Anti-vax stand by some may be long term global health threat

We live in a hyperconnected world, faced with the twin threats of vaccine hesitancy and inequitable distribution of vaccines in this pandemic. Hence, we must accept that the Corona virus is here to stay in the foreseeable future. A large swathe of population across the globe are not vaccinated, be it due to inequitable access or prioritization or delivery logistics or reluctance to take the vaccine. Even in the resourceful country , USA, 40% of the eligible population have still not taken the COVID vaccine. Thus the longer the virus circulates , the more chance that it is going to mutate.

It is unlikely that all these fundamental issues will be addressed soon. Hence, the virus is going to stay here with us for some time.The Omicron mutation won’t be the last , there will be more. However, there is no need to have sleepless nights over OMICRON. Just like the way we don’t notice when flu virus mutates every year making the previous vaccine ineffective. That is why we take the flu vaccine every year.

Each new mutation will cause an increase in the number of people infected with the virus- but it most likely won’t overburden the healthcare system like the 1st or 2nd wave did. A large percentage of the population is already exposed to the virus and vaccinated , thus developing immunity. Even though the vaccination or previous infection will not give full protection against a new mutant virus , still it will offer some degree of protection. This will give protection against severe forms of the disease. Lets address some key questions-

How fast will Omicron spread?

This will depend on factors like
a. Percentage of the population vaccinated
b. Percentage of people who have already recovered from previous infection
c. Safety measures followed by the masses.

When a new mutation enters a population that is highly vaccinated, but has given up on other control measures, it might still spread rapidly. Those that are vaccinated and continue to wear face masks, maintain social distance, follow hand washing, take steam inhalation and boost immunity with 8 hour sleep, exercise, yoga and take supplements like Vit C and Vit D etc are less likely to be affected by newer mutations.

Do we need a booster dose of vaccine and how often do we need booster doses?

We still do not know the duration of protection offered by the vaccine. While flu vaccine gives protection for 6-9 months, the vaccine developed for earlier SARS coV-1 was effective for 18 months.The current vaccines will probably give protection for a similar duration. Data from Israel where a large part of the population has received booster dose and projections from the United Kingdom suggest that a booster dose certainly gives protection against severe form of disease and will help bend the pandemic curve as well as reduce hospitalization from newer mutants. Till the time we have concrete data on the duration of protection and if and when a booster dose should be given; it is wise to protect the vulnerable population with a booster dose.

Will the booster dose or earlier vaccination protect against Omicron?

Though there is not enough scientific information available on the transmissibility or severity of illness caused by Omicron or protection due to prior vaccination or infection with earlier strain, preliminary sketchy information suggests that those who had breakthrough Omicron infection after prior vaccination or earlier strain have mild disease, not severe form of disease. This suggests Omicron will not bypass the entire immune system of the body- especially among those who have been vaccinated or had prior infection. Some aspects of the immune system will still protect against severe form and reduce hospitalization rate. Hence, while we may see lots of breakthrough infection or reinfection, there is less likelihood of significant increase in hospitalization. I sincerely urge those who have not been vaccinated to get vaccinated. The vaccines are still effective against mutants. For example AstraZeneca vaccine is still 67% effective against delta variants as opposed to 74.5% against earlier strains.

If the virus continues to circulate in the world , which is of a high likelihood, it is possible that we may have to take booster doses at specific intervals and that each of these new booster doses may be targeted against newer variants.

The chain of healthcare protection offered by vaccination is as strong as the weakest link. Unfortunately, there are too many weak links- this includes individuals who are coming out strongly against ‘being forced to take the vaccine.’ This hesitancy as well as the need to make vaccines available in every nook and corner of the world is a global necessity. Otherwise, the virus will continue to circulate and mutate. Every country will be affected and more likely we may have to live with it like flu, which established as a seasonal disease after 1918 pandemic.

The Government, both at the State and the Center want the Indian economy to rebound to normalcy. Any alarm bells, especially unsubstantiated ones, would be a great setback. India has already administered 1.2 billion + jabs. Hence, more severe manifestations of OMICRON are highly unlikely. But its high time we added Covid booster dose to our list of mandatory vaccinations for vulnerable population.

The writer is world’s leading cardiac surgeon and head of Mumbai’s Asian Heart Institute. Views expressed are personal.