# What's the straight dope on the vaccine? **URL:** \ **Category:** The Quarantine Zone\ **Tags:** covid-quarantine\ **Created:** [May 26, 2020, 3:47pm UTC](https://boards.straightdope.com/t/whats-the-straight-dope-on-the-vaccine/854494 "2020-05-26T15:47:09Z")\ **Posts on this page:** 12\ **Page:** 3
**Author:** ![Do\_Not\_Taunt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/do_not_taunt/32/2968_2.png) [@Do\_Not\_Taunt](https://boards.straightdope.com/u/Do_Not_Taunt)\ **Post date:** [June 3, 2020, 7:38pm UTC](https://boards.straightdope.com/t/whats-the-straight-dope-on-the-vaccine/854494/41 "2020-06-03T19:38:40Z")
> [@DSeid](#): > > Testing as rates are dropping means bigger n needed. Ok, so we need to get infection rates back up. Roger that. On a more serious note, thanks both of you for your replies! ---
**Author:** ![Corry\_El](https://avatars.discourse-cdn.com/v4/letter/c/ecae2f/32.png) [@Corry\_El](https://boards.straightdope.com/u/Corry_El)\ **Post date:** [June 4, 2020, 2:18pm UTC](https://boards.straightdope.com/t/whats-the-straight-dope-on-the-vaccine/854494/42 "2020-06-04T14:18:02Z")
> [@CarnalK](#): > > It was in response to Corry El. Yes, he gives lip servce to “never” as a possibility - “it can’t be ruled out”. Meanwhile inside of 6 months is a realistic best case. I don’t see where ‘lip service’ comes from, and please explain the contradiction you seem to imply between: -Vaccine might be available in useful quantity in 6 months: per Anthony Fauci, who is hardly infallible, and nobody _knows_ this, but I think that qualifies year end 2020 as part of the range of reasonable estimates. -An effective vaccine might never pan out: on what basis of solid evidence can this be ruled out as a possibility? ---
**Author:** ![Corry\_El](https://avatars.discourse-cdn.com/v4/letter/c/ecae2f/32.png) [@Corry\_El](https://boards.straightdope.com/u/Corry_El)\ **Post date:** [June 4, 2020, 2:24pm UTC](https://boards.straightdope.com/t/whats-the-straight-dope-on-the-vaccine/854494/43 "2020-06-04T14:24:07Z")
> [@DSeid](#): > > Proving safety is where the big n is needed. Vaccine efficacy doesn’t need as many. > > Kid vaccine phase 3 trials can have 30 to 70K kids to demonstrate safety before approval. Harder yet for a germ in which rare delayed adverse impacts are concerns. > > How big is big enough depends on frequency of the infection and of adverse outcomes in the group. Less frequent infections and less frequent adverse outcomes needs more enrolled. Testing as rates are dropping means bigger n needed. Younger adults with less frequent death or serious disease from the germ need bigger n to prove safety. > > Time also varies. Several months is pushing it. Years not unheard of. I don’t know if that’s in response to me, but again it seems clear Fauci is saying a usable vaccine could be available in useful quantity before year end. I don’t see how to read that quote as ‘the stuff may have been manufactured by then, but there’s no way it would be cleared for use that soon’. He seems pretty clearly to be saying ‘we may be clear to use it by Nov/Dec, and by then 100mil doses may have been produced, though a completely adequate total number of doses would come later’. I also doubt he doesn’t know or is forgetting what tests have to be done to clear it for use and how long those take. So seems the strongest argument you can reasonably make is that the earliest date for use could be later than Nov/Dec 2020…which nobody disputes. But I don’t see how my original statement that the realistic best case is year end has been refuted. ---
**Author:** ![CarnalK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnalk/32/486_2.png) [@CarnalK](https://boards.straightdope.com/u/CarnalK)\ **Post date:** [June 4, 2020, 2:53pm UTC](https://boards.straightdope.com/t/whats-the-straight-dope-on-the-vaccine/854494/44 "2020-06-04T14:53:32Z")
> [@Corry\_El](#): > > -An effective vaccine might never pan out: on what basis of solid evidence can this be ruled out as a possibility? I am saying that severely underplays it. Less than 20% of drugs in Phase II trials go on to be FDA approved. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [June 5, 2020, 3:19am UTC](https://boards.straightdope.com/t/whats-the-straight-dope-on-the-vaccine/854494/45 "2020-06-05T03:19:11Z")
