To the editor:
I wanted you to hear my take on the COVID-19 vaccine from both a physician and an emergency medical services perspective.
First, and most important, we have set aside Friday, Jan. 1, from 11 a.m. to 2 p.m. to give the vaccine to any Lincoln County EMS workers at Waldoboro EMS. We will set up in the ambulance bay to get the benefits of fresh air. Getting the vaccine will take less than 30 seconds; the longest part will be doing the paperwork.
Because of our role in patient care, we are at much higher risk of contracting and dying from COVID-19. Hospital staff with patient contact has a three times greater risk of dying from COVID-19 than the normal population. However, EMTs have an even higher risk — 5 times more than physicians. This makes EMS the highest risk occupation for dying from the disease.
Thus, the most compelling reason for getting the vaccine is so you personally won’t die from COVID-19.
The science is very good on this point. In the Phase 3 trials, the Moderna vaccine eliminated critical cases of COVID-19 in the 15,000 patients getting the vaccine. As the National Institutes of Health noted, “there were 11 cases of severe COVID-19 out of the 95 total, all of which occurred in the placebo group.”
From a public health perspective, the vaccine is also a vital step in stopping the spread of COVID-19 through the “herd immunity” concept. This simply means that if enough people in the overall population become immune to COVID-19, the coronavirus has nowhere to go since it only survives and replicates itself in non-immune people.
Because this coronavirus is so contagious, the proportion of people that need to be immune for herd immunity to happen is very high. Current estimates put this proportion around 90% of the general population. These preceded the arrival of the COVID-19 mutations in Europe and Africa that make it even more contagious, further cementing the high proportions of immunity needed to stop the pandemic.
Therefore, until we reach widespread immunity in our population, we expect repeated surges and resurges in cases forever. The possibility that we never will achieve sufficient population immunity is so great that many public health and hospital models include plans for a permanent COVID-19 pandemic.
For these personal and public health reasons, I’m getting this vaccine with the rest of the EMS staff. Like many, I’m generally very conservative on adopting new therapies due to safety reasons. However, I’m pleased with how this vaccine was developed, tested, and approved. The mRNA technology has been previously vetted in cancer immunotherapy and worked well. Also, the immunity provided through this new type of vaccine development is more than double that afforded by older vaccine technologies like that used to make influenza vaccine. That’s because the mRNA vaccines better mimic the way viruses invade our tissues in order to trigger more than one pathway of immune response.
Over the next one to three months, news about the population-based vaccine rollout will accelerate, particularly as it becomes clear that the coronavirus will continue to disrupt our lives and our economy. We have a unique opportunity to get a well-vetted, high-tech treatment that offers incredible protection from a disease that has caused national and global distress. Getting it early is a good thing for us personally, professionally, and for the greater good of the public that we serve.
James Li, M.D.