How Can We Prepare for the Next Pandemic? One Expert Says This Is Key.
“Vaccines, they're probably one of the most powerful and most important tools in health equity.”
The COVID-19 pandemic has brought to light the need to invest in vaccine development and research to protect the most vulnerable populations and prepare for future outbreaks.
If global vaccination improves, millions of deaths related to vaccine-preventable diseases could be avoided.
The New York-based Human Vaccines Project (HVP) is working to decode the human immune system to prevent and control diseases for all people around the world by speeding up the development of new vaccines, diagnostics, and treatments.
Modeled after the Human Genome Project, an ambitious global effort to sequence and map all the genes found in humans, the world’s top scientists are collaborating with HVP to explore machine learning and artificial intelligence to find new ways to fight disease.
HVP co-founder and COO Ted Schenkelberg spoke with Global Citizen about getting ahead of the next pandemic, the importance of pregnant women receiving a COVID-19 vaccination, and more.
Global Citizen: Can you tell me a little about HVP’s COVID Vaccine Initiative?
Schenkelberg: The immune system ... is probably one of our most complicated biological systems that we have. It's also the system that's responsible for us being alive today ... It can fight an immense array of viruses or bacteria, even non-communicable diseases like cancer. And it's the reason vaccines have been so successful.
And so in a Human Genome-like effort, we're trying to basically decode immunity and figure out at a molecular biological level what the principles of immunity are across different population groups. That will lead to the next-generation vaccine, next-generation therapies for diseases from the next pandemic to non-communicable diseases like Alzheimer's or cancer. We want to understand more about how these vaccines are working and how they're working in key populations so we can be ready for the next pandemic and continue to improve the design of vaccines and understand the underlying immunity that they're generating.
Theodore Schenkelberg, co-founder and chief operating officer, Human Vaccines Project. Courtesy of Theodore Schenkelberg.
The second thing is, looking forward to the next pandemic — there will be more, and likely we'll see more coronavirus outbreaks. We and others have come up with the concept of [a] universal vaccine that works across coronaviruses, one that could protect against future viruses that cross over from animals to humans, and we know that happens with some regularity. And [also] that they would be available before the outbreak, before the pandemic starts. This is really the moonshot idea in helping us secure our futures and our economy and our society against this really major threat, which is the coronavirus family.
How will these new technologies and this new approach to vaccines help us end extreme poverty?
Vaccines, they're probably one of the most powerful and most important tools in health equity for our kids. We can help ensure that children have a healthy chance at life. When you do this at a national or community level, this uplifts [people] and reduces and ends disease, which is one of the main drivers for poverty and inequality. You have to have the will. You have to have the financing. The tool is one of the most powerful tools in medicine — medical technology — and it saves tens of millions of lives. Most of those lives have been in low- and middle-income countries.
The new technologies that have come out are going to allow us to do even more. But we need to have the policy commitments and we need to have the financial commitments and we need to have the moral commitments to continue to ensure that these vaccines are available, they're distributed, and there is a price point where we can make an impact and really have accessibility for all.
Vaccines have probably been one of the most important health interventions that we've had. We've eradicated smallpox. We've eliminated many of the childhood diseases that limited our lifespan here in the US during the early 20th century. But we are looking to a future where we can do much more about understanding the nature of our own immunity, how our bodies fight disease, and using that to design the vaccines against things like HIV or highly infectious diseases like malaria, which still take a big toll in the developing world. Or, even further, harnessing our own immune systems through vaccines and therapeutics against diseases like cancer or Alzheimer's or the next pandemic, which may not be as easy as the current one in terms of developing vaccines.
We are really thinking we have these new technological tools at our disposal and if we use them correctly, we can unravel the mystery of the power of the immune system for vaccines to do even more to protect more populations to fight for diseases, and to help ensure human health in the coming decades.
For the COVID Vaccine Initiative, what are some of the challenges that your organization has faced in terms of making these vaccines accessible to the most vulnerable populations?
