Why A Covid Vaccine Won't Be A Magic Bullet

Many regard a vaccine as the solution to the problems being wreaked by Covid-19. But it's no panacea, writes Asha Fowells.

Although shielding officially ended in the summer, there are many people who are continuing to stay at home rather than expose themselves to others, even with social distancing and hygiene measures in place.

Ask these individuals – who, let’s not forget, are among the frailest in our society and so have legitimate fears for their health at the hands of coronavirus – what will make the difference and the answer is usually: a vaccine.

But the reality is that the Covid-19 vaccine, groundbreaking though it will be both in the speed with which it will come to market and the sheer number of people who will receive it, is not the magic bullet some are making it out to be.

Clinical trials are essential in order to demonstrate that the vaccine causes the immune response necessary to reduce the chance of someone getting ill if they come into contact with the virus.

Yes, reduce the chance, not eliminate it. No vaccine offers 100 per cent protection.

Some individuals simply don’t develop the expected immune response – for instance, this happens in five to 10 per cent of children with measles after the first dose of the measles, mumps and rubella (MMR) jab – whereas others respond in the first instance but then lose their immunity over time; this is why children are given repeated doses of the whooping cough (pertussis) vaccine, for instance.

Testing is key for a vaccine that is potentially going to be rolled out so widely, and that doesn’t just mean the immediate reaction someone experiences after an injection such as a sore arm or slight headache.

Scientists, and importantly regulators, need longer-term data on safety, such as whether adverse effects occur weeks or months later. For anyone who thinks this isn’t important, a single word of caution: thalidomide.

It will also take a while for vaccine production to reach the scale at which it can meet the massive and unprecedented demand. Some of the vaccines in development are being produced using cutting edge technology – those based on RNA, for example; there are no such vaccines currently approved for human use – so it is going to potentially involve significantly more effort on the part of manufacturers than simply switching over a flu jab production line.

“None of this is to say the Covid-19 vaccination isn’t the right thing to do. It absolutely is.”

The logistics of vaccinating as many people as possible also cannot be understated.

While the UK government may have secured early access to 90 million doses of two of the Covid vaccines currently being trialled – and let’s assume that these are the successful candidates – there is a lot to work out in terms of getting supplies to the healthcare staff who run vaccination clinics, and getting the people to those clinics in an organised manner.

Consider for a moment Public Health England’s annual flu report for 2019-2020: this states that over the course of several months just over 14 million vaccines were administered to people in the eligible priority groups for free NHS seasonal flu vaccination (over 65s, those with clinical vulnerabilities, pregnant women and healthcare workers), and uptake in those groups ranged from just over 41 to nearly 75 per cent.

Now consider these figures in the context of the UK’s nearly 67 million population, and the impact that deploying so many healthcare workers with vaccine administration as their sole purpose will have on their usual patient duties.

There will be some who refuse to have the Covid-19 vaccine, not just the traditional anti-vaxxers but also the Covid-deniers; those who reject the restrictions put in place to try and control the spread of coronavirus in order to protect the most vulnerable and manage demand on NHS services.

Anti-vaxxers may benefit from an awareness campaign that emphasises how the personal and public health benefits of vaccination far outweigh the real but exceptionally small risk of post-vaccination adverse reactions, perhaps by comparing them to medicines where there tends to be less pushback.

As tough a job as that is, it pales into insignificance in terms of trying to persuade Covid-refusers of the need to prioritise the greater good to society over the perceived breach of their rights.

None of the above mean that Covid-19 vaccination isn’t the right thing to do. It absolutely is.

And even if 60-70% of people receive the vaccine, there is a good chance that herd immunity will start to develop, which in turn can lead to gradual but safer lifting of restrictions such as lockdowns, and relaxation of measure such as social distancing. But a panacea it is not.

Asha Fowells is a pharmacist and freelance journalist.