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Can Herd Immunity End the COVID-19 Pandemic?
The COVID-19 pandemic has created an unprecedented situation worldwide, causing millions of deaths and significant damage to the world economy. For more than a year, people have heard and hoped for the herd immunity that can be achieved in the long term with near-universal vaccination. Do low infection rates around the world suggest that herd immunity to COVID-19 is just around the corner?
More than a year has passed since the world was first confronted with the highly contagious SARS-CoV-2 virus. The resilient coronavirus has managed to spread and spread throughout communities, despite social distancing measures and other precautions to stop transmission. Now that multiple vaccines for COVID-19 have been authorized and released for use, people are positive about the development of “herd immunity.” According to the United States Centers for Disease Control and Prevention, herd immunity refers to the sufficient percentage of the population that becomes immune to a particular disease due to the development of antibodies either from vaccination or from previous contracting the disease.
If the majority of the population becomes immune after vaccination, they will not be able to spread the infection further to the vulnerable population. Thus, herd immunity provides protection to the remaining population and reduces the risks of transmission. The development of herd immunity seems like a practical solution to a fight against the COVID-19 infection and therefore the vaccination drives are in full swing. There is none “magic threshold” but, typically 50-90% of the population needs immunity before infection rates begin to decline, however the number can vary depending on how contagious the virus is. For COVID-19, herd immunity is estimated to be between 70-90%, as immunity lasts longer.
How can we achieve herd immunity with SARS-CoV-2?
While wearing masks in public, social distancing and reducing the level of interaction can help slow the rate of infection, the virus can change as communities open up and become even more contagious. However, there are two ways to achieve herd immunity, either a large part of the population is vaccinated or infected with the virus. Achieving herd immunity in the United States would require more than 230 million Americans to become infected. However, this can lead to more hospitalizations, ICU admissions and cost millions of lives. Patients suffering from mild infection may also have severe illness for weeks or other long-term side effects. Therefore, achieving herd immunity through infection becomes a painfully ill-conceived thought.
Another way to achieve a threshold of herd immunity is through high vaccination rates, immunizing the mass population so that society can return to normal. Vaccinating 70-80% of the population with the COVID-19 vaccine will not only protect vulnerable populations at high risk, but also extend the benefits of immunization beyond the directly targeted population. Some of the vulnerable groups that depend on herd immunity to achieve protection against disease include:
• People with compromised immune function
• People undergoing chemotherapy treatments
• People suffering from HIV
• Newborns and infants
• The elderly
Why is vaccine parity essential to develop herd immunity?
While more than 1.65 billion vaccine doses have been administered in rich countries, only 0.8% of all vaccines have been allocated to poor countries. Wealthy nations have focused more on providing vaccines to their own populations, while neglecting to invest in collaborative initiatives for equitable distribution of vaccines across the globe. However, global vaccine coverage is necessary to manage the transmission of COVID-19. The imbalance is creating a need to move beyond outdated charity models and instead focus on strengthening production and distribution capacity around the world in order to increase immunization. The international community should empower nations by transferring technology or agreeing to waivers of intellectual property at the World Trade Organization for vaccines so that poor countries can produce their own vaccines.
Vaccine nationalism may not be the best solution to defeating the spread of the virus. As rich countries roll out domestic vaccination plans, new and emerging variants are reducing the effectiveness of vaccines against the virus. Even with vaccination shields, rich countries are vulnerable and their economies are also at risk. The International Chamber of Commerce predicts that if poor countries are not immunized, the global economy could lose $9.2 trillion, while funding for Access to COVID-19 Tools (ACT) would require only $22.9 billion. Furthermore, global sharing may delay the spread of local vaccines, but in doing so will contribute to global herd immunity.
Obstacles to achieving herd immunity
• Reluctance to vaccines
Some people are reluctant to get vaccinated because of a lack of information about the safety of vaccines, or widespread misinformation about them. In addition, religion, party affiliation or ethical obligations are increasing reluctance to vaccines. According to one study, one in four young adults does not want to be vaccinated, endangering the health of unvaccinated older adults and facilitating the growth of vaccine variants. However, education and public health messages can encourage youth and young adults to reduce vaccine hesitancy.
• The appearance of new variants
As long as there are unvaccinated populations around the world, the COVID-19 virus will continue to change and become more dangerous. Even if wealthy nations successfully achieve herd immunity, the risk of transmission will not decrease, and booster shots may be required to provide protection against variants that can evade the immune response provoked by current vaccines. In addition, the emergence of new strains worldwide due to mutation in the spike protein of the coronavirus may not induce an antibody response in the infected person.
• Delayed arrival of vaccines for children
Children have been less susceptible to the coronavirus, but not all have escaped unscathed. In addition, infected youth have inadvertently passed the disease on to others, thereby increasing the overall rate of infection. Although many vaccines are being tested to determine their effectiveness against the coronavirus in children, it is only a matter of time before the virus mutates and starts attacking the younger population. The devastating wave of the coronavirus in Brazil is targeting younger age groups and pregnant women. Despite the growing paranoia, many new mothers are reluctant to seek vaccination for their children due to misinformation about vaccines and their potential side effects.
• Limited evidence on immunity Post-Covid infection
Some studies suggest that infection with SARS-CoV-2 provides protection against the virus for at least a year. While antibodies enhance the immune response and confer strong resistance against coronavirus variants, infection guarantees some level of protection. The level of immunity that vaccines provide varies depending on how a person’s body reacts to it. A single dose provides some level of protection, but a second dose is essential to achieve full immunity. While scientists have assessed the effectiveness of vaccines for most people in the first few months, they have no data on long-term immunity as many vaccines have not even completed a year of follow-up.
Vaccinating as many people as possible can be important in slowing the spread of COVID-19. However, achieving herd immunity would not guarantee the complete eradication of the coronavirus as it is highly infectious and continues to evolve. Herd immunities vary at the global, national and community levels and change over time, so even when the threshold is reached, there would be small outbreaks due to uneven vaccine coverage.
According to TechSci Research Report on “Global Coronavirus Vaccines Market By type of infection (SARS-CoV-2, SARS-CoV, MERS-CoV), By type of vaccine (virus vaccine, viral vector vaccine, nucleic acid vaccine, protein-based vaccine and others), By by type of product (monovalent vaccine v/s multivariant vaccine), by route of administration (intramuscular, oral, intranasal), by type of patient (adult v/s pediatric), by end user (hospitals, clinics, research institutes, others), By Region, Competitive Forecast and Opportunities, 2026”, the global coronavirus vaccine market is projected to grow at a formidable CAGR during the forecast period due to factors such as increasing incidence of coronavirus infection as well as the introduction of new vaccines on the market.
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