At least two new COVID-19 vaccines are close to obtaining approval for use in the United States, fueling hope that the global pandemic will soon shift to a better-controlled phase. Here, Stanford Medicine Children’s Health pediatric infectious disease expert Roshni Mathew, MD, explains what the news means for immunization of children and pregnant women and debunks myths about the vaccines.
Q. Can the vaccines give you COVID-19?
Dr. Mathew: No. None of the COVID-19 vaccines in development in the U.S. are live vaccines. The vaccines cause the body to recognize the virus protein so the immune system can develop a response to it.
Q. Could the COVID-19 vaccine make you more susceptible to other illnesses or dampen the function of your immune system?
Dr. Mathew: COVID-19 vaccines allow the immune system to recognize the SARS-CoV-2 virus and mount a response to it. The vaccine does not cause one to be more susceptible to other illnesses. Our immune system is capable of recognizing and protecting us from many different pathogens simultaneously.
Q. Will the COVID-19 vaccine be made mandatory?
Dr. Mathew: The vaccines will initially receive an emergency use authorization from the Food and Drug Administration (FDA), which allows their use in a limited fashion. In these situations, use of the product cannot be made mandatory. There could, however, be local and institutional vaccination requirements, such as for employees in health care or other front-line jobs.
Q. How was it possible to make an effective vaccine in such a short time?
Dr. Mathew: Developing a new vaccine typically takes several years; the mumps vaccine, which took four years to develop, was the fastest until now. In case of COVID-19 vaccines, several steps that typically occur in sequence happened in parallel. In addition, several pharmaceutical and academic establishments worked toward developing a vaccine independently. The safety and efficacy safeguards, however, are all still in place. Vaccines will not be approved for civilian use until they meet all the required standards.
Q. Will the COVID-19 vaccines stop the pandemic?
Dr. Mathew: Vaccination is one strategy to reduce the risk of acquisition and transmission of the infection. Since the vaccines are not 100% efficacious, other measures to reduce transmission — such as social distancing, frequent handwashing, and wearing masks in public — will need to continue until a substantial number of people are vaccinated. The Centers for Disease Control and Prevention will continue to closely monitor the response to vaccination and infection rates as more people are vaccinated to provide advice on when we can return to in-person activities. This will depend on how long it takes to manufacture sufficient supplies of vaccines and deploy them to the population. The timeline is still to be determined.
Q. When will children be able to receive COVID-19 vaccines, and what research is still needed before that can happen?
Dr. Mathew: Some of the vaccine trials are including children older than 12 years at this time. When the vaccines initially get rolled out, we do not expect that children will receive them. However, as we get more information from the trials, the FDA and CDC will weigh in on when children can safely receive the vaccines.
Q. Are pregnant women at higher risk for COVID-19 illness, and what are the plans for vaccinating them?
Dr. Mathew: Although there is more to learn, studies so far raise concerns that pregnant women are at increased risk for severe illness from COVID-19. To date, vaccine trials have not enrolled pregnant women. But there are women participating who have become pregnant during the course of the trial, and so some information will be available on them in the future. The FDA, the CDC, and the American College of Obstetricians and Gynecologists will use this information to make vaccination recommendations specific to pregnant women. Pregnant women who have specific questions about the vaccine as it relates to their care should stay in contact with their health care provider for the latest information.