Ask Dr. Halverson: 'The race for a COVID-19 vaccine'

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By Dr. Jim Halverson
When will the coronavirus pandemic no longer alter our daily routines, affect our economy or threaten our health or the health of our family and friends? Some suggest we should go quickly toward normal now. Stop social distancing for all but those at high risk, reopen businesses and resume daily routines similar to 2019. This approach would recommend that more than 50 million Americans continue to shelter in place while the rest resume their jobs, vacations and weekend get togethers. 
It would put those over age 65 and with compromised health conditions at even greater risk than they are now as more “low risk” would become ill. 
The argument that most of those low risk would have mild cases is also a dangerous one. Currently in California, more than 10 % of deaths from COVID-19 have occurred in those under the age of 65. Therefore, I believe our lives will return to our “new normal” when we have an almost perfect drug to treat COVID-19, or when a least 75% of people in our country (and ideally the world) have immunity obtained from a safe and effective vaccine against the novel coronavirus.


A vaccine is our greatest hope. A near-perfect drug is very unlikely to happen anytime soon. It would need to be at least 95% effective. None of the current drugs in randomized clinical trials are near that powerful. This drug would also need to be extremely safe and easily available to people worldwide. 
Here is a quick explanation of how our immune system works. When a disease pathogen (in this case the novel coronavirus) gets into our body, our immune system responds by producing antibodies that attach to substances called antigens on the surface of the virus. This process then activates our immune protective cells to attack and defeat the virus. Our immune system also keeps a record of every virus it has defeated so that it can quickly recognize and prevent recurrent infections by that virus.
Vaccines circumvent this whole process by teaching your body how to defeat a virus without ever getting sick. Vaccines stimulate our immune system to produce disease-specific protective antibodies. The two most common vaccine types are inactivated vaccines that contain all or part of viruses that have been killed (such as the yearly flu vaccine) and live attenuated vaccines, which use a weakened form of the virus (such as the MMR and chickenpox vaccines). Recently, researchers have also developed RNA and DNA vaccines. By injecting a small part of the viruses’ genetic code, you essentially turn your body into its own vaccine-manufacturing unit.


Developing safe and effective vaccines takes time. Very rigorous standards have been developed to protect all of us from serious side effects. To fully test a potential vaccines safety and effectiveness it must go through three phases of human trials.
PHASE ONE is the safety trial. A small group of healthy volunteers gets the vaccine candidate. You try out different dosages to create the strongest immune response at the lowest effective dose without serious side effects.
PHASE TWO tells you how well the vaccine works in the people who are intended to get it. This time, hundreds of people get the vaccine. This cohort should include people of different ages and health statuses.
In PHASE THREE, you give the vaccine to thousands of people. This is usually the longest phase because it occurs in what’s called “natural disease conditions.” You introduce it to a large group of people who are likely already at risk of infection by the target pathogen, and then wait and see if the vaccine reduces how many people get sick.
The normal developmental time for this process is at least five years. This time has already been substantially shortened by the massive worldwide effort to create a vaccine. As of April 9, there were 115 different COVID-19 vaccines in development. Several are now in phase 1 trials and one has just been given FDA approval to start phase 2. Hopefully, a safe and effective vaccine will be available in the next six to 12 months.


Humankind has never had a more urgent task than creating broad immunity for this virus. The medical and scientific communities are working with unprecedented cooperation worldwide to develop a vaccine that will help return all of our lives to a new normal. Our lives and livelihood and those of our family, friends and world citizens depend on it.
Stay safe and stay well.
— Dr. Jim Halverson is a longtime Ojai physician who is providing weekly COVID-19 information for Ojai Valley News readers.