COVID-19 vaccine has been distributed, what now?

ByKate Larsen and Tim Didion KGO logo

Wednesday, December 16, 2020

COVID-19 vaccine has been distributed, what now?

As we watch the COVID-19 vaccine rollout with a mixture of hope and anticipation many questions are still on the table. Stanford doctors attempt to answer those questions and breakdown what happens next.

SAN FRANCISCO (KGO) -- As we watch the COVID-19 vaccine rollout with a mixture of hope and anticipation many questions are still on the table.

When and where are you likely to get a vaccine? And which one will be available? The answer according to Stanford infectious disease expert Dr. Yvonne Maldonado, M.D. starts with what we do know, followed by what we don't.

"That is health care workers, essential workers, you know, high-risk conditions, over 65, all that stuff. And then I think it's really going to be up to the governor's task forces to decide how to allocate based on that," she explains.

Now, as the first vaccine deliveries reach California, Governor Gavin Newsom's team is fine-tuning distribution plans with the counties, prioritizing which hospital workers get the first doses, as well as elderly residents in various levels of care facilities, then turning to the broader numbers.

"You know, what's your positivity rate? How many doses do you think you can start off with? And how do you think you're going to faze it in, how many people fill in each of the different categories?" says Dr. Maldonado, explaining the broad criteria.

If you're in an early group you'll most likely get the Pfizer vaccine, with a similar formula from Moderna expected to be cleared soon as well, another from AstraZeneca could follow. All of these require two doses, including a booster, spread anywhere from three weeks to a month apart. But another candidate, still in a clinical trial at Stanford, is from Johnson and Johnson and could require just a single dose.

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Since the coronavirus started spreading across the globe in late 2019, scientists have been looking for a vaccine. Now that vaccines are proven, it will ultimately be up to each state to determine who will get the vaccine, and when?

"You know, clearly, if you can make a vaccine that you would only need to give a single dose of, that would represent a major step. From a practical point of view, it's so much easier to deploy a single-dose vaccine than it is to do it twice," says Stanford immunology researcher Bali Pulendran, Ph.D.

Especially considering volume. The federal government has reached agreements with major drug chains Walgreens and CVS to administer vaccines. Hospitals and clinics may handle a significant portion of the early load. And there have been discussions about public vaccination sites, similar to the drive up tents used for early virus testing.

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So how long will the lines be? Berkeley epidemiology professor Arthur Reingold, M.D. says, that's harder to calculate.

"It's only based partly on projections of how many doses of vaccines that we presume will be approved for use and available, number one. Number two, we don't know the extent to which some people will not be interested in vaccination will refuse vaccination out of whatever concerns they have. So to be perfectly honest, nobody can predict with certainty what the vaccine availability will be," Dr. Reingold argues.

Another unknown is whether some people may want to wait for a specific vaccine, if they feel more confident that it's right for them. And right now, there's no definitive word on how long your immunity will last, although preliminary data from Moderna found antibodies at least four months after inoculation.

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Finally there's the issue of cost. Most health insurance plans are expected to pick up most or all of the out of pocket expense. But during the campaign president-elect, Biden went further, suggesting the vaccine should be made available free of charge to everyone.

And what about after you've had the vaccine? Doctors are recommending that you continue to wear a mask until the virus is under control. That's because while the vaccine will likely prevent you from getting sick, researchers still aren't certain if a vaccinated patient could carry enough of the virus in their system to transmit it to others.

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