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Industry must continue research and development to combat the pandemic.
Well into year three of the pandemic, we face a patchwork reality. Parts of the world resemble pre-COVID-19 days as people increasingly travel, leave home for work, and put their masks aside. At the same time, countries in Asia and Europe are battling surges fueled by the BA.2 Omicron sub-variant and US cases are rising sharply. Now we’re seeing recombinant variants such as Omicron XE, a combination of the strains BA.1 and BA.2. While not a new phenomenon, recombination can make a virus more infectious, tougher to detect, and wily enough to evade immunity.
Although many people are acting like the pandemic is over, that’s far from where we are. More than 1,500 Americans are still hospitalized with COVID daily and over 12.9 million children have tested positive for the virus, including almost 8 million since early September. Researchers have detected reinfections under 30 days apart, long COVID has affected nearly 23 million Americans, and we have no definitive evidence that mRNA vaccines protect against long COVID complications. As leaders advocate for “living with” the virus, we are fast approaching more than 1 million COVID deaths nationwide.
The problem isn’t the cognitive dissonance. Who can blame any of us for wanting this all to be over? The issue is that COVID circa 2022 is rapidly evolving and getting even smarter, and our best weapons are still vaccines developed in 2020 based on the original Wuhan strain. We have essentially stalled our COVID defense based on a myth: That mRNA vaccines would lead us out of the pandemic. But first-generation vaccines will never win this fight against a shrewd, shape-shifting virus. It’s like swinging at a cloud with a sword; we’re constantly outmaneuvered.
So why are we stuck in a two-year-old strategy that’s not working? This is the country that made history with novel COVID vaccines in record time. And now we’ve given up? Omicron was the fifth major variant and the third identified last year. There will likely be more strains ahead in 2022—perhaps one that’s deadlier than any we’ve encountered.
If you consider the underlying immunology, it is a lethal mistake to stop fighting COVID now. There are two basic types of targeted immunity, one mediated by antibodies and one by T cells. Most of the protection from mRNA vaccines comes from antibodies that are present in the blood for about six months. T-cell immunity, on the other hand, can last years, decades, or even a lifetime.
After rapidly developing mRNA vaccines, Operation Warp Speed wound down before putting its power behind live virus vaccines, which are time-tested and capable of generating strong T-cell responses, among other things. Like the vaccines that debilitated smallpox, mumps, measles, and rubella, live virus technologies can be powerful enough to block forward transmission. And here’s the thing about forward transmission: It feeds COVID’s ability to stay alive at all costs. Despite how glorious it may feel to act as if we somehow defeated the virus, until we stop spreading the infection to one another, COVID is the victor and our public health remains in peril.
One of the great triumphs of our mRNA vaccines is that they bought us time to deliver vaccine alternatives which offer longer protection and block forward transmission. The country has lost more than 18 months of that opportunity, but it’s not too late to deliver vaccine technologies that finally stop the spread. It is time to invest seriously in alternatives that induce a more robust immune response.
We should be pivoting to a bigger COVID strategy for the long term, one that includes better vaccines. Science can still lead us out of this pandemic. Getting there will take dramatically ramped-up research and development and trials fast-tracked in a way only our federal government can make happen.
Congress and the White House have already enacted laws providing billions of dollars to the Department of Health and Human Services to combat COVID, including over $6 billion in the American Rescue Plan Act. We should be using that money and additional resources to fund private-public partnerships and accelerate efforts to produce vaccines that generate long-term immune responses. If we ramp up federal action with a Warp Speed–style infrastructure, we can bring virus-fighting weapons to the front line for 2022 and beyond.
This is no time to surrender. It’s time to follow the science further and do the work to deliver the final turning point of the pandemic.
Seth Lederman, MD, is a physician-scientist and CEO of New Jersey-based Tonix Pharmaceuticals, a company developing technologies to prevent COVID-19 and treat long COVID. His research led to the discovery of the CD40 ligand and its role in T-cell helper function.