Scientists have managed to create a vaccine for covid-19. Getting enough people vaccinated will be even harder
科学家已经设法研制出了新冠疫苗。让人们充分接种是更大的挑战

NINE LONG years elapsed between the isolation of the measles virus in 1954 and the licensing of a vaccine. The world waited for 20 years between early trials of a polio vaccine and the first American licence in 1955. Marvel, then, at how the world’s scientists are on course to produce a working vaccine against SARS-CoV-2, the virus that causes covid-19, within a single year.
从1954年分离出麻疹病毒毒株,到一种麻疹疫苗获批,足足花了九年。从小儿麻痹症疫苗的早期试验,到美国首个疫苗在1955年获批,世界等待了20年。所以,惊叹吧,全球科学家眼看将在仅仅一年内就拿出有效的新冠病毒疫苗了。

And not just any vaccine. The early data from a final-stage trial unveiled last week by Pfizer and BioNTech, two pharma companies, suggests that vaccination cuts your chances of suffering symptoms by more than 90%. That is almost as good as for measles and better than the flu jab, with an efficacy of just 40-60%. Suddenly, in a dark winter, there is hope.
而且这不是什么寻常的疫苗。两家制药公司美国辉瑞(Pfizer)和德国BioNTech上周公布的三期临床试验的初步数据表明,接种疫苗可令出现症状的几率降低90%以上。这样的预防效果几乎和麻疹疫苗差不多,优于流感疫苗的40%至60%。突然之间,黑暗的冬夜里显现了曙光。

Not surprisingly, Pfizer’s news on November 9th roused the markets’ bulls. Investors dumped shares in Clorox, Peloton and tech firms, which have all benefited from the coronavirus, and instead switched into firms like Disney, Carnival and International Consolidated Airlines Group, which will do well when the sun shines again. The OECD, a club of mainly rich countries, reckons that global growth in 2021 with an early vaccine will be 7%, two percentage points higher than without.
毫不意外,11月9日辉瑞发布的消息激发股市走强。投资者抛售得益于疫情的高乐氏(Clorox)、帕洛顿(Peloton)及高科技公司的股票,转而买入迪士尼、嘉年华邮轮(Carnival)及国际联合航空集团(International Consolidated Airlines Group)这类待到雨过天晴时将表现出色的股票。成员主要为富裕国家的经合组织(OECD)估计,在首批疫苗投用的情况下,2021年的全球增长率将为7%,比没有疫苗的情况高两个百分点。

There is indeed much to celebrate. Pfizer’s result suggests that other vaccines will work, too. Over 320 are in development, several in advanced trials. Most, like Pfizer’s, focus on the spike protein with which SARS-CoV-2 gains entry to cells. If one vaccine has used this strategy to stimulate immunity, others probably can, too.
这确实很值得庆贺。辉瑞的结果意味着其他疫苗也会奏效。全球正在研发的疫苗超过320种,其中多个已处于后期试验阶段。大多数都和辉瑞研制的疫苗一样,着眼于新冠病毒入侵宿主细胞所依赖的刺突蛋白。如果一种疫苗能通过这种策略激发免疫力,其他疫苗很可能也可以。

Pfizer’s vaccine is also the first using a promising new technology. Many vaccines prime the immune system by introducing inert fragments of viral protein. This one gets the body to make the viral protein itself by inserting genetic instructions contained in a form of RNA. Because you can edit RNA, the vaccine can be tweaked should the spike protein mutate, as it may have recently in mink. This platform can be used with other viruses and other diseases, possibly including cancer, BioNTech’s original focus.
辉瑞的疫苗也是首个运用到一种前景大好的新技术的疫苗。许多疫苗通过向体内引入病毒蛋白的惰性裂解片段来激发免疫系统。而辉瑞的这款疫苗则是把含遗传指令的RNA注入体内,让人体自行生成病毒蛋白。因为RNA是可编辑的,所以刺突蛋白假如发生了变异——最近在养殖水貂中可能就出现了变异——也能对疫苗作相应微调。该技术平台可用于其他病毒和疾病,可能包括癌症,这也是BioNTech本来的研发重点。

So celebrate how far biology has come and how fruitfully it can manipulate biochemical machinery for the good of humanity (there will be time later to worry about how that power might also be abused). And celebrate the potency of science as a global endeavour. Drawing on contributions from across the world, a small German firm founded by first-generation Turkish immigrants has successfully worked with an American multinational company headed by a Greek chief executive.
生物学取得了长足发展,能够运用生物化学机制大大造福人类,这值得庆贺(这种力量也可能被滥用,暂且把担忧放在后头)。全球联合科研攻坚的成效也让人欢欣鼓舞。通过吸收世界各地的科研成果,一家由第一代土耳其移民创立的德国小公司和一家由希腊人担任首席执行官的美国跨国公司合作成功。

Yet despite the good news, two big questions stand out, about the characteristics of the vaccine and how fast it can be distributed. These are early results, based on 94 symptomatic cases of covid-19 from among the 44,000 volunteers. Further answers must wait until the trial has gathered more data. It is, therefore, not clear whether the vaccine stops severe cases or mild ones, or whether it protects the elderly, whose immune systems are weaker. Nor is it known whether inoculated people can still cause potentially fatal infections in those yet to receive jabs. And it is too soon to be sure how long the beneficial effects will last.
不过,在这个好消息背后仍有两大问题——疫苗的特性和普及速度。目前的说法是基于早期结果:44,000名志愿者中有94人出现感染新冠病毒的症状。但要获得进一步的答案,必须等到试验收集到更多数据。因此,尚不清楚该疫苗是可以预防重症还是轻症感染,能否保护免疫系统较弱的老年人,也不知道接种者是否仍会在未接种人群中造成可能致命的感染。疫苗的预防效果能维持多久暂时也不能确定。

