A vaccine won’t immediately return life to normal
A COVID-19 vaccine will not return life to normal by spring 2021
Accurate (supported by evidence and facts; acceptable margin of error)
In October 2020, BBC News released a story on a report written by the Royal Society, which described a need to be “realistic” about what a vaccine’s role would be in ending the COVID-19 pandemic. The article claims that the development of a vaccine would not automatically return life to normal, as it was before pandemic. Our verdict is that the claim is accurate.
This is because a vaccine has not yet been released, so it still isn’t clear how effective it will be, how long immunity would last, and how quickly it will be distributed. While many are hopeful that a vaccine could be available as early as the end of 2020 or early 2021, there are many other factors, such as production and distribution, that will prolong any return to normal. Because of this and because it takes time to scale up production nationally and internationally, necessitating prioritization and availability, we arrived at our verdict. We are uncomfortable with the term “normal”, as many aspects of life from before the start of the pandemic will have changed, such as the number of people teleworking, for example. In addition, while the COVID-19 pandemic will eventually end and the world will find a way to effectively manage the disease moving forward, other diseases may cause new pandemics, yet again disrupting what a “new normal” may look like.
When would a successful vaccine be ready?
According to the World Health Organization (WHO), there are 169 vaccine candidates in development as of October 2020. However, it is not clear when exactly one will be deemed safe to be slated for wide release. So far, only 26 of them are at the human trial phase. As COVID-19 Facts has previously noted, trials can be suspended unexpectedly due to situations outside of the researchers’ control. Indeed, the American Council on Science and Health has explained that the overall probability of success of all drugs and vaccines is 13.8% and that this varies based on the therapeutic area. Simply, while there are many candidates, it is still uncertain as to when and which one will officially be ready to be mass produced. This uncertainty creates other questions about doses and effectiveness.
Do we know how effective or how many doses the vaccine would be?
Because there is not a vaccine approved for use in the general population, the effectiveness and how many doses a vaccine would require are still unclear. WHO’s profile of preferred and minimally acceptable standards for vaccination for long-term protection against COVID-19 lists their minimum acceptable efficacy of a vaccine is 50%. The preferred range would be 70% or higher. Similarly, in the United States, the Food and Drug Administration, released a statement that they would only approve vaccines that were 50% or more effective. This means that if a vaccine is 50% effective and 100 people were exposed to the virus, then half would either not get sick or have less severe symptoms and be sick for a shorter period.
According to the United States Centers for Disease Control and Prevention, there is a difference between vaccine efficacy and vaccine effectiveness. Vaccine efficacy measures how effective a vaccine is in ideal conditions, like in a clinical trial, while vaccine effectiveness measures how effective a vaccine in “typical” conditions, like everyday life. According to WHO, factors that can affect vaccine effectiveness include age and the presence of other chronic or pre-existing conditions or diseases. This means that if a vaccine is the only intervention employed to prevent COVID-19’s spread, then the vaccine would protect at least 50% of people.
“All of this doesn’t mean that a vaccine with a lower efficacy would not be useful,” Dr. Bruce Y. Lee, study author and professor at City University of New York Graduate School of Public Health and Health Policy wrote for The Conversation in July. “It would mean that social distancing and mask-wearing likely would have to continue until the pandemic runs its course or a vaccine that is actually ‘good enough’ arrives.”
Are there other factors besides the vaccine’s effectiveness to take into account?
When a vaccine passes successfully through all the phases of a clinical trial and is proven to be sufficiently effective, there will be several logistical questions around the production, scale and distribution to take into account. While there are cases of companies producing vaccines before they are officially approved, in order to be ready for high demand should it be approved, it will still take time to ramp up production to be able to serve an international population. An article in the Journal of Infection estimated that it would take 70% immunity to reach herd immunity. On an international scale, according to Lee, published in The Conversation that would be 5.25 billion people and this would only be in scenario of the vaccine being one dose rather than several. For vaccine production, this is an unprecedented size and will not be solved as soon as a vaccine is released.
According to the National Academies of Sciences, Engineering and Medicine, regardless of international demand, any initial vaccine supply will be limited. Because of this, certain groups will be prioritized. In their framework, WHO outlines that this would include frontline workers in health and social care settings, people over the age of 65 years, and people under the age of 65 years who have underlying conditions that put them at a higher risk of death. This report was released as part of COVAX Facility, which aims to create fair equitable access to vaccines for every country and avoid what is being called “vaccine nationalism.” Vaccine nationalism is the competition between individual countries for supplies to produces vaccines for their own population, which could create scarcity for other countries and their populations. According to WHO, under COVAX, each of the 172 countries who have joined, which include Australia and Canada, regardless of their ability to pay would have equal access to vaccines.
Even the United States, which has not joined COVAX, has a draft prioritization five-phase plan proposed by The US National Academies of Sciences, Engineering and Medicine to fairly allocate a coronavirus vaccine to US residents. Their first phase would cover health-care workers and first responders, while the second would cover people with underlying conditions that put them at high risk for death and older adults in densely populated areas.
So, what does this mean in the long run?
The statement that a vaccine will not immediately return life to normal and that there will continue to be challenges is accurate because there is still not a viable vaccine and it is unclear how effective that vaccine will be when it is developed. Challenges surrounding production, scalability and distribution will mean that production will be limited and that prioritization of who will be vaccinated first will be necessary. Because of this we will not be able to depend exclusively on a vaccine to contain or eradicate COVID-19 and end the pandemic. Testing, contact tracing, physical distancing, and masks will continue to play an important role even when a vaccine is released. A vaccine would be a key piece, but one of many. Moreover – “normal” is not clearly defined and will most certainly not be what it was before the start of the COVID-19 pandemic.
The Royal Society
The American Council on Science and Health
Journal of Infection
The National Academies of Sciences, Engineering, and Medicine
The US Centers for Disease Control and Prevention
The US Food and Drug Administration
The World Health Organization
A COVID-19 vaccine will not return life to normal by spring 2021
October 23, 2020
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