COVID Q&A

When Will We Reach Herd Immunity? Boston Doctors Explain

Despite the concerning metrics, Boston doctors are hopeful that the daily COVID-19 case count will begin to decline in Massachusetts in the next week or two

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About 85% of the population has received at least one dose of a COVID-19 vaccine in Massachusetts, while the latest surge has prompted "astronomical" case numbers.

With both vaccination-induced and natural antibodies, are we any closer to reaching herd immunity? Three top Boston doctors answered that question during NBC10 Boston's weekly "COVID Q&A" series Tuesday.

Massachusetts' COVID metrics have been spiking to heights not seen even in previous surges, thought to be driven at least in part by the omicron variant.

Two record-breaking days were reported in Massachusetts just last week. State health officials reported a new single-day record on Jan. 5, topping 27,000 cases, followed by the second-highest single-day total on Jan. 7, with more than 26,000 cases.

"Case numbers are astronomical. I never -- I have to admit, I never thought we could see something like this in a post vaccination era," said Dr. Shira Doron of Tufts Medical Center. "And the cases that we do know about are probably a massive undercount, considering that a lot of people are getting their diagnosis at home with a home test."

Despite the concerning metrics, Boston doctors are hopeful that the daily COVID-19 case count will begin to decline in Massachusetts in the next week or two and then drop dramatically.

But when, if ever, will the pandemic come to an end?

Top Boston doctors are hopeful that the daily COVID-19 case count will begin to decline in Massachusetts in the next week or two, then drop dramatically.

Building an immunity wall

Boston doctors are hopeful that the majority of the population will become immune to the disease, but just how long that will take remains to be seen.

"Unfortunately, because omicron is so transmissible, if you're not vaccinated, omicron will find you," Boston Medical Center's Dr. Sabrina Assoumou said. "That means that, hopefully, our immunity wall would actually get taller and we'll be able to get to a more steady state and be able to get in adjust to the new normal."

Assoumou, a member of Boston Mayor Michelle Wu's COVID-19 Advisory Committee, emphasized the need for people to get vaccinated and, when eligible, boosted, in order to both prevent severe illness and death and reach a collective state of immunity.

"I'm hoping that we'll get there," she said. "But I hope that we're not going to have to go through a lot of deaths because as we know, vaccination can prevent deaths before we're able to get to that steady state."

Doron was skeptical of reaching herd immunity in the classic sense, which she described as enough people becoming immune that the virus fades into the background. The problem, she said, is that immunity wanes over time, as seen with vaccines.

"Although infection provides immunity and vaccination provides immunity, there's a waning of that immunity over time, at least against infection and, to some extent, also against severe disease and death. So it's the lack of durability of immunity, both types of immunity," Doron said. "I don't think that we'll see the virus sort of fade away."

However, with repeated exposure through vaccination as well as infection to the different forms of the virus, she is hopeful that, "the societal impact of this virus, hopefully, lessens."

Dr. Daniel Kuritzkes, chief of infectious disease at Brigham and Women's Hospital, noted that due to the mutations, it may take a higher level of immunity to get there.

"If we thought that you needed to have two thirds of the population immunized to protect against the original strain, it may have been amped up to 90 or 95%. Now with omicron, it's probably 99% need to get vaccinated," he said. "We don't yet have an estimate of the reproductive number, but it may be approaching the R zero of measles, which is 18, and that means that you really need pretty much everyone immunized or everyone to have natural immunity, and I'm not sure that's going to happen."

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