6 vaccine experts told us how they'll decide whether to get a coronavirus shot
- Business Insider asked six infectious-disease experts when they'd feel confident getting a coronavirus vaccine.
- Their answers varied in terms of which data would convince them.
- Richard Condit, a retired University of Florida virologist, said he'd trust the scientists making the critical regulatory decision. Ultimately, if they recommended people his age get the shot, he'd likely get it, he said.
- Other experts wanted more. University of Pennsylvania's Dr. Paul Offit emphasized the need to see data for people representing his demographic.
- William Haseltine, a longtime biotech executive, said he would "wait a couple years" for long-term follow-up data on safety and effectiveness.
Experts who have been studying viruses and vaccines for decades don't agree on when they'll get a vaccine.
The drugmakers behind the leading COVID-19 vaccine candidates expect conclusive results by the end of this year, perhaps as soon as this month, that demonstrate whether the shots prevent disease. These final studies, called phase-three trials, are enrolling tens of thousands of volunteers to determine whether these experimental vaccines outperform a placebo group.
But it's unclear how comprehensive that data will be. In interviews with five experts in vaccines and virology, Business Insider asked how they planned to assess the data and ultimately decide for themselves if they'd get the shot.
Some were confident they'd get vaccinated if US regulators determined it was safe and effective and recommended it for their age group. While they generally hope a vaccine will be highly effective, they said they'd also settle for a shot that's less effective, more in line with the seasonal influenza vaccine, which can be about 50% effective some years.
Others want more specific data that represents their demographics or long-term follow-up results for safety and effectiveness.
Here's what it would take for six infectious-disease experts to feel confident about getting a COVID-19 vaccine.
Virologist Richard Condit: 'I'm going to trust the people running the trials.'
Richard Condit has been studying viruses for several decades in the lab.
While he's well-versed in virology and infectious diseases, his primary expertise isn't vaccine development. That leads him to trust the scientists most closely involved with these shots, he said.
"I'm going to trust the people running the trials," he said. "If they say we have enough disease in the control group so that we can say statistically this is a certain acceptable level of efficacy, and we haven't seen significant adverse effects, I'm probably going to go for it."
The 72-year-old retired virologist said he was closely watching for signs of political pressure on vaccine decisions. Condit said he trusted the pharmaceutical companies, along with the scientists at the Centers for Disease Control and Prevention and the Food and Drug Administration, but not the Trump administration.
"I trust what [Trump] would call the 'deep state,'" he said.
"I don't say I'll go ahead and get the vaccine without reservation," Condit said. "There's a little bit of nervousness associated with that, but I'm 72 years old. I'm very healthy, but agewise, I'm in a group that has sufficiently high risk ... There's significant probability that the benefit of being vaccinated exceeds the risk of that crappy outcome from getting the disease."
Condit said ideally a coronavirus vaccine would be 80 or 90% effective. But he'd also take one that was less effective but still helpful, such as one that reduces the chance of getting COVID-19 by 50%.
"If I can get a vaccine that reduces my chances of getting this crappy disease by 50%, I'll take it," he said, adding that a 50% effective vaccine "is probably a stopgap measure that makes us safer but not completely safe."
Pediatric vaccine researcher Dr. Robert Frenck: 'As soon as the vaccine is available, give me the shot.'
The vast majority of Dr. Robert Frenck's adult life has centered on vaccines. The director of Cincinnati Children's Hospital's Vaccine Research Center is now helping run Pfizer's final clinical trial for its COVID-19 candidate.
Frenck told Business Insider he'd attempt to get Pfizer's vaccine now if he was allowed, but ethics rules forbid clinical trial researchers from enrolling in their own studies.
"As soon as the vaccine is available, give me the shot," Frenck said, expressing confidence in the rigor of the studies and the FDA's vetting process.
Frenck has been a pediatrician for 40 years, specializing in infectious diseases and vaccine development. Testing tens of thousands of people in these studies will give "a pretty good idea of the safety profile," he said, adding it is possible the studies won't catch extremely rare adverse events.
"The worst that happens is I get an immune response that didn't work as well," Frenck said. "But if I get a runny nose instead of dying from it, I'm ready for that risk."
