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A COVID-19 vaccine is on the horizon, but the state of Pennsylvania reports early distribution will be severely limited.
Dr. Jeffrey Jahre, an infectious disease specialist at St. Luke's University Health Network, said when the vaccine does arrive in the Lehigh Valley, the first group of people it will be available to is healthcare workers and staff that have contact with the sickest COVID-19 patients, those who work in the ER, ICU, and on COVID patient floors.
Next, it would be available to healthcare workers who do procedures that put them at high risk. It would be available to health care workers and patients who are in high-risk areas like nursing homes.
"We cannot require workers to get a vaccine that still has some unproven components although we are very, very optimistic that it will meet the needs," Jahre said.
Vaccines would also be available for other essential emergency workers, like firefighters and police officers.
"We think that in several months we think there will be enough vaccine for what we call other risk populations. For instance, people who are out there who have diabetes, high blood pressure, are over the age of 65," said Jahre.
Jahre said eventually the vaccine will likely be available to the general public in places like doctor's offices and clinics. The state may initially prioritize sending doses of the vaccine to areas that have the highest number of cases.
Jahre said St. Luke's has applied to be among the facilities that will become vaccine distributors and has made arrangements to have the necessary equipment to do so. While initial vaccine distribution won't mean the end of mask wearing and social distancing, there's a light at the end of the tunnel.
"The hope is if we can get enough people to take the vaccine, we can put a halt to the kind of pandemic we're seeing right now. It remains to be seen if that will actually come about and how many people will actually take this vaccine and of course the long-term effectiveness," Jahre said.
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While recent announcements from Pfizer and Moderna have raised hopes about a possible COVID-19 vaccine, several state officials have said they still need federal government money to ensure they can distribute the vaccine when it is released.
States say they will need more money from the federal government to hire staff to administer vaccines, develop data systems to track doses and communicate the importance of getting vaccinated.
At least a dozen states told ABC News that they will likely need additional funding or are awaiting additional funding. Other states suggested they are still deciding whether they will need additional funding.
Trish Riley, executive director of the National Academy for State Health Policy, said she wants to avoid a repeat of the problems the country faced early in the pandemic, when states were competing for essential resources like personal protective equipment and ventilators.
"That's the wake-up-at-night worry," Riley told ABC News. "States can't do this alone."
According to a letter to Congressional leaders from groups that represent local health officials and immunization managers, states may need as much as $8.4 billion in extra funding.
States have received $340 million for COVID-19 and flu vaccine planning efforts and are expected to receive $140 million more in December to design vaccine distribution plans and start updating the necessary information systems, but multiple states said they will need more federal money and still don't know how much will be available.
White House spokesman Michael Bars said states will not be responsible for the majority of expenses because the federal government has paid for doses and administration costs will be covered by private insurers, Medicare, and Medicaid. Shipment and storage will be covered by CDC's contracts to distribute the vaccine and through partnerships with private pharmacies like CVS and Walgreens to distribute vaccine doses to participating nursing homes and administer vaccines when one is made available to the general public.
"The Administration continues working hand-in-hand with our state and local partners and remain intensely focused on helping Americans communities prepare for and respond to health threats while ensuring they have the tools and resources to better treat patients and protect the most vulnerable. We are sparing no effort or expense to save millions of lives," he said in a statement Wednesday.
In response to concerns raised by the National Governors Association, Operation Warp Speed has said they are in the process of planning to make additional funding and resources available to support vaccine operations, information systems, and communications campaigns.
In this undated still image from video, a researcher works in a lab run by Moderna, Inc.
But many state officials say they are still concerned it won't be enough.
New Jersey Gov. Phil Murphy expressed concerns about the lack of federal government support during a press briefing on Monday. "As good as the distribution plan may be, we need the feds," he said.
"It is essential that we get federal support, and that includes money," he added.
Mississippi's health officer, Dr. Thomas Dobbs, said during a press briefing on Tuesday that the state "will certainly need additional funding," emphasizing that the vaccine distribution effort is expected to be a massive operation that will not be possible without federal support.
Kentucky Health and Family Services spokesperson Susan Dunlap echoed Dobbs' concern and said, "Once CARES Act funding expires after Dec. 30, funding will be insufficient."
"It is crucial that Congress provide additional financial support to states to successfully distribute COVID-19 vaccines," Dunlap said.
A North Carolina Department of Health and Human Services spokesperson told ABC News that the state has been allocated $5.9 million from the federal government for vaccine response so far and anticipates another $3-4 million in additional funds; still, they believe they will need approximately $30 million for its vaccination management and distribution efforts.
