CDC sees widespread COVID vaccine use in 2021

But expert cautions three leading candidates not even out of trials

CDC sees widespread COVID vaccine use in 2021

BOSTON — You might call the planning document released today by the federal government the first draft of the last pandemic chapter. At least that’s the hope.

“COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations” is a 57-page dry read that hints at something sweet: A world without face masks and distancing and hospitals stocking up on ventilators.

“It’s better to be prepared for distribution of a vaccine ahead of time rather than to be taken by surprise that it becomes available and you don’t know what to do with it,” said Dr. Paul Sax, the clinical director of the Division of Infectious Disease at Boston’s Brigham and Women’s Hospital. “So, I do applaud CDC and HHS for getting this kind of document out there.”

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The document outlines who would initially get the vaccine, where they might get it and when it might become available. On the latter point, Sax cautions that the CDC’s November estimate for the first doses becoming available seems very optimistic.

“There’s tremendous uncertainty still when the vaccines will become available, whether it’s going to be multiple vaccines,” Sax said. “I will say that the three sort of leading candidates for the vaccines have done quite well with their enrollment. So it is possible we’ll hear about some preliminary results before the end of the year but as far as vaccine availability it seems extremely unlikely and we don’t know which vaccine it would be.”

Three companies are now testing vaccine candidates in humans: Astra-Zeneca, Pfizer and Moderna. Astra-Zeneca recently stopped its trial after one study subject developed a side effect.

“That study has still not resumed in the United States,” Sax said. “There are several study sites with the Astra-Zeneca vaccine here in this country. It has resumed in Britain, so presumably, whatever safety review they did there they’ve been satisfied that it’s okay to go forward.”

Sax said so far there have been no ‘safety stalls’ with the Pfizer or Moderna products.

Two of the vaccine candidates will require a booster dose three to four weeks after initial dosing and that second dose must be of the same vaccine because the products are not interchangeable.

Whenever a vaccine does get approved, the government plans to funnel initial doses to essential workers, such as healthcare personnel, as well as to those most likely to become infected with the virus and those likely to get severely ill.

“One thing we’ve consistently seen in study after study after study is that older people are at greater risk of getting severe COVID-19,” Sax said.

Once vaccine supplies become plentiful, the federal government plans to procure millions of doses and distribute them to authorized providers who will immunize Americans free of charge. Those providers could very well include corner drug stores.

“We have such a fractured health care system in this country,” Sax said. “Every time you see something covered it’s remarkable and it’s really welcomed.”

One big concern is whether enough Americans will partake of the free vaccinations to bring about the kind of herd immunity needed to reign in the pandemic.

“There is some vaccine skepticism out there and not surprising since this is a new disease there’s skepticism about the COVID-19 vaccine,” Sax said. “I think once we see the data we can make a much more informed opinion about whether it’s worth getting.”

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