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Triple play on the way

Laurie Garrett in Foreign Policy:

The world has fought many battles against the novel coronavirus since January 2020, losing more than 4.2 million people and vanquishing some of its spread. But the war is still raging and will do so for a long time. I predicted early last year, in a best-case scenario, that we would face a 36-month battle before COVID-19 could be considered under human control. We are only now in month 19.

Sure enough, the United States is again awash in virus, with the incidence of new COVID-19 cases having soared 131 percent in the third week of July. To be clear, the vaccines available work well—especially the Pfizer and Moderna products based on mRNA technology. But it is likely that waning vaccine efficacy, coupled with a stubborn one-fifth of the adult population refusing any immunization, has opened the door for the dangerous mutant delta variant of SARS-CoV-2 to wreak havoc among the vaccinated and unvaccinated alike.

That’s why the United States is going to need a third dose of mRNA vaccines; for the nation’s older population, the triple play is already overdue. “I don’t see the virus just disappearing,” said Stanley Plotkin, considered the godfather of vaccinology. The University of Pennsylvania vaccine inventor and immunologist told me that the U.S. Food and Drug Administration (FDA) should comply with requests from Pfizer, following Israel’s example, and immediately approve third-dose immunization for adults over the age of 60, with general triple dosing for all Americans to follow. I agree.

The World Health Organization (WHO) has voiced opposition to third dosing in richer nations before making primary doses available to billions of people in middle-income and poorer countries. It’s a completely reasonable point, both morally and strategically, in the war against COVID-19. But evidence now points in an alarming new direction, suggesting that fully vaccinated individuals can carry the delta variant in their noses and mouths, shedding in some cases just as much virus to infect others as do unvaccinated infected individuals.

Moreover, in the absence of fully effective vaccination of better than 75 percent of adults, a society may act as a herd of walking petri dishes, cultivating immune-escape mutant forms of SARS-CoV-2—that is, mutants that evade existing vaccines. The vaccine that rolls out tomorrow in a poorer country may have already been rendered less effective by its prior inadequate, or incorrect, use in richer countries.

Urgent action is required from the FDA, the U.S. Centers for Disease Control and Prevention (CDC), and their counterparts in Europe, Canada, and other parts of the world that have already widely administered vaccines. And recommending the usage of masks, while necessary, is no longer enough. The message must be that if you’ve had a second shot, it’s time to start planning to get a third.

I’m ready and willing to get shots any time they are necessary and will do whatever it takes to get one. I’ve been worried about the virus evolving from the beginning and it’s the main practical, if not moral, reason for having everyone vaccinated. We are walking petri dishes providing opportunity for this deadly bug to get worse and worse.

We need a WWII level global program to knock this thing out or we’re going to be stuck with it for a long time to come. If the wingnuts are worried about losing their “way of life” they should be looking at this rather than taco trucks on every corner and doing what’s necessary to deal with it.

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