Vaccine compliance versus the politics of fear

Summer is here, and for many, COVID-19 is starting to fade as an ugly memory. Emergency Room physicians in both New York and California have told me that the diagnosis isn’t even on the top of the list of possibilities when patients come in with respiratory viruses. The case positivity rate in New York has dropped to below 0.5 percent and stayed there.

More than 65 percent of adult Americans have received at least one COVID-19 vaccine, and a significant percentage of Americans have natural immunity from having had COVID-19. Both kinds of immunity have now been found to last for several months, possibly years, and this should allow reentry to normal life. Though we don’t know the exact particulars in terms of verifiable antibody titers or measurable T-cells, an exact amount or number above which constitutes immunity, we can certainly count on the strong protection these immunities provide as we look to exit the pandemic.

Don’t get me wrong, especially with the Delta variant emerging, the only sure way to protect oneself and children over 12 is to take two shots of an mRNA vaccine (Pfizer or Moderna), or at least one shot after having had COVID-19. Reinfection is possible, though it appears milder. Data from the United Kingdom, where the Delta variant has become the predominant strain, reveals a greater incidence in people who are between 5 and 24 years old, than in older people.

This demographic shift underlines the importance for teens to be vaccinated against COVID-19, as soon as possible. Rather than this variant leading to more compliance, the question of whether or not to vaccinate young adolescents is now raging in the media, attributable to fear-stoked reports that an extremely rare complication (myocarditis) can inflame the heart following the mRNA vaccine, most often in males under 30 following the second shot. But the remote risk is far from sufficient to warrant not giving the vaccine on this basis. An analysis of data from the Vaccine Safety Datalink found a rate of 16 cases per million second doses in people ages 16 to 39. I think the best approach is to consider delaying the second dose for a few weeks in teens and young adults.

Keep in mind that though COVID-19 complications have been largely among the elderly, there have still been well over 10,000 COVID-19 pediatric hospitalizations during the pandemic, and over 4,000 cases of documented MIS-C (multi-system inflammatory syndrome in children). In other words, the risk of the disease is far greater than the risk of the rare vaccine complication. The risk of having a heart problem from COVID-19 is greater than it is from the vaccine, and a new study adds to the data building up on long-term COVID-19 effects (at least 25 percent of patients with long-term sequelae), to suggest a loss of brain tissue after COVID-19 in many cases as well. 

Unfortunately, I have found that one fear is not the best method to battle another. Specifically, fear of COVID-19 and its variants is not the best way to motivate vaccine compliance. I would have thought that, by now, we would have learned an important lesson — that shutting down our society and intimidating the populace with COVID-19 fear had a great associated psychological cost, without shutting down the virus. 

The last thing we need to do now is add a vaccine non-compliance threat to bully our young people (and their parents) into obedience. All the restrictions and limitations and mandates and closures have had a cumulative negative impact. In fact, the Centers for Disease Control and Prevention (CDC) has just released a new study that reveals that from late February through late March, at a time when the case and hospitalization numbers were already plummeting, there was a greater than 50 percent increase in suicide attempts leading to emergency room visits among adolescent girls age 12 to 17 compared to the same time last year, before the pandemic took hold. 

The public debate over vaccinating our teens just adds fuel to the fire. Instead, we must involve doctors more — and politicians less — in the conversation over vaccine compliance, and have it be a matter of informed choice.

Take the vaccine because it makes medical sense, especially if you are in a high-risk group for COVID-19 complications, not because you are being forced to do so.

Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of the new book, “COVID; the Politics of Fear and the Power of Science.”