Despite virus vaccine, we all need to remain cautious

Dr Theodore karasik

The announcement by pharmaceutical company Pfizer that trials of its coronavirus (COVID-19) vaccine could be more than 90 percent effective generated plenty of excitement this week.

While this in itself does not guarantee delivery of a fully tested and effective vaccine, it nevertheless offers hope for Americans desperate for the pandemic to end. The virus is infecting more and more people across the country every day. It will indeed be a “very dark winter,” to quote President-elect Joe Biden.

Nevertheless, the Pfizer vaccine offers at least some tangible hope, more so perhaps than other vaccines under development in China, Russia or the UK.

However, the urgency of the situation means that none of the potential vaccines have been tested in the traditional, rigorous manner that usually calls for years of experiments and trials. We are facing the possibility of using, in a quickly changing environment, multiple vaccines around the world that have not been fully tested and tried. As a result, there are a number of unknowns about the possible long-term effects.

Therefore anti-vaccine sentiment is likely to be high among some, while others will rush at the chance of protection from the virus so that they can return to something approaching normal life as soon as possible.

Early data from tests of Pfizer vaccine — and the word “early” must be emphasized — suggests that it could be more than 90 percent effective. This result, from a very short trial, appears to be very good. However, more testing is needed before the vaccine can be approved by the US authorities. The company estimates it will likely have the required two months of safety data by the third week of November. It predicts it will be able to produce up to 50 million vaccine doses by the end of this year and up to 1.3 billion in 2021.

There is also a possible political aspect to the release of a vaccine, given the continuing vitriol between the Trump and Biden campaigns in the aftermath of the presidential election. Production and delivery of a vaccine could potentially be affected by some kind of “mega-event,” whether natural in origin or the result of national unrest.

The Biden team is already working on the community distribution networks that will have to be set up. Federal authorities anticipate that the first Americans could be vaccinated as soon as December.

It is important to note that when we talk about “vaccine effectiveness,” we mean how effective it is at preventing infection. In other words, if the test results reported by Pfizer are accurate, out of every 100 people given the vaccine, the virus would infect fewer than 10 of them.

The fact that so many vaccines are at such advanced stages of development around the world is a major feat of planning and coordination, and runs counter to the typical drug and vaccine development process. These are unusual times, however, and the sooner production can start, the sooner vaccinations can begin. Already, the US is preparing for the manufacturing process in parallel with the development and approval processes.

Government scientists are aware there are dangers associated with this strategy. The simultaneous completion of processes that usually happen one after another is a resource-intensive, high-risk strategy. It is possible that some vaccines will turn out to be unsafe or ineffective after thousands of doses have been produced.

But speed is of the essence in the current situation, so US authorities are moving forward in line with the pace of the pharmaceutical industry. If a vaccine becomes available in December, there will be a much bigger roll-out between January and April, with the aim of vaccinating the majority of Americans by the middle of next year. What to do about those who resist the vaccine is another question, and a challenge the Biden administration will probably have to face.

The US military will coordinate vaccine distribution but will not play a direct role in transportation or giving the injections. This responsibility will fall on commercial enterprises, as is the case with flu vaccines and other medications.

Pfizer has an assembly center in Kalamazoo, Michigan, and the company plans to use private carriers such as UPS and FedEx to deliver vaccines to hospitals and vaccination sites. Medical supply company McKesson, which has a contract with the government to distribute COVID-19 vaccines, will be another distributor.
Until the majority of people have been vaccinated, masks will remain the most potent form of protection against the spread of the virus.

The good news, then, is that the necessary infrastructure for vaccine distribution is, broadly speaking, already mapped out. The US government will allocate initial vaccine supplies to states and jurisdictions as it sees fit, and then local authorities will be responsible for determining which groups get priority.
Planning for mass vaccination campaigns will already be underway in many areas. In some communities, pharmacies such as CVS and Walgreens are common providers of vaccinations. In others, hospitals and health centers are used. Temporary injection centers might be set up, too, alongside the testing centers we have become familiar with, thereby creating a pathogen-eradication infrastructure across the country.
How effective a US vaccination strategy will be when international travel returns to normal and when we add to the mix people who arrive in the US having received different vaccines from other countries remains unknown, and could spell trouble down the road.

With some projections predicting that a further 200,000 lives could be lost in the US before a vaccine is widely available nationwide, one thing is certain, however: All Americans need to continue to take sensible precautions, including wearing face masks in public. Until the majority of people have been vaccinated, masks will remain the most potent form of protection against the spread of the virus. Let us all remain alert and careful during these coming dark months.
Dr Theodore Karasik is a senior adviser to Gulf State Analytics in Washington. He is a former RAND Corporation Senior Political Scientist who lived in the UAE for 10 years, focusing on security issues.