5. Young people. This pandemic, Round 2, is primarily being observed in younger patients than in Round 1. Our children’s hospitals are even already filling up or full. Because of the delta viral dynamics, it is much more capable of causing severe disease in a larger swath of the population. You spew enough of any human pathogen on someone without immunity, and it’s not going to end well. This sets up very poorly for the beginning of the school year — which has already started in Florida — and it scares me. Check that. It is actually terrifying. I sure hope we have vaccines for the 5- to 11-year-olds soon.
6. Vaccines work! Speaking of vaccines. Are they working? Yes! They are absolutely doing their expected job. We know a lot about vaccines for upper respiratory viruses, as we have been giving the population one every year for decades (influenza). To explain all of this, I need to provide some biological context. When you get a vaccine as a “shot,” the “antigen” in the vaccine leads to formation of an antibody response. You probably knew that. What’s important, though, is that it primarily leads to a specific Immunoglobulin G (IgG) response. That’s the antibody type that circulates around in really high numbers in the blood, is located some in tissues and is more easily detectable by blood tests, etc.
What that shot does not do is produce an Immunoglobulin A (IgA) antibody response to the virus at the surface of the throat mucosa. That’s the antibody type that could prevent the virus from ever binding in the first place. As such, in a vaccinated person, the virus can still attach like it’s about to break into the house, but it doesn’t realize that there is an armed homeowner on the other side of the door. When that virus is detected, the IgG beats it up and clears it before the person gets very ill (or ill at all). (Sidebar: Anyone ever had their kid — or themselves — get the “Flumist” vaccine as their annual flu booster? The idea there is to introduce the antigens at the surface of the throat mucosa leading to that IgA response that will prevent infection from happening at all. Sounds good and still has a place, but it isn’t quite as effective overall as the shot.)
7. Preventing disease and death. The COVID-19 vaccines are designed to prevent disease/death through that IgG response (though it does also reduce infections somewhat). How good are the vaccines at doing all of this with delta? The Centers for Disease Control and Prevention has just released data addressing that very question. Punchline: They’re remarkably good! The vaccine shows an 8-fold reduction in the development of any symptomatic disease secondary to delta. For hospitalization, it is a 25-fold reduction. That’s 25 times! Remarkable. For death, it is also 25 times! This is a very effective pharmaceutical class when looking at overall efficacy toward the intended/expected purpose. When looking at the very tiny side effect profile, I’d personally consider it one of the best overall pharmaceuticals on the market in any class of drugs.
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