By Mantej Singh, BASIS Ahwatukee, Phoenix, Arizona, USA
Recent headlines have championed the success of much of the developed world in combating the COVID-19 pandemic, but the fight is far from over. Although developed countries such as the U.S. can somewhat afford a return to normalcy, a lack of action in confronting the struggles of the developing world will come back to haunt us - and the evidence shows that it already is.
India’s experience is a good case in point. Despite the country’s initial success, a new variant of the SARS-CoV-2 virus has emerged, driven largely by a loose adherence to public health guidelines and no resources to deliver an effective national vaccination strategy. The Delta variant, B.1.617.2, is now estimated to be around forty to fifty percent more transmissible than the previous U.K. variant, associated with more severe infection and greater risk of hospitalization, and given its highly contagious nature, has already spread worldwide (Abbott, 2021). The worry surrounding the introduction of mutated forms of the coronavirus into society has made the race to vaccinate more people increasingly critical. Yet, despite the alarm, global vaccination efforts have seemed stagnant. But why?
The first obstacle arguably has to do with corporate protection. Many of the developers of the first generation of the vaccine, including Pfizer, Moderna, and Johnson and Johnson, have sought immunity from any legal liability that could arise with each vaccine’s administration. This explains the robust vaccine distribution in the U.S., which grants such companies protection from liability under the PREP Act if anything were to go wrong with their vaccines (Sigalos, 2020). However, the reality in economically disadvantaged countries is quite different. With no laws to guarantee immunity, pharmaceuticals have made outrageous demands in an effort to shield themselves from any potential legal costs. For example, Pfizer, in negotiations with Brazil and Argentina over vaccine distribution, requested that state assets, such as military bases and national bank reserves, be offered as collateral in the event of a lawsuit (Nawrat, 2021). No country could reasonably agree to such terms. And although initiatives to help donate vaccines to developing countries have seemed promising, a sustainable vaccination campaign is not feasible without a solution to this legal conflict that continues to hamper recovery in countries battered by the pandemic.
Another obstacle lies in mobilizing resources to make widespread vaccination a reality in the developing world. Despite how remarkable they are, most of the current vaccines are incredibly difficult to manufacture and distribute. The production of mRNA vaccines that are widely used today is an intense and expensive process. It involves synthesizing DNA to form a template, transcribing that template to a mRNA strand that codes for spike proteins around the COVID-19 virus, placing that mRNA in a fatty envelope to make sure it remains secure, and finally packaging and testing to ensure that the doses are not contaminated and ready for use (Hopkins et al., 2021). But it does not stop there. Given the fragility of mRNA, the doses must be stored in subzero environments so they can be successfully preserved for distribution. Indeed, the Moderna vaccine must be kept at -20 degrees Celsius and the Pfizer vaccine at -70 degrees Celsius (Simmons-Duffin, 2020). Current vaccine production is tedious and draining, and it may not be something developing nations can afford.
Now, given these realities, is there hope out there for developing nations? Maybe a vaccine that they themselves can afford, produce, and distribute?
The answer is NDV-HXP-S, an old vaccine that may prove to be gold.
Let’s start with the old. NDV-HXP-S adopts the longstanding molecular design method of flu vaccines, which countries can cheaply produce in abundance. Flu vaccines are created by inserting the influenza virus in a chicken egg, allowing the virus to proliferate, collecting the copies, and weakening them to produce multiple doses (Zimmer, 2021). The goal of the NDV-HXP-S vaccine is similar, namely to create a dead or inert form of the COVID-19 virus that can be injected into the body. Researchers have accomplished this by integrating the gene that codes for spike proteins into Newcastle Disease Virus (NDV), which is an avian virus innocuous in humans. The modified NDV is then placed in a chicken egg, leading to the proliferation of harmless viruses teeming with the desired spike proteins (Zimmer, 2021). In short, instead of receiving the recipe to fight off infection, your body is trained to fight with a dead form of COVID-19.
Now, what makes it gold? There is an economic and scientific case to be made. First, manufacturing NDV-HXP-S is incredibly cost-efficient. It requires relatively less input for much more output. Specifically, a single egg can result in five to ten vaccine doses (Zimmer, 2021). Second, this potentially could be a better vaccine, given that it succeeds in ongoing human trials. The spike proteins used were modified to contain six proline (HexaPro~HXP), resulting in improved stability, resilience, and enhanced tolerance to heat and other chemicals compared to existing vaccines (Zimmer, 2021). This could have massive implications for vaccine distribution, making it easier to get shots into arms.
Although NDV-HXP-S is still in its early stages and continues to go through testing, we should all remain hopeful that there is gold in this old technique that developing nations can afford.
References
Abbott, B. (2021, June 9). Covid-19 Delta Variant First Found in India Is Quickly Spreading Across Globe. The Wall Street Journal. https://www.wsj.com/articles/covid-19-variant-first-found-in-india-is-quickly-spreading-across-globe-11623257849.
Hopkins, J. S., Eastwood, J., & Moriarty, D. (2021, March 3). mRNA Covid-19 Vaccines Are Fast to Make, but Hard to Scale. The Wall Street Journal. https://www.wsj.com/articles/mrna-covid-19-vaccines-are-fast-to-make-but-hard-to-scale-11614776401.
Nawrat, A. (2021, February 23). Pfizer accused of 'bullying' Latin America during vaccine negotiations. Pharmaceutical Technology. https://www.pharmaceutical-technology.com/news/company-news/pfizer-latin-american-vaccine/
Sigalos, M. K. (2020, December 23). You can't sue Pfizer or Moderna if you have severe Covid vaccine side effects. The government likely won't compensate you for damages either. CNBC. https://www.cnbc.com/2020/12/16/covid-vaccine-side-effects-compensation-lauit.html.
Simmons-Duffin, S. (2020, November 17). Why Does Pfizer's COVID-19 Vaccine Need To Be Kept Colder Than Antarctica? NPR. https://www.npr.org/sections/health-shots/2020/11/17/935563377/why-does-pfizers-covid-19-vaccine-need-to-be-kept-colder-than-antarctica.
Zimmer, C. (2021, April 5). Researchers Are Hatching a Low-Cost Coronavirus Vaccine. The New York Times. https://www.nytimes.com/2021/04/05/health/hexapro-mclellan-vaccine.html.
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