The Effectiveness of the COVID-19 Vaccines and the Need for Boosters

At a recent White House press conference, the Director of the Centers for Disease Control and Prevention, Dr. Rochelle Walensky,  made a rather startling comment as you will see in this posting.

Before we delve into Dr. Walensky's comments, let's look at the opening comments by Jeffrey Zients, the White House COVID-19 Response Coordinator since January 2021 with all bolds throughout this posting being mine:

"First, I want to provide a brief update on our fight against the virus.  We continue to see a rise in cases driven by the more transmissible Delta variant, with cases concentrated in communities with lower vaccination rates.

So this remains a pandemic of the unvaccinated.

We know getting more people vaccinated is the best way to end this pandemic.  And thanks to our relentless efforts to get more shots in arms, we are making progress."

Here's what he has to say about the growing need for booster shots:

"President Biden committed to the American people that he would do everything in his power to end this pandemic.  And from his first day in office, the President has marshalled a wartime effort to do exactly that.  We’ve been preparing for every scenario, including the potential need for vaccine booster shots.

Our approach on booster shots is simple, and it’s consistent with our approach on every other front of this war: Be guided by the science, and always, always stay one step ahead of the virus."

I just love how these non-scientist types always refer to "the science" and how it is guiding their narrative.  While he states that "we" must stay one step ahead of the virus, it is quite clear that "we" have not.

Now, here are the key comments from Dr. Walensky:

"Today, we are releasing three articles in MMWR (the Morbidity and Mortality Weekly Report) with data I will now describe that are helping to inform our booster plans.  Recognizing that for most vaccines there is a reduction in protection over time, we have been analyzing the data closely from a number of cohorts in the United States and around the world to understand how long protection from the initial COVID-19 vaccine series will last.

Examining numerous cohorts through the end of July and early August, three points are now very clear.  First, vaccine-induced protection against SARS-CoV-2 infection begins to decrease over time.  Second, vaccine effectiveness against severe disease, hospitalization, and death remains relatively high.  And third, vaccine effectiveness is generally decreased against the Delta variant. 

So, let’s jump into the data.  On this slide, you will see two studies — one from New York and one an analysis of data from the Mayo Clinic.  From May 3rd through July 25th, New York examined COVID-19 tests and linked them to individuals’ vaccination status based on the state’s vaccine records.  This allowed New York to study vaccine effectiveness against infection over time for more than 10 million New Yorkers of all ages."

Here is the slide that she is referring to:

"Vaccine effectiveness in May, during — early, during the vaccine rollout in the state, was 92 percent.  In the later months, further from vaccination, vaccine effectiveness declined to 80 percent.  These data will be published in the MMWR today.  The Mayo Clinic analysis looked at vaccine effectiveness for both the Pfizer and Moderna vaccines among over 80,000 vaccinated and unvaccinated individuals across all age groups with data through July 16th.  Like we saw in the New York data, vaccine effectiveness against infection declined over time — in this case, from 76 percent to 42 percent for those who received the Pfizer vaccine, and from 86 percent to 76 percent for those who received the Moderna vaccine.  These data are currently available on a preprint server.

Today, CDC will also publish data from our National Healthcare Safety Network, a nursing home cohort where we analyzed more than 85,000 weekly reports from more than 14,900 facilities.  Weekly COVID-19 case counts were used to evaluate vaccine effectiveness over time.  These data demonstrate that vaccine effectiveness declined over time — from 75 percent in March, to 53 percent as recently as August 1st, 2021.  This represents a substantial decline in vaccine effectiveness against infection among those who are most vulnerable, including during months where Delta was the predominant circulating variant."

Remember that the Delta variant was not classified as a Variant of Concern VOC by the CDC until June 15, 2021 and, until then, made up a very small portion of COVID-19 infections as shown here meaning that the vaccine effectiveness likely declined against the original strain as well:

Here is the slide that Dr. Walensky refers to:

Let's go back to her commentary:

Taken together, you can see that while the exact percentage of vaccine effectiveness over time differs depending on the cohort and settings study, the data consistently demonstrate a reduction of vaccine effectiveness against infection over time.

