9 Questions About the COVID-19 Vaccines, Answered
The promising results of COVID-19 vaccine trials and pending emergency use authorization is hopeful news as cases of the disease surge to historic highs. So far, the pandemic has seen 58.9 million COVID-19 cases worldwide, 1.42 million deaths and in the U.S., no letup. Reports suggest that there could be an estimated 20 million cases in the United States alone by Inauguration Day.
So hopes are being pinned on the new COVID-19 vaccine candidates which could be available in the US as early as next week. There are two major frontrunners—products by Pfizer and Moderna— all of which are in late-stage clinical trials and showing remarkable efficacy, ranging from 90 to 95%. (FYI: there are many companies attempting vaccine trials.)
Along with hopes for the vaccines, there are concerns about who gets it first and how we know its safe, questions about how you get it, how many doses you’ll need, how long it lasts—basically, questions about everything.
We reached out to experts to get the answers on what you need to know about COVID-19 vaccines now.
How do the COVID-19 vaccines work?
Typically, a vaccine imitates its intended virus, causing it to produce antibodies and subsequently build immunity. A COVID-19 vaccine would be no different. (Though there is a new technology that uses a genetically modified spike protein, which is found on surface of virus.) “These will be administered essentially the same way as the flu shot,” explains Will Kimbrough, MD, national virtual medical director at One Medical. Depending on your specific vaccine, “three to four weeks later you would get a second injection,” says Dr. Kimbrough. Some pharmacies are recommending that people use their app, which has built-in reminders to return for the second dose.
Are there side effects?
“For the next day or two, common side effects could include pain around the area of the injection, feeling run down, headache, muscle aches, and less commonly, fever,” Dr. Kimbrough says.
Severe side effects, he says, seem to be rare with these vaccines. Although during the ACIP advisory committee meeting on December 1—that was the panel that recommended to the CDC who should get the vaccine first—there was discussion that healthcare facilities consider not vaccinating everyone in the same department at once, in case they all run up against these side effects at the same time.
How long does it take for protection to kick in?
“One to two weeks after the second dose is when the vaccines have been measuring themselves as being “protective” or providing enough immune response to prevent cases of COVID-19,” Dr. Kimbrough says. By that we mean “your body will create antibodies within a few weeks to potentially protect you from infection or defend against the invading virus, thereby reducing or preventing severe symptoms, if any,” Daniel B. Fagbuyi, MD, an emergency physician and an Obama Administration Biodefense and Public Health Appointee.
These came out pretty quickly. Are they safe?
That’s a common question. In fact, a survey conducted by Pew Research Center revealed that 78% of people say their primary concern with a vaccine “is that it will move too fast, without fully establishing safety and effectiveness.”
It’s understandable why these COVID-19 vaccines, which have been in overdrive for eight months (a typical process usually takes about five to 10 years, from research to delivery) may seem like a rush job.
Two things on that:
1) The “new” technology, called mRNA, that these two vaccines use, isn’t actually all that new.
“While the specific vaccines are new, the platforms behind them (i.e., how they get the virus information into your body) have been either in development or in use for years,” Dr. Kimbrough writes. “It’s easy to look at the idea of a ‘never before used’ genetic vaccine platform as intimidating, but the actual concept of it has been studied for years on thousands of volunteers.” In other words, he says, the only think actually new is the COVID-19-specific genetic message.
2) There are practices in place to ensure safety.
That includes guidance in the form of the 21-page June 2020 FDA guidelines, which outlines standards for safety and effectiveness. Also worth noting is that FDA Commissioner Stephen Hahn, MD was recently quoted in USA Today, saying “There are several steps to the vaccine authorization process. First, a company must apply to the FDA. Then, the FDA must go through the application and send it to an outside review board called the Vaccines and Related Biological Products Advisory Committee (VRBPAC). That committee meets on Dec. 10 and will send the FDA its comments and recommendations. Only then can the FDA make a final decision on a vaccine.”
When can I get the vaccine?
For the average person, it won’t be right away.
First, emergency authorization has to happen, and that’s likely to be soon. On December 10, two committees (the Centers for Biologics Evaluation and Research (CBER) and the Vaccines and Related Biological Products Advisory Committee (VRBPAC)) will meet to review Pfizer’s application for EUA. FYI: It’s an open meeting so you can watch the proceedings, too. Moderna filed for a EUA earlier this week, and their review meeting has now been scheduled for December 17. The UK has already given authorization to Pfizer for its vaccine to be used in the country.
EUA status does not mean the vaccine is coming to the general public—all 328 billion of us in the U.S.— right away. “There is a detailed logistical process that has to take place in order to successfully deliver the vaccine to the public, says Dr. Fagbuyi, who says it will be a logistical nightmare and there will be hurdles to get to the end-user.
Healthcare workers and people in long-term care facilities should be at the front of the line, according to recommendations to the CDC by an advisory committee. Per slides shown during the advisory committee meeting, next in line would be essential workers and after that, adults with high-risk medical conditions and adults 65+. Be aware that the CDC recommendation is just that, and states are not obliged to follow it to the letter.
“Most public health officials estimate it could take up until spring or summer of 2021 for wide distribution,” says Purvi Parikh, MD, an allergist and immunologist at NYU Langone. However, the first inoculations could come as early as 24 to 48 hours after an FDA authorization, according to what Moncef Slaoui, chief advisor to Operation Warp Speed and former chairman of vaccines at GlaxoSmithKline told Reuters.
How long does immunity last?
According to the drug manufacturers and the WHO, it’s too early to know.
When I get the vaccine, can I stop wearing a mask?
Not yet. “If a large enough percentage of the population takes the vaccine, then we could be on track for not having to wear masks and socially distance by mid-2021,” says Will Kimbrough, MD, national virtual medical director at One Medical. “Since no vaccine is 100% effective, those measures will remain important until we reach a high level of confidence that we’ve achieved herd immunity.”
Whether you can still spread it to others even after you've been vaccinated is a question that hasn't yet been researched.
Dr. Fagbuyi believes we’ll still be “wearing masks until the end of next year 2021,” also noting that “there will be a slight culture change that will sustain the periodic continued use of masks moving forward almost every flu season.”
Will you be able to ask for a specific vaccine?
With vaccines from several companies racing to market, which one you get likely depends on availability, as they may not all be available at the same time in all regions.
Will the vaccine end the pandemic?
“It will take months for enough people to be vaccinated to reach that herd immunity we need to significantly reduce transmission,” says Purvi Parikh, MD, an allergist and immunologist at NYU Langone. “While this vaccine has great efficacy, it is not 100 percent effective, so you can still get sick, albeit hopefully milder, and still pass it on to others at risk. So safety and caution will be needed.”
But a vaccine, along with standard precautions—wearing a mask, social distancing, and washing hands frequently— is one of the best shots at loosening the grip this pandemic has put on every aspect of life. “As an immunologist, I often get asked about ‘immune boosters,’” says Dr. Parikh. “Outside of a healthy lifestyle, there is no quick fix [for your immune system] except for vaccines. They are the single most efficient and cost effective ‘immune booster.’”
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