By Paul V. DeMarco
AUTHOR’S NOTE: The vaccinated among you who read this will rightly wonder why, as a doctor, I don’t make a stronger case for vaccines. First, plenty of frontal assaults on the unvaccinated have already been published. Second, it’s one thing to talk theoretically about vaccine hesitancy and another to have a one-to-one conversation about the vaccine with someone for whom you are providing medical care. Although I am frustrated and confused by the widespread resistance to vaccines, unleashing that frustration on my patients would do no good. If the piece leaves you wanting a more direct, robust argument, I sympathize. But I’m not writing for you. I’m hoping to address readers who can be convinced to join your ranks.
When I hear stories about illness, I often imagine that I am the physician for the sick person being described. So when I read about people who decline the opportunity to be vaccinated against COVID-19, I envision them sitting with me in one of my exam rooms. By now I’ve had hundreds of conversations about the vaccine.
In the winter, many of them were about where patients could get the vaccine most quickly.
Over the past several months, the discussions have evolved; now it’s mostly coaxing the unvaccinated to overcome their hesitation. Hard-won experience has taught me that as I attempt to persuade a reluctant patient to accept a therapy, the harder I push, the less I succeed.
I begin by asking whether my patients have been vaccinated. If they say yes, I exhort them to encourage everyone they know to follow suit. I have several vaccinated ministers who tell me that every week they implore the disinclined among their flocks to get the vaccine.
There are very few patients (myself included) who do everything their doctor recommends. Countless patients of mine have refused my offer of a flu shot because “I got the flu from the flu shot.” Despite my gentle rebuttal that it is impossible to get the flu from the flu shot (although you can get flu-like symptoms from the vaccine), I rarely win the argument. I recognize that my advice is only part of my patients’ decision processes: Personal experiences, advice from other people they trust, and information from media also inform their decisions.
With the COVID-19 vaccine, I have had more success with ambivalent patients, although the majority still decline. Since I have an office practice, I spend much of my time trying to prevent illness rather than saving lives. But during a pandemic, convincing a patient to get vaccinated can be lifesaving, and therefore has been a source of intense focus for me. Most of my patients are over 50 and have chronic diseases that put them at higher risk. Thus far, I’ve lost two patients to COVID-19. Several more of my patients have lost family members. One patient lost a brother, a sister-in-law, and a niece in the space of just a few days.
If patients says they have not been vaccinated, I ask “Do you want to talk about it?” Most do, and express legitimate concerns – it was created and tested quickly; it’s still under emergency authorization or it had been when I wrote this); there have been side effects (blood clots and heart inflammation, to name two); they are not in high-risk groups; they don’t go out much; and they social-distance. A number can’t articulate a reason except that they are afraid of the vaccine.
My response goes like this: I acknowledge their fears. I admit that I can’t guarantee that they will not have a rare side effect from the vaccine. For those who express fear of dying from the vaccine, I acknowledge that the risk of death is currently unknown. All I can say is that it appears to be exceedingly rare.
My argument for the vaccine is based on what we do know. The latest data I can find from the CDC (for the calendar year 2020) shows the COVID-19 death rate in South Carolina was 78 per 100,000, making it the third leading cause of death in our state behind heart disease and cancer. Since the beginning of the pandemic, approximately 10,000 South Carolinians have died. The vaccine is approximately 99% effective in preventing death from COVID-19. If there was a vaccine that had a 99% efficacy in preventing death from heart disease or cancer, I ask, would you take it?
Surprisingly, a few of my patients, when I ask whether they want to talk about being unvaccinated, say “No thanks.” If that is the response I leave it be, but I wonder what they are reading or watching to make them unwilling to hear from the person in whom they have entrusted their medical care.
I suspect their unwillingness is driven by cable news or internet media. One of the worst things that has happened during the pandemic is the unwarranted attachment of political and philosophical meaning to the virus. Recently, I heard a caller to a radio talk show describe people who wear masks as “our enemies.”
COVID-19 is no respecter of political party or religion. It’s a simple virus with no brain. All it knows how to do is reproduce itself in our cells. The longer it has susceptible hosts, the longer it will continue to infect us, and the more efficient it will become. The delta variant is the latest example of this. The longer it takes for us all to be vaccinated, the more likely another, even more infectious and more deadly, variant will arise.
You may not be my patient, but as a doctor I care about people’s health whether I know them or not. Please get vaccinated.
Paul DeMarco is a physician who resides in Marion, SC. Reach him at firstname.lastname@example.org. This was first published as a column in the Florence Morning News on Aug. 18.