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Covid and vaccination: mary_spiri — LiveJournal

Two and a half years have passed since the beginning of the pandemic, the virus came to us around the same time that the youngest granddaughter was born. And it’s already possible to sum up some results, I mean about the pandemic (we’ll wait with my granddaughter). The main results of Covid are the successes of vaccination. And then there was a review from Bloomberg, which I really liked for its brevity and clarity: https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/

And I will try to retell even more briefly what made the greatest impression on me.
1. Vaccination scale: 12 billion doses in 184 countries, averaging 153 doses per 100 people. This is the largest vaccination campaign in the history of mankind (in terms of the absolute number of people vaccinated). States – about 600 million doses, 177 doses per 100 people, Russia – 168 million, 115 doses per 100. Champion – Cuba, 340 doses per 100, Israel – about 200 doses per 100, Germany – 220 per 100. Sweden, about which There is a legend that they ignored their Covid – 218 doses per 100 people (they only ignored the lockdown, not vaccines). By the way, in Europe, in general, the picture is very dependent on the country: Switzerland with its powerful biotech – only 183 doses per 100, less than neighboring Austria (213).

China, with its zero Covid policy and current omicron binge, is doing well, with 240 doses per 100 people, more than Europe. For 300 doses, Chile exceeded 100. But India is stuck at 142 doses per 100. Ukraine is very behind – only 80 doses per 100. But now, against the backdrop of population losses from the war and the complete impossibility of calculating who and how were vaccinated from February to June, this figure is not credible. All Central Asia – at the level of 120 doses per 100, worse than Iran (180).

It should be borne in mind that most vaccines require 2 doses to create protective immunity, and there are vaccines, in particular those used in Cuba, that immediately require 3 doses (not 2 + booster, but 3 at once with intervals of 2-4 weeks).

In total, more than a dozen working vaccines were made (oh, and how many non-working vaccines were made, and you can’t count them). Access to them in different countries was very different, in the States it was reasonable and good. By the way, in the States, by the summer of 2021, the need for vaccines has decreased, those who wanted to did it (approximately 60%), the rest were waiting for who knows what. RNA vaccines have a very clear expiration date, and production facilities were at full speed by that time. And then the States organized the transfer of vaccines to Latin America. Doses were loaded on the plane, which had no more than a month of life left. And in Brazil, a clinic was organized right at the airport, there was a queue, and the vaccine from the plane went to those who wanted it – straight, no corruption schemes, the danger of violating storage conditions, etc. There are airports in large cities where the vaccine was most needed, and the process was underway. It was good for the states too – prestige instead of a discarded vaccine, for which American taxpayers’ money has already been paid.

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2. In the countries with the highest vaccination rates, Covid deaths have dropped dramatically despite the Omicron binge. Vaccination greatly facilitates the course of the disease, but does not save from infection (which we learned from ourselves when we got sick in February). Actually, the graphs of morbidity and mortality showed the same waves until about November 2021, and since then they have diverged sharply – the wave of death has remained at the bottom, the wave of morbidity has gone up steeply.

And here is an article in the Lancet (https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00320-6/fulltext): if you extrapolate the mortality curve from Covid to vaccination and model it into the future, then vaccination reduced mortality by 14.4 million deaths. And if you look at the official average deaths before the pandemic and in the first year before vaccines, and then calculate the estimated excess deaths that would have been in the absence of vaccines, the number of deaths averted looks even higher: 19.8 million.

3. Israel, thanks to the speed of its vaccination campaign, was the first country to achieve a “kink” in the incidence curve: a sharp decrease in new infections due to immunity from vaccines. After Israel, the same thing was observed in dozens of countries, where vaccination went quickly and covered a large percentage of the population.

4. Expert judgment: 70-85% of the population must be vaccinated with access to booster doses in order for the country to fully live normally. Globally, this goal can be reached no sooner than in 9 months if the current level of vaccination is maintained. Locally – in the States around me, life returned to normal. Masks are no longer required anywhere, although many places are recommended. However, a lot of people spits on recommendations. An estimated 77.4% of Americans received at least one dose. The “democratic” states are in the lead, where Democrats are in power. The reason is very simple – Democrats in power are usually found in states with well-educated populations. A well-educated population does not believe in horror stories and is not afraid of vaccines. And the worst of all are Alabama, Wyoming and Missouri, well, in general, it’s understandable. As our son-in-law said, when Toyota wanted to open an assembly shop in Missouri 20 years ago, they had to abandon the idea, since many of the locals could not read enough. I hope that now at least this situation has changed.

