As the country begins the rollout of COVID-19 vaccinations, questions linger as to why there remains no vaccination for the HIV virus.

HIV has been around since the early 1980s and today it is estimated 1.2 million Americans have the virus that causes AIDS.

So why did the novel coronavirus get fast-tracked for vaccination while HIV continues to linger? Dr. Stephen Fallon, executive director of Latinos Salud, an HIV/AIDS service organization serving Broward and Miami-Dade counties, explains that while both COVID and HIV are RNA viruses, HIV mutates much more rapidly. Fallon put it in terms of swatting a fly.

“Imagine how much harder it is to swat a fly than an ant,” Fallon said. “Flies just get themselves out of the way more quickly. Viruses that don’t change rapidly can’t ‘get out of the way’ when attacked, whether by our natural antibodies, medicines, or vaccines. One of the main reasons that it’s been difficult for scientists to develop an effective vaccine for HIV is that the virus itself has the highest reported mutation rate for any biological entity.”

HIV, Fallon notes, is much harder to catch than COVID and condoms for sex provide a similar preventative tool as masks and face shields. 

Glen Weinzimer is a long-term HIV/AIDS survivor who founded the SMART Ride, a bicycle ride from Miami to Key West that raises funds for HIV/AIDS support agencies. Weinzimer believes the arduous work of AIDS activists paved the way for a quick COVID response.

“Because of HIV/AIDS and the research that was done they are able to fast pace [COVID vaccines],” Weinzimer said. “The scientific advancements they made are helping make this vaccine hopefully come to market a lot quicker. I think there is something to say about all that research they had learned to do to fight a virus they didn’t know how to handle is affecting in a positive way how COVID is going to be handled.”

Two COVID vaccines — produced by Pfizer and Moderna — are approved for use in the United States. Frontline health care workers, first responders and the nursing home residents are currently prioritized for receiving vaccinations which consist of two inoculations, three weeks apart. 

Weinzimer said the COVID vaccines function similarly to HIV-blocking pills such as Truvada, clinically known as pre-exposure prophylaxis or PrEP.

“They are not coming out with a cure — the vaccine is like a flu shot — it needs a booster and in some ways it's no different than taking PrEP,” Weinzimer said. “If you take [PrEP] the chances of you getting HIV/AIDS has been reduced to pretty much zero but it’s not a cure for HIV/AIDS, it’s just a way to prevent you from getting it.”

The National Institute of Allergy and Infectious Diseases is currently engaged in a late-stage multinational HIV vaccine efficacy trial in North America, South America and Europe. Code named Mosaico, the trial studies immune responses in cisgender men and transgender people ages 18 to 60 who have sex with other cisgender men and transgender people. 

“We are committed to developing a safe and effective preventive HIV vaccine suitable for the global populations most vulnerable to HIV acquisition,” said NIAID Director Anthony S. Fauci, M.D, in a statement dated July 15, 2019. “Ensuring that investigational vaccines are evaluated in diverse populations is critical to achieving this goal.”

As promising as Fauci’s statement was at the time, it appears COVID jumped the line. This reality doesn’t sit well with some HIV/AIDS activists. 

“As thrilled as I am about the rapid response globally pertaining to COVID-19 and its vaccine, I have often thought about the similarities between this pandemic and the pandemic that was and still is HIV/AIDS,” said Aaron Darr.

Darr, an HIV positive gay man, serves as vice-chair of the World AIDS Museum and Educational Center in Fort Lauderdale. He said gay stigma is one reason for the slow response to control HIV.

“I can’t help but think that because HIV/AIDS has been stigmatized and unfairly associated with gay stereotypes over the years, the reality is HIV/AIDS can affect anyone, just like COVID-19.”

Fallon admitted the government’s lethargic response to HIV was due in part to the virus affecting primarily marginalized people such as Black immigrants, gay men and sex workers.

“It’s absolutely true that the world more highly prioritized the COVID-19 pandemic,” Fallon said. “Leaders will say that’s because, compared to HIV, it’s both more contagious and more rapidly deadly for those who it takes out. But it’s worth remembering that Ronald Reagan did not speak the word ‘AIDS’ until 25,000 Americans had died. In one of his first speeches, and I remember it well, he engaged in ‘blame the victim’ rhetoric, when he said, ‘And when it comes to AIDS, don’t medicine and morality teach the same lesson?’”

Darr said he has come to resent America’s slow response to HIV/AIDS which he said is a result of political leanings and views on sexual orientation. 

“I can only hope that for the millions of individuals living with HIV/AIDS, that the disease we live with is taken more seriously in the years ahead and given the same respect and attention COVID-19 has been given in terms of the steps necessary to achieve a vaccine,” Darr said.

Weinzimer, 30 years Darr’s senior, is surprisingly less bitter.

“I don’t think it’s a matter of we didn’t put the resources in early enough and we were cheated in some ways, I don’t think that’s the case,” Weinzimer said. “I think we laid the path to an unknown that is now allowing them to move faster on this new pandemic.”

For more information on HIV vaccines, visit HIV Vaccine Trials Network’s website.