The messenger RNA vaccination against SARS COV-2 ( Pfizer, Moderna)has shown greater than 90% efficacy after two doses. It effectively reduced serious illness and death from SARS COV-2 infection. Surprisingly it also reduced asymptomatic infections thereby reducing further transmission. Some authorities even expected the elimination of the virus but this was an over-enthusiastic expectation. New variants have come up over time due to antigenic drift.


So has the SARS COV- 2 vaccination failed? NO, NOT AT ALL; It has done its primary job pretty well -to prevent death and severe illness in the vaccinated persons.  Elimination of a virus is probably not possible in any situation where the virus has high transmissibility and exhibits antigenic drift, example can be drawn from the history of another respiratory virus INFLUENZA during and beyond pandemics and the vaccination strategy. Every year a novel Influenza virus comes up, In order to protect the population in general and high-risk population in particular. These new strains of the Influenza virus are quickly added to the upcoming vaccine and thus the main risk of death and serious morbidity is averted. 


The mild illness of the Influenza pandemic remains an yearly phenomenon affecting masses of the population and there is no panic in the country, no lockdowns, no interruption of International travels, and no shutdown of businesses. This is how the SARS COV-2  vaccine strategy is probably going to work. The vaccine is although highly efficacious its antibody levels wane gradually and a booster dose will be needed. The Omicron variant is already making headlines for its rapid transmissibility but the data so far is suggesting only a mild illness except for the first death that has been announced by the UK. More upcoming data will be needed for a final conclusion.


We can now see a picture emerging where the use of an effective vaccine will continue to be critical over the long term. An increase in asymptomatic infection or mild illnesses in vaccinated people will nonetheless continue to be possible as variants continue to emerge but death and severe illnesses will be largely prevented. However, the possibility of severe illnesses in a small proportion of vaccinated people does exist and highlights one of the greatest unmet needs we currently face -continued emphasis on better therapeutics and antiviral agents.


The future timing and composition of booster vaccines will be determined based on observational studies and emergent data.
Overall, the situation will be fluid but we will require the future use of vaccines to avoid severe consequences even if mild illnesses still occur at a low frequency. we need to learn to live with these illnesses just as we have learned to live with Influenza.

REFERENCE: THE FUTURE OF SARS COV-3 VACCINATION-LESSONS FROM INFLUENZA PANDEMIC,

Arnold S. Manto, MD. The New England Journal of Medicine, November 11, 2021.

 

By

DR. SYED MOHAMMED SARWAR HUSSAIN - MBBS, MD (PAEDIATRICS)

Specialist Paediatrician

 

Jabal Sina Medical Centre L.L.C
Delivering Healthcare That Works for You

Jabal Sina Medical Centre L.L.C is a flagship medical centre in Ajman from the founders of Ibinsina Medical Centre, an institution that has provided ambulatory healthcare for over 20 years. Having started in 1998, our founders brought substantial investment to create the first custom-built private hospital in the area and we pride ourselves on maintaining a philosophy of shared management with patients throughout the process. Operating mainly in primary care, this approach places the patient at the centre of the care cycle, with doctors, nurses and specialists working together to provide a service that addresses each patient's core individual needs. Our fully qualified team of professionals are committed to supporting you in your journey from sickness to health in a compassionate, caring and confident manner, taking care of all of your concerns and providing necessary referrals.