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Within a week, the FDA has issued emergency clearances for the Pfizer / BioNTech and Moderna vaccines. Here are some key questions and answers about America’s historic vaccine program:
As the vaccines work?
Both the Pfizer / BioNTech and Moderna vaccines are mRNA vaccines that are injected into the muscle of the upper arm. They represent a new form of vaccine technology: Using messenger RNA, they instruct our cells to produce a protein that triggers an immune response.
The mRNA vaccines instruct our cells to produce and display “spike proteins,” which are found on the surface of the Sars-CoV-2 virus. When our immune system realizes that this protein does not belong, it begins to produce antibodies. Through this process, you learn how to respond to future exposure to the virus.
To be effective, two doses are required. For Pfizer, the second dose is 21 days after the first, and for Moderna, 28. In clinical trials, vaccines were found to offer protection against Covid-19, but how long that protection lasts is still unknown. Importantly, these protections don’t kick in until about a week after the second dose. Only people with a history of severe allergic reactions have been discouraged from getting vaccinated.
Although both vaccines prevent 95% of Covid-19 cases, vaccinated people can still be contagious and transmit the virus to other people. It will be important to maintain precautionary measures before and after getting vaccinated.
What vaccines are currently available?
Although only the Pfizer / BioNTech and Moderna vaccines have received emergency clearance in the US So far, there are many other manufacturers working to bring the vaccines to market.
According to data compiled by the London School of Hygiene and Tropical Medicine Vaccine Center, more than 200 vaccines are in various stages of development and testing around the world, with twelve in the final stage of clinical trials. Other notable manufacturers with contracts with the US include Janssen Pharmaceutical Companies, University of Oxford / AstraZeneca, Novavax, and Sanofi / GSK.
Bar chart showing the number of vaccines at different stages of clinical trials.
How are states deciding who gets the vaccine?
Plans for vaccine distribution will vary by state, although the Centers for Disease Control and Prevention (CDC) and related advisory group recommendations guide their development. So far, state allocation plans have focused on the first groups prioritized by the CDC advisory committee. For the first phase, the committee gave priority to healthcare workers and those in long-term care facilities.
Donut chart showing the phases of vaccine allocation.
Of course, the biggest challenge will be delivering the vaccines effectively. The Surgo Foundation’s vaccine allocation planner estimates the number of people in each group and, along with the reported initial supply, points to an uncomfortable reality: it is quite likely that initial vaccine distributions are insufficient even for groups of higher priority. before spring.
Logistics further complicates deployment. Although the incoming Biden-Harris administration expects to invest $ 25 billion in manufacturing and distribution, The Guardian reported that local health departments are currently underfunded and understaffed.
How are the states determine which populations have been the most affected by the pandemic?
Advisory groups have recommended the consideration of statistical tools, such as the CDC’s Social Vulnerability Index (SVI) or the Surgo Foundation’s Covid-19 Community Vulnerability Index (CCVI), to make equitable allocations of any Covid-19 vaccine . Researchers studying the relationship between these rates and Covid-19 hotspots have found that highly vulnerable counties, especially those with higher minority proportions, were hit hardest by the pandemic. The CDC’s Morbidity and Mortality Weekly Report in June had similar findings.
Map of the most vulnerable counties and Covid-19 hotspots.
Other researchers worry about the legal implications of making placement decisions based on race. Instead, they propose using the Area Deprivation Index (ADI) to circumvent potential legal challenges. However, the use of ADI to make allocations, according to their analysis, would produce less benefits for minority communities, compared to SVI.
Will there be enough vaccines?
In a long enough timeline, most likely. As noted above, the initial shipments of Pfizer vaccine are not enough for most states to cover even the highest priority groups. Leaders at Operation Warp Speed (OWS) expect to make 20 million doses available by the end of the year, with another 60 million in January and 100 million in February.
The United States has also secured more than 2 billion doses through various agreements with manufacturers. While this number may seem high, it is important to consider the time it takes for each vaccine to go through manufacturing, licensing, and distribution.
Although the US has secured 100 million doses of the Pfizer / BioNTech vaccine, with the option of 500 million more doses, states are unlikely to see even the first 100 million until next year. Pfizer has already had to reduce its global production forecast for 2020 by 50 million doses due to problems in the supply chain.
The Moderna vaccine also provides additional supply: Nearly 6 million doses were shipped when the FDA cleared the vaccine on Friday. The U.S. Department of Health and Human Services (HHS) has secured an additional 100 million doses of the Moderna vaccine, with continued delivery expected through June 2021.
Will my employer require that I get vaccinated?
The Guardian reported earlier this week that while employers have the right to require vaccines and some, such as hospitals, have done so in the past, the Covid-19 vaccine is complicated because it is still considered technically experimental until it is granted. full approval. Reporter Lauren Aratani notes: “For now, the rights of employers to require a Covid-19 vaccine will be in a legal gray area for the indefinite future.”
When can I expect to get the vaccine?
Depending on who you are, there may well be millions ahead of you in the vaccine line. The New York Times created a tool to estimate your rough spot, but it’s important to know that there are many unknowns that make assigning an estimated time to match your spot quite difficult.
Many states are still finding out exactly who counts as an essential worker. The questions will be resolved at the state level and will be further complicated by the launch and availability of the vaccine supply.
When can I expect things to get back to “normal”?
Normality will take time to arrive. Dr. Anthony Fauci, in an online event at Harvard’s TH Chan School of Public Health, noted that if vaccine administration goes well, some form of normalcy could be within reach by the end of 2021.
There are two important moments that vaccines make possible, according to an analysis by McKinsey & Company. One is a epidemiological endpoint: When a sufficient number of the population has immunity to the virus, community transmission becomes less likely. How quickly this arrives depends largely on the success of the vaccine distribution and administration. Expert estimates place this level of immunity as achievable by the third quarter of 2021, despite unexpected complications.
McKinsey’s analysis points out that the restoration of parts of our social or economic life, the second end point, may come before the epidemiological end of the pandemic.
