A recent study estimated that, as of July 15, the average global immunity of the population to SARS-CoV-2 in the United States was 62%. The authors rightly concluded that “the immunity of the American population against COVID-19 may still have been insufficient to contain outbreaks and safely return to prepandemic social behavior.” The most important finding here is that we are very close to sufficient immunity of the population and we will probably get there soon. In November, the global immunity of the population should exceed 85% and, if we do the right things, we should be able to end the misery of this pandemic.
The study stopped on July 15, which was the start of the fourth big wave COVID-19 in our country. Since then, we have had about 8 million more cases, the vast majority of which have been in unvaccinated people. The wave is starting to grow and assuming it follows the same pattern as other waves, we could assume that the case load could return to a minimum in November, with perhaps 8 million more cases. This would account for another 5 percent of the country, mostly the unvaccinated who gain natural immunity, and would bring us to 67 percent. This increase, of course, comes at a high cost of morbidity, mortality and hospital burden, with nearly 2,000 people dying every day.
Another thing that has happened since July 15 is the continued increase in vaccinated people. At the time of the estimated 62% immunity of the population, only 48% of the American population was vaccinated. We are now at 54%, with 63% having received at least one dose. If only half of those who received just one dose proceeded to full vaccination, that means another 10 percent of the population has been vaccinated since the July 15 estimate. So adding all of this to the unvaccinated natural immunity you gain from above brings us to 77%.
Of course, the largest immunity gap is found among children, with an estimated immunity level of only 17.9% among children under 12 and who currently do not have access to vaccines. However, vaccines will arrive soon for children ages 5 to 11, most likely in November. With 30 million children aged 5 to 11, even if only 60 percent were recently vaccinated, this adds another 18 million vaccinated, or another 5 percent in the country, which brings us to 82 percent. . Of course, school vaccination mandates (for which there is a strong historical precedent) could further increase this.
Speaking of mandates, school mandates are not the only ones that come into force. Many hospitals have implemented vaccine mandates for employees and a large number of other large private companies have followed suit for their employees. The desire to create safe work environments is growing and is now supported at the federal government level by recent executive orders requiring vaccination of federal employees and contractors, as well as by the Occupational Safety and Health Administration’s decision to require all companies with 100 or more employees require vaccination or weekly testing.
Other slightly lighter methods, such as fines imposed by Delta Airlines on its unvaccinated employees, also appear to work: Delta has already seen its vaccination rate increase from 74% to 78%. It seems reasonable to estimate that these vaccine warrants will add at least another 5% to the immunity of the population in the next two months, which will bring us to 87%.
Unfortunately, there are millions who cannot achieve immunity through vaccination, but the outlook also improves for them. With the changes of the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) last month, immunocompromised people now have a third successful vaccination shot, and there is growing evidence that those who fail even the third shot could benefit from a fourth shot, changes in their medications, or prophylaxis of monoclonal antibodies.
Thus, with a rampant wave of unvaccinated people receiving COVID-19, increasing vaccination by choice and through protection mandates, the availability of vaccines for younger children, as well as better protection for the immunocompromised, it seems that in November we could exceed 85% of the immunity population.
Will it be enough to prevent this disease from wreaking havoc as it has been doing? Well, that depends entirely on us. If we let our impatience get the best of us and pretend it’s over prematurely, we’ll probably see another wave, a variant even worse than Delta, or who knows what other biological punishments for our recklessness. But if we can only endure two months or so of wearing masks in public, with vaccination / test warrants for big meetings, we will still be able to live fully this fall and, in the winter, there will be no more. It wouldn’t be good.
Dorry Segev, MD, Ph.D., is a professor of surgery in the Johns Hopkins University School of Medicine and a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. Segev has been leading an observational study of COVID-19 vaccine responses in immunocompromised individuals since December 2020 and is the lead researcher on the NIH / NIAID-funded interventional trial “COVID-19 Post-Transplant Protection (CPAT) “. Follow him on Twitter: @dorry_segev