The Oxford, UK’s Jenner Institute and the Oxford Vaccine Group jumped out to an early lead in the race for the SARS2 vaccine in March. In April, the Cambridge, UK-based AstraZeneca partnered with the Oxford group to mass-produce and distribute the SARS2 vaccine when it became available. The vaccine was supposed to be among the first, and maybe only, of its kind. It’s a recombinant adenovirus vector vaccine, which the company claims is “based on a weakened version of the common cold.” In other words, it’s a adenovirus that has SARS-CoV-2 RNA inserted into its DNA. Usually adenoviruses are quite weak. And given that it’s not our pandemic coronavirus, it would mean more than one dose might be needed for immunity. Yet it also claims that a modifier based on ChAdOx1—an adenovirus derived from the feces of chimpanzees—will make the vaccine so potent that recipients will need only a single dose to receive immunity.
Yesterday, the Phase 3-trial of this ideal vaccine from Oxford had to be put on hold when at least one individual involved in the trial had a serious reaction. AstraZeneca scrambled over much of the intervening hours to assure shareholders that everything is fine—that this is just a precaution, that holds are normal at this stage. While the condition that doctors discovered in the patient, transverse myelitis, is extremely serious, these sorts of holds are not unusual.
It is worth pointing out that the adenovirus delivery system, and its possible dangers, are not new, even though the Oxford-AstraZeneca group is portraying it as a revolutionary vaccine system. Adenoviruses usually produce only respiratory problems, diarrhea, and fevers. Yet they’ve been associated with acute flaccid paralysis (AFP) and transverse myelitis. Genetically engineered adenoviruses have been used for almost three decades. The reason it has not been approved for vaccine delivery before now is likely due to a dose of a gene therapy treatment in the 1990s using an adenovirus delivery system that killed 18-year-old Jesse Gelsinger. Gelsinger received one dose of genetically-modified adenovirus. His immune system went out of control and killed him four days later. The tragedy put a damper on gene therapy trials for years, until venture capitalists began seeing it as a strong investment again after the 2008-09 recession.
Those investments—the vast sum of money going from the US federal government toward these biotech companies—will keep AstraZeneca, Johnson & Johnson, and all the rest pushing forward with vaccine development, come what may. And their financial investments in Congress, both Democrats and Republicans, will no doubt help shield them from severe repercussions should another Gelsinger event happen.
Perhaps for these reasons, the far right and the far left have found common ground in their distrust of vaccines.
The anti-vax movement has a long history—longer even than vaccines themselves. Most ancient societies had a practice of “variolation,” meaning some small bit of diseased tissue, a scab or a thread dipped in pus, was intentionally introduced into a small cut on a child’s arm or blown up their nostrils. The recipient expressed a much milder form of the disease. In China, India, and across Africa, this practice inoculated millions against smallpox. In March 1717, while traveling in Istanbul, Lady Mary Wortley Montagu learned of the treatment. A year later, she had her young children variolated; they survived a smallpox epidemic. In 1721, smallpox struck Britain and her North American colonies. English aristocrats tentatively attempted Wortley Montagu’s reported method. Boston preacher Cotton Mather learned of variolation from his slave, Onesimus, and told respected local physician Zabdiel Boylston. Boylston used his own slaves as medical subjects for the smallpox inoculation. When they recovered, he and Mather attempted to inoculate more of Boston. But white folks were not keen on a medical treatment introduced by a Black slave, even threatening to throw the once admired Mather and Boylston out of town for attempting it. Still, many did get the inoculation, and were glad for it. Those who did receive the smallpox inoculation had about a 2.5% case fatality rate compared to over 11% among the non-inoculated general public.
Vaccines originally introduced a parallel disease from a different organism into a human in order to inoculate against a different illness (“vaca” being Latin for cow; some of the first vaccinations were derived from cowpox pus). This alone was enough to disgust the original anti-vaxxers.
