When influenza spread around the world in 1918 people weren’t as lucky as we are today. There were no flu shots back then. But people found ways to protect themselves and others, including isolating and mask wearing. Communities that started such measures early did much better than those that delayed. Mask wearing, social distancing, and basic hygiene such as frequent, thorough hand washing still help to keep diseases from spreading. Masks are easy to wear, though inconvenient, and many studies show that they help to keep you from spreading the virus if you’re infected or from inhaling enough virus particles to make you sick.
Staying about six feet away from other people, especially indoors but also in outdoor crowds, is also effective. It’s a matter of how much virus is in the air. Smoke from a single campfire in the mountains spreads so quickly that any remaining particles are harmless. But in a city such as 19th century London or steel-era Pittsburgh, the air becomes so dirty that it is not safe to breathe.
Non-medical prevention works by limiting the amount of virus we’re exposed to. Vaccines help by making us less likely to get sick or seriously ill when we are exposed. When the SARS CoV-2 virus emerged, we had a hundred years of learning about viruses and decades of vaccine development to draw upon. Operation Warp Speed reduced the typical vaccine development time by funding multiple vaccine projects simultaneously, reducing production and supply chain red tape, and setting up manufacturing capacity before vaccine approvals were granted.
Messenger RNA vaccines such as Pfizer and Moderna were created using technology that has been studied thoroughly since the 1990s.
mRNA vaccines instruct our bodies’ cells to make a piece of a spike protein like that on the surface of the SARS CoV-2 virus. When the body’s immune system sees this “foreign” material it produces antibodies and other immune cells to fight it. Afterwards, the body knows what to do if it sees that protein on the real virus. It’s far safer to develop immunity this way than by getting the actual virus. After delivering its instructions, mRNA is eliminated from the body within a few days.
Vector vaccines have been widely used since the early 1970s. The Johnson & Johnson vaccine uses a modified version of an unrelated virus to stimulate the immune response. Like the mRNA vaccines, they cannot cause COVID-19 and are quickly eliminated from the body through normal processes.
Because everyone is different, no vaccine works perfectly for everyone, but the COVID vaccines are more than 90% effective in preventing serious illness, hospitalization, or death. Most reactions to the vaccines are mild and last only a day or two. Severe reactions are rare, and the risk of them is tiny compared to the risk of getting COVID if you are unvaccinated.
We have seen a serious wave of new infections and deaths in recent months. This is partly because the Delta variant of SARS-CoV-2 is a little more likely to be transmitted than the original and a little better at evading the immune system, and partly because not enough people have been vaccinated.
We are seeing “breakthrough” infections in fully vaccinated people. This is disappointing but not unexpected. Remember, no vaccine is completely effective for everyone. Still, being vaccinated is better than not being vaccinated. Being vaccinated is like closing the windows in your house for a heavy rainstorm. This keeps your home dry, unless a tree branch cracks a windowpane and lets a little water in. Even if the window shatters completely, only one room gets soaked, not the whole house. Some protection is much better than none!
Breakthroughs can be due to immunity decreasing over time, which is also not unusual. We renew tetanus shots every ten years rather than risk that terrible disease. This is why boosters have been made available for older folks, whose immune systems may be weaker, and for other high-risk people.
Sad to say, COVID-19 may be here to stay. Bottom line? The fewer chances we take, the safer we will be. That means getting vaccinated and continuing to wear multi-layered, snugly fitting masks, especially in crowds, especially indoors. Covering sneezes and coughs but not with our hands. Washing our hands often and thoroughly. Fewer meals in crowded restaurants. Inconvenient, yes, but absolutely worth it.
Michael Heyd, a retired medical librarian from Fairfield Township who spent more than forty years searching the literature for professional hospital staff, is a member of Let’s end COVID!