Our Vaccine Expectations Are Unrealistic

here's what happened in Virus News today. Spain, the country with the most cases in Europe, is closing nightclubs and asking local authorities to enforce a law that bands drinking in the streets. The country also prohibited smoking if people can't maintain a distance of at least two meters that it's meant to prevent clusters of smokers outside night spots and restaurants. More than a third of Americans say they won't get vaccinated when a COVID nineteen vaccine becomes available.

According to an NPR PBS News Our Merist poll of around twelve hundred adults, about thirty five percent of people won't line up for the shot when it's ready. The resistance to the vaccine is split by party and education. With Democrats and college educated people more likely to say they will get inoculated. Vietnam may order up to one hundred and fifty million doses of Russia's coronavirus vaccine, according to a local newspaper citing the country's acting health minister.

Vietnam reported eighteen new infections on Friday, including seventeen locally transmitted cases and one imported. According to the Health ministry, Russia has rushed its vaccine plan despite international criticism, and we'll start mass inoculation this month before clinical testing is completed. On Thursday, the Philippines said it would join the final phase of clinical trials for the vaccine starting October, and President Rodrigo du Terte expects to be inoculated by May.

And now for today's main story. In the fight against COVID nineteen So many are pinning their hopes on a vaccine, but how long will it take. Russia's super fast tracked COVID nineteen one is technically the first in the world, but the first vaccine may not be the best one, and even with other vaccine trials underway around the globe, it would be wrong to think we can resume normal

life as soon as we have one. I spoke to Bloomberg healthcare reporter Michelle fake Cortez, who explains why Russia's approach to vaccine development is so different and why the world may be expecting way too much from an inoculation. What is actually the realistic timetable of us having a vaccine from where we are right now, in the weeks or months ahead when you think about it, the most

advanced trials are going to enroll thirty THOU people. Maderna is one of the ones who's in the very forefront of this effort right now. As of the first week of August, they had enrolled about six percent of the thirty THOU patients that they're planning on enrolling. That means more than of those thirty patients still need to be found entered into the clinical trial and get their first injection.

The thing to keep in mind is that everybody needs two injections of most of these vaccines, and they have

to come a month apart. So if we spend the month of August enrolling patients in this trial, and then we spend the month of September giving everyone the second injection, then perhaps we'll spend the month of October seeing whether or not the vaccine is offering any protection, and the fact that we're seeing some decreasing numbers of infections actually works against us in this particular context, because in order to show that a vaccine works, the people who have

been vaccinated have to naturally come into contact with the pathogen. We're not doing challenge trials where people are being exposed intentionally to coronavirus, so you have to encounter it in your natural life. If you're being very careful, which hopefully everyone is, you're wearing a mask, your social distancing chances are you're not going to be exposed to it that much, so they need to give you a little bit more

time in order to have that exposure. If we don't get those numbers, then it's going to be hard to show whether or not the vaccine works and how effective it is in the context of people who have been exposed. So that would be happening over the month of October. Then we're looking at November for analyzing these data, and so perhaps by late November early December we might be seeing some of the results. But that's just for the

Maderna trial that has already started. The other trials aren't even supposed to start until later in August or September and even October. From the news that we've had out of Russia that they have approved, you know, a vaccine test and they actually think that they have a viable vaccine, are we aware of exactly what steps they have moved forward? A little bit more quickly then than what we would

see in the States. Russia has actually been very open about what they're doing, which is a little bit surpris rising to me in the U. S. We've heard all these announcements from the government that they're buying vaccine doses, and not only are they buying them, they're actually manufacturing them and their stockpiling them in warehouses, and they're going to wait until the clinical trial results come in and show whether they're beneficial or not, and if they work,

we will have this huge dose build up that we can start rolling out to our citizens. In Russia, they're taking the opposite approach these vaccines. As I said earlier, thirty people are being enrolled in these trials in Russia. They're saying, what are you more afraid of? Are you more afraid of the coronavirus? Are you more afraid of the vaccine. If people are willing to roll the dice on this, why don't we just let our entire citizenship

decide for themselves if they wanted or not. So they've been very open that they haven't even started their phase three clinical trials. They have results on a few hundred people, just like the other trials that show that there have been no devastating side effects, no anaphylactic show, no one dying because they were using this coronavirus vaccine. And in Russia they're just going to let people make that own decision.

