CMO Update July 6, 2021
While we have not quite hit the White House goal of 70% vaccination by 4th of July, the US continues to expand vaccination efforts and reap the wonderful rewards!! We are becoming more liberated from COVID restrictions and returning to summer vacation travel, family reunions and fun with friends.  
For those of you who are not yet vaccinated, I again invite you to contact me anytime if I can help answer your questions or concerns.  There is a tremendous amount of evidence on safety for all 3 vaccines, with nearly 300M doses administered in the US and billions worldwide. Given the sufficient long-term safety data, the FDA is expected to soon grant “Full Approval” for the vaccines instead of the temporary status of “Emergency Use Authorization”. For anyone concerned that these vaccines are still ‘experimental’, this FDA recognition should provide reassurance.  
 
Furthermore, I remain worried about unvaccinated teammates because of the growing threat of the Delta variant, which is causing local surges of infection in communities with low vaccination rates. States and rural counties, primarily in the Midwest and South, with the lowest vaccination rates are experiencing the highest rates of new cases and hospitalizations. 
  • Missouri offers a clear example. In the last week of June it reported more new Covid cases per capita than any other state, and they are concentrated in rural areas that have low vaccination rates. In the parts of the state with high vaccination rates — like the metro areas of Kansas City, St. Louis and Columbia — the number of new cases remains very low. 
In fact, 99% of recent COVID hospitalizations are in unvaccinated people. There can be rare breakthrough infections in those with immunity from prior infection or immunization, but these patients have lower viral load and much less severe symptoms, with almost never a hospital admission or death. Delta now accounts for >25% of all new US cases
 
  • Former FDA Commissioner Dr Scott Gottlieb warned on Face the Nation. 

1. Transmissibility of Delta COVID means you have an 85% chance of getting either vaccinated or (if you refuse vaccination) infected. 

2. Data on immunity decline suggest that if you refuse vaccination, you may get infected "more than once."  
 
  • The CDC issued a warning about the delta variant ahead of the holiday weekend. “There’s sort of isolated parts of the country where you’re seeing infection levels rise, the rest of the country looks very good”  
99% of more than 8,500 Americans who died from COVID-19 last month were unvaccinated 
  • Vaccination is how this pandemic ends. And the Delta variant seems to be raising the human cost of not being vaccinated. 

CDC Director Walensky also said COVID-19 vaccines “are nearly 100% effective against severe disease and death – meaning nearly every death due to COVID-19 is particularly tragic, because nearly every death, especially among adults, due to COVID-19 is at this point entirely preventable.” 
 
An Axios-Ipsos poll found that 84% of Americans have at least heard of the delta variant of coronavirus, with 72% saying they are concerned about the variant 
 
Families tend to stick together regarding vaccines, for better or worse. About 77% of vaccinated adults said everyone in their household is vaccinated, while 75% of unvaccinated adults said no one they live with is vaccinated, according to a recent survey from Kaiser Family Foundation. 
 
New England Journal of Medicine published study this week in 3,975 health care workers showing mRNA vaccines (Pfizer and Moderna) highly effective in preventing COVID in real-world conditions; vaccines also reduced viral load, fever and duration of illness for whose workers with rare breakthrough infection. 
 
The J&J coronavirus vaccine is also effective against the highly contagious Delta variant, even eight months after inoculation, the company reported on Thursday — a finding that should reassure the 11 million Americans who have gotten the shot. 
 
The benefits of COVID-19 vaccination far outweigh the risks of heart inflammation in young people, a panel of independent advisers to the CDC said last week. Still, the Advisory Committee on Immunization Practices, agreed that a warning about the potential risk should be added to the FDA official fact sheets on the vaccines. 
  • The CDC and the Department of Health and Human Services, together with 15 of the country’s leading medical and public health organizations – including the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Medical Association and the American Nurses Association – issued a joint statement after the meeting saying they ‘strongly encourage everyone 12 and older’ to get the shots because the benefits far outweigh any potential harms.” 
 
A new study published in Nature has found the COVID-19 vaccines from Pfizer-BioNTech and Moderna “set off a persistent immune reaction in the body that may protect against the coronavirus for years, scientists reported on Monday. Boosters may not be needed at all or for years. 
 
How to build a Delta immunity wall? Israel is showing us the way, with its very high vaccination rate countering the dominant Delta strain. No further case increases or hospitalizations. Zero deaths for past 12 days. (see graph below) 
  • US example is seen in Marin County, just over the Golden Gate Bridge from San Francisco, where >90% of people aged 12 and above have received at least one shot. As a result, Marin has virtually extinguished the virus, with only three new confirmed cases per day in recent weeks. 
I have fielded questions again recently about our need to continue temperature checks and other safety protocols in our clinics. While the rest of the country has basically opened up (thankfully!!) and dropped all mask mandates and social distancing restrictions, the CDC continues to recommend these practices in all health care settings to protect our vulnerable and immunocompromised patients and staff, including children who cannot yet be vaccinated (although these should be approved for children by the start of school this fall). Please continue to help educate visitors and patients who may question the rationale and/or resist these safety measures. When told ‘why’ most people are understanding and appreciate our focus on safety. 
 
Have a great week and safe travels to those who may be enjoying well deserved vacations!! 

Best Regards,
~ Dr. A
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