Impact of Vaccination on Changing the Global Pandemic Situation

By Jiya Chatterjee

Published in Horace Mann's Spectrum Magazine June 2021

The COVID-19 pandemic has been raging on for over a year now, and now that scientists have gained a better understanding of the impacts of the virus, it is safe to say that the world has made some progress regarding containment of the virus. On December 11, 2020, the Food and Drug Administration (FDA) issued approval for emergency use of the Pfizer-BioNTech vaccine in the United States, which is now available for people 16 years of age or older. In parallel, other institutions producing vaccines such as the Moderna vaccine, Oxford-Astra-Zeneca vaccine, and Johnson & Johnson vaccine began distributing globally in the following weeks. All of the vaccines have impressive efficacies: Pfizer’s efficacy is 95%, Moderna is 94.1%, Astra-Zeneca is 67%, and Johnson and Johnson’s efficacy is 67%. Efficacy, as per Center for Disease Control and Prevention (CDC), measures the proportionate reduction in cases amongst vaccinated people based on results from a clinical trial. By May 3rd, 2021, 3.6% of the global population had been fully vaccinated. However, what have been the ramifications of this mass vaccination in controlling the pandemic–has transmission of the virus decreased after vaccines released globally, and are less people getting sick?

Of the top four countries who were severely impacted by the pandemic, China, the United States, India, and the United Kingdom, 40% of the US’s population, 36.7% of the UK’s population, and 3.11% of India’s population have been fully vaccinated as of May 29th, 2021. China has not officially published any globally available data yet on their vaccination rates. The country that has reached the highest vaccination rate as of yet is Israel, with 59.3% of the Israeli population being fully vaccinated. These numbers are a positive sign for the most part. The CDC recently published data that shows that people who are vaccinated have a lesser chance of being infected. However, this does not mean that transmission rates have reached zero, or that they will even reach zero at all by the end of this year or in the future. Transmission of the virus can occur between two vaccinated people– although, according to the CDC, vaccinated people who are infected have a lower viral load than unvaccinated people. The two vaccinated people probably will not experience any symptoms, but they may continue contributing to a viral spread, especially if there are a large number of unvaccinated people globally. According to experts in infectious diseases from Georgetown University, Dr. Angela L. Rasmussen and Dr. Saskia V. Popescu, allowing a silent viral spread - a spread that occurs asymptomatically – to continue will likely result in new variations of the COVID-19 virus. "Until there is widespread implementation of robust surveillance and epidemiological measures that allow us to put out these smokeless fires, the COVID-19 pandemic cannot be fully extinguished," the pair wrote in a recent journal article. The most dangerous aspect of a silent viral spread is that despite not affecting vaccinated people with severe symptoms, it will cause unvaccinated people to contract the virus and increase the chance of hospitalizations and deaths. There are still a large number of people who are unvaccinated globally, and data has shown that the spread of the virus amongst that population is significantly higher. As analysed and published by the Washington Post on the week of May 26th 2021, in the US, where 40% of people are already vaccinated as of May 29th, 2021, the rate of infection is 73% higher amongst unvaccinated people than the number published for the full population of the US.

While the scientific community understands the above issue, vaccines are building confidence amongst people to take off masks and get back to a normal lifestyle; thus, new cases are still being reported daily especially amongst unvaccinated people, because it seems to many that the pandemic is essentially over. “It is unfortunate, but not surprising, to me that you are seeing increases in the number of cases per day in areas—cities, states or regions—even though vaccines are being distributed at a pretty good clip of 2 to 3 million per day,” Dr. Anthony Fauci, an expert in infectious-diseases, noted in a recent conference on the COVID situation in the US. States that had avoided the worst of the pandemic such as Vermont and Michigan have been struggling to curb a possible disaster, with the latter state reporting an 80% spike in cases as of April 29th.

There are a number of explanations as to why cases have been steadily increasing in unvaccinated populations, especially in countries such as India. In India, 412,262 new coronavirus cases were reported in a single day in May 2021. On that same day, 3,980 deaths were tallied by the country, adding to the rapidly growing number of tragic deaths the country has experienced these past few weeks. Between April 6th and May 7th the country has recorded 8.3 million new cases. There are insufficient numbers of oxygen tanks, ICU beds, medicines, and trained medical staff, as well as an acute shortage of vaccines–India is unable to cope with the influx of COVID patients each day.

One of the reasons behind the latest surges of infections is that many governments, including India, have been lifting COVID guidelines that were implemented at the beginning of the pandemic, with the false hope that the global pandemic was under control. On April 10th, massive crowds gathered in the state of Uttarakhand in India for the celebration of Kumbh Mela, a Hindu religious holiday. The government made no move to cancel the event nor impose any restrictions. Consequently, 1,600 cases were recorded between April 10th and the 14th in the city where the festival took place, and there was a rapid spread to other states through the festival goers who returned home. Despite having low vaccine supply and vaccine administration rates, the Indian government’s and the community’s confidence in the idea of a natural herd immunity and Indian vaccines being available have been the driving factors behind their complacent behaviour towards the evolving COVID crisis in India.

In the US, in 24 states there are no regulations regarding masks–that is, residents, whether vaccinated or not, are not mandated to wear them, despite recommendations for unvaccinated people to do so by the Center of Disease Control (CDC) and the World Health Organization (WHO). In Florida, where cases have been rising significantly, the governor signed an executive order at the beginning of May that suspended all local COVID-19 restrictions until July 1st, after which all of the federal regulations will also be invalidated in the state. The governor has been criticized by the media and fellow politicians, mainly because all of his orders were not based on science but more so based on the false notion that the pandemic was over. Not surprisingly, Florida has been recording an average of 2,000 cases daily in the week of May 26th.

