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The vaccines are coming! The vaccines are coming!
Hold it. Not for most of us. Not now.
For maybe six months our 'vaccine” remains 'wear your mask, social distance, and wash your hands.”
By then, hopefully, over 70 percent of Americans will be vaccinated or next in line - the participation required to restrain COVID-19. Can enough anti-vax folks be converted? Acceptance percentages are increasing, but a recent poll indicated, at that time, even 60 percent of nurses and 40 percent of doctors were not planning to be vaccinated.
There are reasons why most drugs' clinical trials take years not months. Participants in the BioNTech SE (Pfizer) trial will be followed for two more years while the vaccine is being administered.
There's no rational reason to refuse inoculation. But there are still questions, and evolving answers, as the world's beta test group expands from thousands to millions. Here's a checklist.
Global pandemics require global eradication. It took the World Health Organization 25 years to eradicate smallpox.
The BioNTech SE vaccine requires refrigeration at minus 94 degrees. Packing requires dry ice, now in short supply. Dry ice produces CO2 that, on planes, risks combustion.
Only 25 countries have access to minus-94-degree refrigeration, thereby excluding five billion people from vaccination.
Nor is equity guaranteed in the U.S. distribution to people of color, the poor, immigrants, prisoners, and low population rural areas.
Best case, distribution from manufacturers' plants to Americans' arms is a logistics nightmare, and the last mile is 50 governors' responsibility. How has that been working for us the last 10 months?
What does 'inoculation” mean? Will everyone show up for their second shot? What's known about dosages? AstraZeneca discovered cutting the first dose in half dramatically improved results. Protection for mild infections only or more? For six months or a lifetime? Will annual vaccinations be required? Can those vaccinated still infect others? Has anyone been tasked with maintaining a national database of those vaccinated?
Little is known about the vaccines' safety and effectiveness with children, pregnant women, and the oldest of the elderly. Five of the FDA's Advisory Committee did not vote for approval, two because it was approved for those 16 and above. Two cases have revealed additional side effects for those with allergies. What additional side effects may emerge, for which groups, and how serious will they be?
Follow the money. Is this a profit maximization operation? Or is health care a right - especially when no one is protected from a global pandemic until everyone is? Who pays? Who profits? Vaccine recipients? Individual states? The federal government? Pfizer's CEO proclaimed its vaccine a success. The stock price escalated and he sold $5 million of his Pfizer shares.
Ultimately, every American who wants a vaccine can have one. By then we'll know more about these vaccines. They can help mitigate COVID-19 cases and deaths. Sadly, our need, our goal is not mitigation but global eradication.
Nicholas Johnson, Iowa City, is former co-director of the Institute for Health, Behavior and Environmental Policy. email@example.com