Illustration: Annelise Capossela/Axios

The first coronavirus vaccine may arrive soon, but it’s unlikely to be the knockout punch you may be hoping for.

Why it matters: The end of this global pandemic almost certainly rests with a vaccine. Experts caution, however, that it’s important to have realistic expectations about how much the first vaccines across the finish line will — and won’t — be able to accomplish.

Where it stands: Work on a coronavirus vaccine is moving at an unprecedented pace. There are nearly 200 candidates in development, 27 are being tested in humans and a handful are already in an advanced phase of clinical trials.

  • Each new bit of positive news out of that effort makes the pie-in-the-sky best-case scenario — that one of these products will prove out and win at least an initial nod from the FDA by early next year — seem more plausible.

Yes, but: First-generation vaccines often aren’t the ones that stop a new virus in its tracks, and experts’ hopes for an initial coronavirus vaccine are much more modest.

  • “Right now, we just need something that's going to mitigate the damage this virus causes,” said Amesh Adalja, an infectious-diseases expert at Johns Hopkins University. “Maybe it doesn’t prevent you from getting infected, but it prevents you from getting hospitalized, or prevents you from dying … that would be huge.”

How it works: Some vaccines, like the one for measles, mumps and rubella, produce near-complete and long-lasting immunity. Others, like the annual flu shot, are important tools to help contain a virus but don’t achieve “sterilizing immunity.”

  • It's not yet known how much protection any of the potential coronavirus vaccines might provide, or how long it would last.
  • "It's hard to make vaccines against coronaviruses," said Mark Poznansky, an infectious-disease specialist at Massachusetts General Hospital. "It doesn't mean its not possible but it is a challenge, especially with COVID-19, where we don't yet understand the inflammatory response to the virus and what part of the immune response is critical to prevent infection."
  • While the initial evidence for COVID-19 vaccines seems promising, second- and even third-generation products will likely target more of the virus and, hopefully, generate stronger and longer-lasting immunity than the first few vaccines will offer, Poznansky said.

Vaccinating enough people to get safely back to our old, communal habits will also pose more practical challenges.

  • Even with a jump start on manufacturing, which is happening now, there won’t be enough supply, at least at first, to address the sheer scale of a global pandemic. So we need some kind of system to distribute the global supply, and then to prioritize who in the U.S. gets our doses.
  • And if distrust in a vaccine stops large numbers of people from getting it, then the U.S, may not achieve the "herd immunity" that prevents widespread outbreaks.

Two of the leading candidates — drugs under development by Oxford University and the U.S. biotech firm Moderna — require patients to get two shots.

  • So if you want to vaccinate 300 million people, you’ll need 600 million doses. And getting 300 million doses will already be a tall order.

The bottom line: Even after a vaccine becomes available, the coronavirus may still hang around, infect and even kill people. The numbers would just be lower.

  • That may not be what the quarantine-weary public is imagining, but experts say it’s a realistic expectation — and would be an incredible step forward.

Go deeper: A vaccine reality check from an ex-CDC director

Go deeper

Bryan Walsh, author of Future
Oct 26, 2020 - Health

Rockefeller Foundation commits $1 billion for COVID-19 recovery

A health worker performs a COVID-19 test in New Delhi. Photo: Raj K Raj/Hindustan Times via Getty Images

The Rockefeller Foundation announced on Monday that it will allocate $1 billion over the next three years to address the pandemic and its aftermath.

Why it matters: The mishandled pandemic and the effects of climate change threaten to reverse global progress and push more than 100 million people into poverty around the world. Governments and big NGOs need to ensure that the COVID-19 recovery reaches everyone who needs it.

Oct 25, 2020 - Health

Ex-FDA chief: Pence campaigning after COVID exposure puts others at risk

Former FDA commissioner Scott Gottlieb said "the short answer is yes" when asked whether Vice President Mike Pence is putting others at risk by continuing to campaign after several aides tested positive for COVID-19, stressing that the White House needs to be "very explicit about the risks that they're taking."

Why it matters: The New York Times reports that at least five members of Pence's inner circle, including his chief of staff Marc Short and outside adviser Marty Obst, have tested positive for the virus. Pence tested negative on Sunday morning, according to the VP's office, and he'll continue to travel for the final stretch of the 2020 campaign.

Updated 37 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Politics: Axios-Ipsos poll: Federal response has only gotten worse. The swing states where the pandemic is raging.
  2. Health: The coronavirus is starting to crush some hospitals. 13 states set single-day case records last week.
  3. Business: Where stimulus is needed most.
  4. Education: The dangerous instability of school re-openings.
  5. States: Nearly two dozen Minnesota COVID cases traced to 3 Trump campaign events
  6. World: Unrest in Italy as restrictions grow across Europe.
  7. Media: Fox News president and several hosts advised to quarantine.

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