The latest on COVID-19 and vaccines: Johnson & Johnson shots continue to be on pause as health officials investigate extremely rare side effects; Moderna and Pfizer vaccination appointments are becoming easier to snag in many states; and what scientists are learning about the vaccine’s efficacy against variants and ‘breakthrough infections.’ ProPublica reporter Caroline Chen joins Hari Sreenivasan to discuss.
With more than 127 million doses of COVID-19 vaccinations administered in the U.S. Now, there are still questions of efficacy as new strains and some breakthrough infections are emerging. I recently spoke with ProPublica's Caroline Chen about those concerns and the latest vaccination efforts.
Caroline, one of the things that's disconcerting right now is these breakthrough infections, people who have been vaccinated, who are still coming down with COVID-19. Why is it happening?
The first thing I would say is that no vaccine is 100%. And so we have to remember that. And what was actually tested in the trials was their ability to stop symptomatic COVID. And so, as we all know, there is always a chance for asymptomatic infection. And you add onto that the fact that the vaccines are very good, but not 100%. And what that means is just that breakthrough infections are going to occur. And that's expected by everyone, that's not surprising. The part that we are maybe concerned about is those extremely, extremely rare cases where somebody is fully vaccinated but still gets hospitalized or has severe COVID because one of the hopes for the vaccine was that, you know, even if you do have an infection post-vaccination it will likely reduce it so you barely have symptoms or you have a cold. That would be a win for us. Right? So if every single breakthrough infection was mild or asymptomatic, that'd be a win. But unfortunately, there have been very, very, very rare cases, I'm talking about 0.0005% of people who have been fully vaccinated, in which people do end up still getting hospitalized.
So the CDC recently came out with some numbers saying of the people that they tested that were vaccinated, about 5,800 people got infected and only about 7% or so ended up dying. How do we make sure that people recognize the rarity of this, that this is not a reason to hesitate in getting the vaccine?
Yeah, absolutely. So I actually think that 7% number, which is technically accurate, is a little misleading because it's 7% of those people who had a breakthrough infection who ended up being hospitalized. The real denominator that I think is important to people is how many percent of those who actually were fully vaccinated ended up hospitalized? That's what you want to know, what are my chances of being fully of being hospitalized even after I've been fully vaccinated? And that's the 0.0005% that I cited earlier. So, extremely rare. And you have to then think about, again, your risk benefit. You know, if you were not vaccinated and you caught COVID, what are your chances of getting COVID, and what are your chances of then being hospitalized? Versus, if you are fully vaccinated, your chances of getting COVID lower dramatically, then your chances of that being a hospitalization case is even lower. So there's still a clear benefit to being vaccinated.
So what are scientists able to learn from these breakthroughs? Do we know that the virus that might be in somebody that has been vaccinated is stronger or has figured out a way around the vaccine?
Yeah, so this is the topic of the story that I just did, which is how are we learning from these extremely rare cases? And there are basically, I would say, two big concerns. One is that there might be a variant, a different strain of COVID that comes up that might be more resistant to the vaccine. So catching these breakthrough cases, if they're caused by a variant, would be sort of the leading indicator maybe that something like this has happened. That's why we have to keep an eye on them. The second concern is that there might be small populations of people who are more predisposed to not having a good immune system response to the vaccine. And there are already some studies that are starting to show that immunocompromised people, so people with, who have received organ transplants, for example, people on some blood cancer medications and also some people on some rheumatology drugs, autoimmune drugs, which all of these people are on drugs that tamp down their immune system. So it's actually not that surprising, unfortunately, that they might not mount a good antibody response to the vaccine. But it's important for us to understand who are these people so that they know that maybe the vaccine is not going to protect them and they have to continue to be careful.
The Johnson & Johnson vaccine: at this point ,still a pause. Likely to be un-paused?
I really would hope that it will be un-paused because this is a really important vaccine, not just for the US but for the world. We've talked so much about the cold storage requirements of Moderna and Pfizer and Johnson & Johnson has some advantages in that it doesn't require this ultra-cold storage. It's just one shot. It's also cheap. Johnson & Johnson has promised to provide it on a non-profit basis. So we do need this vaccine in the world. Right now, it is a very small percentage of the supply in the US. So the pause is not going to mean that suddenly everybody can't get that vaccinations. But I think it is going to be really critical for scientists to understand, look, is there anybody we have to warn to be careful not to take this vaccine, particularly? Is there a subpopulation or a pre-existing medical condition that might predispose you to these super, super, super rare events? And then be able to go forward with the vaccine again.
For months, we were talking about a supply-side problem. Were we going to have enough vaccines? We seem to be, in certain states and localities, turning a corner where we have vaccines, but we have a demand-side problem, where for whatever reason, people aren't lining up to get it.
Yeah, so I think this could have been foreseen for sure. And we knew that supply would keep ramping up and that the people who are most eager to get the vaccine would just line up. And as we know, we've heard so many stories of people who spent hours clicking the refresh button on their computers to get their vaccines because they were so eager. And now you're right, the story is starting to change. We now have much more supply, even abundant supply in some states. And there is we're starting to move beyond the low-hanging fruit, I guess, to people who either are more hesitant to get the vaccine or want the vaccine but are having trouble accessing it. And we've talked about that to the various barriers that there may be to easy access to people who can't take time off work, people who don't speak English and find it hard to navigate the Internet. So this is the point at which public health officials' roles become so much more important to get out messaging, to make the vaccines easy for people to get and to overcome hesitancy and try to convince those who maybe still have doubts, maybe still be worried, may find it too difficult. And I think that this is the challenge for the months ahead.
Caroline Chen of ProPublica, thanks so much.
Thanks for having me.
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