> [@Corry\_El](#): > > I don’t know if that’s in response to me, but again it seems clear Fauci is saying a usable vaccine could be available in useful quantity before year end. I don’t see how to read that quote as ‘the stuff may have been manufactured by then, but there’s no way it would be cleared for use that soon’. He seems pretty clearly to be saying ‘we may be clear to use it by Nov/Dec, and by then 100mil doses may have been produced, though a completely adequate total number of doses would come later’. I also doubt he doesn’t know or is forgetting what tests have to be done to clear it for use and how long those take. > > So seems the strongest argument you can reasonably make is that the earliest date for use could be later than Nov/Dec 2020…which nobody disputes. > > But I don’t see how my original statement that the realistic best case is year end has been refuted. It was in response to Do Not Taunt’s questions. Not directed to you. Having a vaccine through Phase 3 and approved by end of year would be unprecedented. Unprecedented is, however unlikely, not impossible. It is taking shortcuts but not impossible. For high risk groups the risks associated with shortcuts may be a fair deal. I would personally decline if I perceived shortcuts with proving safety were taken. ---
**Author:** ![Corry\_El](https://avatars.discourse-cdn.com/v4/letter/c/ecae2f/32.png) [@Corry\_El](https://boards.straightdope.com/u/Corry_El)\ **Post date:** [June 5, 2020, 1:52pm UTC](https://boards.straightdope.com/t/whats-the-straight-dope-on-the-vaccine/854494/46 "2020-06-05T13:52:14Z")
> [@CarnalK](#): > > I am saying that severely underplays it. Less than 20% of drugs in Phase II trials go on to be FDA approved. If I’d said one particular vaccine not succeeding now could only be ‘not ruled out’ I’d see that point. However we’re not discussing one particular vaccine effort, but a vaccine eventually. There are around 90 different efforts as of recently (though not as far progressed any trials in most cases)\*, and if they all fail they could presumably still give clues to what might work in another round of efforts. No vaccine ever is possible but would be a landmark failure of pharma research worldwide. I think ‘can’t be ruled out’ is fair. Nor again any contradiction that I can see with the statement that best realistic case is late this year. Your earlier reply ‘he gives lip servce to “never” as a possibility - "it can’t be ruled out’. Meanwhile inside of 6 months is a realistic best case." again to me implies some contradiction which I just don’t see, and I guess maybe you don’t either on reflection since you wouldn’t address that point. There’s nothing contradictory in an opinion that the range of outcomes is wide. - [https://www.nature.com/articles/d41586-020-01221-y](https://www.nature.com/articles/d41586-020-01221-y) ---
**Author:** ![Corry\_El](https://avatars.discourse-cdn.com/v4/letter/c/ecae2f/32.png) [@Corry\_El](https://boards.straightdope.com/u/Corry_El)\ **Post date:** [June 5, 2020, 2:29pm UTC](https://boards.straightdope.com/t/whats-the-straight-dope-on-the-vaccine/854494/47 "2020-06-05T14:29:25Z")
> [@DSeid](#): > > It was in response to Do Not Taunt’s questions. Not directed to you. > > Having a vaccine through Phase 3 and approved by end of year would be unprecedented. Unprecedented is, however unlikely, not impossible. It is taking shortcuts but not impossible. For high risk groups the risks associated with shortcuts may be a fair deal. I would personally decline if I perceived shortcuts with proving safety were taken. Well according to the scenario there would not be enough doses for everyone by year end anyway so the issue of whether to give it to low risk people would solve itself for some period of time in the optimistic timing case. And since high risk groups represent the overwhelming % of deaths (~80% of deaths people over 65, in the US as of recently) that’s not exactly an even ‘on the one hand/OTOH’. An effective vaccine that’s shown it doesn’t make the infection worse and isn’t outright toxic for a large % of people would be a game changer in terms of what society is (or at least should be) intensely focused on IMO: the fairly small % of people with a predictably high chance of very bad outcome if infected. ‘Eradicating’ COVID I agree would require a vaccine with, besides high effectiveness, a highly certain very low chance of adverse affects, short or longer term, to make it attractive to (and ethical to use any kind of strong persuasion to get it on) the large portion of society with next to zero chance of dying from COVID. So in this respect as in many, there isn’t necessarily a binary of ‘vaccine/no vaccine’. The first usable vaccines is likely to have limitations, in effectiveness of protection, length of protection, quantity available, risk trade off for groups with near 0% death rate (you mentioned testing for safety for kids, who do). But which are likely IMO to be improved upon subsequently by that effort or other efforts. IOW I don’t think anybody said ‘realistic best case the COVID problem is history by end of 2020’, but rather the reputable references which say there’s a realistic chance of _a_ useful vaccine, in useful quantity, by then. And I’m not sure it’s ‘however unlikely’, you may know better than I, but no point in arguing about unknown future outcomes beyond a certain point. ---
