As the coronavirus pandemic progresses, questions are cropping up regarding natural immunity, the delta variant and breakthrough infections. Dr. Anthony Fauci, the nation’s top infectious disease expert, spoke to WTOP to answer some rising and lingering questions and shared an update on the guidance for booster shots.
FDA to decide on booster shots
Currently, the only people who should get a booster shot are those who are immunocompromised, the director of the National Institute of Allergy and Infectious Diseases said.
But, within the next few days, Fauci said, the Food and Drug Administration will be deciding, based on the data presented to them by Pfizer, who, when and how people should get their third shot of the Pfizer vaccine.
“Right now they’re discussing the situation with Pfizer, but people should not do anything until they get the approval from the FDA,” he said.
The discussion for the Moderna vaccine will be a few weeks down the pike.
Originally, booster shots of the Pfizer or Moderna vaccines would be offered starting Sept. 20, but more time may be needed to examine the evidence. FDA scientific advisers will debate Pfizer’s evidence on Friday, and if the FDA approves another dose, then advisers to the Centers for Disease Control and Prevention will recommend who should get one, The Associated Press reported.
If I had COVID-19, do I need to get a vaccine?
While people who got COVID-19 would have some protection, which could be good protection for a while following infection, it’s not known how long that lasts or how durable that immunity is.
“We do know that when you give someone a vaccination after they’ve recovered from infection, and superimpose that upon their natural acquired immunity, you can dramatically increase the level of protection … well over and beyond with a couple of doses of vaccine,” Fauci said.
Some 180 million people have been fully vaccinated in the U.S. and more than 41 million people have had COVID-19, according to the latest numbers from the CDC.
In August, the U.S. reached President Joe Biden’s goal of getting at least one COVID-19 shot into 70% of U.S. adults. It’s closer to achieving herd immunity, but Fauci said the country is not there yet. Some 73 to 74 million people who are eligible to be vaccinated have not yet gotten vaccinated.
He said herd immunity is an “aspirational goal,” but “we don’t’ know what that number is.”
It will be a combination of vaccinated and protected people and those who have been infected and have durable protection and immunity following infection, and with a highly transmissible disease, the number of both of those together is very high.
“For example, with measles, which is a very transmissible virus, perhaps the most transmissible virus that we deal with, when you’re dealing with measles, you need well over 90% of the population to be vaccinated before you can actually feel that you have true herd immunity. So, it is conceivable that we may need that amount for individuals with regard to COVID-19. We hope when you add up vaccinated people, plus the protected people from infection, that’ll be close enough to that number to protect us all, and give us truly herd immunity,” Fauci said.
‘Unlikely going to eradicate this virus’
What can you do with a virus? You can eradicate it, eliminate it or control it.
“It’ unlikely that we are going to eradicate this virus in the sense of getting it off the planet,” Fauci said, adding that only one virus in the history of public health has been eradicated — the smallpox virus.
Polio and measles have been eliminated from the U.S. but not from the world. What Fauci hopes to happen with the coronavirus, at minimum, is to very strongly control it.
“So that if it is around, it’s only a very unusual infection in the community and people who might get a breakthrough infection or people who are not vaccinated,” he said.
If the coronavirus could get controlled, after a while, eliminating it could be possible, but Fauci said he does not see that happening in the next year or so.
“But it is possible that if we continue to mount a very good vaccine program that we might be able to eliminate it,” he said.
Breakthrough infections are being reported, spurred in part by the delta variant, but with the vaccines in play, it’s a world of difference.
“If you look at the people who do get breakthrough infections who have been vaccinated, generally not always, but mostly, they get mild disease or even asymptomatic disease. So the one thing that vaccination does, it protects you against infection. And when and if you do get infection, it protects you against severe disease. So the advantage of vaccines, even in the arena of the delta variant is overwhelmingly beneficial,” Fauci said.
WTOP’s Mike Murillo contributed to this report.
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