The battle against the coronavirus pandemic is further splintering Americans into brittle groups, segments familiar because they long have been components of the inequitable U.S. health care system — let’s call them the have nots, the have somes, the have much, and the won’ts.
Regulators have decided that those who have some protection with lifesaving vaccines are now eligible for more — a third dose of the Pfizer vaccine. It will be given six months after the original two-shot regimen was completed to people:
- older than 65
- at high risk of becoming severely ill with Covid-19
- at risk of serious complications from the disease due to frequent exposure to the coronavirus at their jobs.
Those with compromised immune systems, such as cancer and transplant patients, already were allowed to get a third Pfizer or Moderna shot. A slice of older or wary people also have worked with their doctors or ignored guidelines, fibbed, and gotten the additional shot.
Disagreement over the need for a third shot
Biden Administration officials pushed for the boosters, arguing they would help people protect themselves as the vaccines waned in effectiveness. They got hefty push back from experts on their plans. Dissenters said the available data — from other nations and the product makers — showed that the vaccines continue to provide high effectiveness against infection, hospitalization, and death. The greater need is for more people, in this country and globally, to get their first and second shots, not for a third dose. Further, dissenters argued that discussions of boosters and vaccines’ waning effectiveness might fuel further doubt about the coronavirus shot.
Confusion will hang over the national vaccination campaigns for a time now. That’s because makers are still submitting data and regulators are still considering whether additional doses will be recommended for two other vaccines that tens of millions have gotten in this country — products made by Moderna and Johnson and Johnson. Those decisions will be made soon, officials said, though critics slammed the discrepancy, asking what sense it made that half the country (vaccinated with Pfizer) now can get a third dose but not the other half (vaccinated with Moderna or J&J).
Rochelle Walensky, the head of the federal Centers for Disease Control and Prevention (shown above), also threw regulators for a loop when she used her authority to override her agency’s advisors and to allow individuals at higher coronavirus risk because of their work to qualify for a Pfizer booster.
Critics said the administration’s booster qualifications — which also allow patients to “self-attest” about their eligibility — have thrown the doors wide open for most people who got the Pfizer shot to get the booster.
A scramble is now on to ensure that seniors in nursing homes and other long-term care facilities get third doses and that adequate vaccine supplies are available in pharmacies and doctors’ offices, where most of the inoculations are now occurring. Administration officials say they have worked with major drug store chains, hospitals, and public health clinics for weeks to roll out with urgency an estimated 60 million shots. Federal officials report that, as of Sept. 24, 213 million Americans older than 12 had gotten at least one coronavirus shot (75% of that group) and 183 million of us are fully vaccinated (64.5%).
The current vaccine push will differ from the earlier national campaign, of course, because the third dose is voluntary. Some patients will talk with their doctors and decide to wait or skip this shot.
Vaccinating the willing, tussling with the ‘antis’
For public health officials, of course, the added traffic of those seeking boosters may add yet more to their toil as they continue to seek out the have nots — the poor, working poor, poorly informed, uninsured, and others who are willing to get vaccinated but have not overcome obstacles to do so. These individuals may worry about their immigration status, may work odd shifts that do not accommodate vaccination schedules, or may not be near facilities where they can get shots. They also may be misinformed about the vaccines’ cost (free), safety (high), or effectiveness (excellent).
The unvaccinated, especially those who will not consider getting the coronavirus shots, are causing huge harms — to themselves, those around them, and the U.S. health system and the exhausted folks who work in it and deserve great praise.
While the anti-vaccination crowd crows about the preeminence of their purported individual rights and their mistrust of authority and modern medicine, they do not hesitate to overwhelm hospitals, clinics, and doctors’ offices when infected with the highly contagious Delta variant. This means long waits or delayed care for patients with urgent treatment needs but not associated with coronavirus emergencies. This is a big, needlessly painful consequence of the pandemic and a Delta variant surge that has killed more than 690,000 and infected almost 43 million.
The unvaccinated have pushed health systems in Alaska, Idaho, Montana, and Oregon into alarming treatment territory in which doctors, nurses, and hospitals must make impossible choices as to which patients receive care — and which might not.
Further, health workers report that the anti-vaxxers — even as they lapse into critical condition — berate medical staff trying to save their lives and insist they should not be vaccinated (it’s too late) or that they should be given remedies that are hokum and could harm them.
Groups are gathering on social media and urging others to pull critically ill loved ones from hospital intensive care units, so they can be at home and receive bunk treatments (that likely will kill them).
In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damages that can be inflicted on them by an array of awful circumstances and things, including:
In these cases, a crowd of problem people and institutions — these can include doctors, hospitals, insurers, regulators, and politicians — may press victims to move on, settle, and they fast forget the lonely agony of the suffering. It can, however, take a long time for patients to recover from terrible illness or injury. Harms can last a lifetime. Patients may need medical services, as well as financial and other support for months or years. They also need closure and justice for wrongs done, as well as the sense that they may be able to help others avoid the problems that afflicted them.
We are not done with the coronavirus and the huge trauma it has inflicted on us all. Please get tested, if appropriate, and get vaccinated. Officials are trying to make it as easy and convenient, as possible — and it’s free. All medical interventions carry risk. But vaccines’ benefits long have been shown to far outweigh their harms. If you’re uncertain about getting a booster, talk to your doctor, pronto. And, while you’re at it, ask about and get your annual flu shot. We cannot ignore disease and death and embrace nihilism and fatalism. We can quell the coronavirus and we must do so before it mutates again in ways that can be even more disastrous.
