Why do we vaccinate?

Last update: Tuesday 7/5/22 

Why do we vaccinate? Our reasons have shifted over the course of the pandemic. But before there were COVID vaccines, we mitigated. Remember that?  Throughout the last year of the Trump administration, we all wore masks and kept social distances from each other ... Well most of us did ... most of the time. We mitigated in order to reduce the speed with which the coronavirus spread throughout our communities. 

A. Mitigation ... under Trump

No virus ever killed everyone, not even the Bubonic Plague. Many people got sick; some got sick enough to be hospitalized; and some of the folk in the hospital died, despite the medical staff's best efforts. But everyone did not die. 

• Without vaccines, the worst situations occurred was when too many of the most vulnerable victims of a virus got very sick at the same time. Hospitals that only had 200 beds were confronted with 300 very sick victims ... many of whom died in the waiting rooms ... or on the parking lots.
  
  
• But when we slowed the spread of a virus, our hospital never confronted too many patients at a time. Most patients only stayed for a few weeks, after which they either went home or died, leaving empty beds for new patients
  
  
• Successful mitigation efforts also left enough empty beds to accommodate non-COVID patients who had other severe medical conditions.

B. Vaccination as obliteration ... under Biden
In the early months of the Biden administration in 2021, we switched to a pandemic management strategy that used our powerful vaccines to achieve herd immunity. When a high enough percentage of a community became vaccinated, 

an infected outsider would have little or no chance of bumping into a vulnerable unvaccinated member of the community during the few weeks in which the outsider remained contagious.

Of course, this concept of herd immunity was based on an assumption that vaccinated persons were immune to infection. So the administration's goal was to vaccinate as many people as possible as quickly as possibility. From January 2021 to May 2021, "breakthrough" infections, i.e., COVID infections of vaccinated persons from the original coronavirus and early variants were rare events. We anticipated that our powerful vaccines would eventually obliterate the coronavirus from all U.S. communities.

President Biden's efforts to vaccinate a high percentage of the public were so successful that he (and the CDC) encouraged everyone to celebrate their "independence" from the virus by foregoing masks and social distancing as part of their July 4th Independence Day festivities.

C. Vaccinations & boosters become mitigators ... Delta variant

Unfortunately the Delta variant suddenly appeared in India during the spring of 2021. Its presence in the U.S. was announced by the detection of a mega cluster of  over 900 breakthrough infections that occurred in Provincetown, Massachusetts, over the July 4th holiday. Delta was not only more lethal than previous variants; it was far more transmissible because it could evade our vaccines. Breakthrough cases were no longer rare events. Therefore herd immunity was no longer an achievable goal.

Adding to the confusion caused by Delta breakthroughs was the near simultaneous discovery that the effectiveness of our vaccines waned over time. At first some experts incorrectly concluded that breakthroughs were only caused by the waning immunity of people who had been vaccinated many months earlier. However there was no confusion over the fact that our vaccines were still highly effective in preventing illness that was severe enough to require hospitalization. In other words, our vaccines were now repositioned as high powered mitigators that did not reduce the speed of the spread of the virus, but reduced the severity of its infection.

D. Vaccination & boosters & antivirals as mitigators ... Omicron & sub-variants

When Omicron displaced Delta in late December 2021, there was no room for doubt that newly infected, fully boosted persons could become breakthrough cases. Omicron was less lethal than Delta, but it was far more transmissible. 

In January 2022, Dr. Fauci correctly predicted that sooner or later just about everyone would become infected by Omicron, a prediction that came true for the good doctor himself in mid-June 2022. Indeed, reinfections occurred among persons who were not only fully vaccinated and fully boosted, but who had been infected just a couple of weeks earlier. Fortunately, our vaccines still greatly reduced the likelihood of severe illness and our antivirals reduced the likelihood of severe illness among breakthrough cases whose vulnerabilities would have made them candidates for severe illness, e.g., the elderly, e.g., the 81 year old Dr. Fauci in late June 2022.

But as the original Omicron variant begat a series of evermore transmissible sub-variants, a bothersome problem moved to the forefront of our collective consciousness: long COVID. Whereas our vaccines and antivirals reduced the likelihood of illness that was immediately severe, there is little evidence that they reduced severe consequences over the long term, not even from mild infections.

At this time, unlike other medical conditions, long COVID is defined by its victims. Their doctors will diagnose as long COVID any adverse medical condition that appears and lingers after a COVID infection that their patients do not recall having had before the infection. Such a wide range of conditions suggests that the only common prevention might be the development of all powerful vaccine that blocked infections from all coronavirus variants as effectively as our current vaccines blocked infections from the original variants of the virus. No COVID, no long COVID. 

In late December 2021, a research team at Walter Reed Army Institute announced initial success in developing this kind of super vaccine, but announcements of further progress have not appeared.

• "US Army Creates Single Vaccine Against All COVID & SARS Variants, Researchers Say", Tara Copp, Defense One, 12/21/21

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Links to related notes on this blog:  

• "Why are we wasting most of our vaccines?", Last update 5/15/22