April 5, 2021 – “It’s not for yourself,” Paul realized, “I finally did the right thing.”
Paul and Sue have never met. Living 1,000 miles apart, they are at different stages in their lives. Paul, in his 50s, oversees 1,500 employees in his role as an operating executive for a large health services supplier. He and his wife, a teacher, raised three adult children and now dote on their three pre-school-aged grandchildren.
Sue, in her 30s, is a hospital nurse. She and her husband are raising three children, one in high school and two in middle school.
Paul and Sue shared a view with millions of their fellow Americans: they weren’t getting vaccinated.
Paul held deep convictions against getting jabbed. “I have worked for 25 years. I never had a flu shot. Never missed a day of work,” he argued. “I got this from my father. He never missed a day in 35 years.” In Paul’s world, you buckled your bootstraps every day and put in an honest day’s work. You took care of your own health and well-being.
Paul’s COVID vaccine hesitancy ran still deeper: he bristled at media sensationalism of the COVID-19 crisis. To Paul, the cacophony of doom-and-gloom distorted the actual risk, reducing the media to nothing more than the “boy who cried wolf.” Suspect guidance from the CDC early on – but since modified – strengthened Paul’s resistance, “if I’m vaccinated and can still transmit, why bother?”
Sue didn’t share Paul’s view that the crisis was overblown. She witnessed up close the pain and suffering of those in the Covid unit of her hospital. Sue saw fear in the eyes of her patients as the virus ravaged their bodies. She was close enough to the devastation that she could predict which patients would suffer life-threatening oxygen deprivation during her shift.
None of this convinced Sue she needed a vaccine’s protection. Her patients were older and had risk factors that she did not. The protective equipment she wore while working her shift and her well-honed safe hygiene practices were enough to protect her and her family.
Yet, both Paul and Sue changed their minds. Both were vaccinated, even while reaching their decisions in different ways.
Paul realized that it wasn’t about him. The tipping point came when one of his managers, Ted, tested positive. Ted’s medical history placed him at high risk for complications from a COVID infection. He took all the prescribed precautions but still could not resist the virus’s grim clutches. Paul began worrying about how he might unwittingly expose someone like Ted. It struck Paul that getting vaccinated wasn’t about protecting himself. It was about safeguarding Ted and others at risk. When the CDC updated its guidance to suggest that vaccinated people were at low risk of transmitting the virus, Paul changed his mind.
Almost reflexively, Paul drove to a nearby church that set up a vaccine clinic. Getting jabbed before he could change his mind again, his thoughts then shifted to a more significant concern: his distress that a nearly all-white crowd was getting vaccines intended for an underserved black community.
Paul’s friends, many of whom have been outspoken anti-vaxxers, others more fittingly described as vaccine-hesitant, also seem to be warming to the vaccines.
Sue took a more clinical approach in changing her mind. She never objected to the vaccine; she didn’t see its value to her. Nonetheless, Sue kept questioning. She consulted doctors on staff at the hospital she worked and at the teaching hospital downstate. She researched the ingredients used in making the vaccines. She poured over data from the clinical trials.
Her efforts assuaged her anxiety about the vaccines’ risk. However, the reward still wasn’t enough for her. Her risk factors didn’t scream to her to get vaccinated.
That is until she watched the demographics of her patients change. Her unit began to fill with people her age – young and otherwise healthy people suffering stroke-like symptoms. The shock overwhelmed her. Sue grasped that she and her family were at greater risk than previously believed. She got the vaccine without telling her husband, fearing that his libertarian views would weaken her new-found resolve.
Vaccine hesitancy and anti-vaxxing views are declining in the United States. A recent Kaiser Family Foundation poll discovered that more than six-in-ten Americans have already been vaccinated or plan to do so as soon as possible. Only one-in-five will definitely not or will do so only if required. As recently as December, one-in-four would not get vaccinated or would only do so if required. Only one in three wanted to be vaccinated as soon as possible.