Well, to be clear, we are still early and others are still very, very early on in this approach. We've been one of the leading groups doing advocacy around it, saying that this is one of the largest threats to human health and human society — coronavirus — and we need new approaches. The science is difficult. We're at the advocacy phase, highlighting this need to really have governments put their money where their mouth is behind this substantial reform. The challenge of science is not inconsequential, but it's definitely doable. We've definitely [seen] a number of studies that there is the possibility to have the type of vaccine. We really have to get, globally, these efforts underway to accelerate a big development in this area. New tools like artificial intelligence computing can be used to really accelerate the process.
Once we do have vaccines that are able to work universally or more universally against coronaviruses, again, if this can be distributed correctly, that can be something that's an important health equity tool. But we need those policy commitments. We need the technology and then we need the policy commitments.
What are some of HVP’s efforts to highlight women and girls as one of the more vulnerable groups that could benefit from these kinds of advancements?
We've launched something called the Newborn Immunity Initiative, which is basically focused on understanding and improving our ability to protect pregnant women and newborns through vaccination. We're learning this group, particularly in the first month of life, newborns, still have stubbornly high death rates from infectious diseases.
We believe that if we better understand the really unique immunology of pregnancy as well as newborn infants, that we can make substantial advances against the 800,000-plus deaths that occur in the first month of life.
One of those ways is to use existing vaccines in new ways. It turns out that vaccines like BCG for tuberculosis not only have some effect against preventing TB or preventing diseases associated with TB, but they also jumpstart the immune system to fight a wide range of other diseases. We want to understand why that's happening, what the mechanisms are, and use that as a tool to really design vaccines that are tailored to protect this really vulnerable group.
What has HVP found so far in its research about women's ability to pass immunity through their vaccination to their children and strengthen immune systems in general?
What we and others are learning is that the trajectory of a baby's child, a kind of healthy life, really starts with the mother and the mother's immune system. If the mother's immune system is balanced and working well, that helps give both the in-utero child and then the newborn a strong basis for health. It turns out that, and we need to study this a lot more, but it appears that there are ways where you can vaccinate the mother [and] you are safeguarding the unborn child.
There are a lot of questions around how do we design vaccines better to facilitate a transfer of immunity through breast milk [and] what type of antibodies cross over via breast milk, and can you really optimize that, think about it in new ways that we can extend that natural protection that mothers have both during pregnancy and after pregnancy and are able to give to their children.
Why is it critical to fight misinformation about pregnant women and the COVID-19 vaccine?
As a group, it's really critical that pregnant women are protected and the vaccines work and are safe. There was a study that was just released in the New England Journal where they have followed tens of thousands of women who have been vaccinated with the Moderna or Pfizer vaccines. And they found them to be safe. We need to continue to follow that group.
It appears the vaccines are really safe in pregnant women. The downside is that pregnant women are particularly susceptible to all the risk factors of COVID. If you look at a pregnant woman versus the women of the same age who aren’t pregnant, her outcomes are likely to be worse in terms of severity of hospitalization, death, and preterm birth. And so by not getting vaccinated, you're actually accepting a much higher level of risk, both you and possibly to your baby because of the effect of COVID-19 in pregnant women.
Vaccines can be a powerful tool to help safeguard pregnancy and to help safeguard women during pregnancy. There is always the risk trade-off that if you're not vaccinated, particularly if there's a high level of spread of COVID in your community, you're likely taking on a fairly significant risk to yourself or your baby by not being vaccinated.
What can everyday people do to support your organization's mission and advocacy?
Alot of this starts with the support of basic research. The fact that we had COVID-19 vaccines that are so effective and so quickly rests on decades of research before that. If it didn't occur, we might have been looking at 10 years of vaccine development.
I think [it’s important] to continue to speak about the importance of vaccines in our community, the importance of vaccines in terms of health equity, the importance of vaccines, in terms of childhood development. And lastly, people can take action by either supporting us directly or, more importantly, talking about highlighting these issues with their representatives in Congress. Basic research and immunology are one of the foundations that allow our modern society to work. And we need to continue to support that and we need to fight scientific misinformation.
This interview has been lightly edited for clarity.