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Abstract
The ongoing coronavirus disease 2019 (COVID-19) pandemic has caused over 1 000 000 deaths worldwide and over 200 000 deaths in the US to date.1 Most, but not all of the deaths and more severe consequences of COVID-19 have been among older individuals.2 However, in addition to the direct morbidity and mortality figures, there have been enormous disruptions in the lives of persons of all ages, with attendant emotional, economic, and social stresses.3,4 Approaches to managing the pandemic have relied upon what are referred to as nonpharmaceutical interventions (NPIs), such as social distancing, wearing masks, washing hands, and testing and contact tracing. These approaches can be effective at mitigating the damage caused by COVID-19, but only if they are widely accepted and implemented, which has generally not been the case in the US. NPIs often are characterized as stop-gap measures, “until a vaccine or cure is available.” In fact, there have been unprecedented efforts to develop vaccines to prevent infection because of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19. As of the writing of this report (October 2020), there were 44 candidate vaccines in human clinical trials, with 11 in phase 3 trials.5 As a result, there is great expectation that a vaccine soon will be available. However, vaccination, like NPIs, will not be effective without well-designed public health policies, clear public health communication, and widespread acceptance among the population. In addition, we do not yet know how efficacious a vaccine will be or how long vaccine-induced immunity will last, including whether vaccination will need to be on a seasonal basis, like influenza vaccination. In addition, it is essential that a plan is in place for equitable allocation of any vaccine that becomes available, including for children and adolescents, to ensure that all are protected and that existing COVID-19 health disparities are not made worse.6
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