10 Questions about the Coronavirus Vaccine
By: Timothy J. Sabo
Tags: Vaccines, Vaccination, Questions, America, Coronavirus

Daniel Schludi for Unsplash

Unless you’ve been living under a rock lately, you know that we are getting close to having a vaccine for the coronavirus. At least three companies have completed Phase 3 trials — Pfizer, Moderna, and AstraZeneca — and soon will be approved by the FDA. Then the lengthy process of vaccinating the public begins, with all the trials and tribulations involved in that.

Needless to say, vaccinating 330 million Americans will be a great challenge: vaccinating 7+ billion people worldwide will be unprecedented, and will take years to accomplish. In the end, Americans may very well look back and regret being the first nation to get vaccinated, as there remains a number of questions about this virus/vaccine that have yet to be answered.

Question: Can someone who has had COVID-19, but is still suffering its side effects, be vaccinated?

Anderson Cooper and 60 Minutes discussed the devastating effects many coronavirus patients still have months after surviving the coronavirus. To this day many are still facing daily symptoms of the virus, from memory loss to dizziness, fatigue, inflammation of lung tissue, even irregular heart beat. Is it safe to give a vaccine — one that may bring its own set of side effects — to someone still brandishing the effects of the actual virus?

Question: Children, especially those under the age of 14, have not been included in the vaccine trials. Can children be vaccinated with a vaccine that has not been proven safe for children?

The Association of American Medical Colleges published an article discussing the current state of a vaccine for children. Their point is simple and direct:

“A growing number of doctors and researchers are sounding alarms that the nation cannot beat COVID-19 until it inoculates children — and that if human trials for them don’t start soon, those inoculations might not be ready by the start of school next fall.”

Without children being vaccinated, the population as a whole continues to be at risk.

Question: Once a person receives the vaccine, how long will the vaccine protect them against the virus?

Since we have never faced this virus before-thus the term novel coronavirus-no one knows exactly how long protection by the vaccine will last. In a recent interview, Dr. Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID) suggested that protection should be at least one year, but he did not expect that protection would last twenty years.

“We’re less than a year into the disease, so you can’t say it lasts more than a year — I mean, that would be impossible,” he said.

Question: The vaccines are 95% effective, but it will take up to a year to get all Americans vaccinated. Should we continue to follow mask and social distancing guidelines then until we achieve herd immunity?

Herd immunity is a term used to describe when enough people have protection — either from previous infection or vaccination — that it is unlikely a virus or bacteria can spread and cause disease. Unfortunately, experts do not know what percentage of people would need to get vaccinated to achieve herd immunity to COVID-19.

Americans have witnessed the tragedy of not wearing masks: the virus is more widespread, more deadly in this nation than any other on earth. A large portion of the population have been convinced — by misguided politicians, including the President of the United States — that wearing a mask is unnecessary. This failure to permit public health policy to dictate our lives has led to a nation strife with those who won’t wear the mask, and those who are weary of wearing one. In both cases, Americans are suffering from virus fatigue. Unfortunately, the vaccine will not eliminate the need for masks.

In late October, Infection Control Today published an article quoting findings from the Journal of the American Medical Association (JAMA):

“As countries around the world seek to safely reopen businesses, schools, and other facets of society, mask use in the community to prevent the spread of SARS-CoV-2, in conjunction with other low-cost, low-tech, commonsense public health practices, is and will remain critical.”

Dr. Fauci echoed those comments:

“While results of phase 3 trials for multiple candidate vaccines are on the near horizon, ‘low-tech’ tools to prevent the spread of SARS-CoV-2 are essential, and it must be emphasized that these interventions will still be needed after a vaccine is initially available.”

Think about it: as many as 20 million people may be vaccinated with the first dose of the vaccine. For each successive round, another 20 million may get vaccinated, but there will be some time period between when the first group receives their vaccine and when the final group receives theirs. If the amount of time to vaccinate everyone is 300 days, but the vaccine provides protection for only 200 days, those who receive the vaccine first will be vulnerable again in those final 100 days. Anyone who receives a vaccine in one of the final groups could end up infecting someone who was vaccinated in the first group.

Question: What happens if someone on a two-shot vaccine protocol fails to get the second dose within the specified time window?

According to Pfizer’s clinical trials, a two-shot regimen is required for immunity to the novel coronavirus. The window during clinical trials for the second doses varied between 19 and 42 days. Unfortunately, Pfizer was not able to state the outcome of missing the second dose, other than to clarify their vaccine would not provide protection without both doses.

