Despite having immunized most of the vulnerable population with available vaccines, the U.S. has not yet escaped a COVID-19 pandemic.

Pamela Cruz. Peninsula 360 Press [P360P].

Today, more than 120 million people in the U.S. are fully vaccinated against COVID-19, the Centers for Disease Control and Prevention (CDC) announced that they will no longer have to wear masks in any environment, news that seemed to be the announcement that the country reached the light after a long dark tunnel, however, experts believe that there is still a long way to go.

Harvard Communicable Disease Center director Dr. Marc Lipsitch said it is "quite unlikely, even with existing vaccines, that the country will reach a level of herd immunity where transmission is almost impossible on a sustained basis and where the virus essentially disappears."

He said this during a briefing held by Ethnic Media Services, in which he said that there are still misunderstandings about what herd immunity is, so he clarified that this is simply the existence of people in a population that are totally or partially immune and that stop transmission by hindering the passage of the virus through them. 

He explained that while the United States is at a point where the virus cannot be transmitted in a sustained way, where each case is not even replaced, at the beginning of the pandemic each COVID-19-positive person could infect four to five people.

Given this, he said that to reach a point where social behavior is normal, the kind we had before the pandemic and without masks, transmission should be reduced by a factor of an equal number of people, however, the variants of the virus have increased transmissibility.

In that sense, he said, to achieve a reduction in transmission by a factor of five means immunizing four-fifths of the population so that what were five infections become one. 

"On that notion, we need to immunize eighty percent of the population. That means fully immunizing them, meaning they have to be fully protected against the ability to transmit the virus and the vaccines we have certainly protect to a large extent, but they don't seem to be 100 percent protective. They're very good, but they're not 100 percent.

However, he stressed that the task will not be easy due to the levels of reluctance of the population to obtain the vaccine, coupled with the continuing challenges of access to immunization.

Added to that, he said, "the fact that we're not vaccinating our entire population because children under the age of 12 are not eligible, I think it's very unlikely that, as a nation, we're going to uniformly reach the required coverage of probably 85 or 90 percent.

That is why, he said, vaccination of those most vulnerable should continue to be a priority, especially when it is not yet known how long immunity will last with the vaccine and whether revaccination will be necessary. 

For Ben Newman, head of virology at Texas A&M University's Global Health Research Complex, "bubbles are beautiful, but they don't last long in this world," and a bubble that can create any vaccine is fragile.

"Unfortunately we know that immunity declines and we know from the limited studies that exist that there is a certain rate at which B cells, T cells and antibodies will decline over time. But we don't know exactly what is the point at which a person stops being protected. We just know it's a matter of time, and that's why I would oppose any of the partial solutions," he said.

Faced with this, he explained that the only way out is "a single global solution, which would be to vaccinate, literally, everyone. And not just vaccinate them, but vaccinate them within a certain window. The window, maybe six months or a year, and that's the challenge. 

However, unlike Lipsitch, he believes that vaccines should not only go to small groups or vulnerable groups, or take partial measures "as we have done so far", but should be applied collectively.

"I really don't like the way this has been handled so far and what I'm seeing is the greater reluctance of people with proximity to solutions and the greater desire for solutions from people who are further away and I think that's a terrible thing," he stressed.

"I think when a lot of people calculate whether or not to take precautions or get vaccinated, they're thinking about the original versions of the virus and yes, at least in this particular place and time, there's about a 100 percent chance that you're going to run into something that grows faster and has the potential to spread further and maybe hit harder than one would expect," he added.

And that is because, he explained, "we have underestimated as a world, not even as the United States, the virus time and time again. We've relaxed restrictions and we've seen the virus come back.

That's why he felt that the CDC's announcement that those who are fully vaccinated can stop wearing masks may not be the path to the most rapid extinction of the virus, so he called on everyone to get the vaccine and keep wearing masks until infection numbers drop much further. 

