In an interview with the JAMA on June 2, 2020, Anthony Fauci, MD, director of the U.S. National Institute of Allergy and Infectious Diseases (NIAID) said that while he was “cautiously optimistic” about the effectiveness of the vaccines being developed for COVID-19, he was concerned that any protection the vaccines may provide might only be temporary. “If you look at the duration of protection when you recover from one of the several benign coronaviruses that cause the common cold, the durability of infection is only measured in a year or less as opposed to the other infections where you can get 15 to 20 years of protection,” Dr. Fauci said.1 2 3
Fauci and others developing or promoting COVID-19 vaccination are talking about the likelihood that the new coronavirus vaccine will have to be administered in multiple doses, perhaps even annually like the influenza vaccine.
There are more than 100 research programs around the world working on candidate vaccines for COVID-19, including 10 that have reached the clinical evaluation stage, either phase 1 or phase 2. Among these are programs led by Western pharmaceutical companies such as AstraZeneca plc (in partnership with the University of Oxford); BioNTech SE partnered with Pfizer, Inc.; Inovio Pharmaceuticals, Inc.; Moderna, Inc. (in partnership with NIAID) and Novavax, Inc. Another 123 programs to develop a COVID-19 vaccine remain in preclinical evaluation.4
Doubts About Coronavirus Vaccine Long Term Effectiveness
According to Dr. Fauci, “It is still not clear which vaccine will be effective.” He believes that the phase 3 randomized, placebo-controlled trials involving thousands of people will provide the data needed to better evaluate the potential effectiveness of the candidate vaccines. The messenger RNA (mRNA) vaccine being fast tracked to licensure by Moderna, Inc., which is funded not only by NIAID but also by the Coalition for Epidemic Preparedness (CEPI) and half a billion dollars from the federal Biomedical Advanced Research and Development Authority (BARDA),5 as well as the AstraZeneca/Oxford coronavirus vaccine development programs are scheduled to proceed to phase 3 trials later this summer.
“The real business end of this all will be the phase 3 that starts in the first week of July, hopefully. We want to get as many data points as we can,” Dr. Fauci said. “I’m cautiously optimistic that with the multiple candidates we have with different platforms, that we’re going to have a vaccine that shows a degree of efficacy that will make it deployable.”1 6 Dr. Fauci’s said he is less worried about whether someone would get a “protective response” from a COVID-19 vaccine than he is about the “durability” of that response.
Vaccinologist Greg Poland, MD of the Mayo Clinic noted that immunity for seasonal coronaviruses may last several years or as little as 80 days. “There’s an immunologic secret locked up in the long class of coronaviruses that we don’t yet understand,” Dr. Poland said.1 2 3 6
COVID-19 Vaccine Likely Given Several Times or Annually
Vaccinologists like Fauci and Poland, who are expressing uncertainty about the length of protection a COVID-19 vaccine would provide, have reinforced speculation that two doses of a COVID-19 vaccine will be required over the course of about a month and that a booster shot may also be needed a few years later. In a recent article for USA Today, Elizabeth Weise wrote, “The first shot would prime the immune system, helping it recognize the virus. The second shot would strengthen the immune response.”7
Immunologist Barry Bloom, PhD of Harvard University’s T.H Chan School of Public Health said:
As far as I am aware, with one set of exceptions, all the front-line vaccine developers are contemplating two shots. The one exception is Merck, which last week pushed forward on two vaccines, each of which they hoped would be one-shot vaccines.7
Scott Gottlieb, MD, who joined the board of directors of Pfizer after resigning as Commissioner of the U.S. Food and Drug Administration (FDA) in March 2019, recently told CNBC that a vaccine for COVID-19 (like the one Pfizer is developing) may have to be an annual shot. Gottlieb said:
This is probably going to be a seasonal vaccine, the coronavirus vaccine. It’s probably a vaccine that we’re going to need to take every year, and Dr. Fauci is right… the immunity is not going to be long-term in the form of like a smallpox vaccine or a polio vaccine where you get the vaccine once and you’re protected for life or most of your life, or a measles vaccine. You’re going to need to take this shot regularly and maybe annually and the immunity might last up to a year.8 9
Pfizer and its German partner BioNTech recently began clinical trials in the United States testing one and two doses of their experimental BNT162 vaccine for COVID-19 on human subjects.10
1 JAMA Network. Coronavirus Q&A With Anthony Fauci, MD. YouTube June 2, 2020.
2 Lovelace B. Dr. Anthony Fauci says there’s a chance coronavirus vaccine may not provide immunity for very long. CNBC June 3, 2020.
3 Rodriguez A. Fauci says he’s optimistic about coronavirus vaccine protection but concerned how long it will last. USA Today June 4, 2020.
4 World Health Organization. Draft landscape of COVID-19 candidate vaccines. June 2, 2020.
5 Fisher BL. COVID-19 Meltdown and Pharma’s Big Money Win. The Vaccine Reaction Apr. 13, 2020.
6 Medical Xpress. Fauci says any COVID-19 vaccine would be in plentiful supply by 2021. June 4, 2020.
7 Weise E. A coronavirus vaccine could require you to get two shots. Here’s why. USA Today June 4, 2020.
8 TVR Staff. Former FDA Commissioner Gottlieb Joins Pfizer. The Vaccine Reaction July 10, 2019.
9 CNBC Television. Expect Covid-19 vaccine to be seasonal like the flu shot: Former FDA chief. YouTube June 3, 2020.
10 TVR Staff. Pfizer and BioNTech Begin Human Clinical Trials of COVID-19 Vaccine in U.S. The Vaccine Reaction May 25, 2020.