Unvaccinated coronavirus patients express regret; urge others to get the vaccine

·9 min read

Aug. 15—Words of regret.

Dr. Jennifer Hanrahan hears them frequently now from unvaccinated people who are about to die.

You've heard such anecdotes in the national news about people elsewhere in the country who came to realize on their deathbeds they should have gotten vaccinated.

But that's not just happening in faraway places. Those words of regret are being spoken right here in Toledo, within earshot of medical providers like Dr. Hanrahan, who runs the infectious-disease programs for both the ProMedica and the University of Toledo's College of Medicine and Life Sciences.

And she said she is witnessing a lot of needless death and suffering by those who refused to get vaccinated or waited too long.

"Once you're in the hospital — critically ill with COVID-19 — it's a little late to get a vaccination," Dr. Hanrahan said. "The [unvaccinated] people I see every day, who are sick, are deeply regretful they did not get vaccinated."

While it's too late for an epiphany as death nears, the three types of vaccines now available in the United States — Pfizer, Moderna, and Johnson & Johnson — offer scads of scientific research with ironclad conclusions: The vaccines Americans get really do work and are generally better than some used in other countries.

They won't eliminate all possibility of catching the virus, but they are highly effective at keeping it from ravaging bodies — even the highly contagious delta variant, which has freshly spread like wildfire across the nation. The U.S. Centers for Disease Control and Prevention claims it's as contagious as chickenpox.

No vaccine is 100 percent effective, though.

Dr. Carlos Malvestutto, an Ohio State University associate professor of infectious diseases and principal investigator of coronavirus trials, said he and other experts have been blown away by the effectiveness of the two mRNA vaccines, Pfizer and Moderna.

Both have effectiveness ratings in the high 90th percentile for the coronavirus strain that predominated until recently. And they're nearly as effective against the delta variant, Dr. Malvestutto said.

According to the New England Journal of Medicine, the two-dose regimen for Pfizer and Moderna must be followed to have substantial protection against the variant. Skipping that second dose hurts effectiveness.

Even the Johnson & Johnson vaccine, which is rated in the high 80th percentile for the delta variant, is well above the threshold for emergency authorization. Vaccines have to be at least 60 percent effective to be considered for emergency use, Dr. Malvestutto said.

The small cadre of breakthrough cases — even those in Ohio — usually don't result in hospitalization unless patients have underlying conditions, such as asthma or a severe case of diabetes, Dr. Malvestutto said.

Dr. Hanrahan also said there's no question vaccinated patients fare much better even if they fall ill.

"There are a few people I have seen in the hospital who have been previously vaccinated," Dr. Hanrahan said. "Those people are generally sick for a couple of days and go home."

If you're not willing to sift through the stacks of clinical research and try to make sense of it all yourself, consider this analogy by Dr. Michelle Au, a Columbia University-educated anesthesiologist who now also serves as a Georgia state senator.

Think of an unvaccinated person as someone who is dry kindling, dry logs, and everything necessary to get a campfire started. Coronavirus is the match.

Vaccinated people, on the other hand, are thick, wet, and unseasoned logs. While it's not impossible to start a campfire with the latter fuel, the odds are considerably slimmer.

The whole vaccine hesitancy thing continues to befuddle medical experts.

They now suspect it's as much of a communication problem as anything. But they're also dealing many people leery of the government and unlikely to act if they don't agree with what President Biden, former President Donald Trump, or other political leaders tell them.

"As a clinical researcher, I know exactly what has gone into the trials," Dr. Malvestutto said. "Corners have not been cut."

Toledo-Lucas County Health Commissioner Eric Zgodzinski said he firmly believes there is something about the "emergency authorization" phrase that turns some people off.

Only 49.7 percent of the eligible Lucas County residents had received at least one shot as of Saturday, well below the Biden Administration's national goal of 70 percent by the Fourth of July. Wood County's vaccination rate stood at 54.2 percent on Saturday.

Mr. Zgodzinski said he's convinced a certain segment of the population still riding the fence — what percentage is anyone's guess — will agree to get vaccinated once the three vaccines receive full authorization from the U.S. Food and Drug Administration, a process he said appears inevitable.

"We all kind of knew we would hit a wall," Mr. Zgodzinski said.

Dr. Malvestutto agreed.

"There will be a bump. There are people waiting for that," he said. "The moment we have FDA authorization, that idea will likely go away."

