Virologist: We need to adjust expectations for the COVID vaccine

We’re still waiting for a COVID vaccine to be released, and one virologist has some questions about the way it’s being tested. Dr. William Haseltine has taught at Harvard and raised some concerns about some of the vaccine testing. He joined Seattle’s Morning News to discuss.

“First of all, I think most people expect the vaccine to prevent infection. That is not a criterion for approval of these vaccines. In fact, they assume that everybody — vaccinated or not — will be likely be infected. The measurement for success is what is the difference in the symptoms of those who are infected. That very criterion tells you that they expect everybody to be infected in both arms of the trial vaccinated or not. That probably is an eye opener for most people,” he said.

It’s not much different from the way the flu vaccine is designed, which is part of the issue for Haseltine.

“Actually, it’s the way the flu vaccine is designed, and that’s the second surprise I think for most people. The flu vaccines are not designed to prevent infection. They’re designed to prevent serious disease, so that gets to the next question. What type of disease are the trials meant to prevent? Mild disease such as a cold, a headache, the cough of fever or serious symptoms that may land you up in the hospital? And the answer is in the initial submissions that preventing most people from getting serious disease and preventing them from dying is not part of the approval process,” he said.

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Haseltine added as well that there are misconceptions for what exactly such a vaccine would do, even if it did resemble the flu vaccine.

“The hope would be that this vaccine would act as the flu vaccine, and that is saying a lot because first of all, it’s saying what it does and doesn’t do. The flu vaccines don’t stop influenza pandemics, and we know that because we’ve had the vaccine for many, several generations now and they don’t stop seasonal flu. I don’t think we can account on any vaccine is being developed now to stop seasonal COVID,” he said.

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“The flu vaccines moderate the disease symptoms in between 30 and 50% of those vaccinated, the other 50 to 70% get just as sick as if they’d never been vaccinated–something else you might expect from this. The third thing the flu vaccines don’t seem to do very well is to slow down transmission. That is, the number of people who were infected, and so you could expect this vaccine to behave similarly. In other words, it wouldn’t slow infection. It would moderate and possibly reduce the death rate, which of course, is very good. But only in some, not in all people.”

If anything, he believes we need to adjust our expectations.

“I have a collateral fear that the very notion that there’s a vaccine will cause people to loosen up their behavior even more than it already is … I am in favor of vaccines in general. I’m even in favor of these vaccines. But we have to modulate our expectations and make sure that we are clear about what they will do and the safety procedures.”

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