Why Do Vaccinated People Still Get COVID-19?

I’ve been vaccinated, boosted, and reboosted. I’ve had COVID at least twice every year. It sure LOOKS like vaccines don’t work. Or is there something wrong with my immune system? Neither. Allow me to explain.

Information is Power

The War

The interaction between a virus and our immune system is analogous to a war: on one side are the viral particles and, on the other, our white blood cells. The freaky thing about viruses, however, is that they actually only come alive INSIDE our cells. Then they hijack the cell’s internal machinery to make more viruses.

The white blood cells fight this by trying to capture the virus before it enters our cells using antibodies. The white cells also work to aid in blowing up virus-infected cells so the cells can’t make viruses. Seriously!

Sometimes, the white blood cell generals get overwhelmed and panic—we call that a cytokine storm. That’s what sometimes happens in the second week of infection in people who aren’t vaccinated and have never had the disease. It’s what kills.

He with the most soldiers usually wins.

When a person wears a mask, it cuts down on the number of viral particles that can reach them. If fewer viruses invade them, their immune system has a better chance of assembling the soldiers, artillery, and bombs, being ready to go before the virus takes over the body. And the white blood cell generals are less likely to panic. So, masks don’t just benefit others; they help you — if you get COVID, you won’t get as sick.

The Lock and Key

The second analogy that may be helpful is a lock and a key. Cells communicate in a way that viruses use to their advantage. Locks and keys.  Cells are instructed on what to do by a chemical key that touches a cellular lock.

To get into cells, the COVID-19 virion uses a key (called a spike protein) that binds to a cellular lock (called an ACE2 receptor). This results in the cell unwittingly opening the door and allowing the virus to enter—and then being hijacked to produce more virus.

ACE2 receptor locks are found on the nose, throat, lungs, blood vessels, kidneys, and liver cells. Interestingly, people with high blood pressure, diabetes, and heart problems seem to have more of the locks on their cells than do other people. It then makes sense that COVID preferentially infects the nose, throat, lungs, etc., and that it causes worse disease in people with high blood pressure, diabetes, and heart problems.

Vaccines work by educating the immune system so that it recognizes the key.

Thoroughly. Imagine that the key is an elephant. Too many analogies? Just go with it for a minute. If you saw an elephant’s ear, would you know that it belonged to an elephant? What about the trunk? How about the foot or even the wrinkly neck? Our immune systems don’t just recognize elephants—they recognize each micro-part of an elephant, or in this case, tiny parts of the spike protein key.

Antibodies Recognize Keys. So do Memory Cells.

So, whether we’re vaccinated or infected, the immune system learns what the virus and its “key” look like. Antibodies to each micropart of the key are made for short-term clean-up. Memory cells that remember each tiny part of the invader and its key for years or even a lifetime are made, as well. Since what the COVID vaccines “show” the immune system is the key, which is essential for gaining access to the cell, the immunity gained will never become ineffective.

If random mutations change the shape of the key too much, it will no longer fit into the lock, and the virus will be unable to infect.

Why Doesn’t the Vaccine Protect Against Newer Strains—or Does It?

“Hang on,” I hear you saying, “I’ve heard that COVID changes (mutates) so much that it can evade the original vaccine-generated immunity. That’s why we need boosters.”

Not exactly. Yes, the virus does mutate a lot. But, no, the immunity generated by vaccination or infection does not become totally ineffective. After all, if the key totally changed, it would no longer fit the lock. So, once exposed, you will always have some immunity. Then, why boost?

More Antibodies

What the booster does is cause more antibodies to be made. Those can mop up virus before it infects. But it’s expensive for the immune system army to make antibodies continually, so it stops after a matter of weeks, and the serum antibody levels fall. After three months, the antibodies, which are only meant for active ongoing battles, are gone. And that is where the memory cells come into play.

Memory Cells are Usually Enough

After the measles virus gains access to a person, it sets up shop in the cells and hijacks them to make more measles. But it’s patient and is quite happy for the process to take a couple of weeks. We call that the incubation period. By the time the incubation period is over, the memory cells have deployed, the soldiers are trained, and in 5-7 days, the immune system is primed for action. Measles has no chance.

