A COVID-19 Vaccine Has Arrived. What Now?

COVID-19 vaccine.
COVID-19 vaccine. Photo: Getty Images/Tetra images RF

Vaccine development is a typically lengthy process: Under normal circumstances, it can take anywhere between a decade and 15 years to get one approved and on the market, ready for distribution. But these are not normal circumstances. Less than a year after authorities identified a novel coronavirus in China, the Food and Drug Administration has already authorized a vaccine for emergency use; a second vaccine could be authorized by the end of the week. Today, U.S. hospitals are giving out their first doses.

The vaccine that’s currently being distributed comes from the pharmaceutical company Pfizer, and is 95 percent effective at preventing COVID-19 infection. The second vaccine is Moderna’s, and has a comparable efficacy rate.

Here, everything you need to know.

All the COVID-19 Vaccines, Compared

While researchers around the world are currently testing 34 vaccines on humans, according to planning documents circulated by the Centers for Disease Control and Prevention, there two that are either approved, or close to approval, in the U.S. They are:

Pfizer: On November 9, Pfizer — which partnered with German drugmaker BioNTech — announced that its vaccine was more than 90 percent effective at preventing COVID-19 infection in those who have not previously contracted the virus, according to an early analysis. (The vaccine consists of two injections spaced 21 days apart.) Then, on November 18, the company announced the results of their final analysis: Their vaccine was 95 percent effective at preventing mild and serious COVID-19 cases, and produced no serious side effects. Crucially, the New York Times reports that the vaccine is 94 percent effective in older adults who are more susceptible to serious infection and don’t always respond well to vaccines. On November 20, Pfizer applied to the FDA for emergency use authorization, and on the night of December 11 following some characteristic browbeating by the Trump administration — the agency approved Pfizer’s vaccine. On December 14, vaccinations began.

Moderna: On November 16, Moderna — which is working alongside the National Institute of Allergy and Infectious Diseases — announced that its vaccine might be 94.5 percent effective at preventing the coronavirus, per early research. (Among the vaccine’s notable funders: Dolly Parton.) Two weeks later, on November 30, the company announced findings from its final set of data: Its vaccine is 94.1 effective at preventing infection in general, and 100 percent effective at fending off severe infections. The company is now applying for FDA authorization, and hopes to have doses available by the third week of December. (This vaccine consists of two injections four weeks apart.) If the FDA gives Moderna its approval, vaccinations could begin on December 21.

And there’s a third vaccine — this one from AstraZeneca, which partnered with the University of Oxford. On November 23, the British-Swedish pharmaceutical company reported that an early analysis showed their vaccine — which is easier to store and more affordable than the previous two — is 90 percent effective, if administered in a somewhat unusual way. When volunteers in trials were given a half-dose followed by a full dose a month later, the vaccine was the most effective. When volunteers were given two full doses a month apart, the vaccine was only 62 percent effective. But in the days after the company’s announcement, some experts started to identify worrying red flags in the data. To name just two: The company’s results are not from a single, large-scale clinical trial, but rather two smaller studies that were not similarly conducted; also, the trials featured few participants over the age of 55, even though older adults are more susceptible to developing severe cases of COVID-19.

Who was the first person to get the COVID-19 vaccine?

An independent panel that’s advising the CDC has recommended that the 3 million people who live and work in long-term-care facilities, as well as the country’s 21 million health-care workers, should be first in line to get vaccinated. Pfizer’s vaccine rollout aligns with these suggestions. This week, high-risk health-care workers will receive the first of Pfizer’s 2.9 million doses, which are scheduled to reach 636 distribution sites by the end of the week. (According to the New York Times, the Trump administration was also trying to quietly vaccinate some of its senior White House staff members with these limited doses, but the administration has since delayed this widely criticized plan.)

Around 9 a.m. this morning, Sandra Lindsay, a critical-care nurse at the Long Island Jewish Medical Center in Queens, became the first person in the U.S. to receive a COVID-19 vaccine. “I feel hopeful today — relieved,” she said after being inoculated, adding that she wishes to “instill public confidence that the vaccine is safe.”