Microbiologist Deborah Fuller thinks about getting a vaccine as a societal decision, not an individual one
Deborah Fuller, a microbiologist at the University of Washington, said she thinks about getting a vaccine differently than most.
As a vaccine developer herself, she often thinks about getting a shot for the benefit it'll have to the population as a whole, rather than if getting the vaccine will benefit her. An effective vaccine will help build herd immunity and ultimately protect a society against a disease. While she said she'd love a shot to be highly effective at preventing disease, she'd also still get a shot that was modestly effective.
"I'd be OK with a vaccine that is 50% effective, and I would get it if it was available," Fuller said.
She added that a vaccine could still be a major benefit if it reduced the severity of disease, even if that meant vaccinated people may still wind up getting infected and sick to some degree.
"People think of it as a black-and-white thing, that if I take a vaccine I won't get sick at all," Fuller said, adding that the reality is more nuanced.
While people may be mad if they got vaccinated and still wind up experiencing illness, Fuller said they may not get as sick as they would've gotten without the vaccine.
Dr. Jesse Goodman, former top scientist at the FDA, wants to 'look at the real data and make a decision'
Dr. Jesse Goodman, the former chief scientist at the FDA, said he wanted to review the data before making a final decision.
"If I saw a vaccine that was clearly effective in a large phase-three trial, and I thought that evidence was convincing, and there weren't safety signals that bothered me, I would likely go ahead," said Goodman, now the director of the Center on Medical Product Access, Safety and Stewardship at Georgetown University.
Goodman emphasized the importance of the trial results in peer-reviewed journals and their presentation at public meetings like the FDA's advisory-committee meetings. He said drug companies oftentimes highlight positive results and downplay any negative findings in press releases.
"As an infectious-disease and vaccine expert, I'm going to want to look at the real data and make a decision," he added.
Vaccine inventor Dr. Paul Offit: 'I want to make sure my group is represented'
Study results will have to show how safe and effective an experimental vaccine is for people in his age group before Dr. Paul Offit feels comfortable getting the shot.
"I want to make sure my group is represented in the study," Offit, the director of the Vaccine Education Center at Children's Hospital of Philadelphia, said. "I'm over 65. Has my group been adequately studied, and how effective is it, and what we do we know about safety?"
Offit said he hoped a COVID-19 vaccine could slash the chances of getting moderate or severe disease by 70%. But "anything greater than 50% is a value," he added.
Offit is the coinventor of the rotavirus vaccine and a pediatrician at Children's Hospital of Philadelphia. He emphasized the choice wasn't between getting a vaccine and doing nothing.
A vaccine could be another valuable weapon against the virus, in addition to ones we already have, like social distancing and mask-wearing.
"If you gave me the choice of a 75% effective vaccine, or you can wear a mask as you're walking through the hospital, I choose the mask," Offit said.
Biotech exec William Haseltine is far more reserved and worried about long-term safety and effectiveness
The longtime biotech executive William Haseltine has a significantly more cautious perspective on a new vaccine than other experts.
He said he wanted to see long-term safety and durability data before getting a shot himself or recommending one to his family.
"When people ask me, 'Are you going to take that vaccine Bill,' my answer is I'm going to wait a couple years, me and my family," he said. "In the meantime, I'm going to continue my life in the country."
Haseltine is a former Harvard medical professor. He founded two research centers focused on HIV/AIDS and cancer at the school. The virology and infectious-disease expert is now the chairman and president of Access Health International, a nonprofit healthcare think tank. He also founded and led several biotech companies, including Human Genome Sciences, which was eventually bought by GlaxoSmithKline for $3 billion.
His primary concern is theoretical. He is worried that long-term follow-up data will show protection from these vaccines waning. In particular, he is worried that could leave people more vulnerable to infection and make the resulting disease more severe after getting the vaccine.
While this risk, known generally as antibody-dependent enhancement, has been seen in other experimental vaccines, recently against the Dengue virus, no data has yet to flag it as an issue for this novel coronavirus.
Still, Haseltine said he wanted to see the long-term data before getting the shot to assuage his concerns.
"I don't know whether it's going to enhance infection or whether it's going to enhance disease," Haseltine said. "And we're not going to know that for a very long time. The first data is, yes, we're going to get some protection."
This article was originally published on September 24 and has been updated to include Dr. Robert Frenck's perspective.