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The End of the Beginning: COVID-19 Vaccines & Other Conundrums

Philip Seo, MD, MHS  |  Issue: January 2021  |  December 9, 2020

For the others, we should learn from D.A. Henderson’s example. More than anyone, Dr. Henderson is personally responsible for eliminating smallpox from Western and Central Africa.18 He said it was simple: He would travel to a village and gather everyone together so they could watch him and the local leader receive the vaccine. He was vaccinated hundreds of times, convincing village after village to accept the smallpox vaccine by this simple act.

Following in this model, former Presidents Bush, Clinton and Obama have all agreed to be vaccinated publicly, to try to convince others to follow suit.19 Having the cameras rolling as Steph Curry and Beyoncé received the vaccine would be even better. But it won’t be enough. Like Henderson’s experience with smallpox, the battle against COVID-19 will need to be fought village by village, by convincing local leaders to lead by example.

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This is where you come in. Each of you is a local leader, whether or not you see yourself in that way. Those around you will look to you and the example you set. This is a difficult position to be put in, since we, better than most, understand the risks of a new vaccine. But the nation needs our help. We are tantalizingly close to an end to this nightmare. We just have to roll up our sleeves—literally!—and give everyone a push in the right direction.


Philip Seo, MD, MHS, is an associate professor of medicine at the Johns Hopkins University School of Medicine, Baltimore. He is director of both the Johns Hopkins Vasculitis Center and the Johns Hopkins Rheumatology Fellowship Program.

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References
1. Moderna’s COVID-19 vaccine candidate meets its primary efficacy endpoint in the first interim analysis of the phase 3 COVE study [press release]. Moderna. 2020 Nov 16.
2. Vaccines and related biological products advisory committee meeting. FDA briefing document. Pfizer-BioNTech COVID-19 vaccine. 2020 Dec 10.
3. Voysey M, Costa Clemens SA, Madhi SA, et al. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: An interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet. 2020 Dec 8. Online first.
4. Burton TM. FDA to require proof virus vaccine is effective before approving its use. The Wall Street Journal. 2020 Jun 30.
5. Roberts M. Oxford/AstraZeneca Covid vaccine ‘dose error’ explained. BBC News. 2020 Nov 27.
6. Callaway E. Why Oxford’s positive COVID vaccine results are puzzling scientists. Nature. 2020 Nov 23.
7. Miller E, Lemire J. Trump administration passed up chance in summer to buy millions of additional doses of Pfizer’s COVID-19 vaccine. Chicago Tribune. 2020 Dec 8.
8. Arora N, Bhattacharjee N. India speeding up review of Pfizer, AstraZeneca COVID-19 vaccines: Senior official. Reuters. 2020 Dec 6.
9. Smith JC, Hinman AR, Pickering LK. History and evolution of the Advisory Committee on Immunization Practices—United States, 1964–2014. MMWR. 2014 Oct 24;63(42);955–958.
10. ACIP Presentation Slides: December 2020 Meeting. Centers for Disease Control and Prevention. 2020 Dec 1.
11. LaFraniere S, Thomas K, Weiland N. Trump administration passed on chance to secure more of Pfizer vaccine. The New York Times. 2020 Dec. 7.
12. McGinley L, Abutaleb Y, Johnson CY. Pfizer tells U.S. officials it cannot supply substantial additional vaccine until late June or July. The Washington Post. 2020 Dec 8.
13. Mutambudzi M, Niedwiedz C, MacDonald EB, et al. Occupation and risk of severe COVID-19: prospective cohort study of 120 075 UK Biobank participants. BMJ. 2020 Dec 9. Online first.
14. Knoll MD, Wonodi C. Oxford–AstraZeneca COVID-19 vaccine efficacy. Lancet. 2020 Dec 8. Online first.
15. Funk C, Tyson A. Intent to get a COVID-19 vaccine rises to 60% as confidence in research and development process increases. Pew Research Center. 2020 Dec 3.
16. Hinsliff G. It’s the ‘vaccine hesitant,’ not anti-vaxxers, who are troubling public health experts. The Guardian. 2020 Nov 16.
17. Ruane ME. The tainted polio vaccine that sickened and fatally paralyzed children in 1955. The Washington Post. 2020 Apr 14.
18. DG McNeil Jr. DA Henderson, doctor who helped end smallpox scourge, dies at 87. The New York Times. 2016 Apr 21.
19. Diaz J. Obama, Bush, Clinton say they’re willing to get Coronavirus vaccine on camera. 2020 Dec 3. NPR. KQED.

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