When news of an emergency use approval for a Pfizer COVID-19 vaccination hit the news, followed closely by approval for the Moderna vaccine, it seemed to many that an end was in sight to the pandemic that has been holding the world hostage for a year. COVID-19 has hit the fire service particularly hard given their essential worker status, communal living/close contact, and community engagement even when most people are staying home.
National organizations such as the IAFC, IAFF, National Association of State Fire Marshals, and the National Volunteer Fire Council (NVFC) all lobbied strongly to have first responders included in the highest priority for vaccines.
However, hesitation over the vaccine for firefighters has been widespread. Early surveys from FDNY and other departments suggested that the uptake of the vaccine was going to be less than 50% among many firefighters. Many firefighters have been skeptical of being in the first tier of vaccine distribution, with many expressing that they want to wait and see how it goes for others.
Concerns over vaccine fast-tracking
One of the major concerns has been over the rapid pace of vaccine development. Arguably, deeming a vaccine as being developed at “warp speed” has not instilled confidence in its safety or effectiveness. While the vaccine was developed and deployed in record time, it is a testament to the ability of science and medicine to respond collaboratively and safely when there is a desperate need. Here’s how it was accomplished:
“Warp speed” funding: The primary driver of speed in developing the vaccine was the money available. An estimated $9 billion was poured into vaccine development, testing and manufacturing.
Adapting previous vaccines: Due to the work that had been done on similar viruses, the previous academic research could be leveraged to tailor the vaccine to COVID-19. The mRNA used in the Moderna and Pfizer vaccines has been used for cancer treatments for quite a while, and vaccine trials are currently underway for mRNA vaccines for other viruses, thus allowing for quicker adaptation.
Top-tier testing: Clinical trials for each vaccine went through the “gold standard” process that included Phase I testing on approximately 100 individuals to assess initial safety, Phase II testing of several hundred people to examine effectiveness, and Phase 3 testing of thousands of individuals to examine the safety in conjunction with effectiveness. Specifically, Phase 3 trials for Pfizer included 42,000 individuals and Moderna 30,000 individuals.
Most importantly, tracking of safety outcomes and monitoring adverse events is ongoing, not only through Phase 4 trials, but also through collection and investigation of side effects.
Simultaneous testing and manufacturing: One key way the vaccine was brought to market so quickly was in the timing of manufacturing. Countries optimistic about early data from the vaccine trials were willing to bet on the success, thereby allowing funds to be used to manufacture millions of doses while clinical trials were still underway. Manufacturing in this instance started as clinical trials began. Typically, the manufacturing would not have started until clinical trials were complete and approval in place.
Another factor that played into the speed of the vaccine included the high rate of infectivity. COVID-19 is so highly contagious that the rate of those getting the disease in the control condition was quickly apparent compared to those in the live virus condition – and the large pool of willing participants who stepped up to be included in vaccine testing.
Myth: COVID-19 is similar to the flu
While there is wide recognition that COVID-19 is dangerous, there is still some belief that the disease is similar to the flu. Here are the facts:
Mortality rate: Doctors and scientists are working to estimate the mortality rate of COVID-19, but at present, it has been found to be higher than most strains of the flu. Maybe even more important than the deaths, studies show that the COVID-19 virus has a much higher potential for respiratory pathogenicity leading to more respiratory complications and therefor higher mortality compared to the flu.
Recovery: In addition, the typical course of the flu is that you feel sick for a period of time and fully recover. What is being found with COVID-19, in contrast, is that there are long term consequences and damage within the body even in people who were initially asymptomatic.
In one study of asymptomatic individuals, almost 60% had inflammation in their lungs. Among patients who are hospitalized for COVID, 87% still experience symptoms 60 days after contracting the infection. For patients who were not hospitalized, more than one-third still experience symptoms at 2 weeks post infection – and 20% of people 18-34 without co-occurring conditions report symptoms at 16 days post infection.
As for the long-term impact of the initial cytokine storm, the research is still emerging – but it is not looking like something you want to get even if you don’t have symptoms at first.
Infectivity: The infectivity of COVID is significantly higher than the flu, meaning it is spreading far faster than the flu. With the flu, you are typically infectious only the day before you start experiencing symptoms and continue to be infectious for 3-7 days after. With COVID, people are often shedding the virus and contagious for 3-4 days before the experience symptoms and can stay contagious for up to 10 days. The R(0) – pronounced R-naught – is a measure of infectivity. The rate is around 2-3 for COVID, meaning each person will likely infect 2-3 people, while the R(0) for the flu is estimated to be around 1.3. R(0) can be impacted by mitigation factors, so when COVID started and no measures were taken to contain it, the R(0) in Wuhan was 5.7. A measure of whether mitigation factors are working is whether the R(0) is going up or down.
Firefighters, researchers tackle vaccine questions
With a goal of improving education and answering questions about the COVID-19 vaccine, Deputy Chief Billy Goldfeder and a group of fire service physicians and scientists worked with IAFC to host a Q&A separating fact and fiction about the COVID-19 vaccine. Watch a recording of the webinar here. Several questions remained after the session which were answered after the webinar was complete. The PDF can be downloaded below.
If you have a question about the COVID-19 vaccine or if you would like to receive additional resources related to COVID-19 questions, share your questions with the Center for Fire Rescue & EMS Health Research here.
Editor’s note: What questions do you still have about the vaccine? Share in the questions below.
[Poll results: Do you plan to get a COVID-19 vaccine? See what members of the FireRescue1 community had to say.]
