COVID-19: Your Questions Answered on Vaccines, Immunity, and What’s Next
Got questions? We’ve got answers.
While the US hit a grim milestone last week as it surpassed 500,000 covid deaths, there’s good reason to be optimistic going forward. The rate of new cases is down 65% from what it was just a month ago, and the trendline continues to drop. And with the state of Wisconsin vaccinating nearly 50% of its 65 and older population, the next population group – which includes educators and essential workers – will be eligible for vaccinations beginning today, March 1.
So here’s what you need to know, and what you can expect going forward.
First things first: this is not advice on whether or not to get vaccinated – that’s a discussion to have with your primary care physician. I’m a chiropractor, and while I keep extremely well-informed on public health matters, I treat musculoskeletal conditions; giving medical advice on vaccines is outside of my scope of practice. This post is simply intended to give a clear, evidence-based update on where we’re at in the pandemic.
Q: What’s the difference between the vaccines?
With the FDA approval of the Johnson & Johnson vaccine this past week, there are currently 3 vaccines available in the US (and one yet to be approved):
Pfizer-BioNTech
Technology: mRNA
How it Works: This is the first large-scale vaccine campaign to use mRNA (messenger RNA) technology. mRNA is the step between DNA and actually producing a protein – it doesn’t change your DNA. The mRNA used in the vaccine contains instructions for human cells to produce proteins that mimic those on the surface of the coronavirus, teaching your immune system to see the spike protein as foreign and develop antibodies and other immunity weapons with which to fight it. Because mRNA degrades very quickly (which also means it only stays in your system for a few days), mRNA vaccines need to be kept at extremely cold temperatures.
Doses Required: 2 (Separated by at least 3 weeks)
Efficacy: 95%
Major Buyers: EU Countries (200 million doses), US (100 million doses)
Moderna
Technology: mRNA
How it Works: Like the Pfizer vaccine, the new mRNA technology tricks the body’s cells into making the viral protein itself, which in turn triggers an immune response and the creation of antibodies as well as T-cells and B-cells.
Doses Required: 2 (Separated by at least 4 weeks)
Efficacy: 94%, although the vaccine’s efficacy appears to be slightly lower in people 65 and older.
Major Buyers: EU Countries (160 million doses), US (100 million doses), Canada (40 million doses)
Johnson & Johnson
Technology: Viral Vector
How it Works: Uses a harmless adenovirus as a Trojan horse to deliver genetic material from the SARS-CoV-2 virus responsible for producing spike proteins – the knob-shaped surface structure that the virus uses to connect to human cells. Because it’s a more traditional vaccine technology (similar to many seasonal flu shots), it doesn’t need to be kept at extremely cold temperatures.
Doses Required: 1
Efficacy: 66%-85% against moderate to severe Covid infection
Major Buyers: EU Countries (160 million doses), US (100 million doses), Canada (40 million doses)
Oxford University-AstraZeneca
(*Not Yet Approved in the US – Expected in April)
Technology: Viral Vector
How it Works: The AstraZeneca vaccine is based on modified adenovirus technology similar to the Johnson & Johnson vaccine. Though the viral carrier can enter healthy human cells to produce spike proteins, it’s unable to spread in the body, and won’t give people a cold.
Doses Required: 2 (Separated by at least 4 weeks)
Efficacy: 82%
Major Buyers: EU Countries (400 million doses), US (300 million doses), UK (100 million doses)
Q: I’ve recovered from Covid-19. Am I immune now?
The latest research shows that for most of those who recover from Covid-19, immunity to the virus can last at least 6 months – likely years, maybe even decades. And fortunately, naturally acquired immunity is quite strong – up to 99% effective. Reinfections have occurred in less than 1% of people, and when they do occur the cases are usually mild.
But let’s dig deeper into what immunity really means.
The components of immunity protection include:
- Antibodies, which are proteins that circulate in the blood and recognize foreign substances like viruses, and neutralize them.
- Helper T-cells help to recognize pathogens.
- Killer T-cells kill pathogens.
- B-cells make new antibodies when the body needs them.
People who recover from Covid-19 have all four of these components. But there is a massive dynamic range in that immune response, with a 200-fold difference in the production of these immune components between some people. A variable taken off the table with a vaccine is that everyone receives the same administered dose (and similar immune protection).
If you’ve recovered from Covid-19, an antibody blood test can estimate your degree of protection. But look for a quantitative or semi-quantitative antibody test (LabCorp locations nationwide offer a SARS-CoV-2 Semi-Quantitative Total Antibody test), instead of a qualitative antibody test. A qualitative test answers ‘yes or no’, while quantitative and semi-quantitative antibody tests tell you ‘how much?’ By measuring the level of SARS-CoV-2 antibodies in a patient’s blood sample, quantitative and semi-quantitative tests give a more informed answer about the body’s immune protection against the virus.
