Since the coronavirus first appeared in New Jersey last March, wreaking deadly havoc in every corner of the state, one phrase kept being uttered regularly, a seemingly magical yet nebulous two-word goal: Herd immunity.
It’s a point when a community reaches protection from an infectious disease because a sufficient percentage of a population has become immune to infection through vaccination or previous illness. Only when we reach that point can we truly get back to our old way of life.
The problem: reaching herd immunity across the state may never happen, according to public health experts. Even as vaccinations in New Jersey are being doled out at breakneck speeds — more than 3.2 million people, or 48% of the state’s 6.9 million adults, are fully vaccinated as of Thursday — it still likely won’t be enough.
A combination of factors most likely will prevent New Jersey from the threshold, the experts said, including: researchers aren’t certain how transmissible COVID-19 variants are in fully vaccinated people; it’s not known exactly how long vaccinations or previous infections offer immunity from the virus; and a significant portion of residents appear to be refusing to get vaccinated.
“As long as you have multiple uncertainties, getting to herd immunity is something I’m not betting on, because I don’t know how the uncertainties are going to play out,” said Daniel Varga, the chief physician executive at Hackensack Meridian Health.
The other complicating factor is no one knows what percentage of the population needs to be protected to reach herd immunity. Some experts initially estimated it could be achieved with roughly 70% vaccinated or previously infected. But predictions still vary wildly and change almost month to month.
“It’s all speculation,” said Brian L. Strom, the chancellor of Rutgers Biomedical and Health Sciences. “There are some diseases, you can do at 60%, 70% or 90%. But we don’t know for this disease.”
Many now are switching focus from the idea of reaching herd immunity to preparing society to live with COVID long-term.
“Realistically, this is a disease we’re going to need to learn to coexist with,” Strom said. “It’s not going to go away.”
That means being nimble and able to adjust on the fly to emerging cases or hot spots, keeping masks handy in crowded spaces or during cold and flu season for months, if not years, and working coronavirus vaccine shots into our regular, annual health routines.
Social distancing outdoors, and especially indoors, and proof of vaccination to gain entrance into private venues also are realistic possibilities, the experts said. Some school districts could still temporarily close when cases pop up, and remote working could linger for years.
“It’s pretty clear that coronavirus is going to be part of our future for quite some time,” said Martin J. Blaser, director of the Rutgers Center for Advanced Biotechnology and Medicine. “But the more people who get vaccinated, the smaller a part of our future it’s going to be.”
All hope of reaching herd immunity in New Jersey is not lost, some experts still believe. But many have taken stock of the uncertainties surrounding the virus and surmised that crossing the threshold will be increasingly challenging, if not impossible.
Already, several prominent COVID-19 variants have emerged, and although initial research indicates vaccinations provide some level of protection against them, more variants are likely to pop up, and some could be vaccine-resistant, experts said.
“With these variants, we keep upping the proposed proportion to reach herd immunity,” said George DiFerdinando Jr., chair of the Princeton Board of Health. “A year ago, people were saying it was 60% or 70%. Now we’re up to 80%. If it’s 80%, we’ll know it when it happens.”
The most recent data in New Jersey are providing a glimmer of hope. The state’s transmission rate fell Tuesday to a record-low 0.27; the previous low was 0.60 last May, when residents were still in near-lockdown. (Any number under 1 indicates the outbreak is slowing and each new case is leading to less than one additional case.)
As of Thursday, 4.6 million New Jerseyans have had at least one vaccine shot. Another 160,084 New Jersey residents have been vaccinated out of state.
Nationally, more than 110 million Americans, or 33% of the population, have been fully vaccinated. Public health experts also said this week it’s unlikely the U.S. overall reaches herd immunity, according to a report by the New York Times.
“The pandemic is nosediving in New Jersey,” Strom said. “We’re certainly nowhere near what would be conventional herd immunity. But the drop in cases, hospitalizations and transmission rate is wonderful. It means the pandemic is rapidly shrinking.”
The drastic reductions in cases and rates have occurred even despite vaccine hesitancy, anti-vaxxers and new COVID variants. It’s another encouraging sign for snuffing out the virus — eventually.
“Right now, what we’re doing is working,” Varga said. “The degree that New Jersey has hit the vaccine bandwagon has made all the difference.”
If New Jersey has an outside shot at herd immunity, it will need to continue pushing to get shots to people in underserved or densely populated areas where residents lack access to vaccines. Also, it will have to convince a portion of the state’s anti-vaxxers or the vaccine hesitant to get their doses, experts said.
Over time, experts believe the state can make even more headway as people witness the effectiveness of the vaccines.
“It’s my prediction that over time, when people are still dying and it turns out they’re all unvaccinated, that more and more people will say, ‘You know, I think I will get vaccinated,’” Blaser said.
So, what does New Jersey look like without reaching herd immunity?
Experts say it likely will lie somewhere in between the current state of affairs and our pre-pandemic world. But no one knows for sure.
Most experts believe masking will be here to stay for the foreseeable future, especially in crowded spaces, indoors, during cold and flu season and potentially even on public transit or in some office buildings. Even if the state government eliminates a mask mandate at some point, some places of businesses could still require them indoors, experts said.
Another way of life that could be different is the possibility of controversial vaccine passports. Most experts believe the federal government will not mandate showing proof of vaccination, and already the idea has been met by fierce pushback from people who don’t want the government to interfere with their lives. Even so, private companies and venues could still require them.
In fact, versions of this already exist, experts said. The United States requires a negative COVID-19 test or documentation of recovery for all incoming international travelers, including U.S. citizens. And Rutgers University, Montclair State University and New Jersey City University all will require students to be vaccinated against the coronavirus before returning to school for the fall semester.
As to the question of whether the entire notion of herd immunity was overstated or if it was ever going to be the silver bullet that public health officials initially suggested, experts said it was hard to predict an outcome due to the once-in-a-lifetime nature of the pandemic and the novel virus.
But the concept was not without precedent: In the U.S., smallpox and polio have both been eradicated because of vaccination. Smallpox was around for centuries before it was stamped out in North America in 1952, and the polio vaccine helped eliminate that disease in the 1970s.
The Spanish flu pandemic of 1918 ended by the summer of the next year — not through vaccination, but because those who were infected either died or developed immunity.
Other viruses like influenza have not been able to be eliminated through vaccination. That’s why some experts believe COVID ultimately will be treated similarly to the flu with annual inoculations. Others say it’s possible COVID continues mutating and becomes less potent, until it resembles the common cold.
Still, many researchers are optimistic that even without herd immunity, the U.S. will be able to manage the virus and significantly reduce its lethalness, even if it lingers for years to come.
“Is the glass half empty or half full?” Blaser said. “I think the glass is going to be mostly full. I’m hopeful that a year from now things are going to look much more like they did in 2019. But I don’t think they’ll be exactly the same.”
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Matthew Stanmyre may be reached at mstanmyre@njadvancemedia.com. Follow him on Twitter @MattStanmyre. Find NJ.com on Facebook.
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