January 25, 2021 at 12:01 am ET
51% of health care workers said people in their field should be required to get vaccinated, while 44% said vaccines should not be mandatory.
Two-thirds of health care workers said they would get vaccinated even if it werent required.
38% of health care professionals who havent yet gotten a vaccine said they were nervous about its unknown long-term effects.
A new special report from Morning Consult explores how health care workers have fared during the pandemic and how they view the broader COVID-19 response. The data is drawn from a poll of 1,000 health care workers.
When COVID-19 first struck the United States, health officials warned that developing an effective vaccine in record time would be a complex and perhaps impossible feat. As the months wore on and efforts turned to the equally pressing task of swaying a wary public to get vaccinated, the health sector wasnt necessarily contending with how to build trust among its own rank and file.
But many medical workers, despite their proximity to the crisis, have indeed balked at the idea of getting their shots. A new Morning Consult survey of 1,000 health care workers indicates vaccine hesitancy among the group is widespread, with a quarter saying they would refuse a shot altogether.
Vaccine hesitancy overall goes back; its not something thats brand new, said Dr. Seth Trueger, an emergency room doctor and assistant professor of emergency medicine at Northwestern Medicine in Chicago. Trueger said he was concerned early on that COVID-19 vaccines might be rushed, but felt reassured when drugmakers took good faith steps to show they were meeting federal regulators high standards for authorization. He got his second shot Jan. 8.
As of Jan. 4-9, when the survey was conducted, 29 percent of respondents had gotten at least their first COVID-19 shot. The remaining 709 respondents were asked about the major reasons they hadnt yet been vaccinated: 38 percent said they were nervous about the long-term effects of the vaccine, and 23 percent said they dont plan to ever get vaccinated. In the open-ended portion of the survey, commonly cited reasons included having allergies, being pregnant and wariness of going first.
While I am generally all for vaccines I am a little hesitant to be one of the first people to receive it, one health care worker wrote. Another said they dont understand or know what the long-term affects [sic] of this vaccine will be.
Vaccine hesitancy among medical staff has been an issue across the country. In New York City, for example, roughly 30 percent of employees in the public hospital system had turned down a vaccine earlier this month, city officials said. In Ohio, as many as 60 percent of nursing home employees wouldnt take a shot at the end of December.
Other health care workers said they havent been vaccinated yet due to the logistics of the rollout: 27 percent said their employer didnt yet have access to doses, while 23 percent said they werent eligible for a shot and 39 percent said they had plans to get vaccinated soon when its their turn. Survey respondents included nurses, physicians, home health aides, people in administrative roles and others; about 2 in 5 had cared for COVID-19 patients directly.
The lack of availability may in part reflect the rollouts focus on hospitals, which has left many primary care providers and other medical workers without a direct way to get a shot. For example, one health care worker surveyed who said they work directly with patients in a small office that is not affiliated with a health system had no idea how to get in line for a vaccine.
And while nurses and doctors became the joyful online faces of the early vaccine rollout, getting a shot has also led to some conflicting emotions for providers who work with high-risk patients who arent yet able to get vaccinated.
In a way, we still feel a little bit guilty that were getting it and our patients arent, said Dr. Randall Oyer, an oncologist and medical director of the Cancer Institute at Penn Medicine Lancaster General in Pennsylvania and president of the Association of Community Cancer Centers.
Beyond their own prospects, the poll indicates 55 percent of health care workers are not confident that the countrys vaccine rollout will go smoothly, while 39 percent are confident in the process.
The vaccine divide has put some medical workers in an awkward position: prodding coworkers who have so far opted out. In Massachusetts, Kelly Hennessy, a nurse practitioner who runs the East Boston Neighborhood Health Centers COVID-19 testing department, has spoken with younger women concerned about the vaccines potential effects on fertility, a theory that has circulated on social media but is not supported by scientific evidence.
Just saying: We have to trust the science. Your fears are real, but we can show you all the research behind it, Hennessy said of her conversations with coworkers who arent sure about getting vaccinated. But I truly think that the best way is to lead by example.
Shes scheduled to get her second shot Monday.
Health systems and other employers have taken different tacks to compel health care workers to get vaccinated. Houston Methodist, an eight-hospital system that employs some 26,000 people, is offering $500 bonuses to workers who get their shots, while Atria Senior Living, a major chain of senior living facilities, will require its more than 10,000 employees to get vaccinated by May.
Health care workers were split on whether vaccines should be mandatory for those in their profession, with 51 percent saying they should definitely or probably be required to get a shot and 44 percent saying they should not. Two in three said they would get vaccinated even without a requirement to do so, while 25 percent said they wouldnt and 7 percent said they didnt know or had no opinion.
I think the important thing is that its voluntary, Hennessy said, because mandating that people get vaccinated might spook them or cement their point of view against the shots. You cant speak down to anyone about it, because youre not going to change their mind.
From tents to trailers to traffic cones, parts of Post University in Waterbury have been transformed into a mass vaccination site.