It certainly helps that vaccine supplies are improving; that CDC guidance for vaccinated persons is more encouraging; and, that real-life reports of vaccine effectiveness are more optimistic than the clinical trials.
Vaccine Supplies. More than 200 million vaccine doses have been distributed to states and vaccination centers across the country. More than 165 million doses have found their way into arms. Better still, the vaccination pace has accelerated lately: an average of three million doses were administered each day this past week. We set a daily record by administering nearly four million doses on Thursday and then shattered this nascent record with Friday‘s 4.1 million jabs. Saturday’s 3.6 million were the fifth-best day to date.
How’s this for perspective: we have fully vaccinated more than twice as many people in the U.S. as there are people with a detected Covid-19 case. Nearly one-in-three Americans have been jabbed at least once. More than half of senior citizens are fully vaccinated; three of four have received at least one dose.
Most states have announced plans to open vaccine appointments to all interested adults ahead of President Biden’s May 1 target date.
Coupled with immunity protection provided by an infection, nearly half of all Americans may have developed immunity protection from a COVID-19 infection.
CDC Guidance for Vaccinated Persons. The CDC released new guidance on Friday that eased restrictions on fully vaccinated persons. With this new guidance, vaccinated persons may travel within the United States without first getting tested for COVID-19 and without quarantining afterward. The U.S. will no longer require a COVID-19 test for international travel or self-quarantining upon return.
In March, the CDC released guidance that fully vaccinated persons could visit other vaccinated persons indoors without masks or physical distancing; they could forgo quarantining or testing after a known exposure if the person didn’t show symptoms of an infection.
This evolving guidance demonstrates growing confidence that vaccinated persons are at low risk of infection and transmission to others. It enhances the risk/reward calculus for persons weighing a decision to get vaccinated.
Real-Life Reports of Vaccine Effectiveness. COVID-19 vaccines are proving to be as effective in preventing infections as predicted by the clinical trials, if not more effective. In a study published last Monday by the CDC, the Pfizer/BioNTech and Moderna vaccines were 90% effective in protecting more than 4,000 healthcare workers, first responders, and other healthcare workers against even asymptomatic infections. Unlike the clinical trials, this study encompassed a period during which the so-called variants-of-concern circulated widely in the population. The study also showed that the initial vaccine dose was 80% effective within two weeks – better protection than indicated during the clinical trials.
A separate study found that the Pfizer/BioNTech vaccine retained its effectiveness for at least six months. As researchers continue monitoring vaccine recipients, they anticipate seeing that immunity is even longer lasting than six months.
Israel provides the most explicit roadmap to vaccine effectiveness. This country has pursued an aggressive vaccine strategy, administering more than twice as many doses per capita as the United States and an astonishing 14 times the global average. Vaccinations were opened to everyone 16 years and older on Feb. 4. Since Jan. 16, when it suffered from one of the highest infection rates per capita, Israel has seen its infection rate plunge 25-fold. It now has one of the lowest infection rates globally. Hospitalizations and deaths have dropped across all age groups, mirroring the timing of the vaccine rollout.
Improved vaccine access and acceptance come at a critical juncture in the U.S. New infections began rising here two weeks ago, chiefly among unvaccinated persons between 18 and 50 years of age. Surges began earlier and have been steeper in Brazil, Chile, Italy and Spain (among others), where vaccination efforts are lagging. Our relatively strong vaccination rates have spared us from the steep surges seen elsewhere and have likely restrained hospitalizations and deaths. Nevertheless, mimicking Israel’s experience with plummeting infections may require vaccines to be as widely administered here as in Israel.
At the current pace, that may only be a matter of weeks.
Contributing writer:
Mark A. Van Sumeren, strategic advisor, Medical Devices & Integrated Delivery Networks Health Industry Advisor LLC, provides a regular report on COVID-19 numbers for the health care industry.
For more information, or to sign up for the report, contact Mark at Mark.VanSumeren@HealthIndustryAdvisor.com; or visit www.HealthIndustryAdvisor.com.