Clarity will take time. In the next few weeks the trial should be declared safe, though further monitoring of the vaccine will be needed. The companies predict that immunity will last for at least a year. The 90%-plus efficacy is so high that this vaccine may offer at least some protection to all age groups.
要搞清楚这些问题需要时间。未来几周应该会宣布疫苗试验安全,尽管仍需进一步监测。两家制药公司预测免疫力至少可维持一年。有效性高达90%以上意味着该疫苗可为所有年龄段的人群至少提供一定程度上的保护。

While the world waits for data, it will have to grapple with distribution. Vaccine will be in short supply for most of next year. Although RNA jabs may prove easier to make at scale than those based on proteins, Pfizer’s requires two doses. The company has said that it will be able to produce up to 50m doses in 2020 and 1.3bn next year. That sounds a lot, but America alone has over 20m first responders, medical staff, care-home workers and active-duty troops. Perhaps a fifth of the world’s 7.8bn people, including two-thirds of those over 70, risk severe covid-19. Nobody has ever tried to vaccinate an entire planet at once. As the effort mounts, syringes, medical glass and staff could run short.
在等待数据的同时,全球还必须应对疫苗分发的问题。明年大部分时间里疫苗都将供不应求。尽管RNA疫苗可能被证实比基于蛋白质的疫苗更易批量制造,但辉瑞的疫苗需要接种两剂。该公司表示能在2020年生产最多5000万剂疫苗,到2021年生产13亿剂。这听来很多,可单单在美国,急救人员、医务人员、养老院工作人员和现役军人就超过2000万人。全球78亿人口中可能有五分之一(包括70岁以上人群的三分之二)有感染新冠重症的风险。一下子给整个地球的人接种疫苗是前所未有的尝试。随着接种量增加,注射器、医用玻璃和相关工作人员都可能出现短缺。

Worse, Pfizer’s shots need to be stored at temperatures of -70°C or even colder, far beyond the scope of your local chemist. The company is building an ultra-cold chain, but the logistics will still be hard. The vaccine comes in batches of at least 975 doses, so you need to assemble that many people for their first shot, and the same crowd again 21 days later for a booster. Nobody knows how many doses will be wasted.
更糟糕的是,辉瑞的疫苗需要在零下70°C甚至更低的温度中存放,远超出各地普通药房的存储能力。该公司正在打造一条超低温冷链,但物流仍会是个大挑战。运输一批新冠疫苗至少有975剂,所以需要召集这么多人打第一针,21天后再次召集同一群人打补强针。谁也不知道有多少疫苗会在这个过程中浪费掉。

So long as there is too little vaccine to go around, priorities must be set by governments. A lot depends on them getting it right, within countries and between them. Modelling suggests that if 50 rich countries were to administer 2bn doses of a vaccine that is 80% effective, they would prevent a third of deaths globally; if the vaccine were supplied according to rich and poor countries’ population, that share would almost double. The details will depend on the vaccine. Poor countries may find ultra-cold chains too costly.
只要疫苗供应不足,政府就必须定下接种的优先次序。国家内部和国家之间都要处理好这方面的轻重缓急,这事关重大。模型显示,如果50个富裕国家能给国民接种20亿剂有效率为80%的疫苗,全球新冠死亡数字就会减少三分之一。如果疫苗是按富国和穷国的人口供应,该比例会翻近一倍。具体情况将取决于疫苗本身。对穷国而言,超低温冷链的成本可能太高了。

The domestic answer to these problems is national committees to allocate vaccine optimally. The global answer is COVAX, an initiative to encourage countries’ equal access to supplies. Ultimately, though, the solution will be continued work on more vaccines. Some might survive in commercial refrigerators, others will work better on the elderly, still others might confer longer protection, require a single shot, or stop infections as well as symptoms. All those that work will help increase supply.
在一国内部,解决这些问题的办法是成立国家级委员会,对疫苗做优化分配。在全球,应对方案是旨在促进各国平等获取疫苗的“新冠肺炎疫苗实施计划”(COVAX)。但最终的答案仍是继续研制更多疫苗,有些可以用商用冰箱存储,有些更适用于老年人,还有一些能提供更长期的免疫保护,只需注射一次,或者既防症状又防感染。所有起效的疫苗都将有助于增加供应。

Only when there is enough to go around will anti-vaxxers become an obstacle. Early reports suggest the jab causes fevers and aches, which may also put some people off. The good news is that an efficacy of 90% makes vaccination more attractive.
等到有足够的疫苗供应时,反接种派才会成为阻力。早期试验报告表明接种这款疫苗会引起发烧和疼痛,这也可能让一些人心生抗拒。好消息是,高达90%的预防率会让接种疫苗更有吸引力。

The tunnel ahead
前方隧道

The next few months will be hard. Global recorded death rates have surged past their April peak. Governments will struggle with the logistics of vaccination. America is rich and it has world-class medicine. But it risks falling short because the virus is raging there and because the transition between administrations could lead to needless chaos and delays. Squandering lives when a vaccine is at hand would be especially cruel. Science has done its bit to see off the virus. Now comes the test for society. ■
未来几个月会很艰难。全球报告的新冠患者死亡率已超过4月时的峰值。各国政府将迎战疫苗接种的物流问题。美国财力雄厚,医学水平世界一流。但由于那里疫情肆虐,以及政府交接可能导致不必要的混乱和拖延,有可能辜负大家的期待。有疫苗可用还让人白白丧命只会显得特别残酷。科学界已经尽其所能来遏止新冠病毒,现在是考验社会的时候了。