Category: Covid-19 Vaccine

I am extremely torn about what to do. I dont want to call the authorities on my community, but I feel there needs to be some kind of accountability for the flagrant disregard of rules and profound disrespect of others, not to mention that this restaurant has created a potential virus vector. What would be an ethical analysis of this situation? Name Withheld

You witnessed a potential superspreader event, and if you leave things as they are, another one could appear every day at this restaurant for the foreseeable future. Diners there may end up causing sickness and death elsewhere through their indifference to the rules. In these circumstances, reporting what youve seen might save lives.

There can be reasons not to bring down the full weight of the law on people, especially those with whom you have a connection: Maybe the law is irrational or enforced with too heavy a hand. But here the rules are rational, and you offer no reason to think the enforcement will be inappropriate. Meanwhile, the restaurant can still serve its patrons with its takeout service. Current projections have us entering March with over half a million Covid-19 deaths. We need to take all reasonable measures to slow the spread.

Like many single people during the pandemic, I and my sibling, both in our early 30s, have been living on and off with our two baby-boomer parents in the home we grew up in. All four of us are quite close, and our relationships are good: We talk frequently, go on walks, play games and have dinner together often. The only significant cause of tension is a disagreement about the obligation we adult children have to be friendly to our parents. Among other things, this includes making sure to tell them when we are leaving the house, though they grudgingly accept not being told where we are going. When I tell them that I would like to be able to leave without notifying them, or refuse on principle to report on my siblings whereabouts, they become upset.

The house is much too small to afford any degree of privacy. I fully believe that as a guest, I have a duty to do whatever my parents ask of me; but on the other hand, I wonder if my obligations might in some ways be more like those of a roommate. My parents insist that they want to make me as comfortable as possible. After discussing the matter, it seems as if Im either going to act in a way that hurts their feelings or just give in and accept my own feeling that Im under surveillance. Which should it be? Name Withheld

Your parents, apparently, say its a matter of being friendly; you say its a matter of being under surveillance. Neither description strikes me as right. Your parents may enjoy having you around, but theyre doing you a favor in letting you stay with them during the pandemic. Theyve agreed, even if reluctantly, that you neednt say where youre off to. (I agree that would be intrusive.) But is it really such a burden to tell someone whose house youre living in when youre going out for a while? This isnt a matter of being friendly; its a matter of acceding to a request they have a right to make of guests, even if those guests are their children.

I agree that its not your job to report on your siblings movements; hosts dont have the right to oblige guests to regulate the behavior of other guests. But because the house is small and everyone is presumably able to find out whos in and out, the information your parents are asking for is only something theyll most likely learn anyway. To say Im going out for a few hours isnt the same as submitting to surveillance. Besides, I wonder whether this isnt more a matter of anxiety alleviation than control. Old habits die hard; parents can worry when their children disappear without notice.

Kwame Anthony Appiah teaches philosophy at N.Y.U. His books include Cosmopolitanism, The Honor Code and The Lies That Bind: Rethinking Identity. To submit a query: Send an email to ethicist@nytimes.com; or send mail to The Ethicist, The New York Times Magazine, 620 Eighth Avenue, New York, N.Y. 10018. (Include a daytime phone number.)

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Should I Get a Covid-19 Vaccine When Others Need It More? - The New York Times

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Circuit of the Americas drive-thru COVID-19 vaccination site could be able to give 50,000 doses per week - KXAN.com

In this installment of our Hope Behind the Headlines series, we review the worldwide progress in vaccination rates and the resulting drop in new cases in certain countries. We also review how existing vaccines fare against new variants of the coronavirus.

As we near the 1-year mark since the World Health Organization (WHO) first declared COVID-19 a pandemic, it is tempting to lose hope and sight of the progress that we have made in tackling this crisis.

However, scientists, governments, and health systems across the world have been working at speed to inoculate people en masse. The results of this mass vaccination, together with sustained physical distancing and lockdown measures, are starting to show.

Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.

In this feature, we provide an overview of this progress in the hope that it will restore a much-needed glimmer of optimism. We also examine how the vaccines fare against emerging new variants of the virus.

Countries worldwide are now making headway in vaccinating their populations. At the time of writing this article, countries around the world have administered over 204 million vaccine doses.

Currently, Israel is holding the top spot in the number of vaccination doses administered. It has administered over 80 doses per 100 people.

By the beginning of February, 2021, almost 90% of people aged 60 years and above in Israel had received at least their first dose of the vaccine.

The United Arab Emirates is close behind, having now administered over 53 doses per 100 people, according to the same source.

The United Kingdom has administered over 24 doses per 100 people. Its government has recently announced that the country hit its first target of vaccinating 15 million people.

The positive effects of this mass vaccination have not gone unnoticed.

