Fauci insists that an adequate defense against future pandemics will have to be flexible. “I have been saying for eight, ten years that we should make a list of microbes and try to develop a basic platform vaccine,” he told me in 2016. A platform vaccine addresses an entire class of virus, not just a particular strain. “We keep trying to develop a vaccine for one thing—usually the last one—and it’s a waste of time,” he said. “Every time we get hit, it is always something we didn’t expect. So, instead of predetermining what it is you’re going to prepare for, make universal platforms.”
Such an approach is eminently possible. Using gene-sequence information and synthetic DNA, biologists are now capable of making parts of a vaccine in advance. It takes almost no time to sequence a viral strain, and with that information it should be possible to complete a bespoke vaccine in a matter of weeks. “You could build a chassis for the vaccine, and you would have it on the shelf,” Fauci said. “Then all you would need to do is insert the gene of the protein you want to express and make a gazillion doses and send it out.”
There are even more futuristic aspirations: the genomics pioneer J. Craig Venter has proposed using a sort of 3-D printer to manufacture vaccines on demand. It is already possible to print the nucleotides that make up DNA and assemble them. Venter argues that, in the time it takes for an infected person to fly from one side of the world to the other, we should be able to print, assemble, and administer a vaccine.
To even contemplate creating these kinds of treatments, Fauci says, would require building an entirely new system for making vaccines before a pandemic arises. But, in addition to the scientific obstacles, this would cost billions of dollars, and no company or politician has been willing to spend the money. Perhaps, just as AIDS transformed our approach to clinical trials, our experience with COVID-19 will change our attitudes about preventing infectious diseases. A proper investment in both research and emergency preparedness would have prevented at least some of the unspeakable human loss we are now experiencing and the economic crash that has just begun.
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