United Airlines CEO Scott Kirby talked during his airline’s earnings call about the airline expecting to plateau at 50% of last year’s revenue ‘until there’s a vaccine’ and then expecting recovery to come very quickly to the airline business. American Airlines and Southwest Airlines, too, talked about a vaccine for Covid-19 during their earnings calls.
I’ve already written about a vaccine not being a silver bullet, that it’s likely not to be 100% effective and not everyone will take it. That means the virus will continue to circulate, people will still get infected, though hopefully biomedical advances will mean better therapeutics as well that improve patient outcomes. That could help keep hospitalizations down, keep hospital stays shorter, and prolong lives.
We already have a vaccine in fact we have several in that there are medical interventions that have been shown to be prophylactic in early stage trials. China is vaccinating its military in what amounts to a human challenge trial. The Oxford-AstraZeneca, Moderna, and BioNTech-Pfizer vaccine projects all look promising.
There are several known hurdles that still stand in the way of immunizing people once a candidate – or hopefully even more than one – is determined to be safe and effective. The vaccine needs to be mass produced, distributed, and people need to choose to become vaccinated.
It’s this last part that may wind up the trickiest – people may just not take it. I’ve seen an increasing number of people in my Facebook feed talking about not getting the vaccine once it’s available (it seems to correlate with a person’s views on masks). Add in that a vaccine could require a booster shortly after the first dose, and you’ve got a lot resting on voluntary compliance.
And there are going to be non-crazy reasons not to get it, too: side effects. Regarding the Oxford vaccine trial,
Yes, mild reactions were far more common than worse ones. But moderate or severe harms—defined as being bad enough to interfere with daily life or needing medical care—were common too. Around one-third of people vaccinated with the Covid-19 vaccine without acetaminophen experienced moderate or severe chills, fatigue, headache, malaise, and/or feverishness.
Close to 10 percent had a fever of at least 100.4 degrees, and just over one-fourth developed moderate or severe muscle aches. That’s a lot, in a young and healthy group of people—and the acetaminophen didn’t help much for most of those problems. The paper’s authors designated the vaccine as “acceptable” and “tolerated,” but we don’t yet know how acceptable this will be to most people.
Regarding the Moderna trial,
By the time they’d had two doses, every single one was showing signs of headaches, chills, or fatigue, and for at least 80 percent, this could have been enough to interfere with their normal activities. A participant who had a severe reaction to a particularly high dose has talked in detail about how bad it was: If reactions even half as bad as this were to be common for some of these vaccines, they will be hard sells once they reach the community—and there could be a lot of people who are reluctant to get the second injection.
Ultimately if it’s a couple days of fever and aches for some people, that’s better than getting the virus, and more importantly people who go through that fever and aches and avoid the virus do not spread the virus. There’s a selflessness to getting the vaccine, entirely apart from the protective nature of it which allows people to travel again freely without fee. Although we do have to see how tolerable it is for the elderly.
If the vaccine were 100% effective, that would be enough to travel on its own. A 40% effective vaccine, which is the effectiveness of last fall’s flu vaccine, is only effective if enough people take it so that combined with those recently effective or otherwise immune the virus has nowhere to go to spread and infection levels fall dramatically and stay low.
As countries open up to international travel it may not be like before, with visa-less entry for people carrying myriad passports. Requesting advance permission to enter may become the norm – with proof of vaccination. That will shut out many people without early access to a vaccine around the world, and it will preclude the travel industry from returning to normal quickly. More importantly even a vaccine may not vanquish Covid-19, and people may be slow to return to normal life even after one is introduced.
I’m an optimist – I believe that vaccines, therapeutics, and retained immunity perhaps for a year or longer (via T-cells and B-cells after antibodies fade) will combine to make a year from now very much ‘normal’ life. But it’s not guaranteed – and just as important to understand, a vaccine is only one part of a longer process rather than a light switch that gets us there.