Officials from several other states -- including Georgia, Colorado, Idaho, Oregon, Maryland and Minnesota -- have told ABC News that they're expecting to receive additional financial support from the federal government in the coming days and weeks, but are still in the dark about how much more they will be getting.
New Jersey Gov. Phil Murphy speaks during a coronavirus briefing in Trenton, N.J., June 9, 2020.
Minnesota Health Department spokesperson Doug Schultz said additional funding from the federal government is needed to ensure the successful distribution of the COVID-19 vaccine to rural parts of the state.
Claire Hannan, executive director of the Association of Immunization Managers, said states need funding immediately. She said her biggest fear is that states won't have the money to hire and train nurses and other staff to administer vaccinations when a vaccine becomes available.
"I do fear that the vaccine's going to get shipped, we're going to be able to plan out the logistics, but we're not going to be able to have enough manpower for vaccinating and we're not going to have robust community engagement," she told ABC News.
She said it's unclear exactly how much money states will need for administering vaccines because it will depend how many people are vaccinated by private health care providers or through federal partnerships with companies like CVS and Walgreens; regardless, she said states need money to prepare and track that information and they should have access to federal funding for as long as they need.
Hannan said one of the concerns is that states need to train health care providers on specific information regarding the COVID-19 vaccine, which will likely be distributed quickly after the Food and Drug Administration signs off. Health care workers need to know how to store the vaccine and administer it; they also need to know the conditions for who can receive it under emergency authorization and must be able to communicate to patients about its possible side effects.
"The vaccine is so complicated that we don't want to just send a flyer in the box," Hannan said.
States also need money to conduct follow-up monitoring, which includes reminding people to get their second dose of the vaccine.
Experts say it will also take more resources for states to reach the populations that have been disproportionately impacted by COVID-19, this includes rural areas and communities that, historically, have been more reluctant to trust vaccines.
Centers for Disease Control and Prevention Director Robert Redfield warned Congress about the need for more funding and a COVID-19 stimulus bill back in September. He said the agency needed between $5.5 and $6 billion to help states distribute a potential vaccine, and even implied that he would be the one blamed if vaccine distribution plans failed.
Potential COVID-19 vaccine vials from Pfizer, Oct. 31, 2020.
Despite Redfield's warning, stimulus bill talks aren't going anywhere at the moment. Congress is currently more focused on an omnibus spending bill to prevent a government shutdown when the current funding expires on Dec. 11.
Democrats have included $4 billion in their package that would go to vaccine distribution for both a COVID-19 vaccine and the flu, but there is no agreement about whether vaccine funding will be part of the final bill.
Riley said state economies and budgets are already struggling from the economic downturn caused by the pandemic, and next year they could face more problems after they've exhausted emergency reserves of money. But she said getting a vaccine out efficiently will require federal leadership and money.
U.S. Department of Health and Human Services Secretary Alex Azar assured governors they would not be responsible for the expenses of the vaccine program on a call Monday, because the federal government will pay for doses of the vaccine and will reimburse providers for the cost of administering and transporting the shipments.
"What we need for you are the plans to help allocate and deliver vaccines to the appropriate places in ways that makes sense for your state and community. We're working to make this planning as simple as possible," he said on the call.
But Riley said that while federal leadership and a national strategy will help, without more funding the public health system will struggle to get the vaccine out.
"You can't underfund a system and then be surprised when it doesn't have capacity," she said.
ABC News' Laura Romero, Halley Frager, Arielle Mitropoulos and Mariam Khan contributed to this report.
Two new vaccines against the coronavirus that are poised to reach the Food and Drug Administration (FDA) for emergency approval are based on a new method for building vaccines that represents a groundbreaking shift in the way future vaccines are developed, a silver lining to the deep dark cloud of a global pandemic.
The candidates, one developed by Moderna and the National Institutes of Health and the other created by Pfizer and the German pharmaceutical company BioNTech, are called messenger RNA vaccines, or mRNA for short. Early studies have showed both vaccines are around 95 percent effective in preventing coronavirus infections, a tremendous rate that has thrilled health experts.
To say that [the early results are] proof of principle for mRNA vaccines is just a gross understatement, said Ruth Karron, director of the Center for Immunization Research at the Johns Hopkins Bloomberg School of Public Health. This is confirmation of this technology, and I think certainly for this kind of platform, mRNA is ideally suited for a pandemic situation.
The mRNA vaccines use a small segment of the ribonucleic acid of SARS-CoV-2, wrapped in a lipid shell. Once injected, the shell attaches to a human cell, and the segment of RNA teaches the cell to produce a specific protein. The immune system uses that protein to recognize a different protein, dubbed the spike protein, that the virus uses to attach to a human cell.
