Will a COVID-19 Vaccine Save the Day?

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I hope that you and yours are weathering the storm in a crashing economy, but recovery depends on ending the pandemic.

Hopes are riding on a “warp-speed” vaccine. During this week’s coronavirus briefing, President Trump said his administration had reached an “historic agreement” with Pfizer to manufacture and deliver 100 million doses of its vaccine after it is approved for use, and eventually 500 million doses. The deal is worth $1.95 billion. This suggests that approval is assured.

Safety testing for the Pfizer vaccine was completed in 45 subjects. The highest of three vaccine doses was associated with fatigue, headache, or chills in more than 70% of recipients. Only the lower doses were used for the second injection, which caused more reactions than the first. More than half of those who received the intermediate dose (30 mcg) reported fever, fatigue, headache, chills, or muscle pain, and 100 percent reported headache after the second dose. But only a few were judged to be severe, so further testing could  proceed.

A rival vaccine is being developed by Moderna, which is recruiting 30,000 volunteers for Phase 3 efficacy studies at 89 sites in the U.S. A preliminary report on 45 subjects showed that all recipients of the intermediate or largest dose had some type of systemic reaction after the second injection (muscle or joint pain, fever, headache, chills, or fatigue), most judged to be mild or moderate.

It is too soon to rule out long-term complications such as autoimmune disease.

Despite his support for a vaccine, Trump also said, “You tell me, but I almost would prefer the therapeutics even first. You go into the hospital and you make people better. But we’re doing very well with remdesivir and other things. Steroids are turning out to be great, plasma is turning out to be good.”

He did not mention hydroxychloroquine (HCQ), which can also be used as a prophylactic at a dose as low as 200 mg/month. Prophylaxis is the approach used for malaria or HIV, for which there is no vaccine despite decades of effort. Patients are also given prophylactic antibiotics if exposed to tuberculosis, meningitis, anthrax, or other diseases.

Further information: Prophylaxis or early treatment with HCQ