7 Questions About the Coronavirus Vaccine, Answered by Doctors
Will the coronavirus vaccine be mandatory? Here's what experts have to say.
The race to find a coronavirus vaccine is on. Several vaccine possibilities are currently being tested in order to help stop the spread of COVID-19. But as we move closer to the potential of a coronavirus vaccine being made publicly available, many people have questions and concerns. Will a coronavirus vaccine even work, and will it be safe? Will a vaccine be mandatory for everyone? We talked to the experts to answer some of the most pressing questions you have about the coronavirus vaccine. And for more on why a vaccine might be necessary, read our story: Will Coronavirus Go Away Without a Vaccine? Here's What Experts Say.
"How do we know if a coronavirus vaccine will work?"
For the health of everyone, vaccines go through long, rigorous testing before they are publicly available, says Reuben Elovitz, MD, founder and internal medicine physician at Private Health Dallas. This is why we don't have a coronavirus vaccine available yet, as he says the testing process typically takes several years—although it's been somewhat accelerated because of the impact of COVID-19.
According to licensed physician Leann Poston, MD, a medical expert for Ikon Health, this testing means that "vaccines go through an animal trial for safety and efficacy, and then four phases of clinical trials on humans to evaluate dosage and safety." It's monitored through people with "different genetic profiles, different preexisting conditions, and different metabolisms" to understand how it will affect a large population. And to learn about potential production pitfalls, discover The Shocking Problem That Could Prevent You From Getting the Coronavirus Vaccine.
"How many people need to take the coronavirus vaccine?"
No vaccine is 100 percent effective for everyone, says Khawar Siddique, MD, a neurosurgeon at DOCS in Los Angeles. The purpose of the coronavirus vaccine is not to make everyone immune, but instead to create a majority of people able to fight the virus, which leads to "herd immunity" for those who cannot develop immunity or take the vaccine themselves.
Chris Xu, PhD, chairman and CEO of ThermoGenesis and ImmuneCyte, says the coronavirus vaccine may be similar to the hepatitis B vaccine, in which roughly 10 percent of recipients "never develop antibody immunity." That means that in order to effectively work, most people will need to get the vaccine to produce the nearly 90 percent population immunity required for herd immunity, according to Alex M. McDonald, MD, a practicing family physician in San Bernardino, California.
"Will a coronavirus vaccine be mandatory?"
Doctors can currently only speculate on whether or not a vaccine will be mandatory. According to Siddique, most hope it will be. The coronavirus vaccine could just be very strongly recommended, like the flu vaccine, or mandatory, like the meningitis and measles vaccines, according to Janette Nesheiwat, MD, a family and emergency doctor.
But even the meningitis and measles vaccines have exceptions for exemptions based on medical reasons, despite being mandatory. And that's likely to be the case for the coronavirus vaccine, as well, says Elovitz. With any vaccine, there's a possibility that it may not be safe for people with contraindications, like infants, pregnant women, immunocompromised individuals, or those with allergic reactions to the vaccine components, he says. The contraindications that come with the coronavirus vaccine will become more evident during the trial stage, so those exemptions will come to light before it is made available. And to learn more about what it's like to have COVID-19, find out How Coronavirus Affects Your Body, From Your Head to Toes.
"Will a coronavirus vaccine give you the coronavirus?"
There is a common misconception that many vaccines actually give you the virus, especially when it's a live vaccine, and that it is therefore dangerous to get vaccines. A live vaccine is one that uses a weakened version of the live virus, Xu says, but there are various vaccine formats being tested right now that don't include a live virus. Furthermore, a live vaccine won't cause any issues in the vast majority of people.
"If it is not a live virus vaccine, the answer is no," he explains. "If it is a live virus, and you are not immune compromised, the answer is no. If you are someone with a compromised immune system, then a live vaccine could potentially cause an issue. You should seek to use a monoclonal antibody or polyclonal antibody as prophylactic use or therapeutic use to protect yourself. Consult with your doctor to learn more when the vaccine is released."
Siddique says that with any vaccine, you may experience some mild symptoms or side effects from the vaccine, like a fever, but that doesn't mean you are actually sick with the coronavirus.
"Will you need to get the coronavirus vaccine once a year, like the flu shot?"
The amount of times you'll have to get the coronavirus vaccine depends on a multitude of factors. Poston says that biotech company Moderna is currently testing a messenger RNA vaccine for the coronavirus—now in its first clinical phase of testing, where volunteers are getting two shots 28 days apart—but it's too soon to say what a vaccine schedule might look like for the entire population.
Greg Maguire, PhD, founder of BioRegenerative Sciences, Inc., says the number of times you'll need the vaccine has a lot to do with the mutation rate of the SARS-CoV-2 virus. The influenza virus has a fast mutation rate, which is why a new version of the flu vaccine needs to be available every year. However, according to Maguire, the "SARS-CoV-2 virus has been found to mutate at a slower rate than the influenza virus," so it may provide longer-term immunity than the influenza vaccine, meaning you won't necessarily need a new vaccine every year. And for more about the future of the coronavirus, learn How the Second Wave of Coronavirus Could Be Even Worse.
"Will there be different versions of the coronavirus vaccine available?"
The flu vaccine is available as both a nasal spray and as an injection (the flu shot). According to Xu, various vaccine formats are being developed at the moment, but it is too early in the testing stage to know whether different versions—like nasal and injection—will be available for the coronavirus vaccine.
"Will you need to get the vaccine if you've already had the coronavirus?"
Xu says it's possible that people who have already had the coronavirus may still need to get the vaccine, similar to those who have had the flu but still need to get a flu shot every year.
"Not everyone that has had the coronavirus generates a protective antibody response," he explains. "Even if someone is exposed to COVID-19, current studies show that 70 to 80 percent of people exposed to the virus generate a strong antibody response, 10 to 15 percent generate a weak antibody response, and more than 10 percent of people never generate any antibody against the virus." Those in the weak or no antibody response groups, which can be determined after an antibody screening, will still need to take the vaccine, according to Xu. And for more about antibody tests, this is The Only Reason You Shouldn't Get an Antibody Test.