Dr. Marion Pepper, Interim Chair and Associate Professor of Immunology at University of Washington Medical School, discussed testing and treatment advances as they relate to COVID-19 as well as the conflicting information circulating about the variants and the vaccines. 

Q:  What is the COVID-19 Delta variant, and why is it more contagious?

The Delta strain is a version of the virus similar to the original, with a few small changes in the proteins. Unfortunately, those changes make the virus more transmissible and harder to fight off.

Q:  How protected are people who are vaccinated?

It’s important to understand the major point of a vaccine is to prevent illness and disease. There is a 50-75% greater chance, depending on the study, you will be hospitalized if you’re unvaccinated versus vaccinated. So the vaccines are performing as intended. Further, the spread of COVID-19 occurs less from a vaccinated person than an unvaccinated person. Generally, vaccinated people are controlling the virus faster and better.

Q:  Are there any significant adverse reactions to the vaccine?

The three major reactions are anaphylaxis, which is having an allergic response to some part of the vaccine; blood clots; and pericarditis and myocarditis. But they still seem rare. The medical community is working to understand these adverse effects and come up with ways to treat them.

Q:  Could vaccine boosters help? If and when will the boosters be adjusted for the newer variant?

People who have been vaccinated, who have healthy immune systems and are under the age of 75 are largely showing very good protection against the disease. The message may continue to be that anyone age 75 and older, as well as immunocompromised individuals, should get a booster. What we need is for people who haven’t gotten the first shot to get vaccinated. We’ll see how the guidelines continue to change over the next month.

Q:  Some sources say a booster vaccine should be administered six months after the second dose, while others say eight months. Is there a definitive answer?

It’s important for people to remember that science is a process. Experiments are ongoing, with researchers working to figure out exactly when you would need a booster. It’s going to depend on how old you are, what vaccine you got and other factors. In my opinion, the eight-month timeframe is fine.

Q:  Is herd immunity realistic?

We need to think of herd immunity as protection from disease. We are exposed to respiratory viruses all the time and don’t know it. Your body deals with the infection. The idea that we’re going to develop herd immunity and this virus will disappear is not possible; rather this will likely become an endemic respiratory virus. Herd immunity needs to be understood as a measure to prevent massive loss of life.

Q:  It seems children are now getting the virus.

More children are hospitalized than before. The risk is across age groups. Again, the virus will infect a body where it can. Children are going to be more affected now because they are unvaccinated. They will likely become the prevalent population of sick people, unfortunately, along with older unvaccinated adults. Until the vaccine is approved for younger children, it is particularly important parents are vaccinated to prevent them from transmitting the virus to their children.

Q:  When will the vaccines for younger kids be approved?

Trials are ongoing with 5-12 year olds, and so far what we’ve heard is that the results have been not only safe but also effective. The Food and Drug Administration is being cautious and asking for more data, which has pushed back the time to approval. I think we may see approval around November, maybe early December. Ages up to 5 present a different can of worms, but studies are ongoing for that age group. My guess is that we may see some development next year, maybe early spring, for that age group.

Q:  The FDA recently fully approved the Pfizer-BioNTech COVID-19 vaccine, and Moderna is likely not far behind. Has the official approval, as opposed to the emergency use authorization,  made any impact on the approach to getting a vaccine?

I’m hopeful the approval will encourage people to get vaccinated. Millions of people have been vaccinated in the U.S., with few adverse effects. I believe the Moderna vaccine will be approved soon. But again, it’s hard to tell whether the vaccine numbers are slowly going up because people are scared of the Delta variant or because of FDA approval. People are still getting vaccinated, and I hope we can keep moving forward.

Q:  What can you tell us about other variants?

We hear about new variants emerging quite often, partially because science has reached the point where we can see this evolution of a virus in ways we couldn’t before. So, yes, there is cause for concern. We obviously know the Delta variant became more transmissible. A variant can go either way: It can either be more transmissible or less transmissible. Some viruses have actually, over time, mutated themselves into oblivion. We need to be careful about overinterpreting the importance of every variant. The vaccine has so far offered protection from the Delta variant and will largely continue to do so for new variants as they emerge. It’s not only the evolution of the virus that’s important, but also the evolution of the immune system.

Q:  Is it safe for a fully vaccinated, mask-wearing adult, say, 70 years old or older, to travel, given the spikes in states like Florida?

As there’s less transmission overall, fully vaccinated adults over 70 wearing a good mask, preferably an N95, could fly. The riskiest part is going through the airport. Vaccine plus mask is a good strategy. You’re blocking transmission through the mask and disease through the vaccine.

Q: Does taking the flu vaccine reduce the effectiveness of or have any impact on the COVID-19 vaccine?

The flu vaccine should not have any impact on the COVID-19 vaccine. Again, we’re exposed to respiratory viruses all the time, and one doesn’t really impact the other. I highly recommend getting a flu vaccine as well.

Concluding thoughts from Dr. Pepper

The sooner everybody is vaccinated, the sooner we will be through this surge. Wearing masks right now, even though many people don’t like them, is important to help reduce the transmission in people who aren’t able to get vaccinated, like children under 12. I highly recommend just getting vaccinated. And, for now, wear masks, especially indoors, and especially where there’s little ventilation.