Vaccines are more likely to gain success in development compared to other drugs. But according to a recent study, vaccine development has been neglected for decades. If more support was given, more vaccines would be available to address preventable diseases.
The neglect of vaccine development in recent decades was unveiled by scholars at the Massachusetts Institute of Technology (MIT), a private research university in the US. Their findings showed that vaccines had a higher probability of success than any other drug development worldwide. However, there has been a notable footprint of lapse, which could have affected millions of lives. They published the results in the National Bureau of Economic Research.
The Lag in Vaccine Development
The creation of the very first vaccine revealed that diseases can be prevented. While not every illness can be prevented by vaccines, many are preventable by getting one or more shots. Parents no longer have to worry about some diseases that can disable or kill their children. This is because there are vaccines that can either provide near-total protection or some level of resistance, which lowers the chance of complications and increases the speed of recovery. But why has vaccine development become uncommon in recent years?
At MIT, scholars sought the potential cause of the unusual lag in vaccine development. Despite the innovations in modern medicine and associated technologies, fewer vaccines were formulated and established for commercial availability, while there were more non-vaccine medications and therapies launched, regardless of their minimal potential for success. From the period between January 2000 and January 2020, vaccine development efforts in the private sector were 39.6% of the time successful at bringing a vaccine, compared to the 16.3% of the time success of anti-infective medications.
"The probability of success for vaccines is reliably higher than for any other drug development area. If you look at the most significant diseases outside of Covid-19, like MERS, SARS, Ebola, and Zika, among those diseases, there's been a total of only 45 nonvaccine programs initiated over the last two decades for them. And there's been only one vaccine approved, for Ebola, in December 2019. That's worrisome because we know for a fact that these diseases are real threats, and yet there's been relatively little attention paid to them," said Andrew Lo, an author of the study and economist at MIT.
In the study, scholars collected data from Citeline, a firm that maintains proprietary pharmaceutical-industry databases. These databases were about clinical trials and drug development. The data showed 2,544 vaccine programs and 6,829 nonvaccine trials. The team reviewed relevant information to determine the differences between the vaccine and nonvaccine programs. They noted that a drug candidate, either a vaccine or not, normally undergoes three formal clinical trials involving human subjects, after the initial preclinical and development phases. The three human-related clinical trials were designed to test safety and efficacy.
After the data was reviewed, scholars quantified the success rate of vaccine and nonvaccine drugs. As mentioned earlier, vaccine development in the private sector had a greater success rate than nonvaccine drugs, but the success rate was dissimilar outside that sector. Vaccines developed by nonprivate entities had a success rate of 6.8% of the time, while the nonvaccine ones had a success rate of 8.2% of the time. Scholars explained that nonprivate drug developments were small-scale projects, including those led by experts in academic hospitals.
The most common reason why vaccine development in the nonprivate sector had a lower success rate was resource issues. Compared to pharmaceutical giants, academic medical centers lacked the same level of funding that could bolster vaccine research. These entities could draft promising formulas at the earliest stages, but their success would likely be impacted by limited resources. If a firm from the private sector supported it, the development would possibly be handed over to the supporting entity.
Among several nonvaccine drugs, antibiotics were identified with low success rates and it disturbed the scholars. Antibiotics have been a critical part of medical treatments for years. These medications could ward off secondary bacterial infections in patients who developed other illnesses. Lo highlighted that lack of resources in antibiotic development played a huge part. If more resources were pooled, research might unlock the best way to deal with superbugs – microbes resistant to antimicrobials.
When it comes to outcomes of vaccine models, only 12 of the 27 disease categories in 20 years were approved by governments. Only one disease type was found with the highest success rate compared to other types. It was the rotavirus category type and about 78.7% of related programs were successful. Opposite to that was the HIV category type with the most notable lack of successful vaccine models, more unsuccessful than the Middle East Respiratory Syndrome, Severe Acute Respiratory Syndrome, and Zika virus disease category types.
The Reason Behind the Vaccine Research Lag
The deficiency in investment has been the suggested reason behind the lag. About 15 to 20 years ago, vaccines were highly profitable until economic challenges pressed nations. Since governments had to deal with immediate concerns, such as poverty, food shortage, and unemployment, the budget for vaccine research was redirected to those concerns. This made vaccine development less profitable or rewarding for private companies. Governments expected that the private sector would invest more in vaccine research.
But with an urgent threat, like the COVID-19, the focus on vaccine research resurfaced. Similar to past events, many governments pledged their support to create the first vaccine for the novel disease. Due to government backing, private firms decided to direct most of their efforts to that vaccine. This pattern highlighted that a vaccine serves as insurance, wherein no one thinks it is needed until the situation demands it, and usually, it is too late.
According to Our World in Data, an online portal of research data, children benefit the most from vaccines. In 2018, numerous one-year-old children were immunized to multiple vaccine-preventable diseases, of which many have no specific treatment or cure today. About 89% were vaccinated against tuberculosis, 86% against measles at first dose, 86% against diphtheria, pertussis, and tetanus, 85% against polio, 84% against hepatitis B, 72% against Haemophilus influenza type B, 69% against measles at second dose, 47% against Streptococcus pneumoniae, and 35% against rotavirus.
Whether we like it or not, vaccines are a part of the revenue source of pharmaceutical companies. Even if they know how profitable it is, they are unlikely to invest in vaccine research unless the demand for one soars. By the time demand exists, thousands may have died and the research is still ongoing. As such, vaccine development should not be neglected just because there is no outbreak.