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Coronavirus vaccines: Your questions answered

Dr. Anthony Fauci shares some words of hope as the holiday season approaches and offers advice on how to mitigate the spread of Covid-19.

Posted: Nov 18, 2020 6:00 AM
Updated: Nov 18, 2020 6:00 AM

There is sorely needed good news on the vaccine front: A second US vaccine has been found to have a high success rate against Covid-19. Moderna announced on Monday that its vaccine was 94.5% effective against coronavirus, according to early data.

Vaccinations could begin in the United States in the second half of December, starting with high-risk groups and becoming available for the rest of the population in spring, according to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

Here are some answers to common questions about the coronavirus vaccines being developed to prevent Covid-19.

Don't vaccines take years to develop safely? How have these two been developed in just 10 months?

Most vaccines in use today have taken years and, in some cases, decades to develop, but governments have poured huge amounts of money into companies and institutions developing vaccines, with initiatives like Operation Warp Speed in the United States and the Vaccine Taskforce in the United Kingdom.

The pandemic has galvanized the scientific community all around the world, with groups of researchers in dozens of countries on a fast-paced hunt to understand how the virus works.

Operation Warp Speed has also drawn up protocols to allow trials to proceed more quickly, and industrial-scale manufacturing of the vaccines has taken place before we knew whether they would be effective. This means we have millions of doses ready to be used.

How effective is this vaccine?

The vaccine developed by Pfizer, which announced its early successful results last week, and Moderna's are both more than 90% effective, according to the early data, a higher rate than many vaccines for other diseases. However, the results are extremely preliminary and aren't what health authorities will use to authorize vaccines.

In Moderna's trial, 15,000 study participants were given a placebo, which is a shot of saline that has no effect. Over several months, 90 of those people developed Covid-19. Another 15,000 participants were given the vaccine, and five of them developed Covid-19.

Among those receiving a placebo, 11 became severely ill, but none of the participants who received the vaccine became severely ill.

The head of the International Vaccine Institute has hailed biotech company Moderna's early data on its Covid-19 vaccine candidate, saying it is "proof of concept," but cautioned that it's still early days in terms of follow-up efficacy.

"I think it's really great news and in a way confirmation that the RNA vaccines are able to protect against infectious disease and it is also a good example again that Covid vaccines are a possibility," Dr. Jerome Kim, the institute's director general, told CNN on Monday.

"It will be really important to know what efficacy is - not at two months, but at six and twelve," Kim said.

There are still lots of unknowns about how the new coronavirus vaccines would work in practice. It's not clear whether they would prevent infection altogether or make severe illness less likely. Doctors also do not know how long their protection will last.

However, Fauci described it "as good as it gets." He had said previously he would settle for a vaccine that was 70% to 75% effective.

Vaccines have various efficacy rates. According to the US Centers for Disease Control and Prevention, a full round of polio vaccines is 99% to 100% effective; full vaccination against diphtheria, tetanus and pertussis is 80% to 90% effective, while the efficacy of flu vaccine varies from year to year.

How safe are the vaccines, and are there any side effects?

Moderna said its vaccine did not have any significant side effects. A small percentage of those who received it experienced symptoms such as body aches and headaches. It's similar to what people might experience after a flu shot and is a sign the vaccine is working to create an immune defense.

"They report no safety concerns - the main side effects are injection site pain, fatigue, muscle or joint aches and pains and headache which seemed to occur more frequently after the second injection," Dr. Penny Ward, a visiting professor in pharmaceutical medicine at King's College London, told the SMC.

"Clearly we still need to see the complete scientific details in a publication to be able to judge the outcomes independently."

After a vaccine is approved for emergency use authorization in the US, the CDC will continue to monitor side effects and assess whether any are a safety concern that warrants a change in recommendation.

How do these vaccines work? I'm worried they sound experimental.

Vaccines typically mimic part of the virus they protect against, prompting a response from your immune system.

The vaccines from Moderna and Pfizer both use a new approach that hasn't resulted in an approved vaccine before -- although they have been studied in clinical trials for other viruses.

The two vaccines use genetic code rather than any part of the virus itself, with a technique called messenger RNA, or mRNA. The vaccines deliver mRNA, which is a genetic recipe. In this case, the genetic recipe directs cells to make pieces of the spikes that sit atop the coronavirus. Once it's injected, the body's immune system makes antibodies that recognize these spikes. If a vaccinated person is later exposed to the coronavirus, those antibodies should stand at the ready to attack the virus.

The fact that Moderna and Pfizer have independently produced very similar results using the same technique is a vote of confidence in the genetic technology, experts said, and their results could make it much easier and quicker to produce other vaccines.

"Using this technology, vaccine candidates can be produced substantially faster in the future to combat virtually any infectious disease, by producing vaccines against both existing pathogens and future, currently unknown pathogens," Zoltán Kis, research associate at the Future Vaccine Manufacturing Hub, Imperial College London, told the SMC.

Other companies are developing vaccines using other techniques -- the Oxford/AstraZeneca vaccine is made from a harmless modified chimpanzee virus, while the traditional route is to use the inactivated virus.

Sign me up! When can I get it?

While Fauci said he expects the first Covid-19 vaccinations to begin toward the latter part of December, initially there won't be enough vaccine for everyone. The highest-priority groups, which include health care workers, the elderly and people with underlying medical conditions, will get the vaccine first.

"I think that everybody else will start to get vaccinated towards the end of April," Fauci said. "And that will go into May, June, July. It will take a couple of months to do."

The British government has asked the National Health Service, known as NHS, to be ready to deploy a vaccine from the beginning of December.

