at least until the next problem comes along.
Vaccines have given us such remarkable peace of mind that we have come to take them for granted. Can we really any longer imagine the world before vaccines? Imagine for a minute what it was like when the virus out there was smallpox, a much deadlier epidemic disease than Covid-19. Or more recently, when the virus out there was polio, which regularly caused paralysis and death in children. People still had to go about their business and make their decisions about every detail of daily life: Attend a social gathering? Let your kid go to the swimming pool on a hot day?
Vaccines give us a way to protect ourselves individually, but they also give us a way to create a safer world. Smallpox vaccine was not only a person-by-person triumph, but a huge international human victory over an accumulated historical tide of human misery and death.
People have lost that sense of awe and gratitude for both the individual safety that vaccines represent, and also for the glorious communal project of collectively wiping out a source of pain and disability and death.
“Polio really taught people that science could do it,” Dr. Oshinsky said. “What made vaccines so vitally important at that time was that they were providing protection against diseases that were out there that people saw every day.”
And with the disappearance of many of those diseases, that sense of imminent danger had perhaps been lost. Consider the measles epidemic of 2019, which meant that not only the children whose parents distrusted and refused a safe and effective vaccine were at risk, but also that babies too young to be vaccinated and people with immune deficiencies were suddenly living with the possibility that the virus might be in their surroundings. Now, recent events have reminded us all of what it is like to feel vulnerable and unprotected.
Same thing with flu — there’s a safe flu vaccine, not always perfect, but it lowers your odds of getting the disease, and of getting really sick if you do get the disease. And again, flu vaccine reduces the chance that the virus will be circulating in the population, and that the vulnerable (children, the elderly, those with underlying medical conditions) will be exposed. The Centers for Disease Control and Prevention estimates at least 20,000 (and possibly more than 50,000) deaths from flu this season in the United States, including over a hundred in children.
And yet, it’s a struggle every year to convince people to take flu seriously, to get vaccinated, to practice good handwashing — all the things that are suddenly understood to be matters of life and death. Maybe we could all resolve that next year (and yes, there will be a next year), we’ll take flu seriously and greet the flu vaccine with at least a little sense of celebration and appreciation of science and public health.
“It breaks my heart to see that the fear of a pandemic is the only thing that may bring this respect for science back,” Dr. Oshinsky said. “What we have now is sort of a rediscovery of the fact that we do need this sort of protection.”
And when we do have that sort of protection, when the Covid vaccine comes, we will need to cooperate and think collectively and deploy it — as we should do with the flu vaccine — not only to save our individual selves, but to make a safer world. Vaccines are one of our human victories, a triumph of our ingenuity and intelligence, our science taking advantage of our biology by turning on our immune systems, and we need to be worthy of them.
Dr. Perri Klass is the author of the forthcoming book “A Good Time to Be Born: How Science and Public Health Gave Children a Future,” on how our world has been transformed by the radical decline of infant and child mortality.