The development of a vaccine for any disease usually takes several years or about a decade on average. That’s due to the extensive testing and regulations that follow every vaccine’s production (1).
However, this year’s ongoing Covid-19 pandemic (2) has forced many pharmaceutical companies in overdrive. This means that we can end 2020 on a high note – with several Covid-19 vaccines getting very close to being approved (3). Namely, the vaccines showing the most promise so far are:
- The University of Oxford and AstraZeneca’s AZD1222 vaccine
- Pfizer and BioNTech’s BNT162 vaccine
- Moderna’s mRNA-1273 vaccine
But while this is undoubtedly great news for everyone, experts are warning that we shouldn’t get too overjoyed just yet. Not only is the testing of these vaccines not over yet but even when they’re 100% finished, we’ll still be looking at multiple months of wait time at the very least.
Or, as Alyson Kelvin, a researcher of emerging diseases from the Dalhousie University puts it:
“It’s completely understandable to have enthusiasm, but this is not going to be instantaneous.”
“I’m glad people are excited about the vaccine and excited to get it,” Kelvin continued. “We’ll get there, but it’s important to be balanced.”
Why are Kelvin and other experts warning people to be patient? There seem to be several main reasons:
- Production takes time.
- Distribution takes time.
- Storage can be tricky.
- Long vaccination process.
- The need for masks and social distancing will remain for a while.
And then, there’s also the risk of too many people refusing the vaccine altogether thanks to a growing global anti-vax movement (5). But putting that aside, let’s take a look at the other 4 points above in more detail.
Mass production takes time
Even though all of the pharmaceutical companies and institutions above have already produced and tested tens of thousands of vaccines, we’ll need much more than that to end the pandemic.
With over three hundred million people in the U.S. and billions more across the globe, companies will need to produce an unprecedented number of vaccines in record times. And that’s not counting all the unavoidable wasted vaccines during distribution and storage.
Albert Baehny, the Company Chairman of Moderna’s Swiss production partner Lonza explained it like this:
“We can only produce more than 500 million doses a year if we install additional manufacturing lines, so it is clear that we need additional investments in installation if we want to produce more than 500 million (per year) in the future.”
He also went on to say that even those 500 million doses aren’t certain yet and currently the company has the capacity to produce at most 400 million doses per year. Add the fact that the vaccine is intended to need two doses per person to work and the numbers look more and more grim.
Distribution won’t be easy either
As we know from other vaccines, distribution is usually very complicated as well. Not only are many places in the U.S. and across the world hard to reach but big cities present different logistical challenges as well.
However, the main distribution issue stems from the expected slow production times. Because the demand is expected to outweigh the supply by a lot at first, meaning that there won’t be enough vaccinations for everyone, countries are expected to employ certain “prioritization strategies” with the vaccines.
Most health departments have already laid out vaccination plans that look like this:
- First to be vaccinated will be high-risk people such as the elderly and those with high-risk pre-existing conditions.
- Next will be frontline workers such as those working in health care and in long-term elderly care homes.
- Vaccinated after that will be essential workers such as grocery store staff, firefighters, police, and others.
- Then come high-risk communities such as indigenous people and other minority groups.
- After that, the next vaccine doses will be made available for everyone else.
This means not only that the vaccine won’t be available for everyone at the same time but also that distributing it to the right people at the right time will be even more complicated.
While the BNT162 vaccine of Pfizer and BioNTech seems very promising with its 95% success rate, it does have one major drawback – for it to remain effective during the distribution process it needs to be stored in very specific freezer units (7). More specifically, it needs to be kept at temperatures of –70° Celsius (-94°F) at all times.
This can lead to several problems:
- Distribution of the vaccine becomes even more complicated since not every local distributor will have the right freezers for such frosty temperatures.
- The cost of the vaccine will jump even higher because of this.
- There’s the risk of lots of vaccines being rendered ineffective due to improper storage by local distributors.
“It [the vaccine] has some unique storage requirements,” confirms the immunization program manager Kurt Seetoo at the Maryland Department of Public Health in Baltimore. “We don’t normally store vaccines at that temperature, so that definitely is a challenge.”
A long and multi-stage vaccination process
What also makes things even more complicated is the fact that the vaccination process isn’t simply “one and done”. Instead of just getting one shot and walking out of the clinic free of any concerns, the vaccination process with most vaccines is expected to include the following steps:
- First shot of the vaccine.
- A wait period of 2 to 4 weeks, depending on the vaccine.
- A second “booster” shot of the vaccine.
- Wait 7 to 14 more days for antibodies to develop.
All this combined means a “vaccination process” of around 6 weeks.
Or, to quote a stand-up comedian for a change, here’s how Jesse Case described the whole process on Twitter (9):
“Omg what’s the first thing you’re gonna do when YOU get the vaccine shot?? You’re gonna go back home, wait a month, get your second shot, go back home, wait 14 days for antibodies, then keep wearing a mask and social distancing until community transmission reduction. That’s what.”
And it’s that last part that many people keep missing.
Vaccines alone won’t be enough
Another problem with the whole “vaccines will save us!” hope is that the vaccines aren’t 100% effective yet and likely won’t be 100% effective even when they start getting mass-produced. Even if they were, however, the fact that they won’t be available to everyone at once means that they’ll provide only partial defense against the virus.
In other words, even when the vaccines are out, we’ll still need to wear masks and maintain social distancing.
Alyson Kelvin makes the “Swiss cheese model” anology – the vaccine is just one layer of Swiss cheese that has holes in it. Masks provide a second, different layer of holed Swiss cheese we can put on top of the first one. Social distancing also presents another layer. By piling these different methods on top of each other we can minimize the “holes” in each of them as well as possible.
“The vaccine will be just one layer and there will still be holes in that layer,” Kelvin said. “We’ll still have to keep the other layers of protective measures, like wearing masks and physical distancing, but there’s more of a hope we’ll be able to relax others, like opening stores again.”
Isaac Bogoch, an infectious disease specialist based out of Toronto General Hospital also agreed – “We’re not going to see an outright return to normalcy, but we’ll start to slide towards it as these programs roll out, and more so as they become widespread.”
All this means that even with the vaccines, Covid-19 likely won’t ever disappear completely.
“These trials are measuring the reduction or absence of disease, not reduction of infection,” Kelvin said. “What we don’t know is if you are still able to contract the virus and if you are still able to spread it after getting the vaccine.”
This is not great news, especially for older people.
“Just because an older person was vaccinated doesn’t mean they will have the same response as a younger person and be as protected,” Kelvin added.
On the other hand, Bogoch chooses to focus on the positives. “If this turned COVID-19 from a severe illness into the sniffles, it’s still a huge success and we won’t be paralyzed the way we are,” he said. “Even if people with reduced severity of the illness can transmit the infection to others, if vulnerable populations have received this vaccine, you’re still miles ahead. You’re not going to have lockdowns.”
And even with all those problems, the main issue may still be the growing anti-vax movement and the threat of not being able to vaccinate enough people because of it.
Still, the vaccines are good news, despite the problems.
Neither Kelvin nor Bogoch or any of the other experts aren’t saying that vaccines aren’t a welcomed reprieve. They are, they just aren’t a panacea.
But “there will be some relief,” said Kelvin. “Hold onto that enthusiasm. Just take it a bit slower and know it’s not going to happen overnight.”