It's a pretty significant undertaking. The logistics are mind-boggling, said John Hopkins, Post University CEO and president.
Starting Monday, school staff are helping with logistics as nurses from Waterbury Health administer the COVID-19 vaccine.
I don't know as though anybody has ever been involved in anything quite like this, but we couldn't sit back. I think Post took the perspective that we needed to get involved. We could, and so we did. It's what the community needed, said Hopkins.
This week, they hope to vaccinate 500 people a day and work up to eventually giving out up to 2,000 doses a day depending on vaccine availability.
The university said this will be the first drive-thru site in New Haven County.
All the logistics of the design so that from registration to vaccine to monitoring, you stay in the car and you get your shot in the car and so it should expedite things and help us vaccinate that many more people, said Hopkins.
Right now, people age 75 and older are eligible as part of the states Phase 1b plan. That will be expanded to other groups in the coming weeks and months.
As of last week, the state had administered more than a quarter-million doses and ranked fourth nationally for distribution.
The important thing is that we have to get a significant number of people vaccinated. This vaccination won't work unless we have a significant number of people vaccinated. We're hoping that 70, 75, 80% of the Greater Waterbury community gets vaccinated, said Hopkins.
The site at Post University will be open six days a week and will run for months.
Those looking to head there need to register and that can be done directly with Waterbury Health online or by phone at 203-575-5250, Ext. 4.
Monday will mark the first day that people 75 and older, along with other eligible patients will get to roll up their sleeves to get their COVID-19 vaccine at the Floyd Little Athletic Center at Hillhouse High School in New Haven.
Those 75 and older can now sign up for a COVID-19 vaccine in Connecticut. State officials say Phase 1B will eventually expand to include those 65 and older, but it will take time to get enough doses.
It's the latest effort by the city to boost up vaccinations after some early logistical issues. The goal is to ensure that those who are eligible can receive their shot.
At least 22 vaccination centers will be set up inside the Floyd Little Athletic Center.
Dr. Anthony Fauci on Thursday said new data indicated the existing COVID-19 vaccines were still effective against new variants. Right now from the reports we have literally as of today, it appears that the vaccines will still be effective against them with the big caveat that you want to play close attention to it, Fauci said.
The city is partnering with Yale New Haven Health to help with vaccine distribution. A second vaccine site is located at the Lanman Center on Ashman Street. The goal of the new sites is both accessibility and equity for all communities who need to get vaccinated.
Health and city leaders are formulating plans to offer mobile sites in the near future at different housing authority sites.
As COVID-19 vaccines roll out, a study has found that they are disproportionately reaching white populations before Black and other minority communities. One of the authors of the Business Insider report, senior healthcare reporter Shelby Livingston, joined LX News to discuss the difference in vaccination rates, and the questions it raises about racial equity.
New Haven's Health Department said The Medical Reserve Corps will help with vaccine distribution and different nursing students from Quinnipiac University and other area universities will help with administering shots.
The Floyd Little Athletic Center will open on Monday and is open seven days a week. Appointments are required.
A medical staff member prepares the Pfizer-BioNTech COVID-19 vaccine at Tudor Ranch in Mecca, Calif., Thursday, Jan. 21, 2021. (AP Photo/Jae C. Hong)
MERCED COUNTY, Calif. (KSEE/KGPE) Merced County announced Sunday it will hold two more COVID-19 vaccination clinics later this week in Merced and Los Banos.
The additional clinics follow the successful launch of four vaccination clinics last week, the county Department of Public Health said.
A total of 800 doses will be split between the two sites this week and additional allocations will be provided to eligible Merced County healthcare providers to administer.
The health department reported that the state provided a smaller allocation of doses last week and county officials are advocating for a higher allocation of doses in coming weeks.
Residents are advised to visit Vaccinate Merced County to determine eligibility and receive further vaccination notifications.
Anyone who doesnt have access to a computer or internet can call the Public Health Information Line at 209-381-1180 starting on Monday at 10 a.m. on a first-come, first-served basis to request an appointment.
The Public Health Department said eligible residents who register through the website will receive a notification email with appointment options, which will remain available until the schedule is full.
Those who would like to receive a vaccination are strongly encouraged to sign up at Vaccinate Merced County in order to be notified of future availability and appointment options. Vaccination appointments are prioritized based on state eligibility criteria and are handled in the order submitted.
The county is currently vaccinating residents that fall under Phase 1A along with individuals 65 and older.
Vaccinations are appointment only at the moment in order to administer the vaccine orderly and effectively, officials said. Additional vaccination sites and options are planned as the vaccine becomes more widely available.
Arts And Culture
Updated January 24, 2021 2:55 PM
Published January 24, 2021 1:38 PM
Cheech Marin (Cheech & Chong, Born in East L.A.) is one step closer to opening a center dedicated to Chicano art in Riverside.
City officials announced in 2017 that it will commit $10.7 million to the project, and late last week, the City Council approved a management agreement and a bid for the construction company.
