Why a vaccine won't end the covid pandemic - TribLIVE

With vaccine distribution likely weeks away, spirits have been buoyed at the thought of a literal shot in the arm after months of covid-19 anxiety and fatigue. While that optimism is just fine, experts say, many states face months of continued mitigation measures before vaccination becomes a reality.

“Though these vaccines are lights at the end of the tunnel, we’re still in the tunnel,” said Dr. Amesh Adalja, a Pittsburgh-based infectious disease expert.

Pfizer, the front-runner of the half-dozen covid-19 vaccines in development right now, applied for an emergency use authorization on Friday. The application is the latest in a chain of events that still needs to see the Food and Drug Administration and its independent advisers rule on whether the vaccine is ready.

“That’s the first big step,” said Scott Burris, a professor at Temple Law School and director of the school’s Public Health Law Research Project.

The emergency use authorization, or EUA, “is a quick way of cutting through the FDA approval process.”

The panel of experts will dig into the data gathered by the studies and trials – a full picture of the 90%, 95% effectiveness rate the pharmaceutical companies have been touting – and ultimately make a recommendation as to whether the vaccine should be authorized despite not having the usual level of evidence.

“If there was ever a case for granting an emergency use authorization to a vaccine that seemed safe and effective because of an emergency, this is it,” Burris said.

Because the team is under the gun, they will likely work quickly, he said. By legal standards, pharmaceutical companies must only show there is “reasonable evidence” that the vaccine will be safe and effective.

Once that happens, advisers the Centers for Disease Control and Prevention must solidify a plan for who is first in line for the vaccine.

First in line will likely be health care workers and the most vulnerable populations, Adalja said, something that has already been seen in CDC draft plans and the Pennsylvania Department of Health’s tentative plan.

“To turn a vaccine into a vaccination is a long process,” Adalja said, as huge swaths of the population will need to receive the vaccine. Both the Pfizer vaccine and the Moderna vaccine candidate, which is not far behind Pfizer in the road to reality, require two doses given about three weeks apart.

“You’re talking hundreds of millions of doses that need to be made, and they’re not going to be available all at once,” he said. “They’re going to trickle out over time, and there are going to be priority groups set for those who should receive the vaccine first.”

That’s why continuing mitigation efforts – staying physically apart, wearing masks and washing hands – remain vital to get the country over this mountain and into that timeframe where the vaccine supply will be able to meet the demand.

Dr. Amy Hartman, an assistant professor at the University of Pittsburgh’s Center for Vaccine Research, said the early results from vaccine trials have her feeling more optimistic than she’s been throughout the pandemic.

But, she cautioned, “it’s important to keep in mind that vaccines aren’t necessarily a finite ‘solution’ but they are an important step toward controlling the pandemic.”

Manufacturing and distribution take time, and there will likely be a lag because of a limited supply. While vaccinations of select groups could happen before year’s end, she said the majority of vaccines will be released in the first months of 2021.

A widely distributed vaccine, she said, will go a long way in bringing back a sense of normalcy – or at least some sense of what used to be normal.

“It’s likely that we won’t be back to completely normal for a while – maybe never – due to an increased awareness of infectious diseases passed from person to person.”

The vaccine will not fix the here and now, said Dr. Mike Ryan, executive director of the World Health Organization’s health emergencies program.

“Many countries are going through this wave and they’re going to go through this wave and continue through this wave without vaccines,” Ryan said in a live question and answer session this week. “We need to understand an internalize that and realize we have got to climb this mountain this time without vaccines.”

On top of that, he said, it must be understand that a vaccine will not be “the unicorn we’ve all been chasing.”

“How do we get covid equal to zero? Adding vaccines is going to give us a huge chance,” Ryan said. “But if we add vaccines and forget the other things, covid does not go to zero. We need to add vaccination to the existing physical measures, being careful, and hygiene – if we add that … to the vaccine, I think we will go a long way toward getting rid of this virus.”

It is a reality that public health leaders locally and nationally have been pushing all along and even more so as the vaccines become tangible.

In Pennsylvania, Secretary of Health Dr. Rachel Levine released the state’s draft plan for a phased rollout of the vaccine, with health care workers and vulnerable populations at the top of the first phase. How fast those phases move will depend upon a number of variables.

“A lot will depend on exactly how much vaccine we get, which will determine how many people we can vaccinate,” she said, stressing that nothing is a cure-all.

“We’re going to be rolling this out through the winter and then the spring and into the summer,” she said of the vaccine. “It could take a significant amount of time to immunize everyone in Pennsylvania. I anticipate that we’re going to be wearing masks in 2021 — well into and maybe until the end of 2021.”

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, gave similar sentiments Thursday morning in a panel discussion with the Hastings Center, an independent bioethics institute.

Getting vaccinated with a highly efficacious vaccine does not mean you’re going to completely abandon public health measures,” he said, indicating that masks and distancing will remain part of daily life for some time.

A vaccine, he said, keeps you from getting the disease and the symptoms, not from getting the virus. You might not feel ill or show any symptoms, and that means the vaccine is successful, but it doesn’t mean you can’t have the virus and thus spread it to others.

“Public health measures … can be dramatically reduced as more and more of the population gets vaccinated and there’s more of a veil of protection,” he said. “But you don’t want to abandon public health measures completely until — and this is important — until the level of virus in the community is so low that the risk of someone getting infected is minuscule.”

Megan Guza is a Tribune-Review staff writer. You can contact Megan at 412-380-8519, mguza@triblive.com or via Twitter .

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