But for whatever percentage of holdouts are waiting for the FDA to give its official blessing, experts agree that will likely only be another step forward and not enough to overcome the monumental political and cultural anti-science beliefs some people cite as their reasons for vaccine hesitancy.

What seems rational to one person isn't to another.

Experts said it's important to go beyond the textbooks and data-crunching to find what kinds of messaging resonates best with different groups of people.

For some, as Dr. Hanrahan pointed out, it may be a matter of having vaccines promoted more by faith leaders and others they are more prone to trust than the government.

For others, it's a matter of listening and trying to better understand their concerns.

Dr. Malvestutto, for example, said he has some Latino patients who are wary of the vaccines because they fear the government will use their information to deport them.

And, of course, many whites can't fathom the lingering mistrust of the government and other institutions because of what began in 1932, when 600 rural Black men — many of them sharecroppers — were secretly used for an infamous U.S. study of syphilis in Tuskegee, Ala.

Known as the Study of Untreated Syphilis in the Negro Male, the unknowing male subjects were left to suffer from the disease for years so those running the program could see how it played out.

A Black pastor spoke about that in a national podcast Dr. Hanrahan moderated recently for the Society for Healthcare Epidemiology of America, or SHEA.

Pastor Gerard Duncan of Prayers by Faith Ministries in Gainesville, Fla., has been vaccinated himself and has become one of the leading advocates for coronavirus protection among Blacks and Hispanics in and around the University of Florida.

But he said anxiety is especially understandable for Blacks because "they tried to kill us."

"Historically, we understand minority groups have reason to be hesitant or mistrust," Pastor Duncan said.

The other two panelists — Sheikh Nuru Mohammed, minister of religion at the Al-Abbas Islamic Centre in the United Kingdom, and Marielee Santiago, director of MetroHealth's Institute for H.O.P.E. in Cleveland — agreed there are language barriers, cultural barriers, and a digital divide for many groups of people.

Religious backgrounds are "very, very important" when it comes to trusting people about vaccine advice, Sheikh Mohammed said.

"People will only accept the message and take it on board when they can relate it to them," he said.

Sheikh Mohammed also urged healthcare officials to stop relying so heavily on social media, television, and other platforms and strive for more face-to-face conversations instead.

"In-person communication is as important as digital," he said. "Do not underestimate in-person communication."

Dr. Hanrahan said it's important not to "make broad generalizations" about people.

She agreed the healthcare industry should work more with individual groups of people, not just send out one-way mass messages.

Dr. Hanrahan said she hopes society can continue to move forward with more effective vaccine messaging.

"It's a terrible, terrible illness," she said. "It's preventable."

She and others don't see a way out of the crisis without getting a higher percentage of people vaccinated.

Although vaccine controversies date back to the first one developed in the West by Edward Jenner in 1796, misinformation's recent spread has been greatly enhanced by social media.

"Social media can be our best friend and also our worst enemy," Mr. Zgodzinski said. "False information is given and it gets legs. We're all human beings and we question things, but we have to follow the science."

Measles, once considered a historical relic, is making a comeback, especially in Europe after unproven linkages between autism and the vaccine to prevent measles, mumps, and rubella.

Polio, which could have been wiped from the face of the Earth, hasn't been in large part because of misinformation spread across the last three nations known to have it: Nigeria, Afghanistan, and Pakistan.

Mr. Zgodzinski said his parents grew up in an era in which Dr. Jonas Salk was hailed as one of the 20th century's heroes because of his research leading in 1955 to the polio vaccine.

"They were in that era where they saw people die in an iron lung. They lived through that. They saw the sheer terror of polio," he said. "These are all things people have forgotten about because they don't have to live with them."

Dr. Malvestutto said the chances of developing a blood clot from a coronavirus vaccine is about one in 1 million, roughly equivalent to the odds of being struck by lightning.

"It's difficult for your average person to understand what their actual risk is," he said. "I worry about what's coming. I think the only way we can get out of it is with more vaccination."

He drew an analogy to physicians trying to get people to stop smoking, saying that decision doesn't necessarily arrive after one appointment.

"It's similar with vaccines. It's not a yes-or-no decision that will not change, to some extent. To me, it's very important to not shut down," Dr. Malvestutto said. "It's important we don't leave any groups behind. We have to make sure we're reaching everybody. We're moving in the right direction, slowly. Too slowly. But we're moving in the right direction."

First Published August 14, 2021, 7:00pm

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