Fully Vaxed and Still Got COVID? No, It Doesn’t Mean the Vaccines Didn’t Work

Whether you did or not, COVID-19 took the phrase 'new year, new me' quite seriously with most of the world witnessing yet another COVID wave, thanks to the new and improved Omicron variant.

Now, COVID variants, like with other viruses, come and go, but what makes the new Omicron variant a Variant of Concern is that it is more transmissible than the Delta variant.

Apart from being highly transmissible, Omicron also seems to be able to circumvent COVID-19 vaccine protection which means people who are fully vaccinated are also at risk of catching COVID, and they are, by the thousands.

Why is this happening?

Essentially vaccinated people are getting infected because,

1. Strong scientific evidence shows vaccine induced antibody protection starts waning after some months.

2. Omicron variant is able to get past the vaccine induced immune response.

With fully vaccinated people getting infected left and right, it may lead you to feel disheartened and confused and ask, does this mean the vaccines aren’t working?

YES they are. Just not the way you think.

For one, the COVID vaccines don’t make you immune to infections, and that’s always been the case.

Many people have the misconception that getting vaccinated means having complete protection against the virus. But that is not so.

Let's break down what we know about the COVID-19 vaccines, what experts are saying, and why you're better off having been vaccinated.

COVID Vaccine 101: How it Works

You've heard it before, but here's a quick run down of how COVID vaccines work.

Vaccines work by triggering your own body to produce antibodies against a particular virus, in this case SARS CoV2, by introducing either a killed or weakened whole virus, parts of the virus (like the spike protein), or part of it's DNA, depending on the type of vaccine.

Kind of like a dummy target for practice rounds.

So that when your body is exposed to the real thing, your body can recognise the threat immediately and destroy it.

In theory, this mechanism, if efficient should be able to provide complete or 'sterilising immunity', but unfortunately it's not that simple.

Vaccines Aren't Bulletproof Shields

Realistically speaking, complete, ironclad protection against infection might be unacheivable, because, well, mutantations gonna mutate.

Viruses are always hard at work trying to figure out ways to sidestep obstacles that come in the way of them setting shop in our cells. Most of the time, they do this by mutating into forms that the vaccine elicited antibodies are not able to pick up on.

But it's a good thing that antibodies are not our only line of defence. This is where the killer Tcells take the reign.

Antibody vs T Cell Immunity: Where One Defence Fails, Another Shines

When antibodies are unable to keep the bad guys from infecting your cells, there is not much they can do once the cells are infected.

But this is where the next line of defence, T Cells come into play.

Unlike antibodies, T Cells don’t just neutralise free-floating pathogens in the body but are also able to seek out infected cells and prevent them from causing disease.

Speaking to FIT for a different article, Virologist Dr Shahid Jameel explained, “much of the discussions we have these days when we say 'waning immunity', we are essentially measuring only the antibodies, saying that when you got the vaccine you had a certain antibody level but six months later your antibody level has gone down, therefore your immunity must have gone down."

"I am not very sure whether we can call it waning of immunity. It is certainly waning of antibodies, and like I have been trying to emphasise, antibodies are only one arm of the immune system," he said.

“The AstraZeneca vaccine which in India is called Covishield is the best in class vaccine as far as T Cells are concerned.”

Dr Shahid Jameel, Virologist

Infection vs Disease

Considering the COVID virus is able to infect its host without any outward symptoms, it can be hard to distinguish between infection and disease, but experts agree that it is an important distinction to make when we talk of vaccine effectiveness.

So yes, the COVID vaccines may not be able to provide as strong a protection against infections as they once did, but they're still pretty good at protecting against severe illness and death, like they were meant to.

This has not only been proved in clinical studies but also through real world studies and evidence.

Infact, Omicron being a 'milder' variant than Delta perhaps has alot to do with the vaccine coverage we have acheived so far.

Although vaccinated people are being infected now, hospitalisations have mostly been among the unvaccinated population. This is in some sense good news.

Severe or not, a rise in infections is a matter of concern in itself.

For one, vaccinated people in high risk categories are vulnerable to severe illness. Moreover, in countries with a large population, high rate of infection can mean a great strain on the medical infrastructure of the country.

What Boosters Do

This is where booster doses come in.

Booster doses are essentially meant to reduce the risk of infections. But if vaccine immunity wanes over time, booster doses may need to become a recurring thing.

Some countries are already talking about offering a fourth dose, and even fifth and sixth dose in the future.

But, by the looks of it, it's unlikely we will ever be able to achieve total protection from infection with COVID-19 vaccines.

"What they (the vaccine companies) promised was the vaccine will prevent serious infection and that they're doing that. Booster doses are being taken to prevent infection, and in my opinion that won't work."

Dr JP Muliyil, Epidemiologist

"The antibody level going up will happen, but does not necessarily correlate with protection against infection," Epidemiologist Dr JP Muliyil, told FIT.

Do You Need Boosters?

Speaking to FIT, Dr Swapneil Parikh explained, "for immunocompromised people, 3 doses is equivalent to 2 doses for a young, healthy, immunocompetent person. So, three doses should be considered primary dosage for them."

But, on the other hand, if you are otherwise healthy, and have received two doses of the vaccine, experts say there isn't a need for boosters, at least not at the moment.

Moreover, many experts have also talked about how 'hybrid immunity' in people who have been infected with COVID and then vaccinated elicits an even stronger immune response for longer.

"The combination of immunity from past infection and vaccine elicited immunity appears to be the most robust immune response," Dr Swapneil Parikh told FIT.

"Antibodies titers, memory responses, and cellular responses were significantly higher in individuals with this 'hybrid immunity’," he added.

But again, it doesn't seem to be robust enough to prevent infections, as we're seeing with Omicron.

Protecting Against Variants

There is no special or different way to prevent certain variants of the virus.

Some vaccine companies have said they are modifying their vaccines for Omicron. But what happens when the next variant emerges, and the next, and the next?

Right now, as COVID cases once again spike in the country, it's time to bring back the lessons that were drilled into us right from the initial days of the pandemic.

• Wash your hands frequently

• Avoid crowds and maintain social distancing

• Avoid touching your face, your eyes, and nose

• Wear a well-fitted mask when you step out (preferably N95 masks)

• Make sure your living spaces are well ventilated

• And ofcourse, get vaccinated, and take the booster dose if you're eligible

Because although it might not seem like it, the vaccines are working, they're protecting you from the worst case scenerio.