As Covid-19 rates continue to increase steadily and with the reproduction rate for the virus now at 1.8, we are all getting a little more concerned. Vaccine development, while always in the background, now has added urgency. So how long before a vaccine against Sars-CoV-2 will be available for use and who will be first in line to be immunised?
The fastest a vaccine has ever been produced before now is four years – that is how long it took mumps vaccine to get from the laboratory bench to widespread availability in clinics. But there is widespread confidence among scientists that this record will be shattered by current efforts to develop a vaccine against the coronavirus. US infectious diseases guru Anthony Fauci says he expects a vaccine will be produced by the end of December.
The pharmaceutical industry has committed huge resources to the search for a Covid-19 vaccine. There are more than 160 vaccines at various stages of animal and human testing at present, according to the World Health Organisation.
However, when the first Covid-19 vaccines become available, there won’t be enough for everyone who wants to be immunised. The discovery of a suitable vaccine is just the beginning. So the expected good news of a December breakthrough will be followed by a period when factories will have to work to produce vaccines to the required safety and quality standards – something that cannot really be expedited.
With a global population of 7.8 billion people, not everyone will be able to get the vaccine from the get-go. With the US and UK buying up millions of vaccine doses in advance from the two front-running pharma companies, some countries will get more access than others. In turn that means we will have to decide who gets priority.
Speaking to the Canadian Broadcasting Corporation, Dr Noni MacDonald, a professor of paediatrics and infectious diseases at Dalhousie University, with a special interest in ethical issues related to vaccines, said countries will need to find a way to get the maximum benefit for whatever minimal supply they have.
In my opinion it will be April 2021 at the earliest before we see the first administration of Covid-19 vaccine in Ireland
In Canada, that evaluation, based on evidence, is done by the National Advisory Committee on Immunisation, which is guided by the goals of Canada’s pandemic response: to minimise serious illness and overall deaths; and to minimise societal disruption, including reducing the burden on healthcare resources. In the Republic, NPHET will make a recommendation to government, based on advice from our national immunisation advisory committee, the national immunisation office and other expert groups.
You would expect frontline healthcare workers who care for Covid-19 patients to get the highest priority for access to vaccines, as they are at high risk of being exposed to the virus. Beyond that decisions get more complicated, but in general you would expect people that are at the highest risk of severe disease and death from Covid-19 to be targeted.
So to answer the question posed at the beginning of this piece, in my opinion it will be April 2021 at the earliest before we see the first administration of Covid-19 vaccine in Ireland.
Meanwhile my last column dealt with the long-term effects of Covid-19 infection. Since then an important piece of Irish research into the issue has been pre-published. Dr Niall Conlon, consultant immunologist at St James’s Hospital in Dublin and colleagues examined the prevalence of fatigue in individuals who had recovered from the acute phase of Covid-19 illness.
They found that, of 128 participants, more than half reported persistent fatigue some 10 weeks after initial Covid-19 symptoms. Interestingly, there was no association between the severity of the acute phase of Covid-19 and subsequent fatigue.
"Our findings demonstrate a significant burden of post-viral fatigue in individuals with previous SARS-CoV-2 infection after the acute phase of COVID-19 illness," the authors conclude.
mhouston@irishtimes.com