MILWAUKEE — In the worldwide race for a vaccine to protect against COVID-19, some candidates are nearing the finish line in the U.S., and in record time.
There’s a lot to understand, and a lot still to be determined, as the first shots may be on their way to high-priority Americans within weeks. Here, we round up some recent developments in the vaccine world and what they might mean for the Badger State.
Pfizer and Moderna may be close to getting the FDA’s green light
There are dozens of vaccine candidates in various stages of development across the world. But Pfizer/BioNTech and Moderna are looking likely to be the earliest ones approved in the U.S.
These leading vaccines use mRNA technology — a novel way of kickstarting the body’s immune response. And they each require two doses to establish the full immune response.
Pfizer was the first company to apply for FDA authorization on Nov. 20, with Moderna following suit on Nov. 30. Both groups found in late-stage trials that the vaccines were highly effective at preventing illness: 95% efficacy for Pfizer and 94% for Moderna.
The FDA’s vaccine advisory committee is set to meet Thursday to review Pfizer’s data and recommend whether the vaccine should get an emergency use authorization. Just one week later, the committee will be back in session to debate Moderna’s vaccine candidate.
If one of these companies gets the OK, millions of vaccine doses could go out across the country within days.
The United Kingdom has already approved Pfizer’s vaccine, which is now on its way to hundreds of thousands of high-priority individuals. But the FDA’s approval process, which tends to be more thorough and time-consuming than in other countries, is still ongoing.
Beyond these two groups, AstraZeneca is also in the mix as one of the leading vaccine developers in this race. The company announced last month that interim results put the efficacy at 70% to 90% — although some confusion about the trial remains.
CDC panel says health care workers, long-term care residents get first dibs
As approval for a vaccine draws nearer, another question has been front and center: Who will get it first?
According to an expert panel from the Centers for Disease Control and Prevention, people working in health care settings or living in long-term care facilities should be at the front of the line.
The Advisory Committee for Immunization Practices met last week to discuss which Americans will be in Phase 1a — the very first group to receive vaccines. Members of the committee voted 13 to 1 in favor of prioritizing health care personnel and residents of long-term care facilities.
“Those of us that are in the area of public health at this time see the growing number of cases coming before us,” ACIP chair José Romero said after the vote. “We see the growing number of health care providers that have become infected, and some of which, unfortunately, have passed away. We see that the individuals living in long-term care facilities are at exceptional risk.”
Romero said this recommendation supports the committee’s ethical goals of “maximizing benefits, minimizing harm, promoting justice, and mitigating health inequities.”
Both groups face extra risks because of the settings they live or work in, experts pointed out. Plus, health care personnel serve important roles in keeping others safe, while older residents at nursing homes or assisted living facilities are likely to battle more severe COVID-19 cases.
Together, these two groups make up an estimated 24 million people. The next priority phases will likely include other essential workers, people with underlying conditions, and older adults — although official votes on these groups are still to come.
CDC director Robert Redfield also endorsed the ACIP decision on Thursday. The recommendations now get passed along to states to inform their vaccine planning.
Wisconsin preps to dole out its first doses
With the first vaccine batches possibly on the way within weeks, public health officials are getting ready to take on the next logistical challenge: Getting the shots into Wisconsinites’ arms.
“Distributing COVID-19 vaccine is the most significant public health undertaking of our lifetime,” DHS deputy secretary Julie Willems Van Dijk said at a Monday briefing.
Willems Van Dijk explained that the Pfizer and Moderna vaccines would follow different distribution pathways because of their different cold storage needs.
The Pfizer vaccine needs to be kept at an ultracold negative-70 degrees Celsius, which means specialized freezers are required. To account for this, Willems Van Dijk said the state would use a “hub-and-spoke” model — shipping vaccines to central locations in each region, and from there sending out smaller batches to providers in the area.
UW Health, for example, will serve as one distribution center for Pfizer vaccine doses, which will then be sent out to health systems and long-term care facilities, according to a Monday release.
The Moderna vaccine still needs to be frozen, but at a more reasonable minus-20 degrees Celsius, around the temperature of a normal freezer. Because these vaccines can be stored without specialized equipment, they’ll be shipped directly to vaccinators, Willems Van Dijk said.
Another challenge: Even for the top-priority groups, there probably won’t be enough doses available right off the bat.
Last week, Evers sent a letter to Alex Azar — the U.S. Department of Health and Human Services Secretary — asking for Wisconsin to get priority as one of the “states currently experiencing the brunt of this virus.”
Evers requested that Wisconsin receive 450,000 doses, enough to vaccinate its entire healthcare workforce. In the letter, Evers said the Badger State faced extra challenges in fighting the pandemic because of political and legal battles over public health measures.
But DHS officials said Monday that they were expecting 49,725 doses in the first delivery, in a portion calculated according to population. That batch would be used as the first doses for high-priority Wisconsinites, with another shipment of the same size set aside for their follow-up shots, they explained.
Wisconsin’s State Disaster Medical Advisory Committee will help make recommendations on how to triage these limited doses as the state waits for more shipments, Willems Van Dijk said. And some of the early distribution priorities might come down to “pragmatic issues” as well, she said.
“There may be times when we are doing a group of health care workers because they are there, and readily available, and the vaccine is thawed,” Willems Van Dijk said. “So, it’ll be both thinking about who is most at risk and targeting those folks first — and, how do we make sure we don’t waste a single dose of vaccine.”
In the meantime, stay vigilant on COVID-19 measures, experts warn
All of this vaccine news means that there’s a light at the end of the pandemic tunnel. But most Americans still have months to wait before they get their shots, so it’s important to keep up with our other protective measures — especially as major COVID-19 surges continue across the country.
"These vaccines will be going to front-line healthcare workers first, and there are still uncertainties around the quantities we'll get and the timing of their arrival," Matt Anderson of UW Health said in a release. "The public must remain diligent as it will not be widely available anytime soon."
Wisconsin’s cases are down from their extreme highs earlier in the fall. But across the U.S., deaths from COVID-19 are spiking, and experts have raised concerns about holiday gatherings.
White House coronavirus response coordinator Dr. Deborah Birx told NBC that the growing surge could be “the worst event that this country will face.”
For the coming months, Birx stressed, all the now-familiar protections — wearing masks, social distancing, washing hands — remain essential. Even as some of the top-priority groups may get vaccine doses before the year ends, many others won’t have access until later in 2021.
Infectious disease expert Dr. Anthony Fauci also emphasized that a vaccine will not immediately bring the pandemic to a halt. We’ll still need patience as we wait to see how well the vaccine is protecting people, he told Spectrum News.
“You don't know the degree to which you are protected,” Fauci said. “You can pull back on some of the stringent public health measures, but you don't want to abandon them completely and put yourself and your family at risk.”