**Author:** ![CarnalK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnalk/32/486_2.png) [@CarnalK](https://boards.straightdope.com/u/CarnalK)\ **Post date:** [June 5, 2020, 2:41pm UTC](https://boards.straightdope.com/t/whats-the-straight-dope-on-the-vaccine/854494/48 "2020-06-05T14:41:58Z")
> [@Corry\_El](#): > > . No vaccine ever is possible but would be a landmark failure of pharma research worldwide. I think ‘can’t be ruled out’ is fair. Oh? What is your guesstimate on how often landmark failures happen? ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [June 5, 2020, 4:16pm UTC](https://boards.straightdope.com/t/whats-the-straight-dope-on-the-vaccine/854494/49 "2020-06-05T16:16:00Z")
Indeed whether eventual success or failure is probable or improbable is an unknown … and may even depend on what gets counted as “success” or “failure”. Whatever the bar failure “can’t be ruled out” and success should not be counted on. Yes there are many swings at bat being taken at the same time. That of course increases the odds that at least one of them will be a solid hit. Thing is that success or failure of each are not necessarily independent events. If one vaccine ends up triggering some adverse excessive response (inclusive of but not limited to vaccine enhancement, as seen in previous coronavirus immunization efforts) then the odds of others doing so goes up and the threshold for proving safety on the others would likely be raised as well. Getting a strong protective response, hopefully one that is not too transient, without triggering those responses, may not be easily done. What should count as “success”? Protection to the highest risk populations? Tricky. The highest risk populations may have the weakest protective responses - it is part of what makes them higher risk in some cases. Preventing exposure is the most effective way to protect them. If by vaccination that means having what counts for them as herd immunity. But sure something that provides even partial protection for them may count as success. And again a higher incidence of adverse vaccine outcomes may be tolerable for those at higher risk from the disease. OTOH demanding that lower risk HCWs (inclusive of the low paid aides and such) all subject themselves to that in order to create lower risk for those at higher risk will be ethically … dicey. For the little it is worth I would place “eradication” in “can be ruled out” box … _maybe_ not tape the box’s lid shut. Should success be defined as having a safe and effective vaccine available for at least all adults before natural disease has resulted in enough herd immunity that the disease is no longer causing major levels of morbidity and mortality? Should we count as success an effort that results in a safe and effective vaccine \*at a point when few opt to take it \*because the disease is no longer such a big threat to them or to to society as a whole? ---
**Author:** ![CarnalK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnalk/32/486_2.png) [@CarnalK](https://boards.straightdope.com/u/CarnalK)\ **Post date:** [June 5, 2020, 7:51pm UTC](https://boards.straightdope.com/t/whats-the-straight-dope-on-the-vaccine/854494/50 "2020-06-05T19:51:18Z")
I should say, I am not completely pessimistic. I’m just not comfortable thinking a useful vaccine is particularly likely just because we’re trying hard. I also think that if it takes more than 3 years to develop, it might as well be never because I doubt many people will be worried about covid-19 in 4-5 years. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [June 5, 2020, 8:15pm UTC](https://boards.straightdope.com/t/whats-the-straight-dope-on-the-vaccine/854494/51 "2020-06-05T20:15:51Z")
> [@Corry\_El](#): > > …No vaccine ever is possible but would be a landmark failure of pharma research worldwide. I think ‘can’t be ruled out’ is fair… You know that we don’t have vaccines for HIV or for Dengue, despite a great deal of effort into each, right? ---
**Author:** ![CarnalK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnalk/32/486_2.png) [@CarnalK](https://boards.straightdope.com/u/CarnalK)\ **Post date:** [June 5, 2020, 10:55pm UTC](https://boards.straightdope.com/t/whats-the-straight-dope-on-the-vaccine/854494/52 "2020-06-05T22:55:32Z")
Oh, but there is a vaccine for Dengue. But that goes back to what DSeid was talking about regarding what constitutes “success”. From [wiki article](https://en.m.wikipedia.org/wiki/Dengue_vaccine): > [@](#): > > The vaccine is only recommended in those who have previously had dengue fever or populations in which most people have been previously infected.[2] The value of the vaccine is limited by the fact that it may increase the risk of severe dengue in those who have not previously been infected.[3][2] It is given as three injections over a year.[1] Would you call that a success, Corry El? [Previous page](https://boards.straightdope.com/t/whats-the-straight-dope-on-the-vaccine/854494.md?page=2)