Vaccines Are Coming, And They Work, But The End Of COVID Is A Long Way Off

Governor Andrew Cuomo with an example of the cold storage box that the vaccine will be shipped in and a vial of the vaccine. MIKE GROLL/OFFICE OF GOVERNOR ANDREW M. CUOMO

Infectious disease experts this week hailed the unprecedented speed with which COVID-19 vaccines have been created and the promise they provide for ending the pandemic, but also warned that numerous logistical hurdles mean it will still be a long time before the sort of “herd immunity” that can protect the general population will be achievable and that social distancing vigilance will still be needed for months.

The vaccine trials thus far have produced much reason for hope.

There are seven vaccines in the late stages of clinical trials or already being considered for approval in the U.S. One is expected to be approved this week. All appear to achieve an extremely high level of efficacy — as much as 95 percent — and have shown few side effects. All will be free.

But as relatively fast as the process has gone up until now, it’s about to slow down.

The “fast and furious race” to develop a COVID-19 vaccine that only began after Chinese scientists first mapped the novel coronavirus’s genome on January 11, 2020 produced its first fruits less than 11 months later as British citizens began receiving the first doses on Tuesday of a vaccine developed by Pfizer. The same formula is also expected to get FDA approval this week and be ready for distribution in the U.S. next week. Governor Andrew Cuomo said the first New Yorkers will be getting vaccinations by Christmas.

The breakneck development of the vaccines was helped along by research done on vaccines during the outbreaks of SARS in 2003 and MERS in 2011, both of which are caused by coronaviruses similar to the one that causes COVID-19.

“In the last 11 months, we have been witnessing what could be arguably characterized as one of the most impressive scientific undertakings in the history of humankind,” said Fotis Sotiropoulos, dean of the Stony Brook University College of Engineering and Applied Sciences. “This has to be one of the most striking scientific accomplishments attesting to the boundless power of human ingenuity.”

Now comes the hard part: getting the vaccines into the arms of hundreds of millions of people.

Disease experts have said that 80 percent of a population cohort must be inoculated in order for the virus’s spread to be brought under control well enough that protections like social distancing and limits on crowds are not needed.

In the U.S. alone, the first three groups of priority at-risk people — healthcare and nursing homes patients and staff, essential workers and senior citizens — totals some 140 million people and the need for as many as 280 million doses to be administered, since most of the vaccines developed thus far require two doses.

While the public appeal is already being undertaken at almost every level of government, the logistical hurdles are being tackled by a network of federal and state experts working on the development of mobilization protocols as part of the federal initiative dubbed Operation Warp Speed, Dr. Sharon Nachman said.

New York State has already developed its plan of attack and set up online networks for tracking who has been given first and second doses and what side effects or “adverse events” they experience, to add to the understanding of how the vaccines are working.

The Pfizer vaccine must be stored in deep freeze at minus 80 degrees until within a few hours of application, presenting storage and transport difficulties for large quantities. Dr. Kenneth Kaushansky, dean of Stony Brook University’s Renaissance School of Medicine, said that the hospital network has capacity for storing up to 4 million doses and has laid out a priority list for the vaccination of its medical staff, at risk patients in hospitals and at the Long Island State Veterans Home and for setting up a public immunization center.

“We here at Stony Brook are ready,” Dr. Kaushansky said.

Dr. Bettina Fries, the chief infectious disease specialists for the university, said that it’s not yet known how long the immunity from the vaccine will last in a person. If the COVID-19 virus is not broadly eradicated from the population — like SARS and MERS were — new rounds of immunization may be required.

“We have vaccines that last an entire lifetime,” she said, noting that the new vaccines do seem to stimulate the same cellular responses that have provided long-term immunity to other viruses. “But it may be that if the virus persists in our community that we will need to get re-immunized.”

Dr. Kaushansky said that the studies done on the vaccines thus far appear to show that the vaccines produce a much better immunity to the virus than the natural antibodies produced when someone is infected with the virus will.

“The vaccines are putting a tremendous amount of antigen into your muscle, which is producing a very high amount of spike protein and, consequently, a very robust immune response,” Dr. Kaushansky said. “Even if you had COVID-19, and I hope you didn’t, it would be very much worth your while to get vaccinated when it is available to you.”

Once vaccinated, a person will not be able to carry or spread the coronavirus, Dr. Nachman, head of pediatric infectious diseases, said.

One of the failings of the vaccine development effort thus far, Dr. Nachman said, has been the lack of trials involving young people, under the age of 18. The FDA has ordered the companies to go back and do new studies of the efficacy on these age groups.

Nonetheless, because of the enormous number of people who will need vaccinations — which will likely require two doses per person administered weeks apart — Dr. Nachman says it is likely that social distancing protocols and mask-wearing in social settings will have to continue until at least late summer 2021, and possibly into the fall.

Along with the delivery and infrastructure for making the vaccines available, the timeline for a return to normal life will depend on the rate of vaccination compliance among the general public.

“Vaccines don’t save lives, vaccination does,” Dr. Kaushansky said. “A vaccine on a shelf doesn’t protect anybody.”