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Is the vaccination in Russia an historic move or a gamble?

14 August 2020

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Jonathan Marriott, Chief Investment Officer

When Russia announced that they were going ahead with a COVID-19 vaccine this week without further trials, it was greeted with a degree of caution by experts around the world. The Gamaleya Institute, where it was produced, has a recent track record of success, having produced an internationally accepted Ebola vaccine. The concern here, however, is that this vaccine has not been through the third phase of clinical trials that would normally be required before a vaccine is approved.

To set an example, President Putin has had his daughter inoculated. In doing this, he is following in the footsteps of a long past Russian leader. A Russian spokesman claimed Russia has led the way in the past, pointing out that Catherine the Great was vaccinated against smallpox thirty years before the practice was taken up elsewhere. Putin may wish to have his name associated with Catherine the Great, but the story is not that simple. In a further nod to past Russian leadership in the space race, they have named the vaccine 'Sputnik V', in reference to the world's first satellite. 

Catherine the Great was inoculated in 1768 by putting a small amount from the pustules of someone who was suffering from smallpox under the skin, which carried the risk of developing the full-blown disease. This technique had been known about for many years and may have been used in China as early as 200 BCE. It had been introduced to Europe via Turkey in the 17th century. The Princess of Wales had two of her daughters variolated, as the technique was known, in 1722, long before Catherine the Great. The Empress wanted to set an example, but imported an English physician Thomas Dimsdale to conduct the procedure. It was considered so dangerous that the doctor had a relay of horses ready to make his escape if it went wrong. Whilst it had been noted that dairy maids, through contact with cowpox, achieved an immunity to the much more dangerous smallpox, it was not widely used until the English scientist Edward Jenner published a detailed study in 1798. It was vaccination using cowpox that eventually led to the eradication of smallpox by 1980. It was work by Jenner, who has been referred to as the father of immunology, that eventually led to other vaccines in the 19th and 20th centuries. So Russian claims of early leadership in the field are not well-founded.

Edward Jenner had many interests and had been made a fellow of the Royal Society for his study of cuckoos. He observed that cuckoo chicks ejected other chicks and eggs from their foster parents' nest; this was only fully accepted when photographed in 1921. His first paper on vaccination was rejected by the Royal Society and he published it privately. There were doubters from the start who used the paper on cuckoos to ridicule his other ideas. The anti-vaccination movement is nothing new. More recently, it was falsely suggested that the Mumps Measles and Rubella (MMR) vaccine was linked to autism and the take-up fell leading to a resurgence in cases. New vaccines can have dangerous side effects and full testing is needed to make sure they are both safe and effective. If we want to eradicate COVID-19, we need a high proportion of the population to have the vaccination, which means confidence in its safety is vital. Releasing a vaccine without thorough testing risks adverse effects and will damage public confidence in vaccination.

Russia is taking a gamble in approving the vaccine without phase three testing. The Gamaleya Institute may have confidence in their vaccine and moving ahead is a bold move. A fully-tested vaccine for COVID-19 may not be available until the end of the year and making it available to seven billion people around the world will be a massive task. We must hope the Russian move is not a false start, which could do more harm than good. There are many different approaches to making a vaccine and the UK is taking a more cautious approach, ordering vaccines from six potential sources, a total of 340 million doses for a population of 66 million, in the hope that at least one of them works.

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