Opinion / Chris Smith
Dose of realism
Some of my financially motivated friends were not celebrating with the rest of us on Monday. “I wish I’d bought shares in Pfizer,” reflected one, ruefully, as the markets surged off the back of the good news about the coronavirus vaccine that the US pharma giant is developing. It comes as a welcome shot in the arm for the nation’s flagging morale but, as the UK’s deputy chief medical officer Jonathan Van-Tam commented at a recent press briefing, “One swallow doesn’t make a summer.” What he’s getting at is that these results from Pfizer are preliminary. The phase three trial that will formally show whether the vaccine really works isn’t even over yet and some major questions remain unanswered.
We’re told that the vaccine is 90 per cent effective. So, turning that around, it means that it doesn’t work for one person in ten. So who are those 10 per cent? If they’re chiefly the patients that are also destined to become severely ill from coronavirus, then that makes the vaccine a lot less useful. And how long lasting is the immunity that’s conferred by the new vaccine? The trial has been running for only a matter of months, which means we can only say with certainty that the protection lasts that long. So will we have to find out the hard way that immunity has worn off?
Looking on the bright side, let’s assume that the odds are in our favour and those vulnerable to severe coronavirus are protected. Does that mean we can get back to normal? Ultimately this is likely but not for a long time – a year, realistically. Manufacturing vaccines at the scale required to protect entire populations will be no mean feat; globalisation has resulted in many countries outsourcing vaccine-manufacturing capacity to just a handful of specialist providers. Physically distributing a vaccine that – in the case of Pfizer’s agent – needs to be stored at minus 80C is another major challenge. Then there’s the issue of administering it. In the UK alone we struggle to vaccinate 15 million people against the flu every year, and coronavirus will require us to upscale this by 400 per cent. There’s also the consideration that, alarmingly, surveys in some countries suggest that as many as half of all adults might be reticent to take up a vaccine due to safety concerns.
So, while I welcome the news that at least one of the 20-plus coronavirus vaccines currently in clinical trials is looking likely to reach the finishing line, I am under no illusions that we’re out of the woods or that our present handshake-free, physically distanced existence is going away soon. I do wish I’d bought some Pfizer shares too though…
Chris Smith is a consultant clinical virologist at Cambridge University. He has served as Monocle 24’s health correspondent during the pandemic and also presents ‘The Naked Scientists’ podcast and ‘5 Live Science’ on BBC radio.