Still fighting: Vaccines vs. COVID

Physicians from Saint Luke’s and CHC/SEK share their concerns as COVID cases rise. They discuss the delta variant, why vaccinations still matter, and the impact of the recent surge in positive cases and illnesses.

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August 13, 2021 - 3:32 PM

Register reporter Vickie Moss, left, interviews Dr. Brian Wolfe for the podcast series, “Registered.” To listen, find the episode on Apple Podcasts or Spotify. Photo by Richard Luken / Iola Register

What went wrong?

After nearly a year battling the COVID-19 virus and vaccines approved last winter, life was supposed to have returned to normal by now.

And at first, that seemed to be happening. Starting with those who were most vulnerable, Americans began to get immunized. Cases started to drop.

But in the past couple of months, the emergence of a new variant coupled with the reluctance of some to get the vaccine, cases are going  back up. Hospitals across the country are filled, and many are refusing to accept transfers from other hospitals.

Dr. Andrew Schlachter, a pulmonary and critical care physician who works with COVID patients in the ICU at Saint Luke’s Hospital in Kansas City, responded passionately when asked how it got to this point.

“Because YOU didn’t get vaccinated,” he said Friday. “Yesterday, our system saw over 140 patients who were COVID positive. Five weeks ago, we had 30.

Dr. Andrew Schlachter, Saint Luke’s Hospital

“The first wave, we saw the most critically ill and deaths occur in our older population or those who were sick or had underlying medical issues. Now we’re seeing people in their 20s, 30s and 40s. A lot of young patients and otherwise healthy patients who may not die, but who may be forever different.

“Why would anyone choose to gamble on that when they have a very sure bet with a very safe and effective vaccine?”

In Allen County, COVID cases grew by 36 over the past week, to a total of 1,425 since the pandemic began.

The county’s vaccination rate, meanwhile, remains below the state average. So far, 41.51% are fully vaccinated, against a national rate of 51%.

The delta variant is believed to now be the dominant strain of COVID-19. Because it is more virulent than previous strains, its reach includes younger people, who before were viewed relatively safe from the virus. 

While there are reports of “breakthrough” infections for those who have been fully vaccinated, physicians report most of the illnesses are those who have not been vaccinated.

The Register visited with Schlachter and local physician Dr. Brian Wolfe of the Community Health Center of Southeast Kansas on the latest updates on COVID-19, the delta variant and vaccines.

Their responses are posted below. The conversation will continue in Monday’s paper. 

Dr. Wolfe’s interview also is available as part of our podcast series, Registered.

If people who are vaccinated are still getting COVID, why get vaccinated?

Wolfe: If you have been vaccinated and you get COVID — which is much, much less likely — you’re not going to end up in the ICU and you’re not going to die. Getting vaccinated is huge from the standpoint of how sick you might get.

The vaccines have been effective against the variant to some extent, but it is fairly contagious and it has some new characteristics. It’s getting younger people sick. Kids, infants, pregnant women. So the new variant is concerning but we also know that if you get immunized, that variant is less likely to be a problem.

Schlachter: People who would get a vaccine may get COVID as a breakthrough infection but are very unlikely to die, very unlikely to get critical illness, very unlikely to be my patient in an ICU on a ventilator.

Any day of the week, I would take a cold or mild symptoms as opposed to critical illness if I had the choice.

We have newer concerns than we did when the vaccine first came out. The vaccines were initially targeting a protein that sort of helped with the virus latching on and getting into our bodies. The viruses are now mutating. So that’s why we do see some breakthrough infections and our vaccines are not 100% efficacious.

What happens if you get COVID, even though you are vaccinated?

Schlachter: With a vaccine you are far less likely to get critically ill or severely diseased. We also think that you have a reduced rate in your ability to transmit the virus but that again is not a certainty. We cannot completely eradicate this virus with the vaccine.

We’re dealing with a virus that wants to learn how to evade and learn new protections or defenses.

So yes, you can still contract the disease. Yes, you can still even spread it to someone. But if you’ve spread it to someone who also had a vaccine, they will probably not get severe disease.

Wolfe: Sometimes, people don’t even know they are sick. If you have a sore throat, fever, or are feeling rough, it’s probably not a bad idea to get tested for COVID. Sometimes, just that reassurance is good. 

I wear my mask all the time because the variant is out there. I may or may not know if I get it. I have grandchildren and I don’t want them to get it.

If you have had COVID, do you still need the vaccine? Will side effects be worse? 

