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A Realistic Expectation for a COVID-19 Vaccine Debut & Distribution

Dr. John Zurlo, chief of infectious disease at Thomas Jefferson University Hospital, weighs in with the latest developments on the COVID-19 vaccine.

Are you making future plans according to when the COVID-19 vaccine comes out? Like that haircut you desperately need or taking that overdue vacation or meeting up with the friends and family you’ve missed since March?

Reports of “promising results” from vaccine trials help buoy the hopes that our social lives could return to some sort of normal with a vaccine ready by late fall/early winter.

We sat down with Dr. John Zurlo, chief of infectious disease at Thomas Jefferson University Hospital, to get his take on when we can realistically expect the debut of the COVID-19 vaccine, how it could be distributed and what life looks like after vaccination. Spoiler: “Normal” might still be a far target.

Dr. John Zurlo standing in front of Thomas Jefferson University Hospital

When would you guess the COVID-19 vaccine will be ready for distribution?

After the first of the year [2021] if everything works beautifully in the final trials. My hope would be sometime in the first quarter. My guess would be some time in the first half of the year.

Will one vaccination be enough to carry throughout the year or will we need multiple vaccinations?

There is a question of the efficacy of the vaccine. Sometimes when we get a flu vaccine, it’s only 30% effective against that year’s flu strain. We need a COVID-19 vaccine that is at least 50% effective in order to be viable. The next question is the durability of the COVID-19 vaccine, and that’s a big question mark. The duration of immunity from COVID-19 infection is anyone’s guess. If this virus is like other respiratory coronaviruses, the immunity is likely to be short-lived. We can only hope that COVID vaccines will provide long-lasting immunity. As for dosing, most of the vaccines in active testing require two doses. That does make distribution more complicated.

Has a vaccine ever been distributed at this scale in the U.S.?

I doubt it. I think back to the H1N1 pandemic in 2009, but we already had an influenza vaccine on which to base the new vaccine. Polio was certainly devastating. Back then people had more trust in medical science and government, and because the virus affected children, people would line up for blocks to get their children vaccinated. Polio wasn’t a pandemic though. Rather it was endemic, emerging every summer.

Who do you believe should be prioritized first?

Nursing home patients and staff along with healthcare workers should get priority along with older patients, particularly those with chronic medical conditions. However, we need more data to know how old populations will respond to this vaccine first. The people who will respond best to this vaccine are young, healthy people who, though they are much less likely to become seriously ill, are now getting infected at the highest rates and potentially transmitting infection to our vulnerable populations.  Therefore, they should also be targeted for vaccination.

Is it correct to say that the federal government will be working with organizations like the CDC, NIH and public health experts to determine how to distribute the vaccine? 

I would have to think and hope so. With that being said, there hasn’t been great coordination so far.

Do you have any sense of how the vaccine will be administered? There are reports of it being a microneedle patch?

None of the vaccines that are currently in Phase 3 trials utilize a microneedle patch. Some vaccines in earlier-stage trials are experimenting with this method of inoculation.

Some people are concerned about the expediency with which this vaccine was created. Is it safe?

We know from surveys that 75% of the population would take the vaccine once it’s ready. The 25% that say they would not aren’t necessarily anti-vaxxers.  They are a portion of the population that have genuine concern and skepticism. There have been valid downsides to vaccines so I think people are logically cautious but would probably agree to vaccination if it is proven to be safe and effective. Remember, you don’t need 100% of people to be vaccinated. If we can get numbers even exceeding 50% the pandemic level of this virus could be greatly reduced in which case hospitals would not be overcrowded and the economy could fully reopen.

Will you personally be getting a vaccine once it’s available?

I think each of us is going to have to think through it and weigh the pros and cons just like we do with every risk in life. I think the majority of the population will take the vaccine and it will probably be adequate enough so that the rate of infection will drop. There will be different vaccines by different pharmaceuticals. There may be differences in effectiveness and different side effects. At this point, none of the vaccines in trial have noted serious side effects but that may change with more people being vaccinated. But yes, I would very likely agree to vaccination.

Once we do have the vaccine, how optimistic can we be that life will go back to normal? What does life after the vaccine look like?

How efficacious, well-tolerated and durable the vaccine is or vaccines are will all be measures to the return to normalcy. I wonder if people will need to carry something like a card to show they have been vaccinated. Maybe that would help businesses like restaurants, bars, and shops open if they were able to open to card-carrying vaccinated customers. It will be a very interesting challenge.

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COVID-19, From the Experts