By Marsha Mullings, MPH
On March 11, 2020, the World Health Organization (WHO) declared Coronavirus Disease 2019 (COVID-19) a pandemic. The world was alerted to the magnitude of the spread of an infectious agent that was first identified and described in Hubei Province, China. Meat and animal markets in Wuhan, its capital city, are thought to be the original transmission points of the virus. Despite extensive efforts to trace its origin, there has been no official declaration regarding the source of this disease agent. What is important, is that WHO had recognized and declared that the entire world was in the grips of a new and deadly respiratory illness.
In the early months following the declaration, COVID-19 exploded across the globe, starting from isolated cases in Wuhan, to the devasting assault on the citizens in the Lombardy region of Italy. The town of Bergamo, northeast of Milan, was the epicenter of this assault. One of Europe’s largest and most advanced hospitals, Papa San Giovanni XXIII, in Bergamo, suffered under the strain of disease and deaths, unable to manage the torrent of patients coming into the hospital by the hour. We watched as the Italians desperately tried to manage the burden of COVID-19 on their citizens. There were heart-rending accounts of people dying in hospital hallways, and in parked ambulances at the door of hospitals. Desperate doctors made agonizing choices – sacrifice the old, whose survival odds were low, to save the young, who had better survival odds. This is where we were in the early months of this pandemic – watching COVID-19’s cruelty in Italy. In contrast, our disease burden here was low. We were secure in knowing that we have the world’s best scientists, the greatest advances in medicine, and above all, vast economic resources. Yet our public health experts watched Italy anxiously.
It was not long before we started to witness the spread of the virus across this country. From nursing homes in Washington state, to New Rochelle, New York. The number of infections were increasing rapidly. Alongside infections, deaths were rising. Before long, New York City had surpassed Italy’s startling statistics and had become, the world’s epicenter for COVID-19 disease. America had largely escaped the gruesome choices made in hospitals in northern Italy, but in sheer numbers of cases and deaths, we had surpassed the Italian nightmare. America, despite its vast resource of scientific expertise and economic power, had become the worst example of the COVID-19 crisis, and New York City was the center of this predicament. The exponential growth of infections continued, in America and throughout the world. Yet while the world suffered the scourge of COVID-19, global scientific and pharmaceutical organizations worked diligently to devise weapons against this disease. America threw its scientific and economic infrastructure into the global effort to develop safe and effective vaccines against this virus. Operation Warp Speed provided the financial reserves that supported the immense undertaking for vaccine development. Consequently, in an astounding feat of technological innovation, the world’s best scientists and scientific bodies developed effective vaccines for this virus nine months after the declaration of this pandemic. The first vaccines have a 90% plus rate of efficacy. They have been given emergency approval and the first doses have been given across the UK and now the US. We have begun the fight to defeat this disease.
We believe that these developments warrant a special report on vaccine and the way they work. To that end, we offer here a general overview of vaccines, their development, and their mode of operation in the body. This will be offered in three parts: part 1 will provide a basic overview of vaccines, part 2 will provide a description of how these vaccines were developed, and finally part 3 will discuss the mode of operation of these vaccines in the body. This series is meant to provide a basic overview of vaccines and their function. It is not intended as a technical description of vaccinology or immunology. For more in-depth understanding of these topics, consult any journal on immunology, vaccinology, or the CDC and WHO websites, which can provide a vast trove of scientific texts on these topics.