Why must I still wear a mask? Part 2

 Dear John,

Now that I am vaccinated, why is the government insisting that I still wear a mask? (Part 2)

Since writing part 1 in this series, there have been new developments with respect to vaccination protocols and data supporting their efficacy. Children aged 12-15 are now eligible to receive the Pfizer vaccine under an Emergency Use Authorization (EUA). This still confuses me as this age group is the lowest risk age group and not likely a major contributor to hospital beds, deaths, or contagion. Two of my children in this age group elected to get vaccinated for their peace of mind. I can only presume efforts were made to include this demographic to boost vaccination statistics and reduce any further limitations to getting our kids back into school full-time. Our kids being out of school has had devastating psychosocial consequences manifesting in the huge uptick in mental health disorders, screen time, disconnection, and social languishing in school-aged children. Getting our kids back into school needs to be a priority.

The other information that has come out to quell fears and reduce hesitancy about the vaccination are: 1) evidence supporting that fully vaccinated individuals are “unlikely” to spread the virus, 2) nearly all side effects or complications in vaccine development are discovered within the first 2 months of clinical trials, and 3) the vaccine is just as likely to protect you from serious complications and hospitalization with the original strain (alpha) of Covid as it is the delta variant. From both social and safety concerns, this checks all boxes. Yes, you can still get Covid if vaccinated, but the preponderance of evidence suggests that approximately 80% will be asymptomatic and over 90% will not require hospitalization. If you are fully vaccinated and you get Covid, the data shows that the viral load is “unlikely” to be great enough to infect another individual. They may be exposed, but exposure doesn’t equal clinical disease if the viral load is too small. This is not the case with the delta variant. Initial studies are showing that the delta variant rapidly reproduces once in the host, achieving viral loads great enough to spread. Also, because it reproduces rapidly, symptoms often present in 4 days instead of 5.5 days with the alpha variant. We have seen contradictory statements made by governmental, scientific, and medical agencies only to be later revised or retracted. This is not from a position of ignorance or stupidity, but in an attempt to circulate the best and most current information early and often to the masses.

I personally was very hesitant to get the vaccine when it was released for a few reasons, which I will share: 1) I am a low-risk individual in a low-risk age group. I have no comorbidities or risk factors, live an active and healthy lifestyle, don’t drink or smoke, am not overweight, and have deep and meaningful relationships in my life. 2) I wanted to see more long-term data on the vaccine before I decided to get a vaccine that was rushed through the clinical trial process and eventually given emergency use authorization (EUA). 3) I wasn’t sure that the vaccine prevented the spread of the virus. 4) From a safety perspective, I was concerned about the rush to push the vaccination into development and distribution under an EUA.

Fortunately, my concerns have not proven to be valid. Vaccination efficacy, specifically Pfizer, at preventing clinically significant disease is 93% vs 88% for alpha variant and delta variant, respectively. It’s essentially the same. And, while vaccinated individuals may still spread delta variant, at least it won’t be sending them to the hospitals or causing hundreds of thousands of deaths per day. Scientists are methodical and meticulous in their work. Knowing that most, if not all, complications of vaccinations are discovered and remediated within the first 2 months is important to know. The vaccine was released for EUA in December 2020. We now have 6 months of data from the public, which does not account for the Phase 1-3 clinical trials. Given the impact on our hospital systems and the astronomical number of new cases and deaths, it was a no-brainer to release the vaccine and stop the hemorrhage. The more recent outbreaks and uptick in Covid cases is predominately a result of unvaccinated populations.

The choice to vaccinate or not is a personal one. However, there are some important facts to know when making that decision so that you can make an informed one. There was a moment during the late Spring, early Summer where it looked like we were “out of the woods.” Around that same time, the delta variant ravaged India and its unvaccinated populations, spread through Europe and the world, eventually landing in the United States. Now, we are dealing with the delta variant, forced to mask back up, and reinstitute safety guidelines and preventative measures. We are losing the social liberties we gained after the deadly Winter. For those who choose to remain unvaccinated, you are a host for the virus. If the virus has a host, it can infect, replicate, and spread. The more often it can do that, the more often it will mutate. If the virus continues to infect available hosts and mutate, we could be dealing with variants that eventually reinfect those that are vaccinated. The alpha variant or original strain of Covid was unable to spread once it infected a vaccinated individual. Now, the delta variant is here and able to remain contagious once in a vaccinated host. Fortunately, it is not likely to cause significant clinical disease in vaccinated individuals, but that is no guarantee if people continue choosing to remain unvaccinated and ignore safety recommendations. The coronavirus will continue to mutate at a rapid pace if we don’t stop it from spreading, which could lead to devastating social and global consequences. We will keep playing catch up if people don’t do their part by following precautionary guidelines, managing risk if they choose to remain unvaccinated or getting vaccinated to reduce the hosts available for spread.

As you can see, new information is coming out all the time, which reminds me to stay open and discerning. I need to do what is best for myself, my family, but also make sure I do my part for society at large. We all have a part to play in helping the world heal from this pandemic. We have more evidence now to support removing our masks when vaccinated, but it is still important to follow local business rules and governmental regulations. If you have concerns, questions, or curiosities, please reach out. Be safe, be healthy, and be well!

With love and light,

John Moos, MD