Updated: After this piece was published, biotechnology company Moderna also announced that preliminary data show its COVID-19 vaccine to be 95 percent effective. Vaccines from both companies still require approval from the Food and Drug Administration.
Update: After this piece was published, biotechnology company Moderna also announced that preliminary data show its COVID-19 vaccine to be 95 percent effective. Vaccines from both companies still require approval from the Food and Drug Administration.
News this week that a COVID-19 vaccine on the runway is far more effective than originally predicted has been hailed as a potential game-changer in fighting the coronavirus.
Pfizer Inc. that early results from clinical trials show the vaccine it鈥檚 developing with German company BioNTech is 90 percent effective鈥攚hich would put it on par with the childhood vaccine for measles. Many scientists had anticipated the level of effectiveness would be only about 50 or 60 percent.
Because supply will be limited at first, vaccines will be rationed. As EdWeek has reported, it鈥檚 possible that teachers and other school employees may get priority for vaccinations over some other groups.
But the vaccine has not yet been tested in young children, and trials with older children have only just begun. So what could Pfizer鈥檚 announcement mean for schools? Could they bring more students into the classroom and ease other mitigation efforts as long as teachers are inoculated? And when will a COVID-19 vaccine that鈥檚 safe for children be ready?
Education Week put these and other questions to two experts: Dr. Walter Orenstein, a professor of infectious diseases at Emory University School of Medicine and a former director of the immunization program at the Centers for Disease Control and Prevention, and Cherise Rohr-Allegrini, an epidemiologist serving on San Antonio鈥檚 COVID Response Coalition and the CEO of the San Antonio AIDS Foundation.
The responses were edited for length and clarity. Here鈥檚 what the experts had to say:
If districts are able to inoculate large numbers of their employees, would schools be able to return to full-time in-person learning?
Orenstein: You鈥檙e asking the right question. It鈥檚 unclear from the Pfizer data so far what the age distribution of the trial participants is. How effective is it in older people? In younger people? We don鈥檛 know that yet. If it is 90 percent-plus effective [as Pfizer indicated], and when there is an adequate supply so groups like teachers would be recommended for the vaccine, it would certainly facilitate their coming back. Where they will be within the priorities [to be vaccinated] is not yet clear. We know frontline healthcare workers are at the top of the list, then elderly people.
Rohr-Allegrini: Until we have a vaccine for everyone, we will have to follow strict control measures. But it means we can maybe bring more kids into the classroom. So much as well is dependent on community transmission.
Can schools ease up on mitigation efforts like masks and social distancing when vaccinations begin?
Rohr-Allegrini: I think the more people who are vaccinated, that will decrease community transmission, which will allow you to relax some of those mitigation efforts. If the goal is to have as many children in school as possible, we might have to relax on the physical distancing requirements for a classroom, but we keep the mask requirements.
Remember, 90 percent effective means that there are still 10 percent who will get the vaccine who are not going to be protected. And then you have the others who can鈥檛 get the vaccine for medical reasons, so you are going to have people who are still at risk. So you鈥檙e going to have to be cautious until we have community transmission at such a low level that we can feel comfortable that there is very limited risk.
Orenstein: If there was enough vaccine to vaccinate everybody, including children, and we had a high uptake of it, then I think we could relax the social distancing, mask-wearing, those non-pharmaceutical interventions. But we certainly won鈥檛 be able to do that right away. We shouldn鈥檛 expect 300 million doses the first day. We鈥檒l have to see the data from Pfizer, [and] what indications and recommendations the FDA gives for its use. Hopefully, we have a number of other vaccines coming down the pike as well. And I hope to see similar efficacies. That would facilitate a highly vaccinated and highly immune population.
What are the limitations of the new vaccine for schools?
Orenstein: At the moment there are a lot of unknowns. One big hassle is distributing it. This vaccine needs very, very strict maintenance of the cold chain, at -70, -80 degrees centigrade. Second, there鈥檚 the number of doses available. Third, we need to develop a process where the vaccine could be administered safely. For example, we wouldn鈥檛 want to gather people in an indoor stadium or movie theater to vaccinate them. We don鈥檛 want them coming so close to each other. We need to assure the public we have good efficacy and safety in all the potential populations.
How important a piece of the puzzle in K-12 schools is a children鈥檚 vaccine? Can the Pfizer vaccine make any difference for K-12 schools if it can only be used with adults?
Orenstein: I think we need to get to the point where both kids and adults are [getting vaccinated]. It would be concerning to me if we had no vaccine for children. We need to get it, and get it sooner rather than later.
Rohr-Allegrini: Having a vaccine for adults is very important for schools because we can feel more confident that the adults are protected. Teens are as likely to transmit as adults. The youngest ones, it doesn鈥檛 mean they aren鈥檛 infectious or perfectly safe, but the risk is lower.
What is the timeline for getting a COVID-19 vaccine for children?
Orenstein: [laughing] I wish I had a good crystal ball. My hope would be the middle of next year, maybe early next year, but I don鈥檛 know. Children have not been in most of the studies. We鈥檙e just getting to that now. It will take longer. It鈥檚 really important to get the data presented and published in a peer-reviewed journal so these questions can be answered.
Rohr-Allegrini: This Pfizer vaccine, they have started to test it in kids as young as 12. I think other vaccine manufacturers will start soon as well. Assuming this vaccine works in children, I suspect it will be ready in six months or so. Not this school year鈥擨 would be shocked just because it takes a while to ramp it up and you always roll out a vaccine slowly.
Why is there a delay in producing a COVID-19 vaccine for children?
Rohr-Allegrini: I wouldn鈥檛 call it a delay鈥攏ormally a vaccine takes years to develop. That we have a vaccine in less than a year, that鈥檚 promising鈥攊t really is warp-speed, it鈥檚 incredible. Normally when we develop of a vaccine, we start with the population that is most at risk but also is relatively healthy because you don鈥檛 want to test it in people who have other complications.
And we tend to test it in adults first. There are a lot of reasons why we don鈥檛 want to start with children鈥攅thical reasons. Adults can consent for themselves. Having a parent consent for their child adds a layer of complication.
What are the most important things communities can do to handle 鈥渧accine hesitancy鈥?
Orenstein: We need to be truthful, show we鈥檙e not cutting corners, and give the public confidence that the data we present on effectiveness and safety are real and valid. Vaccines don鈥檛 save lives; vaccinations save lives. A vaccine that remains in the vial is zero percent effective.
How should school leaders deal with vaccine hesitancy among teachers and school staff?
Rohr-Allegrini: The messaging has to incorporate enough of the science that people feel confident in getting the vaccine and we need to be sensitive to any concerns, that they鈥檙e not scared or that they feel forced into getting it.
I don鈥檛 expect school district leaders to be scientific experts on vaccines. But you rely on the people that are to craft your messaging. We know the questions that come up鈥攚e鈥檙e used to these questions, we get them all the time. We know how to craft these messages in a sensitive way.