Coronavirus vaccines: Your questions answered

Dr. Anthony Fauci shares some words of hope as the holiday season approaches and offers advice on how to mitigate the spread of Covid-19.

Posted: Nov 18, 2020 5:00 AM
Updated: Nov 18, 2020 5:00 AM

There is sorely needed good news on the vaccine front: A second US vaccine has been found to have a high success rate against Covid-19. Moderna announced on Monday that its vaccine was 94.5% effective against coronavirus, according to early data.

Vaccinations could begin in the United States in the second half of December, starting with high-risk groups and becoming available for the rest of the population in spring, according to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

Here are some answers to common questions about the coronavirus vaccines being developed to prevent Covid-19.

Don't vaccines take years to develop safely? How have these two been developed in just 10 months?

Most vaccines in use today have taken years and, in some cases, decades to develop, but governments have poured huge amounts of money into companies and institutions developing vaccines, with initiatives like Operation Warp Speed in the United States and the Vaccine Taskforce in the United Kingdom.

The pandemic has galvanized the scientific community all around the world, with groups of researchers in dozens of countries on a fast-paced hunt to understand how the virus works.

Operation Warp Speed has also drawn up protocols to allow trials to proceed more quickly, and industrial-scale manufacturing of the vaccines has taken place before we knew whether they would be effective. This means we have millions of doses ready to be used.

How effective is this vaccine?

The vaccine developed by Pfizer, which announced its early successful results last week, and Moderna's are both more than 90% effective, according to the early data, a higher rate than many vaccines for other diseases. However, the results are extremely preliminary and aren't what health authorities will use to authorize vaccines.

In Moderna's trial, 15,000 study participants were given a placebo, which is a shot of saline that has no effect. Over several months, 90 of those people developed Covid-19. Another 15,000 participants were given the vaccine, and five of them developed Covid-19.

Among those receiving a placebo, 11 became severely ill, but none of the participants who received the vaccine became severely ill.

The head of the International Vaccine Institute has hailed biotech company Moderna's early data on its Covid-19 vaccine candidate, saying it is "proof of concept," but cautioned that it's still early days in terms of follow-up efficacy.

"I think it's really great news and in a way confirmation that the RNA vaccines are able to protect against infectious disease and it is also a good example again that Covid vaccines are a possibility," Dr. Jerome Kim, the institute's director general, told CNN on Monday.

"It will be really important to know what efficacy is - not at two months, but at six and twelve," Kim said.

There are still lots of unknowns about how the new coronavirus vaccines would work in practice. It's not clear whether they would prevent infection altogether or make severe illness less likely. Doctors also do not know how long their protection will last.

However, Fauci described it "as good as it gets." He had said previously he would settle for a vaccine that was 70% to 75% effective.

Vaccines have various efficacy rates. According to the US Centers for Disease Control and Prevention, a full round of polio vaccines is 99% to 100% effective; full vaccination against diphtheria, tetanus and pertussis is 80% to 90% effective, while the efficacy of flu vaccine varies from year to year.

How safe are the vaccines, and are there any side effects?

Moderna said its vaccine did not have any significant side effects. A small percentage of those who received it experienced symptoms such as body aches and headaches. It's similar to what people might experience after a flu shot and is a sign the vaccine is working to create an immune defense.

"They report no safety concerns - the main side effects are injection site pain, fatigue, muscle or joint aches and pains and headache which seemed to occur more frequently after the second injection," Dr. Penny Ward, a visiting professor in pharmaceutical medicine at King's College London, told the SMC.

"Clearly we still need to see the complete scientific details in a publication to be able to judge the outcomes independently."

After a vaccine is approved for emergency use authorization in the US, the CDC will continue to monitor side effects and assess whether any are a safety concern that warrants a change in recommendation.

How do these vaccines work? I'm worried they sound experimental.

Vaccines typically mimic part of the virus they protect against, prompting a response from your immune system.

The vaccines from Moderna and Pfizer both use a new approach that hasn't resulted in an approved vaccine before -- although they have been studied in clinical trials for other viruses.

The two vaccines use genetic code rather than any part of the virus itself, with a technique called messenger RNA, or mRNA. The vaccines deliver mRNA, which is a genetic recipe. In this case, the genetic recipe directs cells to make pieces of the spikes that sit atop the coronavirus. Once it's injected, the body's immune system makes antibodies that recognize these spikes. If a vaccinated person is later exposed to the coronavirus, those antibodies should stand at the ready to attack the virus.

The fact that Moderna and Pfizer have independently produced very similar results using the same technique is a vote of confidence in the genetic technology, experts said, and their results could make it much easier and quicker to produce other vaccines.

"Using this technology, vaccine candidates can be produced substantially faster in the future to combat virtually any infectious disease, by producing vaccines against both existing pathogens and future, currently unknown pathogens," Zoltán Kis, research associate at the Future Vaccine Manufacturing Hub, Imperial College London, told the SMC.

Other companies are developing vaccines using other techniques -- the Oxford/AstraZeneca vaccine is made from a harmless modified chimpanzee virus, while the traditional route is to use the inactivated virus.

Sign me up! When can I get it?

While Fauci said he expects the first Covid-19 vaccinations to begin toward the latter part of December, initially there won't be enough vaccine for everyone. The highest-priority groups, which include health care workers, the elderly and people with underlying medical conditions, will get the vaccine first.

"I think that everybody else will start to get vaccinated towards the end of April," Fauci said. "And that will go into May, June, July. It will take a couple of months to do."

The British government has asked the National Health Service, known as NHS, to be ready to deploy a vaccine from the beginning of December.

What if I'm old, pregnant or clinically vulnerable?

