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How often do vaccine trials hit paydirt?
Vaccines find more success in development than any other kind of drug, but have been relatively neglected in recent decades.
Vaccines are more likely to get through clinical trials than any other type of drug — but have been given relatively little pharmaceutical industry support during the last two decades, according to a new study by MIT scholars.
Over a two-decade span from January 2000 to January 2020, private-sector vaccine-development efforts succeeded in bringing a drug to market 39.6 percent of the time, the researchers found. By contrast, programs to develop anti-infective therapeutics — medicines that lessen the severity of illness, including antibiotics — succeeded 16.3 percent of the time.
"The probability of success for vaccines is reliably higher than for any other drug development area," says MIT economist Andrew Lo, co-author of a new paper detailing the study.
At a glance, that might seem to augur well for drug-development prospects during the Covid-19 pandemic, since over 100 projects globally are aimed at finding a vaccine for the virus. But scientists may be racing to make up for lost time, in a sense — because as the study also shows, vaccine development for some of the world's most dangerous diseases has lagged in recent decades.
For instance: Out of nearly 10,000 drug-development projects in the study, just a relative handful have addressed the high-profile, highly problematic contagions of the last 20 years.
"If you look at the most significant diseases outside of Covid-19, like MERS, SARS, Ebola, and Zika, among those diseases, there's been a total of only 45 nonvaccine programs initiated over the last two decades for them," Lo notes. "And there's been only one vaccine approved, for Ebola, in December 2019. That's worrisome, because we know for a fact that these diseases are real threats, and yet there's been relatively little attention paid to them."
The paper, "Estimating Probabilities of Success of Vaccine and Other Anti-Infective Therapeutic Development Programs," was released on May 18 as part of the National Bureau of Economic Research (NBER) working paper series and has been accepted for publication in the Harvard Data Science Review. The authors are Lo, who is the Charles E. and Susan T. Harris Professor in the MIT Sloan School of Management and director of MIT's Laboratory of Financial Engineering; Kien Wei Siah, a PhD candidate in the Department of Electrical Engineering and Computer Science; and Chi Heem Wong, a PhD candidate in the Computer Science and Artifical Intelligence Laboratory and the Laboratory for Financial Engineering.
Limited big pharma investment
To conduct the study, the scholars examined information collected by Citeline, a firm that maintains proprietary pharmaceutical-industry databases about drug development and clinical trials. The study reviewed 2,544 vaccine programs and 6,829 nonvaccine development programs. After an initial preclinical research and development phase, a drug candidate usually undergoes three formal trial phases in human subjects, the first generally aimed at examining its safety, and the next two more focused on efficacy.
Among other findings, the scholars identified lower success rates for drug-development programs outside of private industry — such as those led by investigators in academic hospitals. These efforts succeeded 6.8 percent of the time for vaccines and 8.2 percent of the time for therapeutics, something Lo chalks up to the smaller scale of many of the projects.
"Academic medical centers don't have the resources big pharma does," says Lo.
Lo also points out that the relatively low success rates for nonvaccine therapeutics, including antibiotics, "jumped out" at him. "I don't think people realize just how important antibiotics are, and how few of them we currently have in our medical arsenal," Lo adds. "We're just not investing enough resources into this critical field."
The researchers also found widely varying outcomes by types of illnesses. Out of 27 disease categories for which vaccine development efforts occurred, only 12 have seen drugs receive government approval. The disease type with the highest success rate, among those with more than one drug candidate, was rotavirus; in this category 78.7 percent of programs have been successful.
By contrast — and in addition to MERS, SARS, and Zika — HIV is a case with a notable lack of a successful vaccine, after hundreds of projects attempting to develop one.
Lo notes that only four of the top 20 pharmaceutical companies are heavily invested in vaccine development, down considerably from two decades ago — despite the fact that vaccines have easily the best odds of becoming successful drugs.
"This tells me that the economics of vaccines must be really challenging, if fewer and fewer big pharma companies are willing to commit resources to this business," Lo says. "If there's a silver lining to this terrible pandemic, it's that things are going to change in the aftermath of Covid-19."
Why an "insurance" drug may be less profitable
Indeed, Lo suggests, the specific economic challenge is that vaccines are the equivalent of "insurance," among medicines: We apply them to limit the cost of disasters, but do not always think to invest in them in advance. Many governments may not have perceived a need to develop and stockpile vaccines, thereby reducing the demand for vaccine research and making it less rewarding for private industry.
"Vaccines used to be [more] profitable," Lo says. "But over the course of the last 15-20 years, I think governments have started cutting budgets and ignoring issues that aren't clear and present dangers, perhaps expecting private insurers to pick up the slack. Unless there's an immediate threat to public health, it's really hard to get people to focus on it. It's like insurance … You don't think you're going to need it, until you do. And then it's usually too late."
That fiscal austerity may also have been combined with historical complacency, as past successes against smallpox, polio, and other diseases created a perception that terrible pandemics were a thing of the past.