Marin is one of the world's leading collectors of Chicano art, and his collection will be the anchoring exhibit at the Cheech Marin Center, planned to open inside the Riverside Art Museum this Fall.
Drew Oberjuerge, the museums executive director, said that while construction is underway on the center and museum doors are closed during the pandemic, Marins project has been active online. The actor has been hosting public Zoom conversations, including a recent event with Carlos Santana.
Cheech is talking to these artists and these creative people to get a deeper understanding about their art, what's motivated them in the past, Oberjuerge said. We've also had [talks with] photographers who documented the protests around the Chicano moratorium.
Marin has spoken on the Riverside Art Museums Instagram about why he's drawn to the artists in his collection.
Julia Paskin
Rain
Updated January 24, 2021 12:31 PM
Published January 24, 2021 12:30 PM
The rain that blanketed L.A. on Saturday has tapered off, but is likely to return tonight and continue into Monday.
Some areas in SoCal may get snow at elevations as low as 2,500 to 3,000 feet.
Adam Roser, a meteorologist with the National Weather Service, said Big Bear will get six-to- eight inches of snow, and towns nearby could get even more.
Places just to the west of Big Bear, or Lake Arrowhead, will probably see a foot, maybe more, he said.
The rain is expected to be periodic on Monday night and Tuesday probably a beautiful day to go see the snow in the mountains, said Roser and return at its heaviest on Tuesday night or Wednesday morning, when total rainfall could hit two inches.
Experts are advising residents to drive with extra caution, particularly through higher elevations, and to expect snow and ice on mountain highways such as the Grapevine and the Cajon Pass.
Julia Paskin
The Vaccine
Updated January 24, 2021 10:29 AM
Published January 24, 2021 9:54 AM
A new vaccine distribution supersite is open in Orange County, the second to open in the area following the launch of the Disneyland site on Jan. 13.
The new location, at Soka University in Aliso Viejo, is in the southern part of the county.
Molly Nichelson, a spokesperson for the Soka site, said that workers there can administer around 3,000 vaccinations per day.
We have approximately 600,000 people in the tier 1A in Orange County, she said, so obviously we're trying to make sure we can get through those people as quickly as possible.
Wait times at Disneyland have been between one and two hours, so seniors coming to Soka University are encouraged to bring a chair while they wait, and an umbrella for the rainy weather.
Orange County's vaccine supersites all require appointments, which can be made online. The County has also set up a multilingual hotline for questions about the online appointment system, at 714-834-2000.
Julia Paskin
The Vaccine
Updated January 24, 2021 9:22 AM
Published January 24, 2021 9:21 AM
Local researchers are working to turn the COVID-19 vaccine into an easy-to-deliver skin patch.
Similar to nicotine patches used to quit smoking, such liquid-coated swaths are already used for vaccine administration to guard against other illnesses.
Dr. Lbachir BenMohamed, who is leading the research at UC Irvine's School of Medicine, said that switching the coronavirus vaccine from an injection to a patch will make distribution easier.
Delivering the vaccine is six times more expensive than the vaccine itself, he said. If we come up with something that you can just put in an envelope and ship it to a remote area, I think that is going to be a game changer.
A vaccine patch would also eliminate the need for the constant cold storage currently required for some of the approved vaccines.
BenMohameds lab started testing the vaccine patch with mice late last week. If the trials are successful, the patch will be submitted to the Food and Drug Administration.
Julia Paskin
Politics
Updated January 24, 2021 8:34 AM
Published January 24, 2021 8:01 AM
The FBI is investigating vandalism and an explosion at an area church known for its anti-LGBTQ stance.
Police and firefighters responded to smoke coming from the First Works Baptist Church in El Monte just after 1 a.m. on Saturday. The walls were vandalized and the windows were broken. No injuries were reported.
Church pastor Bruce Mejia has been the target of protests for preaching again same-sex relationships, and for making derogatory statements about women, Jewish people, and the Black Lives Matter movement.
The Southern Poverty Law Center classified the church as a hate group in 2019.
On Jan. 17, Keep El Monte Friendly, an activist group devoted to inclusivity, held a protest outside First Works against what it calls the churchs hateful rhetoric. The group has since cancelled a demonstration planned for today, and issued a statement condemning the attack.
Julia Paskin
We have seen how powerful social media is in spreading information. With the emergence of the COVID-19 vaccine, its important to make sure that information is accurate
Shivansh Ahuja for The Daily Iow
Patients are injected with the COVID-19 vaccine at the VA Medical Center in Iowa City on Tuesday, Dec. 22, 2020. The center received the Modern vaccine for its employees.
Nearly a year has passed since the start of the COVID-19 pandemic. With the virus came fear and uncertainty because of fast-spreading misinformation.
Social media plays an intrinsic role in our society and has become a lightning-quick outlet for information. With the emergence of a vaccine, its important that correct information is circulating rather than fear mongering false information that will turn people away.
