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Despite the public emergency and pandemic being declared over, COVID is still with us and will be for the foreseeable future, much like the flu has been with us since the pandemic of 1918.
It now appears it will join the flu as a mainly seasonal illness that will require regular vaccination. I believe that like the flu vaccine, there will be a new COVID vaccine available in late summer and fall to concentrate on the most common strains expected to hit that fall and winter and will join the flu vaccine as a routine preparation for the illness season to come.
Sadly, many people have not gotten the bivalent booster that protects against some newer strains and some never completed their primary two shots.
I realize people are ‘over COVID’ but we still don’t know what the long-term outcome of a COVID infection will be. We have been seeing people suffer from long term COVID, with long periods of loss of smell. These sequelae are concerning and may just be the start of what we will see years down the line from one’s infection.
As a society that is for the most part well vaccinated, we forget the long-term effects of other vaccine-preventable diseases that led to the search for vaccines. It’s not just about the acute phase of the illness but what can follow if one becomes quite ill with one of these diseases. So, I’d like to remind people of what happened ‘back in the day’ before some of these diseases were eradicated and/or lessened in acuity by vaccines.
As seen by the pandemic of 1918 many people died of the flu, in fact, 675,000 U.S. citizens died of the flu that year. In comparison thanks to the vaccine, we lose 25-50,000 people per year now. The long-term effects can be myocarditis (inflammation of the heart) and encephalitis (inflammation of the brain). These are greatly reduced in incidence due to the vaccine.
Measles and German measles can have late sequelae with one of the worst being Subacute Sclerosing Panencephalitis which can occur 7 to 10 years after infection and attacks the brain resulting in death. There were also heart complications and patients could go blind from the measles.
Mumps, the second ‘M’ in the MMR vaccine did lead to miscarriage and encephalitis (brain swelling). A dreaded complication was orchitis which could lead to infertility in young men as well as swelling of the ovaries in women with fertility risks too. Hearing loss was also a long-term complication.
Polio had probably the most concerning course of all. One type is paralytic polio which led to complete paralysis and dependence on an iron lung. For some, this was for the rest of their lives requiring total nursing care most often in a hospital for polio patients. Now it is true that people survived polio and most with just a limp from a somewhat paralyzed limb and some actually seemed to have a complete recovery from the acute illness.
For many as years went by, they started to develop post-polio syndrome where muscle weakness returned and severe exhaustion, which compromised their quality of life, and this does not improve but can get worse with time. Also, there was a 5-10% chance of death if you contracted polio. Until recently polio was considered eradicated in the U.S. Now with many parents choosing to not vaccinate their children, it is showing up again in our country with devastating consequences.
HIB, a severe infectious disease affecting mainly children, has been almost eradicated by the vaccine that came out in the 1980s. Prior to this, it caused the highest amount of meningitis deaths in young children. This disease could lead to hearing loss and brain damage in children as well as amputation of limbs in severe cases.
As an older pediatrician, I saw all of these sequelae and the deaths from HIB. I recall that the disease seemed to disappear after the introduction of the vaccine and I rarely even think of it now. Again, with vaccine resistance, we may see this illness quickly recur and lives lost once again.
These are just some of the concerns of after-effects of illnesses we rarely see now thanks to vaccination. Why would we want to go back to having long-term disability to something we can prevent? This is what is a big concern about COVID as we have no idea what will be the consequences of severe disease in 10 to 40 years from now in survivors.
With vaccines, we don’t always prevent all acute illnesses but we do mostly prevent severe long-term sequelae. So, the need for COVID vaccination is not over and we will have a new booster out in the fall. So, I would recommend we all line up for the flu and COVID vaccine this fall and protect ourselves and our loved ones.