By Norbert Goldfield, M.D.

Anti-Vaxxer husband and wife long-time patients of mine were both hospitalized last week with COVID pneumonia. I had on numerous occasions tried to convince them to be vaccinated – to no avail. That said, the vast majority of my patients are vaccinated. 

Data bottom lines locally:  COVID-19 test positivity rate has increased to 5.98%, MA vaccination rates are significantly higher than national ones: All ages: 71% fully; 86% at least one dose 12 and older. For 65 and older: 92% fully; >99% at least one dose. Key points: Vaccine Breakthrough cases in MA are rare but do occur 1.6% of fully vaccinated individuals have been diagnosed with COVID-19 infection (I have one of those patients who Friday received monoclonal antibody as she has a risk factor – elderly like me) Since vaccines were introduced 3% of these vaccine breakthrough cases have been hospitalized less than 1% (0.77%) of vaccine breakthrough cases have died from COVID-19 (Colin Powell who had significant chronic illnesses is one example). Key points: Cases are >5-times higher and deaths are >13 times higher in the unvaccinated; most hospitalized COVID cases were not vaccinated. Unlike all other industrialized countries, we are unable as a country to come together on vaccine mandates. 

Vaccine-induced immunity wanes over time; this is especially noteworthy in older people. This and omicron are driving the booster initiative nationally. At the same time, Republicans are not only decrying efforts to increase vaccination rates, but threaten people at the individual level. The result: people living in counties that went 60% or higher for Trump in November 2020 had 2.7 times the death rates of those that went for Biden. Counties with an even higher share of the vote for Trump saw higher COVID-19 mortality rates. In October, the reddest tenth of the country saw death rates that were six times higher than the bluest tenth. This is occurring in tandem with health care workers quitting. Omicron might change this. Dylan Scott this week highlighted key Omicron questions/points:

1)     How transmissible is the omicron variant?

2)     Does omicron cause more severe disease?

3)     How well can omicron evade the Covid-19 vaccines?

4)     How do the existing Covid-19 treatments hold up against omicron?

Bottom line for me: We have good treatment available; vaccines work very well but better to err on the side of caution and most importantly: get your booster, wear masks, avoid large crowds. 

COVID is just one health challenge. Health insurance saves lives. Medicaid expansion saves lives but here are two stories of why communication matters if voters decide to expand Medicaid- Oklahoma and Missouri. The “Better Building Act” passed by the House of Representatives will pass permanent funding of children’s health insurance plans and make it harder for children to lose Medicaid benefits due to eligibility issues, thereby supporting children’s continued access to health insurance.

The political corollary of Republican resistance to vaccines is the benefit that Republicans accrue at last month’s electoral box. Vaccine mandates feed into the cultural narrative that Republicans are capitalizing on with misinformation. Challenging for me as the child of Holocaust survivors is comparisons of vaccine mandates to the Nazi regime. Apathy on the part of those favoring vaccines (and electoral reform) is still widespread. ‘Ask Nurses and Doctors’ will continue to work on vaccine hesitancy – trying to work with health professional societies to, in turn, encourage businesses on vaccine hesitancy and support, for example, the pharma price control provisions of the Better Building Act. We will switch over to electoral support in the next few months but are preparing now. In addition, we are trying to encourage universal vaccine access – without vaccines for all (need to address patents and not America First) we will continue our current path. AND is working with Justice is Global on this. Consider supporting their efforts. Engagement on any issue discussed here is welcome. The picture below, courtesy of my wife who took this picture in Northampton MA says it all.

Norbert Goldfield, M.D.