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When a new pathogen emerges,
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our bodies and healthcare systems are left vulnerable.
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In times like these, there's an urgent need for a vaccine
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to create widespread immunity with minimal loss of life.
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So how quickly can we develop vaccines when we need them most?
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Vaccine development can generally be split into three phases.
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In exploratory research, scientists experiment with different approaches
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to find safe and replicable vaccine designs.
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Once these are vetted in the lab, they enter clinical testing,
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where vaccines are evaluated for safety, efficacy, and side effects
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across a variety of populations.
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Finally, there's manufacturing,
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where vaccines are produced and distributed for public use.
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Under regular circumstances, this process takes an average of 15 to 20 years.
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But during a pandemic, researchers employ numerous strategies
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to move through each stage as quickly as possible.
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Exploratory research is perhaps the most flexible.
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The goal of this stage is to find a safe way
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to introduce our immune system to the virus or bacteria.
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This gives our body the information it needs to create antibodies
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capable of fighting a real infection.
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There are many ways to safely trigger this immune response,
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but generally, the most effective designs are also the slowest to produce.
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Traditional attenuated vaccines create long lasting resilience.
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But they rely on weakened viral strains
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that must be cultivated in non-human tissue over long periods of time.
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Inactivated vaccines take a much faster approach,
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directly applying heat, acid, or radiation to weaken the pathogen.
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Sub-unit vaccines, that inject harmless fragments of viral proteins,
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can also be created quickly.
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But these faster techniques produce less robust resilience.
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These are just three of many vaccine designs,
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each with their own pros and cons.
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No single approach is guaranteed to work,
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and all of them require time-consuming research.
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So the best way to speed things up is for many labs
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to work on different models simultaneously.
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This race-to-the-finish strategy
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produced the first testable Zika vaccine in 7 months,
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and the first testable COVID-19 vaccine in just 42 days.
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Being testable doesn't mean these vaccines will be successful.
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But models that are deemed safe and easily replicable
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can move into clinical testing while other labs continue exploring alternatives.
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Whether a testable vaccine is produced in four months or four years,
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the next stage is often the longest and most unpredictable stage of development.
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Clinical testing consists of three phases, each containing multiple trials.
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Phase I trials focus on the intensity of the triggered immune response,
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and try to establish that the vaccine is safe and effective.
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Phase II trials focus on determining the right dosage and delivery schedule
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across a wider population.
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And Phase III trials determine safety
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across the vaccine's primary use population,
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while also identifying rare side effects and negative reactions.
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Given the number of variables and the focus on long-term safety,
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it's incredibly difficult to speed up clinical testing.
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In extreme circumstances, researchers run multiple trials
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within one phase at the same time.
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But they still need to meet strict safety criteria before moving on.
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Occasionally, labs can expedite this process by leveraging
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previously approved treatments.
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In 2009, researchers adapted the seasonal flu vaccine to treat H1N1—
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producing a widely available vaccine in just six months.
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However, this technique only works when dealing with familiar pathogens
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that have well-established vaccine designs.
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After a successful Phase III trial, a national regulatory authority
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reviews the results and approves safe vaccines for manufacturing.
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Every vaccine has a unique blend of biological and chemical components
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that require a specialized pipeline to produce.
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To start production as soon as the vaccine is approved,
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manufacturing plans must be designed in parallel to research and testing.
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This requires constant coordination between labs and manufacturers,
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as well as the resources to adapt to sudden changes in vaccine design—
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even if that means scrapping months of work.
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Over time, advances in exploratory research and manufacturing
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should make this process faster.
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Preliminary studies suggest that future researchers
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may be able to swap genetic material from different viruses
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into the same vaccine design.
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These DNA and mRNA based vaccines could dramatically expedite
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all three stages of vaccine production.
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But until such breakthroughs arrive,
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our best strategy is for labs around the world to cooperate
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and work in parallel on different approaches.
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By sharing knowledge and resources,
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scientists can divide and conquer any pathogen.