Graphic courtesy of Isabelle Goetz.
The race for a coronavirus vaccine has had a major breakthrough, with Pfizer and BioNTech the first to achieve a high level of effectiveness in clinical trials. Their vaccine recently reported a 90% efficacy rate in tests on 43,500 people in six countries, with minimal associated safety concerns. Although multiple vaccines have made it to the last stages of testing, this is the first to succeed at this rate in clinical trials. The news is particularly welcome given the recent surge in Covid-19 cases. Pfizer hopes to request FDA approval for Emergency Use Authorization by December, pending finalized safety results expected in mid-November. If these steps are successful, there could be as many as 50 million doses prepared by the end of 2021, with roughly half expected to be provided to the United States. The vaccine requires two doses, which means that this would be enough to vaccinate 12.5 million people, a significant step but still less than 4% of the American population.
With a promising vaccine in sight, the urgent need now is for a distribution plan as well as a communication strategy to get more people committed to getting vaccinated. When surveyed in October, only half of Americans said they would get the coronavirus vaccine. It is unknown what percentage of the population will have to receive the vaccine to make it effective, but it is certain that half of Americans is not nearly enough. Even with a 90% success rate, 10% of those vaccinated are still at risk of catching Covid-19, in addition to those who have not received the vaccine.
Deployment of an approved vaccine is an equally important problem that hasn’t seen much of the spotlight. Distributing the vaccine itself on a wide scale is a logistical dilemma, but it is only a piece of the puzzle. It requires efficient collaboration between development and manufacturing companies, federal and state agencies, health workers, and medical facilities to provide syringes, needles, and other supplies and train enough workers to administer the vaccine to patients. There is also the unanswered question of who will have access first, which may largely fall on state governments to decide. Another challenge is that patients must receive both doses three weeks apart. Additionally, the Pfizer vaccines must be stored at -94°F until just before being administered. Both of these conditions are tricky but vital to obtain the 90% success rate. There are 9 other vaccines in the final rounds of testing, which are all stored at higher temperatures than the Pfizer vaccine, but assessing how to distribute multiple different vaccines could raise even more questions.
It is also likely that this vaccine may cause flu-like symptoms with each of the two doses, discouraging more people from getting vaccinated. While hesitancy is expected, if there is not widespread adoption of a vaccine, there is little chance it will be effective enough to have a large impact on the global pandemic. A unified, concerted effort to promote vaccination has never been more critical. The CDC has prepared a strategy called “Vaccinate with Confidence” to provide information and spread this message, but it has not received enough funding at this point to make it a reality.
Vaccination will be a tiered process, with the general public unlikely to receive vaccines until Spring 2021 at the earliest. Dr. Anthony Fauci, the leading infectious disease expert in the United States, expressed caution that this step, while vital, is not a cause to let down our guard. Dr. Fauci explained that the virus will take a long time to diminish, and it may never be fully eradicated but instead linger like the seasonal flu. The public is advised to continue wearing masks and social distancing even after a wide distribution of vaccines is available in order to keep everyone safe and give the vaccine its best chance to succeed.
Sources: BBC News, NY Times, NBC News, The Hill, Pfizer •