To have an effective vaccine, you want something that will initiate a substantial immune response, remain effective despite mutations and provide lasting protection. One of the “good” things about the novel coronavirus (in terms of producing a good vaccine) is that it causes a robust immune response when it enters the body. This means that when the vaccine is introduced to the body, it will cause a strong response that prepares it for battle when it encounters the real virus. Many of the vaccines that are currently in development for COVID-19 target the interaction between the spikes on the surface of the virus and the ACE2 receptor on human cells. This is an ideal target for a vaccine because interfering with the interaction between the virus and its receptor can prevent the virus from entering the cell, multiplying and causing disease. Understanding this spike on the coronavirus has been a key part of developing a vaccine and its structure was resolved in record time. Because the virus spikes play an important role in getting the virus into the cell, it is predicted that they will not undergo a lot of mutation and still remain effective – making them an ideal vaccine target. Getting long-lasting protection against the novel coronavirus may be the most daunting challenge. Infection with human coronaviruses does not always result in lasting antibodies that will protect you from a subsequent (re-) infection. Even though the disease may be mild or asymptomatic after antibody levels wane, it is not known if these individuals would still transmit the virus.This will have to be addressed in vaccine trials, as this would be a significant issue if the virus becomes endemic. Despite the record pace of vaccine development for COVID-19, time is still needed to ensure efficacy, safety and accessibility. Simultaneous, as opposed to sequential activities in the development process can help to shorten timelines, however a certain amount of time is still needed to ensure that the vaccine has the desired impact. New production technologies, increasing capacity and distributionmust also be taken into consideration. It is still early in the trajectory of this pandemic and too soon to expect effective tools such as drugs or vaccines to be widely available. Cautious optimism seems to suggest that we will have good information about some of the vaccines currently in trials by early next year. The nature of this virus, as we continue to learn more, is such that it is not likely that a vaccine will be a ‘silver bullet’ and public health measures will continue to be important. Our best strategy right now is to direct concerted efforts towards limiting the spread of the virus, protecting those at high risk and providing supportive care for those affected. Previous experience suggests that in the first few years of a pandemic, there is an ebb and flow as population-level immunity develops, either through vaccination or community transmission. It is also important to remain vigilant. Not only in our activities, but also with respect to information. In a context where both public health and science are important for success, access to knowledgeable, credible information about COVID-19 will be essential. COVID-19 CSANews | FALL 2020 | 43
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