Healthcare providers must be able to explain the latest data supporting the safety and efficacy of vaccines for coronavirus disease 2019 (COVID-19) so they can strongly encourage vaccination when appropriate while acknowledging that uncertainty and unknowns remain. This message comes from a new commentary co-authored by Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and other leading NIAID scientists in the journal Annals of Internal Medicine.
The commentary provides an overview of the seven COVID-19 vaccines furthest along in development in the United States. For each vaccine candidate, the authors describe the platform used, the current stage of development, and the clinical trial results that have been reported or when results are expected. Noting that rare side effects may emerge as large populations become vaccinated, the authors caution that careful analysis will be required to distinguish between conditions that occur by chance after vaccination and side effects caused specifically by the vaccines.
The authors also explain that outstanding questions about the vaccines include their safety in special populations, how long they protect against symptomatic disease, and the degree to which they protect against infection and transmission of SARS-CoV-2, the virus that causes COVID-19. Study data are being analyzed to answer this latter, urgent question, the answer to which may have the greatest immediate impact on the pandemic.
Recent polls suggest that only 40% to 60% of the U.S. population currently plans to get vaccinated. Therefore, the authors write, if the COVID-19 vaccines do not prevent transmission, the virus will continue to circulate, infect and cause serious disease in some people who are not vaccinated. In addition, if the vaccines do not provide durable, high levels of protection from infection and do not drive the prevalence of the virus to near zero, researchers will need to thoroughly analyze virus shedding and transmission. This information could guide the prioritization of populations for vaccination and help researchers improve upon the first generation of vaccines, according to the authors.
Meanwhile, they write, even as vaccination is scaled up, healthcare providers must continue to reinforce the importance of "low-tech" public health measures of physical distancing, handwashing and masking until the current outbreak is under control.
M Connors et al. SARS-CoV-2 vaccines: Much accomplished, much to learn. Annals of Internal Medicine
DOI: 10.7326/M21-0111 (2021)
NIAID Director Anthony S. Fauci, M.D., is available for comment.
Annals of Internal Medicine