There is palpable optimism in the American air as evidenced by the over 1.7 million Americans traveling by air on yesterday. Happy Mother’s Day to all those brave women who have guided, worried, and loved us through this 14-month pandemic. While we mourn the 581,756 people who are no longer with us in the USA, we can celebrate that the running 7-day average of deaths has remained below 700 for at least the last 3 weeks. Average 7-day % positivity is down 8.5% compared to the previous week. Cases of Covid-19 are trending downward as well having dropped 13.2% to 45,817 (7-day average).  Hospitalizations continue to trend downward as well showing an 8.4% decrease in the 7-day average compared to the prior week. To put this in context we cite the 4,640 hospitalization 7-day average compared to the 16,473 average on Jan 3-9, 2021.  Our ICU occupancy rate with patients infected with the SARS-Cov-2 is well below 30%, so they are no longer under occupancy stress. Americans, particularly those most vulnerable to the severe ravages of Covid-19 flocked to get vaccinated.  The result of this momentum is 8 of 10 people over the age of 65 have been fully vaccinated. At least 149.5 million Americans have received at least one dose of a vaccine.  The “fully vaccinated’ number in the USA is 108.9 million (100.3 million Moderna or Pfizer, and 8.6 million J&J). Yet only 57% of adult Americans have been fully vaccinated. This percentage of vaccinated is weighed down by only 1 in 3 people ages 18-29 having received shots and by political, cultural, and historical hesitancy.  It is acknowledged that we will need to eventually vaccinate adolescents and even most younger children.  This effort can now go forward since today, May 10, 2021, the FDA has granted Pfizer the Emergency Use Authorization for ages 12-15 for its mRNA vaccine. Clinical trials to assess the appropriate doses, safety, and efficacy for Moderna, J&J, and Pfizer for all children are ongoing.

Addressing the residual hesitancy concerns of the unvaccinated is indeed a multifaceted challenge.  In this space we have previously chronicled many of the deterrents to vaccination in the Black community.  The impact of the historical mistrust of the medical community, mixed messaging from the federal government, and the counterproductive moniker of “warp speed” has been dramatically lessened by real information delivered by trusted voices.    Specifically, back in December 2020 fifty-two percent of Black Americans polled voiced a “wait and see” attitude and 20% said they would get the shot as soon as possible. Compared that to now where 59% of Blacks stated that they had already received a vaccine or would do so ASAP, and only 19% voiced a “wait and see”.

 

Every person who refuses to get vaccinated keeps US another step away from getting to herd immunity.  The current 57% level of adult vaccination is far short of the 75-80% of the population necessary for herd immunity or the July 4th 70% adult vaccination goal of President Biden. These goals will be aided by some people’s skepticism being eliminated by Pfizer seeking actual licensing for its vaccine since there is now six-month safety data available in tens of millions of recipients.  Getting more people vaccinated soon will not only lessen the illness, hospitalizations, and deaths but also get all our kids back into the classroom and our society back to worship, work, concerts, sports, and socialization. By reducing virus replication we reduce the opportunities for the virus to mutate.  Virus mutation is becoming more of a problem for the world.  India is suffering now from what the USA experienced this past winter. Thousands of people are dying there every day and that country accounts for 46% of the world’s new cases.  An India variant, classified by the WHO as B.1.617, has been identified which spreads more easily.    There are five “variants of concern” in the United States and notably 60% of the new cases in our country are caused by the B.1.1.7 (British variant).  In order to end a global pandemic the disease must be fought everywhere. In order to save our health and the world’s economy we must do more. 

Clyde E. Henderson, MD

Cincinnati Medical Association