The bad news: On Thursday, Science published the largest study to date looking at the effectiveness of COVID-19 vaccines over an extended period. The results of that study are not great. 

Looking at a pool of over 780,000 veterans—just under 300,000 of them unvaccinated—the initial effectiveness of all the vaccines was just about as good as advertised. At the peak of protection—a week after the second shot (or a few weeks after the first shot, in the case of Johnson & Johnson)—the average level of protection against infection was 87.9%. However, eight months later, protection against infection had dropped to 48.1%. For Johnson & Johnson, that level of protection against infection was down to just 13.1%.

The news on protecting against deaths was much better. For veterans under 65, Pfizer-BioNTech provided an 84.3% improvement in the rate of death at the end of the study, Moderna was at 81.5%, and Johnson & Johnson was at 73.0%. For those over 65, the protection was 70.1%, 75.5%, and 52.2%, respectively. 

It’s not that these numbers weren’t expected, but seeing them in black and white, in such a large study, is still somewhat sobering. There is a reason that the Centers for Disease Control and Prevention (CDC) recommends boosters for all Johnson & Johnson vaccine recipients. One other thing: It’s easy to read this as the vaccines having a definitive expiration date, but the actual study isn’t really able to differentiate between the effect of vaccines declining over time from the growing dominance of the delta variant. Barring the entry of a new variant that is more vaccine-evasive, vaccines may remain effective over a longer period. That’s still unclear.

Let’s get to the good news.

Good news

The good news can be described in a single image from Our World In Data.

Half the planet has now received at least one dose of COVID-19 vaccine.

How do we get rid of COVID-19 going forward? This is a great start. Half the people on Earth have now received at least one dose of COVID-19 vaccine. Out of those, 39% are fully vaccinated. 

Granted, a sizable percentage were treated with vaccines that have since proven to be less effective than the top-of-the-heap mRNA vaccines. But we’re getting there, and at the recent G20 meeting, wealthy nations once again agreed to secure and distribute hundreds of millions more doses to less-wealthy nations. 

Over at EndCoronavirus.org, there are now 26 entries on their list of nations that are defeating COVID-19, and another 55 nations have made the “almost there” list. That leaves the rest of the world—including the United States—on the list of countries that need to take further action. With U.S. cases having leveled off above 70,000 a day, that’s definitely true. Vaccinating children should help, but what would help even more is targeted use of mask mandates to keep community transition low.

Better News

Pfizer’s name wasn’t just in the news this week because of vaccines, but because it announced a new antiviral pill that it says cuts the risk of hospitalization or death by 89% when taken within three days of the onset of symptoms. In a study of 1,200 patients, none of those getting Pfizer’s pills died, while 10 who received placebo pills died. Which is great testimony to the effectiveness of the pills, as well as further evidence that we really, really need another way to do these trials.

Pfizer’s pill is a protease inhibitor, drugs that as a group have proven effective against a number of viral illnesses. The company has not yet provided the data for peer review or submitted the new drug for approval by the Food and Drug Administration, but if it becomes broadly available, it could have an enormous impact and might even be given as a safety measure to those who have been vaccinated but are at additional risk of serious illness from COVID-19. 

The treatment follows another announced by Merck over the summer. That drug, Molnupiravir, was approved this week for use in the United Kingdom. It will be offered to adult patients with mild to moderate COVID-19, who are at elevated risk of developing severe disease due to preexisting conditions. Indications in early testing are that Molnupiravir cuts the risk of hospitalization in half. 

The U.K. has continued to have the highest rate of COVID-19 in western Europe ever since the government declared “Freedom Day” in July, dropping most limitations and mask mandates.

WTF?! News

On Saturday, the Fifth Circuit stayed enforcement of the vaccine mandate for large companies ordered by President Joe Biden. Rather than providing any justification for this ruling, the court simply said that the issue has “grave statutory and constitutional issues.” How this will affect a program that is already going extremely well isn’t yet clear.