These Coronavirus Trials Don’t Answer the One Question We Need to Know

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These Coronavirus Trials Don’t Answer the One Question We Need to Know

We may not find out whether the vaccines prevent moderate or severe cases of Covid-19.

By Peter Doshi and

Dr. Doshi is an associateprofessor at the University of Maryland School of Pharmacy. Dr. Topol is a professor of molecular medicine at Scripps Research.

  • Sept. 22, 2020
A participant receiving an injection during a Phase 3 coronavirus vaccine clinical trial.
A participant receiving an injection during a Phase 3 coronavirus vaccine clinical trial.Credit...Paul Hennessy/NurPhoto, via Getty Images

If you were to approve a coronavirus vaccine, would you approve one that you only knew protected people only from the most mild form of Covid-19, or one that would prevent its serious complications?

The answer is obvious. You would want to protect against the worst cases.

But that’s not how the companies testing three of the leading coronavirus vaccine candidates, Moderna, Pfizer and AstraZeneca, whose U.S. trial is on hold, are approaching the problem.

According to the protocols for their studies, which they released late last week, a vaccine could meet the companies’ benchmark for success if it lowered the risk of mild Covid-19, but was never shown to reduce moderate or severe forms of the disease, or the risk of hospitalization, admissions to the intensive care unit or death.

To say a vaccine works should mean that most people no longer run the risk of getting seriously sick. That’s not what these trials will determine.

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