Notes on A Shot to Save the World: The Inside Story of the Life-or-Death Race for a Covid-19 Vaccine by Gregory Zuckerman
“Treatments save lives, but vaccines save populations.”
—Hanneke Schuitemaker
A Shot to Save the World is a book about some of the greatest scientific achievements of all time. It is a story of passion, perseverance, hard work, and brilliance. It is a tribute to those who have saved countless lives through their inventions. And it is an inspiration for future scientists.
In 1774, the English farmer Benjamin Jesty used a knitting needle to scrap pus from a cow showing symptoms of cowpox. Then, he intentionally infected his family with the material. Thus, the Jestys became immune to smallpox, and vaccination was born.
In 1796, Edward Jenner decided to do something similar. However, he evaluated his subjects, analyzed the results, and published his findings. Soon thereafter, vaccination was embraced worldwide.
Today, all vaccines must undergo a rigorous approval process. There are three testing phases involving numerous participants and randomized control groups. Neither the researchers nor the participants know who gets a real drug and who gets a placebo. Phase 1 is about safety, phase 2 is about impact, and phase 3 is about efficacy. To be approved, vaccines must work better than a placebo and be safe to use. They need not be 100 percent effective or have zero side effects because such utopian goals are practically unachievable and unnecessary. The side effect of many diseases is death, and the job of vaccines is to increase the chance of survival.
Vaccines work together with our immune system, which has two lines of defense: innate and adaptive. The former doesn’t require prior exposure to a pathogen to be activated against it, but it is not always powerful enough. The latter is slower but more specific. It involves so-called B cells, which produce antibodies against particular pathogens. What vaccines do is trigger the adaptive immune system as though real danger were present, thereby preparing it for the future.
Most vaccines employ a harmless version of a pathogen to achieve this. But there is another way: they can use messenger ribonucleic acid (mRNA), or as Moderna’s CEO Stéphane Bancel calls it, “the software of life.”
This molecule takes instructions from the DNA, which is located in the cell nucleus, and brings them to the cytoplasm, where proteins are manufactured. It was discovered in 1961 but didn’t intrigue many researchers at first due to its short life. However, some were hooked.
Slowly but surely, scientists learned how to insert mRNA into a body to create proteins. In 1995, David Boczkowski even made an mRNA vaccine, but it wasn’t very good. It took 25 more years, thousands of scientists, and tens of billions of dollars to develop not one but two safe and effective Covid-19 mRNA vaccines.
Covid-19 is the latest coronavirus that has managed to jump from a nonhuman animal to humans. Other notable coronaviruses are OC43, which arose in the 19th century and is one of the causes of the common cold, SARS-Cov (2002), and MERS (2012). The last two are deadlier than Covid-19 but less infectious.
Only six months after the first Covid-19 cases in Wuhan, China, more than 100 teams were already racing against the clock to develop a vaccine against the virus. Companies such as BioNTech, Pfizer, Moderna, and Novavax had gone all in, neglecting all other projects and working 24/7 on this one. Oxford, AstraZeneca, and Johnson & Johnson had brought their A game too. The results were spectacular. The world had several vaccines developed in less than a year: four times faster than the previous record (mumps in 1967). In conclusion, A Shot to Save the World by Gregory Zuckerman is a masterfully written book based on fact-checked interviews with more than 300 key players in the race for a Covid-19 vaccine. It is about what went right. It educates and entertains. And it gives hope. After all, necessity drives progress, and crises can result in medical breakthroughs. The First World War gave us ambulances and anesthesia, the Second World War brought us antibiotics and antimalarial drugs, and the Covid-19 pandemic taught us how to develop vaccines faster than ever and how to harness the power of mRNA. If only we didn’t have to pay in human lives.
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