We have witnessed through this year how misinformation endangered health care workers handling the pandemic, such as the false idea that masks are not effective ways to curb the spread of the virus. Now, we are seeing more wrong claims circulate about the vaccines.
Because of the novelty of the COVID-19 vaccine, misleading information could be detrimental to slowing the spread of the virus and encouraging people to get vaccinated.
Social media companies are now challenged with the task of keeping up with false claims and conspiracies about the vaccine. Shortly after the vaccine came out, social media was filled with false claims about the vaccine altering peoples DNA or not being able to keep up with the mutated strains of the virus.
The spread of this information only instills fear and distrust in people, perpetuating the severity of COVID-19 in the U.S.
In Iowa, 144,955 COVID-19 vaccines have been administered as of Jan. 2. 4.12 percent of the population has received at least a single dose of the vaccine. However, the number of people fully vaccinated is only 12,629.
As of this month, 9,411 doses of the COVID-19 vaccine have been administered in Johnson County, making Johnson County the second-highest county in number of vaccines administered in the state.
According to MU Health Care, it would be ideal to have 80-90 percent of the population vaccinated in order to achieve herd immunity.
With only 4.12 percent of the state vaccinated, Iowa has a long way to go. Spreading accurate information is crucial to administering the COVID-19 vaccine.
As of November, 60 percent of U.S. adults reported that they would get the COVID-19 vaccine with only 37 percent feeling comfortable being among the first vaccinated.
These numbers were found to be influenced by many different factors. However, hesitation mainly stemmed from whether people had concerns of falling ill, levels of trust in the vaccine, and participants experience receiving other vaccines.
Peoples willingness to receive the COVID-19 vaccine heavily relies on their trust in the medicine behind it.
Its understandable that there would be doubts and concerns about receiving a vaccine for a virus especially for marginalized communities that historically have been exploited by medical professionals. This is why it is all the more important to make sure there is easily accessible accurate information circulating through the media.
Columns reflect the opinions of the authors and are not necessarily those of the Editorial Board, The Daily Iowan, or other organizations in which the author may be involved.
Samuel L. Stanley Jr., Mark S. Schlissel and M. Roy Wilson Published 10:51 p.m. ET Jan. 23, 2021
As COVID-19 case counts continue to rise across the United States, getting everyone possible vaccinated as soon as enough doses are available is vital to stopping this pandemic, reviving our national economy and getting children and college students back to in-person school.
The alternative is what we have now: high caseloads that are overwhelming our hospitals and health care workers, and millions of students able to attend classes only online. Our economy will continue to falterand layoffs will increaseas the coronavirus makes it unsafe to shop and dine as we normally do. Family gatherings and large meetings will remain off limits or, if held, become potential superspreader events.
As presidents of the three major public research universities that make up Michigans University Research Corridor Michigan State University, the University of Michigan and Wayne State University weve been on the front lines of battling the COVID-19 pandemic. URC researchers have worked to develop tests, treat the virus and create vaccines. Were training thousands of physicians, nurses and other health care workers in dealing with the virus. Were helping educators, business owners and government officials deal with the challenges of COVID-19.
As COVID-19 case counts continue to rise across the United States, getting everyone possible vaccinated as soon as enough doses are available is vital to stopping this pandemic, the university presidents write.(Photo: JOSEPH PREZIOSO, AFP via Getty Images)
In undertaking these efforts, it has been helpful that all three of us have medical degrees in addition to experience as university leaders. Our backgrounds:
Michigan State University President Samuel L. Stanley Jr.is an expert in infectious diseases.
University of Michigan President Mark S. Schlissel is an immunology expert.
Wayne State University President M. Roy Wilson has expertise in epidemiology and health disparities.
With this training, were familiar with the science and medicine behind a pandemic such as COVID-19, how vaccines work and how herd immunity develops.
When it is our turn according to CDC and state guidelines, were eager to get vaccinated ourselves. And we are urging all our students, staff, faculty and patients to do the same. We know vaccines have effectively stopped the spread of other bacteria and viruses, including those that cause the flu, tuberculosis, polio, smallpox, typhoid, measles, hepatitis, shingles and pneumonia.
Millions of people worldwide have benefited from these vaccines, and the COVID-19 vaccines are no different. Although theyve been researched and rolled out in record time, that doesnt mean theyre unsafe. They have been built on decades of investment in vaccine discovery and development, proven vaccine innovation and a focused global effort. They have been tested and proven safe and effective in studies gone over carefully by scientists trained in evaluating vaccines. The COVID-19 vaccines provide protection against a disease that has killed more than 400,000 of our friends, family members and co-workers across the nation and more than 2 million people worldwide.
Protecting the health of our students, faculty and staff has been the driving force behind our actions at all three universities since the pandemic began. Weve focused our research on finding vaccines and treatments, developing better and faster COVID-19 tests, and on helping health care and essential workers get the personal protection equipment they need to stay safe.