In any case, Lo says, the data paints a clear picture: Vaccine research is both promising and underfunded.
"The reason we wrote this paper is to bring more awareness to this situation," Lo says. "Now that we've experienced the deadly consequences of a pandemic, the hope is that governments around the world — and it really has to be governments — will pay more attention."
Lo adds: "As the saying goes, 'crisis is a terrible thing to waste,' so we need to take advantage of this opportunity to come up with a more enduring solution, not just for this pandemic, but for all future pandemics, because inevitably another pandemic will emerge, whether its SARS, MERS, or some other pathogen we've never encountered. Thanks to a number of recent biomedical breakthroughs, we now have many more ways of creating anti-infectives than ever before — we just need the political will to do so."
The study drew upon research support from the MIT Laboratory for Financial Engineering and funding from The Rockefeller Foundation. Lo also helped found a consulting firm that analyzes drug development data.
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Evolution doesn't clean up after itself very well.
- An evolutionary biologist got people swapping ideas about our lingering vestigia.
- Basically, this is the stuff that served some evolutionary purpose at some point, but now is kind of, well, extra.
- Here are the six traits that inaugurated the fun.
The plica semilunaris<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NjgwMS9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYxMTgyMzg1NX0.ZY8qmhtoZfbRMAqrNnmbgyk7GLabglx_9lBq3PKcy7g/img.png?width=980" id="99882" class="rm-shortcode" data-rm-shortcode-id="68e8758894b0359c6ef61b2c158832b2" data-rm-shortcode-name="rebelmouse-image" />
The human eye in alarming detail. Image source: Henry Gray / Wikimedia commons<p>At the inner corner of our eyes, closest to the nasal ridge, is that little pink thing, which is probably what most of us call it, called the caruncula. Next to it is the plica semilunairs, and it's what's left of a third eyelid that used to — ready for this? — blink horizontally. It's supposed to have offered protection for our eyes, and some birds, reptiles, and fish have such a thing.</p>
Palmaris longus<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NjgwNy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzMzQ1NjUwMn0.dVor41tO_NeLkGY9Tx46SwqhSVaA8HZQmQAp532xLxA/img.jpg?width=980" id="879be" class="rm-shortcode" data-rm-shortcode-id="970e9c15f3c3d846dde05e2b2c6ebf12" data-rm-shortcode-name="rebelmouse-image" />
Palmaris longus muscle. Image source: Wikimedia commons<p> We don't have much need these days, at least most of us, to navigate from tree branch to tree branch. Still, about 86 percent of us still have the wrist muscle that used to help us do it. To see if you have it, place the back of you hand on a flat surface and touch your thumb to your pinkie. If you have a muscle that becomes visible in your wrist, that's the palmaris longus. If you don't, consider yourself more evolved (just joking).</p>
Darwin's tubercle<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NjgxMi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0ODUyNjA1MX0.8RuU-OSRf92wQpaPPJtvFreOVvicEwn39_jnbegiUOk/img.jpg?width=980" id="687a0" class="rm-shortcode" data-rm-shortcode-id="b38a957408940673ccc744f0f6828d18" data-rm-shortcode-name="rebelmouse-image" />
Darwin's tubercle. Image source: Wikimedia commons<p> Yes, maybe the shell of you ear does feel like a dried apricot. Maybe not. But there's a ridge in that swirly structure that's a muscle which allowed us, at one point, to move our ears in the direction of interesting sounds. These days, we just turn our heads, but there it is.</p>
Goosebumps<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NzMxNC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyNzEyNTc2Nn0.aVMa5fsKgiabW5vkr7BOvm2pmNKbLJF_50bwvd4aRo4/img.jpg?width=980" id="d8420" class="rm-shortcode" data-rm-shortcode-id="f735418322b34382dcd882299c9ccc48" data-rm-shortcode-name="rebelmouse-image" />
Goosebumps. Photo credit: Tyler Olson via Shutterstock<p>It's not entirely clear what purpose made goosebumps worth retaining evolutionarily, but there are two circumstances in which they appear: fear and cold. For fear, they may have been a way of making body hair stand up so we'd appear larger to predators, much the way a cat's tail puffs up — numerous creatures exaggerate their size when threatened. In the cold, they may have trapped additional heat for warmth.</p>
Tailbone<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NzMxNi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxMDMzMDc3N30.p9BEtkf3-PV3EtDSQMUGUeopsimiCHUagx97P4f8IBw/img.jpg?width=980" id="e8ab8" class="rm-shortcode" data-rm-shortcode-id="0063ce99bdd22fbebe1279244b87935c" data-rm-shortcode-name="rebelmouse-image" />
Coccyx. Image source: decade3d-anatomy online via Shutterstock<p>Way back, we had tails that probably helped us balance upright, and was useful moving through trees. We still have the stump of one when we're embryos, from 4–6 weeks, and then the body mostly dissolves it during Weeks 6–8. What's left is the coccyx.</p>
The palmar grasp reflex<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NzMyMC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNjY0MDY5NX0.OSwReKLmNZkbAS12-AvRaxgCM7zyukjQUaG4vmhxTtM/img.jpg?width=980" id="8804c" class="rm-shortcode" data-rm-shortcode-id="45469ca5ee5f43433a782f7d4ac0a440" data-rm-shortcode-name="rebelmouse-image" />
