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Fact check: The vaccine for COVID-19 has been nearly 20 years in the making

USA TODAY logo USA TODAY 1/26/2021 Miriam Fauzia, USA TODAY
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The claim: The COVID-19 vaccine was developed in less than a year, but there are no vaccines against viruses and diseases that have existed for far longer 

a close up of a bottle: The Moderna COVID-19 vaccine at the Tequesta Fire Department on January 15, 2021 in Tequesta, Florida. The city received 50 doses. There are 1600 residents that are 65 and older. The online appointments were taken in under three minutes. © Greg Lovett, The Palm Beach Post via USA TODDAY Network The Moderna COVID-19 vaccine at the Tequesta Fire Department on January 15, 2021 in Tequesta, Florida. The city received 50 doses. There are 1600 residents that are 65 and older. The online appointments were taken in under three minutes.

It is approaching a year since the World Health Organization declared COVID-19 a pandemic, and on Dec. 8, Britain was the first Western country to begin vaccination against the virus. The rollout was followed by the U.S. Food and Drug Administration's emergency authorization of Pfizer-BioNTech's COVID-19 vaccine on Dec. 11 and Moderna's on Dec. 18.

Given the quick scientific response to the newly emerging virus, one Instagram post is calling foul, questioning why vaccines for equally debilitating diseases, predating the pandemic, have not yet been developed. 

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The Nov. 30 Instagram post from author Boyce Watkins shares a screenshot of a Facebook comment alleging countless years of research effort have yielded no vaccine.

"40 years worth of research...no vaccine for HIV (sic) At least 100 years research...no vaccine for cancer (sic) Ongoing research...no vaccine for the common cold (sic) Less than a year for a covid (sic) vaccine? Thanks but a hard pass on that shot..." claims "Lee Morin" in the comment.

"This does make you wonder: How did you come up with this so fast, but you can't vaccinate against viruses that have been harming people for centuries?" asks Watkins. The post has received over 13,800 likes and comments agreeing with Watkins' charge. 

"Come on. You have 7 BILLION customers. No other virus/cancer/ailment has that many customer. Follow the money," writes Instagram user borzirtc.

Other social media users have posted the same or a similar claim, as recently as Jan. 13.

USA TODAY has reached out to those who posted the claim for further comment.  

More: Fact check: COVID-19 outbreak at NY nursing home started before vaccinations

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It began with chickens

Operation Warp Speed, the private-public partnership initiated by the White House during the pandemic, may give the impression the COVID-19 vaccine developed overnight, but in actuality, it depends on research dating back nearly 100 years. 

Coronaviruses were first encountered in April 1930, when a strange respiratory disease ravaged poultry farms across North Dakota and Minnesota, killing tens of thousands of baby birds, The Scientist reports. Unsure of what exactly this illness was, veterinarians Arthur Schalk and Merle Hawn of North Dakota Agricultural College, now North Dakota State University, called it "infectious bronchitis of baby chicks," the viral agent later named infectious bronchitis virus.

Further scientific research into IBV and recognition that it was not like influenza A, a flu virus known to cause bronchitis, would transpire over the next 30 years. In November 1968, a group of scientists wrote to the journal Nature asking for IBV, and viruses resembling it like mouse hepatitis virus discovered in 1947, to be classified as coronaviruses, a name derived from its appearance – the spike proteins casting a halo around the surface, much like the sun's corona – on electron microscope imaging.

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SARS was the first attempt at a human coronavirus vaccine

While coronaviruses could cause a variety of fatal diseases in animals, the two known to infect humans were not a grave concern, as they only caused the common cold. This belief was challenged in November 2002 with the emergence of a new respiratory illness in Guandong Province, China, that would infect over 8,000 people worldwide and claim 774 lives.

In less than a month, researchers decoded the enormous genome of the new virus, which caused a disease called severe acute respiratory syndrome. Researchers concluded it was a coronavirus, likely to have jumped from animals to humans because it was only somewhat related to other known coronaviruses. (It took over 15 years of search to identify bats as the potential animal source.) By July 2003, thanks to isolating and quarantining patients, the World Health Organization declared SARS officially contained.

Nevertheless, fears of future seasonal SARS outbreaks called for a vaccine. SARS-CoV's spike protein was an obvious choice for a target. Prior research found the spike protein was critical in determining which species a coronavirus infected, where it preferred to hunker down – called organ or cell tropism – and disease severity. The spike protein had even been proposed as a vaccine target for canine coronavirus in 1991.

More: Fact check: Vaccination helped eradicate smallpox

A number of vaccines targeting the spike protein were designed, tested in animal models and found to be quite promising against SARS and other coronavirus illnesses like Middle East respiratory syndrome, which appeared in 2012. But further testing reached an impasse when funding declined steadily in the years following the 2003 outbreak, said Dr. Peter Hotez, a vaccine scientist and dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, whose team collaborated with Galveston National Laboratory to create a SARS vaccine in 2016.