We most certainly will have a greater number of missed second doses than Pfizer’s clinical trials because vaccines have side effects, and side effects are one of the leading causes patients don’t return for the second dose.

“Participants in Moderna and Pfizer’s coronavirus vaccine trials in September reported that they were experiencing high fever, body aches, bad headaches, daylong exhaustion and other symptoms after receiving the shots.”

Question: No data yet exists on side effects, other than what the manufacturers have provided. Should we limit the percentage of healthcare workers that receive the vaccine — at least for a reasonable time period — until we know the effects of the vaccine on those first recipients?

This is the easiest question to answer, because there simply is not enough vaccine to go around for every healthcare worker in the first round. Or the second round. And maybe not through a number of rounds. While the CDC has recommended that healthcare workers be among the first group to receive the vaccine, the governor of each state will actually make the final disbursement decision based on state needs. Some states simply won’t receive enough vaccines in a number of rounds to cover a majority of healthcare workers, while other states are focusing on splitting their vaccine batches between healthcare workers and those living in long-term care facilities.

In reality, some healthcare workers don’t even want to be first: for a variety of reasons, there is a growing number of those who provide healthcare that are not confident in the care and safety used in the development of the vaccine.

Question: If one of the vaccines produces an outbreak of dangerous side effects, to include serious illness and death, would we discontinue its use?

Not to engage in scare tactics, but in the history of vaccines, things have not always gone well. The Polio vaccine, developed in the 1950s, was enormously successful, albeit not without some serious setbacks.

Reports from those who have participated in clinical trials of the coronavirus vaccine suggest flu-like symptoms are to be expected: headaches, body aches, soreness, and fatigue are typical.

While most of those who participated had mild symptoms, there were documented cases of more serious issues. Moderna Phase 3 results produced severe results in 2% of vaccine recipients.

Unless one of the vaccines produces regular, harmful side effects, the vaccine effort will continue until every American has been vaccinated.

Question: America will be one of the first countries to have widespread inoculation of its residents. How will this impact international travel?

Once a large portion of the American public is vaccinated, people will want to get back to some sense of normalcy, to include traveling. Americans traveling abroad support many nations with tourist dollars, and Americans will be more than ready to leave the world of COVID behind.

But with an efficacy of between 90-95%, that leaves a good number of Americans without protection; and who wants to wear a mask on vacation?

Beyond that, we must recognize the other side of the coin: how do we deal with foreigners who have not yet been immunized that want to visit the U.S.? As America begins to come out of the corona nightmare, businesses will eagerly want to invite patrons back, opening their doors and letting down their guard. There will be a time when most Americans will have been vaccinated but will still be at risk: again, there is no clear answer yet as to how long the vaccine will provide protection. Opening our borders to those from ‘across the pond’ before we know how protected we truly are could create a new medical nightmare.

Question: Millions of Americans have already had coronavirus, and have some natural immunity. Should those who have already had it be last to get the vaccine?

Whether those who have had coronavirus get it last or not remains to be seen. There will be benefits to all Americans to get the vaccine, but those who have suffered an infection already may not have much more protection than those who haven’t.

“There is not enough information currently available to say if or for how long after infection someone is protected from getting COVID-19 again; this is called natural immunity. Early evidence suggests natural immunity from COVID-19 may not last very long, but more studies are needed to better understand this. Until we have a vaccine available and the Advisory Committee on Immunization Practices makes recommendations to CDC on how to best use COVID-19 vaccines, CDC cannot comment on whether people who had COVID-19 should get a COVID-19 vaccine.”

CDC Coronavirus FAQ

Question: What if only half of the U.S. population gets the vaccine?

Dr. Fauci has said that the vaccine alone will not provide America what it needs to get out of COVID-19 jail.

“At least 80 to 85 percent” of people would need to be vaccinated to meaningfully reduce infection rates.”

If Americans refuse to get vaccinated, we could face a continuation of the coronavirus crisis for years. Fauci suggests that a rate of 50% would result in a “considerable public health challenge.”

Getting the vaccine created — in record time — will prove fruitless if the people simply refuse to get vaccinated. There can be no return to normal, no growing economy, no kids back in school, no sporting events, none of the things we have all been missing…unless we get the vaccine. All of us.

Bonus Question: Where can I find answers to more questions I have about coronavirus, the vaccine, and the like?

Check out the website of the Center for Disease Control and Prevention.

©Timothy J. Sabo