When a COVID-19 vaccine is ready, will we all be ready for it?
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EDITORIAL
When a COVID-19 vaccine is ready, will we all be ready for it? Marta Fadda1 • Emiliano Albanese1 • L. Suzanne Suggs1 Received: 15 May 2020 / Revised: 27 May 2020 / Accepted: 28 May 2020 Ó The Author(s) 2020
The current response to the COVID-19 pandemic involves aggressive implementation of containment, suppression, and mitigation strategies. Such an approach encompasses the enforcement of a variety and combination of public health measures including hand hygiene and respiratory etiquette, disinfection, case identification, isolation of sick people, tracing and quarantine of contacts, and unprecedented mass community restrictions. Besides considerable investments in interventions to contain transmission, and in diagnostics and therapeutics research, whose way forward is framed within the WHO coordinated global research roadmap (WHO 2020), a vaccine represents the most promising strategy for combatting the COVID-19 pandemic through primary prevention. In addition to bio-tech companies and governments pushing, and in some cases suggesting, that a vaccine may be available as early as Fall 2020, it is widely believed that an effective and available vaccine will be ready for licensure no sooner than 12–18 months from now (Kormann 2020). Five phase I clinical trials are ongoing in the USA and/or China and other trials are expected to be initiated soon in Germany and the UK (Le et al. 2020). The sole availability of a vaccine does not equal uptake. For example, in 2009, despite a vaccine against influenza A H1N1 being offered before or at the onset of the second epidemic wave, vaccination rates were lower than expected, with population coverage ranging from 0.4 to 59% across 22 countries (Mereckiene et al. 2012). The low uptake of an available vaccination for a high risk infection has been called a ‘‘pandemic public health paradox’’ (Reintjes et al. 2016), to which vaccine hesitancy (i.e. ‘‘the reluctance or refusal to vaccinate despite the availability of vaccines’’) significantly contributes. While hesitancy level and reasons vary by vaccine, geographic location, health system, accessibility and availability and can be driven by & Marta Fadda [email protected] 1
Institute of Public Health, Universita` Della Svizzera Italiana, via Buffi 13, 6900 Lugano, Switzerland
emotional, cultural, social, and political factors as much as cognitive ones (MacDonald et al. 2015), one characteristic is universal; vaccines only protect if enough people get them. As the world is focused on combatting COVID-19 by imposing protective and preventive measures, the expectation is that an effective vaccine will come to market and allow us to contain the spread of the virus. However, vaccine availability is necessary but not sufficient to attain a significant reduction of susceptible individuals through active acquired immunity. Public opinion and trust in the vaccine is of paramount importance for adequate coverage. The current pandemic entails three unique challenges for public confid
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