The Misplaced Focus on COVID-19 Vaccines: A Look Back to Move Forward

A Pandemic Foretold and Ignored

Despite widespread attention to COVID-19 research, crucial lessons from previous coronavirus outbreaks like SARS and MERS went unheeded. The narrative around antibody levels as a measure of immunity, for instance, was consistently misrepresented in both public and scientific media. The fact is, antibody levels alone don't tell the whole story of protection. The overemphasis on vaccines, particularly those using only the spike protein, sidelined other vital approaches.

As KLG, a Professor of Biochemistry and experienced researcher, aptly points out, “COVID-19 did not appear out of nowhere. Had the scientific and political establishments paid more attention to the known pathobiology of coronavirus disease…our collective responses might have been more effective.” This inherent lack of durable immunity to coronaviruses, a well-known fact, was bafflingly overlooked in the global response. Why?

Learning from Chickens: The Case of Infectious Bronchitis Virus

The story of Infectious Bronchitis Virus (IBV) in chickens offers invaluable insights into coronavirus behavior. IBV, a significant concern in poultry farming, reveals that even with vaccination, protection is short-lived, requiring frequent re-vaccination. The reliance on the spike protein for vaccines is also problematic, as even minor variations can significantly reduce cross-protection.

Crucially, circulating antibody levels don't correlate with protection, a fact relevant to understanding the limitations of COVID-19 vaccine efficacy. In 2003 D. Cavanagh, an expert in IBV, warned “Application of a SARS vaccine is perhaps best limited to a minimal number of targeted individuals who can be monitored”. This prescient observation, based on years of research, highlights the challenges and potential risks of widespread coronavirus vaccination.

Prioritizing Antivirals: A Missed Opportunity

Why were antivirals not prioritized in the fight against COVID-19? Existing research on SARS clearly highlighted the importance of early intervention to minimize viral replication and the subsequent immunopathological phase. Established drug targets, successful in managing HIV, were readily available and offered a promising path for coronavirus treatment.

Yu-Lung Lau, in a 2004 review, emphasized the need for antiviral drug screening as a primary focus, even before vaccine development. This insightful recommendation, sadly ignored, could have significantly altered the trajectory of the pandemic.

The Perils of Epistemic Closure: Overlooking Alternative Solutions

The laser focus on vaccines created a form of epistemic closure, blinding researchers and policymakers to the potential of alternative solutions. The allure of mRNA vaccines as the “hot new thing” overshadowed the historical shortcomings of vaccines for coronaviruses and respiratory viruses in general. The expectation of “tunable” vaccines to combat emerging variants remained largely unexplained and ultimately unrealized.

"Viruses that replicate in the human respiratory mucosa…generally do not elicit complete and durable protective immunity by themselves," states a 2024 article in Cell Host and Microbe. This fundamental understanding was overshadowed by the rush for a vaccine-only solution, even though the limitations of this approach were already known.

The Path Forward: Remembering the Past to Shape the Future

COVID-19 served as a stark reminder of the importance of learning from the past. The overreliance on vaccines, while a testament to scientific innovation, neglected fundamental principles of coronavirus pathobiology. Moving forward, a broader, more integrated approach is crucial. Antivirals, non-pharmaceutical interventions, and a deeper understanding of immune responses must be prioritized alongside vaccine development to effectively combat future pandemic threats.