In Israel, the Ministry of Health reported that by the beginning of February, 2021, confirmed SARS-CoV-2 infections in people over 60 years of age had fallen by 41%. Also, hospitalizations from mid-January to early February had dropped by 31%.

According to Florian Krammer, a virologist at Icahn School of Medicine at Mount Sinai in New York City, NY:

What we see here are early and very encouraging signs that the vaccine is working in the population.

Krammer also told Nature that Israel is the first country to see a direct effect of vaccines working in such a large group of people. The strict national lockdown the country imposed also contributed to this success, according to the authors of the Nature article.

In the U.K., too, a new study has found that infections in England dropped by two-thirds since the beginning of lockdown. London, in particular, saw an 80% drop in infection rates, according to research from Imperial College London in the U.K.

These results are from the REACT study. Prof. Paul Elliott, the director of the research program, deemed these results really encouraging.

The rate of COVID-19 deaths is declining, but death rates worldwide are still high. A study that examined fatalities in intensive care units across the world found that COVID-19 deaths in hospitals declined from 60% to 36% between March and October 2020.

Staying hopeful can be particularly challenging in light of the new emerging variants of SARS-CoV-2. So far, there are three main variants that may be a cause for concern. These are:

These variants are potentially more contagious, and there has been concern that some may have the ability to evade the immune system.

However, it is worth remembering that according to the data we have so far some COVID-19 vaccines may overall remain effective against the new variants, even if the neutralizing ability of the antibodies these vaccines generate may be slightly lower.

For example, a study that we recently covered found that two doses of the Pfizer-BioNTech vaccine remained effective against the B.1.1.7 variant.

The paper, which appeared in the journal Science, notes that the vaccine stimulates the immune system enough to produce sufficient quantities of antibodies that can neutralize the new, more contagious SARS-CoV-2 variant.

The study used pseudoviruses, which bore the spike protein characteristic either of the B.1.1.7 variant or that of the older, original variant that appeared initially in Wuhan, China.

When using the new variant spike protein, there was a slight reduction of neutralizing antibodies in younger participants and no reduction in older participants.

The scientists do not think that the slight reduction is biologically significant. They conclude, therefore, that the Pfizer-BioNTech vaccine would still offer sufficient protection against the new variant.

Another study, this time appearing in the journal Cell, reached a similar conclusion. The authors write that although the B.1.1.7 variant is harder to neutralize than [the] parental virus, it does not escape from monoclonal antibodies or from the antibody responses that the vaccine generates more widely.

Finally, the authors of the Science study also write that the Pfizer-BioNTech vaccine may protect against SARS-CoV-2 through an additional avenue besides antibodies: by boosting levels of cytotoxic T cells.

So, even if antibodies become insufficient for neutralizing a newer variant of SARS-CoV-2, the vaccine could still be effective.

Recent research that has not yet undergone peer review found a similar result for the Moderna vaccine.

The producers of the Moderna vaccine released a statement at the end of January, 2021, suggesting that their vaccine retains protection against not only the B.1.1.7 variant but also the B.1.351 variant, which scientists first identified in South Africa.

The scientists document their findings in a study appearing on the preprint server Biorxiv. In it, Dr. Kai Wu, Ph.D. from Moderna, Inc. in Cambridge, MA and colleagues conclude:

Taken together these data demonstrate reduced but still significant neutralization against the full B.1.351 variant following mRNA-1273 vaccination.

However, just to be safe, Moderna are also testing a booster vaccine that targets the B.1.351 variant.

As the Moderna scientists put it in their statement: As we seek to defeat the [SARS-CoV-2] virus, which has created a worldwide pandemic, we believe it is imperative to be proactive as the virus evolves.

We are encouraged by these new data, which reinforce our confidence that the Moderna COVID-19 vaccine should be protective against these newly detected variants.

Stphane Bancel, the chief executive officer (CEO) of Moderna

However, just to be extra cautious, the creators of the Moderna vaccine and those of the Pfizer-BioNTech vaccine agree that devising an adapted booster vaccine would be a wise thing to do in the fight against new variants.

Out of an abundance of caution and leveraging the flexibility of our mRNA platform, adds Bancel, we are advancing an emerging variant booster candidate against the variant first identified in the Republic of South Africa into the clinic to determine if it will be more effective to boost titers against this and potentially future variants.

The authors of the Pfizer-BioNTech study agree with this approach. In their Science paper, they write:

Although sustained neutralization of the current B.1.1.7 variant is reassuring, preparation for potential COVID-19 vaccine strain change is prudent. Adaptation of the vaccine to a new virus strain would be facilitated by the flexibility of mRNA-based vaccine technology.

Finally, the creators of the Oxford-AstraZeneca vaccine have also announced that they will create adapted versions of their vaccine to address new variants.

Prof. Uur ahin, the CEO of BioNTech, and team touch on a key aspect in their paper quoted above: the flexibility of mRNA vaccines.