They basically were able to very precisely print out the mRNA sequence that would create a protein to recognize the virus, said Prabhjot Singh, a health systems expert at the Icahn School of Medicine and the Mount Sinai Health System. Its almost like 3D printing. Theyre able to say, heres the sequence of what we want to go after, lets design mRNA custom specifically to chase down that thing.
Once the bodys immune system recognizes the spike protein of an invading organism, it learns to launch a response. If someone who has been vaccinated encounters SARS-CoV-2, theirimmune system will recognize the same spike protein and attack the interloper before it can begin replicating.
When you see the virus, you already have components of the immune response that are specific to it, ready to detect it and able to prevent the beginning of the infection, said William Klimstra, an immunologist at the University of Pittsburgh whose laboratory is working on its own mRNA vaccine candidate.
More traditional vaccines and dozens of candidates for potential coronavirus vaccines still under development use pieces of live or inactivated virus built into another family of pathogens, called adenoviruses, that are harmless to humans. The immune system recognizes the adenovirus base, and whatever elements of the coronavirus it incorporates, and learns to recognize the new elements of the coronavirus as a signal to mount a response.
Those vaccines that use other viruses can carry some small risk of infection in a tiny segment of a vaccinated population. And they are not always completely effective influenza vaccines can reduce the risk of catching the seasonal flu by between 40 and 60 percent, according to the Centers for Disease Control and Prevention.
But the mRNA vaccines do not carry the same risk as adenovirus-based vaccines. The mRNA vaccines only carry the RNA that instructs the cell to create the spike protein; they do not carry any of the RNA that leads to disease in humans.
These mRNA vaccines are inherently extremely safe, Klimstra said. Theres no replicating virus that can spread and cause disease like the live attenuated vaccines.
The mRNA vaccines can also be produced at a faster pace than more traditional vaccine candidates. Laboratories do not need access to live virus to begin production; they can use genetic sequencing posted to online databases to begin designing their own mRNA candidates.
The biggest advantage of mRNA has been the speed at which you can develop the vaccine. If you have the sequence, you can make a vaccine, you dont have to grow the virus, Karron said.
The mRNA vaccines do carry small downsides: Because the messenger RNA itself degrades once it has taught a cell to produce the spike protein, it requires two doses spaced several weeks apart to achieve full effectiveness, unlike an adenovirus vaccine that requires only one dose. The two vaccine candidates developed by Pfizer and Moderna must also be kept at sub-freezing temperatures, a challenge for some medical facilities.
And experts warned that the early trials have yet to develop a comprehensive set of safety profiles that would fully show the potential for negative consequences, though none have emerged so far.
But the efficacy rates are tremendously encouraging, on par with some of the most impressive achievements in the history of public health, vaccines that have eradicated smallpox or nearly ended polio.
This efficacy is greater than what we would have expected, Karron said.
Its crazy high, Singh said. Its like ridiculously high, if these numbers bear out.
The eventual success of mRNA vaccines has the potential to reshape global public health, both in the race to contain future pandemics and in treating other more endemic diseases like cancer. If successful, it is likely to set off a clash in the scientific community that Singh compared to the emergence of the electric car maker Tesla and the disruptive challenge it posed to traditional automobile manufactures.
The technology has been used to create other potential vaccines, though those have only been tested in small-scale trials. Others have failed. None have been submitted to the FDA for final approval.
But the urgency of the crisis wrought by the pandemic, and the billions invested by governments around the globe in the race to create a vaccine, have broken the logjam.
I think it was a marriage of technology and need. As we as a global community recognized that we had a pandemic on our hands, that this was not going to be a controlled infection, people were thinking about what is the quickest way we can make a vaccine, and this technology was known, Karron said. It will really profoundly influence our approach to pandemics in the future, and it may also influence our approach to other non-pandemic pathogens.
With potential COVID-19 vaccines on the horizon in the coming months or even weeks, for some state officials and local public health departments are making plans to vaccinate Minnesotans as soon as the inoculations become available.
In recent weeks, both Pfizer and Moderna have announced they have reason to believe theyve developed highly effective COVID-19 vaccines. Both may seek emergency authorization from the Food and Drug Administration to make them available soon. Data suggest both vaccines are roughly 95 percent effective, far more so than some in public health had dared hope.
From a scientific and potential public health standpoint, this is an extraordinarily important advance, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told NPR earlier this week.
With this news, its possible some Minnesotans could be vaccinated as early as late December. But for the rest of us, it could be a bit. Here are some questions you might have about Minnesotas vaccination plans, answered:
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So Pfizer and Moderna both sound like they have promising vaccine candidates. What do we know about them?
