If Donald Trump can stand on the White House lawn on 1 November – US flag flying bolding behind him, captive journalists in front – and announce that an American company has been the first to launch a safe, effective vaccine against coronavirus, he might just tip the election vote in his favour.
That’s clearly a dream that is playing on the president’s mind. He has promised an announcement from the government’s vaccine programme (the not too subtly named, Operation Warp Speed), “before a special date”. If he can add to that announcement that he is a ‘coronavirus survivor’ – all the better.
American people will go to the polls on 3 November with two key expectations of their new president: beat the virus and rescue the economy, preferably in that order. The notion that an imminent vaccine launch will allow the country to begin to rebuild its economy plays nicely into the hands of the Republican campaign.
And a US vaccine announcement in time for the election might not be out of the question. The vaccine being developed by a consortium of companies which includes Pfizer (US: PFE) has successfully sparked the production of the antibodies needed to fight off coronavirus in clinical trial volunteers. Pfizer’s chief executive said the company would know if the vaccine works in October. Moderna’s (US: MRNA) vaccine trial began in January and the product has now been tested in 30,000 healthy people. And Johnson & Johnson (US: JNJ) – the pride of American pharmaceuticals – has a vaccine which is being tested in 60,000 people. The mechanism that makes it work has already proved effective in preventing Ebola.
But a potential vaccine launch within the next few weeks is causing consternation for vaccine experts who fear that premature approval could be dangerous. The US Food and Drug Administration (FDA) has already been criticised for extending emergency use authorisations (EUA) to coronavirus treatments, including hydroxychloroquine which has since proven ineffective against the virus.
EUAs allow pharma companies to offer access to new diagnostics and treatments for critical illnesses, but are rarely given to vaccines because of the way they work. Vaccines stimulate an immune response by exposing healthy people to tiny volumes of virus or other foreign particles. Premature vaccine launch could therefore expose otherwise healthy people to particles which make them ill, or release nasty viruses which spread illness further.
The pharmaceutical industry has therefore attempted to apply the brakes to vaccine development. Nine companies, including the three US leaders, recently published a co-signed letter vowing not to participate in a premature vaccine rollout.
Problems are also posed by the way vaccines are tested as trial participants must encounter the illness which the vaccine is expected to protect against. A fall in coronavirus cases over the summer means pharmaceutical companies are pondering the idea of using so-called challenge trials in which participants are injected with a small vial of coronavirus to test the efficacy of the vaccine. This would be highly unusual for an illness whose potency is still unknown.
Indeed, Moderna – perhaps the most advanced of all the US vaccine trials – says it needs to wait for enough participants to become naturally sick with coronavirus before it can determine whether the vaccine is effective and that “it may take until the end of 2020 or early 2021 to reach the necessary numbers.” But with the government bankrolling the trial, there may be some pressure to accelerate.
Space race take two
It’s not just in the US where politicians are turning up the heat on their pharmaceutical companies. A race to find a coronavirus vaccine has become a global political issue.
Russia hasn’t attempted to hide its competitiveness. Its vaccine is named Sputnik V after the satellite launched in 1957, which gave the Soviet’s an early lead in the space race. Moscow has declared victory in the vaccine race after Sputnik was formally approved by Russian regulators (and then reportedly given to President Putin himself). But no scientific data has yet been published and the vaccine is only now being tested in a large enough population to be considered a proper clinical trial.
China too has technically approved a vaccine. CanSino’s product – which was one of the first to enter clinical trials at the start of the year – was approved by the Chinese military as a “specially-needed drug” in June. The company has not confirmed whether the vaccine is mandatory or optional for Chinese soldiers.
Both Russian and Chinese vaccines use genetically altered adenoviruses – which are common and relatively mild – to spark an immune response that leads to the production of antibodies to protect against coronavirus. It’s the same mechanism of action being used by the British project led by AstraZeneca (AZN) and the University of Oxford.
The Oxford vaccine – as it is patriotically known – was forced to pause for a week in September while a safety review was conducted after a participant became inexplicably ill. Still, the trial is one of the most advanced and AstraZeneca is gearing up to manufacturer 2bn doses once it gets the green light from regulators. Boris Johnson would have a strong response to critics bemoaning the UK’s lack of innovation in an increasingly tech-focused world, if one of its universities was the first to launch a vaccine.
The rocky political situation in France would also no doubt be settled if one of the country’s pharmaceutical companies could deliver a vaccine imminently. And Angela Merkel’s retirement party next year will be a much merrier place if Germany can produce a vaccine that ensures huge demand for the country’s many chemical companies.
But the international competitiveness between brassy world leaders pales in comparison to the vitriolic debate between America’s two presidential candidates. It is therefore in US domestic politics that the timeline for vaccine development matters the most.
A toxic race for the White House
For most of the 2020 election campaign, the government's handling of the virus has played nicely into the hands of the Democratic campaign. American death and unemployment figures are easy punches for Biden to throw and voters – fearing a second wave and repeated lockdowns over the winter – are not tired of hearing the criticisms. But Biden will not be able to claim a hand in the successful launch of a vaccine. Trump on the other, despite his clear lack of scientific expertise (remember he suggested, “we can bring sunshine into the body”) will likely exaggerate his role in a medicine that the world is waiting for.
And it’s not just in vaccine development that coronavirus is having an influence in the 2020 presidential election. Postal votes are expected to account for 80 million of the votes cast this year – more than double the 2016 election – as the country tries to keep a lid on coronavirus by preventing people from gathering at polling stations.
Postal votes have already been a hotly debated topic amid fears of voter fraud, which are being fanned by the president. There are suggestions that postal voting will help turnout among the Democrats more than it will the Republicans and Donald Trump has encouraged voters to “test the system” by sending off their postal vote and then heading down to the polls on election day.
And the tension is likely to reach a climax on election night, where the volume of postal votes is likely to cause big delays in the announcement of the final result. The 2016 Democratic nominee Hillary Clinton has warned her successor not to accept the result of the vote on the night because “this is going to drag out”. Donald Trump has vowed not to accept the result of the vote at all if he loses and will not be removed from the White House quietly.
Coronavirus and global governments’ responses to it are incredibly divisive issues. The illness which, for a long time pulled people together in solidarity, is causing cracks in society and a toxic race for the White House is unlikely to ease the tension. Further discontent might spark issues that even a successful vaccine launch can’t fix.
