The world breathed a sigh of relief as promising news of an effective COVID-19 vaccine was announced. The first was Pfizer, swiftly followed by other large pharmaceutical companies. I hope to God they work and result in a swift end to the pandemic. Successful vaccines have been nothing short of miraculous for humanity, in helping to virtually eradicate many diseases including measles and polio. Success is however, far from certain. I like to always be thinking ahead strategically, and not be caught off guard. We should never get caught up in emotional euphoria. Let’s smart and anticipate potential problems before they happen. Here are 4 big ones to prepare for:

1.Will enough people consent to it?

Over the last few months, and even last couple of weeks since the announcement—I have talked to multiple individuals, mainly educated healthcare professionals, who have stated categorically that there is no way they’ll be getting a newly released, expedited, mRNA vaccine—produced in record time. And certainly not giving it to their children. They are far from being anti-vaxxers, but have said that they would rather wait a year or two, to make sure it’s completely safe and well-tolerated. I get that sentiment, and completely empathize with it.

2.Side-effects

In a mass-vaccination program that involves millions of people, you will inevitably start hearing stories of people reporting unusual side-effects. Perhaps some developing medical syndromes soon after the shot, and blaming the vaccine. This is bound to happen and these stories will start spreading like wildfire on social media. What effect will they have on the population remains to be seen.

3.Will it help vulnerable people with impaired immunity?

We already know that the majority of people exposed to COVID 19—some estimates suggest as much as 80 percent—are completely asymptomatic. The virus doesn’t proliferate in their bodies because their immune systems deal with it. COVID-19 is not an indiscriminate killer. It overwhelmingly severely affects anybody with impaired immunity, including the elderly and those with chronic disease. Did the initial studies involve enough of these people? For a vaccine to work, you must have a functioning immune system. Unless we are completely relying on herd immunity to protect the vulnerable, they will remain at significant risk of illness.

4.What will happen when vaccinated people report infection?

After 3, 6, 12 months, some people may still contract COVID-19 despite having received the vaccine. We may find that the vaccine is more similar to the Flu vaccine, than it is to the Polio vaccine. How will we respond to these stories, and will they cause a mass panic or rejection of the shot? I can see the viral media story now: Patient dies of COVID despite getting the vaccine.

The last point is the one I’m most concerned about. While we all hope that the vaccine is a staggering success and none of the above happens, we—especially the medical community—should be prepared just in case it does.

Suneel Dhand is a physician, writer, and YouTuber. He is Founder at MedStoic Lifestyle Medicine and DocsDox . Follow him on YouTube and Instagram