The sprint to safety is on: Let’s try to win it

We live in evolutionary competition with microbes—bacteria and viruses.  There is no guarantee that we will be the survivors.  ­

— Joshua Lederberg

A March 22 article in The Atlantic by Daniel Engber entitled: “America Is Now in the Hands of the Vaccine-Hesitant: A subset of Americans who haven’t yet made up their minds about getting a COVID-19 shot. Whether they turn out in the coming weeks will determine the future of the pandemic.”  That statement could be true because these people will harbor enough virus to cause a fourth spike of hospital admissions. Dr. Rochelle Walensky, our CDC Director, has a nightmare that someone will die in a hospital on the week before they were scheduled to get the vaccine. Success comes down to buying time by wearing a mask, distancing, and hand washing. Also, staying outside. People who do this could be vaccinated by June. That means work, sports, theater, restaurants, schools, museums, and thankfully, an economy. In Israel all of these places are open. 

The most difficult category to reach is people who think vaccines are unhealthy, unnatural, and perhaps a reflection on their parenting skills. Or they may think in terms of a conspiracy by pharmaceutical companies and the FDA. The people Mr. Engber was most concerned about are men; either conservative middle-aged men or young people on spring break, for whom tempting fate is an act of defiance. (I was one of them once and declined the 1975 swine flu vaccine). Tens of millions of people may refuse the COVID-19 vaccine, leaving an unnecessary reservoir of virus. The beginnings of a fourth rise of people in this demographic may be starting as young people are admitted to hospitals with COVID-19. That increase in cases caused the sense of doom that the CDC director has been talking about.

There are factors that make me wonder if all of these people will refuse the vaccine. First, all three of the vaccines by Moderna, Pfizer and Johnson and Johnson are effective and prevent death or even hospitalization. The AstraZeneca vaccine is better than their planning and communications staff. From recent analysis, we know that asymptomatic people do not spread the virus, which is a great relief. Also, it is safe for teenagers, which has benefits too numerous to list, but including school and sports.

The vaccines do not contain active virus, as was the case with polio and other vaccines, but rather one gene, the famous Spike gene. The Spike variants, especially the UK variant, will not cause a problem in vaccinated people, but will increase infection rates and severity in people who are not vaccinated. There is enough vaccine; distribution is a problem that has been mastered. There is no reason to take this risk of infection. Let’s start with incentives, in Texas, say. Get vaccinated and get a ticket to a football game of your choice.  Recalcitrant males may be a little stubborn; but they are not fools. 

Not being vaccinated has consequences, even if you do not get sick. First, travel: not to Canada, not to Mexico, or any other country and that will last for a while. Universities will require COVID-19 vaccination just as they require meningitis and other vaccines. The military and medical professions will require vaccination. There will be other pressures on harumphing men. Dr. Walensky is talking to Republican governors about using masks and other measures while vaccinations are completed over the next three or four weeks. Next, she will talk to the women of Texas and other states. If I were Governor Abbott, I might feel a little nervous. 

Good New Englanders that we are, we can help him. The Astros play the Red Sox in Houston for four games, starting on May 31. I am sure Dr. Walensky is busy, but even the CDC director needs a baseball game from time to time. “Governor Abbott, please invite her. You two have a lot to talk about.” 

Author’s note: Joshua Lederberg was one of the founders of molecular biology, a Nobel Prize winner, and more importantly, a great mentor.

Richard Kessin, PhD, is Emeritus Professor of Pathology and Cell Biology at the Columbia University Irving Medical Center.  He has been writing the Body Scientific column since 2010 for The Lakeville Journal. Reach him at Richard.Kessin@gmail.com is you have questions about the vaccines.