Disease X: the practical challenges of vaccinating against the unknown

Key points

  • Disease X is the new disease we should all be preparing for

  • Our research will look at how policy can impact our vaccine response to emerging infectious disease

The WHO has recently announced a new priority disease. But rather than being a current devastating epidemic, Disease X represents the notion of one. According to the WHO:

“Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease”

By calling for proactive research and development (R&D) that can be applied to multiple hypothetical infectious diseases, the WHO hopes that we will be better prepared in the future to fight emerging epidemics such as Ebola, Lassa, Zika, and Influenza. Such diseases are posing great challenges in the wake of globalisation and climate change. But should we invest significant research, time and money in the hypothetical?



Research budgets are already spread thin and recent science cuts are making the issue worse. However, recent outbreaks have shown that having previous research knowledge under our belts can have a significant impact on the course of an epidemic. The 2014 Ebola outbreak in West Africa saw the rapid introduction of a new vaccine: Ebola vaccines had begun to be developed in the 1970s following an outbreak in Zaire, but low commercial interest had prevented them from reaching the licensing stage. This previous research knowledge, as well as facilitation by policy-making bodies, meant that the vaccine was being trialled in Guinea as early as 2015. This would not have been possible without the background research allowing the rapid rollout of clinical trials of the vaccine. Vaccination is only one component of a multi-faceted approach which includes surveillance, containment and treatment, but it can have a major impact on the course of an outbreak.

Our research will ask which practical challenges need to be overcome to establish an effective vaccine response to a previously little known or unknown disease. Policy has a key role in overcoming obstacles to not only R&D, but vaccine manufacture, distribution logistics, and uptake. We cannot predict the biology, location or contagion dynamics of Disease X, so by implementing measures which improve our ability to produce, distribute and administer vaccines in a variety of situations, we can be prepared for any situation.

By evaluating evidence from peer-reviewed literature we will consider the steps which should be taken to facilitate the above measures, and the key public and private bodies responsible for funding and co-ordinating the approach. We believe that R&D is only one of many important investments and that an approach of generating a general vaccine response can have diverse co-benefits. Recommended measures would improve our vaccine production capacity and create better health infrastructure in low-income countries, which will give guaranteed benefits as well as a better outlook in a theoretical new epidemic.

Disease X is an unknown entity and needs to be treated as such. By facilitating a predictable vaccine response to any unpredictable disease, we can ensure that the world is better prepared for the next big epidemic- whether it’s unfamiliar or not.

Further reading

About me

A 4th year medical student at Cambridge with an interest in infectious disease, evolutionary anthropology and women’s health. Likes mid-morning cups of coffee. Dislikes Vogon poetry.

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