COVID-19 vaccine distribution is a reason for optimism as we ring in the new year

Written by: Parker Davis
Edited by: Esther Melamed

Since Pfizer and Moderna received Emergency Use Authorization from the FDA for administration of their COVID-19 vaccines back in December, we have witnessed the beginnings of a vaccination campaign of unprecedented proportions. The first dose was given on December 8, 2020, to a woman in the UK, followed shortly thereafter by the first administration in the US on December 14. As of January 14, 2021, more than 35 million doses of the COVID-19 vaccine have been administered worldwide, 11.9 million of which were in the US, according to Bloomberg.com (this figure is a combination of both Pfizer and Moderna doses). While this is a great start, delays and logistical challenges in distribution have meant that we are still far short of the approximately 20 million doses that both vaccine manufacturers predicted by the end of 2020 – across all states, only 39% of distributed doses have been administered. Nationally, an average of only 3.6 doses per 100 people have been delivered. This figure is the same in Texas, for a total of roughly 1,000,000 individuals having received one dose, and 132,000 receiving both (Bloomberg.com). Even in the state with the highest rate of administration – West Virginia – the statistic is only about 7 people per 100.

The Texas Department of State Health Services has outlined a distribution plan that follows distinct phases of inclusion. Currently, in the “Limited Supply” category, administration is mandated for those in direct care of patients, employees and residents of Long-Term Care facilities, and all individuals aged 65 and older, or aged 16 and older with “at least one chronic medical condition, including pregnancy,” (For more information, visit dshs.state.tx.us). The individuals now receiving the vaccine comprise the 1A and 1B phases of rollout. The DSHS has not yet enumerated the individuals who will be covered in subsequent phases – including 1C, 2, and 3 – which will become active as additional supply is made available.

An important clarification to make is what the actual effect of vaccination is on the body and one’s chances for re-infection, transmission of the virus to others, or infection with new strains, etc. The vaccine does not grant perfect immunity to SARS-CoV-2 or COVID-19. There are scenarios in which an individual may receive the vaccine and still become infected and develop COVID-19. 

Mechanistically, the mRNA vaccines provide a small, non-infectious dose of mRNA which your cells use to create viral proteins that they can then recognize as foreign and use to “train” the immune system. However, this training takes time (days to weeks, especially given the fact that both Pfizer and Moderna vaccines require two separate doses given weeks apart) and individuals can still become infected until fully immunized with two vaccine doses and develop the full suite of COVID-19 symptoms. Individuals that are infected just prior to receiving the vaccine can similarly contract the disease. Because they do not contain live viral particles and are not producing live particles in the body, one cannot contract COVID-19 directly from the vaccine itself (CDC.gov). Another important consideration is whether immunized individuals may still contract COVID-19 and spread it to other people while remaining asymptomatic themselves. This important question remains to be studied.   For these reasons, it is important that we continue to wear masks and maintain social distancing, even after receiving the vaccine shots.

As a final note, recent reports of novel strains of the SARS-CoV-2 virus have re-instilled concerns that our attempts to establish herd immunity via vaccination may not be foolproof. While we should use this new information to bolster our social distancing and mask-wearing efforts, it does not necessarily spell doom. Viruses, like all organisms, mutate to overcome obstacles in their environments, and this has been expected from the beginning of the COVID-19 pandemic. Even if we establish protection against the most widely circulating strains currently, there is a chance that a new strain will emerge to which our immunity may be lacking. But, of course,  this is the nature of the evolutionary arms race. The good news is that the vaccine makers understand this principle and have designed their vaccine production schemes to adapt rapidly to the changing viral landscape. Therefore, if new strains do arise, there is infrastructure in place now to roll out new doses more rapidly than ever before.

In closing, while there are still many unknowns about SARS-CoV-2 and we have to be more vigilant than ever given the current dire wave of infections, 2021 also brings a glimmer of hope that with powerful vaccines on-board, we are now better than ever equipped to take on the virus and hopefully defeat it in the months to come.