Our next vaccine must stomp out variants to end COVID pandemics once and for all

The omicron variant has made one thing clear; SARS-CoV-2 is not done with us. 

To stop this pandemic and mitigate future coronavirus pandemics, we need a pan-coronavirus vaccine to stop all variants in their tracks, and we need to rewrite the rules for how we make and distribute vaccines on a global scale.

This crisis has been the perfect storm. It attacked humanity with stunning success, revealing our public health vulnerabilities. Around the globe, we see healthcare systems under strain, hesitancy to adopt protective measures and worst of all, poor access to vaccines in underserved populations once they were created. Even if we were to vaccinate everyone in the United States today, the virus would find unvaccinated populations in other countries, infect, and quickly mutate, only to return to our shores.

Virus variants revisit communities because they elude our immune systems. Even as mRNA vaccines that target the SARS-CoV-2 spike protein have protected us from severe illness, the virus has spread among the unvaccinated and mutated several times to more infectious forms, including the delta and omicron variants. To outwit this aggressive, natural evolution, we must help our immune systems fight not only SARS-CoV-2 but other coronaviruses as well. 

COVID-19 is caused by just one member of the family of coronaviruses that has previously caused outbreaks of severe human disease in 2002 and 2012 (https://www.niaid.nih.gov/disease-conditions/coronoaviruses). Since the first known outbreak, scientists have studied how to protect us, fearing what we have now experienced: a mutating contagion spread by aerosol sweeping through a vulnerable, interconnected world. The pandemic is reinvigorating efforts by the scientific community to create pan-coronavirus vaccines to shield us from the entire coronavirus family. Dr. Anthony Fauci recently touted the universal coronavirus vaccine approach to Congress as a powerful strategy.

To achieve this broad coverage, the new vaccines do not target just the spike protein but an additional 20 viral proteins the immune system can recognize. This primes our bodies to spot coronaviruses in multiple ways, shutting them down before extensive replication to prevent both illness and mutations that can produce the next variant of concern. Pan-coronavirus vaccines are built to stop diseases like COVID-19 before they spread widely.

By itself, the creation of a pan-coronavirus vaccine will not end the risk of pandemics. The World Health Organization has recognized this challenge, issuing a Solidarity Call to Action on vaccine equity. To avoid the next coronavirus-initiated pandemic, the new vaccine needs to be accessible around the world. While global vaccination efforts have improved markedly over the recent decades, they are nowhere near what is needed to prevent pandemics. A new worldwide strategy is required to manufacture, distribute, educate and immunize in all regions, including those that are underserved.

Around the world, slightly more than 50 percent of people are now fully vaccinated for SARS-CoV-2. In California, more than 70 percent of the population is vaccinated but in Africa, the rate is only 10 percent. As providers, we celebrate small local increases in vaccine adoption, but to care for ourselves, we must also care about others. A virus knows no geographical boundaries and even now we remain at risk for new waves of COVID-19 variants. To protect locally, we must act globally.

Worldwide leadership is needed to end this pandemic and preempt future contagions. In some respects, we are well on our way. Most developed nations, including the United States, enabled their healthcare sectors to develop and roll out vaccines and diagnostics with exceptional speed through investment and responsive regulations. Our success required an unprecedented exchange of scientific and health information in a collaborative and timely way. The next step after we develop a pan-coronavirus vaccine will be more complicated than the science, revising the many regulations and mitigating market forces that control how people gain access to medications.

Microbiologists studying coronaviruses warned us for decades that pandemics would occur. At the University of California, Irvine, our pan-coronavirus program that is designed to protect against COVID-19, the common cold and coronaviruses in bats and pangolins that might move to humans, has already entered phase 1 clinical trials. As we await the trial results, it is incumbent on national and international governing bodies, the pharmaceutical, health and nonprofit sectors and the social enterprise community to innovate so we can manufacture, supply and deploy the vaccine around the globe.

The ability to prevent the next COVID pandemic is in our hands — but we need pan-coronavirus vaccines and a global strategy for access. 

Steve A. N. Goldstein, MA, MD, Ph.D., FAAP, is the vice chancellor of Health Affairs at the University of California-Irvine.