The degree of polarization around the COVID-19 vaccine today is not surprising. One perspective comes from those who are champions of individual rights, bolstered by what they read and hear about the dangers of the vaccine. On the other side are those who accept the reported science and believe vaccinations are the only solution to the pandemic.
Those of us who have had the privilege of watching human nature for many years remember similar battles around compulsory use of seat belts, motorcycle helmets, fluoridation of water supplies, and various other public health mandates. Perhaps the most pertinent example is smoking. As long as your smoking was just a danger to you, we were willing to let you pursue your habit. But when research showed that second-hand smoke from you is damaging my health, the tide turned, and smoking bans were instituted in public places.
That seems to be the crux of the controversy today. If someone wants to risk their health, and even life, by not being vaccinated, that is their right. But when their decision puts others at risk, it assumes a broader public health impact for all of us. That is what so many of our health professionals feel today, as we are now faced with caring for many unvaccinated patients who neglected or refused to be vaccinated. More than 90% of admitted patients and deaths at hospitals and throughout the country today are among this group. And their decision enables the virus to continue to spread, placing children and others at risk of the infection. The frustration and even anger from many of these working health professionals caring for ill and dying patients is increasingly being expressed.
But what about all the dangers of the vaccine that are reported in our information-saturated society? I could try to chase down all the stories, from embedded microchips, to fertility threats, to long-term genetic alterations, to its experimental status (although Pfizer’s vaccine is now approved by the FDA for general use). But I am afraid that suspicions are hard to change, as we all tend to look for evidence that bolsters our beliefs. In these situations, one needs to balance the data from all sides when seeking to make a wise decision. It is also important to check credentials and find trusted sources of information.
As an old public health doctor who has worked in vaccination programs for 50 years, I have seen the incredible benefit of vaccines. We have eliminated smallpox, largely stamped out polio, and controlled measles, diphtheria, pertussis, tetanus, hepatitis A and B, and many other infectious diseases. Many of these are what we call live-attenuated vaccines, meaning the virus has been modified in the lab to largely eliminate its infectivity and danger but still retain enough characteristics of the virus to stimulate the production of antibodies. While there has been controversy around each of these in years past, they are all accepted now by the vast majority of people and have become required in this country for our children to attend school and health professionals to work in health care settings. Everyone has benefited from these vaccines.
But this one is different, they say. Yes, it is born out of the urgency of a rapidly spreading pandemic. We have benefited from an advanced understanding of how our immune system works and ways to use it more effectively against infections. We are also blessed with a delivery mechanism, mRNA, that was developed in 2005 and can now be used to stimulate antibody production and inhibit viral growth. These new vaccines use our own God-given defense mechanisms to target the spikes on the COVID-19 virus and inactivate it. The mRNA vaccines never enter the cell nucleus and cannot change our DNA. Like most vaccines, they are not 100% effective and do have minimal side effects. But the risk from the actual disease is many times greater than any risk from the vaccine, as shown in many studies and the 170 million Americans who have now received them.
So how will this end? It is hard to say, though some believe this virus will continue to circulate through our society until everyone has either received the vaccine or had the infection. That would be a tragedy when we have such an effective tool and can avoid many needless deaths.
It is unfortunate that many organizations, including hospitals, are having to resort to mandates to push up their vaccination coverage of employees. It seems that these mandates, especially from the government, only accelerate the suspicion about the vaccines. Some feel outside forces are seeking to control us. Others believe this is a fulfillment of prophecy or evidence of evil forces. But most of us accept that these mandates are apparently necessary to protect us from ourselves in these situations. This is very similar to what we have gone through with other public health measures when society determines the greater good requires the subjugation of individual rights, as sincerely held as they may be.
We have been here before, and it usually takes a decade for any new measure to be fully accepted. My hope and prayer is that logic and understanding will prevail, and our class warfare can end as we seek to protect each other. Until we do, COVID-19 infections and deaths will continue to ravage the world.
Richard H. Hart, MD, DrPH is President of Loma Linda University Health. This originally appeared in the "Notes from the President" newsletter on August 26, 2021. Reprinted with permission.