Even if the neutralizing ability of antibodies the vaccines generate in response to new variants is lower than that of previous variants, as some studies suggest, mRNA vaccines still have a significant advantage compared with other types of vaccines.

Scientists can quite easily adapt mRNA vaccines such as the Pfizer-BioNTech and Moderna ones as opposed to vaccines that use an inactivated form of the virus, for example to tackle new virus variants.

That is because mRNA vaccines use genetic instructions for our cells to create viral proteins themselves, rather than using an infectious pathogen or parts of such an infectious virus in itself.

Vaccines from the latter category may require a complete overhaul in order to cope with new variants because they use either the whole virus or a part of the virus.

To adapt this to a new variant would require making the virus from a new variant rather than from a previous variant. By contrast, mRNA vaccines are a lot more flexible.

Dr. Stephen Hoge, the president of Moderna, explained for TIME magazine that adapting the vaccine to new variants would be like copying and pasting we could paste the South African strain mutations into our vaccine very quickly.

In his interview, which he gave at the end of January, 2021, Dr. Hoge added that new booster shots could be ready to test in a matter of 6 to 9 weeks.

For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.

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Hope Behind the Headlines: COVID-19 vaccines and variants - Medical News Today

The U.S. Food and Drug Administration issued new guidance Monday that streamlines the vetting process for COVID-19 vaccines that are modified to target new coronavirus variants.

The recommendations, detailed in a 24-page document on the FDAs website, are intended to speed up the review process amid worries that the new variants some more contagious, some more able to evade current vaccines will undermine efforts to halt the virus spread.

We know the country is eager to return to a new normal and the emergence of the virus variants raises new concerns about the performance of these products, Dr. Janet Woodcock, the FDAs acting commissioner, said in a statement. By issuing these guidances, we want the American public to know that we are using every tool in our toolbox to fight this pandemic, including pivoting as the virus adapts.

The recent emergence of a spate of variants has led to rising concerns that the first generation of vaccines which were developed based on an early version of the coronavirus may not be well-equipped to protect people against the mix of viruses currently in circulation.

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For example, several vaccines have been less effective in South Africa, where a strain known as B.1.135 dominates, than in other parts of the world where that variant is not as prevalent.

A vaccine from Johnson & Johnsons Janssen Biotech unit reduced the risk of moderate to severe cases of COVID-19 by 72% when tested in the U.S., but was only 57% effective in South Africa. Similarly, a vaccine from Novavax that was nearly 90% effective at reducing the risk of all types of COVID-19 in Britain was only 49% effective in South Africa.

Also concerning: A COVID-19 vaccine developed by AstraZeneca and Oxford University was 75% effective at reducing the risk of mild to moderate illness when tested in South Africa before the B.1.351 strain was widespread. But after it took over, the vaccine was no better at preventing mild to moderate illness than a placebo.

And in laboratory tests, antibodies generated by people who had received a vaccine developed by Pfizer and BioNTech did a better job of thwarting a coronavirus variant from the United Kingdom than it did against the South Africa strain.

Vaccine makers have responded to the threat posed by new variants by adjusting their recipes so the immune system will better recognize them.

The new guidance is part of a flurry of recommendations for developers of vaccines, tests and therapeutics in light of these new variants. It allows modified vaccines to be authorized under an amendment to their existing emergency authorizations, officials said.

The FDA would like companies to submit clinical data showing that the modified version of their vaccine is more effective against new variants than their original vaccine. The agency is also asking vaccine makers to test their modified vaccines in people who have never been vaccinated and in people who were previously vaccinated.

Dr. Peter Marks, director of the FDAs Center for Biologics Evaluation and Research, said trials to test the immune response prompted by a tweaked vaccine would probably involve a few hundred individuals, and might take about two or three months.

Compare that with a typical Phase 3 clinical trial, which can involve tens of thousands of patients and can take several months longer.

Such a speedy vaccine alteration is the norm for viruses like influenza, said Dr. Diane E. Griffin, a viral immunologist at the Johns Hopkins Bloomberg School of Public Health.

Its possible that in the future, modified vaccines could be authorized without the need for additional clinical studies, the FDA noted. But that is not yet the case.

The agency emphasized that the two vaccines currently authorized for use in the U.S. the one made by Pfizer and BioNTech and another developed by Moderna and the National Institutes of Health are still effective against the mix of variants now circulating in the U.S.

That said, its reasonable to think these companies are thinking about these changes or are thinking they may need to make changes, Griffin said. This just helps them to know what kind of information the FDA would want and what they wouldnt need.

