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Ask Dr. Halverson: COVID-19 vaccination: An opportunity for all adults to end this pandemic

web 4 17 Halverson photo
By Dr. Jim Halverson

On April 15, every resident of California aged 16 and over will be eligible to be vaccinated for COVID-19.

The impact of vaccinations in Ventura County on hospitalizations, ICU admissions and deaths from the SARS-CoV-2 virus has been substantial since vaccinations began in mid-December. For much of December and January, our county was averaging more than 400 people in our hospitals, including more than 100 in intensive care units, where they were often staying for long periods of time. Hospitals were often at capacity due to COVID-19. Elective surgeries were canceled. Visitation was severely restricted or not allowed at all. Deaths were occurring at alarming rates, especially in those 65 and over, and many people were isolated from family when they were desperately ill. Many of those who have recovered continue to have significant symptoms, including shortness of breath, severe fatigue and difficulty with memory and concentration.

As vaccinations have rolled out, these very difficult situations have improved dramatically. Vulnerable individuals who have been vaccinated are now much more protected from serious illness. There are only 22 people hospitalized in Ventura County hospitals and eight in the ICU as of April 8. Hospital staffing shortages are much less severe as health care workers have been vaccinated. Businesses have been able to reopen. We are able to anticipate a gradual lessening of the impact this pandemic has had on all of us.

Here are the current vaccination statistics in Ventura County as of April 7.

Total doses administered- 480,850

Percentage of eligible county residents who have received first dose of a vaccine — 45.6%

Percentage of eligible county residents who are fully vaccinated — 27.2%

In Ojai (93023 ZIP code), the numbers are even better. Forty-six percent of our residents have received at least one vaccine dose and 26.2% are fully vaccinated. The outstanding efforts of our Ojai Valley Community Hospital, under the leadership of Haady Lashkari, Help of Ojai, the Ojai Unified School District as well as many others who have volunteered to staff our Nordhoff High School site, have helped us to achieve these very good rates.

When I ask patients in my medical practice who are eligible to get the vaccine if they have been willing to get vaccinated, the vast majority say yes. Most have already received at least the first dose and many are fully vaccinated. Side effects have generally been mild. All are pleased to have been given the opportunity to receive the vaccine and they state that they have done it not only for themselves but for other family members, friends or for the overall health of our community.

Now that all of us will have the opportunity to be vaccinated, let’s look at the most common concerns regarding vaccines that I have been asked about in my office or are frequently brought up in the news.

 

VACCINATION CONCERNS

1) Case rates in the United States are going up despite more than 3 million people nationwide getting vaccinated every day. Doesn’t this suggest that they are not as effective as we are being told?

As of April 4, 32% of the U.S. population has received at least one dose of vaccine and 18.5% are fully vaccinated, including 55% of the people 65 and over. The age distribution of cases is changing. In Michigan, where cases are up by 400% in the past two months, most cases, hospitalizations and deaths are occurring in unvaccinated people under age 65. In Detroit, many are occurring in the Black population, where vaccination rates are significantly lower due to difficulty with access to vaccines for Blacks and a significant hesitance in their population to take the vaccine. Rather than focusing on national statistics, I advise people to look at what is happening in our county, where Ventura County Public Health has been very proactive in getting the vaccine to migrant farmworkers and our older population. Where people have good access to the vaccine, the declining case numbers confirm they work. 

 

2) The vaccines are new. I don’t think they are safe. I want to wait until more people get them before I will consider being vaccinated.

The initial trials for both the Pfizer and Moderna vaccines started in mid-March of 2020. As of April 4, 2021, more than 165 million doses have been given in the Unites States and many millions more around the world. Yes, there have been severe reactions. Fortunately, they are rare. The most mentioned is a severe allergic reaction called anaphylaxis. It is the reason that everyone is observed for at least 15 minutes after receiving the vaccine and 30 minutes if they have a history of a severe reaction to vaccines, medications or food. The incidence to date of these reactions, which occur within minutes of the vaccine and must be reported, are 11 per 1 million vaccinations. No fatalities have been reported. 

 

3) I am in good health and should have no trouble if I get COVID-19. I believe healthy people under 65 do not need to be vaccinated. 

It is clear COVID-19 gets worse with age. However, there is no age that is absolutely safe. Those in their 50s and early 60s are three times more likely to die from the disease than a 40 something, and 400 times more likely to die than a teenager. Even children are at slight risk of serious disease. At least 279 have died across the United States since the start of the pandemic. The highest number of confirmed pediatric deaths recorded during any of the previous 10 flu seasons was 188, according to the Centers for Disease Control. More than 2,500 children have developed a rare but serious disease that is linked to COVID-19 called multisystem inflammatory syndrome (MIS-C). Additionally, an article published April 2 on WebMD, a highly regarded source of medical information, illustrated how the rising number of cases in children in the Midwest and the Northeastern United States are increasing the spread of more contagious variants in those areas. Finally, recent data from the United Kingdom show that 10% to 15% of children infected with COVID-19 still had at least one symptom five weeks later.

 

4) The side effects of the vaccine are likely to be worse than having COVID-19 especially if I am under 65. 

The vaccine can cause a sore arm, chills, fever, fatigue and several other symptoms in the first few days. That is just the immune system doing its job. Severe illness from the vaccine is very rare. But severe illness due to COVID-19 is not rare. Based on data from COVID-NET, a surveillance network that captures hospitalizations across the United States, hundreds of thousands of people under the age of 50 have likely gone to the hospital with COVID-19. Several studies have indicated that at least one-third of hospitalized people suffer from long term symptoms of COVID-19. Ironically, getting vaccinated against COVID-19 has helped many improve.

The idea that the vaccine is worse than the disease for people under 65 falls apart when we consider death. Approximately 100,000 people under age 65 have died of COVID-19. Meanwhile, out of the 165 million doses of vaccine delivered in the United States, a CDC review of clinical information found no information that they had caused any deaths as of this time. The current score between non senior pandemic deaths and conclusive vaccine deaths is 100,000 to zero.

Finally, I received a touching voicemail a week ago from a woman who left only her first name and stated that she was not a patient of mine. She did not leave a phone number. She wished that I would give some positive news to people who are hesitant to get vaccinated or are simply not going to get it. Several of her vaccinated friends and family had been excluding her from small gatherings and she felt that she was being unfairly treated.

I believe that we all should feel hopeful as vaccinations increase, whether we receive the vaccine or decide not to. For those of you who are fully vaccinated, (two weeks after your final vaccine dose), remember that you can spend time with an unvaccinated individual, according to the CDC,  even inside and briefly unmasked as long as they have no symptoms and are not at risk from getting COVID-19. Please refer to the CDC guidelines regarding this. If you are not vaccinated, thanks to the millions in the United States that are and will be in the next three months, your opportunities to spend time with people you enjoy and resume activities you have missed will also improve. 

This stage of the pandemic is a race between the variants that are more contagious and the number of people who get vaccinated. In many states, such as Michigan, normalizing behavior combined with more contagious strains of the virus are pushing up cases again. This is not evidence that America’s vaccination campaign is not working. Rather, it highlights the urgency of moving faster to deliver vaccines, which is our best chance to control the spread of more contagious variants and bring this pandemic to an end.

Stay hopeful, stay diligent, stay properly informed, stay safe and stay well.

— Dr. Jim Halverson is a longtime Ojai physician who writes a weekly column on COVID-19 for the Ojai Valley News.