Wolfe: If you’ve gotten COVID and you’ve recovered, about 90 days after that you should be getting the vaccine. The vaccine stimulates two different types of cell immune systems in the body. We’re not sure that just getting the COVID virus itself necessarily will do that.

If you have had COVID and you get a vaccine, even on the first injection of the immunization you’re probably going to have some kind of reaction. You’re probably going to get achy and headache. You may even get a low grade fever and it may last for 24 hours.

If you’ve not been infected, especially if you’re under 50, that first shot you may not get anything, but with the second one, you’re probably going to.

In fact it’s good to have that reaction because it means your body is doing what it’s supposed to do.

Will we need booster shots?

Schlachter: A booster makes a lot of sense. We get a flu shot every year. Pneumonia shots we repeat in some interval in our lifetime.

Vaccines get repeated because our immune systems need to be sort of reminded. This idea of a booster is not a foreign entity for this vaccine or for any vaccines and I do anticipate ongoing recommendations for different populations.

I do agree there’s a major concern both within America and within the world about some people who get boosters when others have not yet gotten any vaccine. 

Wolfe: The people that are immune compromised — that might mean they’re on chemo, they don’t have an immune system that works very good, they’re elderly, maybe they’ve had steroids — getting a booster appears to make sense. It just stimulates the immune system one more time.

What’s different about this delta variant? How do variants work? Can we expect another one?

Wolfe: The amount of virus in the body,  especially in the nasal cavity, is high. It also appears people get ill more quickly and younger people are more susceptible to this delta variant.

As time goes on all viruses change their genetic material. They mutate. They change. Many times that doesn’t amount to anything but sometimes it does make a difference.

One of the reasons for getting the world immunized is because the more people you have protected, you’re less apt to have these changing viruses. 

We’re probably going to see even more variants come along. Some may be even more of a problem. 

So that’s one of the reasons to be good stewards of our world. It behooves us to be sharing the vaccine worldwide. We need to get people in this country up to that 80% number of vaccinations. 

Schlachter: I’d like to make an analogy to this bacteria called MRSA. It’s a form of a very common bacteria that has become resistant to antibiotics. We have heard about it in mainstream media for years.

Bacteria and viruses are learning to create new defenses. They want to build walls. They want to avoid death by our therapies.

And so the delta variant is just that. 

(You can also listen to the interview with Dr. Brian Wolfe at Spotify.)

It has created new cousins or strains that are now more sinister. It is a more deadly pathogen. It is a more contagious pathogen. It is avoiding and evading our defenses better than the original strain.

The concern that I would voice is that if we as a population continues to struggle with vaccination and these variants continue to spread unchecked, it’s going to lead to a new variant. A more sinister one. Even worse than delta.

And this will perpetuate on and on.

Are most of the new cases from the vaccinated or unvaccinated? What impact does that have?

Wolfe: Most all of the cases that we’re seeing are unvaccinated people. Almost everybody that ends up in the hospital, with rare exception, has never been vaccinated. 

People who are on ventilators, people who are in ICU have never been vaccinated. 99.5% of the people that die have never been vaccinated.

Schlachter: I’ve never met a patient who’s dying of COVID who wants to stick to their guns and be adamant against the vaccine.

When anyone is looking at the possibility of a ventilator and I’m the last face and voice they hear in their life, they are begging me for anything and everything. 

I will take care of you the best that I can, no matter whether you’ve been vaccinated or not. But it does have a toll on our health care teams. We spent a year collaborating. We created structure and teams. I’ve never seen camaraderie and collaboration like this in health care in my life.

But we’re getting tired. You would not ask your Navy SEALS to come back from their sixth deployment and then return to the battlefield. Even the most dedicated still get tired.

This is the passion that I have, and I wish that passion could come through in these quotes. 

We’re working so hard. We saw some light. We had so much energy at the idea of this going away and returning toward normal. Now we’re fearful of steering back. That light is going away.

I want to give the sincere message that even though you don’t see it, it’s there. Just like maybe you don’t see poverty or you don’t see abuse or you don’t see domestic violence. To say that that’s not there, is silly. COVID is here. It’s real. People die every day and people are dying alone and they don’t have to.

Every single day I’ve come to work, I’ve seen a patient who’s going to leave this earth as a consequence of COVID that they did not have to.

In Monday’s paper Drs. Schlachter and Wolfe talk about how the virus affects children, how safe the vaccine is for teenagers and more.

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