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Comment by swalsh | Hacker News Reader

In a recent article about the Moderna vaccine, it was mentioned that the actual development only took 2 days.... and it was done in January!

Given how short of a time it took to actually develop this thing, could we have drastically sped up this process by maybe being a bit more risky with the trials? At this point ~1.5 million people have died from the virus.

I've really struggled with this knowledge that we've had a vaccine which it turns out is 95% effective for practically the entire course of the pandemic at at this point... and our conservative "moral" process was to let 1.5 million people die while we vet it.

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There are 321 vaccine candidates under development as of September with about 30 in clinical trials. Throughout the year there were probably many, many hundreds or thousands more discarded at early stages of development and evaluation. How would you have selected this particular candidate over all the other possibilities that got dropped?

I understand your point, I really wan't try to make some kind of moral criticism of the process. I realize it was developed for a reason. My question was more about the point that especially with this new mRNA process, we're going to be able to develop these things blazingly fast. But the process for approvals is still glacier slow (and this was already the SPED UP timeline).

My question was more where is there room to speed this stuff up?

Efficacy (the main thrust of Phase 3 trials) could be sped up and made more thorough by deliberately exposing participants. I think one could argue that deliberate exposure and waiting around for enough people to be "naturally" exposed are pretty equivalent in terms of end results, but that's not a winning argument so far. Might be harder to recruit when you know you're definitely getting exposed vs. no change in risk from the no-action option.

But that does presume your methods of exposure are equivalent to what's happening in the real world, both in terms of method and dose. And those are both open questions here and could have bearing on efficacy.

To be fair, a lot more than 1.5 million people could have died if there were delayed adverse affects of the vaccine and we'd already done a mass rollout. I think it's probably good that we put it through a proper trial process.

Also, we'd still have had to wait for production ramp up which I believe has been done in parallel to the testing, so it may not have saved that much tie.

Whether or not it would have been a good idea to loosen the approval process aside, accelerating it would likely not have had much of any effect on saving those lives. The bottleneck is production capacity. As I understand it Moderna and Pfizer/Biontech have both been building production capacity and creating vaccines as fast as possible, but have only now created enough to vaccinate a few tens of millions of people combined. If they had been approved in the summer, when they went to Phase III trials, they might have, perhaps, been able to turn out a few thousands vials a day which is not really enough to meaningfully impact the spread or death rates even if you were able to highly target high-risk groups.

If we were serious about preventing deaths, a lot more could and would have been done before going as far as taking risks on experimental drugs.

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