We are midway into November 2020. Across the United States we are now in the third wave of Covid-19 and the number of new cases daily is higher than in the previous two waves. One out of every 30 people in the US has had Covid. It is very likely that you know of someone who has had Covid.
The great news is that development of a vaccine has been at rocket speed. If we are successful at every step going forward, the vaccine might help life return close to normal by the middle of 2021. For caregivers, this means the ability to have gatherings and to go on outings with less risk. Now is a time to keep our fingers crossed and hope for the best but still be prepared for setbacks.
Below are some of the steps critical to a successful vaccination program, all of which need to be pulled off:
By the end of 2020:
The FDA (Federal Drug Administration) would need to approve the vaccine as effective and safe. Scientific review of research data is very likely to begin this month. Distribution of the vaccine will start rapidly once FDA approval occurs.
By February/March 2021:
The vaccine would need to show early evidence of effectiveness and safety in high risk patients. The data would need to show a drop off in Covid infections among vaccinated patients. The current vaccine trials, based on volunteers, is not final proof of effectiveness. I myself volunteered for the Pfizer vaccine study but I do not have multiple chronic medical illnesses that many people in the real world have. I don’t know if I received the vaccine or a placebo but my immune response would likely be strong if I received the vaccine. This may not be true for higher risk patients who may not respond so strongly to a vaccine.
If the vaccine proves to be effective, then people who have been vaccinated will be at lower risk for Covid. However, life will not return to normal until vaccination is widespread.
By June 2021:
70% of the US population would need to have had 2 doses of the vaccine administered. The doses are separated by approximately 3 weeks. (One major vaccine being studied requires only one vaccination but efficacy data is not available yet.)
If a very large percentage of the population receives an effective vaccine, then relatively few people are contagious and spread is limited. This is described as “herd immunity”.
In the USA, the estimate is that 200 million people need to be immunized to achieve herd immunity; thus at least 400 million doses. Estimates are that Pfizer will have 50 million doses available in December. Pfizer will likely produce doses very rapidly but there will be worldwide demand for billions of doses.
A huge challenge is the planning and logistics for administering the vaccines. The Pfizer vaccine requires constant maintenance of a super cold minus 94 degrees Fahrenheit (the average restaurant freezer has a temperature of minus 10 Fahrenheit). The very cold temperature is needed because the vaccine consists of a fragile molecular structure surrounded by a fragile, easily broken molecular container. It is so fragile that preservatives cannot be used. The cost of transport and storage and the potential for the vaccine to “go bad” are major issues. The Moderna vaccine only requires minus 4 degrees but, as of now, efficacy data from trials has not been reported. (The data may come soon.)
Probably the biggest hurdle will be that many people will decide not to take a Covid vaccine and we won’t achieve herd immunity. Across the USA, approximately 50% of people choose to take the flu vaccine.
Cost of the vaccine may also be a major issue. The vaccine itself will be provided at no cost to most patients in the US but there are associated costs for transportation, supplies and administration of the vaccine.
Many of us have pandemic fatigue, living lives that are heavily impacted by Covid. My goal is to have caregivers stay informed and mentally prepared for the time ahead.
If our hopes come true, a vaccination could help our lives return to normal by the middle of 2021. The most difficult challenge will be attaining a high level of immunization in the population. In the meantime, we must keep up our diligence and continue the fight ourselves. We need to continue being very careful, maintaining physical distancing, masking, washing hands frequently and avoiding group settings. Combining these measures with a successful vaccination campaign will increase the likelihood that the virus stops spreading.
Warmest Aloha and stay well,
PS. I’m here to support you. Be connected, stay strong.
HOT OFF THE PRESS!!
On Monday 11/16 the drugmaker Moderna announced very promising trial results for its Corona virus vaccine. Of great importance, the Moderna vaccine does not require super cold storage. Moderna states it will be able to produce 20 million doses by the end of December. The second dose is 28 days after the first.
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