Consider the following hypothetical scenario. The scientific community rushes to produce a Covid-19 vaccine for the world in record time. They manage to deliver, but there’s a catch: The best estimate is that it will protect you for about 3-4 months. [Cue The Price is Right losing horn.]
If you were to get the vaccine I described above, would you feel secure enough to resume your normal “pre-Covid” life? Think about it for a moment. For instance, how would you or anyone else who was vaccinated know when the protection has worn off?
Keep in mind that at this time we don’t have a treatment that can effectively –by which I mean safely, affordably and quickly– alleviate or prevent serious complications of Covid-19 in a broad swath of the population. That’s a big problem. Indeed, without a treatment to serve as a backstop, the value of a vaccine that provides only short-term protection will be even less. Many if not most of us won’t feel comfortable resuming our normal lives.
Is a scenario like I described above possible? According to the scientists I’ve communicated with, very much so.
Keep in mind that scientists are rushing to produce a vaccine at an unprecedented rate. If it takes less than a year to deliver one, there’s no guarantee it will protect us against Covid-19 for longer than this (or even as long). Yet a year or more of protection is probably necessary for the majority of us to feel secure enough to fully resume our normal lives and get the economy back on track. Again, this underscores the importance of having a broadly effective treatment (or treatments). Ideally, the treatment(s) will come before the vaccine(s).
Under the current conditions, Covid-19 is worse than the flu, which has effective treatments and a vaccine. If you decide not to get the influenza vaccine, your chances of experiencing life-threatening complications are generally lower than would be the case with Covid-19. This partly explains why so many people decide to take their chances by skipping the vaccine and going on with their normal life. If they catch it, they figure they’ll get through it okay. “It’s just the flu,” after all.
What got me thinking about all of this? I’m always in search of the “forward-looking” view (aka “fortune-telling”). When I read the news, watch the financial markets and listen to people speaking, I get the feeling that many people regard a Covid-19 vaccine as a sure thing. That is, scientists will soon produce one (or more) for us and the world will be “saved”. Alas, it’s more complicated than that, partly because this the first time we’ve dealt with SARS-Cov2, the virus that causes Covid-19.
Before I go, I’ll share a some of the responses I received from scientists I communicated with:
Dr. Robin Shattock, Imperial College of London:
“The issue of vaccine durability is important and I agree that a vaccine that only protects for 3-4 months is not much benefit except perhaps for those most at risk and who have to be shielded. Right now it’s unclear what level of immunity is required to prevent infection or at least illness (mild to severe). If only a small level of immunity tips the balance then I expect most vaccines will work for 12 months or longer. If high levels of immunity are required then fewer candidates will be successful. I think all vaccine developers anticipate that a vaccine must be protective for a minimum of 12 months, and ideally longer. An annual booster is likely acceptable. The main dilemma at the moment is time. If you show that a vaccine prevents infection after 3 months of study then you know it protects during that period. Do you then delay deployment for another 9-12 months to be sure it continues to be protective for a long period of time? Let’s say a group shows a vaccine works by this September, should they delay till September 2021 before deployment, by which stage most of the world will have been already infected? If it wasn’t pandemic then you would wait for this period, but in the midst of a pandemic it is likely that such a vaccine would be deployed and monitored to see if infections started to re-occur.
I suspect we may see different waves of vaccines becoming available such that if the first give less that 12 months protection, the next wave that will be better will then replace early less effective ones?”
Dr. Michael Kinch, Washington University, St. Louis (author of “Between Hope & Fear: A History of Vaccines & Human Immunity”):
“Hi Rob. Thank you for your note. I am very concerned about exactly the scenario you described. As I pointed out my second book, Between Hope and Fear, we encountered the problem of a short-term vaccine with the pertussis vaccine (for whooping cough). In this case, the damage was self-inflicted.
Looking at COVID-19, I fully agree that we need to have a balanced portfolio, including both therapeutics to treat infected individuals as well as vaccines to prevent the disease. Even within vaccines, we need to expand beyond the “whiz-bang” technologies and include tried-and-true methods. Sadly, we are doing a poor job of this but fortunately, Chinese companies are doing well.
In summary, I agree that more emphasis needs to be placed upon developing therapeutics. I fear that the current focus on vaccines is insufficient. We will need more science-based and inspired leadership to recognize the challenges and possibilities moving forward.”