The “unnaturalness” of taking a dead virus or bacteria from a different animal, a chicken egg, say, and injecting it into a human arm continues to fuel many arguments against vaccines today. The fact that vaccination is compulsory angers others—especially when bundled with the argument that pharmaceutical companies earn piles of money and/or cultural capital through vaccines for even seemingly non-threatening diseases once they’re added to (and almost never removed from) the national “schedule.” We know corporate interests have led to low quality, even dangerous drugs. And there’s a very real race to get any vaccine out and claim piles of government money. Add the repeated lowering of regulations, lack of oversight, and the “place any bet” attitude of the current administration toward the corporate producers of the vaccine. Mix this short-term, consumerist drive with the uncertainty about the current administration’s understanding of what constitutes good medical science and what falls closer to quackery. For instance, hydroxychloroquine is back on Trump’s radar, now being promoted by a discredited medical worker who attributes “endometriosis … molar pregnancies …fibroids … cysts … [to] evil deposits from the spirit husband.”
Together, this creates a much more potent recipe for doubting a coronavirus vaccine than anti-vaxxers had when resisting smallpox inoculation in the 1700s. Libertarians will see a vaccine mandate as another form of governmental coercion. Conservatives doubt the seriousness of the coronavirus in the first place. Right-wing reactionaries believe Fauci’s CDC birthed this second SARS just so they could drop some poison or a Bill Gates-manufactured microchip into them. Left-leaning Americans who already distrust the current administration suspect that whatever comes out this fall will be a placebo at best, and perhaps merely a Trump 2020 political talisman. And many on both sides of the spectrum have become convinced that there is a link between vaccinations and rising rates of autism in America. My own sister tried to convince me at lunch yesterday that, in her words, “thirty percent of all children born in the year 2035 will be autistic.” As we sat watching the turtles sunning on the rocks of a pond, she looked me square in the eye, “it is all because of vaccines.”
What incentive is there to ditch these worries and to push your child or your significant other or yourself to the front of the line for the injection when it comes? So that they can go back to their unprepared, underfunded school full of terrified teachers who feel that they’re being used as political pawns by Congressional Republicans, most of whom are too old to have kids in school themselves?
Meanwhile, the White House is being roiled by two new controversies. The more immediate is in support of legendary Bob Woodward’s new book Rage. Taped interviews between Woodward and the president reveal that Trump admitted he knew the coronavirus was bad. On March 19—when those of us who had underfunded (or non-existent) retirement plans learned that some members of Congress used their insider knowledge to sell their stocks ahead of time, and while I was comforting my students who were upset at being sent home from college—Trump was spilling the beans to Woodward about not wanting to tell people the truth about coronavirus, lest they “panic.” Trump lied, tens of thousands died, Woodward is arguing.
The other controversy seems frivolous compared to lost lives, but turns out to be significant because it relates to the federal justice system itself. E. Jean Carroll claims that Trump raped her in a department store dressing room in 1996. Last year she made the claim explicitly and, on June 21, 22, and 24, 2019, Trump claimed he “never met this person in my life.” Carroll subsequently sued him for three counts of “publicly, falsely, and maliciously smearing her reputation.” What worries other scholars is that Attorney General Bill Barr has stepped in to argue that Trump “was acting within the scope of his office as President of the United States when he publicly denied as false the allegations made by Plaintiff.” Barr, then demanded that the United States would act as the defendant in this case. In other words, the federal government will be defending the president for things he said as president about a personal case. This again raises the unsettling issue that Barr is acting as Trump’s “fixer,” when instead he should be protecting the interests of the country. It’s the same charge that has been leveled in case after case since Barr’s appointment. It bodes ill for the election itself, which is only 55 days away.
 Adrian Kemp, “AstraZeneca and Oxford University Announce Landmark Agreement for COVID-19 Vaccine,” AstraZeneca, April 30, 2020, https://www.astrazeneca.com/media-centre/press-releases/2020/astrazeneca-and-oxford-university-announce-landmark-agreement-for-covid-19-vaccine.html.
 Rebecca Robbins, Adam Feuerstein, and Helen Branswell, “AstraZeneca Covid-19 Vaccine Study Is Put on Hold,” STAT (blog), September 8, 2020, https://www.statnews.com/2020/09/08/astrazeneca-covid-19-vaccine-study-put-on-hold-due-to-suspected-adverse-reaction-in-participant-in-the-u-k/.
 Adam Feuerstein, “AstraZeneca CEO Says Participant Had Neurological Symptoms, Could Be Discharged Today,” STAT (blog), September 9, 2020, https://www.statnews.com/2020/09/09/astrazeneca-covid19-vaccine-trial-hold-patient-report/.
