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  • Writer's pictureDr. Bow Tie

I'VE DONE WHAT YOU ASKED AND GOT VACCINATED, NOW I'M BEING FORCED TO GET A BOOSTER?

Today is my 33rd birthday. My second birthday in the pandemic. I wish I didn't still have to write these posts, but here we are. I make these posts to educate and answer questions, but I know that often gets shoved aside or drowned out by those who use their platforms to prey on people's insecurities and misery in a global pandemic. People are tired of the changes we have had to make, and the desire to return to pre-pandemic “normal” is starting to override everything, and the disinformation-mongers of the pandemic are seizing that opportunity to drop all protections (some in favor of their own products). If I’m being honest, even though I still believe we can work closer to eradication of COVID, the world will never go back to 2019 “normal.” This pandemic has changed some things permanently. Still some things have actually remained the same even though they seem different, which brings us to today's topic.


Last year a vaccination mandate was handed down and some folks weren't happy about it, but a majority approved and an even larger majority did what they had to do to protect others (some viewed it solely as keeping their job, I suppose).

With the latest surge, we were faced with a booster mandate for a hot second there and for whatever reason all of the previous complaints, resentment, and vitriol came back. That booster mandate has been delayed (to avoid personnel shortages), so I am left standing here bewildered at people's stance relapses. I've had a few conversations with a few different people who objected to it, so let's discuss the common points. Some of you will see elements of our conversations here, but I'm not calling anyone out - if I'm addressing something you said, other people definitely also said it.


I SHOULDN'T BE FORCED TO DO SOMETHING TO KEEP MY JOB!

There are requirements for every job. I am always surprised to hear this from healthcare workers because we work in places where vaccinations have been required for decades. Physicians, NPs/PAs, nurses, respiratory therapists, and nearly anyone else that works in healthcare had to have up-to-date vaccinations when they entered school. If their vaccinations were out-of-date or titers were low (because sometimes that happens), they were given a booster. None of this has been new for a long time for anyone that works in a healthcare setting (which also includes social workers, discharge planners, environmental staff, and more).

Now, as we face a pandemic that killed 2,000-3,000 people EVERY DAY last week, suddenly it seems like a strange thing?


BUT THESE VACCINES DON'T STOP SPREAD! EVEN VACCINATED PEOPLE GET COVID-19!

They do limit spread, actually. I've said this from the beginning - vaccinations are not meant solely for individual protection. You cannot spread what you don't get, and if you get rid of the infection much faster due to vaccination, that is also less ability to spread.

There are still a great many people who have gotten their vaccines and their boosters who have NOT gotten COVID-19. Yes, there ARE high numbers of vaccinated folks who get COVID, but that's because they're part of a high number of COVID cases in general. More severe disease happens in those not vaccinated, by a much higher percentage overall if you look at state-by-state rates (which are harder to find as states stop reporting, but I showed a few in a recent post).

Vaccines were never the sole component of protection, either. No one has EVER said that vaccines are 100%. They are a cornerstone, but a cornerstone alone does not make a building. Layers of protection (masks, distance, ventilation, frequent testing) have always been key to avoiding one of the most contagious viruses of our time.


THE PEOPLE I SERVE AREN’T REQUIRED TO GET VACCINATED IN ORDER TO USE SERVICES, WHY IS IT ON ME?

To be frank, I'm frustrated by this at times, too. You will not find me making jokes about how people shouldn't seek care if they don't get vaccinated. If you come into the hospital, we'll take care of you, no matter how frustrating your life choices may be, and you get the same care as anyone else if not vaccinated. Healthcare remains a human right. But why wouldn't you take every step to stay out of the hospital nowadays? Healthcare workers are suffering...we are not okay. We've watched SO many people as they become sick and leave disabled or dead. We went from being called "heroes" to being yelled at and shamed. And we are unable to provide the best care we can when our hospitals are overwhelmed. Staff shortages happened even before COVID, but now they're a consistent part of the pandemic with every surge, and it means patients suffer. Get vaccinated and use mitigation for them.


OMICRON IS MILD! WE’RE JUST GONNA BE ENDEMIC!

"Mild" in terms of this disease just means fewer adult cases requiring intubation and/or the ICU. The reason we have seen fewer cases or "milder" cases is, in large part, due to vaccinations. But the healthcare system still suffered immensely during this past wave. As I said, 2000-3000 people dying daily (and that was on the downtrend) is not mild. Highest rates of pediatric infection, hospitalizations, and deaths are not mild.

There is benefit to post-vaccination Omicron infection acting like a booster, but as we already know, infection-mediated immunity is temporary and even when present, it is not reliable. It buys time, but the vaccine-mediated immunity is more consistent (the new variant determined the need for a booster mandate, not waning immunity).


”Endemic” disease still requires extreme vigilance. "Endemic" doesn't mean we get to stop thinking about it. In places with other diseases, such as in parts of Africa where Ebola is endemic, there is a significant degree of vigilance and when an outbreak occurs (not if, but when), action is immediately taken with lockdowns and quarantines. With a disease as widespread and easily contagious as COVID-19, that vigilance would mean it's still just as pervasive in our consciousness as it is today. You'll still be looking at weekly COVID reports of transmission and hospitalization, and that would still affect businesses and other parts of our pandemic response. So no, we don't get to shrug it off as "endemic" despite what media commentators want to say.


IF PEOPLE ARE STILL SCARED OF IT, THEY SHOULD JUST STAY HOME!

That's not how it works. By existing in public, we have a societal contract to contribute to public health. That's why we wear seatbelts, obey traffic laws, refrain from smoking on airplanes, and so many other day-to-day things that nowadays are understood. If you choose not to contribute to public health, then YOU can stay home. Don't put others at risk.


MY BODY, MY CHOICE!

Stop it. It’s disingenuous and malicious, a deliberate misinterpretation of that slogan and its purpose. We’ve discussed this already.


WELL, AM I GONNA HAVE TO DO THIS EVERY YEAR? AM I GONNA BE MADE TO GET A BOOSTER EVERY YEAR TO KEEP MY JOB?

No. We are still learning about this virus and what is needed for protection (and remember, boosters are nothing new for vaccinations), but it's important to remember two things:

  1. The vaccines+booster provide great protection, even against Omicron.

  2. The original two-dose vaccines WERE high protection against pre-Omicron variants.

  3. Variants emerge because not enough people are vaccinated. Variants emerge when viruses are allowed to replicate and spread, and that happens most in people who are not vaccinated.

  4. Boosters become necessary with further variants.

So if you want to stop the need for additional boosters, then #GetVaccinated and get everyone you know vaccinated and boosted. Not to mention other layers such as frequent testing prior to gathering, masking when needed, (#VaccinateAndMitigate) so that we stop further variants from developing.


3-Vaccine Regimen vs. Delta & Omicron: https://jamanetwork.com/journals/jama/fullarticle/2788485

Boosters vs. Omicron (Letter to the Editor with Data): https://jamanetwork.com/journals/jama/fullarticle/2788487

Vaccine-mediated immunity vs. Infection-mediated: https://www.nature.com/articles/s41598-022-06629-2



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