ACROSS AMERICA — A sharp surge in COVID-19 cases — many of them driven by the highly contagious delta variant — appears to be motivating more unvaccinated Americans to get their shots.
New COVID-19 cases are averaging about 90,000 a day, the most since February, and sending hospitalizations in states such as Florida and Louisiana to the highest levels since the pandemic began. The Centers for Disease Control and Prevention is clear that the problem is with the unvaccinated population.
Some 165 million Americans, just over half of the population, are fully vaccinated. Vaccination rates are trending upward — but until more Americans are vaccinated, the virus has more opportunities to mutate into an aggressive, pervasive variant the vaccines can’t defeat, Dr. Anthony Fauci said Wednesday.
“Quite frankly,” Fauci, the nation’s leading infectious disease expert, told McClatchy, “we’re very lucky that the vaccines we have now do very well against the variants — particularly against severe illness.”
Individual political bent influences vaccine reticence among some; for others, it’s rooted in uncertainty about side effects of the vaccines and their quick emergency use authorization.
Here are seven things to know about the COVID-19 vaccines:
1. Think of mRNA, used in the Pfizer and Moderna vaccines, as a Snapchat message that disappears after sending instructions to your immune system on how to fight the virus.
All three vaccines send instructions to the body to create antibodies to fight the virus. All can prevent serious illness or death due to COVID-19. None of the vaccines causes a COVID-19 infection.
The Pfizer and Moderna vaccines both use messenger ribonucleic acid (mRNA), a molecule that teaches cells how to make the protein that triggers the body’s immune response. The mRNA technology was established well before the coronavirus appeared.
“An mRNA vaccine doesn’t actually contain the virus itself,” Dr. Tom Frieden, a former CDC chief, said late last year. “Think of it as an email sent to your immune system that shows what the virus looks like, instructions to kill it, and then— like a Snapchat message — it disappears. Amazing technology.”
Shane Crotty, a vaccine scientist and professor at California’s La Jolla Institute for Immunology, pointed out the mRNA doesn’t stay forever in the body, but is like Post-it notes “that get torn up by the cells within minutes or hours after being read.”
Dr. Amar Kelkar, a Boston hematologist, said “vaccines are like playing the most catchy part of the song on loop until it’s recognizable even without the whole song and you can stop it from being played again.”
“Sooo basically,” he tweeted, “we’re using #COVID19 spike proteins to rickroll your immune system.”
The Johnson & Johnson vaccine uses traditional virus-based technology to deliver the instructions. A so-called vector vaccine, it uses a disabled adenovirus — one that causes the cold and flu-like symptoms typical among COVID-19 patients but is unrelated to the coronavirus.
It sends the instructions to the immune system on how to defeat the virus but doesn’t replicate itself and won’t give those using the vaccine a viral infection.
2. The vaccines are 72 to 93 percent effective, depending on the type of vaccine and the mutation.
Keep in mind, it takes a couple of weeks after the second dose of Pfizer or Moderna and single dose of Johnson & Johnson for the body to build immunity to COVID-19.
Overall, the efficacy of both the Pfizer and Moderna vaccines are in the 93 to 95 percent range, but lab data so far shows they are less effective against the alpha, beta and gamma and delta variants.
Pfizer is asking the U.S. Food and Drug Administration to authorize a booster vaccination, after a study in Israel showed it to be only about 64 percent effective against the delta variant.
Moderna said in its second-quarter earnings call Thursday that its vaccine’s antibody levels have been shown to decline over time, and those who received two doses may need a COVID-19 booster shot before winter to protect against variants. Moderna also has asked for full FDA approval.
In the United States, the Johnson & Johnson vaccine has about 72 percent efficacy in preventing symptomatic COVID-19 infections, which is slightly higher than the 66 percent efficacy in the global clinical trials. According to a new study posted online Tuesday, the J&J vaccine is much less effective against the delta and lambda variants than the original virus. The authors said their finding contributes to mounting evidence the 13 million people who have received the vaccine may need a second dose, ideally one of the mRNA vaccines.
3. Breakthrough infections don’t mean the vaccines are failing.
First, understand what a breakthrough infection is: It means a person who is fully vaccinated tests positive for virus, but it doesn’t mean they’ll become ill or transmit the infection to someone else.
Most people with breakthrough infections don’t even know it because they’re asymptomatic. Those who do have symptoms tend to have only mild illnesses that don’t require hospitalization.
