Unvaccinated and their impact on the fifth wave of the pandemic. Op-Ed by Ala Tocarciuc

"The solution that we have at our disposal is now only one – rapid vaccination of the unvaccinated people and the beginning of the introduction of a booster dose for the vaccinated. My recommendation to people will, if possible, reconsider their own decisions not to vaccinate in favor of vaccination in the light of the new circumstances..."

Six months ago, Europe entered the fourth wave of the pandemic with a high dose of optimism, bolstered by rising vaccination rates. The fourth wave was perceived as the last wave of the current pandemic. Events over the past month have diminished optimism and added a few features of concern.

The number of new cases has increased significantly in the Northern Hemisphere. Europe entered winter with lower vaccination rates than forecast earlier this year. The opposition to vaccination along with the emergence and dominance of new strains are among the determining factors of the current situation in Europe.

More and more voices are arguing that Europe is now entering the fifth wave of the pandemic at a higher speed than the entries in previous waves. The previous wave was said to have been a wave of the unvaccinated. However, we see that in this fifth wave, those who are vaccinated are also sick.

We will try in this editorial to analyze what really happens to the unvaccinated and vaccinated in the fifth wave.

Unvaccinated also perform the function of creating new strains of the virus.

Unvaccinated people today are favorite targets of the virus. These cases are mostly cases in people who have not previously tested positive for COVID-19 and have not given the vaccine with the full scheme. These people become infected and quickly turn into natural incubators for the virus, produce a huge number of new viruses and easily transmit them to others. Sometimes they don't even know that they're practically an aerosol dispenser filled with viral particles.

Some of these people easily go through the disease, but others go through it harder and even end up in intensive care.

The role of these unvaccinated people is not limited to community transmission. Many of these people perform the function of creating new strains of the virus without having to know it. New strains most easily change their structure of spike proteins in the body of an unvaccinated person. An unvaccinated person has no antibodies, that is, he has no protection against the virus. In cases where that person's immune system is not functioning well, the virus does what it wants, changes as it sees fit, following its survival goal.

The newly created strain usually spreads faster, learns to bypass antibodies, can become more aggressive and cause more severe forms of the disease. The slow rate of vaccination contributes to the creation of new strains.

A recent case of the discovery of a new strain at a school in France confirmed assumptions about the risks of importing new strains from countries with low vaccination rates. The new strain was brought from a country in Africa and had a lightning-fast spread among school students and their families.

We saw from the statistics that among the infected there are vaccinated according to the full scheme people. We wonder why this is so? The answer is already known.

First, the level of antibodies after the first vaccination begins to decrease after 120 days. After 180 days, a third dose of the vaccine is recommended to increase the antibody titer, which is also called booster. Many people who have not yet been able to get a booster dose of the vaccine and have a lower degree of protection have encountered the virus and become ill. Some people have various comorbidities that complicate the form of the disease.

Second, these people may have encountered a new strain of the virus and become ill.

Thus, the current fifth wave is now determined by many unvaccinated people and the emergence of new strains. New strains, in turn, are determined equally by many unvaccinated people.

In conclusion, unvaccinated people today have a big impact on the evolution of the pandemic. One possible solution to avoid this wave would be to speed up vaccination in both directions: both primary vaccination and booster vaccination.

Moldova between the fourth and fifth waves

Recently, someone in my inner circle faced COVID-19 again. This man was vaccinated in April and went through the disease a year ago. Several tests for COVID-19, including PCR, have come back negative. The diagnosis was confirmed after the clinical picture of the disease and after other clinical tests.

What does this case tell us? This is indirect confirmation that there is probably a new strain of COVID-19 that current PCR tests or rapid antigen tests present in Moldova cannot detect.  There is a risk of infection, losing precious time and getting into a severe form of the disease, because tests (false negative) will mislead you.

If you imagine the impact of the multiplication of this case on a large scale, then we can already make predictions for the fifth wave of the pandemic in our country.

It is clear that while the vaccination rate remains low, there remains an increased risk of new strains and an increased risk of new infections with multiple hospitalizations. Obviously, having a large number of unvaccinated people determines these increased risks to the same extent for people who have already been vaccinated.

The solution that we have at our disposal is now only one – rapid vaccination of the unvaccinated and the beginning of the introduction of a booster dose for the vaccinated. My recommendation to people will, if possible, reconsider their own decisions not to vaccinate in favor of vaccination, considering the new circumstances.

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