Why doesn't everyone get vaccinated? This may be a philosophical question even though it is really a scientific question. Right now about half the country is vaccinated and the government is essentially begging people to vaccinate. Simultaneously, infection rates are dropping, mortality rates are dropping, and restrictions are being lifted. So, is it even necessary to get vaccinated to Covid or really any other infection?
We need to understand the answer to this question for several reasons. First, and foremost is that I believe this Covid-19 virus is a signal of the world to come. For most of human history our population has gone through frequent and regular losses of huge numbers due to bacteria and viruses. The middle ages were fraught with repeat visits of the Bubonic plague often times wiping out 30% or more of the population. Small pox has a mortality rate of 30-50% in immune ignorant populations and wiped out large swaths of indigenous people throughout the world with European expansion. Logically, we are due for viruses and bacteria to resume their pace of population control.
We have lived in a golden era that began in the 1930's. Medicine in the 20th century effectively stopped the scourge of these diseases with a combination of vaccines and antibiotics. Virtually no one born after 1960 in the United States knows of the terror of a deadly contagious disease. AIDS/HIV was the closest thing to a deadly pandemic but due to it's predilection for a specific segment of society it did not and still does not create the wide population terror of seeing children dying or paralyzed like we did with polio. I suspect our lack of exposure to these terrifying diseases has enabled a large number of people to errantly feel that they are safe from disease.
This period of health in our lives may be lulling us in to a state of unpreparedness. The Covid pandemic awakened that fear in some of us but it also led to government lock downs that incited anger and even violence. We now have people who decline vaccination not because they are fearful of side effects but more to make a statement that government cannot tell them what to do. I have many friends who have this feeling and they try to justify it but calling the vaccine unsafe.
What about this danger of vaccination? The CDC recently published that there have been about 4500 deaths following the Covid vaccination. Could this be true? I looked up the CDC website and given how poorly they have managed this pandemic I was unsurprised by how poorly they presented this data. They stated that indeed about 4,500 people have died who have been vaccinated out of about 275 million vaccines administered, but they have only found about 7 deaths they can associate with the vaccine. They don't make this very clear and they don't explain how long they track people after vaccination and they don't state clearly the fact that they are recording deaths of any cause. For example, if you die in a car accident on the way home from the vaccine you are probably recorded as a death. This poor communication strategy reminds me of how people who were 90 years old with stage IV cancer who died with a positive Covid test were recorded as dying of Covid. I guess these guys never learn. But, the take home message is that less than 10 people have died directly from the vaccine, making this probably the safest medical treatment in human history.
I have asked patients and friends who do not plan to be vaccinated why they are declining this treatment. Most just don't want to do it. They don't think it is necessary and some either don't believe the infection is real or feel they may have already had the infection, or don't believe the risk of dying is significant enough. But, we don't do vaccines or medical treatment only to prevent death. We also desire a high quality of life and if we can maintain that with a relatively simple treatment that has virtually no downside aside from a day or two of discomfort it seems like a relatively easy choice. For example, Covid can cause a permanent change in smell, most people recover but there have been a large number who haven't just lost their sense of smell but now have a smell disorder where everything smells like garbage. I would think that the quality of life would be impacted when sitting down to sip that glass of cabernet and readying to bite into that medium rare filet mignon and all you smell is the local dump. Do you think this might impact how you feel about life? Preventing that might just be worth it. How about the large number of people who a year after infection still can't play sports, concentrate at work or climb a flight of stairs without exhaustion?
I appreciate that state, federal and local governments are trying to create incentives to get people to vaccinate but have they done any actual outreach to the anti-vaxers to see what would motivate them? I have my doubts that a lottery or a free beer is going to impact this group. It may get people who plan to vaccinate anyways to move a little faster.
The reason this problem is pressing is that the next virus might be a lot more dangerous than this one and we need to be ready. We need to figure out now how to handle this better. Was there a better way to close the country? Could we have done preventive moves better with less economic trauma? Can we learn how to not only develop an incredibly effective vaccine in record time but convince our country that it is our patriotic duty to protect ourselves and others?
This virus was just a warm up, a warning of the future, and we need to be better prepared to fight this better with more cohesion because if we don't the future we have will not be the future we want. Imagine instead of a virus that kills 1% we have an infection that kills 20-30%. Would our economy survive? Would we have a complete societal breakdown? A 4 day disruption in oil flow nearly crippled the Eastern United States, what happens when no one is left to run the electricity? Keep the stores stocked? And in the meantime, consider whether it is your patriotic duty to be vaccinated.