Pfizer announced Wednesday that its data find the companys vaccine is 95 percent effective at preventing COVID-19. Modernas data suggest its vaccine is 94.5 percent effective. The FDA had initially said it would consider approving vaccines found to be at least 50 percent effective, and numbers at 90 percent and above would put these vaccines in line with most childhood vaccines. In a briefing with reporters Thursday, Minnesota Department of Health Infectious Disease Director Kris Ehresmann emphasized that the data are still not peer-reviewed but called the trial results very encouraging.
Both vaccines would require two doses, weeks apart, which creates some logistical challenges for health officials who need to track who got which doses, and when: they arent interchangeable, so you couldnt get your first round vaccine from Pfizer and the second from Moderna.
This all happened pretty quickly. How do we know the vaccines are safe?
These vaccines have been developed remarkably quickly: Its less than 11 months since the genome of the novel coronavirus was sequenced, and now were talking about a vaccine.
MinnPost photo by Peter Callaghan
Director Kris Ehresmann
While drug companies hurried to recruit participants for vaccine trials so theyd be lined up as soon as they were needed for each phase, the trials are happening as they would for other vaccines, Ehresmann said.
This vaccine has gone through the same safety evaluations that you would expect for any of the other regular vaccines, she said.
Another reason a COVID-19 vaccine is expected to be available so soon is that the federal government is footing the bill to manufacture promising vaccine candidates before theyre even approved. If a vaccine doesnt pass muster, the manufactured units wont be used. But for vaccines that do, doses will be ready.
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OK, so these vaccines sound like they might be approved. What has to happen for people in Minnesota to get them?
Minnesota will begin using a vaccine only after the Food and Drug Administration and the Centers for Disease Controls Advisory Committee for Immunization Practices (ACIP) give the green light, Ehresmann said.
Pfizer has said it plans to submit its application to the FDA within days, and Moderna could follow soon. Once applications are submitted, Ehresmann said she expects a two week timeframe for the agencys review.
If a vaccine gets the go-ahead from the FDA, it then goes to the ACIP, which is a committee that makes recommendations about vaccines use. The ACIP could make decisions within days, Ehresmann said.
While some states are planning to do their own safety evaluations, Ehresmann said Minnesota officials trust the ACIP based on experience. Ehresmann has served on the committee previously, and another MDH staffer currently serves on it.
Presuming the ACIP recommends a vaccine, it will also issue guidance on how to administer it. Ehresmann expects it would be a week before Minnesota would be able to get trained on the recommendations and start vaccinating.
Who gets the vaccine, and when?
Who gets vaccinated and when will come down to what the ACIP recommends. But right now, MDH is planning to roll out vaccines in three phases.
First, people who ACIP deems first priority would get the vaccine. The expectation is that this would include people who work in health care, though it might not include every group of health care workers right away.
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When we talk about who needs to be vaccinated, it doesnt mean that every single person who works in health care in an acute care setting would be a priority for vaccination before, say, long-term care, Ehresmann said. An allocation work group will help tailor federal guidance to Minnesota. Phase 1 vaccination will likely happen through workplaces, such as hospitals and clinics.
Once more vaccine is available, people with the second highest level of priority would be vaccinated. These are likely to be people who are in vulnerable populations, those who have been disproportionately impacted by COVID-19 or have more severe virus outcomes. In this phase, people may get vaccines through their health care providers.
Officials expect more vaccines to make it through the FDA and ACIP approval process at some point in this timeframe, which will increase supply. Once the people in priority groups one and two are vaccinated, the shots should be available to the general public. In addition to health care providers, counties and local jurisdictions are likely to help provide vaccination sites to make sure the vaccine is available to all.
Counties are already being asked to work on plans for vaccinating their residents in this phase of the efforts. Katie Albert, of St. Louis County Public Health, said much is still in the works, but St. Louis County has been drawing up plans for drive-through vaccination clinics during phase 3 of vaccination.
We would likely do drive-through clinics simply because of the risk of being indoors and trying to vaccinate people presents its own problems, especially with the need for PPE, she said.
Fauci has said a vaccine may be available to the average American as soon as April.
What if some people refuse to get the vaccine?
In recent years, skepticism towards vaccines has been on the rise, despite that scientific evidence overwhelmingly finds them safe and effective. But the degree to which Minnesota can reach herd immunity with an estimated 70 percent to 80 percent of the population inoculated will affect how widespread COVID-19 continues to be.
Ehresmann said having a vaccine that is 90 percent or more effective helps: If the vaccine was only 50 percent effective, you would expect a quarter of the population to have antibodies if half the population got the vaccine. But health officials are trying to get the message out that a COVID-19 vaccine that passes the FDA and ACIP will be safe.
