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What If There’s No COVID Vaccine?

Although the multi-decade struggle against HIV/AIDS featured a great deal of tragedy and despair, the upshot is that medical science prevailed: what was once a death sentence is now a chronic condition. In thinking about worst-case scenarios for COVID-19, this recent experience offers both lessons and hope.

NEW YORK – When it comes to ending the COVID-19 crisis, our experience beating back HIV/AIDS can teach us much. Above all, it was never clear during that earlier pandemic whether we could count on an eventual vaccine to be part of the solution. In our efforts to overcome today’s crisis, we would be remiss to forget this lesson.

During the early years of the HIV/AIDS crisis, I ran a laboratory at Harvard University, where we were researching the virology of the disease. Early observations showed that an HIV infection elicits an unprecedentedly strong response from both arms of the immune system – the B cells and the T cells. The body detects the threat posed by the disease, and it fights back as hard as it can, but fails. How, I wondered, can we create a vaccine that outdoes the best our bodies can do? It has now been 35 years, and we still don’t have an answer.

The quest for a COVID-19 vaccine isn’t this bleak, but nor is it particularly bright. Six decades of experience with coronaviruses – which cause the common cold as well as more serious diseases like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) – offers reason for both optimism and caution.