Shifting Goalposts: The Atlantic Says Expecting Vaccines to Give You Immunity is 'Asking The Impossible'

We're Asking the Impossible of Vaccines

Complete protection against infection has long been hailed as the holy grail of vaccination. It might simply be unachievable.

By Katherine J. Wu
SEPTEMBER 9, 2021

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Some people hoped the COVID-19 vaccines could achieve sterilizing immunity, especially after reports in the winter and spring trumpeted the jabs' surprising power at preventing infections—enough that the CDC told vaccinated people they could shed their masks in May. Then sterilizing immunity came back to bite us, when breakthrough infections began to pop up among the immunized, prompting fear and confusion among those who'd been certain that the vaccines alone could quash the coronavirus's spread.

COVID-19 vaccines were never going to give us sterilizing immunity; it's possible they never will. But the reason isn't just their design, or the wily nature of the virus, or heavy and frequent exposures, though those factors all play a role. It's that sterilizing immunity itself might be a biological myth.

That technical coarseness might help explain why several historical vaccines have been assumed to be sterilizing. With measles, for instance, scientists initially lacked the tests needed to show them otherwise, Diane Griffin, an immunologist at Johns Hopkins University, told me. When virtually no one fell ill after an inoculation campaign, researchers figured that infections had evaporated as well. Now, however, techniques are far more powerful, giving researchers the ability to zero in on even tiny blips of infection. Post-vaccination measles infections, though still uncommon, are much more "regularly observed" than they were once believed to be, Griffin said.

As detection tools improve, each data point further erodes the mythos of sterilization. With enough scrutiny, the experts I spoke with told me that similar illusions can probably be shattered against supposedly "sterilizing" shots that guard against other pathogens, including poxviruses such as smallpox, bacteria that cause meningitis, and the parasites that cause malaria. "I think it's literally chasing rainbows," [Mark Slifka, an immunologist and vaccine expert at Oregon Health & Science University] said. "The closer you get, the sooner you realize it's not there."

Perhaps it's more useful, Yonatan Grad, an epidemiologist at Harvard, told me, to understand the ideal of sterilizing immunity as just that—an ideal, rather than a practical goal, like the unattainable end of an asymptote. [...]

For most of vaccination history, humans have been guided by stopping sickness, and that's been enough.

NEW - Dr. Fauci calls for unvaccinated Americans to be banned from air travel and to mandate #COVID19 vaccines for school children.pic.twitter.com/AyYL0F8xkM

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