Keep in mind, though, that you lose antibodies much more quickly than you lose T-cells and B-cells (your immune “memory cells”), which can last for years. So even an antibody test doesn’t tell the whole story when it comes to immunity.
A recent development for those who’ve already had Covid-19 is that studies are now suggesting that they might not need to get a second vaccine dose. While a first shot gives people who’ve recovered from Covid-19 a boost, the second shot makes little difference. However, as of now, the federal government has not changed its recommendation for a second dose.
Q: When can I get the vaccine?
The Covid-19 vaccine is being distributed to Wisconsin residents in a phased approach. So far nearly a million Wisconsinites have received at least one vaccine dose.
Phase 1A: Health care workers and nursing homes, as well as people 65 and older. This phase began December 2020.
Phase 1B: Phase 1B begins March 1. The newly eligible groups include the following in priority order:
- Education and child care staff
- Individuals enrolled in Medicaid long-term care programs
- Some public-facing essential workers
- Non-frontline essential health care personnel
- Facility staff and residents in congregate living settings.
Phase 1C: Those with chronic health conditions and essential workers.
Phase 2: Everyone age 16 and up who hasn’t already been vaccinated.
Phase 3: Vaccinations incorporated into preventative care.
Q: How close are we to herd immunity?
Herd immunity, also known as community immunity, is the idea that a community can collectively prevent the spread of infections if a certain percentage of the population has immunity to a disease. Achieving herd immunity means it’s unlikely that a disease, in this case Covid-19, can spread from person to person even if a small percentage of the population is not immune.
Even individuals not vaccinated (such as newborns and those with chronic illnesses) are offered some protection because the disease has little opportunity to spread within the community.
White House chief medical advisor Dr. Anthony Fauci has previously said that 75% to 85% of the population would need to develop immunity to create an “umbrella” of protection – whether through vaccination or natural infection. Officials with the CDC also recently said that upward of 85% of people would need to be covered to achieve so-called herd immunity if a faster-spreading form of the virus, such as the U.K. variant, become the dominant strain in the U.S.
But even though estimates appear to have the U.S. on track to vaccinate about half the U.S. population by the summer, many experts are predicting that we’ll reach herd immunity much earlier. Those predictions take into account the number of people in the U.S. who have been infected and already have natural immunity to the disease, which is much higher than the CDC has been able to track.
Testing has been capturing only 10% to 25% of infections, which – if models are correct – could mean about 55% of Americans already have natural immunity. Now add to that the number of Americans who’ve been vaccinated. As of this week, that’s about 15% of Americans (and rising).
Taking those figures into account, last week John Hopkins University School of Medicine epidemiology expert Dr. Marty Makary said the U.S. could actually reach herd immunity as early as April.
Not every health expert, though, agrees that the country will be totally open for business by April. Those who are less optimistic point to new SARS-CoV-2 variants that may lower the effectiveness of vaccines. Data suggests that the new strain first seen in South Africa may reduce protective antibodies provided by the current vaccines. If the vaccines become less effective, it’ll extend the time needed for the country to reach herd immunity.
Q: What’s the next big development on the horizon?
Inovio is currently finishing phase 2 trials on a novel Covid-19 vaccine delivery system that transmits SARS-CoV-2 DNA plasmids directly through the skin (transdermally) via a weak electrical pulse – which means no needles. Plus, it’s stable at room temperature for over a year.
Vaxart, a biotech company that develops vaccines that are administered by tablet rather than by injection, is beginning phase 2 trials on it’s oral Covid-19 vaccine. If they’re successful, not only will it mean simply taking a pill, but it will massively simplify logistics of distributing the vaccine.
Finally, as the number of Covid-19 variants increases, researchers are shifting their focus to a universal coronavirus vaccine that can work on not just all SARS-CoV-2 variants but all coronaviruses, period. VBI Vaccines has developed a ‘pan-coronavirus’ vaccine candidate designed to be a one-shot immunization against Covid-19, SARS and MERS, as well as the coronavirus responsible for the common cold. It has yet to enter into clinical trials.
The Ascent Chiropractic Difference
At Ascent Chiropractic, we’re committed to keeping our community healthy and optimizing your body to function better than it ever has before. Our unique, low-force, evidence-based approach to treatment allows us to correct biomechanics, restore normal function, and get you out of pain and on the road back to optimal health. Ready to get started? Schedule an appointment by calling us at 262-345-4166 or use our online scheduling app.
Medical photo created by wirestock – www.freepik.com
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