Approval of the two mRNA Covid vaccines by the FDA in mid-December and possibly two more in February does not necessarily represent the beginning of the end.
To quote Winston Churchill at the time of the successful conclusion of the Battle of Britain in 1941, having the two vaccines available for administration by the end of 2020 is certainly "the end of the beginning."
In an insightful opinion article in the Dec. 4 edition of The Wall Street Journal, Dr. Tom Frieden, previously a director of the Centers for Disease Control and Prevention, noted the logistic and epidemiologic restraints relating to vaccination in the presence of escalating incidence rates in most states, and elevated hospitalizations and mortality.
It is axiomatic that unless the U.S. can effectively control Covid-19 in both rural and urban areas of the nation, restoration of the economy will not be possible. The second reality is that vaccines, under the best of circumstances, will not have any appreciable effect on the progress of COVID-19 infection in the U.S. until mid-2021. Although these vaccines provide 95 protect against clinical disease, it has of yet been determined if these vaccines protect against infection or viral transmission or the durability of the immunity. In addition, the continual presence of unstable coronaviruses in wild animals makes development of herd immunity a more difficult task. Also unknown is the amount of the population needed to be immunized to develop herd immunity. It can only be estimated based on the level of transmission. Current estimates range from 60 to 75 % of the population.
Health official in the UK and several other countries have said that they have identified a significant number of people who have become infected with a new strain of the coronavirus. These mutations have greatly increased the speed of transmission and could potentially impact the severity of the disease as well as the efficacy of the newly developed vaccines although they have not found any evidence that they can cause vaccine failures.
Acceptance of the vaccine will be critical to attaining a level of immunity that restricts transmission and persistence of the infection. There is a segment of our population characterized as "antivaxxers" who are spreading misinformation about the vaccines on social media. Despite the promise of at least two effective vaccines, it is obvious that administration to the general population of the U.S. will not be a reality until late spring of early summer of 2021. It is again emphasized that vaccination is not a panacea but is a component of an integrated program of prevention. Vaccination and immunization are not synonymous. Vaccination is the administration of a vaccine and immunization is the development of immunity after vaccination. Immunity from vaccination will only be achieved two weeks after the initial dose. In the interim it will be necessary to continue with commonsense precautions. These include masking in public, soil distancing, avoiding large gatherings, and good sanitation and hygiene.
Joseph Giambrone is a professor emeritus in Auburn University’s Department of Poultry Science with a joint appointment in the Department of Pathobiology in the College of Veterinary Medicine.
During his graduate research career at the University of Delaware, he was part of a research group that developed the first vaccine against an antigenic variant of an avian coronavirus. During a sabbatical leave during his tenure at Auburn, he was part of a research group in Australia that sequenced the entire genome of antigenic variant of a coronavirus of chickens. During his 42-year research career as a molecular virologist, immunologist and epidemiologist, he has made critical advancements in understanding the ecology of viral pathogens, led efforts to improve detection and surveillance of viral diseases and developed new and effective vaccines and vaccine strategies to protect commercially reared chickens as well as pathogens, such as avian influenza viruses, which have spilled over into human populations.