Medical Professors Say Vaccines Proving Effective
More Vaccinations Necessary to Combat Delta Variant Spread and New Variants
By Theresa Ho
In September, the CDC reported that 63.5% of the total U.S. population had received at least one dose of a COVID-19 vaccine while 54.2% of the total U.S. population was fully vaccinated. According to the CDC, the United States is seeing an increase in COVID-19 cases in most of the country following a surge of the Delta variant and continued low vaccination coverage in many communities. The Colorado Department of Public Health and Environment reported that 83% of Coloradans currently hospitalized for COVID-19 are unvaccinated.
Combining Science, Faith and Community to Combat COVID-19
Dr. Oveta Fuller is an associate professor of microbiology and immunology at the University of Michigan Medical School. Her research team has explored the molecular mechanisms of entry into cells of human pathogenic viruses and how such viruses cause disease. She is part of the FDA advisory committee that has reviewed the three COVID-19 vaccines used in the United States. During an interview that began on the phone and continued over email, Fuller discussed coronavirus, the COVID-19 vaccine, and working with communities to address health disparities.
Fuller explained that the amazing feat of scientific research to develop and distribute COVID-19 vaccines occurred because of unprecedented cooperation between scientists, the government and regulatory agencies during a time of pandemic.
“They came together with resources from each – some brought research funding, some had studied the spike protein of other coronaviruses, and some had studied messenger RNA carrier technology and how to package materials for stability. These came together with the provision of upfront funding so that researchers could make a full throttle effort without knowing if the approaches taken would work. We are so grateful for the high vaccine protection against disease,” she said.
The only thing that differs from what usually occurs, Fuller said, was the ability to document the longer-term vaccine effects.
“In the midst of much loss of life, we did not have that luxury,” she said.
She added that negative effects from vaccines emerge usually within the first weeks or months after vaccination. There is no precedence or reason these COVID-19 vaccines will differ.
Fuller is not convinced, however, that currently available data support a need for everyone to get a booster shot. She explained that the data provided in the recent Pfizer application for licensing of an immune boosting third dose were not as extensive as the results from the clinical trials of the original application in December 2020. Evidence to support a third dose was presented from the Minister of Health of Israel. They are using a third injection of Pfizer vaccine as a booster strategy to combat illness from a surge of the Delta virus variant.
“Their data indicated that antibody levels were lower before they started giving the booster to older people who were becoming ill from infection by the Delta virus variant. With the third dose, primed immune systems responded with stronger protection. Hospitalizations and deaths in Israel now are decreasing,” Fuller said. “But, there’s a huge difference between Israel and the U.S. First, Israel’s vaccination level of those over 12 years was high. Secondly, they only used Pfizer vaccine in Israel, so providing a boost also of Pfizer was simpler for everyone. We have three different vaccines and just over 54% of the U.S.A. population fully vaccinated. This means over 40% of our population is not vaccinated. These are very different circumstances. Third, Israel is a highly homogenous country with extensive health care and a younger population. The U.S.A. is a highly heterogeneous country with an older population. It’s almost like comparing apples to oranges, or perhaps apples and cucumbers. The features are very different.”
The advisory committee did not think there was compelling evidence yet for waning immunity in the U.S. to suggest that every person currently needs a booster. Thus, the application to license Pfizer for a third dose for those 16 and older was not recommended for approval. Instead, the committee recommended emergency use authorization availability of a third Pfizer dose for those aged 65 years old or those in medical or other high risk occupations.
Fuller conducts research with the Trusted Messenger Intervention, which involves moving science advances into wider use in communities through engaging networks of faith leaders in communities. She has conducted prevention implementation research through using a science-based intervention, Trusted Messenger, to reframe perspectives on HIV/AIDS and leadership actions within networks of religious leaders. She uses similar principles to help combat COVID-19.
“[The community leaders] are major opinion leaders and gatekeepers in their communities,” she said. “We provide them with a fundamental science background so that they are more capable and confident in helping people to get to and use available resources. This reduces misconception and misinformation. The approach is used with COVID-19, except the response is not rigorously documented as in the HIV research. We seek to change real-time practices that affect the COVID-19 pandemic. People need the truth on what is known, and they need to hear truth from people that they trust. We try to be accessible and trustworthy.
