COVID-19 has evolved, our expectations for the vaccine must also evolve
- Changing COVID-19 vaccine recommendations have caused confusion.
- The vaccine is intended and successful in reducing serious illnesses, hospitalizations and deaths.
- Although being “up to date” on the vaccine may require additional doses of vaccine, this is not unusual when it comes to vaccinating against infectious diseases.
As Omicron continues to cause major infections among fully vaccinated people and safety recommendations evolve, public confidence in COVID-19 vaccines has begun to decline.
However, medical experts say understanding the primary purpose of vaccines can shatter feelings of betrayal.
“Many people expect vaccines to be perfect, and if you get vaccinated and boosted, that should solve the problem. Some of that is not unreasonable because we have such spectacular pediatric vaccines like the polio and measles vaccines,” Dr William Schaffnerprofessor of preventive medicine and infectious diseases at Vanderbilt University Medical Center in Nashville, Tennessee, Healthline told Healthline.
However, he said communication about vaccines was flawed from the start. For example, when vaccines were first released, Schaffner said, “the communication was quite euphoric, but it wasn’t very clear. We emphasize extraordinary triumph.
Political confusion around vaccine acceptance also played a role in misunderstandings, as did the emergence of variants, which necessitated a recall.
“Because it’s an evolving story, it’s difficult for the audience. There’s a real vaccine fatigue and downright grumpiness about it all. They want simple, clear, and comprehensive answers, and we in public health must work to achieve that,” Schaffner said.
Because the virus can continue to evolve, as most viruses do, scientists have always known that breakthrough cases can occur in vaccinees, said Dr Natasha Bhuyanfamily physician and infectious disease specialist in Phoenix.
“[However,] these generally tend to be light. The data shows that vaccines work regardless of breakthrough infections, as vaccines continue to be extremely effective in preventing serious illness, hospitalizations and deaths from COVID-19,” Bhuyan told Healthline.
According to recent Data from the Centers for Disease Control and Prevention (CDC), hospitalizations were 16 times higher for unvaccinated adults 18 and older in December 2021.
“Remember, we told you that these vaccines were 90% effective in keeping people out of hospital. For the vast majority of people who are vaccinated and have a booster, if they come across the virus, they get bad cold and don’t require hospitalization. That’s the main goal of the vaccine,” Schaffner said.
Still, those who chose to listen to public health officials and get fully vaccinated, but suffered a breakthrough infection, may find themselves frustrated. Bhuyan said he heard the frustration of patients in this situation.
“But I also saw it quickly turn into relief when they finally had a mild case and recovered in just a few days,” she said.
In January, Dr. Anthony Fauci told J. Stephen Morrison, senior vice president of the Center for Strategic and International Studies, “Omicron, with its extraordinary and unprecedented degree of transmissibility efficiency, will eventually find just about everyone world.”
However, Fauci explained that people who have been vaccinated and boosted and who are infected with Omicron “will most likely be fine, with some exceptions, in the sense of having no hospitalizations and no deaths.”
Getting people to understand this requires regular and ongoing conversation, Bhuyan said. In addition to talking to patients about how the vaccine protects them from serious illness and death, she explains how it affects society.
“Our hospitals and healthcare systems are also currently facing a huge increase in COVID-19 cases. If we are able to reduce serious illness and death, it helps free up health care resources for other important health conditions that people seek care for – ranging from strokes to heart attacks to surgeries,” Bhuyan said.
Since January 16, the
However, the CDC also states that being “up-to-date” on vaccines “means that a person has received all recommended COVID-19 vaccines, including any booster doses when eligible.”
“From the beginning, many of us [in infectious disease] thought people were going to need another dose after the first two doses of Pfizer and Moderna and more than one dose of J&J, and of course it was needed,” Schaffner said.
He mentions other vaccines that require more than 2 doses, such as poliomyelitis (4), hepatitis B (2, 3 or 4) and tetanus (5 doses, plus boosters).
Bhuyan noted that being fully vaccinated may have different definitions for different populations. For example, immunocompromised people need three doses of the COVID-19 vaccine to trigger an adequate immune response.
Regarding the use of “up to date” in relation to being boosted versus changing the meaning of “fully vaccinated” to include the booster, Schaffner said there could be issues. legal and administrative.
“There were a lot of institutions that were implementing software for their employees that fully vaccinated meant two doses. Now that we’re asking everyone to be reinforced, if we want to change that designation to fully vaccinated, that has all kinds of ramifications, and the world has been split on that,” he said.
Some public health people suggest staying “fully vaccinated” at two doses with the recommendation to get a booster. Others believe that changing “fully vaccinated” to include the booster is the best way to impress upon the public its importance.
“I don’t know which is the most functional in our population. Right now, I think we’re in a transition and maybe moving towards a new definition of what fully vaccinated means,” Schaffner said.
As to whether “fully vaccinated” for COVID-19 could include more doses in the future, he doesn’t think so, although he thinks the vaccine could end up like the flu shot in that a booster is recommended periodically.
“Some of the vaccine makers are already working to combine flu and COVID vaccines so that if the recommendation is annual, we would only have to roll up our sleeves once,” Schaffner said.
When COVID-19 hit the world, it was a new infection in humanity. Schaffner said public health officials and scientists could have done more to express that to the public.
“We opened our textbooks, and they were blank, so we had to learn that, and as we learn, we’re going to tell you more, so what we tell you will change. We should have said that every times we were talking to the public,” he said.
He thinks that’s where the public annoyance, distrust and confusion comes from, and he expects public frustration to continue unless people start to understand that viruses evolve, which requires science and human behavior to evolve with them.
“If another variant of COVID appears, people may need to get vaccinated again. From a public health/physician perspective, the answer is simply to get vaccinated; this virus is killing people,” he said.
The idea that the world will have to deal with COVID-19 somehow and create some new “normal” in the future is daunting.
“It’s not going to be easy. We will have to make a sustained effort together,” he said.