New drugs coming, but some wary
Nearly a year into the coronavirus pandemic, the “wildly successful” clinical trials of vaccines by Pfizer and Moderna have helped get millions vaccinated against COVID-19, but new vaccines on the horizon will be needed to curb the pandemic more quickly, said Dean Sten Vermund of the Yale School of Public Health.
Those vaccines, which should arrive in February and March, will need to be combined with efforts to persuade reluctant people that the vaccines are safe and effective against spreading the disease, he said.
As of Wednesday, 16 million Americans and 52 million people worldwide had received at least their first dose of vaccine, according to Bloomberg, an average of 2.35 million doses per day.
Vermund called the rate at which the vaccines are being rolled out “suboptimal,” given that the Trump administration had promised 20 million shots by the end of 2020. “The logistics were not particularly well established,” he said.
However, he said, “I think Connecticut’s doing well. The rollout to health care workers went expeditiously.” Residents and staff of nursing homes also have been successfully immunized. “We still have a ways to go,” including persuading workers in health care settings who are not doctors or nurses to get their shots, Vermund said. That’s because many of those workers, including aides and food service and sanitary service employees, are people of color who have a higher degree of mistrust in the health care system in general, based on historical abuses.
To get those people on board, Vermund said, they should be told, “You’re not the first” to receive the vaccine. “There have been 15 million that have come before you in the U.S. alone. You’re not a guinea pig.”
“They’re just nervous because it’s a new vaccine, it’s new technology, or they’re young and healthy and [believe] they’re not going to get it,” said Dr. Michael Parry, head of infectious diseases at Stamford Health. The resistance is “completely unfounded,” he said.
The vaccines are so safe, Vermund said, that only one person in the country has died after receiving a shot, a doctor in Florida who died of a blood disorder. That could have been a coincidence, Vermund said.
The other populations that need to be reached are people who are homeless, the mentally ill, those with substance abuse issues and people in remote and rural areas, he said.
The new drugs, by Johnson & Johnson, AstraZeneca and Merck, will help in reaching those communities, Vermund said. They use more traditional technologies to trigger the body’s immune system and will not need to be stored in subfreezing temperatures like the current vaccines.
Parry said vaccine supply remains an issue, which is why Phase 1B of the state’s rollout has not moved beyond people 75 and older.
“We could use more vaccine than they’re giving us,” he said. “Whatever the volume is, you’d like it to be predictable because then you can hire vaccinators and people to run the program.” The health system, which includes Stamford Hospital, needs to schedule appointments three to four weeks in advance, and it’s not helpful to have to cancel them for lack of vaccine.
The state had distributed 211,325 first doses of the vaccines as of Jan. 10, according to the governor’s COVID-19 Vaccine Advisory Group, and 73 percent of those had been given. A total of 31,200 second doses had been allocated, with just more than half given as of Jan. 13.
Stamford Health is giving staff their second dose of vaccine at the same time people 75 and older are getting their first dose. “We’ve had to extend maybe by a week the second dose for individuals, but that is perfectly fine,” Parry said.
Getting a COVID vaccine will protect someone from getting sick, but it’s not certain it will keep that person from infecting others, though that has been true of other vaccines, Vermund said. “We don’t have the studies of the viral load in the upper respiratory tract and the nasal passages. … Within a month or so we’ll know,” he said.
“I think that persons who are protected from COVID will be wearing masks to protect other people,” Vermund said. Even if it’s shown that vaccination prevents spread of the virus, masks still should be worn unless it’s certain that everyone in a group has been vaccinated, such as in a classroom or workplace where vaccinations are mandatory.
“We’re going to be wearing a mask indefinitely” because it will be some time before socalled herd immunity is achieved, Parry said. That requires up to 80 percent of the population to have immunity.
It’s uncertain how mutations in the virus might affect the protection of the vaccines, Parry said, and “those changes need to be closely followed,” but he said, from what he’s read, “the changes that have … happened did not alter the efficacy of the vaccines.”
The two vaccines being rolled out now still have not been approved for children, but those trials should not take long because the efficacy of the drugs already is known, Vermund said.