US vaccine policy risks undermining use of tech to advance medical science

Flaws in US vaccine policy could make it impossible to leverage technology in optimal ways to advance medical science

In the late 18th century, Edward Jenner discovered vaccination. He used cowpox, a relatively benign disease to protect against its cousin, the deadly smallpox. Others picked up on his principles and looked to vaccinate against other diseases. The United States’ War of Independence saw George Washington ordering troops to take the smallpox vaccine. 

For the next 200-odd years, vaccinations guarded people against an array of diseases, like measles, rubella, smallpox, cholera, typhoid, polio, and mumps. By 1980, widespread vaccination had eradicated smallpox. 

Then Covid happened. By 2020 there had been huge technological advancements that allowed vaccines to be developed, tested and rolled out at scale quickly. But the US administration was, at that point, being run by people who could, at best, be politely described as pseudo-libertarian. Bodily autonomy and medical freedom were cited as reasons for not imposing vaccine mandates. 

In states run by Republican administrations (Red states), vaccine mandates were not imposed. A lot of people didn’t take shots. Six years later, the data is clear. The red states suffered much higher infection rates and far more deaths. But the second Trump administration is ignoring the data and dragging Anthony Fauci through a Senate hearing. 

The logic for vaccine mandates is obvious. If an unvaxxed individual moves around, he or she could get infected and infect many others. We have data from 2020 and 2021 that supports that logic. Balanced against that is an argument, which one may consider bad faith. Republicans don’t accept bodily autonomy as a reason for allowing abortions, and the current health czar Robert Kennedy Jr (an anti-vaxxer) could not find more cogent arguments against vaccines than “medical / bodily autonomy” at his confirmation hearing. 

In the past five years, technology has advanced explosively. For example, artificial intelligence (AI) has made a vaccine for the flu, unaided by human intervention. AI has also developed 16 artificial viruses in the recent past. The implications are astounding. 

The flu vaccine, which comes out of a Cambridge lab, is an ambitious attempt to get past a data barrier. Flu viruses mutate very fast. This requires vaccine-makers to tweak their vaccines and keep developing new ones. 

But some part of the virus “design” remains common to different iterations and mutations of the virus. Moreover, many vaccines (especially RNA-based vaccines) are delicate and require cold storage. An AI designed vaccine may be able to work its way through all the data in a virus’s genome to isolate and identify elements that remain common across iterations and design vaccines that will continue to work against new mutations. AI may also be able to design vaccines that don’t need cold storage, improving logistics of distribution. 

The design of new artificial viruses could lead to kneejerk fears, given the paranoid narrative about the possible escape of Covid-19 from a Chinese lab. However, the new viruses are an elegant attempt to attack dangerous bacteria. They are bacteriophages — viruses designed to eat infective bacteria, while not affecting other bodily functions. 

This is an attempt to tackle the problem of antibiotic-resistance through an alternative approach. It’s an old idea but AI may lend muscle to the fast development of phages. Stanford researchers collaborated with a private lab, Arc, to work through 700,000 potential designs based on a specific (natural) virus that eats E-coli. They narrowed these down to 285 potential designs and then to 16 designs  that can reproduce. Several of these artificial viruses are more efficient than the original bacteriophage when it comes to eating E-coli. 

Of course, there are big risks to this approach.  AI’s ability to design viable, entirely new biological entities with predetermined characteristics moves into science-fictional territory. There are real fears that the entities could escape and go rogue, or may have undesirable side-effects.  But this is transparent peer-reviewed research and the chances of going rogue are therefore lower than with a secretive hole-in-the-wall lab. 

This brings us back to the flaws in US vaccine policy. Defense Secretary Pete Hegseth rescinded flu vaccine mandates a few months ago for US defence forces, citing medical autonomy and religious freedom. A flu outbreak promptly followed with 220 soldiers infected at an air base in Texas. 

The technology has improved. But the logic that led George Washington to order vaccination hasn’t changed. And policy flaws could make it impossible to leverage the technology in optimal ways. 

The writer is a New Delhi-based independent journalist