Among the 30,000 participants in the Moderna trial, more than 7,000 Americans were over the age of 65, the company said. It also included more than 5,000 Americans who are under the age of 65 but who have high-risk chronic diseases that put them at increased risk of severe Covid-19, such as diabetes, severe obesity and cardiac disease.

The study also includes more than 11,000 participants from communities of color, representing 37% of the study population, which Moderna said was similar to the diversity of the US population. This includes more than 6,000 participants who identify as Hispanic or Latinx, and more than 3,000 participants who identify as Black or African American.

Noubar Afeyan, the co-founder and chairman of Moderna, said the company doesn't see "any difference in the results," among the subgroups in its Covid-19 vaccine trials.

"Moderna actually slightly slowed down the trial recruitment to ensure that we had a substantial representation, and it turns out, 37% of our trials were people, were subjects, that are considered of color," Afeyan said on CNN International Monday.

"Generally, it looks like the vaccine performs broadly across all the population groups," Afeyan said.

However, we don't know anything about groups not involved in the trial such as children or pregnant women.

"Urgent questions remain to be answered, including how long these vaccines will be effective for and whether these vaccines work across different populations, in all age groups, ethnicities, and those with prior health conditions," said Charlie Weller, head of vaccines at medical research charity Wellcome.

"Only upon trial completion will we be able to assess the full efficacy and safety of any vaccine candidate."

Will the vaccines be compulsory? What happens if I decide not to get vaccinated?

Some people will see it as their patriotic duty to get vaccinated, but others may not. The UK has said it won't make it compulsory, and Fauci has said that getting the vaccine likely won't be mandatory.

If you decide against getting a vaccination, it does have wider implications. Not only will you not have protection against Covid-19, but it could potentially make it harder to achieve community, or herd, immunity. This protects high-risk groups that might not be able to get the vaccination.

It is estimated that a Covid-19 vaccine will need to be accepted by at least 55% of the population to provide community immunity, according to the London School of Hygiene & Tropical Medicine, and some scientists anticipate even higher numbers will be needed.

Minnesota Coronavirus Cases

Data is updated nightly.

Cases: 692029

Reported Deaths: 8118
CountyCasesDeaths
Hennepin1420361857
Ramsey59138950
Dakota52802499
Anoka48675484
Washington31035311
Stearns25220241
St. Louis20709336
Scott19922146
Wright18796163
Olmsted16101111
Sherburne13732104
Carver1228652
Clay928595
Rice9218124
Blue Earth883747
Crow Wing7961102
Kandiyohi750289
Chisago725258
Otter Tail680795
Benton6577101
Mower570538
Winona561352
Goodhue557680
Douglas543684
Itasca527671
Beltrami521172
McLeod513464
Steele512821
Isanti497170
Morrison473363
Nobles453850
Becker445859
Polk439975
Freeborn434140
Lyon399854
Carlton395659
Nicollet384747
Pine379526
Mille Lacs360360
Brown354244
Cass350835
Le Sueur345930
Todd328434
Meeker311049
Waseca294725
Martin268733
Wabasha24734
Dodge24655
Hubbard238541
Roseau235924
Houston207416
Redwood204042
Renville202548
Fillmore200810
Pennington193622
Wadena189426
Faribault182825
Sibley178810
Cottonwood178524
Chippewa172739
Kanabec167029
Aitkin157338
Watonwan156711
Rock141819
Jackson135412
Pope13478
Yellow Medicine127020
Pipestone125526
Koochiching122319
Stevens121611
Swift118819
Murray116610
Marshall105818
Clearwater105418
Lake93021
Wilkin90314
Lac qui Parle87024
Mahnomen7069
Big Stone7014
Grant6958
Norman6739
Lincoln6624
Kittson53722
Unassigned50993
Red Lake4937
Traverse4325
Lake of the Woods4124
Cook2140

Iowa Coronavirus Cases

Data is updated nightly.

Cases: 438547

Reported Deaths: 6420
CountyCasesDeaths
Polk69441683
Linn26618363
Scott23312265
Black Hawk19397338
Woodbury17483233
Johnson1698692
Dubuque14775221
Pottawattamie13369186
Dallas13048102
Story1211448
Warren707893
Webster6479103
Cerro Gordo6370105
Clinton635898
Des Moines618084
Muscatine5985109
Marshall586981
Sioux547676
Jasper532076
Lee529084
Wapello5230128
Buena Vista479442
Marion464086
Plymouth442185
Henry351341
Jones341159
Bremer331365
Washington330454
Crawford326844
Carroll326553
Benton325756
Boone318636
Mahaska282754
Dickinson276547
Kossuth257471
Clay255629
Jackson253844
Tama246073
Hardin244547
Buchanan244238
Delaware240143
Cedar228025
Fayette227945
Page225724
Wright221741
Winneshiek219237
Hamilton216752
Harrison205476
Madison199920
Clayton199758
Floyd195742
Butler191936
Poweshiek188837
Mills188225
Iowa185927
Cherokee184740
Allamakee181152
Jefferson178238
Lyon178041
Calhoun172213
Hancock170336
Winnebago170131
Cass164356
Louisa161651
Grundy161335
Appanoose158149
Shelby156539
Emmet153241
Franklin152224
Humboldt151626
Union149937
Sac147922
Mitchell146143
Guthrie142132
Chickasaw141618
Palo Alto134527
Clarke130226
Montgomery127940
Keokuk121332
Monroe118733
Howard118422
Ida109838
Davis105025
Greene103012
Pocahontas102623
Monona99034
Lucas98523
Adair97734
Worth9558
Osceola84717
Decatur76710
Fremont76511
Van Buren75221
Taylor73412
Wayne66323
Ringgold63027
Audubon60114
Adams4254
Unassigned270
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