Amir Imani is a clinical pharmacist and instructor at the University of Toronto. Zain Chagla is an infectious diseases physician and associate professor at McMaster University.
As more COVID-19 vaccines are approved in Canada, we gain more tools to end the pandemic.
But these vaccines won’t accomplish anything sitting in a fridge. We need to get Canadians vaccinated, and that means educating and having honest conversations with them using the best data we have. Right now, vaccines are our best hope for reducing the suffering caused by this virus.
When it comes to the choice of vaccines, the recommendation from many scientists, clinicians and epidemiologists has been the same: “The best vaccine is the first one you’re offered.” There is no political influence behind this statement. It is simply a recognition of what we know thus far and of the toll this illness has taken on our communities. The benefits of being vaccinated sooner outweigh every other metric at this stage of the pandemic. Mass vaccination is the best way forward.
While it might seem easy to compare the approved vaccines, these are imbalanced assumptions. Their clinical trials were run with different protocols, in different countries, and at different stages of the pandemic. Pfizer and Moderna did not have to deal with problematic variants in their landmark studies, and even the definition of “efficacy” varies between the trials. But it’s hard for anyone to not develop a preference after hearing about “60 to 70 per cent efficacy” with AstraZeneca and Johnson & Johnson, and “95 per cent efficacy” with Pfizer and Moderna.
Vaccines are not created equal. However, the long-term efficacy of these agents is still being borne out, and there will likely be important differences we notice over time: Some vaccines might better protect the elderly, some might confer longer immunity, and some might be more effective against variants of concern. We’re still gathering this information as it evolves over time.
However, there are three things we do know.
1) Thus far, all the vaccines approved in Canada for COVID-19 have shown great efficacy in preventing hospitalization and death from infection. You can still develop symptoms or test positive after receiving any vaccine, but with the caveat that the illness will be mild, and you’ll be at low risk of hospitalization, need for a ventilator, or death.
2) When it comes to vaccines, you are not “stuck” with what you get. As our supply and knowledge of COVID-19 (and its variants) grows, we can look at optimizing protection with boosters or different types of vaccines. This is a common strategy for other infectious diseases: In bacterial pneumonia, high-risk patients receive two different vaccines from two different companies sequentially in order to gain the highest level of protection. And with shingles, we’ve revaccinated individuals when a more effective product was discovered and came to market.
3) These vaccines likely lower transmission in the community. More people getting vaccinated promptly will lower our community burden and help develop herd immunity. This creates an extra blanket for us to lower all of our individual risks.
Here’s an analogy for how we see this: You’ve been sitting out in the cold without anything to shield you from the elements. Someone comes along and offers you a coat. We don’t know if it’s the warmest coat we have on the market, but it’ll protect against the cold and keep you from getting hypothermia. You could refuse and keep waiting for someone to come along with a (possibly) better one, but we’d recommend taking that first coat. We can get you bundled up better later if needed.
Voltaire noted that perfection is the enemy of the good. With multiple approved vaccines in less than a year since the pandemic was declared, we’ve entered a period of hope and optimism. The end of this suffering and a return to normal is in sight, but fixating on efficacy differences between the vaccines may hinder this. When their turn comes, we encourage all Canadians to roll up their sleeves.
Keep your Opinions sharp and informed. Get the Opinion newsletter. Sign up today.