Those efforts continue. But the COVID-19 vaccine is a game-changer that can stop the pandemic from endangering the lives and livelihoods of so many Americans. Were urging everyone to get vaccinated, because we know its the only way to end this pandemic.
Samuel L. Stanley Jr. is president of Michigan State University; Mark S. Schlissel is president of the University of Michigan; and M. Roy Wilson is president of Wayne State University. To learn more about the work of the URC universities, see "Confronting COVID-19: Research, Innovation and Leadership: Advances in Medicine, Education & Business to fight COVID-19" at urcmich.org.
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Andrew Brewer, one of three cooks at Franciscan Outreach homeless shelter, cleans pots and pans after making the day's lunch, Jan. 22, 2021. "I will take the vaccine if there is a chance of not catching it again," Brewer said about taking the COVID-19 vaccine. He said he had COVID-19 in May. (Jose M. Osorio / Chicago Tribune)
The nation's preeminent infectious disease expert says he believes the country can expect "some degree of normality that is close to where we were" by the end of next year if 75-80% of the population is vaccinated. (Dec. 9) AP Domestic
It is approaching a year since the World Health Organization declared COVID-19 a pandemic,and on Dec. 8, Britain was the first Western country to begin vaccination against the virus. The rollout was followed by the U.S. Food and Drug Administration's emergency authorization of Pfizer-BioNTech's COVID-19 vaccine on Dec. 11 and Moderna's on Dec. 18.
Given the quick scientificresponse to thenewly emergingvirus, one Instagram post is calling foul, questioning why vaccines for equally debilitating diseases, predating the pandemic, have not yet been developed.
The Nov. 30 Instagram postfromauthor Boyce Watkins shares a screenshot of a Facebook comment alleging countless years of research effort have yielded no vaccine.
"40 years worth of research...no vaccine for HIV (sic) At least 100 years research...no vaccine for cancer (sic) Ongoing research...no vaccine for the common cold (sic) Less than a year for a covid (sic) vaccine? Thanks but a hard pass on that shot..." claims "Lee Morin" in the comment.
"This does make you wonder: How did you come up with this so fast, but you can't vaccinate against viruses that have been harming people for centuries?" asks Watkins. The post has received over 13,800 likes and comments agreeing with Watkins' charge.
"Come on. You have 7 BILLION customers. No other virus/cancer/ailment has that many customer. Follow the money," writes Instagram user borzirtc.
Other social media users have posted the same or a similar claim, as recently as Jan. 13.
USA TODAY has reached out to those who posted the claim for further comment.
More: Fact check: COVID-19 outbreak at NY nursing home started before vaccinations
The COVID-19 vaccine is using new technology that has never been used before in traditional vaccines. Here's how an mRNA vaccine works. USA TODAY
Operation Warp Speed, the private-public partnership initiated by the White House during the pandemic, may give the impression the COVID-19 vaccine developed overnight, but in actuality, it depends on research datingback nearly 100 years.
Coronaviruses were first encountered in April 1930, when a strange respiratory disease ravagedpoultry farms across North Dakota and Minnesota, killing tens of thousands of baby birds, The Scientist reports. Unsure of what exactly this illness was, veterinarians Arthur Schalk and Merle Hawn of North Dakota Agricultural College, now North Dakota State University, called it "infectious bronchitis of baby chicks," the viral agent later named infectious bronchitis virus.
Further scientific research into IBV and recognition that it was not like influenza A, a flu virus known to causebronchitis, would transpire over the next 30 years. In November 1968, a group of scientists wrote to the journal Nature asking for IBV, and viruses resembling it like mouse hepatitis virus discovered in 1947, to be classified as coronaviruses, a name derived from its appearance the spikeproteins castinga halo around the surface, much like the sun's corona on electron microscopeimaging.
More: Fact check: Pregnant women do receive vaccines, but more study needed on COVID-19 shot
While coronaviruses could cause a variety of fatal diseases in animals, the two known to infect humans were not a grave concern, as they only causedthe common cold. This belief was challenged in November 2002 with the emergence of a new respiratory illness in Guandong Province, China, that would infect over 8,000 people worldwide and claim 774 lives.
In less than a month, researchers decoded the enormous genome of the new virus, which caused adisease called severe acute respiratory syndrome.Researchers concluded it was a coronavirus, likely to have jumped from animals to humans because it was only somewhat related to other known coronaviruses. (It took over 15 years of search to identify bats as the potential animal source.)By July 2003, thanks to isolating and quarantining patients, the World Health Organization declared SARS officially contained.
Nevertheless, fears of future seasonal SARS outbreaks called for a vaccine. SARS-CoV's spike protein was an obvious choice for a target.Prior research found the spike protein was criticalin determining which species a coronavirus infected, where it preferredto hunker down called organ or cell tropism and disease severity. The spike protein had even been proposed as a vaccine target for canine coronavirus in 1991.