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The higher effectiveness makes a difference in terms of the number of people needed to be vaccinated to really have an impact on disease transmission.
She also hopes that having a vaccine thats 90 percent or more effective bolsters the publics confidence in it, because if you get the vaccine, its highly likely youre protected.
Its a confidence boost for the public, if youre on the fence about getting vaccinated and you hear that the vaccine is 95 percent effective, that is certainly going to be weighed in the pro side of getting vaccinated as compared to I dont know if I should do this, the vaccines only 50 percent effective.
In a tweet, Sen. Rand Paul misleadingly suggested that immunity from [n]aturally acquired COVID-19 was better than that from a vaccine. But its not known how immunity from the two sources compares and the entire point of a vaccine is to offer immunity without the risk of getting sick.
Paul made his claim in a Nov. 17 tweet in which he listed interim efficacy figures from two ongoing vaccine clinical trials and then provided his own calculation of the effectiveness of natural infection with the coronavirus.
In a follow-up tweet, the Kentucky Republican shared a link to a New York Times article about a new unpublished study that found evidence of some immunity to the coronavirus in most people for at least six months. He commented: Why does the left accept immune theory when it comes to vaccines, but not when discussing naturally acquired immunity?
Paul, who has previouslyspread misinformationabout childhood vaccines, hasinaccurately argued during the COVID-19 pandemic that parts of the U.S. have reached herd, or community, immunity because of preexisting immunity to other coronaviruses.Herd immunityis when enough people in a population are immune to prevent spread of the disease.
Public health experts, however, have said that threshold is still a ways off and that allowing the virus to spread uncontrolled would lead to many needless deaths. A better approach, they say, is to stave off the spread of the virus until a vaccine is widely available.
A Paul spokesperson told us that the senator was not suggesting that immunity through natural infection with COVID-19 is better than getting immunity from a vaccine, but rather, highlighting research that says immunity is real.
We were directed to subsequent tweets, including one in which Paul said he was not arguing against vaccines but that COVID-19 patients can celebrate immunity if lucky enough to survive, as well as Pauls support for alternative options to speed along access to COVID-19 vaccines.
Still, the efficacy figure Paul provides for natural COVID-19 infection isnt accurate. And the juxtaposition of the numbers implies a kind of superiority of natural infection over vaccination a dangerous notion, given that contracting the virus poses a serious risk.
As University of Florida biostatistician Natalie Dean pointed out in response to Pauls tweet, The key distinction is that vaccines are a SAFE way to achieve immunity. Getting sick with COVID-19 is inherently unsafe. We would never ever tolerate a vaccine that carried even a fraction of the risks of natural infection.
While Paul purports to offer a precise percentage for how effective natural infection is relative to vaccines, experts told us that the comparison is premature and faulty.
The efficacy figures for the vaccines come from interim results released in press releases by the two companies, Pfizer and Moderna, and refer to the ability of the vaccines to prevent symptomatic COVID-19 infection in phase 3 trials. (The day after Pauls tweet, Pfizer announced additional data reflective of the full trial, which showed 95% efficacy.) But the number for natural infection is a broad-strokes calculation Paul made based on reinfections.
We dont really know how many reinfections there have been, virologist Angela Rasmussen said in a phone interview, adding that many reinfections have not been confirmed and that efficacy of naturally-acquired immunity isnt a thing.
Its just really ridiculous to try to use the way that efficacy is calculated in clinical trials for vaccines and apply that to epi[demiologic] data across the entire population, she said.
Dr. Paul Offit, director of the Vaccine Education Center at the Childrens Hospital of Philadelphia and a member of the Food and Drug Administrations Vaccines and Related Biological Products Advisory Committee, agreed.
Clearly, there are people who can be reinfected. As a general rule, its usually more mild reinfection, he told us. But, he added, most people arent tested, so you dont really know whos getting reinfected and who isnt.
Its true that reinfections so far appear to be rare, which bodes well both for a vaccine and for people who may have immunity as a result of infection. But no one knows yet how the immunity from each will compare.
Most vaccines do not offer quite as good protection from a pathogen as a natural infection will but of course, a person has to survive or suffer through the infection to get that future protection, sidestepping the entire function of a vaccine. Its therefore largely irrelevant whether or not vaccine immunity is superior to that from natural infection.
There are some instances in which a vaccine does elicit a better immune response. Thats the case for vaccines against human papillomavirus, or HPV; tetanus; Haemophilus influenzae type b; and pneumococcus.