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Modified COVID-19 vaccines may get nod from FDA without repeating full trials - Los Angeles Times

Where Florida will send its COVID-19 vaccine doses this week - South Florida  Sun Sentinel

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Where Florida will send its COVID-19 vaccine doses this week - South Florida - Sun Sentinel

Amber Dow with her dad, retired sportscaster Duane Dow, 80, at their home in Chicago's West Lakeview on Friday, Feb. 19, 2021. Amber had been looking to get him vaccinated because of his heart-related medical issues then she found help through a Chicago Facebook group called Chicago Vaccine Hunters. (Jose M. Osorio / Chicago Tribune)

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Thousands of frustrated COVID-19 vaccine seekers are turning to social media for help and getting it - Chicago Tribune

As COVID-19 case numbers continue to drop in the US, some states have lifted their mask mandates.

Gov. Doug Burgum of North Dakota let his state's mask mandate expire in January. Gov. Kim Reynolds of Iowa said earlier this month that Iowans no longer had to wear masks in public. And Montana's new Republican governor rescinded his Democratic predecessor's state-wide mask mandate last week.

The drop in coronavirus cases has been cited in decisions to lift restrictions, and, indeed, all three states are down from their November peaks. But infectious-disease experts told Insider that while the dropping case counts were promising, it might be too soon to make dramatic changes in restrictions, especially when it comes to masks.

"It's completely too soon," Dr. Peter Chin-Hong, an infectious-disease specialist at the University of California at San Francisco, told Insider.

"It goes against the grain of what President Biden is trying to do, which is a national strategy that we never had," he said. "COVID doesn't restrict itself by state borders."

Chin-Hong said individual states' lifting mask mandates echoed the situation in the US last year, when he said the lack of a national strategy hindered efforts to restrict coronavirus transmission.

Even as President Joe Biden's administration has vamped up vaccinations, Chin-Hong said coronavirus variants were a big concern.

"The vaccine rollout is progressing everywhere, but it probably won't be able to protect the population fast enough," he said.

The experts Insider spoke with all said that there were encouraging signs but that the US was still in a race to vaccinate before virus variants spread more widely.

For Iowa specifically, Chin-Hong noted that several cases of the B.1.1.7 variant had been discovered there this month.

He called those cases only "the tip of the iceberg," given the limited work being done to identify the variant.

The B.1.1.7 variant, first identified in the UK, is known to be more transmissible than the original strain. British scientists have also become increasingly convinced that the variant could be deadlier as well.

The variant has been detected in 44 states, and Chin-Hong said it would most likely be the country's dominant strain by March. If states continue to lift restrictions like mask mandates, it will increase the likelihood for B.1.1.7 to spread.

In Iowa, a state that has dramatically lifted restrictions, Chin-Hong said the virus was "probably having a party right now."

B.1.1.7 is just one of many coronavirus variants circulating in the US. And it's possible that more will emerge, making it an evolving issue with lots of uncertainty.

"We're entering a phase where it's harder to know what the near-term future is like," Andrew Noymer, an infectious-disease specialist at the University of California at Irvine, told Insider.

He said his expectations for what would happen throughout the pandemic such as the summer and winter surges had largely been accurate. But, he said, for the first time he felt as if he really didn't know what the immediate future would look like regarding the pandemic.

Cindy Prins, an epidemiologist at the University of Florida, agreed that it's too soon to be lifting mask mandates.

"The thing is, we still have COVID circulating and don't have the majority of people vaccinated," she said, adding that while case numbers were lower than they were during the holiday surge, they're still not at ideal levels in most places.

According to data from the Centers for Disease Control and Prevention, more than 63 million doses of COVID-19 vaccines have been administered in the US. About 13% of Americans have received their first dose, while less than 6% are fully vaccinated, NPR reported.

To reach herd immunity, an estimated 65% to 80% of a population needs to be immune.

The Biden administration is well on its way to achieving its goal of administering 100 million vaccine shots in its first 100 days, and it has plans to further ramp up vaccinations. The president's team hopes to vaccinate all eligible adults by the end of summer, the Associated Press reported.

But Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases who is also Biden's chief COVID-19 medical advisor, has said priority groups won't finish getting vaccinated until sometime in April.

If the more-transmissible B.1.1.7 variant is expected to be dominant by March, that leaves a lot of time for it to circulate in environments with loosened restrictions.

"It is really a race against time," Prins said.

Before dramatically lifting restrictions, she said, states should have a combination of low transmission as well as a high number of fully vaccinated people to reach a "balance where we feel like we're not going to have widespread transmission."

"We'll get to that point," she said. "But we're not there yet."

Despite concerns over variants, Noymer of UC Irvine said it's reasonable for states to reevaluate restrictions as case numbers drop.

"People are getting antsy," Noymer told Insider. "What you don't want to have is a situation in which people don't want to follow any restrictions because they feel it's all too strict."

Noymer said loosening restrictions could even have an overall positive effect in some situations. For instance, he mentioned California, where an outdoor-dining ban in the fall sparked outrage and even prompted some restaurants and local jurisdictions to flout the rules.

Noymer considers this a significant problem because it risks some restrictions being viewed as meaningless.

