Tue. Nov 30th, 2021

Lockdowns are back in continental Europe. Austria has been at the forefront, first locking down just those who have not been vaccinated, then imposing a national lockdown for everyone. Other governments have imposed new restrictions with the possibility of full lockdowns if the situation does not improve. Weren’t vaccines supposed to put an end to all this?

Firstly, vaccines can only directly protect those who have actually been vaccinated. Moreover, it has been clear since the Delta variant of Covid became dominant that a single vaccine dose does not really cut it – two doses are required to give a good level of immunity. For many countries in Europe, between a quarter and a third of the population have not been fully vaccinated.

Second, immunity – whether from injection or infection – seems to wane over time. By just how much is still unclear, but it seems that millions of people in most countries are still susceptible to Covid, either because they have never had the disease and have never been vaccinated or because their immunity has faded. That said, while immunity to infection seems to decline markedly over time, vaccines still provide a high level of protection against serious illness and death. So even if you had your second jab six months ago or more, your likelihood of ending up in hospital is still much lower than if you have never been vaccinated at all.

The good news is that a third dose of the vaccine appears not just to boost immunity back to the level achieved soon after a second dose, but also actually to produce even greater immunity. This was demonstrated in Israel, which led the world in vaccination but then saw that immunity tail off. Third doses have had a dramatic impact on the numbers of people being infected, hospitalised and dying. In the UK, over 26 per cent of people over 12 years old have already had a third dose – and those triple-jabbed people are in the most vulnerable groups. The boosters should help keep a lid on hospitalisations as we head into winter.

Yet some people cling to the idea that vaccines do not really work. They will find some way of cutting the data so that it appears that vaccinated people are more likely to die than unvaccinated people. But such claims rarely take account of age. Almost all older people have been vaccinated, yet because the risk from Covid is much, much greater in older people, they may still die in greater numbers. For example, the US Centers for Disease Control and Prevention (CDC) estimate that for someone who is 85 or older, the risk of hospitalisation is 10 times greater than for someone aged 18 to 29. When we compare vaccinated and unvaccinated people in the same age groups, it is crystal clear how effective vaccines are.

Another claim being made a lot lately is that vaccines do not have any impact on transmission. This is clearly wrong. A recent study in the Lancet has muddied the waters somewhat. It found that in household settings, the risk of an infected person transmitting the virus to another member of their household is pretty much the same whether the infected person is vaccinated or not. It also appears that vaccinated people have a similar ‘peak viral load’ as unvaccinated people, on average.

But we need to be clear about what is being said here. The Lancet paper looked at infected people – yet people who have been vaccinated are less likely to be infected. Transmission is impossible until there is infection – that is, until the virus is spreading and reproducing in someone’s body. As one respondent to the Lancet study argues, ‘a vaccinated person is less likely to get Covid in the first instance, is less contagious and is contagious for a shorter time, resulting in significantly less spread of the virus through a highly vaccinated community’.

The results of the Lancet paper are plausible because if household members are in close contact every day, there is a good chance they will interact during the period of peak infectiousness. Nobody would claim that vaccines offer complete protection against transmission, but they do cut it significantly. The other point the Lancet paper makes is that if all members of the household are double-jabbed, the risk of transmission is considerably reduced.

A nuanced understanding about vaccines and transmission is important in relation to a couple of big issues right now. On vaccine passports, it means that if only vaccinated people are allowed into venues like the theatre, pubs and nightclubs, the risk of transmission is probably lower than if everyone – vaccinated and unvaccinated – was allowed entry. For those of us who hate the idea of being asked for our ‘papers’ just to go about our normal lives, disputing that fact is not the right way to oppose vaccine passports.

Rather, we can point to the much lower risk from Covid in general thanks to vaccines. We should persuade those most concerned about the risk of getting Covid that their best bet is to get vaccinated themselves, not to exclude millions of unvaccinated people from social life. The right argument against vaccine passports is that we should value freedom and set a high bar for any restrictions on it. What we can say is that vaccine passports cannot provide any guarantee that you will not get infected in a particular venue. Transmission of the virus by vaccinated people is still possible, even if it is significantly less likely. Both in principle and practice, vaccine passports seem like a bad idea.

The other question is around the mandatory vaccination of care-home staff. Care homes are very similar to households in the sense that staff and residents are in very frequent contact, so the results of the Lancet paper may be relevant. If a care worker can still transmit the virus even if they are vaccinated, does it make sense to sack them if they refuse to be vaccinated?

The principle of having to be vaccinated in order to work with vulnerable people seems reasonable, as I have previously noted on spiked. However, whether it is the best thing to do in practice, right now, for this particular virus and these vaccines, is not a simple, black-and-white question. This is especially true given the existing staff shortages in care homes and the fact that almost all care-home residents are themselves vaccinated and have had a booster jab. It seems to me that to justify sacking possibly thousands of people, there must be a clear benefit to such a policy. Does that benefit exist?

Once, we hoped that even just one dose of a vaccine might be enough to suppress Covid (Johnson & Johnson even designed its vaccine to be a ‘one and you’re done’ jab). But real-world experience and the rise of more infectious Covid variants have tempered that optimism. Nonetheless, vaccines have been the single biggest factor in ending the Covid emergency, turning a deadly pandemic into a troubling, endemic illness – at least, in those countries wealthy enough to provide them.

In less than a year, over 7.7 billion doses of the vaccine have been dished out worldwide. The vaccines are, by any reasonable measure, safe and effective. It is time to put the anti-vaccine sniping aside and get on with vaccinating even more people so we can really put this pandemic behind us.

Rob Lyons is a spiked columnist.

Picture by: Getty.


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