COVID is not so kind—it’s a harsh taskmaster, kind of like the bosses at Amazon, and insists that the new viruses be ready to go in three days! COVID has a short incubation time.

Activation Takes Time

Back to the army analogy. As I wrote, about three months after the immune system last sees COVID, there are no more antibodies. Moreover, the army appears to have gone to sleep.

If the person is then exposed to COVID, the virus sneaks in past the walls and hijacks a few throat cells, telling them to produce more COVID. The hapless cells do as they’re told, but not before putting out a help flag on their surface.

The sentry immune cells see the flag, send a signal to the other white blood cells, and they wake up the memory cells, which jump into action. Within 5-7 days, the antibody factories are up and each cell pumps out 1000’s of antibodies per second until the cell dies of exhaustion in about three days.

But, in the meantime, millions of the newly formed COVID-19 viruses have infected new cells. It’s a race to see who wins, and it’s hardly surprising that the people in which the warfare is happening become sick. But, on the whole, vaccinated people do recover.

What About Those Mutations?

By now, we’re used to the COVID vaccine being updated every year. Is this necessary? Yes. And no. If the virus were to mutate so much that the spike was totally unrecognizable, then the key wouldn’t be able to fit into the lock.

But the goal is for the immune system to be fine-tuned to recognize the latest variant. That way, the antibodies, when they’re generated, will do the best job.

Is the Vaccine Dangerous?

One last thing—for which we’ll eventually need the elephant analogy. I’ve heard talk about people getting a medical exemption for the vaccine or how the vaccine itself is dangerous. Let’s put both of those objections to bed at the same time.

All of the vaccines do the same thing. They show the immune system parts of the virus so that it’ll recognize the real thing if the person gets infected in the future.

What Vaccines Don’t Do

They do not change your DNA or hang around for life. No. The mRNA vaccines are made of the substance that the body uses for quick messaging—like carbon paper. mRNA is destroyed after use. It is gone in days, if not earlier.

Vaccines are NOT Drugs

They do not bind to all kinds of cells and have unexpected effects on the body. Vaccines do not interact with our systems.

Immunocompromised People

Some vaccines are contraindicated for people who are immunocompromised. Those are the vaccines that contain live, if weakened, strains of the germ. The mRNA COVID vaccines do not contain live virus, so they are absolutely safe for use by those who are immunocompromised. The Johnson and Johnson vaccine contained an attenuated live virus, so it would be better for those people to avoid it.

Allergies

Being allergic to one of the ingredients may be another reason for a medical exemption. This is very, very rare, as we’ve seen with the millions of doses that have been administered. Less than 1% of highly allergic people get a severe reaction, about 5/1,000,000 total doses. In that study, everyone survived; even an anaphylactic reaction can be reversed. Unfortunately, a bad case of COVID cannot.

Blood Clotting

Some people are concerned about the fact that the vaccines sometimes cause a blood-clotting disorder. Were you wondering about the elephant? Here’s where it comes lumbering in. In some people, one class of the millions of different types of antibodies formed, each of which recognizes a different part of the elephant, thinks that blood vessels look like elephant toes. So the toe antibodies bind to the blood vessel. Not good. Also very rare. According to the BMJ, this happens to 66/10,000,000 vaccinated people.

This blood-clotting disorder can also be caused by getting infected by COVID-19, in fact, it happens much more frequently. About 12,612/10,000,000 infected people experience this problem. This is because: To the immune system, an infection is like having a vaccine every hour or more often for two weeks. Phew! So any mistakes in elephant recognition are hugely magnified.

GBS

What about Guillain-Barré syndrome (GBS)? According to the CDC, it’s safe to get the mRNA vaccine if you’ve had GBS. After all, viral diseases cause GBS, and, since now it’s almost inevitable that everyone will get COVID eventually, if they haven’t had it already, the chance of getting it from being sick with COVID is higher than the chance with the vaccine.

Get That Shot!

This leaves us with a simple conclusion—there are few, if any, valid medical reasons not to be vaccinated, but there are many medical reasons why one should be. It will not prevent illness, since vaccines do not construct an anti-viral force field around us, but being vaccinated does, in most cases, prevent hospitalization and death.

In all probability, because the virus multiplies faster than our antibodies can be formed, we will never totally get rid of this illness, but with vaccinations, we can be safe.