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As I write this, there are 42 COVID-19 vaccines in various stages of human trials. Eleven of these are in large, late-stage trials. More than 100 more are in development. Certainly, over the next year, we will likely have the first of many COVID-19 vaccines ready for deployment.
There are many things that are still unknown about the first vaccine, but this we know for sure: as effective as it is in protecting younger adults, it will be less effective in protecting the most vulnerable older adults.
Vaccines are one of the great achievements of science. They have saved hundreds of millions of lives and led to the eradication of one human disease (smallpox) and the near eradication of another (polio). However, no vaccine is perfect. In other words, no vaccine is 100% effective, 100% safe, and lasts for life.
Fortunately, they don’t have to be perfect.
“Herd immunity” is achieved when a sufficient population is immune to a disease, either through recovery from the disease or vaccination against it, so that the disease can no longer spread and disappear. Herd immunity to smallpox was achieved with approximately 80% immunity. It is too early to be sure what the level of herd immunity is for COVID-19, although early estimates put it at around 70%.
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There are at least eight different types of COVID-19 vaccines in development, including several new technologies, but they are all based on the same thing: preparing the host’s immune system to activate quickly and decisively when the virus attacks. Because older adults have generally weaker immune systems, their response to the vaccine is also weaker.
Sometimes there are ways to compensate. For example, the two flu vaccines recommended by the CDC for people 65 and older this flu season either have a vaccine dose four times as strong or mix an immune booster, in this case, shark liver oil, with the vaccine to improve the response.
How safe and effective?
The Key Questions We’d Like To Answer About Any COVID-19 Vaccine – How Safe? How effective? – Of course, they are unknown at the moment. Science is still in progress.
The issue of security is not trivial. The closest relative of SARS-CoV-2, the virus that causes COVID-19, is SARS-CoV, which caused the 2002-2003 SARS epidemic that infected 8,000 people and killed 800 of them. The vaccines that were being developed for SARS were never tested in humans because the disease died out, but in animal studies some of them caused worse disease. Therefore, shortcuts in security testing would not be wise.
How effective? Again, we don’t know, but we can use what is known about flu vaccines to make an assumption.
Related: Don’t put off your flu shot any longer
Over a five-year period between 2011 and 2016, the average effectiveness of flu vaccines was 38%, meaning that 38% of those vaccinated never experienced flu symptoms. That doesn’t sound like a great vaccine, but it also reduced the severity of symptoms for those who got the flu. So during that five-year period, the vaccine prevented up to 6.7 million illnesses, 3.1 million doctor visits, 87,000 hospitalizations, and 10,000 deaths.
What about older adults? Several studies have found that getting a flu vaccine prevents illness or reduces symptoms severe enough to require medical attention by about 60%. Since current FDA guidelines for approving COVID-19 vaccines require at least 50% effectiveness, any approved vaccine will have a major impact on illness, hospitalizations, and deaths, not to mention disease transmission. We can expect the effectiveness to be considerably higher as well.
Get the COVID-19 vaccine
One thing to keep in mind is that if the first COVID-19 vaccine is 50% effective (subsequent ones will certainly be better) and the current rate of Americans with COVID-19 antibodies, that is, those who have been previously infected, is 9%, so even if everyone gets the vaccine, we will still be below the 70% estimate for herd immunity.
And as we know, not everyone, unfortunately, will receive the vaccine. Masks and social distancing can be with us for a while even after a vaccine is available.
What can older adults do to stay as safe as possible?
First of all, get the COVID-19 vaccine once it is available. The pharmaceutical industry is taking safety very seriously in its vaccine testing as it should.
Second, don’t necessarily give up wearing masks in public and maintain social distancing just because you received the vaccine, unless you also have an antibody test that confirms that you have been protected by the vaccine.
Third, practice the best health habits.
Read next: Are you older and worried about rising health care costs? You’re not alone
And finally, support research on how to reduce and slow the weakening of the immune system and all body systems as we age. We are making great progress towards that goal. Let’s move on.
To learn more about the response of older people to vaccines, AFAR and Next Avenue invite you to a free webinar led by experts on Wednesday, October 28 at 1 pm ET: “The Biology of Aging and Preparing Our body for vaccines. ” Dr. Austad will moderate a discussion with immunobiologists Jenna Bartley from UConnHealth and Dr. Janko Nikolich from the University of Arizona. Get more information and RSVP here.
Steven N. Austad, Ph.D., is the senior scientific director of the American Federation for Research on Aging, the co-principal investigator of the National Institute of Aging Nathan Shock Centers of Excellence Coordination Centerand a distinguished professor and department chair at the Department of Biology, University of Alabama at Birmingham. He is the author of more than 190 scientific articles and more than 100 newspaper columns on science. Follow him on Twitter @StevenAustad.@AFARorg
This article is reprinted with permission from NextAvenue.org, © 2020 Twin Cities Public Television, Inc. All rights reserved. It is part of an editorial partnership between Next Avenue and The American Federation for Aging Research.
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