Leaders on the front lines of the COVID-19 pandemic have often suggested that treatments and a vaccine for the virus are just months away.

Professor David Ridley, a health economist at Duke University’s Fuqua School of Business, is confident scientists will develop an effective vaccine soon – he’s just not sure how quickly manufacturers can produce the billions of doses the world needs.

“I think people are misinterpreting optimism from vaccine makers when thinking about the likelihood they will succeed,” said Ridley, faculty director of Fuqua’s Health Sector Management program. “Every drug maker, every vaccine maker -- when they're starting out, they think a drug is going to be big, or they wouldn't spend millions of dollars testing it.”

Unfortunately, only one in eight drugs that enter the first phase of Food and Drug Administration (FDA) testing actually make it to market, he said. 

A number of candidates have entered early trials, so the odds are good, Ridley said, but manufacturing enough doses could take years. Ridley explained his reasoning in an opinion piece in USA Today and in a discussion for Fuqua followers on LinkedIn (see video above). Even when a vaccine has been proven effective, it takes years to make it.

“You need several years of lead time for manufacturing,” Ridley said. “You need to be welding miles of stainless steel pipe now at a major facility that's going to make your vaccine today if you want even a chance of it at massive scale next year.”

A number of measures could expedite the typical five-year process of getting a vaccine from the lab to market, he said, namely collaborations between the government and manufacturers, the use of existing facilities and concessions to some FDA regulations.
“But the FDA won’t totally let down their regulations for fear of setting a bad precedent, for fear of hurting people,” Ridley said.

To immunize even half of the global population against COVID-19, we’ll need billions of doses of the vaccine, because many vaccines require two doses to be effective, he said.
While the world waits for production, we most likely will have to decide whom to vaccinate and when.

"Fortunately, we’d go a long way just vaccinating health care workers, especially in emergency departments, or people working in long-term care, and people working in grocery stores,” Ridley said. “My point is that you should not expect to be vaccinated unless you’re a member of one of those populations – at least not anytime soon.”