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COVID-19 administration will move into high gear. If multiple vaccines are approved for use, that could help with supply issues. In North America alone, hundreds of millions of people need to be vaccinated, and the demand for an effective vaccine is worldwide. The complex practicalities inherent in a massive vaccination campaign during a pandemic cannot be overstated. Depending on the successful vaccine candidate, multiple doses may be necessary. Vaccinating millions of people not once, but twice, to confer effective immunity, increases the logistical challenges. Different vaccines will have different storage requirements, with potentially significant implications for distribution. Refrigeration, or the need for specific freezing temperatures, may determine how vaccine administration will roll out. The question of vaccination priority will also impact how soon different individuals will have access to an effective vaccine and how soon social restrictions might ease. People at high risk and front-line workers will be among the first to have access to the vaccine. This will likely include seniors and those with high-risk health conditions. Those who are involved in essential services may also be prioritized. It is unclear when children will be vaccinated, as most trials have focused on healthy adults; studies in children are ongoing. Vaccine supply will build gradually. It will likely take some time before all of those who need to be vaccinated have access to the vaccine. Early estimates suggest that 60-70% of the population needs to be vaccinated against SARS-CoV-2 to achieve herd immunity. Recent developments suggest that safe and effective vaccines for COVID-19 may soon be moving through the approval process. The vaccine needs to both be safe, and produce an immune response to the virus adequate to prevent infection or severe infection. This, however, is not the end of our pandemic journey. Regulatory bodies conduct ongoing surveillance to monitor efficacy and safety of a vaccine as it is distributed among the wider population. It is yet to be determined how long immunity will last with the new vaccines. Previous experience with this type of virus suggests that immunity may wane with time and yearly or biennial immunization may be necessary. Due to the immense scale of the vaccination program that needs to be implemented, as well as the associated practical and logistical considerations, it is clear that public health measures to mitigate viral spread will remain a priority for some time. Mass production, distribution and administration to a majority of the population will take time, once a vaccine has been approved. Long-term observations will ensure that the vaccine functions as expected. While it may not be time to discard our masks and hand sanitizer just yet, it does appear that some help is on the way. CSANews | WINTER 2020 | 39

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