The history, development, and politics of vaccines and immunizations

A Shot in the Dark

Welcome to the immunization station, friends! This is what we call a real Long Shot.

Vaccines are top of mind as we all await one for COVID-19 (and apparently, it might actually be coming soon), so we figured it would be a good idea to delve into the vaccines of the past.

Vaccines have been around for more than two centuries, yet immunization is still a somewhat murky concept. Coronavirus aside, vaccines have long been a controversial subject, as a small but nonetheless passionate sect of society is staunchly opposed to them.

We’re unpacking everything you need to know about vaccines past and present, and what we can reasonably expect and accept for a future coronavirus vaccine.

No Small Feat

In order to understand our present vaccine dilemma, it’s useful to consider the past, beginning with the very first successful immunization method to be developed: the smallpox vaccine.

Believe it or not, Caitlyn, Kendall, and Kylie weren’t the first Jenners to steal the global spotlight: In 1796, Edward Jenner, an English physician and scientist, became renowned for inventing the smallpox vaccine. The idea came to him upon observing milkmaids who had previously contracted cowpox (a viral skin infection similar to smallpox, though less deadly) and he noticed that they did not also catch smallpox. In his scientific mind, this demonstrated that one virus could potentially protect against another.

Still, his idea might not have been so original. Before the smallpox vaccine came about in an official capacity, earlier evidence suggests that the Chinese used smallpox material to stimulate immunity to the disease, as far back as 1000 CE. The practice spread to Africa, Europe and eventually the Americas.

To test his hypothesis, Jenner took pus from a cowpox blemish (yes, you read that right) and tested it on an eight-year-old boy. Then, he tried to infect the boy with smallpox. (We didn’t say all scientists were morally sound.) Indeed, the young boy didn’t get sick because his body was immune to the smallpox virus after previously being exposed to cowpox.

So basically, it’s not entirely clear who had the idea to use one virus to protect against another first, but Jenner is believed to have created the initial successful vaccine, which, over the course of 200 years, eradicated the deadly disease altogether.

The Early Days

French biologist Louis Pasteur was the next to create a revolutionary vaccine for rabies in 1885. At the time, it was the dawn of bacteriology, so major developments in the world of vaccinations quickly followed.

Throughout the 1930s, much-needed vaccines for diptheria, tetanus, anthrax, cholera, plague, typhoid, tuberculosis and more were developed. Growing viruses in laboratories became more common, which spurred new discoveries and innovations (and conspiracy theories), ultimately leading to a polio vaccine, among other major strides.

Childhood diseases were a big target for scientists: Creating vaccines for measles, mumps and rubella were top of mind, and the ability to produce viruses in labs helped expedite the process of creating these critical vaccines.

In the years that followed, DNA technology and other scientific advances drove major innovation in the immunization realm. Research eventually shifted to focus on some non-infectious conditions, like addiction or allergies.

Typical Timeline

As far as timelines go, most vaccines require a lengthy process of testing, development and of course, regulation. (Which is precisely why everyone is so panicked about the expedited COVID-19 vaccine.)

Simply put, the clinical development of a vaccine is a long endeavour, one that typically takes between 10 to 15 years (no sh*t people are freaking out) to establish quality, safety and efficacy. Three major factors contribute to the timeline, including:

• Vaccine development complexities: Developing a vaccine is no joke — it takes tons of time-consuming and resource-intensive scientific analysis. This first phase can take years, as it often includes pre-trials and clinical development, followed by multiple clinical trials.

• Globalized clinical development: For the purpose of regulatory approval, data is usually collected from various countries, although different regions have different clinical requirements. But basically, it’s a team effort, especially in situations like the one we currently find ourselves in. And team efforts take time to coordinate.

• Divergent regulatory requirements: Here’s where things get hairy. Since regulatory requirements vary from place to place, establishing a novel vaccine can have significant delays. But given the current coronavirus crisis, it’s likely that once a vaccine is confirmed to do its job safely, the process of global approval will be accelerated.