It's a right to try situation. If you want to get the vaccine, you can get it, and they have approved it. And so now they're claiming to have generated the first formally approved coronavirus vaccine. But the bottom line is is that's not an effective vaccine. They have not approved a vaccine that's proven to be effective. So it's not going to be who's first. It's going to be which one works the best, and we just don't know that.

In the US, we're going to be behind if the vaccines all work, because we're going to have waited for the results. In Russia, they're going to be first, but they might not ever know whether they're vaccines work or not because the benefit that comes might not be entirely and immediately apparent. It depends on how much exposure you have to the virus. And if you're not tracking these people and monitoring how many people do get infected and how many don't, they'll never know how well and whether

it's working. So I'm just wondering along those lines, are there other potential health risks to exposing a population to this vaccine that hasn't had this extent of trials as we're seeing in the US. In addition to side effects like muscle pain, weakness, fever, that sort of thing, there is a really very frightening complication that can come from vaccination, which we've seen with other types of immunizations, including for DANAE and other things. And what happens there is the

vaccine primes your immune system. It tells the immune system what to look for that another pathogen, a bad virus could be coming after it, and it allows the immune system to start to start bulking up to take on that fight. But there are cases where priming the immune system actually leads to a worse infection. In the end, So those people who have been vaccinated and then see the virus again naturally from the community actually have a

worse case. They're more likely to get sick, they get more severely ill, and they have an increased risk of dying because of the implication of the vaccine. That's the thing that in the United States and in most of the western world, that public health officials want to be sure that they're not going to actually take people who are completely healthy and who might not ever be exposed

to coronavirus and actually make those people worse. Looking ahead for the United States, and let's say that a successful vaccine candidate is determined by stay at the end, and we start distributing that vaccine in early what does this actually mean in terms of lockdowns, quarantines, our ability to travel or go out to bars. What actually will the vaccine help us to regain in terms of wanting to return to our normal lives. People really do have a

misperception of what this vaccine is going to mean. And I think that's really to the detriment of all of us and perhaps a shortcoming of the scientific media and public health officials that we're not doing a better job of communicating this to the public, and we're going to have the same problem that we did when it came to the summer and they need to reopen our economies.

Everybody thought we're going to lock down for a few weeks, for a few months, and then we're going to get back to normal, and when that didn't happen, people were flaw mixed, and it created so much stress intention in the entire world, and we're setting ourselves up for another situation exactly like that. A vaccine is not a panacea in this case. It's not even going to be close to a panacea or a magic bullet. People might think of a vaccine a way that you think of it

as a as an immunization for measles. If you get vaccinated against the measles, you almost definitely are not going to get measles. Chances are because everyone else is also vaccinated and we have herd immunity. Measles doesn't spread very much, so you would probably never even come into contact with it, and if you did, that vaccine would protect you so you don't have to worry about it. That's not the

case with coronavirus. We have heard from Dr Fauci and others that they're hoping that we're going to get to be about sevent effective with the first coronavirus vaccines, and in fact, if it only protects only half of the people who get it, they're going to consider that effective. That's what's going to be needed in order to get the vaccine approved. But what that means is that one of every two people who are vaccinated might not get

any protection from the vaccine. So if you go out, it might protect you or it might not, and you will have no idea which camp you're going to fall into. So it's not like it's going to be a magic bullet that once you're vaccinated you can go out into the public. Again, the other thing to keep in mind is going back to that issue of herd immunity. We know that between sixty and of the population needs to have some type of immunity against coronavirus in order to

stop it from spreading. The ways that we get immunity are from people who have already had it and recovered and from people who are vaccinated against it. But again, if only of people get any kind of immunity, even if you've vaccinated a hundred percent of the population. If it's only effective, you're still not at herd immunity, and then you're going to have to wait until the number of people who have been infected catches up and get

you to that higher level. And that's also supposing that a hundred percent of people get vaccinated, which we all know, sadly in our current environment that that's not going to happen. That was Michelle Fake Cortez and that's it for our show today. For coverage of the outbreak from one hundred and twenty bureaus around the world, visit Bloomberg dot com slash coronavirus and if you like the show, please leave us a review and a rating on Apple Podcasts or Spotify.

It's the best way to help more listeners find our global reporting. The Prognosis Daily edition is produced by tophra Forehaz Jordan Gospore, Magnus Hendrickson and me Laura Carlson. Today's main story was reported by Michelle Fake Cortes. Original music by Leo Sidran. Our editors are Francesco Levi and Rick Shine. Francesco Levi is Bloomberg's head of Podcasts. Thanks for listening. Two