What is Needed to Turn the COVID-19 Pandemic into an Endemic

In December 2019, a novel coronavirus was first reported in Wuhan, China.¹ This was one of the first documented cases of COVID-19, the disease caused by SARS-CoV-2.

More than 2 years since the beginning of the pandemic, vaccines have been developed that resulted in lower mortality in all age groups.² There is even evidence to show that boosters aided in protection against variants, such as Delta (B.1.617.2)^3,4 and Omicron (B.1.529).⁵

COVID-19 has caused more than 70 million cases nationwide, which accounts for approximately 20% of global cases. Although there are options available if hospitalization were to occur, vaccination is still the best way to prevent death, as well as hospitalization.⁶

Below is a comparison of the currently available vaccines in the United States.⁷

With the pandemic still ongoing and new variants emerging, new data are constantly coming out. Although the number of variants that are being discovered may sound alarming, it is increasingly evident that the current vaccinations available in the United States are still efficacious in preventing symptomatic infection.⁸

The response rates may differ for new COVID-19 variants. The manufacturer should be referred to for the most recent information, especially with doses for pediatric population under 5 years.

Breakthrough infections are rare in those who are vaccinated, almost as low as 1 in 100,000 people who are in a high-risk environment.⁹

For those that are experiencing a symptomatic infection, the most common symptoms are fever, cough, loss of smell, fatigue, or headache. Going further into the details, symptomatic infection was observed to occur less often in those who have been fully vaccinated compared to those that are not fully vaccinated.¹⁰

One common question that may come up is what will it take to end the pandemic?

This connects to a theory proposed by scientists during the beginning of the pandemic. For COVID-19 to turn into an endemic, there are a few criteria that should be met. Immunity (severity of infection, adaptive immune response after infection), interventions (vaccinations, therapeutics), seasonality, and viral interactions (protection between strains).¹¹

In short, getting vaccinated is one of the best prevention strategies. If one cannot get vaccinated, it is strongly recommended to practice hand hygiene and physical distancing when possible.

About the Authors

Chong Yol Gacasan Kim, PharmD candidate at Feik School of Pharmacy in San Antonio, TX.

Phuoc Anh (Anne) Nguyen, PharmD, MS, BCPS, is a pharmacy manager at Houston Methodist Hospital and a Clinical Adjunct Faculty at the University of Houston College of Pharmacy in Houston, TX.

References

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2. Xu S, Huang R, Sy LS, et al. COVID-19 Vaccination and Non-COVID-19 Mortality Risk - Seven Integrated Health Care Organizations, United States, December 14, 2020-July 31, 2021. MMWR Morb Mortal Wkly Rep. 2021;70(43):1520-1524. Published 2021 Oct 29. doi:10.15585/mmwr.mm7043e2
3. Bar-On YM, Goldberg Y, Mandel M, et al. Protection of BNT162b2 Vaccine Booster against Covid-19 in Israel. N Engl J Med. 2021;385(15):1393-1400. doi:10.1056/NEJMoa2114255
4. Arbel R, Hammerman A, Sergienko R, et al. BNT162b2 Vaccine Booster and Mortality Due to Covid-19. N Engl J Med. 2021;385(26):2413-2420. doi:10.1056/NEJMoa2115624
5. Collie S, Champion J, Moultrie H, Bekker LG, Gray G. Effectiveness of BNT162b2 Vaccine against Omicron Variant in South Africa [published online ahead of print, 2021 Dec 29]. N Engl J Med. 2021;NEJMc2119270. doi:10.1056/NEJMc2119270
6. Tenforde MW, Patel MM, Ginde AA, et al. Effectiveness of SARS-CoV-2 mRNA Vaccines for Preventing Covid-19 Hospitalizations in the United States [published online ahead of print, 2021 Aug 6]. Clin Infect Dis. 2021;ciab687. doi:10.1093/cid/ciab687
7. The Medical Letter. COVID-19 Vaccine Comparison Chart
8. Accorsi EK, Britton A, Fleming-Dutra KE, et al. Association Between 3 Doses of mRNA COVID-19 Vaccine and Symptomatic Infection Caused by the SARS-CoV-2 Omicron and Delta Variants [published online ahead of print, 2022 Jan 21]. JAMA. 2022;10.1001/jama.2022.0470. doi:10.1001/jama.2022.0470
9. Ledda C, Costantino C, Motta G, et al. SARS-CoV-2 mRNA Vaccine Breakthrough Infections in Fully Vaccinated Healthcare Personnel: A Systematic Review. Trop Med Infect Dis. 2022;7(1):9. Published 2022 Jan 13. doi:10.3390/tropicalmed7010009
10. Antonelli M, Penfold RS, Merino J, et al. Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app: a prospective, community-based, nested, case-control study. Lancet Infect Dis. 2022;22(1):43-55. doi:10.1016/S1473-3099(21)00460-6
11. Shaman J, Galanti M. Will SARS-CoV-2 become endemic?. Science. 2020;370(6516):527-529. doi:10.1126/science.abe5960