Ten questions on the next phase of the UK’s COVID-19 response

3. How will development of an effective COVID-19 vaccine affect uptake - and what should be done?

Our rapid policy briefing Fair and equitable access to COVID-19 treatments and vaccines highlights the speed at which many vaccines are being developed. Timelines and processes for development and approval have been accelerated with the support of regulatory authorities, but with huge variation in global approaches: China and the United Arab Emirates have both approved emergency usage of a vaccine still in Phase 3 trials; Russia has approved use of a vaccine without Phase 3 trials or publication of any earlier results; and there has been political pressure in the USA for the Food and Drug Administration (FDA) to approve a vaccine in time for the upcoming Presidential Election.

The speed and urgency of trials should not compromise the safety of participants, quality of the trials, or ethical standards. There are already concerns that the accelerated process, and how that is being communicated to the general public, may (among other factors) impact on public trust and willingness to take up a vaccine.16 Human challenge trials for a vaccine - where healthy volunteers are deliberately infected with COVID - one of which is due to begin in early 2021, also present new challenges which warrant careful ethical review and public engagement.

Over-optimism about what a vaccine might achieve - whether there will be an effective one, whether it will only be partially effective, how effectiveness might differ in certain groups (e.g. the elderly or children) - has been a particular feature of discourse in the past few months. In many contexts it is being touted as a panacea rather than one possible part of the solution.