Can Vaccine Reluctance and New Mutant Strains Prolong the Pandemic?
By: Jag Singh
Tags: Masks, Vaccines, Covid 19, Herd Immunity, Pandemic

Although the vaccine brings hope; the reluctance of many to get vaccinated and the recent recognition of new strains (mutations) of the virus may pose a few challenges. Herd immunity may not be as close, as first imagined.

Vaccine Reluctance

Kudos to the scientists for producing a vaccine in such a short period of time. Truly, a remarkable technological feat. However, this effort remains plagued (no pun intended) by myths, misinformation, and mistrust.

Vaccine reluctance isn’t new — long before COVID, we’ve had anti-vaxxers standing steadfast against all vaccines, including the yearly flu vaccine. And while it may seem that these views are concentrated amongst a small proportion of extreme thinkers, the reality is that this reluctance — especially regarding the COVID vaccine — is widespread. In fact, it seems that nearly half of the United States population is likely to delay or decline vaccination despite regulatory approval. Moreover, 1 in 5 are unlikely to get vaccinated at all, and 1 in 4 would like to wait until they are more certain about the vaccine’s safety. People are nervous; are there side effects that we don’t about? Did we produce this vaccine too hastily?

The simple and unequivocal truth is, no. This vaccine has met the highest regulatory standards to ensure efficacy and safety, while also saving lives. The misinformation and myths that are circulating the internet must be put to rest. This vaccine has been produced through thorough and deliberate research; it will not alter one’s genetic code and it will not cause autoimmune diseases. These mistruths have sparked conversations that could severely undermine the positive and necessary impact of this vaccine.

As good as it may be to propagate knowledge, the spread of this misinformation through social media has been unnerving. Social media has a way of overamplifying any complication or adverse event that may be observed, however rare, and consequently, we are seeing a wave of reluctance. Since thousands of frontline workers, clinicians, prominent politicians, and other trusted celebrities have already received the first dose of the vaccine, there is hope that their freshly photographed band-aids will instill the necessary confidence in those held back by misinformation.

But reluctance does not only stem from misinformation, much of it also comes from mistrust. For long, Black communities have endured countless social injustices and inequities, including in the delivery of healthcare. The Tuskegee syphilis experiment is an undeniable example of this: over the course of nearly 50-years (from 1932 to 1972), the US public health system withheld the known treatment of syphilis to nearly 400 Black men participating in the study. Unknowingly, these men were made to suffer severe complications, transmit the disease to loved ones, and in many cases, die from the disease. This blatant disregard for Black lives had evoked a strong sense of mistrust in healthcare, and particularly vaccines.

On top of this, social disparities and health inequities have continued to persist over the last several decades. In particular, the pandemic has exposed this messy underbelly of the US healthcare system; that has fueled the vulnerability of Black communities to the COVID-19 virus. Black people have a 4-fold increase in hospitalization and 3-fold increase in risk of dying from the COVID-19 virus.

And what about new strains?

We recently heard of a new strain of the virus in the UK, Netherlands and other European countries. This has created havoc, new lockdowns, and travel restrictions, all over again. So, what does this mean?

It is well known that viruses evolve; they mutate for their own survival. Most often this leads to an increase in transmission rate, accompanied by a decrease in virulence, or the severity of the disease. In this case, there is early evidence to suggest that the new strain is a result of a mutation in the spike protein of the virus. This is important, because it is the same region of the virus that is targeted by the vaccine. Scientists are actively culturing this mutant strain and examining if the antibodies produced by vaccines and a natural infection are effective in neutralizing the virus. It is a solvable problem, and not a new one. The influenza virus mutates so rapidly that every year there are new strains selected for vaccine preparation.

The fact that this mutant strain under investigation has found its way into distant lands, such as Australia, goes to highlight our inter-connectedness and our collective, global vulnerability. It is our moral and ethical obligation to ensure that the vaccine is disseminated globally. Of note, the distribution of the vaccine in lower middle-income countries is complicated and not without supply chain issues. This can mean years, possibly decades, before we achieve global vaccination.

Vaccine reluctance + New Viral Strains = Delayed Herd Immunity

Herd immunity requires a critical mass of the population to be immune, in order to halt the spread of the virus. Containment with vaccination is our best bet. But how much of the population do we have to vaccinate to achieve herd immunity?

The greater the infectivity, the more the number people need to be vaccinated. Importantly this can vary by region and country. The infectivity of the same virus is different depending on the density of the population. A larger number of individuals may need to be vaccinated in a high-density region to achieve herd immunity. It is here that vaccine reluctance can become an issue. In certain regions, more than 80% of the population need to be vaccinated while in others, just 50–60% may suffice. Moreover, if the new strains are not susceptible to the current vaccines, they will also pose a problem and delay the herd immunity.

So Where Do We Stand?

Fact is, the next couple of months are not going to look great. The cold weather coupled with family gatherings during the Holidays will cause an uptick in the number of new infections, hospitalizations and deaths. The roll out of the vaccine will help, but it will be a few months before we begin to see its impact. When considering vaccination, it is important to look beyond oneself. Besides protecting ourselves, and perhaps more importantly, we are preventing the spread of disease to our fellow human beings. In decreasing the transmission of the virus, we can protect the elderly, the chronically ill, and so many more of our loved ones.

We have two vaccines and soon, could have two more. We could have enough vaccines and a terrific vaccine dissemination plan, but if folks don’t get vaccinated, the pandemic is not going to go away anytime soon. We must promote vaccination by overcoming misinformation and making an effort to build trust. We must look beyond ourselves and understand that we, as individuals, do have the power to make a global impact. Get vaccinated, continue social distancing, and please continue to wear your masks. Together, we can overcome this pandemic.