Just thinking about why the WHO is so skeptical about the prospect of a vaccine, calling it "no silver bullet", when most respectable scientists agree that the development of an effective vaccine by now is "only" a matter of time (will it be available in October 2020? In January 21? Or in the second half of 2021?).
For me, living in a first world state with a working healthcare system, it is beyond belief how a working vaccine can not be the silver bullet, and I was about to lambast the WHO for scaremongering to prove their continued need to exist.
But then, I thought about the caveats with most or all vaccine front-runners, based on what we learned from monkey challenge trials and phase I/II human trials:
- Needs a booster shot a month in (all except for maybe J&J)
- Needs to be stored frozen, not "only" refrigerated (all except for Oxford and J&J)
- May or may not need a yearly booster, either due to fading immunity and/or covid mutations (likelyhood confirmed for Pfizer and Oxford)
- May only protect younger people, say, under 60 or so
- May only protect a certain percentage of people inoculated, if animal models are anything to go by we are looking at 80-ish percent efficiency (perfectly normal for almost all vaccines on the market)
- May only protect from getting sick, but still leaves a small window of virus distribution (possible for Oxford)
None of these are real problems in a country with a working medical infrastructure and healthcare system*. Probably/hopefully, low levels of transmission will be able to even out anti-vaxxers refusing to get vaccinated, getting us to a point where covid is eradicated except for the occasional outbreak in communities with super low protection rates (like measels outbreaks in anti-vaxxer dominated childcare centers).
Sadly, not even half of the world's population lives in countries like this. Over a third of the world's population lives in Africa and India combined, with South America and the poorer parts of Asia to be kept in mind, as well. None of these places will be able to administer vaccines that need to be stored frozen, or chase people down for follow-up appointments to get a booster. How the US healthcare system will cope with a vaccination campaign of this size has to be seen, as well. So, for all these places outside the warmth of more or less universal healthcare, there's a struggle ahead. We will see whether Bill Gates' optimism of the world being out of the pandemic by the end of 2021 will be warranted or not. I am optimistic us Europeans will be, but we are not the world.
*I see production of enough vaccine as a temporary problem. Especially if yearly boosters are needed, providing a billion shots to the EU and US combined at $20 a pop each year is a surefire business model for any company, while at the same time being little enough money not to bring down the healthcare systems providing the shots. $20 is the number Pfizer has given as a possible per-dose for-profit price point.