COVID-19 vaccines have come to fruition through the extraordinary feat of global collaborative research, the discovery of the virus's genome structure, and innovations in gene therapy. The vaccines have helped mitigate the worst of the Covid-19 global pandemic. However, vaccine hesitancy has become the biggest hurdle in attaining herd immunity. As the COVID-19 virus mutates into new variants, the risks emanating from non-vaccination pose increased morbid outcomes and jeopardize a return to global normalcy.

Some of the quoted reasons for vaccine hesitancy are rapid development and deployment of COVID-19 vaccines; low confidence in vaccine efficacy and safety; perception of lower mortality risk amongst younger age groups; lack of evangelization by the community and trusted leaders; conspiracy theories; and beliefs that vaccines modify DNA.

Early 2021, India was coasting under a false belief that it had beaten Covid-19. By February 2021, daily cases had fallen nearly 90% from the peak of the first wave. Within a short period, the follow-on COVID-19 wave came back as a tsunami. India experienced one of the worst outbreaks that sickened and killed millions. During the peak of the second COVID-19 wave, I was visiting my family in New Delhi, India, ground zero of the highly infectious and lethal delta variant virus. I witnessed heart-wrenching tragedies amongst relatives, friends, families, and communities at large. Sickness was everywhere; most houses with infected people were marked, and it felt like a war zone. The option of taking patients to the hospital was not readily available due to an overwhelmed health care system. Families who could afford it were resorting to at-home care for the sick by privately arranging oximeters, nebulizers, oxygen cylinders, oxygen concentrators, attendants, and nursing staff.

Before I went to India, I took the opportunity to get vaccinated with two doses of the Pfizer

Covid-19 vaccine. Despite being thrown into the thicket of one of the deadliest outbreaks of COVID-19, the vaccine shielded me from getting sick. Although I was confined into a small space with very ill patients, I did not contract the disease and returned home unscathed. Non-vaccinated family members, unfortunately, fatally succumbed to the virus. For many, including me, the difference between life or death was being or not being vaccinated. COVID-19 vaccine saved my life.

Vaccines help train the body to fight viruses and bacteria by mobilizing an immune system response to a harmless version or part of a pathogen, also called an antigen, thereby triggering the production of antibodies. Antibodies are the critical elements that attack and destroy viruses. 

Traditional vaccines are biological products consisting of defanged bacteria or viruses. Since these vaccines contain complex biological molecules which are inherently unstable and prone to degradation, their manufacturing process is laborious and slow. Vaccine shots through traditional technologies typically take more than a decade to develop. 

Among the Covid-19 vaccinesmessenger RNA (mRNA) vaccines have the highest efficacy and use a radically new approach. mRNA naturally found in cells transports the necessary blueprint to the cell's protein-making machinery, directing what proteins to make. mRNA vaccines carry the virus's signature feature blueprint to the cells, mimicking the virus, triggering the immune system into generating the necessary antibodies for fighting the actual virus.

Through the COVID-19 vaccine injection, mRNA ferries into our body cells only the coronavirus spike protein as the signature feature blueprint. Cell protein-making machinery reads the blueprint and starts making the spike proteins, triggering the immune system response to produce the necessary antibodies. By themselves, spike proteins are harmless and cannot cause COVID-19 infection; they only trigger the making of lifesaving antibodies for a contingent fight with the actual virus. 

After the cells finish making the virus mimicking spike proteins, the injected mRNA gets destroyed and never alters DNA. 

According to Professor Jason Wang at Stanford University, "the development and deployment of an efficacious vaccine involve carrying out various steps successfully; Research and development, supply chain management of materials, manufacturing, regulatory, distribution (e.g., transport and cold chain requirements), and vaccine administration with trained health professionals." 

The record development cycle of  COVID-19 vaccines is due to the culmination of many factors, including unprecedented scientific collaboration, a large body of preceding research, unparalleled government funding, and administrative, logistics, and regulatory processes prioritized with accelerated parallel timelines. 

1) After the COVID-19 virus was identified and its genetic material sequenced, scientific and medical communities earnestly started to study it and share the research results. The collaborative effort within the global scientific community helped disseminate invaluable knowledge about the virus, such as how it causes illness and potential vaccination and treatment methods.  

2) The novel technologies employed in the COVID-19 vaccine have been under research for more than thirty years. The existing research gave the scientific community an invaluable head start for developing vaccines for COVID-19.

3) Vaccines development requires lots of testing for efficacy and safety, making the process very lengthy and costly. Propitiously, early into the pandemic, the US government and corporations poured massive funding into the research and development of COVID-19 vaccines. This substantial funding circumvented the financial hurdle, eliminating the need to raise funds, and enabled the pharmaceutical companies to conduct the necessary vaccine research and clinical trials effectually.

4) Normally, the clinical trial phases of vaccine development and testing occur sequentially, making the timelines very long. During the pandemic, many of these timelines were accelerated and done in parallel to shorten development. Regulatory agencies worldwide prioritized COVID studies, committee hearings, and data reviews; instituted rolling reviews, which allowed pharmaceutical companies to submit data on an ongoing basis throughout the trials rather than waiting until the end of the trials. The pervasiveness of the virus made infectious subjects readily available, making the enrollment and studies from the trials adequate and speedy. As the clinical trials proceeded, companies simultaneously tooled and scaled up the vaccine manufacturing facilities. The financial risks associated with pre-building manufacturing were mitigated by vaccine pre-orders and guaranteed buys from governments worldwide.  

The number of people that participated and were monitored during the COVID-19 vaccine trials has been in line with other Food and Drug Administration (FDA) vaccine trials.

Unlike traditional lengthy, cumbersome vaccine development and manufacturing processes, mRNA vaccines are more manageable, cheaper, and faster to manufacture. mRNA molecules for vaccines are manufactured by chemicals rather than by biological synthesis. Hence the mRNA vaccines can be redesigned, scaled up, and mass-produced more efficiently than the conventional vaccines. 

As of August 2021, more than 4.25 billion doses have been administered across 180 countries, and more than 192 million (approximately 348 million doses) people in the United States have received COVID-19 vaccines. These vaccines have undergone and will continue to undergo the most intensive monitoring in US history, which includes using both established and new safety monitoring systems to ensure that COVID-19 vaccines are both efficacious and safe.  

Although the COVID-19 vaccines were developed and deployed in record time, safety steps were not circumvented. Fortuitously, everything came together for the timely availability of the lifesaving vaccines. COVID-19 vaccines are proving to be efficacious against various variants and can be the difference between life and death.

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