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: 707111

Reported Deaths: 13216
CountyCasesDeaths
Marion963501718
Lake51613944
Allen39106671
Hamilton34449405
St. Joseph33979539
Elkhart27255432
Vanderburgh22060394
Tippecanoe21765212
Porter17945298
Johnson17507374
Hendricks16786310
Clark12681190
Madison12338337
Vigo12204244
Monroe11443166
LaPorte11118204
Delaware10341184
Howard9652211
Kosciusko9114114
Hancock7964139
Bartholomew7880155
Warrick7681155
Floyd7555176
Wayne6895198
Grant6837171
Boone6541100
Morgan6390138
Dubois6079117
Marshall5779108
Dearborn569876
Cass5683102
Henry5572100
Noble540683
Jackson493069
Shelby478495
Lawrence4338118
Gibson427989
Harrison427670
Clinton418653
Montgomery417786
DeKalb409184
Huntington378680
Whitley377939
Miami372465
Knox365989
Steuben364457
Putnam352560
Jasper350146
Wabash347678
Adams337952
Ripley334568
Jefferson312980
White308154
Daviess289299
Wells286281
Decatur278792
Fayette277162
Greene270685
Posey268533
Scott261053
Clay253244
LaGrange252470
Randolph235280
Washington230731
Spencer227631
Jennings224747
Fountain208445
Sullivan207742
Starke203952
Owen192156
Fulton191439
Jay186029
Carroll185720
Perry180236
Orange177253
Rush170724
Vermillion166043
Franklin165635
Tipton160943
Parke144616
Blackford133831
Pike130234
Pulaski113645
Newton103534
Brown100040
Crawford97614
Benton96713
Martin82615
Warren79615
Switzerland7698
Union69910
Ohio55711
Unassigned0408

Ohio Coronavirus Cases

Data is updated nightly.

Cases: 1052099

Reported Deaths: 18991
CountyCasesDeaths
Franklin1221671356
Cuyahoga1070432069
Hamilton781801168
Montgomery50040996
Summit45383909
Lucas40122765
Butler37721570
Stark31437895
Lorain24166473
Warren23885293
Mahoning20905583
Lake20009362
Clermont19441229
Delaware18038130
Licking16124207
Fairfield15708197
Trumbull15585460
Medina14868259
Greene14668236
Clark13634293
Wood12767185
Portage12384196
Allen11328229
Richland11041198
Miami10536214
Muskingum8706127
Wayne8576209
Columbiana8546226
Pickaway8436121
Marion8377135
Tuscarawas8376240
Erie7566154
Hancock6714123
Ross6699146
Geauga6537146
Ashtabula6495165
Scioto6289101
Belmont5626158
Union557647
Lawrence5467102
Jefferson5324147
Huron5307114
Darke5273121
Sandusky5174120
Seneca5124120
Washington5076107
Athens501556
Auglaize475684
Mercer471684
Shelby456090
Knox4387108
Madison422859
Putnam421599
Ashland413188
Fulton409467
Defiance402596
Crawford3872101
Brown386455
Logan372976
Preble370398
Clinton361560
Ottawa356978
Highland347059
Williams326774
Champaign320657
Jackson308451
Guernsey306649
Perry289949
Fayette277848
Morrow275339
Hardin264264
Henry263766
Coshocton259457
Holmes253399
Van Wert239162
Gallia233346
Pike233331
Adams228552
Wyandot227253
Hocking209059
Carroll189247
Paulding168638
Meigs141538
Noble132837
Monroe128841
Morgan106623
Harrison105336
Vinton81514
Unassigned02
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