Peter Maybarduk, director of the Public Citizen's Access to Medicines Group, emphasized the international project COVAX - Global Access Fund for COVID-19 Vaccines - an alliance driven by public and private actors with the objective of guaranteeing equitable access to the vaccines that are developed against the COVID-19 coronavirus, being one of the pillars of the accelerated access to tools against the deadly virus.

COVAX is co-led by the Gavi Vaccine Alliance (Gavi), the Coalition for Promoting Epidemic Preparedness Innovations (CEPI) and the World Health Organization (WHO) and aims to accelerate the development and manufacture of vaccines against EVID-19 and to ensure fair and equitable access to vaccines for all countries worldwide.

During the press conference, he explained that COVAX's goal is to vaccinate, essentially, 20 percent of the world, preferably this year, which means two billion doses.

This, he said under two main streams: one for self-funded countries. These are rich countries that essentially buy into the COVAX fund because that way they have access to a broader portfolio of vaccines than they would necessarily be able to buy on their own.

So far, COVAX has only been able to ship 64 million doses to countries that urgently need the vaccine to get by - that's about a quarter of the doses that have been administered in the United States. 

"Hardly enough doses for even one of the largest middle-income countries in the world, let alone 92 countries."

Thus, only 340 million people in the world are fully vaccinated, less than 5 percent of the world's population, "so we have a long way to go, but we expect a rapid increase". 

And is that the production volumes of vaccines licensed by COVAX are far from what is needed, however, according to estimates, it is believed that there will be 10 billion doses by the end of this year.

He added that it is true that the U.S. is prioritizing its own access to raw materials for vaccine production, which puts producers abroad in dilemmas and does not allow other countries access to inoculation in a timely manner.

"We shouldn't just cross our fingers and assume it's all going to work, more doses are needed and we believe it's critically important to urgently increase manufacturing capacity," he said.

Funding is important for COVAX to continue to help other countries obtain the necessary vaccines, however, income has yet to be injected into the fund. So far, it is believed that many people around the world, especially in adverse conditions, will not be able to get vaccinated until 2023.

According to analyses with engineers at Imperial College, it is possible to produce eight billion doses of RNA vaccines in a year and make up the global shortfall. "If we invest significantly and the investment required could be twenty-five billion dollars. That's not a small amount of money." 

In that sense, he pointed out that it is necessary that governments with ample economic capacity such as the U.S. can sit at the table with large pharmaceutical companies to help make more doses available for the COVAX fund and thus support the most vulnerable nations, and finally all, together, get out of a pandemic that many still do not see, not even close, that things will get better.

"It has to be a much more integrated effort. We think it's quite feasible, but it's a political decision that has to be made," Maybarduk said.

Thousands of miles south of the country, Brazil is living its own reality with the pandemic, one very different from that of the American Union.

Dr. Rosane Guerra, who works in the Department of Pathology, Center for Biological and Health Sciences at the Federal University of Maranhao (UFMA), Brazil, stressed that the current situation in the country to stop COVID-19 infections "is not good".

"Now we don't have any drugs to prevent or control the worst symptoms of this disease. The problem is mutations and we have a large number of people affected every day."

He explained that, along with India, are the countries with the highest levels of infection by COVID-19 in the world, so the possibility of having new variants has increased every day to the four that have already been detected so far.

And the government is not helping much to stop the pandemic, because although President Jair Bolsonaro was infected by the SARS-CoV-2 virus, he minimized the disease by saying that the disease was not serious and only generated the symptoms of a mild flu.

Guerra detailed that the president's words are added to those of the minister of health, who, in his opinion, does not know about the issue and has done nothing to stop the advance of the coronavirus in the country.

Areas like the Amazon, he said, suffer tremendously from the virus, and 70 percent of people in this area are believed to have tested positive for COVID-19.

The fact is that the Brazilian variant of the virus has spread the disease more rapidly, a situation that does not help at all.

Vaccination is the hope, yet so far, only 17 million people have received at least one dose of immunization.

Thus, for Guerra, maintaining an immunization bubble for a country is impossible, since not everyone is vaccinated and migration exposes everyone.