Immunity

Vaccines

I grew up in the “heyday” of vaccines.  I have a smallpox scar on my arm.  Every American was vaccinated for smallpox until the early 1970’s.  By then the disease was so rare that unless you were travelling somewhere in the world where it was still prevalent, you didn’t get it.  Today, there is no “natural” smallpox in the world.  It requires human transmission, and so many people were vaccinated, there was no one left to transmit it.

There’s still some around, in the biological warfare centers, and at the Centers for Disease Control.  But the disease that ravaged the Revolutionary Army, the frontier, and scarred and killed so many of our forefathers, is gone.

And I was a “test dummy” for the oral polio vaccine, developed by Albert Sabin.  He lived just down the street, right across from Mom’s good friend Maggie Miller.  The first major US test of his oral vaccine was in the Cincinnati Public Schools. I remember stories of lining up at Sabin’s back door to get it – I was four at the time though, so that memory might not be exactly true.  

However, like most kids of my time, I got the measles, and scarlet fever, and mumps.  Those were “the risks” of growing up in those days.  Somehow I avoided the chicken pox until an eighth grader in my class managed to infect me . I won’t call him out, but he was a pole vaulter. I was thirty-one, but I managed to survive that and the rest without long-term impact.

Too Good?

Now we have vaccines for those diseases as well.  They are so effective, that the few outlier negative results from the vaccines are greater than damage from the actual diseases.  In our short-term memory society, we forget what those diseases did. Some focus only on the “dangers” of the vaccines.  We are close to wiping out polio (three nations still have “natural” outbreaks). But there are measles outbreaks, and mumps outbreaks are actually increasing in the United States after several years of only a few cases.

Today we also have a vaccine for versions of the “flu”.  But there’s a problem.  The “flu” isn’t one virus it’s multiple viruses.  So a “flu” shot might protect you from one version, but not another, and so folks say: “I got the shot, but I still got the flu”.  It doesn’t mean the vaccine didn’t work but it didn’t work for the version you got. 

But that has been the example that everyone uses to “prove” that “vaccines don’t work”.   And there is a growing number of folks who are “anti-vaxxers” who blame vaccines for all sorts of side effects.  There is little scientific evidence of that, but the seeds of doubt are sown.  Some parents are leaving their children unprotected, making the mumps, measles and chicken pox more prevalent childhood diseases again.  And while some vaccines do have side effects, the impacts of the diseases themselves can be much worse.

Rushing for COVID

Today there is a rush to develop a vaccine for COVID-19.  We are in a hurry; the disease is rampant and deadly for the vulnerable.  But there are all sorts of dangers of “hurrying” the vaccine, only one of which is that the first vaccines might be only fifty-percent effective.  That works for epidemiologists:  fifty-percent protection is a whole lot better than none.  But in a society that already questions the established vaccinations like polio and measles, a vaccine that will “fail” half the time isn’t likely to be accepted.

And there’s a second problem.  There’s a movement among some today saying that we should just allow COVID to “burn through” America.  Let everyone get sick, and those that get over it will be “done”.  It’s not unlike my childhood when we “all” got measles, mumps, and the rest.  But we are just learning the long-term impacts of COVID even on those who are “healthy”.  We don’t even know that having COVID once creates a long-term immunity.  Is it the measles, a one-time deal, or the flu? 

Herd Immunity

And if it does create a long-term immunity, then according to them, we will get “herd immunity” and we can go about our life.  Eventually there might be a ninety-nine percent effective vaccine, and that could protect the most at risk.  The big concern with this “attitude”:  to reach “herd immunity” it will require sixty percent of the population to be infected. That’s near 200 million.  With a fatality rate is just one percent (and the trend is closer to three) that would be two million dead.

The President’s newest science advisor, Dr. Scott Atlas, is an advocate of herd immunity.  And while there has been no “announcement”, changes in policy from the White House and the Centers for Disease Control seems to be moving towards that strategy as well.

The alternative to “herd immunity” is what most of our epidemiologists have advised:  masks, distancing, keep places where people gather to small numbers and avoid “mass spreader” events.  This keeps people from getting COVID, and puts America in a “new reality” until an effective vaccine is developed.  And since only a small percentage of Americans would actually get the disease, a much smaller number will die.  Instead of two million, if we followed the advise, we never would have gotten to the 185,000 today, or 200,000 in the next couple of weeks.

Sacrifice

It is a legitimate policy question.  Should we work for herd immunity to regain our national economy and “life”? Or should we keep the disease in check until a viable vaccine is available?  But we do need to call it out:  getting to herd immunity means a huge sacrifice of our elderly, and our sick, and our vulnerable.  Yes, the economy will continue, and little Johnny can play soccer or football or run races and everyone can come and watch.  But many will be sacrificed, including perhaps, even little Johnny.