More: Fact check: Vaccination helped eradicate smallpox
A number of vaccines targeting the spikeprotein were designed, tested in animal models and found to be quite promising against SARS and other coronavirus illnesses like Middle East respiratory syndrome,which appeared in 2012. But further testing reached an impasse when funding declined steadily in the years following the 2003 outbreak, said Dr. Peter Hotez,a vaccine scientist and dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, whose team collaborated withGalveston National Laboratory to create a SARS vaccinein 2016.
"We manufactured a really great SARS 1 vaccine in the lab. We actually had a manufacturer at Walter Reed, but then we couldn't raise the money to do all the clinical testing," he told USA TODAY.
Funding was not the only issue. Testing whether a vaccine can prevent disease requires the disease to still be around. Since there have been no major outbreaks of SARS since 2003, testing vaccine efficacy was difficult. But more instrumental is interest: FewSARS or MERS cases meant pharmaceutical companies were less inclined to invest in a likely rarely used vaccine.
More: Fact check: Doctors say Hilary Duff likely didn't contract pink eye from COVID-19 tests
Typically, the road to creating new vaccines is long, with many steps:Finding and developing a vaccine target (exploratory), testing it in tissue- or cell-cultures and animal models (preclinical) followed by three phases of clinical trials with human volunteers.
If a vaccine proves its mettle, its developers have to seek and gain approval from the FDA before manufacturing. Lastly,in phase four, quality control monitorsfor any possible vaccine side effects.
For vaccines to be effective, a specific targetis needed. This vaccine target, also called an antigen, istypically a fragment of the disease-causing agentthat instructs the immune system on how to recognize and destroy it upon contact. Searching for a suitable antigen can be an arduous process but prior coronavirus research made it all the more easier.
"When the Chinese put up the COVID-19 sequence on bioRxiv in January, our community of scientists looked at it and said, 'Yeah, we got this because we know how to do it.' It was all about plug and play based on all thatexperience," said Hotez.
Having a running start does not mean the testing process was accelerated, however. Hotez, whose recombinant proteinsubunit COVID-19 vaccine is undergoing clinical trials in India, stated the vaccine still underwent testing among a large group of human volunteers, even more than a typical trial with over 30,000 to 60,000 people.
What accelerated the vaccine process was manufacturing.
"The two accelerants are doing the manufacturing of risk (scaling up manufacturing based on the assumption the vaccine will work, also called at-risk manufacturing) and manufacturing the vaccine in parallel with clinical trials. That's new because we usually wait for the phase three results," he said.
More: Fact check: The US saw more deaths in 2020 than in 2019, driven by the COVID-19 pandemic
Human immunodeficiency virus, the culprit behind acquired immunodeficiency syndrome, commonlyknown asAIDS,is a tricky virus. Much like the novel coronavirus, HIV binds to a protein on the surface of T cells,a type of white blood cell, to enter.Once inside, HIV integrates its genetic material with its host cell's DNA, using the host's DNA replication machinery to create new viruses, which blast off to infect and kill other T cells.
Finding a specific and effective vaccine target is therefore difficult, especially since HIV mutates frequently in order to mask itself from the immune system. According to the National Institute of Allergy and Infectious Disease, common vaccine approaches using inactivated or live HIV formshave either not been "effective in eliciting immune responses in clinical trials" or are too dangerous to use.
The same goes for the common cold,which is caused by asmorgasbord of viruses includingover 150 different types of rhinovirus, a common troublemaker.
"It's hard to create a vaccine when you have so many different viruses causing similar symptoms. To make a universal vaccine against all of them is probably pretty daunting, it might be doable, but it's daunting," explained Hotez.
More: Fact check: Biden said he plans to increase COVID-19 small business relief to people of color and women
Cancer, an abnormal growth of the body's own cells due to unchecked genetic mutations, is no virus, but the struggle in finding a suitable vaccine target is not any easier.
"The challenge is getting antigen targets and also access, because a lot of the antigens, or cancer proteins, are first inside the cell. They may not be presented to the immune system so these are much more complicated targets," said Hotez.
Advancesin messenger RNA-based vaccine technology in recent years may help fast-tracksome cancer vaccines, he acknowledged. The platform, which provides the body the equivalent of a genetic assembly instruction booklet for manufacturing target-specific antibodies, has been used for rabies, influenza and Zika and is considered an attractive approach for its low cost, speed of manufacturing, potency and versatility, Nature reported.
Many cancer vaccines using mRNA are in the works, like Moderna's personalized cancer vaccine, mRNA-4157, which is being tested in patients with metastatic common epithelial cancer. The Boston-based pharmaceutical company also announced on Jan. 11 it was working on a mRNA HIV vaccine with phase I clinical trials expected sometime in 2021.