 Mong How Ooi et al., “Adenovirus Type 21—Associated Acute Flaccid Paralysis during an Outbreak of Hand-Foot-and-Mouth Disease in Sarawak, Malaysia,” Clinical Infectious Diseases 36, no. 5 (March 1, 2003): 550–59, https://doi.org/10.1086/367648.
 Ryan Cross, “The Redemption of James Wilson, Gene Therapy Pioneer,” Chemical & Engineering News, September 12, 2019, https://cen.acs.org/business/The-redemption-of-James-Wilson-gene-therapy-pioneer/97/i36.
 Lev Facher, “Pharma Is Showering Congress with Cash, Even amid Coronavirus,” STAT (blog), August 10, 2020, https://www.statnews.com/feature/prescription-politics/prescription-politics/.
 Jackie Rosenhek, “Safe Smallpox Inoculations,” Doctor’s Review, February 2005, http://www.doctorsreview.com/history/feb05-history/.
 LaShyra Nolen, “The Slave Who Helped Boston Battle Smallpox,” Undark Magazine, April 2, 2020, https://undark.org/2020/04/02/slave-smallpox-onesimus/.
 Eve Watling, “Two Hundred Years of Anti-Vaxxers, from ‘cowpox Face’ to Autism Claims,” Newsweek, March 13, 2019, https://www.newsweek.com/history-anti-vaxxers-vaccination-1358403.
 Jennifer Reich, “How Anti-Vaxxers Are Thinking about a Covid-19 Vaccine,” Vox, July 28, 2020, https://www.vox.com/first-person/2020/7/28/21337621/coronavirus-covid-19-vaccine-anti-vaxxer.
 Caleb Ecarma, “Trump’s Sober New COVID Tone Involves Pushing Conspiracies From ‘Astral Sex’ Doctor,” Vanity Fair, July 28, 2020, https://www.vanityfair.com/news/2020/07/trump-sober-new-covid-tone-involves-stella-immanuel-conspiracies; Will Sommer, “Trump’s New COVID Doctor Says Sex With Demons Makes You Sick,” The Daily Beast, July 28, 2020, sec. politics, https://www.thedailybeast.com/stella-immanuel-trumps-new-covid-doctor-believes-in-alien-dna-demon-sperm-and-hydroxychloroquine.
 Robert Costa and Philip Rucker, “Woodward Book: Trump Says He Knew Coronavirus Was ‘Deadly’ and Worse than the Flu While Intentionally Misleading Americans,” Washington Post, September 9, 2020, https://www.washingtonpost.com/politics/bob-woodward-rage-book-trump/2020/09/09/0368fe3c-efd2-11ea-b4bc-3a2098fc73d4_story.html.
 E Jean Carroll, E. Jean Carroll v. Donald J. Trump, No. NYSCEF 113 (United States District Court Southern District of New York September 8, 2020).
 David R. Lurie, “Bill Barr’s New Fix: Trump Smeared His Rape Accuser, E. Jean Carroll, in His ‘Official Capacity,’” The Daily Beast, September 9, 2020, sec. politics, https://www.thedailybeast.com/bill-barrs-new-fix-trump-smeared-his-rape-accuser-e-jean-carroll-in-his-official-capacity.
 Matthew Chapman, “Trump ‘Fixer’ Barr Has ‘Devastated’ the Justice Department and It Will Take Years to Repair the Damage: Report,” Rawstory, August 1, 2020, https://www.rawstory.com/2020/08/trump-fixer-barr-has-devastated-the-justice-department-and-it-will-take-years-to-repair-the-damage-report/; James Risen, “Senate Acquittal Gave Trump a Blank Check. With Roger Stone’s Sentencing, the President’s Crime Syndicate Is Cashing In.,” The Intercept (blog), February 13, 2020, https://theintercept.com/2020/02/13/william-barr-roger-stone-trump/.
This is President Trump on tape, on February 7, saying that the coronavirus is “more deadly than your – you know, your, even your strenuous flus.” But he minimized the threat in public. Brian Stelter. “This Is President Trump on Tape, on February 7, Saying That the Coronavirus Is ‘More Deadly than Your – You Know, Your, Even Your Strenuous Flus.’ But He Minimized the Threat in Public. On February 26, He Told the Public ‘I Think That’s a Problem That’s Going to Go Away.’ Https://T.Co/TOHTpqYtvZ.” Tweet. @brianstelter (blog), September 9, 2020. https://twitter.com/brianstelter/status/1303727882523602946.
