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By Miriam Raftery

November 19, 2020 (San Diego) – A vaccine for COVID-19 can’t come soon enough to protect the health of people around the world and preserve economic futures for businesses that have shut down or been forced to operate under stringent limits. 

Over a quarter of a million Americans have died of COVID-19 in just eight months – nearly five times more than perished in the Vietnam War. That’s far higher than the 34,000 flu deaths last year, and the virus is now spreading exponentially. More than  three million Americans are now believed to have active infections—or nearly one percent of the U.S. population, the Washington Post reports. In San Diego, cases have tripled in the past two weeks; nationally, South Dakota and Iowa reported more than half of all COVID-19 tests were positive as hospitals fill up and nurses are in short supply. 

How effective and safe are the vaccines?

Now Pfizer and Moderna both report large trials have shown effectiveness rates of 95% and 94.5% respectively, with no significant serious side effects. Each vaccine needs two doses, and both manufacturers say limited rollout could begin in late December, if the U.S. Food and Drug Administration (FDA) grants approval. 

On Nov. 18, Pfizer, which developed the vaccine with BioNTech, announced it plans to apply to the FDA for emergency authorization “within days.”  The Pfizer clinical trial included nearly 44,000 volunteers; half received the vaccine and the other half a placebo.  Among both groups, 170 developed COVID-19 – but only eight had been vaccinated, the other 162 got the placebo, a salt water injection.  

The vaccine not only appears to dramatically reduce the risk of contracting COVID-19, it also may reduce severity of the disease.  Out of 10 people in the study who developed severe COVID-19 cases, only one had received the vaccine; the other nine had the placebo. The vaccine was consistent across all ages, races, and ethnicities, according to Pfizer, even proving 94% effective in people over age 65, the age group most vulnerable to severe impacts of the disease.  

Pfizer reported the most common adverse effect was fatigue, with 3.7 percent saying they felt tired temporarily. About two percent reported headaches after the second dose, which also went away after a short time. Pfizer says it could have 50 million doses ready by year’s end and up to 1.3 billion next year. However, only around 12.5 million people (a small fraction of the 330  million Americans) would get vaccines this year, with some vaccines going to other nations. The first 100 million doses given to Americans will be free, the New York Times reports, under an agreement with the federal government.

Moderna studied 30,000 participants in its trial, with half given the vaccine and half the placebo. In the placebo group, 90 contracted COVID-19 and 11 had severe forms.  Of those who received the real vaccine, only five got COVID-19—and none had severe cases.  Body aches and headaches were the most common side effects, experienced by only a small percentage of participants.  Moderna says it’s accumulating more safety data and hopes to apply to the FDA later this month.

Moderna received funding from private donors including country music singer Dolly Parton, who gave $1 million to Vanderbilt University Medical Center for COVID-19 research. She said she is “very honored and proud” to be partly responsible for helping save lives, CNN reports. 

How do the vaccines work and what are the key differences?

Both Pfizer and Moderna vaccines utilize mRNA, a synthetic version of coronavirus genetic material, to stimulate a person’s immune system to attack the virus if the person is exposed. If approved, it would be the first vaccine to use this new technology.

Moderna has one key advantage over Pfizer. The Moderna vaccine can be stored at minus 4 degrees Fahrenheit in a freezer long-term, or in a standard refrigerator for up to 30 days. Pfizer’s vaccine requires storage long-term at minus 94 degrees Fahrenheit, colder than standard freezers. Pfizer plans to ship vaccines in special containers with dry ice. Their vaccines can be stored in standard freezers for only five days maximum, or in the special coolers up to 15 days, but the dry ice must be restocked and boxes opened no more than twice daily. 

Who will be prioritized to be vaccinated?

Dr. Anthony Fauci, the nation’s top infectious disease specialist with the Trump administration, has said the first vaccines would likely be made available for healthcare professionals and other first responders, as well as those at high-risk such as the elderly.  Front-line workers at risk in jobs such as teaching or grocery store jobs would likely also be among the early priorities to receive vaccines.

Dr. Fauci has indicated he hopes that “everybody else will start to get vaccinated towards the end of April,” adding that it could take two or three more months for the vaccine to be widely disseminated to attain herd immunity.

The California Department of Public Health’s draft vaccination report proposes to prioritize access to vaccines based on highest risk including communities with high rates of COVID-19 infections or deaths. Other factors will include  age, housing status, racial and ethnic backgrounds. So people in nursing homes and homeless shelters, prisons, ethnic groups such as Latinos with the highest rate of COVID compared to population size, Native American tribes, students and teachers might be among those to be prioritized.

The state is also outreaching to groups ranging from faith-based institutions to pharmacies, medical facilities, school districts at all levels, nonprofits and tribal health programs to set up a framework for rolling out the vaccines.

It’s not yet known how long immunity provided by vaccines will last, and it’s possible that like the flu vaccine, COVID-19 vaccines may need to be adapted periodically to adjust for mutations of the virus.

How effective the vaccine will be at curbing the pandemic and allowing the economy and daily life to return to normal, however, will be dependent in large part on how many people actually get vaccinated.  Polls have shown substantial numbers of Americans remain wary of the new vaccines, though thus far the risks of the vaccines appear to be far less than the risks of dying or suffering long-term health impacts of COVID-19 which can include brain fog, memory loss, permanent damage to the heart and lungs, strokes, and more.  

Vaccines could be mandated in some settings, such as for workers in healthcare facilities or children in public schools.  Some employers could potentially require workers to be vaccinated and nations could add COVID-19 to the list of vaccinations required of travelers.  

The vaccine rollout could be delayed, however, due to the lack of cooperation by President Donald Trump in providing President-Elect Joe Biden with presidential briefings, including updates on COVID-19 and plans for rolling out any vaccine that is approved.  

Trump has also drawn sharp criticism for taking no actions, other than touting vaccines, to stem the rising tide of COVID-19 that has infected 1.3 million more Americans since Election Day.  Biden has said he would likely order a national mask mandate and accelerate distribution of personal protective gear to workers in high-risk settings.

“We have a totally out-of-control epidemic, and we are taking baby steps,” Andrew November, epidemiologist at the University of California, Irvine, told the Washington Post.

The vaccines offer light at the end of the long, dark tunnel, bringing the prospect of protection to beleaguered healthcare providers, front-line workers and high-risk individuals as early as the holiday season. For everyone else, 2021 offers the promise of containing the virus and offering protection for all who are willing to get vaccinated—a prospect that will bring welcome relief to those who have been isolating for many months, as well as for businesses, places of worship, and other entities that have struggled to hang on during the pandemic in 2020.