“The data arriving from Israel on Pfizer must be read well and shouldn't worry. The vaccines we use in the Western world are all effective against the Delta variant". To clarify the question of the effectiveness of vaccines against the Indian variant is the immunologist Sergio Abrignani, professor at the State University of Milan and member of the Technical-Scientific Committee: “You shouldn't limit yourself to reading the titles of the articles. There are three types of protection: from death, from disease, and from asymptomatic infection. Pfizer's lower efficacy on the Delta variant is related only to mild and asymptomatic infections, in which it passes from 94% to 64% in fully immunized subjects. On the other hand, compared to the more serious consequences, the effectiveness is only slightly lower, from just over 90% to just under 90%”. This explains why in the United Kingdom the Delta variant is rampant despite the fact that over half of the population is fully immunized (and 70% have received at least one dose), causing infections to rise but not so much deaths and hospitalizations in intensive care. So much so that Prime Minister Boris Johnson has decided to reopen everything from July 19th: “The United Kingdom will be an important test for the whole world”, explains Abrignani in the interview granted to FIRSTonline.
Professor, so there's no need to worry about the effectiveness of vaccines against variants?
“No, because as far as the Israeli data on Pfizer is concerned, the -30% efficacy concerns only mild or asymptomatic infections, while on lethality the percentages of efficacy for those who have received both doses remain comparable. This means that the vaccine will not make a virus that we now imagine endemic, such as seasonal flu, disappear, but that it will and is already making it much less lethal. This is what we are seeing in the UK, where infections have exploded to 25.000-30.000 a day from a few hundred in April, but deaths and hospitalizations have marginally recovered over the same period. And the vaccination campaign is far ahead ”.
So is British Prime Minister Boris Johnson right to reopen everything from July 19?
“There are two currents of thought: those who say that by letting the virus run there is the risk of new variants and those who accept that it is becoming endemic, like a normal flu. I am for the second line, for two reasons: the variants have so far developed in countries where vaccination was not done or vaccination was behind, in particular India from which the dominant variant comes today. Where people get vaccinated, variants have not yet emerged. Furthermore, with vaccination, Covid, even with the Delta variant, has a very low lethality: according to what we are seeing in England, less than one in a thousand infected, therefore less than the normal flu, which affects between 4 and 10 million every year in Italy of people, 10-15% of the population, killing about one in a thousand without the country stopping. Obviously every dead person has a weight, but with these numbers it's scientifically acceptable to prove a return to normalcy. Otherwise what do we vaccinate for?”.
Will the United Kingdom also be an important test for Italy, given that the Delta variant is growing day by day in Italy too?
“Absolutely yes, it will be important to see what happens in the month following July 19th. Johnson has foreseen an increase in infections, which today are 25.000-30.000 a day, up to 100.000. He said: let's forget it, there will be other deaths but not many, more or less what there would be with a common flu, in proportion. It will be a test for the whole world because if we see that the virus circulates but deaths and hospitalizations in intensive care do not increase or increase very little, then it means that we can return to a normal life".
In Italy, the drop in infections is slowing down: from your point of view, is there concern for the summer season? Is the Green Pass at risk and is there the hypothesis of new closures?
“Concern I would say no, attention obviously yes. The infections are really too low to think of seeing them still go down, so it is physiological that they can fluctuate or even go back up, as happened in England. Precisely for this reason it will be important to monitor how the situation there will now evolve, given that, among other things, the virus has so far acted in a very similar way between Italy and England, with lethality rates comparable to each other and different from other countries. The Green Pass is absolutely not at risk and as far as closures are concerned, the situation at the moment does not suggest it: we will look above all at the data on deaths, intensive care and, I repeat, those arriving from the United Kingdom which will become the benchmark to a certain extent" .
In your opinion, was it not a bit of a gamble to hold the European football championships with the stadiums open and several matches at Wembley, in England?
“If everything is done safely, with vaccines and Green Passes, I don't see the problem. It is clear that as a doctor I would always advise avoiding gatherings, but as a citizen I also tell you that a return to normalcy must at least be experienced, obviously following certain rules. Every winter we accept thousands of deaths from the flu without doing any lockdowns: if thanks to vaccines the lethality of Covid will be the same, and it seems to be so, I don't see why we change our strategy ".
The virus should become endemic: does this mean that we will have to get vaccinated for several years?
“We have to see if there will be a need, at the moment we cannot know. We can hypothesize that the virus will not disappear, that it will last for decades and that we will be able to tame it thanks to vaccines, but it is not certain that a booster will be needed every year ".
Is it possible that the third dose against the variants will be necessary?
“At the moment all the vaccines we use in Europe, Pfizer but also Moderna, AstraZeneca, Johnson & Johnson and also the upcoming one from Novavax, are safe and cover sufficiently effectively even against the Delta variant. Right now, therefore, there would be no need for a further reminder, except at the limit for the most exposed or vulnerable categories. For the third dose, however, the pharmaceutical companies are already hypothesizing a cocktail of vaccines, using in part the current one and in part a new serum to increase efficacy against the Delta variant".
