As US hits vaccination milestone, some hope for normalcy
On Tuesday, the CDC reported that more than 50% of the U.S. adult population has been fully vaccinated against COVID-19, marking a major milestone in the efforts to end the pandemic.
“That’s a big deal, folks,” President Joe Biden tweeted.
A day later, Pennsylvania became the 10th state to meet Biden’s goal of having at least 70% of the population at last partially vaccinated by July 4.
In a White House briefing, CDC Director Rochelle P. Walensky, MD, MPH, reported that weekly average case counts are down 25%, and that hospitalizations and deaths from COVID-19 also continue to decline.
All of this is happening as the CDC and states relax masking guidance and people begin resuming some normal activities — developments that have cast vaccination in an appropriately positive light, said Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security.
“I don’t think it’s possible to get 100% of adults vaccinated. There are some people who will not get the vaccines under any circumstances,” Adalja told Healio. “However, it is important to show people that getting vaccinated allows them to return to their pre-pandemic life completely.”
“In the early days, the vaccine was undersold,” he said. “It wasn’t shown to be a personal value to the person being vaccinated. Thankfully, that horrible practice has ended.”
In light of this progress, we asked Adalja and several experts, “Is the U.S. back to normal?”
‘We have defanged this virus’
The short answer is “not quite.”
“The United States is back to normal in the sense that we have defanged this virus and removed its ability to threaten hospital capacity,” Adalja said. “This was the original impetus for the public health mitigation measures, and the vaccines have succeeded tremendously in denying this virus the ability to cause serious illness, hospitalization and death.”
Infectious Disease News Editorial Board Member Carlos del Rio, MD, distinguished professor of medicine and executive associate dean at Emory University School of Medicine, said the 50% milestone is a “nice number” but still means that half of adults remain unvaccinated. Case counts and deaths, he said, are still too high.
“‘Normal’ cannot be approximately 30,000 new infections and 500 deaths per day,” del Rio said. “We see that the drop in cases is mostly among vaccinated individuals. Among unvaccinated persons, rates are as high as they were back in January. We need more than 70% of Americans vaccinated.”
What the U.S. is likely facing is a “new normal” as opposed to a prepandemic normal, said Infectious Disease News Editorial Board Member Gitanjali Pai, MD, an infectious disease physician at Memorial Hospital and Physicians Clinic in Stilwell, Oklahoma, and the newly named chief medical officer for the Oklahoma State Department of Health.
Regardless, it is difficult to put a time frame on when that may happen, Pai said.
“Of course, the more people that get the vaccine and follow the three Ws wear a mask, wash your hands, watch your distance the better our chances are of reaching herd immunity and the harder it is for COVID-19 to spread,” she told Healio. “If we get that level of protection, we would then develop an umbrella of immunity that would be able to protect even the vulnerables who have not been vaccinated, or those in whom the vaccine may not have been as effective.”
Monica Gandhi, MD, MPH, professor of medicine and associate chief in the division of HIV, infectious diseases and global medicine at the University of California, San Francisco, said it will be harder to get the remaining 50% of American adults vaccinated.
“We actually don’t need a full 100% of eligible people to get vaccinated to get to herd immunity but as many as possible would be great,” she told Healio. “Now comes the harder work of giving the doses out in communities, at work places, of ensuring employers give people paid time off to get the doses, of talking to the vaccine hesitant with compassion, of community messaging, etc.”
A look ahead
According to Gandhi, cases will likely continue to go down and the country should hit 10,000 new cases per day by July 4. That was the milestone National Institute of Allergy and Infectious Diseases Director Anthony S. Fauci, MD, said said in the past would precipitate a return to normal.
“We should be back to completely normal life by the end of the summer,” Gandhi said.
Beyond summer, Gandhi said schools should be back closer to the prepandemic norm come fall, with no masks for children or vaccinated teachers.
“As vaccination expands to more and more age groups, it will certainly help schools to function in person,” Pai said. “The benefits of in-person learning cannot be overemphasized, and we need to make every effort to continue to have schools operate in-person.”
Experts noted that other parts of the world are seeing a very different scenario, and that the U.S. is capable of doing more. Del Rio said “a big determinant” of what the next 6 months looks like in the U.S. is what happens globally.
“The U.S. has already started focusing on global vaccination efforts. We are moving in the right direction, but we do have a long way to go,” Pai said.
Gandhi rattled off a list of ways the U.S. can help other countries, including donating surplus doses of vaccine and continuing to work with the European Union to waive patents for vaccines.
“The best thing the U.S. can do, in my opinion, is to remove all export restrictions on vaccines and vaccine materials,” Adalja added.
“We will keep inching toward our ‘new normal’ as — and if — cases continue to decline,” Pai said. “We will continue to see local outbreaks, which will hopefully be identified and contained in time. The most important aspect is that if we all continue to do our part, including encouraging vaccination and being vigilant, we will continue to advance toward the end of the pandemic.”
CDC. COVID Data Tracker. https://covid.cdc.gov/covid-data-tracker/#vaccinations. Accessed on May 26, 2021.