Gov. Gavin Newsom reopened outdoor dining in California late last month, prompting some to wonder whether the decision came too soon. But Noymer said it just brought the restrictions closer in line with reality in some places, which can go a long way in maintaining the public's trust.

"I'd like to have these orders still have some meaning when in the fall we might face a new wave with variants," Noymer said.

But as far as what kinds of restrictions can safely be lifted, he said "masks should be among the last to go."

He said relative to other aspects of life that had been disrupted by the pandemic, masks were a minor inconvenience relative to their public-health benefits.

"We know that masking is really important for prevention," Prins said, adding that to keep case numbers from rising again it's crucial for people to continue wearing masks and physical distancing until more Americans can be vaccinated.

Masks may be one of the last parts of the pandemic to go away, as Fauci even said on Sunday that it's possible Americans will be wearing masks into 2022, when life might begin to look a bit more "normal."

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Experts say it's too soon to lift mask mandates as variants spread - Business Insider

Dr. Anthony Fauci, the US's leading infectious-disease expert, is fully vaccinated against the coronavirus, but it seems unlikely that you'll find him dining in any restaurants or catching a movie in theaters just yet.

"There are things, even if you're vaccinated, that you're not going to be able to do in society," Fauci said on Monday during a White House COVID-19 press briefing. "For example, indoor dining, theaters, places where people congregate. That's because of the safety of society."

Fauci's comments came on the same day the US passed the grim milestone of 500,000 confirmed COVID-19 deaths. He stressed that while being vaccinated dramatically increases one's "own personal safety," it's not a free pass to party as if it's 2019, at least not yet.

"Because the burden of virus in society will be very high which it is right now," he said.

Though the number of new coronavirus cases reported each day in the US has fallen dramatically in recent weeks, the virus is still spreading, with nearly 450,000 COVID-19 cases documented in the past week.

"We are still at an unacceptably high baseline level," Fauci said at Monday's briefing.

Though vaccines can help prevent people from contracting severe cases of COVID-19, the jabs may not stop them from getting sick altogether. It's also still unclear whether vaccinated people can be disease carriers, meaning they might spread illness to unvaccinated people in a community where vaccination is far from universal, prolonging the pandemic.

"We hope that when the data comes in, it's going to show that the virus level is quite low and you're not transmitting it," Fauci said, cautioning: "We don't know that now. And for that reason, we want to make sure that people continue to wear masks despite the fact that they're vaccinated."

Early signs are looking promising that vaccinated people may not spread the virus well, but it's still too soon to say for sure.

Fauci's remarks came on the same day when Gov. Andrew Cuomo of New York announced that movie theaters in his state would reopen in early March. Indoor weddings and catered events of up to 150 people will also be allowed to resume in New York mid-March.

Fauci has suggested before that a better strategy would be to reopen theaters in the fall, when a more "substantial portion" of the US has been vaccinated.

In the meantime, there's still the possibility for safe, distanced (and masked) outdoor sports and events, including Fauci's favorite, baseball.

"I would hope that by the time we get into May, June, July, that we will have enough people vaccinated in the country that the level of infection would be low enough maybe not yet total herd immunity but low enough to say that we can go to a game, you know: wear a mask, but be seated not sitting right next to each other," Fauci previously said during an online Q&A with JAMA.

COVID-19 vaccines are already giving relief to millions of people across the country, on an individual level, from the prospect of severe disease and death.

"People are interested in taking the vaccine in large numbers for the same reason people are interested in taking the vaccines for MMR and for the flu," Andy Slavitt, the White House senior advisor for COVID-19 response, said at the briefing with Fauci.

"Because they want to live. They don't want it to be sick, and they don't want to die."

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Fauci: Vaccinated people shouldn't dine indoors or go to the theater quite yet - Business Insider

With the COVID-19 vaccine rollout underway and a renewed sense of hope stemming from an aggressive vaccine dispersal plan, a common question has begun to emerge.

What is the first thing you will do after you get the COVID-19 vaccine?

Some people dream of going to crowded concerts, theme parks or sports arenas. Others hope to see family members again; grandparents long to hold their grandchildren, extended family members hope to catch up at weddings and summer barbecues. Yet others, like healthcare workers, are simply grateful to be able to do their job a bit more safely.

But what is the reality of a post-vaccine life? How soon will life go back to normal?

In an ideal world, the COVID-19 vaccine would provide us with immediate and permanent immunity, and we would be free to socialize to our hearts content. However, modern medicine has its limitations, and the COVID-19 vaccines are no exception.

How do the COVID-19 vaccines work?

mRNA Vaccines

The two COVID-19 vaccines approved in the U.S. (from Pfizer and Moderna) are messenger RNA (mRNA) vaccines. mRNA is normally used in our cells as a sort of instruction manual to create proteins.