Whether COVID-19 will be one of them remains to be seen. Rasmussen said it was possible, but still hypothetical at this point. We dont really know. We only know that these vaccines typically induce levels of neutralizing antibody that are comparable to the higher levels of neutralizing antibody thats been observed in convalescent patients, she said, referring to the type of antibody that can prevent cells from becoming infected with the virus.
Based on the performance of the shingles vaccine, Offit speculated that some of the later-arriving vaccine candidates that include powerful adjuvants, or chemicals that are added to vaccines to boost the immune response, such as those from Sanofi-GSK or Novavax, might be better than natural infection.
For both the vaccine and natural infection, important questions about COVID-19 immunity remain.
We do know that most people who get COVID-19 do develop some kind of measurable antibody response, but we dont know what that really means in terms of protection against either reinfection or whether you will mount protective immune responses upon a re-exposure, said Rasmussen.
As a result, public health officials have cautioned that for now, even if people have previously contracted COVID-19, individuals should still follow the standard recommendations.
The Centers for Disease Control and Prevention, for example, advises all people, including those who have recovered from COVID-19, to continue to physically distance, wear masks, wash their hands and avoid crowds.
Similarly, the CDC notes that it doesnt yet know if or when it will stop recommending masks or physical distancing after vaccination.
This is in contrast to Pauls assertion that people can celebrate immunity. In a Nov. 12 interview on Fox News, Paul used similar language and advocated that people drop these precautions.
We have 11 million people in our country whove already had COVID. We should tell them to celebrate, he said. We should tell them to throw away their masks, go to restaurants, live again, because these people are now immune.
A huge question is how durable immunity will be. Although the study Paul highlighted suggests that most people will be protected for at least six months and might mean they are protected against severe disease for many years its still not definitive, and doesnt mean that those timeframes will apply to everyone.
Shane Crotty, an immunologist at the La Jolla Institute for Immunology and one of the senior authors of the paper, noted on Twitter that the team observed a wide range of immune responses in people, including a lack of a measurable response in some people.
That led us to speculate, he said, quoting his manuscript, that it may be expected that at least a fraction of the SARS-CoV-2-infected population with particularly low immune memory would be susceptible to re-infection relatively quickly.
The CDC, notably, has said that people who have had COVID-19 may still benefit from a coronavirus vaccine. And some experts envision a future in which multiple vaccines are on the table for everyone.
It strikes me as not unlikely that we will learn what the duration of protection is and people will need whether naturally infected or vaccinated to have booster shots over some period of time, once a year, once every two years, once every five years, Barry Bloom, an immunologist and global health expert at Harvards T.H. Chan School of Public Health, said in a press call.
In his tweet about the new immunity study, Paul also suggested that Democrats were somehow denying realities about immunity from natural infection.
Why does the left accept immune theory when it comes to vaccines, but not when discussing naturally acquired immunity? he asked.
Scientists, however, objected to Pauls characterization.
I dont think anybodys dismissing [immunity following natural infection]. I think what people are saying is, its a bad idea as a strategy for dealing with infection, said Offit, who noted that 30% to 40% of the population could be considered at high risk for COVID-19.
Both Offit and Rasmussen also pointed out that historically, there isnt a lot of precedent for building herd immunity through natural infection.
People were getting smallpox for millennia, Rasmussen said, and the herd immunity threshold was never really reached.
The much safer way of getting to herd immunity is to use a vaccine instead, especially when multiple candidates are on the horizon.
Trying to achieve herd immunity [without a vaccine] would result in hundreds of thousands more if not millions of unnecessary deaths and debilitating illness for millions more, Rasmussen said. So I think its not really right to talk about vaccine-induced herd immunity versus naturally-acquired herd immunity without mentioning the fact that one of them has a very, very large price tag in human lives and quality of life attached to it.
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The scientists have designed the vaccine. Now, government bureaucrats must figure out how to quickly and fairly distribute the life-saving COVID-19 medication.
For Los Angeles County, this effort has already included acquiring 16 ultra-cold storage freezers to be installed across the region. They can store tens of thousands of doses at temperatures as low as minus 86 degrees Celsius.
But the bigger question involves where the vaccine will go from there. Its shaping up to be the largest and most complex public health effort in the countys history, and concerns are growing that officials are falling behind. The county has already struggled with another essential element of the pandemic response: providing widescale coronavirus testing.
Distributing the vaccine in a safe and equitable manner is an even more vital task, and some officials have already expressed their concerns.
Read the full story on LATimes.com.
(CNN) "Are we there yet?"
"My family will not be together this year for the first time in 27 years. It'll be me and my wife in our bubble, and we'll have a nice Zoom gathering, I suspect, to see how everybody is doing," Dr. Francis Collins, the director of the National Institutes of Health, told CNN's Wolf Blitzer Tuesday.
