"I finally capitulated and got my first vaccination."

Delta means change. 

Events are changing ideas and behavior on vaccinations.

Political comment has focused on a shift in the message coming from the political right. The Republicans message had been that the vaccine was useless or risky, and not worth the risk--especially since Democrats were encouraging people get vaccinated. Events intervened to change the story. The delta variant, combined with realization that COVID hospitalizations and deaths were concentrated among the un-vaccinated in red parts of red states, made vaccine opposition seem foolish and self-destructive. 

Republican House Whip Steve Scalise just got vaccinated. Now he calls the COVID vaccine "safe and effective." Fox and Friends' Steve Doocy says to "get vaccinated." Fox's Sean Hannity now says a vaccination "absolutely makes sense."  Click: The Atlantic

There is evolution on what I consider the vaccine-skeptical left.  Some people are skeptical about high tech "Western medicine." They observe a medical industry, and are concerned with how financial incentives have shaped it.

Today's Guest Post is by Michael Shear, a college classmate, a physician, a resident of Cambridge, Massachusetts. He was a pioneer in Emergency Room specialization. He has practiced medicine in Massachusetts and Nepal, and is currently working for the Harvard Health Services. He just now got vaccinated and he shared with me his perspective on why he waited.

Photo from Michael Shear, center, with two colleagues.

Guest Post by Michael Shear, M.D.

I finally capitulated and got my first (Pfizer) vaccination last week. Harvard now requires it of all students and employees (I continue to work part-time at the Harvard University Health Services). I’m not happy about that. I don’t think an injection of a biologic agent that still only has an Emergency Use Authorization should be mandatory. The other reason I’ve capitulated is because the writing is on the wall: if you want to travel internationally any time in the near future, you’ll have to be vaccinated. But I’ll still be careful where I go and what I do, and have a low threshold for wearing a mask.

Of course I would be amazed if it doesn’t eventually get formal FDA approval, because the situation is so politicized that it would be unthinkable for it not to be approved. But as far as I’m concerned, we’re playing with fire.

I don’t have time to go into details (and the details are important). I would only say that the “science” is much more complicated than the public discussion would have you imagine.

If I felt at great risk of dying from COVID I would get vaccinated. As for the personal risks of COVID, I feel reasonably protected by my own behavior. The incremental benefit to me personally of vaccination I think will be small. Otherwise, I would wait. Either way, I would avoid high risk situations (prolonged exposure in small crowded spaces with strangers or anyone likely to be sick with a respiratory illness).

We aren’t going to vaccinate our way out of this. We will never attain herd immunity. It’s not possible with a highly contagious moving target, especially when you can’t get buy-in from nearly everyone (and why should you expect to when the vaccine technology has not been sufficiently vetted?). Science is undermining its own credibility with its careless messaging.

I am not an anti-vaxxer. But I know what good science is, and what isn’t. Most medical science isn’t. There is too much money and wishful thinking involved. We could do the studies that would give us the information we need, but they aren’t being done because people are impatient and most stakeholders don’t really want to know.

We still don’t really know how well vaccination prevents spread, so it’s hard to tell younger people that they have to get vaccinated, especially since they may incur a disproportion of the adverse effects (like the young women with cerebral vein thrombosis). If you come across studies that address explicitly the prevention of spread, please let me know. I just saw a preliminary report (from Qatar) in last week’s JAMA--the Journal of the American Medical Association--that suggested vaccination might be helpful, but we need more clean data without spin.

COVID could mysteriously disappear. I think it’s more likely that it will be with us for a long time, like influenza. We haven’t had much impact on influenza by vaccination. We’ve just learned to accept tens of thousands of annual deaths in the US as “normal”. We could adjust our cultural behavior to ameliorate that, but we haven’t, and from all indications, we probably won’t. I suspect it will be much the same with COVID.

The delta variant is raising many questions. And we here in HUHS are seeing more cases of COVID in vaccinated patients, though the University is keeping as quiet about it as possible and not letting us test for variants. There was an outbreak last week in Provincetown. Also an outbreak on the Yankees, all vaccinated.