Thoughts about a #COVID19 vaccine - it's not as simple as you may think.

Here are 7 sets of questions that need to be answered (and surely there are more, so feel free to add your own):

[a thread]

1) Will the vaccine candidates actually work?

Yes, there are multiple candidate vaccines and trials underway. But Phase III trials are just starting. Even with promising early phase data showing an immune response - will that response be enough?

2) What does 'efficacious' mean for a vaccine? Are we talking complete immunity, or simply reduced disease severity? There's a range of possibilities, and while anything may be better than nothing, this will impact how we live after 'we have a vaccine'

3) How will it be administered?
Will we have a single dose, or will a series be required?
And how long will protection last?
Will we require periodic boosters? At what interval?
For how long will we have distancing, masks, and other precautions?

4) Some pharmaceutical companies are manufacturing at risk. That means they're making the vaccine before they know if it will work, so it can be ready for patients ASAP if the studies pan out. That's expensive.

What will be the impact on the healthcare economy overall?

5) Not only do we need billions of doses, but we need a way to store and ship those doses. That's billions of syringes or vials to fill under sterile conditions/strict environmental control, plus the materials required to safely transport around the world.

And it's not like we are stopping all other vaccine production or administration.

Rite Aid provided 2.6 million flu shots last year, as just one example.

So we need factories, people, and logistics we don't have.

Even if science is #warpspeed, supply chain may not be.

6) How do we get everyone vaccinated? Some people will refuse.

Some people won't be able to get time off from work.

Rural areas, disability, etc

We'll need a strategy to get the vaccines to people.

Will the vaccines work for kids?

Plus, no one likes needles.

7) How will we prioritize who gets the vaccine first? Probably healthcare professionals, military, and high-risk populations.

But there's going to be ethical considerations that may not be comfortable. I'll just leave that right here.

I'm sure there are more questions to address. But whenever I hear "we'll have a #COVID vaccine in a few months" I just think

We're going to need to hold out much longer to save lives until we solve this problem, so please #WearAMask

#epitwitter knows far more than I on this I'm sure.

@choo_ek @meganranney and others probably do too.

Appreciate your tags on the folks who can round this out an educate us all.