Harriet Okatch

Harriet Okatch

In May, after some 14 months, states across the country relaxed the stay-at-home and shelter-in-place orders instituted to prevent the spread of COVID-19. The number of COVID-19 cases, hospitalizations and deaths were then on the decline across the country.

These successes were partly a result of the various public health measures that had been implemented, including mask mandates, reminders to wash and sanitize hands frequently, social distancing and contact tracing. On Dec. 11, 2020, vaccinations were added to the COVID-19 prevention tool kit when the U.S. Food and Drug Administration issued an emergency use authorization for the Pfizer-BioNTech vaccine.

Vaccination rates peaked in April 2020; about 3 million individuals were getting vaccinated each day.

The COVID-19 vaccines have been proven to be prevent severe illness, hospitalization and death. The vaccines are effective and safe and have few side effects, including pain, redness and swelling to the arm to which the shot is administered, and tiredness, headaches, muscle pain, chills, fever and nausea to the rest of the body,

The question, “to get vaccinated or to not get vaccinated?” has been on the mind of folks since the beginning of the year.

Proponents of vaccinations trust the science, have lost loved ones to COVID-19 or just want their lives to return to normal. Opponents of vaccinations argue that the long-term effects of the virus and the vaccines are unknown; many just wanted to exercise their freedom of choice to not get vaccinated.

However, and unfortunately, there is a third group that exists and these are individuals for whom the COVID-19 vaccines may not be effective because their immune systems are compromised. Booster doses of the Pfizer and Moderna vaccine are being offered to these folks, but they also would be helped if communities attain herd immunity against COVID-19. So, too, would be the relatively small number of those who cannot be vaccinated because they are allergic to the vaccines’ components.

Herd immunity is acquired in a community when enough individuals in the community are protected from the disease. For COVID-19 it was estimated that herd immunity might occur when 70% of the population is vaccinated. The highly transmissible delta variant has pushed that estimate to over 80% and perhaps upward of 90%.

Vaccination rates vary by state and by county. In Pennsylvania, 56% of the total population is fully vaccinated (70% is at least partially vaccinated), according to state Department of Health data. In Lancaster County, slightly less than half of the total population is fully vaccinated.

In the United States, vaccinations also vary by age: 82% of those over 65 years are fully vaccinated, compared to 64% of those over 18.

Low vaccination rates result in outcomes that are financially and emotionally demanding and lead to continued COVID-19 infection and the spread of variants such as delta.

The delta factor

At the beginning of August, the Centers for Disease Control and Prevention reported that the delta variant accounted for 93% of COVID-19 cases in the United States. The CDC says that the delta variant is more than two times as contagious as previous variants.

According to a report published recently by the CDC, a July study of Los Angeles, California, public health records found that unvaccinated people had five times more COVID-19 infections than fully vaccinated people, and had 29 times more COVID-19 hospitalizations. Nearly all of those now dying of COVID-19 are unvaccinated.

Even moderate cases of COVID-19 may prevent an individual from working. And for those who do not have the option of remote work, this might mean an interruption in pay. In addition, sickness is associated with emotional pain for friends and family members and if they have to be caregivers, this can interrupt their pay as well. In the event of a death, families incur funeral costs; death of breadwinners may place a financial strain on the family. Loss of life is always accompanied by emotional strain to the family and friends, and loss of potential years of productivity to the community.

Protecting one another

Health care providers are reporting increased levels of mental health disorders associated with the numbers of COVID-19 cases. A study by the Kaiser Family Foundation found that during this pandemic, “about 4 in 10 adults in the U.S. have reported symptoms of anxiety or depressive disorder, a share that has been largely consistent, up from one in ten adults who reported these symptoms from January to June 2019.”

And according to a Kaiser Family Foundation/Washington Post survey, 62% of front-line health care workers say that worry and stress related to the pandemic have negatively affected their mental health.

Increasing the number of vaccinated folks would result in a reduction in the number of hospitalizations and relieve some of the burden on front-line health care workers, who also have to worry about infecting children who are too young to be vaccinated against COVID-19.

Unvaccinated individuals should consider getting vaccinated to protect the health of their fellow citizens, to protect the economy from the financial hardships that result from job losses and unpaid time off, and to reduce the emotional wreckage associated with sickness and death.

In addition to vaccination, the use of masks, frequent hand-washing, social distancing and contact tracing are critical ways to curb the epidemic. All of these prevention measures can be accomplished at an individual level except for contact tracing, which is generally the purview of a health department.

Penn Medicine Lancaster General Health ended its COVID-19 contact tracing effort in June, so the county now relies on the state health department to conduct contact tracing.

A county health department would be able to perform this important task. A local department of public health would also develop COVID-19 preventive messages in the different languages spoken in this county, and could disseminate those messages efficiently and effectively. Finally a local public health department can provide data that can inform policies and practices that are beneficial to the community.

Harriet Okatch, Ph.D., is an assistant professor of biology and public health at Franklin & Marshall College.

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