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Are Vaccines Beating the Virus? Do We Need Mandates? Are We Demonizing Unvaxxed?

Magazine, Living Well

It’s no secret that the ferocious COVID-19 pandemic continues to pose a threat to the health and stability of the nation.  In addition, the increased rate of transmissibility of the Delta variant, causing a much-needed discussion to be had to help communities protect themselves. A panel briefing organized by Ethnic Media Services brought four medical experts to weigh in on key questions about vaccinations: how effective they are with both vaxxed and unvaxxed, who needs boosters and why, how to speed up vaccination rates before a new variant emerges, what risks we run if we wind up demonizing the unvaxxed.

Monica Gandhi, MD, MPH, Professor of Medicine, UC San Francisco’s School of Medicine – Dr. Gandhi will discuss strategies for vaccinating unvaccinated people and began the panel with some very important key points to consider. Plugging from the recent outbreak in Provincetown, where out of over 800people  infected from a July 4th celebration there were zero deaths. The outbreak in this community proved that the DELTA variant is highly transmissible even among vaccinated people thus making the CDC recommendation to wear masks reasonable. She also reiterated that this does not take away from the protections from being vaccinated because the unvaccinated are more likely than the vaccinated to transmit the infection.

Dr. Gandhi also discussed ways to get unvaccinated, sharing the example of a big country like  India where a 3.7 vaccination rate proved disastrous. Getting vaccinated is the only way to get through the DELTA variant. The US, she said is a mixed bag with a very diverse population making vaccination the only way to contain the spread. Some of the ways to get more vaccinations would need the following:

  • Community-based messaging
  • Bringing vaccines to the people
  • Free transportation and childcare
  • Instituting vaccine passports
  • Vaccine mandates.

She concluded by acknowledging that the dialog she shared has greatly shifted over the last few weeks and combating misinformation is crucial.

Tiffani Jenae Johnson, M.D., M.Sc. UC Davis Health Children’s Hospital – Dr. Johnson discussed the socio-economic and cultural factors that have left many minorities unvaccinated and the risks of demonizing the unvaccinated. Emphasizing the safety and effectiveness of the vaccines she stressed the fatigue that frontline workers were experiencing and the desire to get back to a new normal. There is a lot of finger-pointing going on which she attributes to the fatigue brought on by COVID. She however clarified that the unvaccinated are not a monolith. There are children under 12 and other adults who are not eligible and so we can’t just put blanket blame on the unvaccinated. There are also other factors such as barriers to accessing vaccines including technology, transportation, etc. Concerns about taking time off work weigh heavily on hourly-paid workers who won’t take time off work to get the vaccine for fear of losing income. The potential of side-effects that could keep them at home is a major factor. Under-served communities are of course dealing with mistrust. From slavery, and the history of experimental healthcare there is mistrust of the systems to protect communities of color. The systems need to earn trust and that will take time. Vaccine hesitancy she said, is not very accurately assessed. Some people are affected by misinformation and others are affected by the confusion in the guidelines that are constantly changing. It is important to answer all questions and create safe spaces to have dialog and not shame them. Worth noting that there are still lots of health workers not vaccinated and so we ought to double down on them as well to set the example. Shame and blame are not going to help, more empathy and less shame, meeting people where they are to address where they have barriers would be more effective.

Ben Neuman, Ph. D, Chief virologist at the Global Health Research Complex at Texas A&M University discussed the findings of studies from the U.K. and Israel which determined vaccines to be less effective against the spread of the Delta variant. Dr. Neuman shared that in looking at studies on COVID and its variants everyone wants a definite answer which is impossible. The vaccines are safe and work and everyone should get one. Overall takeaways show that the DELTA variant fairs better in vaccinated than in unvaccinated people. All studies agree that 2doses are more effective than 1 in the Pfizer and Moderna vaccines because of the way the immune system works. Studies from the UK, Canada, Scotland, and Israel show vaccinated people to do better than the unvaccinated. In Hyderabad, India, a look at hospitalized people show the vaccinated to be less likely to die or be severely sick, so the takeaway is that vaccines do work.

Last but not least Dr. Dali Fan, MD, Ph. D, UC Davis Health used slides to discuss the possible need for boosters of the Covid vaccine. An advocate for vaccines see below the summary of his presentation on Delta Variant (B.1.617.2):

  • When things are copied in mass, mistake is unavoidable, especially when the production line is primitive and without quality control

 

  • This is true in the coronavirus, they don’t have the proof-read enzyme, we do, we are not lending…

Is there another wave of Covid: YES

 

  • UNITED KINGDOM:
    • Created a “4th” peak in cases in the UK (56% fully vaccinated)
    •  Corresponding death rate due to COVID is much smaller

 

  • ISRAEL
    • Created a smaller “5th” peak in cases Israel (59% fully vaccinated)
    •  Corresponding death rate due to COVID is again much smaller

 

  • UNITED STATES
    • Created a “5th” peak in cases the US (50% fully vaccinated)
    •  Corresponding death rate due to COVID is again much smaller

 

  • CALIFORNIA
    •  Created a “4th” peak in cases California (53% fully vaccinated)
    •  Corresponding death rate due to COVID is again much smaller

 

Is there another wave of Covid?

  • Yes
    • Multifactorial
      • Delta
      • Social behavior/policies

Vaccination / Lack of in children

Delta in America: Dominating!

  • Variant strains predominant in new US COVID cases

 

  • Delta     ~ 83%
  • Alpha    ~ 9%
  • Gamma     ~ 4%

DELTA VARIANT

  • More contagious
    • R0 increase: 2.5 -> 4.0
    • Found more in younger people ( < 50 yo)
    • Rapidly replacing other variants (more “fit”)
  • More toxic
    • 1.8 x higher risk to put infected people into the hospital

In summary, Dr. Fan laid out the facts of the effectiveness of the vaccine and showed where there have been new waves and how the vaccines are effective. He emphasized that vaccines are effective against infection and hospitalization and they are great for the DELTA variant as well. Right now the booster is not necessary but more important is to get everyone vaccinated. Boosters will be needed after the waning of initial vaccines.

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