Any potential vaccine will have limitations
As we contemplate restarting society, and what a “new” post-pandemic normal might look like, let’s indulge ourselves by imagining a best-case scenario. We are going to imagine that scientists accomplish a near-impossible task and develop an effective vaccine for COVID-19, test it and manufacture it at sufficient scale to inoculate the world’s population within a few months.
Even with this best case in mind, would we then be able to declare victory and get on with our lives? Hopefully, yes, but at least two further huge hurdles would need to be cleared.
The first pertains to how most vaccines work. In developing a vaccine for COVID-19, one of the things that is often missed in general discussions is that vaccines typically protect people from the disease that they are inoculated against, but may not actually prevent people from being infected by that virus.
Consider the hepatitis vaccine. Folks immunized with that vaccine still contract the virus, but they don’t show any symptoms (only show mild symptoms). This is normal for most vaccines. So, if our mass vaccination efforts are effective and most of us are vaccinated, this isn’t a big deal.
But, in essence, the vaccine could turn the vaccinated into asymptomatic carriers who still shed the virus and infect others. This will still leave unvaccinated people vulnerable. The elderly will continue to be particularly at risk because vaccines are less efficacious in older individuals (suggesting that we may even need vaccines developed specifically for the elderly).
This leads to the second issue we must confront: Even assuming we develop an effective vaccine, we need to be thinking very carefully about how to deploy it because unless we vaccinate the great majority of people in the world, nothing will go back to resembling “normal.”
Aside from challenges associated with mass production of vaccines for billions of people in a short span of time, let’s consider the challenges of deploying vaccines in the poorer parts of the world, where public health infrastructures are lacking and populations are rural and sprawling.
Keeping vaccines stable and effective often means needing to keep them at cold temperatures and moving them quickly from the labs where they are manufactured to the health clinics where they are administered. Also, vaccinations often need to be repeated twice, or sometimes three times, before they can show their protective effects.
Consider the polio vaccine — it took decades before health practitioners were able to access enough remote communities with enough vaccines to declare the disease eradicated.
The challenges are equally daunting, but entirely different, when we think about how we will deploy the hoped-for vaccine in Canada, Europe and the U.S. In the so-called “Developed World,” public health must work against decades of mistrust of science.
Consider Alberta Premier Jason Kenney’s comment from May 21, where he stated that Alberta will not make vaccination mandatory when a COVID-19 vaccine is available. Even more worrying was the results of a recent survey from the U.S. where 51 per cent of the respondents either said they wouldn’t get vaccinated if one were available or were not sure if they would get vaccinated. Interestingly, in another survey, 72 per cent of Canadians felt that vaccination should become mandatory.
To conclude, even if we imagine a scientific and logistic “Christmas Miracle” — that by the end of this calendar year we have developed, tested and manufactured an effective vaccine for COVID-19 — we will still need to confront the very serious hurdles of how to deploy it.
To address this, we need, right now, to be helping organizations like the World Health Organization build up the capacity for deploying the vaccine at scale in the world’s poorest regions. And at home, we do have an effective public health infrastructure, we need to be engaging in a massive public communication of science campaign to ensure that people are ready to take the vaccine once one becomes available.