Will doctors be willing to get COVID-19 vaccine?

MGN Online

By Catherine Marfin The Dallas Morning News

DALLAS – Vaccines usually take years to develop, but as the coronavirus pandemic stretches into its fifth month in the U.S., scientists and companies all over the world are racing to find a cure to treat COVID-19 by next year.

Testing has been in the works since January, and vaccines must go through at least three phases of human trials before being approved. According to The New York Times, 27 vaccines are in various stages of human trials.

Many have argued that a vaccine will allow the economy to eventually rebound to precoronavirus levels. But some are concerned about the accelerated process and possible safety protocols that may be moved forward too quickly to meet the goal.

We spoke to three Texas doctors about whether they would receive the first COVID-19 vaccine. Here’s what you need to know.
___
Will you get the first COVID-19 vaccine that becomes available?

All three health experts said they would get the first COVID-19 vaccine, provided the data from human trials is promising.

Dr. Trish Perl, chief of infectious diseases at the University of Texas Southwestern Medical Center and an infectious-disease specialist at Parkland Health and Hospital System, said she would feel comfortable with a vaccine that shows it has a strong immune response both in a lab setting and in humans.

“They actually have several candidate vaccines right now, and they’re generating an immune response, it’s very evident to us,” Perl said.

“You form antibodies, which is what’s supposed to happen when we give you a vaccine,” she said. “But that antibody needs to be what we call ‘neutralizing’ _ it needs to kill the virus. And that’s the part of the puzzle that we need to solve right now.”

Dr. Philip Huang, director of Dallas County Health and Human Services, said he would feel comfortable getting an approved COVID-19 vaccine. But he added that the Centers for Disease Control and Prevention will probably prioritize vaccinating certain groups, such as pregnant women and people over 65. A similar approach was taken with the H1N1 vaccine used in the swine flu epidemic in 2009.

People in high-risk groups or who frequently interact with people in high-risk groups should definitely get vaccinated, said Dr. Beth Kassanoff, an internal medicine physician with North Texas Preferred Health Partners and 2021 president-elect of the Dallas County Medical Society.

“I think I would certainly get it,” she said, adding that she’d feel most comfortable with a vaccine that is approved by the Food and Drug Administration. “I’m in a high-risk group.

I’m immunosuppressed, and my elderly father-in-law lives with me. I think I would encourage my teenagers that live at my house, (for) us all to get it.”
___

Should the public be worried about the accelerated vaccine process?

The experts said that while it’s unprecedented for a vaccine to be created in such a short period of time, the benefits will probably outweigh any risks, as long as vaccine trials are conducted responsibly.

“We know that not only is it hurting people, but straining the health care system,” Perl said of coronavirus. “And we have a lot of people who are exposed, and it’s harming the economy. When you factor all of that in, it gives you a different risk profile.”

In general, she said, vaccines are safe. However, she noted, the risk can vary depending on a person’s circumstances. Elderly people, for example, may not have the same immune response with a vaccine as young adults.

Kassanoff said that she wouldn’t hesitate to recommend vaccination for people in high-risk groups since they are more likely to experience the most severe illness. Vaccination is worthwhile provided it only yields minor side effects, such as aches or low-grade fever lasting only a few days, she said.

“Typically, I’m not the first person to prescribe a new medication,” she said. “I want to see it be around for a while before I start giving it to my patients. I think this is going to be a little bit different though, because the people who get so sick with it are the ones who already have so many health problems.”

Huang said there isn’t cause of worry about vaccines provided shortcuts aren’t taken during development.

Health experts have said that a vaccine that skips animal trials, for example, could be dangerous. Animal trials help researchers determine whether a vaccine runs the risk of “vaccine enhancement,” which makes an illness worse in vaccinated individuals.

“We’d have to review the processes, how they conducted the trial and evaluate them,” he said. “But you have to make an assumption that they’re doing it the way it’s supposed to be done.”
___

How should the public evaluate COVID-19 vaccines?

As more data and information is being released on a COVID-19 vaccine, Huang said he’ll be looking for high efficacy rates and positive data from the safety tests. He also said the public should look at what the benefits of each treatment would be.

“We’d have to wait if it only had minimal benefits but really bad side effects or something,” he said. “But, I mean, these are assumptions.”

When evaluating a vaccine, Perl said, the public should start by looking for evidence of three things: that it works in animals, that it generates an immune response in humans, and that it can prevent infection in humans.

It’s also important to consider the groups of people on which the vaccine is tested. If it is tested on healthy, young adults, that may not inspire confidence in people in high-risk groups.

It’s also important, she said, to look at a vaccine’s side effects. Ideally, they would be mild or rare.

“Everything has a side effect,” Perl said. “We know there’s going to be this side effect, but we want it to be rare. Or if it has a common side effect, we want it to be mild, such as with the HPV vaccine, you have a pretty sore arm.”

She said the public should also look for, and even demand, that companies follow up with vaccinated individuals to ensure no long-term side effects.

Health experts have said it’s possible that the COVID-19 vaccine will require more than one dose, and that it may not be 100% effective. But even a vaccine that behaves like the flu vaccine, which is anywhere from 40% to 60% effective each year, would still be a big step forward in battling the pandemic.

“This may end up being very much like the flu vaccine where it may not be as effective as some of these other vaccines at preventing illness in the individual, but it actually may decrease shedding enough that if we get enough of the population vaccinated, then we get that herd immunity that we really need,” Perl said.