Palmar reflex activated! Photo credit: Raul Luna on Flickr<p> You've probably seen how non-human primate babies grab onto their parents' hands to be carried around. We used to do this, too. So still, if you touch your finger to a baby's palm, or if you touch the sole of their foot, the palmar grasp reflex will cause the hand or foot to try and close around your finger.</p>
Other people's suggestions<p>Amir's followers dove right in, offering both cool and questionable additions to her list. </p>
Fangs?<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Lower mouth plate behind your teeth. Some have protruding bone under the skin which is a throw back to large fangs. Almost like an upsidedown Sabre Tooth.</p>— neil crud (@neilcrud66) <a href="https://twitter.com/neilcrud66/status/1085606005000601600?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Hiccups<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Sure: <a href="https://t.co/DjMZB1XidG">https://t.co/DjMZB1XidG</a></p>— Stephen Roughley (@SteBobRoughley) <a href="https://twitter.com/SteBobRoughley/status/1085529239556968448?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Hypnic jerk as you fall asleep<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">What about when you “jump” just as you’re drifting off to sleep, I heard that was a reflex to prevent falling from heights.</p>— Bann face (@thebanns) <a href="https://twitter.com/thebanns/status/1085554171879788545?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script> <p> This thing, often called the "alpha jerk" as you drop into alpha sleep, is properly called the hypnic jerk,. It may actually be a carryover from our arboreal days. The <a href="https://www.livescience.com/39225-why-people-twitch-falling-asleep.html" target="_blank" data-vivaldi-spatnav-clickable="1">hypothesis</a> is that you suddenly jerk awake to avoid falling out of your tree.</p>
Nails screeching on a blackboard response?<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Everyone hate the sound of fingernails on a blackboard. It's _speculated_ that this is a vestigial wiring in our head, because the sound is similar to the shrill warning call of a chimp. <a href="https://t.co/ReyZBy6XNN">https://t.co/ReyZBy6XNN</a></p>— Pet Rock (@eclogiter) <a href="https://twitter.com/eclogiter/status/1085587006258888706?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Ear hair<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Ok what is Hair in the ears for? I think cuz as we get older it filters out the BS.</p>— Sarah21 (@mimix3) <a href="https://twitter.com/mimix3/status/1085684393593561088?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Nervous laughter<blockquote class="twitter-tweet" data-lang="en"><p lang="en" dir="ltr">You may be onto something. Tooth-bearing with the jaw clenched is generally recognized as a signal of submission or non-threatening in primates. Involuntary smiling or laughing in tense situations might have signaled that you weren’t a threat.</p>— Jager Tusk (@JagerTusk) <a href="https://twitter.com/JagerTusk/status/1085316201104912384?ref_src=twsrc%5Etfw">January 15, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Um, yipes.<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Sometimes it feels like my big toe should be on the side of my foot, was that ever a thing?</p>— B033? K@($ (@whimbrel17) <a href="https://twitter.com/whimbrel17/status/1085559016011563009?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Researchers are using technology to make visual the complex concepts of racism, as well as its political and social consequences.
- Often thought of first as gaming tech, virtual reality has been increasingly used in research as a tool for mimicking real-life scenarios and experiences in a safe and controlled environment.
- Focusing on issues of oppression and the ripple affect it has throughout America's political, educational, and social systems, Dr. Courtney D. Cogburn of Columbia University School of Social Work and her team developed a VR experience that gives users the opportunity to "walk a mile" in the shoes of a black man as he faces racism at three stages in his life: as a child, during adolescence, and as an adult.
- Cogburn says that the goal is to show how these "interwoven oppressions" continue to shape the world beyond our individual experiences. "I think the most important and powerful human superpower is critical consciousness," she says. "And that is the ability to think, be aware and think critically about the world and people around you...it's not so much about the interpersonal 'Do I feel bad, do I like you?'—it's more 'Do I see the world as it is? Am I thinking critically about it and engaging it?'"
President Vladimir Putin announces approval of Russia's coronavirus vaccine but scientists warn it may be unsafe.
A new coronavirus vaccine on display at the Nikolai Gamaleya National Center of Epidemiology and Microbiology in Moscow, Russia.
Credit: Alexander Zemlianichenko Jr/ Russian Direct Investment Fund via AP
Medical workers draw blood from volunteers participating in a trial of a coronavirus vaccine at the Budenko Main Military Hospital outside Moscow, Russia.
Credit: Russian Defense Ministry Press Service via AP
A report from the New York Times raises questions over how the teletherapy startup Talkspace handles user data.