You may be sticking your fingers in your ears when it comes to Covid-19. That is very understandable, I sometimes feel that way, but I always keep an eye on it. Unfortunately, concerns are being raised again. The clouds are gathering, but will we see a damaging Covid-19 storm? And what can we do to prevent this?
The first thing I have to say is that I am sure that vaccination immunity and natural infection will protect us from getting seriously ill from Covid-19. This is how your immune system should work; it recognizes intruders and eliminates them. Then, most importantly, it is trained to do even better next time and deal with the intruders when they come back.
Your immune system is a great example of evolution. Your very ancient ancestors developed an immune system that achieved and survived this feat of elimination. Those that didn’t were wiped out by infection. Survival of the fittest.
All this tells me that our species will survive Covid-19, just like previous plagues. The only problem is that people get sick and die along the way. That’s why medicine was invented. Best of all for Covid-19 are the amazing vaccines we’ve discovered.
We’ve also evolved to be highly ingenious — and that ingenuity, built on at least 100 years of science, was harnessed against Covid-19.
We need vaccines because the vulnerable among us can get very sick and die from Covid-19. There are many reasons for frailty, especially being older, but also people with diseases such as diabetes or heart disease.
Some people may be vulnerable and don’t know it. The dose of virus can overwhelm their bodies. Or they may have genetic differences in their immune systems that put them at risk. That’s why we had a massive vaccination campaign. The virus was a bit like a game of Russian roulette: it wasn’t quite clear who would get the bullet, so it was best to vaccinate everyone.
In the meantime, however, things have changed. The vast majority are vaccinated and/or infected. But Covid-19 threw us a curveball when evidence showed that built-up immunity can decline, especially in vulnerable people. With Covid-19, the immune system forgets what it learned from the vaccines. This is not the case with vaccines against other diseases, whose protection can last for decades.
The good news is that your immune system can get a refresher in the form of booster shots. All the evidence says they work very well. The consistent and compelling advice from every health agency in the world is to get a boost when you’re vulnerable. That means anyone over the age of 50 and those with underlying conditions that put them at risk for serious illness.
Some people say that if they’re infected, they don’t need a boost. Isn’t the infection the immune system’s memory? The problem with that is that infection is highly variable. In some it’s strong, in others weak – while vaccines are more consistent. So you can’t rely on an infection to boost.
Your best bet remains to get a boost. It will help save your life and will also help put pressure on our overburdened healthcare system.
Boosting is all the more important given the latest news. As the weather cools in Europe and North America, people are being forced indoors — and the SARS-CoV-2 virus spreads much more easily indoors. That’s what happens. In Europe, more than 1.5 million people were diagnosed last week, about 8 percent more than the week before. The upward trend is the same everywhere in Europe, including Ireland.
The World Health Organization’s technical director, Maria Van Kerkhove, said: “We are concerned. We need health systems to be prepared.”
International opinion polls show that many people want to move out of the pandemic, which poses a problem in communicating what people should do. In Ireland, a recent survey showed that more than half of those surveyed expect a wave to come, but they strongly believe they will be protected. There remains a high level of trust in doctors, nurses and scientists, which is reassuring to read. It’s also reassuring that 79 percent of people have confidence in the effectiveness of vaccines.
Ireland’s booster campaign is well underway, with vaccines available against the parent strain BA.1 and vaccines covering the parent virus in combination with Omicron variants BA.4 and BA.5. The Omicron BA.5 variant is dominant in Ireland and throughout Europe, but there are sub-strains that are under surveillance including BA2.75.2, BF.7 and BQ.X.
The latest vaccine has been approved for use in the EU by the European Medicines Agency. It based its decision in part on the fact that billions have now had RNA vaccines without raising safety concerns and with notable benefits — and that should be the case with the newer vaccines too.
All other ingredients are the same as in the original version and the dosage is the same. There is also only a slight chemical difference between the RNA molecules used in the newer vaccines compared to the older ones.
The development of the new vaccine was possible because it is easy to modify the original RNA molecule to make it specific for the newer strains. Each of the vaccines, when given as boosters, will provide excellent protection against serious illness and death. As always, the advice is to take the vaccine that is offered to you. If given the choice, you might as well take the latest vaccine, as it may offer even better protection against the BA.4 and BA.5 subvariants.
One thing scientists are hopeful for is that the latest booster shot could give rise to lasting protection, because after it certainly gives the immune system a fourth lesson in recognizing the bad guy, it won’t soon forget. Durable until at least next winter when there may be a different strain, and like the flu vaccine, a variant-specific vaccine can be used for the vulnerable. That’s a reasonable prospect.
As we approach winter, the number of cases will continue to rise and will likely be followed by more hospitalizations. We can hope that this does not lead to more admissions to the IC. The best way to make sure people get their booster.
It is also wise to remind people to wear masks in enclosed areas, especially on public transport, as the health minister said last week.
Personal responsibility becomes important again. If you have symptoms, stay home and don’t visit someone who is vulnerable.
Otherwise, the advice is remarkably simple for those who are not vulnerable. Get a boost and move on with your life. Be thankful for the vaccines and have high hopes that by taking care of each other, especially the vulnerable, we will get through this winter safely – the last winter in which Covid-19 is a major problem.
Luke O’Neill is Professor of Biochemistry at the School of Biochemistry and Immunology at Trinity College Dublin