We got what’s needed for COVID-19 vaccination completely wrong
I would summarize the leading thought in 2020 on vaccination on LessWrong and the review that’s now popular in the mainstream as:
New vaccination technology like mRNA-based vaccines and adenovirus-based vaccines allow faster development of vaccines. We still have the challenge of building enough vaccine factories. To build enough vaccine factories.
This seems to be wrong and the better view is:
Peptide-based vaccines are well understood and unsexy. We have existing adjuvants with well understood safety profile. They can be easily produced with equipment we already have. Given that they are unsexy nobody wants to run a clinical trial right and Western governments are interested in suing people for developing such technology then they are interested in vaccine development.
According to it’s Moderna’s information, the first patient who got the Moderna vaccine got it on the March 16. Two weeks later Euroimmun founder and biotech billionaire Winfried Stöcker gave himself the first dose of a vaccine he developed himself. In contrast to Moderna he however was not focused on bringing a vaccine to market. He just wanted don’t wanted to get COVID-19 and vaccinated himself. His company rather focused on developing antibody tests that were in short supply at the time.
Given past studies of the Coronavirus it was common knowledge that targeting the spike protein of COVID-19 was a good idea for developing a vaccine. Moderna announced that they designed a vaccine in one day by simply targeting the spike protein. Stöcker decided to also go for a domain of the spike protein and mixed it with an already well-understood adjuvant. Given that a lot of the risks from a vaccine come from bad adjuvants and he thought that being in his 70ths getting COVID-19 was undesirable the risk calculation clearly came out in favor of vaccinating himself with his mix. After everything went well with himself and he developed antibodies as predicted he blogged about it and gave it to his family as he didn’t want them to get COVID-19 either.
It’s hard to get the timeline right here but Preston Estep, Don Wang, Alex Hoekstra, Ranjan Ahuja and George Church et al had a similar idea. They also didn’t want to get COVID-19 and knew plenty about biology. In contrast to Stöcker they cared a bit more about not being boring and thought about what they wanted out of a vaccine and coordinated with their friends instead of just making a vaccine alone for themselves. They wanted something that’s easy to brew together and that still works even if the spike protein mutates. Instead of just targeting a protein domain of the spike protein they focused on nanopeptides that are shorter sequences then individual protein domains. Short peptides also have the advantage that they are easy to order online instead of having to wait 1-2 weeks for a protein domain like the one targeted by Stöcker it’s a matter of days to get the sequences one orders for short peptides.
They brew together RadVac and decided to make their whitepaper public in late July where the first public version of the whitepaper seems to be version 2-3-2 from the July 29, 2020. That’s the kind of version number one usually sees in software projects. While the FDA would never allow a product that’s developed as agile to be sold, publishing information is free and given that no scheduled substances are involved in RadVac people are free to brew RadVac together for themselves.
Sometime in September Stöcker thinks (not his words):
“It seems like the commercial vaccine trials don’t provide us a vaccine that allows us to vaccinate everyone in Germany this year. I could easily brew up enough vaccine doses so that we could vaccinate everybody in Germany this year and give them antibodies.”
Stöcker then writes the Paul-Ehrlich-Institut (PEI), which is the German institution responsible for vaccination, a letter proposing to vaccinate everybody in Germany who wants by the end of the year based on his experience of giving five probands (including himself) his vaccine nobody having side-effects and all developing antibodies. First giving it to a sizeable number of volunteers and then giving it to even more volunteers. A single 2000-liter-reactor is able to produce enough peptides for vaccines for 1 million people per day.
From the perspective of the PEI this is heresy. They first ignore his letter and then contact another agency to sue Stöcker for making an unregistered clinical trial with his five probands. By German law as a doctor who’s allowed to practice medicine, Stöcker is allowed to give his patients a mix that he brew together medical trials require registration. In an actual trial with 64 patients Stöcker finds that the adverse reactions to his vaccine brew are a lot lower then that of the currently approved vaccines with their new technologies.
It’s worth noting here that the side-effects of the existing vaccines are worth enduring to be protected against COVID-19. I just want a vaccine and if that means I’m ill for a day because of an adverse reaction that’s completely worth it to be protected against COVID-19. For this post I will leave the question of why companies pushed for getting the new technology to market here for the reader.
Zvi wrote that the problem with the Gates Foundation was that they didn’t trust the new vaccination technologies enough. The problem seems to me the polar opposite. They fall for the mRNA researchers conning them when they funded them via CEPI. The mRNA technology seems to provide no benefit over simply giving the peptides directly but the mRNA researchers really wanted to do fancy research on mRNA.
Gates had a model where he could simply give the mRNA people a few billions to build the necessary factories to produce the vaccines in a time of crisis like our pandemic. Zvi also seems to think this to be true. From basic EA principles we know that room for funding is central when it comes to effective charity interventions. As LessWrongers we understand programming and the principle of the Mythical Man-Month where adding more programmers to a project doesn’t always make it faster. Chief Financial Officer and Chief Operating Officer of BioNTech Sierk Poetting is on record (DER SPIEGEL Nr. 6 / 6. 2. 2021 Site 64) for saying that there was open room for funding for their vaccine effort in 2020. Given that Moderna’s vaccination effort got a similar amount of funding as that of BioNTech/Pfizer, I would expect them also to have no open room for funding. Mixing the mRNA with their lipid coating seems to require custom microfluid mixing technology that can’t be simply ordered and where scaling up the production needs more then just money.
After hearing from Michael Vassar last year that we need a truth and reconciliation committee after this is over, I’m at the point where I want a truth and reconciliation committee.