The Pfizer and Moderna vaccines work by introducing a new mRNA instruction manual in our body to help our immune system build defenses against the SARS-CoV-2 virus (the virus responsible for the COVID-19 pandemic).

So how does mRNA help build an immune defense?

When a person encounters SARS-CoV-2, their body creates cells known as T-lymphocytes and B-lymphocytes that attack the virus. Once created, these T-lymphocytes and B-lymphocytes remember how to fight the virus in the future.

COVID-19 mRNA vaccines work by tricking the body into creating T-lymphocytes and B-lymphocytes to fight SARS-CoV-2 without needing to be exposed to the virus first. The mRNA in the vaccines instructs cells to create a protein called the spike protein.

The spike protein is normally located on the outer surface of the SARS-CoV-2 virus and is not something that our cells would normally produce. When someone gets a COVID-19 mRNA vaccine, their cells begin to create the spike protein (which, by itself, is harmless).

In response, their body creates T-lymphocytes and B-lymphocytes that attack the spike protein. If the person is then exposed to SARS-CoV-2, the T-lymphocytes and B-lymphocytes can quickly attack the spike protein on the surface of the virus and neutralize it. The faster a persons body can neutralize the virus, the less likely they are to get sick.

In most cases, it takes a few weeks after vaccination for someones body to produce T-lymphocytes and B-lymphocytes. For this reason, the Pfizer and Moderna COVID-19 vaccines (both of which require two doses) require a period of three to four weeks between the first and second doses. One way to think about the two doses is like building up an army. The first dose builds an initial army defense, while the second one improves upon the army in terms of both quality and quantity, giving the immune system a better chance to be able to fight off and neutralize the SARS-CoV-2 virus.

Adenovirus vectored vaccines

Although not yet approved for use in the U.S., another type of COVID-19 vaccine is on the horizon. The Oxford-AstraZeneca vaccine, which is approved for use in the U.K., uses a technology known as adenovirus vector technology. Adenovirus vectored vaccines and mRNA vaccines are similar in that they both help the immune system build up an army of T-lymphocytes and B-lymphocytes to fight SARS-CoV-2. However, the vaccines achieve that goal in slightly different ways.

When someone receives an mRNA vaccine, the mRNA goes into their body and their cells treat the foreign mRNA the same way that it would treat mRNA that is normally produced in their body (i.e., they create the protein that the mRNA instructs, and the mRNA is then degraded). In contrast, adenovirus vectored vaccines use a harmless virus known as an adenovirus to insert genetic material (DNA) into cells.

When someone gets the Oxford-AstraZeneca vaccine, the adenovirus enters their cells and the DNA is turned into mRNA. The mRNA then instructs the cells to make the SARS-CoV-2 spike protein and build an immune response in the same way as mRNA vaccines.

Adenovirus vectored vaccines have some benefits over mRNA vaccines. Chief among these benefits is their ability to be stored at warmer temperatures. Because mRNA is very fragile, mRNA vaccines need to be stored at extremely cold temperatures or else the mRNA will fall apart and the vaccine will become ineffective.

Adenoviruses, on the other hand, tend to be more stable at warmer temperatures, making them easier to store and transport. However, adenovirus vectored vaccines also take longer for scientists to create. There are hundreds of adenoviruses that exist naturally in the world and it can take time for scientists to determine the most appropriate adenovirus to use.

It is important for scientists to pick an adenovirus that is very different from adenoviruses that most people have encountered in their lives and given the fact that we all encounter adenoviruses throughout our lives (often without knowing it) identifying and testing them can be time consuming. If scientists were to choose an adenovirus that is too similar to ones that weve encountered before, our immune system would swiftly eliminate the adenovirus, rendering the vaccine ineffective.

Can I infect other people after I get the COVID-19 vaccine?

Most vaccines that fight against viral infections also reduce virus transmission. However, because the COVID-19 vaccines do not completely stop SARS-CoV-2 from entering the body and replicating, it is still possible for people who have been vaccinated to infect others.

Unfortunately, we dont yet have a definitive answer regarding how well the COVID-19 vaccines reduce transmission - but scientists are working on it.

In the early stages of the COVID-19 pandemic, scientists primary goal was to develop a vaccine that could prevent severe infection. Fortunately, the vaccines are exceptionally good at doing so; very few people who are vaccinated end up in the ICU or on a respirator. Now that the initial clinical trials are complete, scientists have begun to investigate secondary questions, like whether the vaccines can reduce or prevent transmission of the virus. However, because vaccine trials examining transmission are still ongoing, we dont yet have an answer.

We don't know if the vaccines will reduce transmission, but its possible that they will, Adan Becerra, an epidemiologist and assistant professor at Rush Medical College told BioSpace. I'm hopeful, and there are a lot of people in the vaccine world who are hopeful. We do know that it's possible to develop an effective vaccine for a disease outcome that doesnt completely prevent transmission. On the other hand, there are vaccines that are fully efficacious, like the polio vaccine, that also prevent transmission. And so, because these are new mRNA vaccines, it could really go both ways. We dont know for sure yet.