Importantly though, despite waning vaccine effectiveness against infection, data analyzed through July continued to demonstrate the stable and highly effective protection against severe illness and hospitalization for people who are vaccinated.  Included in the same reports described before, data from New York State and Mayo Clinic also show that vaccine effectiveness against hospitalization remains relatively high, both over time and during periods when the Delta variant was surging."

And, here is the "money shot" which you can find at the 16 minute, 35 second mark:

"Additionally, reports from our international colleagues, including Israel, suggest increased risk of severe disease amongst those vaccinated early.  Given this body of evidence, we are concerned that the current strong protection against severe infection, hospitalization, and death could decrease in the months ahead, especially among those who are at higher risk or who were vaccinated earlier during the phases of our vaccination rollout."

Let that sink in for a minute.  Reports from Israel suggest that there is an increased risk of severe disease among those who were vaccinated in the early stages of the vaccine rollout.  As well, Israel was the first country to roll out a third shot, however, Dr. Ashraf Shalmon of the Israeli Health Ministry stated this:

"It seems that vaccines are not sufficient to give a very high protective level for a very long time without maybe having a third dose. Now a third dose could create another booster time which serves for six months, one year or it could behave like we see in some types of vaccines like hepatitis vaccines or papilloma vaccines where a third dose usually creates a long-lasting immunity.

Isn't it a refreshing change to see someone admit that they don't know how long the vaccines will provide protection and how long the third dose will remain effective.

Just out of interest, this is what Israel's current death rate from COVID-19 looks like keeping in mind that the third shot began in July 2021:

Let's go back to Dr. Walensky.  Here is the summary slide from her presentation:

 

If you wish to watch the entire press conference, here is the video:

Dr. Walensky's comments start at the 10 minute 35 second mark.

Let's close with these comments by Surgeon General Vivek Murthy:

"The COVID-19 vaccines that are authorized in the United States have been remarkably effective, even against the widespread Delta variant.  But we know that even highly effective vaccines become less effective over time.

Our goal has been to determine when that time might come for the COVID-19 vaccines so we can make a plan to take proactive steps to extend and enhance the protection the vaccines are giving us.

Having reviewed the most current data, it is now our clinical judgment that the time to lay out a plan for COVID-19 boosters is now. 

Recent data makes clear that protection against mild and moderate disease has decreased over time.  This is likely due to both waning immunity and the strength of the widespread Delta variant."

Here is a slide from Anthony Fauci's part of the presentation showing the waning of immunity over a very, very short period of time:

Please note that the horizontal axis scale is in days showing how the Moderna vaccine loses a significant portion of its effectiveness within 6 months.

"Even though this new data — even though this new data affirms that vaccine protection remains high against the worst outcomes of COVID, we are concerned that this pattern of decline we are seeing will continue in the months ahead, which could lead to reduced protection against severe disease, hospitalization, and death.

That is why, today, we are announcing our plan to stay ahead of this virus by being prepared to offer COVID-19 booster shots to fully vaccinated adults 18 years and older.  They would be eligible for their booster shot eight months after receiving their second dose of the Pfizer or Moderna mRNA vaccines.  We plan to start this program the week of September 20th, 2021.

I want to be very clear: This plan is pending the FDA conducting an independent evaluation of the safety and effectiveness of a third dose of the Pfizer and Moderna mRNA vaccines and the CDC’s Advisory Committee on Immunization Practices issuing booster dose recommendations based on a thorough review of the evidence."

Given that the White House wants to roll out the booster shots within a month, one has to wonder how thorough the FDA's and CDC's evaluation will be.  

Big Pharma thanks all of us for kindly rolling up our sleeves to help further their profitability and research into unprecedented vaccines.  It will be interesting to see how many times we have to roll up our sleeves to remain in compliance with the requirements of our governments' vaccine passport rules.

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