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January-February 2021 - Volume 66 - Issue 1

  • Eric Ford, PhD, MPH
  • 1096-9012
  • 1944-7396
  • 6 issues per year
  • 0.900

From the January/February Issue...

In November, we got not one, but two, doses of good news on the COVID-19 vaccine front. Both Pfizer and Moderna announced that they had produced vaccines that were 95% effective in preventing or mitigating the effects of the virus with few or no side effects detectable in the early stages—truly a miracle of modern science. Today, the silver bullet to stop the pandemic is within reach.

Effective vaccines have been held out as the only acceptable way to achieve the herd immunity necessary to return to normal social interactions. Nevertheless, a few economists have suggested that achieving herd immunity by allowing infection and mortality rates to go unchecked would be a financially rational solution. Setting that debate aside, the logistics, human behavior, and moral complexities of distributing and administering the vaccines (plural) will require deft leadership and managerial skills.

The vaccines will provide protection, but getting the silver bullet to its intended target is another matter altogether. Vaccines developed using the messenger RNA approach are difficult to handle in that they require deep-freezing storage. Therefore, large health systems with existing infrastructure will likely be the first to receive and distribute the vaccines. Such an arrangement is also logical in that the employees of large health systems should be among the first tier to receive the vaccine, as they are at the highest risk of exposure. The other populations in the first tier will be those at greatest risk of contracting the disease because of underlying risk factors such as age, weight, and comorbidities. For these populations, the biggest hurdle to overcome will be human behavior.

Despite the threat that COVID-19 presents, many people will resist vaccination based on personal beliefs. Others will not get the vaccine or complete the dosage series out of sheer laziness. Compounding the problem of vaccine resistance, these people are most likely to ignore social distancing guidance and put others at risk. However, the moral challenges of individuals are relatively modest compared to those that public health and health system leaders face.

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