"We manufactured a really great SARS 1 vaccine in the lab. We actually had a manufacturer at Walter Reed, but then we couldn't raise the money to do all the clinical testing," he told USA TODAY.

Funding was not the only issue. Testing whether a vaccine can prevent disease requires the disease to still be around. Since there have been no major outbreaks of SARS since 2003, testing vaccine efficacy was difficult. But more instrumental is interest: Few SARS or MERS cases meant pharmaceutical companies were less inclined to invest in a likely rarely used vaccine.

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Laying the groundwork

Typically, the road to creating new vaccines is long, with many steps: Finding and developing a vaccine target (exploratory), testing it in tissue or cell cultures and animal models (preclinical) followed by three phases of clinical trials with human volunteers.

If a vaccine proves its mettle, its developers have to seek and gain approval from the FDA before manufacturing. Lastly, in phase four, quality control monitors for any possible vaccine side effects.  

For vaccines to be effective, a specific target is needed. This vaccine target, also called an antigen, is typically a fragment of the disease-causing agent that instructs the immune system on how to recognize and destroy it upon contact. Searching for a suitable antigen can be an arduous process but prior coronavirus research made it all easier.     

"When the Chinese put up the COVID-19 sequence on bioRxiv in January, our community of scientists looked at it and said, 'Yeah, we got this because we know how to do it.' It was all about plug and play based on all that experience," said Hotez.

Having a running start does not mean the testing process was accelerated, however. Hotez, whose recombinant protein subunit COVID-19 vaccine is undergoing clinical trials in India, stated the vaccine still underwent testing among a large group of human volunteers, even more than a typical trial with over 30,000 to 60,000 people. 

What accelerated the vaccine process was manufacturing.   

"The two accelerants are doing the manufacturing of risk (scaling up manufacturing based on the assumption the vaccine will work, also called at-risk manufacturing) and manufacturing the vaccine in parallel with clinical trials. That's new because we usually wait for the phase three results," he said.

More: Fact check: The US saw more deaths in 2020 than in 2019, driven by the COVID-19 pandemic

So why is there no vaccine for HIV, cancer, or the common cold?

Human immunodeficiency virus, the culprit behind acquired immunodeficiency syndrome, commonly known as AIDS, is a tricky virus. Much like the novel coronavirus, HIV binds to a protein on the surface of T cells, a type of white blood cell, to enter. Once inside, HIV integrates its genetic material with its host cell's DNA, using the host's DNA replication machinery to create new viruses, which blast off to infect and kill other T cells.

Finding a specific and effective vaccine target is therefore difficult, especially since HIV mutates frequently in order to mask itself from the immune system. According to the National Institute of Allergy and Infectious Disease, common vaccine approaches using inactivated or live HIV forms have either not been "effective in eliciting immune responses in clinical trials" or are too dangerous to use.

The same goes for the common cold, which is caused by a smorgasbord of viruses including over 150 different types of rhinovirus, a common troublemaker. 

"It's hard to create a vaccine when you have so many different viruses causing similar symptoms. To make a universal vaccine against all of them is probably pretty daunting, it might be doable, but it's daunting," explained Hotez.

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Cancer, abnormal growth of the body's own cells due to unchecked genetic mutations, is no virus, but the struggle in finding a suitable vaccine target is not any easier. 

"The challenge is getting antigen targets and also access because a lot of the antigens, or cancer proteins, are first inside the cell. They may not be presented to the immune system so these are much more complicated targets," said Hotez. 

Advances in messenger RNA-based vaccine technology in recent years may help fast-track some cancer vaccines, he acknowledged. The platform, which provides the body the equivalent of a genetic assembly instruction booklet for manufacturing target-specific antibodies, has been used for rabies, influenza and Zika and is considered an attractive approach for its low cost, speed of manufacturing, potency and versatility, Nature reported.

Many cancer vaccines using mRNA are in the works, like Moderna's personalized cancer vaccine, mRNA-4157, which is being tested in patients with metastatic common epithelial cancer. The Boston-based pharmaceutical company also announced on Jan. 11 it was working on an mRNA HIV vaccine with phase I clinical trials expected sometime in 2021.

Our ruling: Missing context

We rate this claim MISSING CONTEXT because without additional context it might be misleading. Vaccines require specific targets against which they train the immune system. COVID-19's spike protein was identified nearly 20 years ago as a potential vaccine target during the development of the SARS vaccine, following the 2003 SARS outbreak. This has helped expedite the vaccine process, given that vaccine platform technologies have advanced in recent years, as well. Another accelerant was the commercial-scale production of COVID-19 vaccine doses prior to FDA clearance, called at-risk manufacturing, when early results appeared promising. Finding suitable vaccine targets for HIV, cancer and the common cold has been more difficult in comparison as these diseases have either elusive or highly variable targets. 

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This article originally appeared on USA TODAY: Fact check: The vaccine for COVID-19 has been nearly 20 years in the making

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