Dr. Mersad Alimoradi 04 Jan 2022

2021 was a long year. It was the year of mass COVID vaccination. The year when most of humanity’s efforts went to combating the pandemic. The year where we learned to live with the coronavirus.

All in all, we managed some incredible things in 2021. Around 9.2 billion doses of COVID vaccines have been administered worldwide so far. That’s roughly 119 doses per 100 individuals. Going around 40 million doses a day. It’s not perfect, but it’s good for now.

In 2021, we learned how vaccines really work. We learned that they’re safe - even in children and pregnant women. We learned that there are different vaccine types and how they compare. We learned about boosters, Delta, Omicron, and the 3rd dose. In a way, everyone now is an expert in COVID vaccines.

This article will summarize the top 10 things we learned about the different COVID vaccines in 2021, in hopes that we can be even more successful in combating the pandemic in 2022.

Vaccines Work

This was the first concern regarding the corona vaccines. Do they really work? Are they effective in preventing infection? In preventing illness? Making it less severe? Preventing spread?

We now know that COVID-19 vaccines do work. And they work very well. They reduce the rate of infection, the likelihood of developing symptoms, requiring hospitalization, and death. They don’t completely prevent the transmission of infection, but they make it very hard for the virus to spread.

  • A recent study found that 3 doses of the Pfizer/BioNTech vaccine are 95.6% effective in preventing illness due to corona infection. The study was done on 10,000 participants.
  • According to a report by the CDC, the Moderna vaccine is 93% effective against COVID19, especially 4 months after the second jab.
  • A study done in the UAE showed that Sputnik V was 97.8% effective against COVID-19 illness.
  • A study analyzing the data of more than 700,000 individuals found that unvaccinated people were 3.5 times more likely to be infected with COVID-19.
  • According to a report by French health authorities during the delta outbreak, 96% of people hospitalized were not vaccinated
  • Another data analysis done in the USA showed that 99% of hospitalizations and 99% of deaths due to corona were in unvaccinated people

To sum up; the COVID vaccines work. Unvaccinated people are much more likely to get infected, develop severe illness, and die from corona.

Vaccine Boosters Are Necessary

In 2021, we’ve learned that the efficacy of vaccines goes down with time. Two jabs are likely not enough to offer long-term protection. Countries are now offering a 3rd dose after 6 months of the second jab.

Some experts have even suggested a 4th dose will be necessary in light of the new Omicron variant.

Here’s what we know about the long term effectiveness of different corona vaccines:

  • A study published in September 2021 found that the protection offered by 2 shots of the Pfizer vaccines decreased to 57% after 6 months. The reduction in protection was more pronounced in women and the elderly.
  • Another study published in November found out that protection from Pfizer, Moderna, and Johnson & Johnson vaccines went down to 45%, 58%, and 13% after 6 months respectively. 
  • As for AstraZeneca’s vaccine, a study showed that vaccine protection decreased to 47% after 5 months of the second shot.

Bottom line, we now know that 2 shots are not enough. They don’t offer lifetime protection. A 3rd dose is absolutely necessary to bring immunity back up.

Vaccines Can (and sometimes should) Be Mixed and Matched

We now know that mixing vaccines of different types or brands can lead to better protection against corona.

Scientists have specifically noticed that getting a second or third jab with an mRNA vaccine (Moderna or Pfizer/Biontech), offered better protection compared to getting only non-mRNA vaccines.

This is why most countries now offer booster mRNA vaccine jabs to all fully vaccinated individuals, regardless of their first one or two doses. There’s been many studies and analyses to support this:

  • A recent study found that mixing AstraZeneca with a second Novavax or Moderna shot led to more protection compared to two AstraZeneca shots.
  • The same study found that getting Moderna after a first Pfizer/BioNTech shot led to a better immune response compared to getting two Pfizer shots.
  • Another study found that mixing AstraZeneca with Pfizer or Moderna provided higher rates of protection (68%) compared to two AstraZeneca doses (50%).
  • An analysis published by the CDC found that giving a Modena booster shot to those who got Johnson & Johnson jabs initially produced a 50-fold increase in protective antibodies.

The WHO now recommends an mRNA booster shot in those who got a vector-based vaccine (like AstraZeneca) and vice versa. An AstraZeneca, Pfizer, or Moderna shot can also be given as a booster to those who got Sinopharm, which delivers an inactivated version of the virus.

Vaccines Might Be Less Effective Against New Variants

One of the unfortunate things we’ve learned in 2021 is that the vaccines we have might not be fully effective against new corona variants.