What if I'm old, pregnant or clinically vulnerable?

Among the 30,000 participants in the Moderna trial, more than 7,000 Americans were over the age of 65, the company said. It also included more than 5,000 Americans who are under the age of 65 but who have high-risk chronic diseases that put them at increased risk of severe Covid-19, such as diabetes, severe obesity and cardiac disease.

The study also includes more than 11,000 participants from communities of color, representing 37% of the study population, which Moderna said was similar to the diversity of the US population. This includes more than 6,000 participants who identify as Hispanic or Latinx, and more than 3,000 participants who identify as Black or African American.

Noubar Afeyan, the co-founder and chairman of Moderna, said the company doesn't see "any difference in the results," among the subgroups in its Covid-19 vaccine trials.

"Moderna actually slightly slowed down the trial recruitment to ensure that we had a substantial representation, and it turns out, 37% of our trials were people, were subjects, that are considered of color," Afeyan said on CNN International Monday.

"Generally, it looks like the vaccine performs broadly across all the population groups," Afeyan said.

However, we don't know anything about groups not involved in the trial such as children or pregnant women.

"Urgent questions remain to be answered, including how long these vaccines will be effective for and whether these vaccines work across different populations, in all age groups, ethnicities, and those with prior health conditions," said Charlie Weller, head of vaccines at medical research charity Wellcome.

"Only upon trial completion will we be able to assess the full efficacy and safety of any vaccine candidate."

Will the vaccines be compulsory? What happens if I decide not to get vaccinated?

Some people will see it as their patriotic duty to get vaccinated, but others may not. The UK has said it won't make it compulsory, and Fauci has said that getting the vaccine likely won't be mandatory.

If you decide against getting a vaccination, it does have wider implications. Not only will you not have protection against Covid-19, but it could potentially make it harder to achieve community, or herd, immunity. This protects high-risk groups that might not be able to get the vaccination.

It is estimated that a Covid-19 vaccine will need to be accepted by at least 55% of the population to provide community immunity, according to the London School of Hygiene & Tropical Medicine, and some scientists anticipate even higher numbers will be needed.

Indiana Coronavirus Cases

Data is updated nightly.

Cases: 590211

Reported Deaths: 9310
CountyCasesDeaths
Marion815581297
Lake44306666
Allen31919541
Hamilton28371304
St. Joseph26766371
Elkhart24098341
Vanderburgh18643213
Tippecanoe17422121
Johnson14496284
Porter14399160
Hendricks13870241
Madison10561212
Vigo10483171
Clark10240130
Monroe9076108
Delaware8836132
LaPorte8771155
Howard7897138
Kosciusko787277
Warrick643890
Hancock638797
Bartholomew626694
Floyd6150105
Wayne5933157
Grant5818110
Dubois544372
Boone534367
Morgan516291
Marshall494184
Henry493664
Cass471760
Noble460557
Dearborn458444
Jackson414745
Shelby402179
Lawrence380575
Clinton364539
Gibson356556
DeKalb337363
Montgomery334851
Harrison328542
Knox327839
Miami309843
Steuben306340
Adams295235
Whitley294125
Wabash293045
Ripley292345
Putnam284847
Huntington283557
Jasper282433
White267538
Daviess261672
Jefferson250738
Fayette242348
Decatur242182
Greene233360
Posey232326
Wells229447
LaGrange224161
Clay217932
Scott216937
Randolph208340
Jennings192535
Sullivan189031
Spencer181917
Fountain179725
Washington177118
Starke171341
Jay162821
Owen159537
Fulton159229
Carroll152115
Orange151433
Rush149918
Perry147227
Vermillion144933
Franklin143433
Parke12908
Tipton128232
Pike113625
Blackford107522
Pulaski95237
Newton89421
Brown85530
Benton84310
Crawford7579
Martin70013
Warren6587
Switzerland6205
Union6113
Ohio4677
Unassigned0374

Ohio Coronavirus Cases

Data is updated nightly.

Cases: 826754

Reported Deaths: 10200
CountyCasesDeaths
Franklin97493705
Cuyahoga821781012
Hamilton61350439
Montgomery41700399
Summit33399726
Lucas30111597
Butler29721228
Stark24811400
Warren18917139
Lorain18086212
Mahoning16758335
Lake15365135
Clermont15160104
Delaware1382177
Licking12679132
Trumbull12401302
Fairfield1218480
Greene11631133
Medina11128165
Clark10608264
Wood9964154
Allen9511126
Portage8867105
Miami886573
Richland8790116
Marion7319113
Tuscarawas7142174
Columbiana7085124
Pickaway702850
Wayne6781164
Muskingum671242
Erie5886118
Hancock537890
Ross530287
Scioto519662
Geauga483555
Darke457589
Ashtabula439068
Lawrence432651
Union430628
Mercer424287
Sandusky421862
Seneca413555
Auglaize412759
Huron410338
Shelby410221
Jefferson403366
Belmont395640
Washington372040
Putnam364672
Athens36369
Madison339329
Knox336522
Ashland331738
Fulton325943
Defiance319278
Crawford313268
Preble311534
Brown296619
Logan292729
Ottawa282134
Clinton279043
Williams270166
Highland262418
Jackson256943
Guernsey241725
Champaign240927
Fayette225529
Morrow22294
Perry221318
Holmes218662
Henry210247
Hardin204133
Coshocton197420
Van Wert196644
Gallia190926
Wyandot190549
Adams165615
Pike164116
Hocking163423
Carroll149516
Paulding139021
Noble117840
Meigs103221
Monroe95629
Harrison8568
Morgan79128
Vinton67113
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