WE’RE NOT QUITE THERE
As COVID vaccinations increase, so do questions on when our lives will return to normal
The path forward to the freewheeling lives we enjoyed pre-COVID is starting to take shape — but some of the course still seems hazy.
How can Texas say it’s no longer requiring masks when New York recommends doubling them? Can we really achieve herd immunity before vaccinating children? And will we all need to get annual booster shots to maintain protection and stay ahead of variants?
They’re complicated questions, experts say, with the answers still largely dependent on how quickly and thoroughly we can get adults vaccinated against coronavirus.
“The best shot at keeping vaccines effective is to limit the degree to which this virus changes and mutates,” Dr. Rebecca Madan, a pediatric infectious diseases specialist at NYU Langone Health who worked on the Pfizer vaccine trial, told the Daily News.
To that end, masks, social distancing and stepped-up vaccinations remain critical, even with death rates dropping.
“If we continue to have high levels of community transmission and the virus is constantly evolving, then we’re going to have to play a lot more catchup with vaccine development. But if we can keep levels of community transmission low, then maybe we can get away with less frequent vaccines and more lasting protection,” she said.
To reach the coveted herd immunity threshold that will keep minor outbreaks contained, experts say the U.S. likely needs 75% of people fully vaccinated.
According to the most recent Gallup polling, only about 50% to 65% of U.S. adults say they want a vaccine. People under 18, meanwhile, make up about 24% of the population.
“Most of the data we have suggest adults are the primary drivers of this pandemic in our population,” Madan said. “But in the near future, we need to have vaccination strategies in place for children.”
When it comes to kids, the Pfizer-BioNTech vaccine is recommended for patients as young as 16, but the Moderna and Johnson & Johnson shots are only permitted for adults.
Various trials are already planned or underway to test vaccines in children as young as infants.
Madan said vaccinations for older adolescents likely will start over the summer, and NYU is hoping to enroll children in a pediatric vaccine trial “soon.”
“I think once we have some preliminary data, we’ll be prepared to make better recommendations for exactly which children should be vaccinated and with what vaccine product,” she said.
“I think we’re not looking at a full return to normalcy until later in 2021,” she said.
In terms of what the recommended vaccine frequency will look like down the road, doctors say the jury is still out.
“We do not yet know how long protection from the vaccines will last,” Dr. Dana Mazo, an infectious diseases expert at Mount Sinai’s Icahn School of Medicine who was the lead investigator for the Johnson & Johnson trial at Mount Sinai in Queens, told The News.
She said people who get COVID-19 naturally appear to be protected for around 90 days to six months.
All the major vendors, meanwhile, are conducting ongoing surveillance and blood tests on trial participants to track how long their shots remains effective, she said.
“We might need [vaccines] again in two years or so to keep the protection lasting. We don’t know,” she said. “There will be more mutations, and there might be variants that the vaccines are less good at protecting against. In that case, we might need boosters.”
And of course there’s the question of which vaccine will ultimately turn out to be the best.
All three currently authorized by the FDA appear to be extremely effective, so experts are urging people to get whatever shot they’re offered first. Speed is what’s most important now.
And getting one company’s vaccination in early 2021 shouldn’t preclude you from getting another vendor’s shot down the line, if supply permits.
“The pneumonia vaccine for adults is like that. There are two different types of pneumonia vaccines that have different mechanisms of action, and in certain situations we recommend boosting one with the other,” Mazo said.
“I definitely recommend people get whatever shot they have access to first. Right now, we’re still in March, at the tail end of winter. There is still a lot of COVID in New York City and the surrounding area, so I would not recommend holding off to get a certain vaccine,” she said.
“But thinking forward to boosters, it’s possible we’ll recommend switching companies to boost with a vaccine that works in a different way, but we don’t have that information yet,” she said.
And once grandparents and other loved ones get all their shots and wait two weeks, vaccinated people can start getting together again without too much worry about asymptomatic transmission, she said.
“The data is still being collected and analyzed, but an early study indicates that if you get vaccinated and you do get COVID, there’s a lower amount of virus in the nose, so it’s harder to transmit,” Mazo said.