The unvaccinated and their impact on the health care system

The Centers for Disease Control and Prevention (CDC) reports that over 77 percent of eligible people have received one COVID-19 vaccine dose, 65 percent are fully vaccinated with two doses and 32 percent have been boosted with an additional dose. Vaccines are weapons in keeping the virus at bay and preventing hospitalizations and deaths. 

Whether a person chooses to remain unvaccinated is based on fear of the mRNA technology, a general mistrust in vaccines, belief that the pandemic is nothing to worry about or any other reason for that matter, they are still unvaccinated and subject to the risks associated with such vulnerability.    

Independent of what such people think about the virus and the vaccines, our health care system — a national asset that is available to serve the health care needs of Americans— is under assault by people seeking treatment and care for COVID-19. 

What is not clear is why those who choose to remain unvaccinated, if they do not trust the very people who endorse the vaccine, namely physicians and health care workers, seek help from such health care professionals when the virus attacks them, they develop a severe case and require medical care? If they opted to remain at home, their choice to remain unvaccinated has less impact on the healthcare system.  

What is also baffling is that many of the unvaccinated who end up hospitalized with COVID-19 ask to be vaccinated at that time, demonstrating a fundamental misunderstanding of how vaccines work and the protection they offer. Whether this is a communication or a message problem, something is awry.  

Our health care system is under attack.  Data shows that in some areas, the unvaccinated are overwhelming hospital resources. Nine hospital CEOs in Minnesota sounded the alarm in an ad imploring the unvaccinated to get vaccinated and help their systems remain viable. Health care workers are burnt out and demoralized. 

The net effect of overwhelming demand on health care services is that it is difficult, if not impossible, to seek care for health conditions that are important, but perhaps not urgent, which includes elective surgeries. By delaying such care, these important but not urgent issues later become urgent, effectively creating a future logjam of demand for health care services that are more expensive and more life threatening, and will take months to work through. The consequence of such a situation is that people will prematurely die from such delays, because others choose to not take advantage of the vaccines that are freely available and proven to reduce the burden on the healthcare system.  

Preventive medicine is another casualty of the current burden placed on health care systems. Whether it is delays in pediatric vaccines, missed mammograms and pap smears or delayed colonoscopies, the eventual impact of more disease and Illness is inevitable. Moreover, given that the cost of treatment is higher than the cost of prevention, this will add enormous future health care costs that will be borne by everyone, both vaccinated and unvaccinated.    

Society is a team sport, requiring coordination and cooperation. In football, if one or more of the offensive linemen decide to “do their own thing” and not provide protection for the quarterback or blocking for the running back, the team’s performance suffers, and games are lost. When people “do their own thing” and opt to remain unvaccinated, they are no longer part of the team. Being on the team accrues benefits, which may no longer be available to them.  

The widespread dissemination of misinformation and disinformation has undermined the pandemic response and management, effectively threatening the viability and solvency of our health care system. Searching the web does not make people smarter. Indeed, anyone can access information via the web and social media that may or may not be accurate. But information is not knowledge — knowledge requires skills to interpret and synthesize. 

The incoming wave of omicron infections is poised to be a defining moment for our health care system. Whether it continues to provide care for everyone, as it has so far, or triage care when resources become constrained, something must give.   

The question soon to be faced by our nation’s health care system is: Who will make these critical decisions, necessary to protect battered providers and the people they need to serve? 

Sheldon H. Jacobson, Ph.D., is a founder professor of Computer Science and the Carle Illinois College of Medicine at the University of Illinois at Urbana-Champaign. He applies his expertise in data-driven risk-based decision-making to evaluate and inform public health policy.