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Herd immunity could be reached by end of summer: Weill Cornell Medicine-Qatar immunology expert

The first COVID-19 vaccines have now been administered in Qatar and around the world, offering hope that an end to the pandemic could be in sight. Professor of Teaching in Microbiology and Immunology at Weill Cornell Medicine in Qatar (WMC-Q), Dr Ali Sultan, says if the ongoing vaccination campaign goes well, herd immunity could be reached by end of summer and situation closer to normal by the end of 2021.

How would you see the pre-COVID vaccine and post COVID vaccine times? 
Scientists, including myself, are very excited at the prospect of an effective vaccine and the prospect of returning to normality. Starting a mass vaccination program is an important first step towards ending this pandemic. And it has come relatively quickly. Producing an effective vaccine against an infectious disease is a long process that in the past has usually taken many years. The development of the COVID-19 vaccine within a span of 8-9 months, on the other hand, has been extraordinarily fast. It has shown how quickly scientific development can be achieved via collaborative hard work, and how much the will can produce the means.

In addressing the above question, I will consider the following  issues: 
1: What next after vaccination: One has to remember that COVID-19 vaccine won’t be available immediately for everybody. Early evidence suggests that the available vaccines reduce people’s risk of developing COVID-19 by around 80-95 percent. Coronavirus is likely to continue its rapid spread until a large majority of the population is vaccinated or has survived a natural infection. The bottom line is that although an effective vaccine will certainly diminish greatly the relative risk of transmission, we still should not completely abandon basic public health measures, including the wearing of masks, hand hygiene and physical distancing.

2: Another issue to consider is re-infection, though rare, may still occur. Hence, strict practice of physical distancing, wearing a mask when in public, and frequent hand washing remain key. In the winter, it is particularly important to not gather indoors in small or large groups. Also, get a flu shot.

3: Post-COVID effect on the health of those infected: We are just beginning to learn more about the after effects of the infection. Some people, now referred to as long-haulers, are also reporting that their COVID symptoms keep dragging on for weeks. These symptoms include everything from headaches and cognitive problems to mood changes, fatigue, decreased exercise tolerance, and body ache.

4: The most important lessons that that this pandemic taught us are:
a) Science and data should guide our decision now and in the future.
b) Practicing good hygienic measures in hospitals, schools and other public places, could drastically reduce the spread and thereby eliminate new cases of COVID-19 and help to protect us from other infections
c) Health authorities and government bodies should have plans and preparedness programs in place in order to avoid future pandemics.
d) The COVID-19 pandemic has been a test, demonstrating that multilateral cooperation is the key to overcoming global challenges.

The first COVID-19 vaccines have now been administered in Qatar and around the world, offering hope that an end to the pandemic could be in sight: How long could it take to reach this in reality? 
If the ongoing vaccination campaign goes well, herd immunity could be reached by end of summer and situation closer to normal by the end of 2021. This estimate is dependent on significant numbers of people in Qatar and around the world being willing to be vaccinated with one of several vaccines in various stages of development.

If 75% to 80% of people are vaccinated, then we should reach the herd immunity threshold by the end of summer and by the time we may actually have enough herd immunity protecting our society that as we get to the end of 2021. This may allow us to reach some degree of “normality” that is close to where we were before the pandemic. If vaccination levels are significantly lower, (for example less than 50%), it could take a very long time to reach that level of protection and herd immunity.

Confidence in the COVID-19 vaccine grows, but at same time global concerns about side effects are on the rise: How could the confidence be built in people? 
There are number of surveys done on vaccine confidence, which showed that strong intent to get a COVID-19 vaccine has risen in countries like USA, UK, China, Brazil, Australia and South Korea. One of the main reasons for people who don’t want to get a COVID-19 vaccine is concern about side effects. Even in countries where vaccines available to wider sections of the population, one hurdle will be public resistance to vaccination, or what is known as vaccine hesitancy or anti-vaxxers.  Through the following facts and information we can build the people confidence in taking the COVID-19 vaccine:
1. The first fact is that the public health authority in each country and the media have important role to play by explaining that there are some temporary side effects that happen with any vaccine injection such as pain at the site of the injection, mild fever, aches and sometimes headaches. These temporary side effects are good news because it means that the vaccine is doing its job by stimulating the immune system to fight. So it is common for highly effective vaccines to give people some symptoms. This is a sign the vaccine is doing what it was meant to do: Wake up the immune system and prepare it to fight off an infection in the future.
2. The second fact is that COVID-19 vaccines do not contain a live or whole coronavirus, so the vaccinated person can’t get COVID-19 from the vaccine.
3. COVID-19 vaccines do not contain microchips or tracer technology.

There has been a lot of debate on whether people who had COVID-19 shall/shall not take the vaccine, what’s your intake on that? 
The current data pointing to the fact that the people who have become sick with COVID-19 have some immunity, but we don’t have enough evidence about antibody persistence to confidently say recovered patients are protected. Data suggest that immunity to SARS-CoV-2 from infection lasts at least 6-8 months, but we don’t know enough yet about the degree to which previous infection confers immunity.
We know that cases of reinfection have been documented; they appear to be rare. Likewise, an asymptomatic reinfection may go unnoticed, yet the individual may still transmit it to others. It would not be good if that person happens to be a healthcare worker. So, there is an argument to vaccine healthcare workers, even if they got infected because vaccines provide more robust immune protection than natural infection.  Those at the highest risk of spreading the virus and those who might be tipping ICU capacity over the limit, are the ones who should be first in line for immunization.

Regarding the new COVID-19 variants that appeared in some countries, will the vaccine be effective in stopping them? 
New mutations of the coronavirus have been reported, which may change the nature of the proteins on its surface. This has led to fears that the vaccines developed so far may or may not work against these new variants because vaccines are based on teaching the body to recognize those proteins and attack them in future.
The new mutations in the SARS-CoV-2 virus detected in UK created a new variant that is more transmissible than the earlier variants. However, there is no evidence that the new mutations seen in the SARS-CoV-2 will affect the vaccine efficacy or increase the severity of COVID-19.
The vaccines teach the body about multiple “spike” proteins on the virus surface, and those spikes are also what the virus uses to get inside our cells. So a change in one protein because of a mutation doesn’t automatically make the whole vaccine useless.  But it’s important to keep looking for mutations in the coronavirus that’s infecting people now. This will help researchers working on the vaccine field to know if we need to change the current vaccines or make new vaccines against COVID-19.
Meanwhile, scientists are still studying whether changes in the coronavirus are making it more likely to infect children and teenagers. It will take time to find all these things out. That’s why it’s important to continue to wear masks in public, and stay away from large gatherings and unmasked interactions with people who don’t live with you.

Source: The Peninsula

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