As both Moderna and Pfizer’s COVID-19 vaccines continue their rollout among the first phases of recipients across the country, and Johnson & Johnson’s just clearing FDA approval, the COVID-19 vaccine is a promising beacon of light at the beginning of 2021 after the dark and winding tunnel that was 2020. Likewise, you may be hearing the word “hope” a lot as you read and watch news stories from vaccine recipients and health care workers who are receiving their shot. While the vaccine does create hope that we will return to life as normal in 2021, it’s important to note that it may not come as quickly as many of us might think.

“The problem is logistics,” says Paul Offit, M.D., a member of an FDA panel of experts that gave a thumbs-up for the Pfizer vaccine, the first of the now three vaccines to be approved for administration. “It’s a matter of making the vaccine and distributing it. It’s making sure people get it, that they aren’t sort of swayed by what is a lot of misinformation that surrounds not only this vaccine but all vaccines. That’s going to be the hang-up.”

Offit predicts that life as we used to know it will go back to normal in the fall of 2021, but that’s only if two-thirds of the American population — roughly 220 million Americans — gets the vaccine in order for us to create herd immunity. For context, the federal government has a similar goal of vaccinating 70% of the population against the flu each year, yet data shows that less than half of Americans get the vaccination.

While that may seem like a huge obstacle, a survey released from the Kaiser Family Foundation reveals that around 71% of respondents said they will “definitely or probably” get the vaccine. The 71% is an increase compared to results from September when 63% of respondents said they would receive the shot.

So what should we expect as the vaccines continue to rollout?

The Long Road Ahead

Although vaccination is underway, you’ll still have to wear masks and practice social distancing for the foreseeable future for three reasons: the low number of people initially receiving the vaccine (only 12% of Texans have received at least one dose), the need for a second dose with two of the three vaccines, and efficacy.

Both Pfizer and Moderna’s vaccines require two doses, the first dose and a booster dose weeks later, meaning you’re only partially protected by the first dose. Pfizer’s study showed that its vaccine has 95% efficacy at preventing symptomatic COVID infection after two doses, while Moderna’s study showed that its vaccine has 94% efficacy at preventing symptomatic COVID-19 after the second dose.

While Johnson & Johnson’s vaccine is just one dose, its efficacy rates are, on the surface, much lower than Moderna and Pfizer’s. But comparisons can be difficult since Johnson & Johnson’s phase 3 clinical tests were much different than Moderna and Pfizer, which creates the difference in rates. Essentially, the trials were testing for different outcomes.

As stated earlier, Pfizer’s and Moderna’s trials both tested for any symptomatic infection. Pfizer started counting cases from seven days after receipt of the second dose, while Moderna waited 14 days to start counting cases.

Johnson & Johnson, by contrast, sought to determine whether one dose of its vaccine protected against moderate to severe illness, versus just symptomatic infection. They defined this as a combination of a positive test and at least one symptom, such as shortness of breath, beginning from 14 or 28 days after the shot. J&J found that their vaccine was 66% protective against moderate to severe infection 28 days after injection and 85% effective at protecting against severe illness.

Saying Goodbye to the “Old Normal”

Although it can be disheartening to hear that after a difficult year, the vaccine doesn’t provide “a quick fix,” to help us go back to normal, think of it much like the flu and its vaccine. Even though you receive the flu shot, there is still a chance that you might catch the flu within the months following your shot, but the hope is that if you do get sick, your symptoms will be less severe compared to if you had not received the vaccine. However, it doesn’t prevent you from passing the flu to someone else while you’re sick, even if they have also received the vaccine.

While preventing severe complications from COVID-19 will save many lives, it still doesn’t prevent the possibility of spreading the virus further and possibly to those who have not received the vaccine yet or cannot due to age, allergies or other conditions. That means masks, quarantining and social distancing will be here to stay for a bit.

That being said, Professor Ugur Sahin, one of the founders of BioNTech, recently noted that he expected the vaccines would reduce transmission between people, but not completely.

“I’m very confident that transmission between people will be reduced by such a highly effective vaccine — maybe not 90% but maybe 50% — but we should not forget that even that could result in a dramatic reduction of the pandemic spread,” he told the BBC.

So, until we compile more data, unfortunately, we must still stay vigilant in our adherence to safety protocols and measures, but that means we must alter our previous idea of “normal” as well.

“Think of how it’s been 20 years after 9/11 and we still take off shoes when we go to the airport,” says Timothy Brewer, M.D., a professor of medicine in the division of infectious diseases at the David Geffen School of Medicine at UCLA and a professor of epidemiology at the UCLA Fielding School of Public Health. “The same things happen as we get closer back to a pre-pandemic state. Two years ago, if we walked into a bank with a mask on, security would have [jumped into action]. Now I suspect that people will be wearing masks at some point going forward, during winter seasons or even when not in a pandemic. There’ll just be more mask-wearing than in the past.”

Brewer said he predicts the plastic barriers we see in supermarkets will remain even after the vaccine rollout. Virtual meetups may also be here to stay, even once it’s safe to meet up with those outside your household, as well as our adoption of curbside options, mainly because of convenience. Some even predict that handshakes may be a thing of the past as well moving forward.

Practicing Patience

In the meantime, as we wait for more people to be vaccinated and data to come forward, we must practice patience, even though pandemic fatigue is a very real thing. If the 2020 Word of the Year was “Pandemic” then 2021’s must be “Patience.” While patience is a virtue, hunkering down just a bit longer can make sure that transmission decreases and fewer people die as the vaccines roll out.

Learn more about COVID-19 vaccines at TexasHealth.org/Vaccine.