As far as Canada’s vaccine views go, Health Canada is the body responsible for authorizing vaccines it deems safe, effective and high quality, as well as conducting post-market analysis of the safety and efficacy of vaccines authorized in the country. In the unlikely event of a pandemic (lol), the Canadian government gives special authorization for emergency access to a vaccine.

For instance, in 2009, Health Canada expedited the process of approving an H1NI pandemic vaccine, recommended by the World Health Organization. The Swine flu appeared in early 2009, and a vaccine was ready by October, though there were major shortages.

Canadian officials say a vaccine remains months away since no vaccine has completed Phase 3 of trials yet, but they are in the midst of looking for ways to speed up the approval process once a viable vaccine is properly developed.

Currently, the Canadian government recommends different vaccines for different demographics, as well as travel vaccines for Canadians headed to certain destinations. There is also a major push for Canadians to get the flu shot this year, in an effort to avoid a “twindemic.” As a result, provincial governments are struggling to meet the overwhelming demand for flu shots.

Provincial governments are responsible for providing vaccines through immunization programs, and compiling data on any adverse reactions from people in the province.

Generally speaking, developing a novel vaccine is typically a long and complicated process, both in Canada and abroad. That’s why the prospect of creating a viable vaccine before the year’s end is shocking, and understandably alarming to many, especially those who have long been opposed to immunization (many of whom now reject mask-wearing, too).

Anti-Everything

Believe it or not, the anti-vaxx movement has a more than 220-year history — about as long as vaccines have existed. Since the idea to create a vaccine pretty much originated from cowpox pus, naturally, people rejected the idea from the get-go.

Over the years, the movement has grown, and people cite various reasons for opposing immunization, ranging from sanitary to religious, scientific to political.

A slew of conspiracy theories by anti-vaxxers have popped up over the years, many of which have absolutely no grounding. A popular and disproven theory is that autism and other “profound mental disorders” are spurred by vaccines. A British physician even published a study on it in 2010 — which has since been discredited.

For the most part, vaccine deniers develop an opposition to immunization based on a plethora of, frankly, bullsh*t stories, consisting mostly of rumours and misinformation, common misconceptions, backlash against the pharmaceutical industry, and a trusting of public figures (including POTUS) who boast an anti-science rhetoric.

In today’s world, the anti-vaxx movement has gained new momentum, especially compounding with the movement against wearing facial masks. There are striking similarities between those who refuse to wear protective masks, and those who are against vaccines. The common ground: a fixation on personal freedom and scientific mistrust.

The movements have gotten so big, in fact, that Facebook has banned anti-vaccination posts on its platform, to avoid spreading disinformation. As we know, social media can make movements spiral out of control, which is perhaps why anti-vaxxers have multiplied in recent years, and especially during the pandemic.

When a COVID-19 vaccine does finally emerge, lord only knows how this group will react.

Politics at Play

All of that to say, we are by no means suggesting there aren’t valid reasons to doubt the future coronavirus vaccine, particularly as there are obvious politics at play.

For weeks now, Trump has been touting his administration’s efforts to fast-track a vaccine, one that will allegedly be ready by the Nov. 3 election. But, if you’ve made it this far into the article, you now understand just how long a typical vaccine takes to develop and regulate.

Canadian officials have also expressed worry that Trump’s vaccine push will result in “immunization hesitancy” in Canada. Especially as major trials, including Johnson & Johnson, have paused due to safety concerns, people are becoming more and more hesitant to eventually get the vaccine.

In fact, a recent poll reinforced that Canadians are against mandatory COVID inoculations, with the number of people opposed growing by the month. In May, nearly 60% of Canadians said they were in favour of the government requiring people to get vaccinated, while now only 39% of respondents think a vaccine should be mandatory.

Canada has made advance purchase deals with a number of biotech companies to secure tens of millions of vaccine doses — so long as they are found to be safe and effective.

Either way, it’s likely that the first round of doses will be reserved for older Canadians and high-risk individuals, only rolling out to the general public in the distant future.

As always, we’ll keep you posted on how the coronavirus vaccine chronicles continue to unfold, so when the time comes, you can confidently call the shots. (We had to.)

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