A COVID-19 Vaccine: What You Need to Know

Since mid-March of this year, it is not an exaggeration to say that life has been turned upside down by something that is as old as time itself and microscopic in size.  The newly discovered coronavirus (SARS-Cov-2 or HCoV-19) was first identified in the Wuhan, Hubei province in China, in December 2019, following cases of patients who developed pneumonia of unknown origin.

Is Coronavirus New?

Coronaviruses themselves are not new and have been known to cause infection in the nose, sinuses and upper throat.  Many infections that we refer to as the “common cold” are in fact caused by types of coronaviruses and are not dangerous for most people.  However, SARS-Cov-2 has proven to be particularly troublesome causing severe illness and death.

Concerns about the Coronavirus

There are several factors which serve to make this new coronavirus exceptionally concerning.  First of all, since it is new, scientists and experts don’t have a complete understanding of it.  Also it has proven to be very easily spread by person to person contact, and, finally, its ability to cause sickness is relatively unpredictable.  In the eight plus months since the virus has been identified there have been some patterns develop that serve to predict risk.  Those who seem to be at a higher risk for becoming ill are:

• Elderly (> 60 years old), with those over 85 being at most risk
• Presence of underlying medical conditions including cancer, chronic kidney disease, COPD, solid organ transplant patients, obesity, serious heart conditions, type 2 diabetes mellitus, sickle cell disease.

Social distancing, the use of face coverings, increased testing and quarantining have helped to mitigate some spread of the virus, but cases, illness and deaths continue to be problematic.

The Need for a Vaccine

History has proven that the best way to combat viruses, especially those with the potential to spread rapidly and cause significant illness, is to develop a vaccine.  Simply put, vaccines use various methods to mimic the virus that they protect against, which allows the body’s natural immune system to develop defenses specific to that virus.  The good news is that in the United States, there are multiple entities working tirelessly on a vaccine for COVID-19 following the president’s Operation Warp Speed initiative.  The government has thus far invested more than $10 billion to support this program.  Several different vaccine production technologies have been proposed and studied in effort to hone in on the most effective and safest option.

COVID-19 Vaccine Status

The United States government’s Operation Warp Speed initiative has certainly served to accelerate the development of vaccines for Covid-19 (also known as SARS-CoV-2).  There are more than 50 vaccine products currently in development worldwide with two distinct vaccines that are on track for FDA EUA (Emergency Use Authorization) within the next weeks.  Products from Moderna and Pfizer are leading the way with the product from Pfizer / BioNTech receiving approval in the United Kingdom on December 2^nd, 2020.  The US FDA has scheduled a meeting of its Vaccines and Related Biological Products Advisory Committee for December 10^th and December 17^th to discuss the safety and effectiveness data provided by Pfizer and Moderna respectively for their Covid-19 vaccine products; with approval expected shortly thereafter.  Data from both products shows effectiveness in excess of 90% against infection and almost zero against severe disease.

Some evidence suggests that individuals who have contracted Covid-19 may be susceptible to re-infection; meaning that the natural immunity developed from infection may not last. At this time it is not known whether a Covid-19 vaccine would be recommended for those who have previously developed an infection or have tested positive in the past.

What Will Distribution Look Like?

At this point, there is still some conjecture among government officials about the groups of individuals who will be prioritized to receive the vaccine.  It is clear however that front line healthcare workers and elderly persons (> 65years; especially those who are in long term care facilities and with multiple chronic conditions) will be among the first to receive the vaccine.  This is likely to occur with the first month or two following approval and release of the vaccines.  There are an estimated 21 million people working in health care and somewhere in the neighborhood of 3 million people in long term care facilities in the US.

Based on the known information at this time, estimates for when the vaccine may be available for the following phased groups are as follows.

• Phase 1  (January and February 2021) – Includes front line health care workers including those caring for patients in hospitals, nursing homes or providing home health care; first responders (EMT’s, firefighters, police).  These individuals are at high risk for exposure and serve a critical role in insuring that the health care system remains functional.  This group represents approximately 5% of the population.
• Phase 1b (March, April and May 2021) – Includes individuals of all ages with chronic conditions (e.g. cancer, serious heart disease or heart conditions) which place them at a higher risk for illness or death from COVID-19.  Also, included are adults aged 65 and older who are living in communal facilities (e.g. nursing homes, retirement communities).  This group constitutes about 10% of the population.
• Phase 2 (Summer 2021) – Includes elementary and high school teachers and staff, childcare workers, and certain critical workers in high risk settings such as food supply and public transportation.  Additionally, included are those who are homeless, residing in group homes, prison inmates, and workers in these settings.  This group is about 30% of the population.
• Phase 3 (Summer and Fall 2021) – Includes young adults, children and workers in colleges, universities, banks, hotels, factories and other facilities that are key to functional societal continuance.  Immunization in children will depend on the established safety and effectiveness in these age groups.  This group represents about 45% of the general population.
• Phase 4 (Fall 2021) – this phase covers any U.S. resident who did not receive the vaccine in previous phases.

For more questions around COVID-19, visit our resource area for Coronavirus.

Updated: Dec. 2020