We rate this claim MISSING CONTEXTbecause without additional context it might be misleading. Vaccines require specific targets against which they train the immune system. COVID-19's spike protein was identified nearly 20 years ago as a potential vaccine target during the development of the SARS vaccine, following the 2003 SARS outbreak.This has helped expedite the vaccine process, given that vaccine platform technologieshave advanced in recent years, as well. Another accelerant was the commercial-scale production of COVID-19 vaccine doses prior to FDA clearance, called at-risk manufacturing, when early results appeared promising. Finding suitable vaccine targets for HIV, cancer and the common cold has been more difficult in comparison as these diseases have either elusive or highly variable targets.
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More than 130 years ago, a brutal respiratory virus swept across the globe, killing a million people out of a worldwide population of 1.5 billion before fading away, eventually overshadowed in history by the deadlier 1918 influenza pandemic.
That 1890 pandemic, which some scientists believe was caused by a coronavirus, may offer a glimpse of the modern worlds escape from COVID-19 or at least one possible path in a future thats still largely clouded by uncertainty.
The United States is in a desperate race to speed up vaccinations and develop herd immunity that would end the pandemic. But with several variants of the virus emerging, including one or more that could make the vaccines less effective, its increasingly unclear what the finish line looks like.
One possibility would be an echo of the 1890 pandemic: The virus slowly drops off as countries develop herd immunity because of a large majority of the population being infected or getting vaccinated. After anywhere from a few years to a few decades, it circulates mainly among children and rarely causes anything more serious than the sniffles.
Or the virus could be stamped out, or close to it, with vaccines. It could disappear like smallpox, or be pushed to such low levels in the U.S. that it shows up only in isolated clusters, as with measles.
Or it could turn into something like influenza, with the world in a constant battle to adjust vaccines to changing variants and keep the virus under control. The stakes, however, will be much higher if the coronavirus remains as deadly as it is far deadlier than the flu or mutates to become worse.
Weve had a cold reality moment in the pandemic with the arrival of several new variants, including one in the Bay Area, in recent months, said Fyodor Urnov, director of technology and translation at UC Berkeleys Innovative Genomics Institute. Scientists had believed that this coronavirus wasnt as changeable as other viruses, but that belief was upended as the virus mutated quickly setting up a race to stamp it out before more undesirable mutations arise.
This virus is a formidable enemy, Urnov said.
The vaccines are well tuned to the coronavirus that currently is dominant around the world itself a variant of the original virus first identified in Wuhan, China, one year ago. The vaccines most likely will work against four new variants that have appeared suddenly in the past two months, including one that seems to have settled in the Bay Area and other parts of California.
But studies suggest that at least one of those variants, found in South Africa, may be able to partially evade the vaccine. The Bay Area variant has a mutation that concerns scientists, who are conducting tests to determine whether its resistant to some antibodies meant to fight the virus, though at this time they believe the vaccine will be effective.
And scientists worry that as the coronavirus continues to spread around the world, more variants will emerge, potentially with mutations that could undermine efforts to control it.
In a race between a pathogen and a host, the pathogen is going to mutate to try to adapt and be a better pathogen. As the host develops a better immune response, the pathogen develops ways of evading the immune response. And it goes on forever that way, said Dr. Joel Ernst, an infectious disease expert at UCSF.
I think were going to be in pretty good shape in the near term, he said. But I dont think we know yet what the ultimate potential of this virus is.
Many scientists like Ernst believe the new variants, even those that appear to be more infectious, wont have a dramatic impact on the current pandemic. They also think the vaccines will remain effective enough to reach at least a temporary herd immunity.
But the Centers for Disease Control and Prevention has warned that a particular variant first identified in the United Kingdom and which has been found in at least 22 states could dominate in the United States by March. That variant is roughly 50% more infectious than the currently dominant virus and would undoubtedly fuel more cases and a surge in hospitalizations and deaths, the CDC warned.
Preliminary findings reported Friday also suggest the variant may be deadlier than other versions, but more research needs to be done.
Only 72 cases of the U.K. variant have been identified in California, but its assumed to be more widespread. And another variant has been identified that may also cause faster spread of disease. That one appears to have gained significant traction in parts of the Bay Area and Los Angeles County in the past month.
Either or both of those variants could prompt delays in lifting current stay-home orders or reopening schools, infectious disease experts have warned. Or they could lead to a new wave of infections in the spring that might once again overwhelm hospitals in much of the state.
The U.K. variant is more infectious in children as well as adults, studies have found, though kids are still less likely overall to be infected or have serious illness. None of the approved vaccines has been tested in children yet.
The variants also could have no effect on the short-term course of the pandemic, as long as they respond well to vaccines and the state picks up its immunization efforts. Scientists are trying to understand how the variants behave in their human hosts.
Theres no reason to panic, Dr. Grant Colfax, director of the San Francisco Department of Public Health, said at a news briefing last week. This is going to be part of this pandemic, as we see variants emerge. Were just going to have to learn more about them.
But a prolonged pandemic would further impact livelihoods of millions of Californians.
Ashley Voss, who opened a Mission District art gallery six months before the pandemic arrived, worries that Californias variant could lead to a longer lockdown. Visitors are sparse, especially because restaurants are closed, so fewer people wander through the neighborhood. And the city cant say when that will change.