She believes that getting the pandemic and the virus under control depends on communities working together. If there are people that are reproducing the virus, she said, then it will be difficult to get rid of, or at the very least, get virus transmission down to a manageable level.
“There are some, a relative few, who cannot get immunized,” she said. “The rest of us must take on responsibly masking, distancing and vaccination as possible to protect them.”
“Yes, there may be fear – fear of the unknown is natural. There are many unknowns about COVID-19 disease and the virus replication. However, the available vaccines have been well studied and been provided safely to many people around the world. As evident with the data from clinical trials, there are side effects. These are short-lived mostly from activation of the immune system by a COVID-19 vaccine. The unknown risks from the vaccines that protect from COVID-19 disease are low relative to the well-known visible risks of serious illness or death from COVID-19,” she continued.
“Getting vaccinated may be a choice or required. If one chooses not to get vaccinated, it is absolutely necessary to be diligent in physical social distancing, masking and avoiding gatherings. Avoiding virus exposure becomes even more difficult because the Delta variant is more contagious. We must come together and put aside individualism and focus on what must occur to get to and manage co-existing with this new human virus,” she concluded.
Current COVID-19 Vaccines and the Nature of Viruses
Dr. Ross Kedl is a professor of microbiology and immunology at the University of Colorado Anschutz School of Medicine where he pursues the discovery and development of novel and clinically applicable vaccine technology. According to Kedl, no strong evidence shows that the Delta variant is symptomatically any worse than the original strain. But what Delta does seem to do, he said, is replicate very well so that it spreads more effectively.
“It particularly replicates and spreads really well from the unvaccinated,” he said. “If you consider its contagiousness, its chances of infecting somebody else as part of its dangerous profile, then yes it is more dangerous in that sense because you’re likelihood of getting infected if you’re standing in the room with somebody with Delta variant versus with somebody with another strain, than your chances of getting infected are certainly higher.”
He emphasized that it is important to recognize that 95% of the people hospitalized due to COVID-19 are unvaccinated, and there is an even greater percentage with serious complications.
“So the vaccines, including J&J, all of them are contributing to keeping you that kind of safe … The vaccines are working, and they’re all working against Delta. At that level of analysis, they are working extremely well,” he said.
“The more people that it has a chance to replicate in and the better it has a chance of replicating, the more likely it is to spin out a variant,” Kedl said. “The larger the pool of people who are unvaccinated, the more likely that we’ll have another variant that comes out. And that’s true locally as well as globally. So if we stay fixed at 30% or 40% of the total population that is unvaccinated, that’s a bit of a recipe for concern because at some point in time, there will be another variant that comes out of this whole thing, and we’ll see what happens.”
He explained that viruses have one goal: to replicate. In the natural world viruses compete at the level of contagiousness and a decrease in symptomology.
“If you think about it,” he said, “The virus doesn’t actually want to kill you, assuming we can describe it as an anthropomorphic desire. It needs a host, or it can’t go any further. So if it kills you too quickly, it dies itself out. The ideal strategy for a virus is for it to get more contagious and less severe. So Delta got more contagious, and there could be ones in the future that decide to get less severe. Others might get more contagious, and they’ll have to duke it out with Delta. And that’s just going to happen at a certain rate.”
While variants are always a concern, Kedl believes that the bigger concern is the rate at which those variants are generated, which is completely dictated by how many people are not vaccinated. He thinks that another question is whether the vaccines will still be able to protect against whatever variants that do come out. But he adds that he is not haunted by variant production or the efficacy of the COVID-19 vaccines.
“At the moment, given the last year and half or so of experience, it doesn’t seem likely,” Kedl said. “In fact, the vaccines for SARS-CoV-2 actually provide a significant amount of reactivity against the original SARS, which is pretty distantly related to the SARS-CoV-2 even though the names are similar … The vaccines are that good, so we’re lucky there.”