COVID-19 has already produced catastrophic social, economic and public health consequences, with more than 107 million documented cases and 2.3 million deaths. Although this pandemic is far from over, we now have the tools to end it, with the largest and fastest global distribution of vaccines underway. It is remarkable that we got this far so quickly, but next time we may not be so lucky. More virulent and deadly coronaviruses are waiting on the wings. Therefore, the world needs a universal vaccine against coronavirus.
The speed with which safe and effective COVID-19 vaccines have been developed and made available is unprecedented, taking less than a year. However, if faced with a more virulent strain with a higher lethality rate than severe acute respiratory syndrome of coronavirus 2 (SARS-CoV-2), even this short period of time may not be enough to avoid a number of deaths on the 1918 flu pandemic scale, which killed more than 50 million. In addition, there is a continuing risk that the virus will mutate in order to make existing COVID-19 vaccines less effective – as we have already seen for variant B.1.351 first identified in South Africa – or even ineffective.
As with the flu, the case for a vaccine that protects everyone against all forms of coronavirus is strong. SARS-CoV-2 belongs to a diverse group of viruses, of which there are thousands capable of infecting a wide range of animals, from bats and pangolins to pigs and mink. SARS-CoV-1, which appeared in 2002, had a 10% mortality rate; The coronavirus of the Middle East respiratory syndrome (MERS-CoV) in 2012 was 34% fatal.
The potential is increasing for other coronaviruses to jump out of species and cause more pandemics. The reasons are many. Animals infected with viruses are those with which humans come into regular contact. Modern farming practices, viral evolution and relentless human invasion into the natural environment mean that there is an increasing risk of people finding previously isolated animal populations that harbor new strains with pandemic potential. With human migration, population growth, urbanization, rapid global travel and climate change accelerating spread, it has never been easier for outbreaks to turn into epidemics and turn into pandemics.
At the same time, the recent convergence of technological advances in the biomedical, computer and engineering sciences ushered in a new era in the discovery of antigens and vaccines. Supercomputing and high-performance machine learning, along with structural modeling, have the potential to greatly speed up the identification of common antigenic targets shared among coronaviruses. Databases of genetic sequences from isolated coronavirus animals can be used to model the evolution of viruses. Continued efforts to decode the principles of immunity in aging populations can increase the effectiveness of vaccines for the most vulnerable. Collectively, studies now suggest that the development of a universal vaccine against coronavirus is scientifically viable.
This must be a worldwide effort. A roadmap is needed to define essential scientific issues, as well as a framework for financing and sharing information, data and resources. Early on, it will be essential to establish a global surveillance network for zoonotic coronaviruses such as the World Health Organization’s Influenza Surveillance and Response System or the United States Agency for International Development’s PREDICT program (which went extinct last year) . In addition, a global effort to identify broadly neutralizing antibodies specific to coronavirus is needed to facilitate the discovery of cross-reactive coronavirus antigens.
None of this can happen until all stakeholders, including governments, industry, academia and non-governmental organizations, recognize this as a global public health priority. With COVID-19, many of the bases were established. Waiting until the crisis is over can be a missed opportunity. It is estimated that the current pandemic will end up costing between $ 8 and 16 trillion globally, ∼500 times more than it would take to prevent the next pandemic.
This is not to say that it will be easy, and a gradual COVID-19 approach to pan-coronavirus for universal coronavirus vaccines may be necessary. SARS-CoV-2 is adapting rapidly to humans, and other new coronaviruses are mutating, recombining and replicating in bats and other animal species, positioning themselves to jump from species at some point in the future. If we decide to wait for the next coronavirus to appear, it may be too late, as it was with COVID-19. Creating tools to prevent the next coronavirus pandemic is within reach and should be considered a global health priority. We can invest now or pay substantially more later.