Next week, residents in nursing homes and other long-term-care facilities will be inoculated, if all goes accordingly. By the end of the year, Pfizer will have about 25 million doses available in the U.S., and Moderna will have 20 million. So, there should be enough vaccines for about 20 million people to get inoculated. (Again, both vaccines require two doses.)

When can you get the COVID-19 vaccine?

Earlier this month, the Washington Post reported that, starting next year, Pfizer and Moderna are expected to produce a combined 70 million doses each month. In January, health-care workers and patients living in care facilities would receive their second doses; in February and March, people who are over 65 or have preexisting health conditions, as well as essential workers, will be prioritized. But per the New York Times, it’s likely that those who fall outside these vulnerable groups will start to get vaccinated in the spring, as well. If all goes accordingly, most Americans could be vaccinated by the start of summer.

But widespread distribution isn’t going to be easy — especially involving Pfizer’s vaccine. While both Pfizer and Moderna have used groundbreaking mRNA technology, Pfizer’s vaccine has to be stored at a temperature of negative 94 degrees Fahrenheit in specialized deep-freeze “suitcases” that can only be opened twice a day and for no more than 180 seconds at a time. “The reality is there has never been a drug that required storage at this temperature,” Soumi Saha, a director at Premier, which procures supplies for hospitals across the country, told CBS News; administering this vaccine to many millions of people — especially those in rural areas, where the hospitals may not be able to afford the significant cost of procuring and storing these vaccines — will be a “logistical nightmare.”

While Moderna’s vaccine must also be shipped frozen, it can be stored at a temperature between 36 to 46 degrees Fahrenheit. And then there’s AstraZeneca vaccine, which can be stored and transported at normal refrigerated conditions, for a duration of half-a-year.

When can children get the vaccine?

Because children’s immune systems don’t respond to vaccines the same way as adults, none of the major pharmaceutical companies have included them in their clinical trials, though most have vocalized their intent to develop a COVID-19 vaccine for kids. (Children are less likely to develop severe cases of COVID-19, hence the early focus on developing a vaccine for adults; however, kids can obviously spread the virus to high-risk groups.) Currently, optimistic timelines have a coronavirus vaccine reaching children by the end of 2021.

Could there be more than one COVID-19 vaccine?

Yes. In fact, public-health experts say that’s preferable. “There are 7 billion people in the world, so we need multiple vaccines to be successful,” said Dr. Daniel Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center. “This is not a race of one developer against another developer — this is a global, collaborative effort.”

The U.S. has supply agreements with a handful of other drug companies that have COVID-19 vaccines in clinical trials, including Johnson & Johnson, Sanofi and GSK, and Novavax. There are also a handful of vaccines that won’t be available Stateside, including those produced by China and Russia.

Now what about cost?

Operation Warp Speed, the Trump administration’s program dedicated to COVID vaccines and treatments, plans to buy doses from the pharmaceutical companies, ensuring that Americans can get vaccinated for free.

So what happens once we’re widely inoculated?

Here’s the deflating news: A vaccine is “not going to be a light switch” back to normalcy, Fauci said during a recent appearance on CNN’s State of the Union, elaborating that we’ll likely be wearing masks and social distancing even after the vaccine is widely distributed. “I would recommend to people to not abandon all public-health measures just because you have been vaccinated,” Fauci said, because, even if you get vaccinated and the efficacy rate of the vaccine ends up being 95 percent, there is still a chance — albeit small — that you could get the virus. Also, Fauci has noted in the past, we have to account for those who don’t get vaccinated, either because they lack access or the means to pay for inoculations or because they’re skeptical.

David Ho, a virologist at Columbia University who’s developing monoclonal antibody therapies, echoed Fauci’s estimation, saying we’ll be continuing our precautionary measures for most of next year.

This article has been updated.

The First COVID-19 Vaccines Are Going Out Today