A preprint released by Oxford University this month suggests that the vaccines may indeed reduce transmission. The preprint, which outlines preliminary data from Oxford-AstraZeneca vaccine trials, reports a 67% reduction in transmission rate among people who received one dose of the Oxford-AstraZeneca vaccine.

While these preliminary data are promising, it is important to note that the trials are not yet complete, and we wont have a definitive answer to how well the Oxford-AstraZeneca vaccine reduces transmission until the final report is released.

Once I get the COVID-19 vaccine, am I immune forever?

It isnt clear yet how long immunity lasts after COVID-19 vaccination since vaccines can vary significantly in terms of the duration of their immunity. The measles vaccine, for example, immunizes against measles for life, while the flu vaccine only immunizes against influenza for several months. While scientists hope that COVID-19 vaccines will last at least a couple of years, the duration could be shorter or longer.

I think, what is clear, is that none of these vaccines are going to be a knockout vaccine, like the polio vaccine, where it's one and done and you dont have to think about it ever again, Becerra said.

Unfortunately, only time and additional data can give us a definitive answer to how long COVID-19 vaccine immunity will last.

Do I still need to wear a mask and practice social distancing after I receive the COVID-19 vaccine?

Since its not entirely unclear yet how well the COVID-19 vaccines can reduce virus transmission and how long immunity lasts, wearing a mask and practicing social distancing are still important safety measures to help stop the spread of SARS-CoV-2.

The way you deal with an infectious disease is to stop it from transmitting, Becerra explained. We're at a point where we have to think about that, even after vaccinations. Because if the vaccines aren't stopping transmission entirely - that's why we still have to wear masks, that's why we still need social distancing.

When will things go back to normal?

It may be a while before we can get back to our pre-pandemic lifestyle (especially if that lifestyle involved crowded, maskless social gatherings).

Some health experts predict that life wont begin to get back to normal until we reach a critical point in the populations collective immunity. This critical point, known as herd immunity, is the point at which most of a population is immune to an infectious agent (like a virus) and those who are immune provide indirect protection to those who are not immune.

For COVID-19, experts predict that 70% to 85% of the population will need to be immune to the virus before we reach herd immunity.

Although herd immunity may sound like a light at the end of the tunnel, there are several reasons that herd immunity may be difficult, if not impossible, to achieve.

First, herd immunity assumes that immunization prevents transmission, which may or may not be the case with COVID-19 vaccines.

Second, children and teens make up 22% of the U.S. population and COVID-19 vaccines are not yet approved for these age groups. Until vaccines are approved for children and teens, we wont likely achieve herd immunity.

Third, our chances of reaching herd immunity are less likely if vaccine-resistant variants arise.

Fourth, many Americans say they don't want to get vaccinated. Vaccine hesitancy alone may make herd immunity an impossible goal.

Despite the many factors stacked against our race toward herd immunity, however, there is another important factor at play: natural immunity.

Recent estimates suggest that 17% of the U.S. population has been infected with COVID-19 since the start of the pandemic. However, given that testing for COVID-19 occurred much less frequently during the early stages of the pandemic, its possible that an even greater proportion of the population has had COVID-19. Considering that both natural immunity and vaccinations push us closer toward achieving herd immunity, we may have a chance at achieving it.

But, even if natural immunity and vaccinations arent enough to reach herd immunity, Becerra suggests that we shouldnt panic.

Here's the thing, we haven't reached herd immunity on many infectious diseases that we don't worry about. We don't necessarily have to reach herd immunity for society to be functional. If vaccines dont reduce transmission, it will affect what interventions we implement, Becerra said. However, it may not reduce the chances of society going back to some kind of normalcy if appropriate public health measures are adhered to.

Overcoming vaccine hesitancy will be critical to getting back to normalcy

Regardless of whether herd immunity is possible, Becerra stresses that vaccinations are critically important to ending the pandemic, and, unfortunately, vaccine hesitancy is a serious issue.

I'm very concerned about vaccine hesitancy, Becerra said. We are already seeing hesitancy among staff at medical centers, and these are nurses, health care workers, doctors and researchers. There's hesitancy for a number of different reasons. There's the anti-vaxxers of course, but then there's also a lot of just general concern about whether the vaccine development was rushed. There are a lot of ludicrous theories people have with no evidence to support them.

Becerra also explained that there is no reason, biologically, to expect that the vaccines would be dangerous.

mRNA degrades in your body, he said. It's just like an email telling your body how to fight the virus, and then it just degrades. People have had concerns about previous vaccines because they use live attenuated viruses. These vaccines dont use attenuated viruses. So, if anything, they might be even safer.