The surge of new Covid-19 infections and hospitalizations in the United States is "substantially steeper than anything we saw back in the spring with New York and New Jersey or in the summer with the Southeast," Collins said.
"This is significantly worse. It's moving faster. It is basically putting everybody in the country at risk," he said. "People need to be deciding right about now, if they haven't already, how are they going to keep themselves and their families safe at this time of great peril."
1. Weigh the decision to travel
To be sure you're not sick and taking the virus along with you to your loved ones, quarantine with your family or traveling companions for two weeks -- that's the typical amount of time it takes for the virus to replicate and subside, even if you have no symptoms.
Some 48 million Americans are expected to hit the road for Thanksgiving this year, AAA predicts.
Alex Wong/Getty Images
"The more cases at your destination, the more likely you are to get infected during travel and spread the virus to others when you return," the CDC says.
2. Prep the car in advance
Avoid potential car problems that might involve unintended contact with others along the way by having your car fully serviced before your trip -- at minimum check oil, fluids, breaks, tires and antifreeze.
Pack several back-up phone chargers, and just in case you lose cell service in some remote area, download your main maps to your phone or GPS.
Experts advise travelers to avoid dining inside on road trips to reduce the risk of coronavirus transmission.
Kent Nishimura/Los Angeles Times/Getty Images
3. Don't forget to safeguard the humans
Prep a first-aid kit for the humans in the car, too, along with plenty of water and healthy snacks, as well as extra masks for travelers older than 2.
Along with that highly protective mask, you should definitely bring disinfecting wipes and hand sanitizer with greater than 60% ethanol or 70% isopropyl alcohol. According to the CDC, that's the level needed to kill most coronaviruses.
4.. Carefully plan your route
5. Try not to stop
If it's at all possible, try to complete your road trip without stopping.
"Making stops along the way for gas, food or bathroom breaks can put you and your traveling companions in close contact with other people and frequently touched surfaces," warns the CDC.
That's obviously not going to happen if you are traveling with little kids for more than a few hours.
Bathroom breaks can be tricky -- some gas stations and fast-food restaurants have closed their restrooms -- so If the opportunity to use the toilet presents itself, encourage everyone in the car to do so.
6. Sanitize everything you touch
Always wear a mask when you leave your car, suggests the American Academy of Pediatrics, and carry sanitizing wipes and hand sanitizer to wipe down door handles and knobs and toilets.
After using the restroom, wash your hands with soap and water for at least 20 seconds (the amount of time it takes to sing "Happy Birthday" twice), open the bathroom door with a hand towel, and use hand sanitizer before touching your car keys or door handles after leaving the facilities.
When refilling at a gas station, use sanitizing wipes on the gas nozzle handles and payment buttons at the pumps before you touch them, then sanitize your hands immediately after you're finished.
7. Keep the windows cracked
Traveling in a car is obviously "a very tight, enclosed space," said Dr. Henry Wu, an associate professor of infectious diseases at Emory University School of Medicine in Atlanta.
That's less of an issue if you're traveling with immediate family from your quarantine bubble. In cases where that's unavoidable, everyone in the car should be masked.
In either scenario, crack the windows, even if it's cold or rainy, said Joseph Allen, director of the Healthy Buildings program at the Harvard T.H. Chan School of Public Health.
He and his team studied airborne transmission inside cars and found "rolling down the windows just a couple inches" can boost air flow and dilute the virus.
Allen also warns against using the recirculation button in your car on the trip. That's the symbol of a car with an arrow in the middle.
"if you're going to have the air conditioning or the heater on be sure that you don't have the recirculating option selected so you're breathing the same air," Allen said. "You want fresh outside air to enter the car."
Packing your own food to eat outside or opting for drive-through dining is safer than eating inside.
Mariah Tauger/Los Angeles Times/Getty Images
8. Have a dining plan
When it comes to reducing the risk of contracting Covid-19 while eating on the road, it's always going to be safer eating outside, where the virus can dissipate into the open air, experts say.
The partitions and six-foot spacing installed in many indoor restaurants isn't enough protection, said Linsey Marr, the co-author of a paper on airborne transmission of Covid-19 via very small droplets called aerosols that can float for hours.
"I think the six feet indoors is not enough by itself" and "plexiglass panels protect against large droplets, but they do not protect against aerosols," said Marr, a professor of civil and environmental engineering at Virginia Tech.
"You have to have good ventilation in that bar or restaurant," she added. "And since I can't wear a mask while I'm eating, I'm just avoiding indoor restaurants until this is over."
