For months, the nation has seen the successful development of coronavirus vaccines as a way out of our current public health and economic crisis. Recent announcements by Pfizer and Moderna that their vaccine candidates may be at least 90% effective and that official submissions to the Food and Drug Administration will soon be received have only further heightened expectations and optimism about the arrival of vaccines.
A highly effective vaccine would undoubtedly be a huge tool in our COVID-19 response, capable of reversing the ineffective national leadership, the politicization of science and evidence-based public health responses, and the recent increase in infections and cases awaiting a terrible winter.
Dissemination of vaccines is crucial
But vaccines – even highly effective vaccines – will only be as good as we are able to deliver them quickly and widely. The unprecedented pace of COVID-19 vaccine research and development, stemming from coordinated government-level efforts and billions of dollars in financial support, contrasts sharply with the attention and funding spent on infrastructure and programs needed so far. ensuring the successful distribution of the vaccine.
The operational and communication challenges of the upcoming national vaccination campaign are as daunting as the scientific barriers to vaccine development. Without an organized and well-funded dissemination program such as ongoing research and development efforts, a vaccine will find it extremely difficult to reverse the current trajectory of a pandemic, let alone end it, no matter how effective it is found to be in clinical testing.
In a new study published in the journal Health Affairs, we used a mathematical model to simulate the performance of COVID-19 vaccines with different performance profiles and efficacy levels that were introduced at varying rates and in the context of different pandemic background severities in a community. A consistent pattern emerged over the dozens of scenarios analyzed. Differences in the effectiveness of the vaccine matter – the higher, the certainly better – but more importantly, whether a vaccination program can reach a very large percentage of the population quickly and that this occurs when the virus spreads as much as possible. suppressed to the greatest extent.
Vaccine efficacy results from clinical trials, no matter how high, provide only partial information on what these vaccines may mean in the coming months and say nothing about our current readiness to maximize the potential benefits of vaccines, if available.
Our findings provide a number of lessons for policy makers, health officials, and the public. First, widespread adherence to wearing masks, physical distance, and restrictions on large indoor gatherings remain as essential as they have been for months, not only as a bridge for vaccinations to arrive, but also for some time after vaccination has begun. If the intensity of the epidemic continues in the fall, even a highly effective vaccine will find it difficult to significantly reduce COVID-19 infections and deaths, we have found.
The virus is currently behaving like a wildfire out of control in communities. Closure must be our first goal, using the tools we already have at its disposal to slow its spread. An effective vaccine would then, by 2021, be a powerful complement to – and not a substitute for – these approaches, which will make vaccination more credible over time.
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Second, the federal government must immediately commit significant resources to support the planning and implementation of vaccine distribution and community delivery. We found that even a highly effective vaccine only moderately reduces the number of COVID-19 infections unless the distribution is rapid and reaches a large portion of the population.
Health leaders need money and plans
Responsibility for the terrestrial distribution of vaccines was largely the responsibility of the state and local health departments. These organizations are underfunded and understaffed in the best of times, not to mention nine months of the century in a one-off pandemic that has strained their resources across borders. The complexity of COVID-19’s mass vaccination efforts is staggering, and states have been warning for months that the billions of dollars needed to do the work expected of them are missing.
Federal funding for the distribution was a fraction of the amount the Trump administration spent on developing and manufacturing the vaccines. President-elect Biden has pledged to invest $ 25 billion in the distribution of vaccines, an amount that meets the challenges we face. A comprehensive, culturally sensitive strategy for vaccine communication should be at the heart of this strategy in response to hesitations that threaten the success of vaccination efforts, especially among black Americans.
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It is a well-known saying among vaccine scientists and decision makers: “Vaccines do not save lives, vaccines save lives.” The development of an effective COVID-19 vaccine would be a scientific achievement in historical time. However, for this scientific success to achieve the public health triumph that so many aspire to for Americans, a commitment similar to the next chapter in COVID-19 vaccination activities is essential. Time is short.
Jason L. Schwartz is an assistant professor of health policy at Yale School of Public Health.
A. David Paltiel is a professor of health policy at Yale School of Public Health.
Rochelle P. Walensky is the head of the Department of Infectious Diseases at Massachusetts General Hospital.
Amy Zheng is a medical student at Harvard Medical School.
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This article was originally published on TODAY USA: COVID-19 vaccine: distribution, not just development needed