If Oxford University’s vaccine proves effective against covid-19, AstraZeneca, a British pharmaceutical company, have said that making each dose would cost about as much as a cup of coffee. From July https://t.co/k48XUWpkpd— The Economist (@TheEconomist) August 3, 2020
Yesterday #NIH @NIAIDNews & @AstraZeneca announced the launch of a Phase 3 #clinicaltrial for #COVID19 vaccine candidate AZD1222. NIH is supporting several vaccine trials since more than one may be needed. We have all hands on deck. https://t.co/cA88mox8HP— Francis S. Collins (@NIHDirector) September 1, 2020
Apparently the individual w/ the adverse event has a transverse myelitis, a neurologic condition which can result from infections or an immune system disorder. The adenovirus component of the vaccine may have been a trigger https://t.co/unZ03Ywq7E pic.twitter.com/oxhXXW5M7e— Eric Topol (@EricTopol) September 9, 2020
Early data for the Russian adenovirus vector #SARSCoV2 vaccine published today @TheLancet https://t.co/08gxfqVd4Y and https://t.co/Az6XHOCEXF @naorbz N=76, no control group, not randomized There’s a planned Phase 3 trial of 40,000 participants Yet it is “approved” in Russia pic.twitter.com/0FJrKE4kMV— Eric Topol (@EricTopol) September 4, 2020
Nine pharmaceutical companies, including Pfizer, AstraZeneca, GlaxoSmithKline and JNJ, today pledging to only seek approval for Covid-19 vaccines that have shown to be *safe and effective.* Maybe this will squelch the not-so-subtle scare tactics being deployed by Biden/Harris.— Dagen McDowell (@dagenmcdowell) September 8, 2020
5 Vaccines Coming Within 2020AstraZeneca/Oxford Moderna/NIH Pfizer J/J CanSino All 5 are in phase 3, being tested on 1000s of volunteers in various countries.All expected to be approved in 2020 if safe Most vaccines will be available in 2021 though pic.twitter.com/sFFywJX1ci — Faheem Younus, MD (@FaheemYounus) September 7, 2020
Breaking: Bob Woodward book 'Rage:' Trump admits to concealing true threat of coronavirus.— Jersey Craig (@Jersey_Craig) September 9, 2020
In a series of taped interviews with Woodward, Trump revealed that he had a surprising level of detail about the threat of the virus earlier than previously known.https://t.co/xPoFn3ceu5 pic.twitter.com/sqSz48rXxd
Trump in newly surfaced audio: 'I wanted to always play [the coronavirus] down. I still like playing it down' (March 19)— NowThis (@nowthisnews) September 9, 2020
CNN has obtained Bob Woodward's new book 'Rage' in which the president admits he was hiding the truth about COVID-19 https://t.co/vmgVfa2wTb pic.twitter.com/6LDtnOzpMu
Dr. Fauci claims to be working to help the American people, yet he won't even meet with our President @realDonaldTrump. Maybe it's time we #DumpFauci and replace him with a credible doctor like @stella_immanuel who shares the truth about #hydroxychloroquine. pic.twitter.com/afDPtaoQHT— Omar Navarro (@RealOmarNavarro) August 13, 2020
HCQ is safe. Period.— ELIJAH SCHAFFER (@ElijahSchaffer) August 5, 2020
According to these respected physicians.
Trump is taking it, so if it’s safe enough for the president, why not for you?
Dr’s @stella_immanuel, @drsimonegold & more speak out!
Find my banned interviews @ https://t.co/8LmXT6gr4Apic.twitter.com/AS4EiYxVf5
Dr. Stella Immanuel (@stella_immanuel) was threatened by the Texas State Medical Board for advocating for & prescribing HCQ.— Dr. Simone Gold (@drsimonegold) September 2, 2020
HCQ is a safe, FDA approved medication for 65 years. It’s outrageous there was ever an investigation.
Glad to see the case dismissed. #HCQWorks pic.twitter.com/QLS6qKRsCz
Stella Immanuel, Trump’s New Favorite COVID-19 Doctor, Believes in Alien DNA, Demon Sperm, and Hydroxychloroquine https://t.co/PjYcMBvCrU— Kathryn Watson (@kathrynw5) July 28, 2020