To beat COVID-19, focus on vaccine distribution and building trust

By: kennylin

Posted on: December 6, 2020

To beat COVID-19, focus on vaccine distribution and building trust

Even as the numbers of persons hospitalized for and dying daily from COVID-19 are surpassing all-time highs, America is suffering from pandemic fatigue. Although millions have curtailed social gatherings or changed holiday travel plans, exhortations by public officials, school closings, and renewed stay-at-home orders don't seem to be slowing the spread of the virus in most states. In September, I warned that a vaccine against SARS-CoV-2 was unlikely to be a "magic bullet" for the pandemic unless it had very high efficacy and population uptake well beyond the historical standard set by annual influenza vaccines. As it turns out, though, the first two messenger RNA vaccines developed by Pfizer/BioNTech and Moderna/National Institutes of Health appear to be highly efficacious (despite these important caveats) in preventing mild to severe COVID-19 infections, and both could receive an emergency use authorization from the U.S. Food and Drug Administration to begin administering the first doses within the next two weeks. Historians of medicine will likely chronicle the "warp speed" development of these vaccines as an amazing achievement given the intense political and humanitarian pressures involved. But in terms of ending the pandemic, that may turn out to be the easy part.

Physicians like me have some sayings about other strongly recommended medical interventions. "The best screening test for colorectal cancer is the one that gets done." "The best blood pressure medication is the one the patient can afford to buy and is able to take every day." Conversely, I agree with the title of a recent Washington Post article by the director of the Yale Institute of Global Health: "Rapid development of a [coronavirus] vaccine won’t help much if people refuse to take it." On one hand, I don't place a great deal of stock in (and feel that there's been entirely too much journalistic hand-wringing about) surveys that found that sizeable percentages of Americans were reluctant or unwilling to receive a coronavirus vaccine; nearly all were polled when no viable vaccine candidate existed, and it's unsurprising and, frankly rational, that people would have reservations about being injected with a completely theoretical foreign substance.
The benefits of a vaccine will decline substantially in the event of manufacturing or deployment delays, significant vaccine hesitancy, or greater epidemic severity. Our findings demonstrate the urgent need for health officials to invest greater financial resources and attention to vaccine production and distribution programs, to redouble efforts to promote public confidence in COVID-19 vaccines, and to encourage continued adherence to other mitigation approaches, even after a vaccine becomes available.