With Covid vaccines, are we out of the woods? Not quite

The Covid-19 vaccine is top of mind everywhere, and for very good reason. Leading pharma companies have developed vaccines at record pace – and we owe gratitude to those scientists working around the clock to develop a safe and effective vaccination.

Surely, there is reason for optimism.  Reports are claiming that once available, the vaccine could get us “back to normal” within just a few short months.

But we are not out of the woods – not yet.

For all the promotional work being done, with heads of state proudly receiving “the first shot” of the vaccines, we still do not have all of the answers.  There remain actual scientific, technical and political hurdles to overcome for this vaccine to have its full impact: Logistical challenges associated with temperature control and manufacturing capacity; geo-political concerns as world leaders prioritize vaccinating their fellow countrymen first; the lack of data in important populations, especially children. These are huge challenges, without adding layers of misinformation, suspicion and other causes for concern.

And it is important to address this underlying concern: Why not take more of a wait-and-see approach?  From a public health perspective, we know that the longer it takes to get most people vaccinated, the longer this pandemic will continue.

Sowing Seeds of Doubt
In recent years we have also seen an insidious narrative – the so-called anti-vax movement – take hold in many sectors. This movement has injected (sorry!) doubt into a significant portion of the population about the safety of vaccines overall, casting a shadow over an approach that has allowed us as a society to completely eradicate certain health conditions.  And it’s only gotten stronger.

Here’s a true story:  A dear friend and his family rented a house near the ocean for the holidays, in a town where he reports almost no one is wearing a mask.  Dad and his 10-year-old son went into a store to get some equipment to go fishing at the beach.  The store owner, an elderly gentleman (also not wearing a mask) was very helpful, giving them tips on the subtleties of surfcasting and catching the species of fish prevalent there.  As he was ringing them up, unprompted, he said “Now son, don’t you let them give you none of that RNA stuff, it’ll mess up your DNA forever!”

For Covid-19 vaccines to take hold, our focus needs to be on correcting misinformation, and we cannot ignore the statistics that show that up to 40% of people are hesitant to consider the Covid-19 vaccine simply due to a fear that it was developed too quickly to be considered safe.

We can, however, look to the past to help inform our approach to the Covid-19 vaccination initiative.

In 2006, the FDA cleared a vaccine against the human papilloma virus (HPV).  The idea was that by eradicating HPV, a sexually transmitted infection, we could significantly reduce rates of cervical and other vaginal cancers.  The vaccine was initially approved for children with the recommendation to vaccinate those around 11-12 years of age. However, when the vaccine was introduced, parents of girls said, “My daughter isn’t sexually active, so she doesn’t need this,” while parents of boys said, “My son doesn’t carry a risk of cervical cancer, so why bother.”

In this case, a lack of political will to make it a requirement, along with misguided parental and societal attitudes, dampened initial vaccine uptake.  Advocacy, education and scientific action had to be taken, and after years of effort, it has made a difference.  In a 2019 survey conducted by the CDC, over 50% of teens reported being fully vaccinated against HPV, with the numbers increasing yearly.  Additionally, this past November, the World Health Organization set a goal to eradicate cervical cancer with one of the three key prongs of the strategy being full HPV vaccination for 90% of girls by age 15.

So, what does this mean for us today, when it comes to the Covid-19 vaccine?

 Like with the HPV vaccine, education, advocacy and research will serve as catalysts to overcome hurdles of acceptance for this vaccine.  Studies must be completed in children and adolescents.  We need to understand how the virus will mutate and whether the current version of the vaccine will remain effective.  We need to learn how long immunity will last.  Many are speculating that the Covid-19 vaccine will become annual, much like the flu shot.  We know that flu shots typically get used by less than 2/3 of the population indicated to take it.  The bottom line is that we need to learn more, and then do everything possible to educate everyone along the way.

Pharma companies continue to tackle the gargantuan task of quickly developing approved vaccines while governments will have to tackle massive logistical and bureaucratic issues to succeed with the largest global vaccination effort in history.  In the meantime, there remains a great need for Covid-19 management solutions – including effective screening, efficient testing, improving treatments and continued mask-wearing and social distancing – to protect the public.

Covid-19 vaccines are the talk of the town, for sure.  They should be.  But equally important – at least for 2021 – is to harness all of our resources and collective knowledge to support a broad, long-term, multi-pronged strategy that will ultimately get us through this pandemic, and out of the woods for good.

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