The United States is in a race against time to vaccinate as many people as possible before other potentially more worrying variants of the coronavirus emerge, according to experts.
Vaccination efforts in the US have been hampered by delivery problems, insufficient supply and hesitation to get vaccines. But to prevent another outbreak of infections, hospitalizations and deaths, scientists say it may be necessary to rethink how vaccines are launched to increase the number of injections administered and to protect against new strains of the virus.
“We are really in a race against new variants,” said Wan Yang, assistant professor of epidemiology at Columbia University’s Mailman School of Public Health. “We need to prepare as much as possible before things increase to a level that puts more pressure on our health systems.”
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The vaccines, one from Pfizer-BioNTech and the other from Moderna, appear to be effective against a more contagious variant that was first reported in November in the UK. With a separate variant believed to have emerged in South Africa, however, Moderna’s first laboratory studies showed a drop in the level of antibodies produced by the company’s vaccine. Although Moderna said the antibodies remained above protective levels, the development prompted the company to start updating its existing vaccine to make it more effective against emerging strains.
In the meantime, it is essential that states try to vaccinate as many people as possible, said Ali Mokdad, professor of global health at the University of Washington. This may mean thinking beyond the progressive approach that prioritizes certain age groups and professions and, instead, offering a vaccine to anyone who wants to.
“You can save lives by targeting the vaccine to the elderly, but there will come a time when we will have enough vaccines, where these phases for those who go first, second and third must be abolished immediately,” said Mokdad.
Mokdad warned that the United States has not yet reached this point, because there are still many obstacles to overcome in the supply and distribution of vaccines. Across the country, the distribution of vaccines has been uneven, with some states struggling to administer all the doses they have received and others being forced to cancel appointments because of reduced supplies.
“The reason we are doing this phased approach is because the supply is limited,” said Deepta Bhattacharya, an associate professor of immunobiology at the University of Arizona. “Generally speaking, if you can fix supply problems, you can vaccinate as many people as quickly as possible.”
Without a stable channel between manufacturing and distribution, Mokdad said, the country remains vulnerable if a new strain begins to circulate that is more contagious or deadly or that could escape current vaccines.
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The outlook is not entirely unfounded, said Dr. Robert Califf, head of strategy and medical policy at Verily Life Sciences.
“The more infected people there are over time, the greater the chance that the virus will mutate,” said Califf, a professor of medicine at Duke University who was a commissioner of the Food and Drug Administration in the Obama administration. “If we do not control the pandemic, there is an increased risk that one of these mutations will escape the vaccine or therapeutic antibodies, or both.”
This makes it even more important to contain outbreaks – with standard mitigation measures, like wearing masks, practicing social detachment and avoiding large or in-house meetings – while vaccine researchers try to stay one step ahead of the evolving virus, according to experts .
“It’s like a competition between the virus and science,” said Califf.
But there are some reasons for optimism, Bhattacharya said, pointing to signs that the Biden government is building a more coordinated federal response than its predecessor. Supply problems can also be mitigated soon if other vaccines, including those developed by Johnson & Johnson and Novavax, are authorized for use in the U.S.
“It has been frustrating,” said Bhattacharya, “but I am quite confident that some of the bottlenecks will begin to be eased.”
