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People who refuse to vaccinate against infectious diseases rarely influence their decisions because herd immunity protects them. Herd immunity is resistance to the spread of an infectious disease within a population and results from a sufficiently high proportion of individuals being immune to the disease. Such immunity may be the result of a natural infection or vaccination. Contrary to what has been published in the media, herd immunity is unlikely to protect us from COVID-19. Our ticket to “being normal” is to get vaccinated.

There is no evidence that natural infection with SARS-CoV-2 (a new coronavirus) provides the long-term defenses needed to generate herd immunity. On the contrary, the four seasonal coronaviruses that cause upper respiratory tract infections circulate each winter and spring. We all probably have them more than once. Defensive immunity lasts only a few years and can then be caught again. What this means is that if SARS-CoV-2 follows without vaccination, most people will eventually catch COVID-19.

Can the COVID-19 vaccine generate herd immunity? It’s too early to say. The COVID-19 vaccine may act like an influenza vaccine, rather than acting like a measles vaccine. The measles vaccine induces bactericidal immunity. In short, the measles vaccine completely stops the infection and prevents it. On the other hand, current flu vaccines are reasonably good at preventing infection. People who have been vaccinated still get the flu and can get it. Influenza vaccines are not bulletproof against infection, but the good news is that sick vaccinated people are less likely to get a serious illness than unvaccinated people. With our flu vaccine, the effects of the herd are less common.

Influenza vaccines may not generate herd immunity because only about half of the population is vaccinated each year. In the case of COVID-19, it is estimated that 70% of the population needs to be vaccinated to generate herd immunity. It’s an incredibly high standard to meet. First, children make up a quarter of the population and will not be vaccinated in the near future. Before a vaccine test begins in a child, it must be shown to be safe and effective in adults. As a result, most adults need to be vaccinated, but it is doubtful if vaccination is a personal choice. Many adults believe that they are not at risk for SARS-CoV-2 and are vaccinated. Vaccines are not required by law.

Sadly, politics is sneaking up on vaccine development, and those who avoid the vaccine continue to try to scare others from the COVID-19 vaccine. None of this is surprising. Look at the recent battle for a safe and effective measles vaccine that has saved lives for over half a century. Without herd immunity, vaccination against the COVID-19 vaccine would be required. When choosing, keep in mind the very real risks of COVID-19.

Dr. Megan Berman is an associate professor of internal medicine at the Sealy Institute for Vaccine Sciences, and Dr. Richard Rupp is a professor of pediatrics at the University of Texas School of Medicine.

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