According to Becerra, overcoming vaccine hesitancy will be key to getting back to our pre-pandemic lifestyle. As he put it, The reality is that we just need to get these vaccines into arms.

It is also critical for people to continue wearing face masks and following social distancing guidelines after they are vaccinated. Despite many people viewing the vaccine as a free ticket to maskless socializing, the reality is that we still need to be patient.

As Becerra explains, we might be waiting a couple of years still for things to get back to normal.

When are we going to be able to go to a football stadium without masks? When can we go out for a drink at a crowded bar? When can we shake the hand of a stranger next to us at a ballgame? It might be a couple of years before any of that, if ever.

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You Got the COVID-19 Vaccine - Now What? - BioSpace

Healthcare workers experience the same inequities in receiving COVID-19 vaccines as the general public, according to a newstudyby researchers from Northeastern, Harvard, Northwestern, and Rutgers.

David Lazer, university distinguished professor of political science and computer and information sciences at Northeastern. Photo by Adam Glanzman/Northeastern University

A hypothetical 50-year old white male doctor in the Northeast who earns more than $200,000 a year had a 45 percent chance of being vaccinated, for example, while a 45-year old Black female nursing assistant in the South earning less than $50,000 had only a 6 percent chance, mirroring society as a whole, the survey found.

The gender divide was equally stark, as males in the healthcare industry were twice as likely to be inoculated as women (18 percent vs. 9 percent), mostly because more men are doctors, researchers found. Women, who make up a larger proportion of nurses and home health aides, were considerably more skeptical than men (27 percent to 13 percent) about getting vaccinated.

Doctors at these hospitals arent trying to talk to the nurses and the janitors about why they should be convinced of the safety of vaccines, explains David Lazer, university distinguished professor of political science and computer and information sciences at Northeastern, and one of the researchers who conducted the study.

Researchers polled nearly 2,000 workers in the healthcare field, a large swath of professions that includes surgeons, lab technicians, nurses, and hospital janitors. Their responses were then compared to a broader demographic of 25,000 people that researchers have been tracking since April.

The healthcare workers, however, were surveyed between Dec. 16 and Jan. 10, right around the time when vaccinations in the United States first began. Many of the first to receive them were nurses.

They and others in the healthcare field made for a good pilot population to make comparisons against because of their diversity, which stacks up well against those who dont work in the industry, explains Lazer.

And, theyre the first population that has had the opportunity to be vaccinated, he says.

In general, the survey found that 21 percent of health professionals were opposed to getting vaccinated, slightly lower than non-healthcare workers (23 percent). Their reasons for not wanting the vaccine were not included in the study.

But when broken down by education level, income, and politics, a wide chasm developed. For example, 29 percent of those in healthcare fields with a high school education or less were opposed to getting inoculated. Those with a bachelors or graduate degree, however, were significantly more likely to say they were already vaccinated.

Likewise, just 8 percent of those earning under $50,000 a year were vaccinated, but 23 percentalmost triplewho make $200,000 or more were inoculated. A similar split emerged along political lines, with 30 percent of Republicans saying they would refuse vaccinations, compared to just 13 percent of respondents who identified themselves as Democrats.

Vaccine resistance among healthcare workers has declined over the last few months, which provides some hope for the future vaccination rates among all healthcare workers, Lazer says.

Prior research from Northeastern, Harvard, Northwestern, and Rutgers shows that the most convincing messengers to reduce vaccine doubts are doctors and scientists.

Healthcare providers are thus much better positioned than most institutions to develop science and health communication strategies to address vaccine hesitancy and resistance, researchers wrote in the current study.

Inequities, however, remain a concern, adds Lazer.

If this is a problem among healthcare workers, its going to be a problem in our society as a whole, he says.

Communication and outreach strategies for skeptical populations are important because of their vulnerability, Lazer points out.

We definitely want to get all the shots in arms as much as possible, he says.

President Biden said last week that the United States will have enough coronavirus vaccines for 300 million Americans. Moderna and Pfizer will deliver a total of 200 million vaccines by the end of July, rather than the end of the summer, he said. The companies also will deliver 100 million expected doses by the end of May, rather than the end of June.

Lazer predicts that by April or May, the nation may face a situation where there are more doses than willing arms because of reluctance.

There will be people who are willing but inaccessible and then there are going to be a lot of people who are reluctant and need to be convinced, he says.

Lazer said that the decision by Massachusetts Gov. Charlie Baker to shift doses away from hospitals and other primary care providers to mass vaccination sites such as Fenway Park has a potentially serious downside.

These sites are great for getting lots of shots in arms, but theyre not great at convincing people to get vaccinated, and they will be difficult for many vulnerable people to get to, Lazer says.

For media inquiries, please contact media@northeastern.edu.

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Even among healthcare workers, inequities exist in COVID-19 vaccine rollout, new study finds - News@Northeastern