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By Dr Rob Grenfell 7 December 2020 4 min read

This article was originally published in The Sydney Morning Herald.

It's big news that the Pfizer-BioNTech COVID-19 vaccine has been authorised for emergency supply in Britain and may give us a glimpse of what’s to come in Australia. Our government secured a deal for 10 million doses of this vaccine in November.

Before the vaccine can be distributed in Australia, there are a couple of hoops it needs to clear. First it needs to be approved by the Therapeutic Goods Administration, which reviews vaccines and medicines to assess their safety, quality and efficacy before they can be distributed here.

Next, it needs to be manufactured in the millions. This vaccine will be manufactured overseas and transported to Australia. Scaling up systems to produce and transport a highly specialised product on such a massive scale is no mean feat. And this particular vaccine needs to stay really cold – about -70°C – or it may not work, so we’ll need a new system to transport and store it (known as cold-chain storage).

If these hoops are cleared, this vaccine may be available in Australia by March. But as it takes time to manufacture, we won’t all be able to get it at once. It would make sense for our frontline health workers to be the first in line to get it, to protect them as they look after the rest of us. There may also be a case for vaccinating more vulnerable people, such as the elderly.

Will life go back to normal after we get the vaccine? Unfortunately, it will probably still take a while before life resembles our pre-COVID-19 days, and new behaviours such as social distancing, wearing masks and sanitising our hands will be with us for some time yet.

Pfizer and BioNTech say their vaccine is 95 per cent effective in preventing the COVID-19 disease. That means for every 100 people vaccinated, only five are likely to still get the COVID-19 disease. But what we don’t know yet is whether immunised people can still pick up the virus from others and spread it anyway, without actually showing any disease.

To get population-wide protection from COVID-19, we need to stop the spread of the virus. Otherwise, people who can’t get the vaccine – such as people with compromised immune systems – will still be able to catch it from others.

Another point to consider is that older people’s immune systems often react differently to younger people. We know that additional trials in older people are underway, but we haven't yet seen evidence that this vaccine will work for them.

This vaccine is welcome news, as it can stop some people from getting sick and ease some of the pressure on our health systems. But a single deployment of a vaccine may not wipe COVID-19 out of our society altogether.

Vaccines are one of our best tools against SARS-CoV-2, the virus that causes COVID-19. But there are two other critical items in our life-after-COVID toolkit: antiviral drugs and diagnostic tests.

Antivirals, as you can tell from the name, are treatments that work against viruses. They are generally given to people who are already infected, to eliminate the infection or reduce the severity of the disease, and are sometimes also used to prevent infection of people at high risk.

Let’s look at HIV/AIDS as an example, which the World Health Organisation describes as a global epidemic. Scientists developed “antiretroviral” drugs to treat HIV. They work by stopping the virus from replicating in the body. They give the immune system a chance to repair itself and prevent further damage.

Antiviral drugs can help against COVID-19 by reducing the severity of the disease in people who are already infected. There are thousands of clinical trials to evaluate potential drugs right now, so watch this space.

Diagnostic testing is also really important. That’s how Australia managed to contain HIV: through a combo of easily accessible tests, and effective pre- and post-exposure medication.

Testing helps us find out who’s infected, who’s infectious and where the cases are, and there’s a lot of work happening in this space. Tests can even help us monitor wastewater, and find out where COVID-19 might be present in a city. Rapid COVID-19 tests are starting to emerge that can be added to our toolkit to reopen our society, businesses and borders.

While this is the first vaccine to reach this stage, it’s far from the only one in development. From a public health perspective, we hope as many vaccines as possible reach this stage. That way we’ll have a range of options that can help different demographics, or are more easily transportable, so as many people can get it as possible.

For now, we’ll keep waiting for a vaccine to be rolled out in Australia. The most useful things we can do in the meantime is keep up with social distancing, contact tracing, wearing a mask when there’s community transmission, and washing our hands well.

Dr Rob Grenfell is the health and biosecurity director at the CSIRO.

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