Getting takeout or using a drive-through and eating in your car or sitting outside is a better option, experts say.
Hotel chains have upped their disinfecting measures. Experts advise steering clear of common areas.
Courtesy Marriott International
9. Choose your hotel carefully
If you have to stay at a hotel during your trip, consider booking one with outdoor access, Marr suggests.
"This is the time to stay in one of the cheaper motels that has the outdoor corridor so you don't have to go indoors, through the lobby, into the elevator or through the hallways," Marr said.
"You just go up the stairs outside to your room," she added. "And those types of rooms usually have their own air conditioning or heating systems so there's no exchange of air between different rooms."
If you can do it, book a room that's been vacant for more than 24 hours as well as cleaned and disinfected. That's an extra precaution, as is bringing your own pillows and pillowcases and even an extra sheet set.
"In terms of the air quality, I think the longer the room's been vacant, the safer it should be," said Emory's Wu.
Try to avoid other guests as much as possible, Wu advises. Many hotels have closed common spaces such as pools, restaurants and public bathrooms, but you can also avoid interactions with others by checking in and out during off hours.
Carry disinfecting wipes with you as you navigate shared spaces, then use hand sanitizer or wash your hands with soap and water for a full 20 seconds.
When you get to the room wipe down door handles, light switches, remote controls and bathroom fixtures with disinfecting wipes before using them, Wu suggests.
10. Take precautions when you arrive
Ideally, you've quarantined before you left and taken proper safety precautions during your road trip. If not, then try to quarantine when you arrive.
"Don't rely on a negative test on Tuesday before Thanksgiving and think that clears you," said pediatrician Dr. David Rubin, who directs PolicyLab, a research and public policy center at Children's Hospital of Philadelphia that's tracking Covid-19 cases in communities across the country.
"Hunkering your family down for a week and a half is your best way to assure that you're likely to be negative," Rubin added.
"The decisions we make now around the Thanksgiving holiday really determine just how bad the depths of winter are when it comes to the spread of the virus," Allen said.
"If we're irresponsible for a short-term gain through the holidays, it really can come back and bite us weeks later with an expansion of cases," Allen said. "And cases lead to hospitalizations and hospitalizations lead to death."
CNN's Shelby Lin Erdman contributed to this report.
The Pfizer/BioNTech COVID-19 vaccine candidate has 95% efficacy according to the latest analysis offered by the companies.
By Jon CohenNov. 18, 2020 , 6:45 AM
Sciences COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.
Not to be outdone by a rival with a similar product, Pfizer and BioNTech today provided an update on the previously announced success of their COVID-19 vaccine. The U.S. pharma giant and its German biotech partner now report 95% efficacy for their vaccine candidate, drawing on the final analysis of a 43,000-person study. And dont worry about the elderly not responding to the vaccine; the efficacy only drops to 94% in people older than 65, the companiessaid in a press release.
As opposed to the vague initialreportlast week that their vaccine had greater than 90% efficacy, Pfizer and BioNTech are providing more specific data now that the study has reached enough COVID-19 cases to end. In all, the trial had 162 confirmed cases of symptomatic COVID-19 in the placebo group versus eight among those who received the two scheduled doses of the vaccine. The efficacy, which was measured 7 days after the second dose of the vaccine, was the same in different races and ethnicities, the companies sayalthough subgroup analyses always have more uncertainty. Nine of the 10 people who had severe cases of COVID-19 during the trial received the placebo, which indicates that even if the vaccine fails to prevent symptomatic disease, it still offers powerful protection from serious harm. No serious side effects surfaced, the companies report, although 3.7% of the vaccinated reported fatigue after the injections.
The results are nearly identical to preliminary findingsreported by Modernaon 16 November from its ongoing efficacy trial. Both its vaccine and the Pfizer/BioNTech candidate contain messenger RNA (mRNA) that codes for the surface protein of SARS-CoV-2, the virus that causes COVID-19. The strategy is novelno medicines made from mRNA have been approved for widespread human use so far.
The Pfizer/BioNTech collaboration says it will submit within days a request to the U.S. Food and Drug Administration for emergency use authorization (EUA) of its vaccine. If recent history repeats itself, Moderna will follow suit about 1 week later. FDA has said it will convene its independent vaccine advisory committee to review any COVID-19 EUA requests, and the first meeting could occur as early as 9 December, an agency official tellsScienceInsider.
This is a remarkable and very reassuring situation that we find ourselves in, says Trudie Lang, who directs the Global Health Network at the University of Oxford. To go from identifying a new virus to having several vaccines at the point of applying for regulatory approval is an incredible milestone for science.
