Vaccines alone cannot get out of this pandemic-STAT

A■ The Covid-19 vaccine is being rolled out nationwide, and Americans seem to be united in a sigh of relief.

Yes, it takes months to get the vaccine to everyone. Yes, there was a big gap in the Trump administration’s vaccine distribution program, including promising doses that did not exist.

But it looks like there is light at the end of the tunnel. As long as you keep a social distance, wear a mask and wash your hands, you will feel like you can hold up until you get vaccinated.

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I’m sorry to write the following words, but here’s: You can’t vaccinate to get out of this pandemic. And a short-sighted focus on achieving herd immunity through mass vaccination may make it even more difficult for the United States, and the world, to defeat Covid-19.

Don’t get me wrong. Mass vaccination is essential. But herd immunity is a game of numbers. This expands the disease community because unprotected individuals are surrounded by a “flock” of people who are immune to the infection, making it difficult, if not impossible, for infected people to transmit the disease. Is defined as the point at which.

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Many experts state that about 70% of the population achieves herd immunity if vaccination or use of Covid-19 is immune to SARS-CoV-2, the virus that causes Covid-19.

How can I reach that number?

It’s harder than I expected.For starters, Pfizer / BioNTech and Moderna vaccines showed about 95% Effectiveness In clinical trials, vaccines effect — How well a vaccine works under real-world conditions — can be low for several reasons. One is that the people who participate in clinical trials are an incomplete representation of the entire population. They tend to be healthier and younger. Real-life factors such as vaccine transport and storage can also reduce the effectiveness of the vaccine.

The Moderna and Pfizer vaccines currently administered nationwide achieve 90% efficacy. Immunization of 70% of US residents gives 63% immunity. Therefore, to reach the herd immunity threshold, 80% of the population must be vaccinated.

Additional vaccines are beginning to be approved. Some of them have lower potency.For example, AstraZeneca vaccine It has about 70% efficacy, And Johnson & Johnson report on their single-dose vaccine 66% effective.. Their actual performance can be even lower. When these vaccines are mixed in the United States, the actual defense is less than the estimated 90% available with the Moderna and Pfizer vaccines alone.

There are other barriers to achieving herd immunity. Covid-19’s belief has been politicized in the United States, and some of the population may not even believe the disease is genuine, so vaccine intake (the number of people actually vaccinated) is It’s well below the required level.so Kaiser Health News Survey Thirteen percent of Americans released near the end of January said they would “never” be vaccinated, seven percent would only be vaccinated when “necessary”, and another 31% would “wait,” See how it works. ” vaccination. It does not encourage a number of people who want a quick journey to herd immunity.

Even if sufficient vaccine supply is restored (perhaps due to President Biden’s enforcement of the Defense Production Act), other factors will further reduce the number of people vaccinated. Eligibility factors currently exclude about 25% of US residents from Covid-19 vaccination. The Pfizer vaccine can only be given to people over the age of 16. For the modelna vaccine, you are over 18 years old. This represents about 20% of the population.In addition, the CDC says that Pregnant person May Once vaccinated, you will not reach clear recommendations. The decision is a “personal choice” left to the individual and their healthcare provider.

Excluding those currently not eligible for SARS-CoV-2 vaccination due to age or other conditions, 75% of Americans will have no vaccination restrictions. Taking into account 13% of Americans who absolutely do not want the vaccine and 7% who only get the vaccine when needed, in the near future only 49.5% of Americans will be immune. If half of the people in standby mode are not vaccinated (an additional 15% of the population), the vaccination rate of the currently eligible population is only 40%, well below the required 70%. Herd immunity. And that’s even before considering that the effectiveness of actual vaccines falls below clinical trial levels.

Young people who are not allowed to receive the Modena and Pfizer vaccines have proven to be Covid-19’s highly efficient asymptomatic spreaders. Leaving this population unprotected allows the disease to continue to spread widely.

Finally, the sustainability of the immune response to various vaccines is still unknown. May last. Alternatively, it may wear down, leaving people vulnerable after vaccination and creating new conditions for outbreaks.

If long-standing global health efforts on the HIV / AIDS epidemic have taught me something, even the best plans cannot predict all the challenges. Immunization of 75% of the US population requires about 248 million people, or nearly 500 million doses. This means that about 2 million people need to be vaccinated daily so that everyone can get immunity by the fall of 2021. At the time of writing, only about 1 million people are vaccinated daily. At that pace Reuters quote It will take at least April 2022 for 75% of Americans to get their first vaccination.

And that’s only if everything works logistically (if it doesn’t), and if SARS-CoV-2 doesn’t have mutations that make it more difficult to fight.

It is time to stop promoting the short-sighted belief that the unrealistic goals of herd immunity can be achieved in 2021 and begin to look to strengthen them. all Aspects of medical care when Covid-19 became endemic and began to admit that it would continue to hide in the population. In the near future, it means continuous physical distance. Occupancy restrictions on restaurants and other retail stores. For example, replacing physical menus with smartphone-based menus to prevent the spread of the virus.

Also, as with tetanus and diphtheria, vaccinated individuals should be monitored to measure the persistence of the immune system’s response and whether booster shots are needed. Finally, we need to strengthen our public health infrastructure and introduce new protocols to monitor new variants of the virus as soon as they emerge.

Can I defeat Covid-19? We can and will do so. But when we look at the short-term goal of achieving herd immunity, the mathematics that governs the spread of the disease is ignored. That approach will take some time. To get over Covid-19, you need to use all available tools.

Iain MacLeod is a co-founder and CEO of Aldatu Biosciences in Watertown, Massachusetts, developing new viral diagnostics, including the diagnosis of pathogens such as SARS-CoV-2, and a researcher at Harvard School of Public Health.