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By the way, the United States had one of the highest death rates from Covid among developed countries. Vaccination put an end to that. Last winter, the divergence of morbidity and mortality curves (morbidity up, mortality more or less stagnant) led to a change in perception: Covid finally turned into a common cold, unpleasant, but manageable. And it also led to the opening of the country and the removal of masks.

5. The effectiveness of different types of vaccines: it must be taken into account that different vaccines are used in different countries, so a direct comparison is not worth making, there are too many social factors. If you still try, then mRNA vaccines (Fizer-Biontek) are in the lead, adenovirus vaccines (J&J, Astro-Zeneca, Sputnik) are in second place, and made from protein fragments (Novavax, a bunch of Chinese and alternative Russian ones) are in third. The difference is not very big, it seems that the vaccines either work or they don’t (Epivaccorona, the Merck vaccine, some Chinese ones don’t work at all). Not a single one completely protects against Omicron, but all workers reduce mortality.

I’ll add right away that developed countries study the effectiveness of only those vaccines that they use at home. Nobody wants to do global comparisons. It is already clear that none of the alternative vaccines made in China, Russia or anywhere else is any better than vaccines from developed countries. So there is no interest in alternative technologies, their own are good. And on the other hand, if, say, the States find out that some vaccine X from country A is much worse than American Modern, then the States will have to act somehow, for example, provide Modern to country A to replace vaccine X. From purely humanitarian considerations , as it was necessary to provide anti-retroviral drugs to Africa, which is dying from AIDS. Africa as a result is no longer dying out, but with American money.

The result – it is easier and cheaper to study your own. And in the absence of evidence-based and statistically competent comparisons of different countries, anecdotes from the life of useful information do not carry.

6. Side effects. The same story: developed countries are studying the consequences associated with the vaccines they use. There is no interest in studying side effects in the developing world: there is a completely different medicine, other protocols for collecting information and describing cases, access to databases is often insufficient. The fight against bureaucracy does not appeal to anyone. As for the side effects observed for American vaccines, there is a good (and short) comparison here: https://www.mayoclinic.org/coronavirus-covid-19/vaccine/comparing-vaccines. The general conclusion is that severe side effects are extremely rare. 600 million doses were delivered in the States. One hundredth of a percent (0.01%) of 600 million is 60,000. Less than 2,000 had heart problems, so we are not talking about hundredths, but about thousandths of a percent. By the way, severe cases in the States rarely lead to death, and usually to a full recovery.

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7. Old vaccines give partial protection against the new Omicron and subsequent strains: basically this is a strong relief of the course of the disease. Do we need new versions of vaccines that everyone is now developing specifically from Omicron? There is such a thing as antigenic imprinting, a fundamental property of immune memory. Upon first contact with an antigen, such as the Covid spike vaccine, the body produces a range of different antibodies and T cells. The C-Protein of Covid is large, something like 1273 amino acids. In this case, the immune response is produced on small sections of the protein, the so-called. epitopes of 6 amino acids. Hence the great diversity of the answer, there are a lot of epitopes. Omicron differs from previous strains not too much, from delta by about 30 mutations. Obviously, most of the epitopes are still the same.

As a result, at the second contact, already with the omicron vaccine (or with the omicron itself), immune memory is immediately activated, with the rapid reproduction of existing cells that respond to epitopes common to the old and new strains. At the same time, the immune system successfully copes with its task, and binds the viral protein. But such an activation of the already existing immune memory interferes with the production of new antibodies to different areas, which seems to be no longer necessary. As a result, there is an immune response, but there is no new additional protection. However, the activation of the immune response is good, it facilitates the course of the disease.

Bottom line: boosters and additional vaccinations are needed, but it is not at all necessary to wait for a vaccine from the very strain that is now walking around. For the old vaccine will do. However, an additional advantage seems to be obtained if immunized with another type of vaccine. In the States, it’s Novavax (a protein vaccine) instead of an mRNA vaccine. So we probably will do it in the fall, we will put Novavax on ourselves.

8. Anti-vaxxer comments I will not discuss, I will just erase. Vaccination against Covid is another example of the success of modern biotech, at the level of the great past (such as vaccination against polio). The need is also obvious at this stage – a sharp decrease in mortality.

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