According to the CDC, 97 percent of those hospitalized for COVID-19 are unvaccinated.
“Anecdotally, from talking to my friends and family and on social media, I think people are more concerned about these breakthrough infections than their prevalence would lead you to be,” Tara Smith, a professor of epidemiology in the College of Public Health at Kent State University, told Scientific American.
Breakthrough infections often occur after getting flu shots and inoculations against measles and many other diseases.
Kawsar Talaat, an associate professor in the department of international health at the Johns Hopkins Bloomberg School of Public Health, told the publication that no vaccine is 100 percent effective and “although some are better than others, most of them have some breakthrough infections.”
4. The best way to knock down the coronavirus is to achieve herd immunity, requiring 80 or 85 percent (depending on variants) of the population to get vaccinated, and that means millions more need to get their shots.
Tom Shaw, a DoorDash delivery driver from Philadelphia, explored his journey from extreme vaccine hesitancy to the point he rolled up his sleeve for a jab in mid-July.
The reason? The delta and other coronavirus variants.
“When you get the virus, it’s able to replicate a lot easier in your body because you don’t have antibodies to it. The more it replicates, the more it mutates, which increases the chance of a new variant,” he wrote.
“The reason for everybody to get the vaccine is to make sure that the virus doesn’t mutate to a point where it’s resistant to the vaccines — now even the people with vaccines are in danger. As soon as I read that, I said to myself, ‘Oh my God, it all makes sense.’ ”
5. Vaccine “paperwork” was fast-tracked for emergency use authorization, but the trials weren’t.
Researchers were already working on vaccines for other types of coronavirus and were able to apply lessons learned from the 2003 SARS epidemic and 2012 MERS outbreak when the global spread of COVID-19 made developing vaccines a priority.
Dr. Andrew Badley, an infectious disease physician at Mayo Clinic and head of Mayo’s COVID-19 Research Task Force, says it’s important to know what parts of the clinical trial process was fast-tracked — regulatory approvals, funding, data analysis and submission to the U.S. Food and Drug Administration.
“Those are all paperwork items. What was not fast-tracked was enrollment of patients, clinical follow-up of these patients, capturing the events which occurred and the follow-up,” Badley wrote on Mayo’s website. “These trials were executed very well.”
6. Severe side effects from the vaccine are rare.
Some people experience no side effects at all after getting their shots. Others may experience swelling, redness and pain at the injection site; fever; headache; fatigue; muscle pain; chills; and nausea.
However, all vaccines carry some risk of severe side effects. The CDC says safety monitoring systems have found only two types of health problems after vaccinations — anaphylaxis and thrombocytopenia syndrome (TTS), both of which are rare, according to the CDC.
The agency has received about 137 reports of Guillain-Barré Syndrome occurring among the 13 million people who got the Johnson & Johnson — statistically, that’s 0.00105385 percent.
The CDC and FDA are also monitoring reports of cases of myocarditis, an inflammation of the heart muscle, and, pericarditis, inflammation of the outer lining of the heart, to determine if they are associated with the Pfizer and Moderna vaccines. More information.
7. The conspiracy theories are just that — conspiracy theories — but they’re an epidemic of their own that requires public education.
U.S. Surgeon General Vivek Murthy recently said misinformation and bogus claims about COVID-19 and the vaccines against it are an “urgent threat” that put lives at risk.
“Misinformation poses an imminent and insidious threat to our nation’s health,” Murthy told reporters last month at the White House. “We must confront misinformation as a nation. Lives are depending on it.”
Murthy said social media platforms, which he said are too often built to encourage rather than counter the spread of misinformation, need to “step up” and “take aggressive action” to flag and remove misleading posts.
He also called on journalists to debunk misinformation without actively spreading it, and for public health officials to do a better job answering questions and explaining why public health guidance — such as on mask guidance — changes as more is learned about the coronavirus.
Murthy said everyday Americans have a role to play, too. He urged citizens to always verify questionable health information with trusted sources such as the CDC and to exercise critical thinking when they’re exposed to unverified claims.
“Misinformation hasn’t just harmed our physical health — it has also divided our families, friends, and communities,” Murthy wrote in a 22-page advisory outlining a national effort to fight COVID-19 and vaccine misinformation. “The only way to address health misinformation is to recognize that all of us, in every sector of society, have a responsibility to act.”