This fear has especially become apparent with the latest variant, Omicron, which took the world by storm as 2021 approached its end.

After the South African variant and Delta Variant, Omicron is now the most concerning variant of concern. The mutant has been shown to be much more infectious compared to the original coronavirus. The good news, however, is that Omicron seems to be less deadly compared to its predecessors.

A recent analysis was done in the UK on 600,000 people infected with Omicron. The researchers reported that 1 dose of the vaccine prevented hospitalization in 52% of patients. Two doses lead to 72% protection, however, the protection waned back to 52% after 6 months.

After getting the third dose, protection against hospitalization due to Omicron was 88%. A very promising result.

The study analyzed data from patients vaccinated with AstraZeneca, Moderna, and Pfizer.

To sum up, two doses of our current vaccines don’t offer great protection against new variants like Omicron, especially after some time passes. A booster shot, however, can provide high levels of immunity.

Vaccines Are For Children Too

We now know that corona vaccines are safe and effective in children and teens. This was supported by numerous studies done with different vaccines all around the globe.

Most countries have already approved the vaccines in this age group:

  • The Pfizer/BioNTech vaccine has been approved in children aged 5 years and up by the FDA, EMA, and other health authorities worldwide
  • The Coronavac has been approved for children aged 3 to 17 by various health authorities, such as in China, Cambodia, and Chile.
  • The Sinopharm vaccine is approved in children above 3 in countries like the UAE and China

Vaccinating children will protect them, help them go back to school, and halt the spread of COVID.

Vaccines Do Not Harm Pregnancy

In 2021, we learned that the COVID vaccines are both safe and effective in pregnant women.

Studies done in 2021 showed that COVID-19 vaccination does not increase the rate of miscarriage or abortion. The COVID vaccines are also safe for breastfeeding mothers and do not harm the baby.

In fact, since pregnant women are considered a high-risk group, vaccination is especially recommended. One alarming analysis from the UK showed that 1 in every 6 women in critical care was pregnant.

There Are Many Vaccines To Choose From

A positive thing about 2021 is that scientists were able to develop different types of corona vaccines. These work in different ways, but all offer great protection against COVID:

  • mRNA vaccines: Pfizer/BioNTech and Moderna. The mRNA vaccine revolution was probably the highlight of 2020 and 2021. The fairly new technology proved to be very safe and effective against the pandemic.
  • Inactivated vaccines: Covaxin, Coronavac, and Sinopharm. This is a traditional technology to produce vaccines. They introduce an inactivated version of the virus, allowing your body to produce immune cells and antibodies against it.
  • Vector-based vaccines: AstraZeneca, Johnson & Johnson, Sputnik V, Covishield, and Coronavac. This is another traditional method for creating vaccines. It introduces virus-specific antigens to train your immune system to recognize and fight the coronavirus.
  • Subunit vaccines: Novavax and Zafivax. This is a fairly new way to produce vaccines. The vaccine contains proteins that mimic the shape of the SARS-CoV-2 virus.
  • Nasal vaccines: Such as the Cadila intranasal vaccine. These are vaccines designed to be delivered through nasal inhalation. Nevertheless, no nasal vaccines are yet approved for public use.

Even though effectiveness and protection differ between different vaccine types, you should not get picky. All the vaccines are effective and safe. Any available vaccine should be taken as soon as you get the chance. That’s the only way we can stop the pandemic.

Vaccines Are Necessary For Travel

Vaccine certificates are now necessary for travel to some countries, like the United States.

As of October 2021, non-citizens and non-immigrants are required to show proof of full vaccination before getting into the United States.

In Germany, you cannot use public transportation unless you are vaccinated, recovered, or recently tested for COVID.

In 2022…

As the new year starts, scientists, doctors, and everyone is hoping that the pandemic will end in 2022.

The pandemic ending does not necessarily mean that COVID will disappear. It might take more time to completely eradicate the disease (if that’s even possible). It also doesn’t mean that we won’t need booster shots in the years to come. These might become part of our routine medical care.

In 2022, we’re hoping that life will slowly go back to what it used to be, and that people will trust the vaccine more so that we can put an end to this pandemic.

If you’re not already vaccinated, take the first chance you get. The best COVID-19 vaccine is the one that is available to you the soonest.

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About the Author:
Dr. Mersad is a medical doctor, author, and editor based in Germany. He's managed to publish several research papers early in his career. He is passionate about spreading medical knowledge. Thus, he spends a big portion of his time writing educational articles for everyone to learn.