COVID-19 Vaccinations are Likely to Slow Dramatically in the Coming Months ... What Then?

Michael Burg, MD
COVID-19 VaccineDaniel Schludi/Upsplash

Soon, every American who desires full vaccination will have received it.

In the near future, the majority of vaccine-accepting and vaccine-eligible Americans will have received either the two-injection Pfizer or Moderna regimen or the single-dose Johnson & Johnson vaccine. Some Americans will be partially vaccinated, for whatever reason, choosing to receive only one of the two recommended injections.

Children between the ages of 12 and 15 will be eligible for the Pfizer vaccine shortly, literally within days of this writing. The status of vaccinations for those under 12 is to be determined. No timeline yet exists for their protection via vaccination.

Currently, it seems that about one-quarter to one-third of Americans who can receive protection against COVID-19 infection via vaccination have not. Some of these individuals may have vaccine access issues. Many in this group have decided to refuse vaccination. There may be other factors impacting this group’s vaccination status.

What will all this mean for the future?

We already have some insights into what a post-vaccination reality will look like.

According to an April 15, 2021, CNN Health story, about 5,800 Americans have contracted coronavirus infections even after receiving full vaccination. “Some became seriously ill and 74 people died, the CDC said. It said 396–7% — of those who got infected after they were vaccinated required hospitalization.”**

This set of facts demonstrates two truths.

#1 Full vaccination is highly protective, but not perfect at preventing disease.

#2 Some, albeit a minuscule number of those who become ill in spite of vaccination, will seriously sicken or die.

We’re still learning.

  • Early data show that the vaccines help keep people from spreading COVID-19, but we are learning more as more people get vaccinated.
  • How long COVID-19 vaccines can protect people is unclear and being vigorously studied.

COVID-19 mutations

So long as the virus exists it will continue to mutate. This ability is not unique to the coronavirus. That is what viruses do; they mutate. A virus that can’t spread, can’t mutate. This fact strongly underlines the need for widespread vaccinations.

It is far too early to tell what that will mean for an individual or population health. The fear is that a mutant strain, resistant to the immune protection afforded by the vaccine, will arise. This has already occurred in a limited way. However, again it’s early still in this part of the pandemic and we’re learning. There’s simply not enough information available to know what will occur.

We are however rapidly approaching an interesting point in our battle against COVID-19.

The “haves” and the “have-nots”

There will soon be an interesting and potentially telling schism in the US population when it comes to protection against COVID-19 infection.

The “haves”

  • those with prior COVID-19 infection who’ve survived
  • fully vaccinated, (soon to be about 60% of 16-to-85-year-olds)
  • partially vaccinated

The “have-nots”

  • un-vaccinated individuals
  • younger children and infants (who may never be able to receive vaccination, although this is unknown currently)
  • individuals who, generally because of specific diseases or medical conditions, are advised not to receive vaccination

The largest group here is likely to be the top category, unvaccinated people.

The “haves” — What will happen going forward?

The so-called “haves” mentioned above will be largely, but not totally protected from disease. This is akin to the protection provided by other vaccinations, like the measles vaccine. Protection isn’t necessarily lifelong or total, but it’s nearly perfect, as good as we manage now given the state of medical science.

Again, this of course assumes that a new and deadly COVID-19 mutant strain doesn’t arise and defeat the protections given by prior COVID-19 infection or by the vaccines.

The “have-nots” — What will happen going forward?

It would seem that disease, specifically COVID-19 infection, will concentrate in this group.

Thankfully, it seems that coronavirus infection in children is milder and less deadly than it is in adults.

However, children who harbor the virus or have mild disease are still quite capable of spreading the disease to others. Again, this emphasizes the need for widespread and rapid vaccinations.

We are learning more with each passing day. Also, it’s important to realize that this is the case in disease caused by the present forms of the virus. A more lethal or serious disease form could change all that.

What about present-day COVID-19 infection in unvaccinated adults?

No one knows for certain of course but all other factors being equal it would seem natural to assume that disease will concentrate in this population. Given that tens of millions are in this group and COVID-19 infection can be both serious and lethal, these individuals will remain at increased risk. However, the unvaccinated may benefit from the overall reduced viral spread in the population. Again, it is too early to tell if this will truly be the case.

As is known, protection from increased risk is both known and readily available, in the form of vaccination.

Also, so long as the virus continues to circulate in high numbers in the population the alarming possibility remains of the emergence of deadly mutant virus strains. This will potentially affect, and sicken and kill, vaccinated and un-vaccinated people. Were this to occur, the pandemic could continue to rage although perhaps less fiercely, this in spite of our scientific progress to date and our work combating COVID-19.


For those who doubt that COVID-19 is creating a viral pandemic or doubt that masks, social distancing, other public health measures, and vaccinations are all real and really helpful at controlling disease, how are we to explain the marked decline in COVID-19 infections since these measures — particularly vaccinations— have been broadly instituted?

Also, note that vaccine side effects and adverse effects have been virtually non-existent, especially when compared with the massive population health benefits we’ve achieved.



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