Is Pfizer’s vaccine a “quick fix”? Scientists warn masks, distancing could last until 2021

© Craig F. Walker / Globe Staff
Researchers at Beth Israel Deaconess Medical Center in Boston are also working to develop a vaccine to prevent COVID-19, as part of a joint effort with Johnson & Johnson.

A raging pandemic country had a silver lining on Monday with the announcement from drugmaker Pfizer that its COVID-19 vaccine has seen early success among a small number of people in its drug trial .

But with so many unknowns about the first batch of coronavirus vaccines still in development, vaccine and infectious disease experts warn the public should be prepared to stay the course with 2020-style precautions for the months to come, and maybe longer. Masks and social distancing in 2021 are still likely, they say.

Pfizer, one of the companies most advanced in its vaccine trials, said its first data on a small group of participants suggests the injections could be 90% effective in preventing COVID-19. However, scientists still do not know whether the vaccine will be effective in the general population and, if so, how long that protection might last.

Whatever vaccines are ultimately effective, there are also significant obstacles to distributing gunfire to millions of people in remote locations.

What you need to know about Pfizer vaccine news

“It could be the silver bullet, but we have to see how long the effect will last. Maybe we need to take the quick fix every six months, ”said Dr. Karen Tashima, director of clinical trials at the Center for Immunology at Miriam Hospital in Rhode Island, of Pfizer’s development. “The worst case is that it only lasts two months. These are only very preliminary data. “

Researchers around the world are rushing to develop dozens of potential vaccines, including four candidates in large-scale trials involving thousands of people in the United States. Recent data suggests that the more distant vaccines show strong protection against the virus in monkeys and produce an immune response in study volunteers.

Pfizer’s new interim analysis, for example, was based only on 94 confirmed infections in a study that recruited nearly 44,000 people in six countries. The data has not been independently reviewed by regulatory agencies of the United States Food and Drug Administration.

“It’s encouraging. 90% protection is wonderful for a first generation vaccine. If it holds up, it will be fantastic, but it’s early,” said Michael Kinch, director of the Centers for Research Innovation in Biotechnology & Drug Discovery at the University of Washington in St. Louis.

“What often happens with vaccines is that the first vaccines you get are imperfect and we learn as we go,” he said.

Pfizer’s coronavirus vaccine could be cleared by mid-December

Many are eagerly awaiting more comprehensive data due to be released later this month by Pfizer and in the coming weeks by Cambridge Moderna biotechnology and AstraZeneca on whether their vaccines are safe and effective.

But even if one or more of them get the green light and some vaccines start to be released at the end of this year, the country’s leading disease specialist, Dr Anthony Fauci, does not expect a more widespread distribution before the second or third trimester of the next. year.

Even as vaccines begin to roll out more widely, researchers will continue to follow people who participated in their large-scale studies to monitor their health. Federal regulators have said companies should follow them for up to two years.

Regulators also expect any COVID-19 vaccine to prevent disease or decrease its severity in at least 50% of those vaccinated. Early data from Pfizer suggests it has exceeded that threshold. (In comparison, annual flu shots typically prevent or reduce the risk of illness by 40-60%, while measles and smallpox vaccines produce lifelong immunity.)

Live tracking: coronavirus vaccines to watch

“When people get the vaccine, they can feel like ‘I’m safe now and I don’t have to wear the mask,’ and we have to make sure that we temper that feeling because we don’t know how long that vaccine effect will last. last, ”said Tashima, of Rhode Island’s Miriam Hospital.

“We are not going to perfectly reach the people who are at risk of spreading the disease,” she said. “I don’t think we can stop wearing masks for another year. Rolling out vaccines to the majority of the population will take that long.”

Vaccine specialists also point to important technical and social justice issues that could hamper the distribution of some of the early vaccines, which would impact the extent of their reception and the length of time social distancing and masks would remain daily routines. For example, Pfizer’s candidate is to remain in an ultra-cold warehouse – around minus 103 Fahrenheit – until it’s ready for use, raising concerns about sufficient capacity for ultra-cold units. to safely deliver and store millions of doses around the world.

In addition, the Pfizer and Moderna vaccines would require patients to receive two injections, respectively 21 or 28 days apart. And patients should stay on the same type of vaccine for both doses, further complicating distribution and taking.

Only one of the four vaccines in large late-stage US trials, the one developed by Johnson & Johnson and Beth Israel Deaconess Medical Center in Boston, would offer protection against COVID-19 after an injection. It doesn’t require super-cold storage.

“The first one [vaccine] Approved may by chance be the best, but the one that arrives a short time or a long time later may be better in terms of safety, efficacy or ease of distribution, ”said Dr Dan Barouch, director of the Center for Virological Research and vaccine from Beth Israel.

Yet, added Barouch, “nothing could be worse than the existence of a safe and effective vaccine, but not enough for everyone. The number of vaccines available is unknown. “

At the same time, there are fears that many people are afraid or hesitant to get the vaccine, fearing that it is not safe because the process could have been rushed. This could hamper the race for large-scale protection known as collective immunity.

Additionally, long-standing mistrust of the health care system in some communities and cultures, stemming from racist treatment by doctors and researchers, could also undermine the effort.

“A safe and effective vaccine that people don’t trust will fail,” Barouch said.

Then there is the question of whether vaccine developers are focusing on the right part of the coronavirus. Most US vaccines target the virus spike protein, which plays a major role in its ability to bind to and infect healthy cells.

But what if it’s not the best approach?

Kinch, of the University of Washington, said more vaccination teams need to focus on other parts of the virus to better protect themselves against the risk that spike proteins may not be the optimal target. While data from Pfizer suggests that this approach may work in people, it’s unclear how long-lasting this protection might be, and whether it works as well in older people, who are most vulnerable to serious illnesses.

The virus that causes COVID-19 is part of a larger family of coronaviruses that typically cause much milder illnesses, including the common cold. People produce an immune response after catching a cold, but that protection wears off and people get sick again with the same cold viruses. Kinch said early data from Pfizer does not indicate whether the same would be true with its vaccine.

“We have to approach it like a 401 (k) that uses a balance of stocks and bonds because we want to balance risk, but instead we put our portfolio in spike protein,” said Kinch. “If we hit big, we’re gold. But if we miss, we’re back where we were in March.”