The troubling thing is, weve never encountered something like this in our lifetimes, so we dont have a playbook on how to navigate this, Voss said. Its difficult trying to figure out how to plan for the future.
Most public health and infectious disease experts believe that with a strong national immunization campaign and a few more months of aggressive social distancing and other protective measures, the United States will come out from under this darkest period of the pandemic.
But the outlook beyond that is murky.
A study out of Emory University this month suggested an outcome similar to what some experts believe happened after the 1890 pandemic. A new virus crashed over the world, causing widespread illness and death among populations that had no natural immunity. Then, after years or possibly decades, the virus either mutated to become less severe or the world built enough immunity that its now toothless.
That coronavirus is now one of four that cause the common cold. Most children are infected with that coronavirus by the time theyre 5, and its as inconsequential in adults as it is in kids.
This could imply that our normal, tame coronaviruses that we see today have arisen in the same fashion as the virus were seeing now, said Dr. Yvonne Maldonado, an infectious disease expert at Stanford. And over time this virus will mutate into a more benign form. And with our ability to build up immunity, well be progressively getting less and less sick from it.
This theory is based on a few premises: That the current coronavirus almost never causes serious illness in young children, and that everyone else in the population will eventually develop some degree of immunity, so even if theyre reinfected they dont get very sick. Also, it assumes that the virus will mutate to cause less serious disease over time, which is often the case with new pathogens as they adapt to their hosts and become less hostile.
It may not disappear, it may stay, but if it stays it may become a normal, regular cold virus, Maldonado said.
It may be possible to eradicate this coronavirus. But that will require a combination of luck and a successful global vaccination effort.
If the vaccines remain as effective as they proved in clinical trials, if the immunity they produce is long-lasting, and if the world gets to herd immunity in all corners, then COVID-19 could disappear entirely, or close to it. But it would take years, and potentially decades, to get to that point.
We may not be able to eradicate it like we did with smallpox. But we can at least get it to a level, once we get a sufficient number of people vaccinated, where the virus will have no toehold, said Dr. Catherine Blish, a Stanford infectious disease expert. Hopefully we just vaccinate everyone and get rid of it altogether. But we will be dealing with this for a while.
Global immunization would be a necessary but monumental task. The vaccines would have to reach countries devastated by war and poverty, along with the pockets of vaccine-resistant communities in the United States. Any gaps in immunity would be opportunities for the virus to spread and mutate, and potentially turn out vaccine-resistant variants.
This is a global problem, said Dr. Warner Greene, an infectious disease expert with the Gladstone Institutes in San Francisco. Its a pandemic, and were only as strong as our weakest link. Were only as strong as our smallest herd.
Perhaps the most likely, and least satisfying, end to the pandemic is not much of an end at all: The coronavirus keeps spinning out variants, scientists keep refining vaccines, and the world learns to live with COVID-19.
This might be the outcome if the vaccines dont provide sterilizing immunity, the kind of protection that lasts for the rest of peoples lives. Depending on how long immunity lasts, people may need regular boosters as often as every year.
There are reasons to be hopeful, though. Even if vaccine immunity isnt permanent, it may provide long-lasting protection that prevents serious illness or death, so another mass immunization effort may not be necessary.
Plus, the vaccines that have been developed can be easily changed to keep pace with variants, infectious disease experts say. If a variant emerges that is able to elude vaccines, developers can tweak the recipe and probably have it ready to inject within a few months.
But that would require constant vigilance to quickly identify new variants and a strong system for vaccine distribution. The coronavirus would remain a threat for decades.
These variants could make us very busy and could prevent a full success of the vaccine, said Dr. Melanie Ott, director of the Gladstone Institute of Virology. Yes, we can adapt the vaccine. But we know the influenza vaccine is not 100% effective, and every year we have to guess what will be the predominant strain and build the vaccine. We really want to avoid that. But we might end up in a situation that is similar to what we have with influenza.
The United States will get some measure of control over the coronavirus eventually, infectious disease experts said. Between vaccination efforts and the natural immunity people will have from being infected, the country will almost certainly reach herd immunity, and that will make a profound dent in the spread of disease here.
How long that takes is unclear, and depends as much on peoples behaviors as on the virus itself. Variants that arent quite as responsive to vaccines may mean more people need to be vaccinated to reach herd immunity. Addressing vaccine hesitancy could add months to the timeline. But if everything goes smoothly, some communities may get to herd immunity by autumn.
Even if the virus cant be quashed, it can be contained, experts said. Im mildly but not exceptionally concerned about the future of this pandemic, Blish said. The good news is weve learned a lot from this, and well be able to respond even better and faster next time.
When COVID-25 comes along, the world will be more ready.
San Francisco Chronicle
staff writer Michael Williams contributed to this story.
Erin Allday is a San Francisco Chronicle staff writer. Email: eallday@sfchronicle.com Twitter: @erinallday
