With the first COVID vaccine having been approved this week, and with a few more on the way, the end of the COVID pandemic is within view. However, there are still several areas of concern surrounding the vaccine. Many of the more high-profile concerns are already being discussed throughout the medical community and the media. The availability of the vaccines to enough Americans to achieve herd immunity likely will not be here until the summer, at the earliest. The United States opted not to order more than 100 million doses from Pfizer - which won the race for FDA approval - even when offered the opportunity to do so as recently as November. Additionally, the willingness of the general public to take the vaccine is hovering at only about 50% nationally, and we could honestly spend the entirety of this column analyzing whose fault that is.
Instead, I’d like to focus on some of the lesser-known and often-disregarded issues yet to face the country despite the vaccine being approved. The point of this exercise is to highlight the fact that even though the light at the end of the tunnel can be seen, there will still be several hurdles to reach before the masks can be ditched and social distancing is over.
I’d like to thank Blimi Marcus, who is an oncology nurse practitioner and public health educator, and one-time guest of the Jewish Living Podcast, for helping me flesh out some of these ideas.
Children
The most significant barrier to exterminating COVID is the fact that the vaccine has not yet been approved for children under the age of 16. Clinical trials are only now beginning for this demographic, and approval probably won’t be here until the start of the 2021 school year, at the earliest. In order to achieve herd immunity, we need about 65% of the population to take the vaccine. As previously mentioned, take into account that only 50% of the entire population is interested in taking the vaccine, and add in that children under 16 (about 60 million in the US) won’t be able to get it, and that 65% target is a long way off.
Two doses
Remember that 100 million dose number from earlier? Well, that only covers 50 million people, because two doses of the vaccine are necessary to get the full impact of the immunity. On the surface, the issue here is one of supply. Double the doses needed means more are going to have to be made. However, the other problem is getting people to come back for the second dose. Speak to any medical provider who deals with patients needing a follow up visit or visits. The mode (or most common number) of visits to a psychologist is one. People go to a therapist once and either think they’ve had enough therapy, or don’t believe it worked at all, and don’t bother returning. With the COVID vaccine, there is less risk of this happening because there is a finite number of visits one needs, but there will definitely be some people who do not return for their second shot.
Incubation time
Like most vaccines, the recipient is not immune immediately upon receiving the dose. These immunizations will take about three weeks to produce the antibodies required, and as we now know, there are two of them. It’s not out of the realm of possibility that individuals get a little too confident after receiving the second dose (or even after just the first dose), and begin to be lax about social distancing and mask-wearing too soon. This could result in a spike in cases right around the time the immunizations become widely available. Public health officials need to get on this issue now and explain to the public that one will not be immune immediately following the injection.
Effectiveness and Side Effects
The reported 95% effectiveness for the COVID shot is extraordinary, especially for a vaccine developed this quickly. For comparison, the flu shot is only about 60% effective, according to the CDC. The problem, though, is that the number is not 100%. The only reason this presents an issue is because at some point, there will be those who contract COVID even after getting the immunization. While those cases will be rare, they will exist, and the worry is that some of these people will be loud. Likewise, there will be those who experience some negative side effects from the vaccine, including achiness, fever, and redness. These individuals have the ability to sway public opinion on the matter, and the more who speak out against the efficacy or side effects of the COVID shot, the higher the likelihood that people who were on the fence won’t take it - regardless of the fact that these possibilities are known to the makers of the vaccine, and are being explained publicly.
Too much unknown
There is so much that we don’t know about COVID yet, and by extension, the vaccine. We don’t know how long the immunity lasts. As of now, we don’t even know how long the antibodies live in one’s system after contracting the disease. Is it possible that by the time the late adopters get the vaccine, the antibodies wear off on the early adopters? I’d say yes, but we just don’t know at this point. We also don’t know if a person can be a carrier of the disease even after the shots. According to New York Times science and health reporter Donald McNeil Jr., it’s entirely possible that the virus can live inside a human’s nose without infecting the body, and a subsequent sneeze can then spread it.
Lastly, and this is related back to the first point, we still don’t know if children spread the disease. There is a lot of misinformation about this issue. While it’s true that there’s no evidence to suggest children spread the coronavirus at the same rates as adults, there is also no evidence to suggest they don’t. Children are widely considered to be germ factories, but that’s only because they spend a lot of their time each day with other children in close proximity. At this point, we don’t know enough about the disease from a scientific standpoint to know if children can transmit the disease the same way adults do. I know there are those out there who will point to data showing children don’t spread the virus, but we won’t know why that is until we know more about the disease itself. It’s possible there are other confounding variables attributable to children that aren’t to adults, which have nothing to do with the simple fact that they are children. That information is yet to be determined.
I don’t mean to rain on the parade of anyone who is looking at the vaccine as an endgame for COVID, but as Blimi Marcus told me, we are experiencing a fatality rate that is too high right now to let our guard down. All in all, we are nearly there. Precautions are still needed, and if we all agree to maintain the standards in effect, we will be able to get back to normal life much quicker than if we just ditched the precautions without medical or scientific backing. We’re in the home stretch. 2020 is basically over. Let’s not wreck it now.
Izzo Zwiren is the host of The Jewish Living Podcast, where he and his guests delve into any and all areas of Orthodox Judaism.