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What happens when vaccinated people get COVID-19?

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A new dichotomy has begun to haunt the discourse of the pandemic. With the rise of the super-transmissible Delta variant, experts say any going to get vaccinated, or going to get the coronavirus.

For some people, a decent number of us will actually be both.

Coronavirus infections are occurring among vaccinated people. They will continue to happen as long as the virus is with us, and we are nowhere near beating it. When a virus has infiltrated so deeply into the human population, post-vaccination infections become an arithmetic inevitability. As much as we would like to think otherwise, being vaccinated does not mean having finished with SARS-CoV-2.

Post-vaccination infections, or breakthroughs, can occasionally become symptomatic, but they are not embarrassing or aberrant. Nor are they proof that injections are default. These cases are, on average, softer and less symptomatic; faster resolution, with less persistent virusAnd, it appears, it is less likely to transmit the pathogen. The immunity offered by vaccines works in iterations and gradations, not in absolute values. It does not make a person completely impervious to infection. It also doesn’t evaporate when some microbes break down the body’s barriers. A breakthrough, despite what it may seem, does not cause our defenses to crumble or even pause; it does not erase protection that has already been built. Instead of establishing fragile and penetrable shields, vaccines reinforce the defenses that I have already, so that we can safely find the virus and potentially take advantage of that protection.

To understand the anatomy of a revolutionary case, it helps to think of the human body as a castle. Deepta Bhattacharya, an immunologist at the University of Arizona, likens immunization to reinforcing that bastion against assault.

Without vaccination, the castle’s defenders have no idea that an attack is coming. They may have put some aggressive watchdogs outside, but these strays aren’t very picky – they’re the system. innate defenders, fast-acting and brutal, but short-lived and woefully imprecise. They will sink into anything they don’t recognize and are easily fooled by stealth invaders. If only rowdy canines stand between the virus and the castle’s treasures, that’s a pretty flimsy first line of defense. But it is essentially the situation many uninoculated people find themselves in. Other fighters, who operate with more precision and strength, the adaptive cells of the body, will eventually wake up. However, without warning, they will come out in full force only after a weekslength delay, at which point the virus may have overlooked all it can. At that point, the fight can literally be at a fever pitch, fueling worsening symptoms.

Vaccination completely rewrites the beginning, the middle, and the end of this story. The COVID-19 shots act as confidential informants, relaying information about the pathogen within the castle walls. With that information, the defensive cells can patrol the building’s boundaries, keeping an eye on a now familiar enemy. When the virus tries to break in, it will hit “backing layer after backing layer” of defense, Bhattacharya told me.

Prepared by a vaccine, immune boosters will come to the fore much faster, within days of an invasion, sometimes much less. Adaptive cells called B cells, which produce antibodies, and T cells, which kill virus-infected cells, will have had time to study the characteristics of the pathogen and hone their weapons against it. As the watchdogs swoop in, archers trained to recognize the virus will shoot it down; the few microbes that go deeper will be destroyed by sword-wielding assassins lurking in the shadows. “Each stage that you have to overcome removes a larger portion” of the virus, Bhattacharya said. Even if a pair of particles clear each obstacle, their ranks are fewer, weaker, and less damaging.

At best, the virus could even be instantly attacked by immune cells and antibodies, still amplified by the recent vaccine visit, preventing any infection from establishing itself. But expecting this from our vaccines is always unreasonable (and, in fact, it was not the stated goal for any COVID-19 vaccine). Some people’s immune cells can have slow reflexes and keep their weapons holstered for too long; This will be especially true among the elderly and the immunosuppressed; its fighters will still unite, only to a lesser extent.

Changes on the side of the virus could also tip the balance. Like disguised invaders, cunning variants could evade detection by certain antibodies. Even easily recognizable versions of the coronavirus can overwhelm the immune system’s initial cavalcade if they assault facilities in high enough numbers, through, for example, an intense and prolonged exposure event.

With so many factors at play, it’s not hard to see how some viral particles can still hit their mark. But a besieged body is not going to raise its hands in defeat. “People tend to think of this as Yes or no“If I get vaccinated, I shouldn’t have any symptoms; It should be completely protected, ”Laura Su, an immunologist at the University of Pennsylvania, told me. “But there are many more nuances than that.” Even when the virus is causing a scandal, immune cells and molecules will try to hold their own, regain their advantage, and take down the pathogen. Those late efforts may not stop an infection completely, but they will still curb opportunities for the pathogen to move throughout the body, cause symptoms, and spread to another person. The lack of hospitality of the vaccinated body for SARS-CoV-2 is what has given many researchers hope that prolonged COVID is also rarer among those immunized, although that connection remains. being explored.

Advances, especially symptomatic ones, are still rare, as a proportion of immunized people. But by sheer numbers, “the more people get vaccinated, the more you’ll see these groundbreaking infections,” Juliet Morrison, a virologist at UC Riverside, told me. (Don’t forget that a small fraction of millions of people it is still Many people-and in communities where most people are vaccinated, most positive tests could be for people who received injections). The reports of these cases should not be alarming, especially when we delve into what is happening. qualitatively. An assault on a castle is worse if its inhabitants are massacred and all their jewels stolen; With vaccines in place, such cases are rare; many of them are being replaced by lighter thefts, in which the virus only has time to land a couple of hits before it kicks in. Sure, vaccines would be “better” if they erected impenetrable force fields around each fortress. However, they do not. Nothing does. And our shots are not to be criticized for failing to meet an impossible standard, one that obscures what are able to achieve. A breached fortress is not necessarily a defeated fortress; any castle that is put together beforehand will be in a better position than before.

There is also a silver lining to the advances. By definition, these infections occur in immune systems that already recognize the virus and can learn from it again. Each subsequent encounter with SARS-CoV-2 could remind the body that the threat from the pathogen still lurks, prompting cells to revitalize their defenses and sharpen their coronavirus detection abilities, and extend the duration of protection. Some of that familiarity might diminish with certain variants. But roughly, a post-inoculation infection can be “like a vaccine booster,” Su of the University of Pennsylvania told me. It’s not much different from keeping veteran combatants in advance – once the dust has settled, survivors of the battle will be on the lookout for the next assault. Certainly that is no reason to seek outside infection. But if such a mishap were to occur, there’s a good chance that “continually training immune cells can be a really good thing,” Nicole Baumgarth, an immunologist at UC Davis, told me. (Vaccination, by the way, could mobilize stronger protection than a natural infection, and it is also less dangerous).

We cannot control how SARS-CoV-2 evolves. But how the disease manifests depends on both the host and the pathogen; Vaccination returns much of our control over that narrative. Understanding the advancements requires some intimacy with immunology, but also familiarity with the realities of a virus that will be with us in the long run, one that we are all likely to encounter at some point. The choice is not about get vaccinated or catch. It is about strengthening our defenses so that we are prepared to fight an infection from the best possible position, with our defensive ingenuity on us and well-armored bodies in tow.

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