A further cause of the increase in new cases can be attributed to the rise of travel to and from places. On March 13th, 1.357 million people came through US airports–the highest number noted in a single day since the start of the pandemic in March 2020. Those who are traveling do not yet have to show their vaccine cards to board a flight, and even if they are vaccinated, as established earlier, being vaccinated does not necessarily guarantee that a person is not carrying the virus or one of its variants from another part of the country or the world. The concern garnered by the COVID-19 variant B.1.351, which is prevalent in South Africa, as well as B.1.617, the variant that is prominent in India, has led to more travel restrictions and recommendations, whether one is vaccinated or not.

Mutations of viruses are very common, especially the coronavirus, since COVID’s genetic material is made up of RNA. RNA is one of the factors that leads to multiple mutations occurring. Essentially, when a virus enters a host, such as a human body, it uses its genetic material to latch on to the healthy cells. It then hijacks the healthy cell, inserting its own genetic material into the genes of the healthy cell so that the body is forced to copy the DNA or RNA of the virus. Once the virus begins to be mass produced by the body, this is when a person is considered infected by a virus and thus becomes sick. Sometimes though, during this process of copying the genetic material of the virus, an error may take place and this is how a mutation occurs. Such an error modifies the gene and can sometimes make a virus stronger or weaker. In the case of COVID-19, variants B.1.351 and B.1.617 are stronger, more infectious versions of the coronavirus than the variant that affected the population in Wuhan, China originally.

It is clear that despite having multiple vaccines available, the risk of COVID-19 related health impacts, including short term symptoms, long term health degeneration, and death, continues to remain high. Infection rates, although not as high in certain parts of the world as they were at the start of the pandemic, are still increasing at concerning rates in other parts of the world which were not affected initially. The spread of the new variants will not decline unless governments and citizens continue to be vigilant and follow scientific guidelines and health protocols. More importantly, governments must ensure that there is equitable distribution of vaccines around the world. There are currently countries, such as Chad, that have 0% vaccines administered, according to TIME, mainly because the vaccine supply has not been directed towards developing nations. This is not only a question about equitable distribution; it is also about preventing continuous mutations through repeated surges in different parts of the world. Moreover, a positive attitude towards a new normal is important, where finding new flexible ways and solutions to live a day to day life safely by keeping scientific information and guidelines in mind should be the norm rather than believing that one can go back to the old normal. We have a moral obligation to our loved ones, friends, community members, and fellow human beings to be aware of how our behaviour plays an important role in containing this pandemic. If we continue to wear masks, socially distance, get vaccinated, and most importantly educate ourselves about the evolving science that supports healthy lifestyle, we can work to bring this distressing, saddening chapter in the history of the world to a close.

Sources:

Keating, D., & Shapiro, L. (2021, May 28). The unseen covid-19 risk for unvaccinated people. The Washington Post. Retrieved May 31, 2021, from https://www.washingtonpost.com/health/interactive/2021/covid-rates-unvaccinatedpeople/#methodology

Chowdhury, D. R. (2021, May 28). Modi Never Bought Enough COVID-19 Vaccines for India. Now the Whole World Is Paying. TIME. Retrieved May 31, 2021, from https://time.com/6052370/modi-didnt-buy-enough-covid-19-vaccine/

Olliaro, P., Torreele, E., & Vaillant, M. (2021, April 20). COVID-19 vaccine efficacy and effectiveness—the elephant (not) in the room. The Lancet. Retrieved May 31, 2021, from https://www.thelancet.com/journals/lanmic/

article/PIIS2666-5247(21)00069-0/fulltext

Center of Disease Control and Prevention. (2021, May 27). Science Brief: COVID-19 Vaccines and Vaccination. Retrieved May 31, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/fully-vaccinated-people.html

Bosman, J., & Smith, M. (2021, April 29). Covid-19: U.S. Vaccinations Increase, but Virus Continues to Spread. The New York Times. https://www.nytimes.com/ live/2021/03/19/world/covid-vaccine-coronavirus-cases

Georgetown University Medical Center. (2021, March 18). Vaccines alone may not

be enough to end pandemic. ScienceDaily. Retrieved May 6, 2021, from

https://www.sciencedaily.com/releases/2021/03/210318142500.htm

Khare, V. (2021, April 17). India's Kumbh festival attracts big crowds amid devastating second Covid wave. BBC News. Retrieved May 6, 2021, from https://www.bbc.com/news/world-asia-india-56770460

Our World In Data. (n.d.). Coronavirus (COVID-19) Vaccinations. Retrieved May 6, 2021, from https://ourworldindata.org/covid-vaccinations?country=OWID_WRL

Patil, A. (2021, March 13). More travelers passed through U.S. airports on Friday than any day since March 2020. The New York Times. https://www.nytimes.com/2021/03/13/world/airline-travel-covid.html

U.S Embassy and Consulates in India. (2021, May 1). COVID-19 Information. Retrieved May 6, 2021, from https://in.usembassy.gov/covid-19-information/

U.S. Food and Drug Administration. (2021, April 9). Pfizer-BioNTech COVID-19

Vaccine. Retrieved May 6, 2021, from https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/pfizer-biontech-covid-19-vaccine#additional

World Health Organization. (n.d.). WHO Coronavirus (COVID-19) DashboRetrieved May 6, 2021, from https://covid19.who.int