At the precise moment when scientists are seeking the so far elusive COVID-19 vaccine, a Chinese translation of The Vaccine Race is released. The work by US writer Meredith Wadman offers a historical and tantalizing view of the complex process, and unexpected difficulties, in the development of vaccines against polio, rubella and rabies in the 1960s and '70s.
The book describes, in absorbing but understandable detail, the path of a vaccine, from its research and development, to its use in the market and the necessary supervision of related public organizations that lead to it becoming an effective and reliable product. The fascinating story is easy to follow, says Wu Zhiwei, deputy director of State Key Laboratory of Analytical Chemistry for Life Science at Nanjing University.
Wadman started writing the book in 2016, determined to tell the stories of obscure scientists Leonard Hayflick and Stanley Plotkin. The former used cells from an aborted fetus to develop a new technology that "would sustain much of the world's vaccine-making for 60 years"; the latter adopted Hayflick's technology to make a reliable vaccine against rubella.
Rubella can cause severe damage to fetuses during the first trimester. But the vaccine developed by Plotkin has been used worldwide and "eliminated rubella in the Western Hemisphere", Wadman says in an email interview with China Daily.
She spent three years preparing and writing the book because she had to "wrestle a very complicated, sprawling tale with many characters into a readable form"-essentially, explaining science so that readers can easily follow and organizing the intricate scientific history into a compelling story.
Another difficulty was to decide whether and how she should approach Mrs X. In 1962, Swedish woman, who was given the pseudonym Mrs X, had a legal abortion and without her knowledge, the fetus was sent to Hayflick at the Wistar Institute in Philadelphia, the United States, who used it to develop a new technology to nurture human cells for vaccine production.
Vaccines developed using tissues from the aborted fetus have made a lot of money for big companies, which raises the question of whether or not Mrs X should be paid.
In 2013, Wadman managed to reach Mrs X, but "she did not want to tell me what happened to her in that long-ago, painful time", Wadman writes. "But she did say: 'They were doing this without my knowledge. That cannot be allowed today'."
Ethical as well as legal issues regarding the research and development of vaccines are, therefore, two major topics in the book.
"It's important to tackle the legal and moral problems that are every bit as much a part of any medical development as the science," she says.
"These are still live questions today: Who owns a medicine or a vaccine developed with cells, proteins or tissues taken from a single person, like Mrs X? Who deserves a share of the profits? Should people always have to give informed consent for the use of their tissue? Even if it is, say, a remnant after surgery from which their name and identifying information has been removed. Why, or why not?"
In the book, Wadman talks about how researchers carried out trials on human bodies in the US in the 1950s and '60s, especially from disadvantaged groups, such as orphans, babies born by female prisoners, and mental patients.
"It's important to document and talk about the past abuse of human beings in medical research because there is always a danger, despite new laws and regulations forbidding such abuses, that they will happen again," she says.
These concerns are especially important at the moment, when pressure of the pandemic requires the quick approval of a COVID-19 vaccine.
"One worries that ethical corners may be cut because of this pressure. That would harm tens of millions of people who might receive an unsafe or ineffective vaccine," she says.
Wadman mainly focused on the research and development of a rubella vaccine, making the book one of very few which records that struggle, she says.
Although there are already whole books devoted to the race for a polio vaccine, which took place a decade earlier than the creation of a rubella vaccine, Wadman devoted one-third of the book to the development of polio vaccine.
The polio vaccine race "was an integral part of the scientific backdrop and the politics that confronted the rubella vaccine makers. It was important to include some of that story", she says.
The rabies vaccine, also developed by scientists at Philadelphia's Wistar Institute in the 1960s, is another area of focus in the book.
"Before the Wistar scientists made this much-improved vaccine, the available rabies vaccines were awful. They were sometimes ineffective and sometimes dangerous. So, the new rabies vaccine was an important advance," she says.
The book is divided into three parts: the development of the cells from Mrs X's fetus by Hayflick, the rubella vaccine invented by Plotkin using Hayflick's cells, and the consequent "wars". "The war on the cells by abortion opponents in the US, and the war between Hayflick and the US government in the 1970s over who owned the cells," she says.
The entangling stories in the book echo Wadman's reply that "every part of vaccine research and development is difficult, from the first lab dish studies to the final distribution of an approved vaccine to millions of people."
The research and development of reliable vaccines usually lasts years, and has "never been developed in the compressed time frame that is being attempted with COVID-19 vaccines". For instance, scientists spent five years developing the first rubella vaccines after a huge epidemic in the mid-1960s.
"Today, some of the molecular methods in scientists' toolkits make it possible, potentially, for vaccine development to happen much more quickly. But human trials cannot be rushed," she says.
Anyone who cares about human health and who loves a scientific adventure story is the target reader of the book, which provides perspectives for people to think about the creation of vaccines, especially under the current circumstances.
For example, both Hayflick and Plotkin met political obstacles that nearly defeated their efforts, especially the latter. "The race for a rubella vaccine, and how favoritism and politics nearly derailed Plotkin's superior solution, is a cautionary tale for today's race for a COVID-19 vaccine," she warns.