By Bea Cabrera
Many people who were skeptical about the Covid-19 vaccine became even more so when breakthrough cases became regular occurrences. Breakthrough infections refer to cases involving fully vaccinated people who get stricken by Covid-19.
The growing number of breakthrough cases has raised more doubts and questions about the efficacy of the Covid-19 vaccines manufactured by Pfizer, Moderna and Johnson&Johnson.
But most of the questions are drawn along political lines, according to Dr. David Weingarten, neurosurgeon and founder of the Weingarten Institute of Neuroscience on Guam.
“One of the greatest tragedies of the pandemic is that everything has become a politicized issue. People side with one camp or another, and completely disregard scientific evidence that doesn’t fit their political narrative,” Weingarten said. “This happens on both sides of the aisle, with both sides accusing the other of being ignorant or misinformed.”
The government of Guam’s Covid-related policies have also polarized the community.
Guam was close to achieving a nearly 90 percent vaccination rate as of the last week of September. Yet, there are weekly protests from groups of people opposing the vaccine mandate for different reasons. Some refuse being forced to roll up their sleeves; others for being shamed; still others for being excluded from society for their choice. Some invoke religious beliefs, while others are simply anti-vaxxers.
“Some people are simply like obstinate children playing a game of ‘you can’t make me,’ no matter the consequence,” Weingarten said. “Thankfully, most people in Guam have been fairly sensible about getting the vaccine and they trust their medical professionals.”
Breakthrough infections, Weingarten said, happen because the delta variant replicates much more rapidly than other variants.
“For the most part, I don’t see people asking honest questions at this point because the information has been out there for quite some time,” he added. “Instead, I see them offering challenges, telling doctors that they don’t know what they’re talking about and claiming to have ‘done their own research’ and come to the conclusion that the vast majority of doctors are wrong.”
Katherine O’Brien, director of the World Health Organization’s Department of Immunization Vaccines and Biologicals, said vaccines operate in different ways.
“First, the degree of severity of disease among vaccinated people who have a breakthrough infection is less severe than the severity of disease among people who aren't vaccinated,” she said.
“Vaccines do not prevent people from getting a disease at all. (But) when the disease occurs among people who are fully vaccinated, the severity of that disease is less.”
O’Brien said her office has been monitoring breakthrough infections carefully.
“This is not something that's happening in an unexpected way, but it doesn’t happen equally among different kinds of people. Those who are at increased risk of disease are people with frail immune systems, people who are in older age groups. They have a greater risk of having breakthrough disease than other people so it's not an equal risk of breakthrough disease.”
The Centers for Disease Control and Prevention recommends booster shots for certain groups, citing studies, which show that after getting vaccinated against Covid-19, protection against the virus may decrease over time.
CDC said although Covid-19 vaccination for adults aged 65 years and older remains effective in preventing severe disease, recent data suggest vaccination is less effective at preventing infection or milder illness with symptoms.
CDC said emerging evidence also shows that among health care and other frontline workers, vaccine effectiveness against Covid-19 infections is decreasing over time. This lower effectiveness is likely due to the combination of decreasing protection as time passes since getting vaccinated— which means, waning immunity— as well as the greater infectiousness of the delta variant.
O’Brien said breakthrough cases are increasing partly because people stop the other interventions that reduce the transmission of the virus. “So when the virus starts to transmit at a greater pace, and with greater frequency, there's a lot more exposure for everybody, including people who are vaccinated,” she added.
O’Brien said the vaccine reduces the transmission of infection to others. “If you happen to get infected, the amount of virus that you have in your nose, or in the back of your throat that you're shedding and potentially transmitting to somebody is reduced. There's less density of the virus in you, and so, there is much less risk that you will transmit it to somebody else.”
Weingarten said some patients continue to refuse vaccination primarily due to the vast sea of misinformation being produced.
“Some people are afraid that the vaccine will do things like make them sterile or make them more likely to get infected, neither of which is true, but some are convinced that it doesn’t work,” he said.
Some who refuse to get the vaccine rely instead on purported alternative Covid-19 therapeutics such as Ivermectin, hydrocloroquine and immune boosting.
“Others are convinced and again, largely due to misinformation campaigns, that they don’t need a vaccine because other things have been ‘proven’ effective. Importantly, they have not been ‘proven’ effective,” Weingarten said.
“There is some evidence suggesting that some of these things may provide some benefit (in most cases fairly marginal), but there is also contradictory data, so it simply cannot be said that their efficacy has been ‘proven,’ and it is highly unlikely that they are ‘miracle drugs’ that obviate the need for vaccination,” he added.
“Just as no army wins every war, some people may still suffer severe Covid-19 infections even if they are vaccinated. The numbers speak for themselves though: unvaccinated people are much more likely to get infected, have a longer-lasting infection, remain infectious to other people for longer, suffer more serious disease, and die,” Weingarten said.