'POST-VAX COVID' IS NEW DISEASE

 The Atlantic

‘Post-Vax COVID’ Is a New Disease

By: MSN, September 23, 2021:

Boghuma Kabisen Titanji was just 8 years old when the hyper-contagious virus swept through her classroom. Days later, she started to feel feverish, and developed a sparse, rosy rash. Three years after being fully dosed with the measles vaccine, one of the most durably effective immunizations in our roster, Titanji fell ill with the very pathogen her shots were designed to prevent.

Her parents rushed her to a pediatrician, worried that her first inoculations had failed to take. But the doctor allayed their fears: “It happens. She’ll be fine.” And she was. Her fever and rash cleared up in just a couple of days; she never sickened anyone else in her family. It was, says Titanji, now an infectious-disease physician and a researcher at Emory University, a textbook case of “modified” measles, a rare post-vaccination illness so mild and unthreatening that it doesn’t even deserve the full measles name.

The measles virus is ultra-infectious, much more so than SARS-CoV-2, and kills many of the uninoculated children it afflicts. But for those who have gotten all their shots, it’s a less formidable foe, which we’ve learned to live with long-term. That’s the direction that many experts hope we’re headed in with SARS-CoV-2 as it becomes endemic, as my colleague Sarah Zhang has written.

We’re not yet at the point where we can officially label post-vaccination COVID-19 cases as “modified”; maybe we never will be. Some immunized people are still getting dangerously sick. But the shots are softening COVID-19’s sharp edges: On average, breakthrough infections seem to be briefer, milder, and less contagious. Among the fully immunized, catching the coronavirus doesn’t mean the same thing it did last year. “It’s a very different kind of infection than in people who are immunologically naive,” Lindsey Baden, an infectious-disease physician and COVID-19 vaccine researcher at Brigham and Women’s Hospital in Boston, told me.

If this virus becomes as inescapable as the culprits behind the colds and flus that trouble us most years, we could all have to grapple with one of these infections, and learn that lesson on a personal level. That’s the social tax of a forever virus: Nearly everyone may eventually know what it is to get COVID-19—but a tamer, more domesticated version of its pre-inoculation self.

Since the start, COVID-19 has been tough to define.

Part of the problem is that COVID-19 is the disease, not the virus. Actual microbes, compared with the problems they cause, are arguably neater conceptual packages. SARS-CoV-2 is a knowable pathogen, a tangle of genetic material swaddled in a protein coat; COVID-19 has fuzzier boundaries, dependent on both the virus and how our bodies react to it. To understand that interaction, researchers had to, unfortunately, wait for a decent number of people to get sick—to observe the virus screwing with us in real time.

Next to other airway-loving viruses, such as the ones that cause the flu and common colds, SARS-CoV-2 can be a bit of an oddball. It lopes almost indiscriminately throughout the body, invading a plethora of tissues; it winds up certain immune responses, while dialing others down, sparking bouts of inflammation that can afflict everything from brain to toe. 

COVID symptom lists that at first focused on the virus’s ground zero—the respiratory tract—eventually ballooned to include nausea, vomiting, changes in mental status, and chest pain. Infection severity operates on a continuum, and SARS-CoV-2 occupies its spectrum fully. Many people never realize they’re infected; others might have a two-day tickle in their throat, while some weather the disability of long-haul COVID for months; a fraction end up ventilated in the ICU.

The experience of having COVID is now poised to splinter further, along immunological boundaries largely defined by vaccines. Inoculated bodies are less hospitable to SARS-CoV-2, making it harder for the pathogen to infect them; when it still manages to, it seems to be purged much faster, affording it less time to cause symptoms—especially the bad ones—and fewer opportunities to hop into other hosts. “I think about it as defanging the virus,” Natalie Dean, a biostatistician at Emory, told me.

A recent study from the United Kingdom illustrates this well. Researchers surveyed nearly 4.5 million people through a cellphone app, asking whether they’d tested positive for the virus, and if they were experiencing any of about two dozen symptoms. Roughly 1 million of them had received at least one vaccine dose. 

Among the fully immunized, nearly all the symptoms—including fever, nausea, and brain fog—were rarer. Many of the cases were totally asymptomatic. Even rates of long COVID, which can sprout from initially silent infections, seemed to be substantially slashed by shots.

These qualitative shifts aren’t easy to capture, especially with the studies coming out now that measure vaccine effectiveness in the real world. Most of them gravitate toward metrics at two opposite ends of the SARS-CoV-2 spectrum—how well the vaccines protect against all infections, or against severe disease, hospitalizations, and death—with less precision around the murky hinterlands of mid-level symptoms that exist in between. 

(The most serious outcomes are, to be fair, what vaccines are intended to prevent, and what inoculated immune systems are best at staving off, making that metric a pretty good one to concentrate on.)…………….

https://gellerreport.com/2021/09/post-covid-vax-disease.html/