This week we’ve had welcome news from one of the key vaccine manufacturers regarding the safety and efficacy of one of the vaccines against COVID-19 and it has raised the question - is the route to a ‘new normal’ for the COVID-19 pandemic in sight? Following the equally positive news from Oxford Vaccine Group on the 23rd November, there is increasing cause for cautious optimism.
In the months since March 2020, when the World Health Organisation (WHO) declared the novel virus SARS-CoV-2 to be the cause of a pandemic, the virus has had a far reaching global impact.
It has impacted not only on physical and mental health and wellbeing, but also on economies and education, irrevocably changing people’s lives. We won’t understand the full impact of this disease on health alone for some time.
The measures adopted thus far to control the virus have been restricted to ‘lockdowns’, behavioural interventions such as social distancing, hand washing and face covering. Their effectiveness is wholly dependent on cooperation by the public and our ability as a society to implement and so they may not be sustainable in the long term. Vaccines appear to be the ‘only way out’ to enable us to resume some kind of normal life.
Vaccines are generally very well accepted in the UK though uptake rates are not as good for vaccines given in adulthood. As it is likely that the COVID-19 vaccine will be targeted at adults, at least initially, and high vaccine uptake will be required, it’s vital to understand people’s concerns about the potential vaccine and address these early on.
Opinion polls and other surveys suggest that about 70-80% would accept or are likely to accept a COVID-19 vaccine. This seems to be a solid base on which to build, but the media and some researchers are claiming that 1 in 7 people report they are not inclined to accept a vaccine. Publicising this perspective alone could knock public confidence at a crucial moment when we need to thoroughly engage with the public on the benefits of vaccination.
So, the big question is what is needed to improve public confidence? The answer is open and honest conversations from trusted health care practitioners. This is challenging for several reasons, not least within the current context of an ‘infodemic’ with dis and mis information circulating freely on social media and other outlets.
However, as healthcare workers, and in particular as nurses, we are at the forefront of vaccine delivery and we know we are trusted by the public. It is vital that the health care workforce are aware of and equipped to respond effectively to the nature of public concerns in order to build confidence.
Even with the promising news on the vaccine development there are still a number of questions for which we don’t yet have answers. The evidence to date around the effectiveness of the two leading vaccines being considered for the UK is very encouraging. They have been tested specifically for preventing disease as a result of infection with the virus.
There is still more information needed on vaccine safety, the long-term duration of protection and whether the vaccine will impact on virus transmission across the population. This will only become clearer once further vaccine trials are completed and the vaccines are in use. As a society we will still need to continue with social distancing and testing and tracing for disease for some time to come, even after the roll out of the vaccine programme.
There has also been concern raised about the apparent speed at which these vaccines are being developed and whether this means they will not be tested to the standard of other vaccines. Although it is true that vaccine development can take as long as 10-15 years, the Oxford Vaccine Group vaccine has not been developed completely from 'scratch'.
Prior to COVID-19, emerging work had already gone on in case of the emergence of a novel pathogen with the precise aim of being able to develop a vaccine quickly. The public need to be reassured that no stages of vaccine development have been omitted, and vaccines have not been rushed into use. Given the need to roll out vaccination to slow the pandemic, the stages of development have been run alongside each other in parallel. All the necessary regulatory processes are being conducted - see this blog 'How to make a virus in record time'.
Vaccines have proved themselves to be among the most effective public health measures available for controlling diseases. Not only has smallpox been eradicated globally due to vaccination, but as of August this year, Africa is polio free with the infection remaining in just two countries as the global polio vaccination programme continues.
Vaccine safety is always the most important consideration in vaccine acceptance decisions - it is understandable that there may be concern about the safety and effectiveness of a novel vaccine. While we wait for a vaccine to become available we can use this interval efficiently by reassuring the public that although vaccines are being quickly developed, no part of the usual development or regulatory process has been omitted.
Vaccinating those who need it safely and as quickly as possible will be challenging. It is clear that it will need input from across the system and from various health care practitioners to ensure safe and timely programme delivery.
Nursing staff will be fundamental to the administration and delivery of this vaccine as they are with all vaccine administration. They are highly skilled in vaccine delivery and have the skills and knowledge to support the programme. They need to be at the forefront of the vaccine delivery plans.