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Vaccines still key in COVID-19 battle

A conservative syndicated columnist recently argued in the Mirror that whether one gets vaccinated against COVID-19 “is your own business and nobody else’s” based on significant numbers of infections from the omicron variant among vaccinated people.

Asked this week whether remaining unvaccinated creates risks for others, two local doctors and a pair of UPMC experts in Pittsburgh shied away from pronouncements on community responsibility, while emphasizing that vaccination continues to be the key to dealing with COVID-19.

When COVID-19 vaccines first became available, the medical community hoped they would not only prevent hospitalization and death, but also infections, contagiousness and spread of the virus, said local primary care doctor Sean Hampton.

But with the delta variant, and now even more with omicron, protection against mere infection seems to have waned.

Existing vaccines “are expected to protect against severe illness, hospitalizations and deaths,” but breakthrough infections of vaccinated people are likely, with scientists studying to find out how much protection against mere infection remains, according to the Centers for Disease Control and Prevention website.

It’s likely some protection against infection continues, although not enough data is available yet for definitive answers, Hampton said.

It’s also likely that with breakthrough infections in vaccinated people, the viral “load” is not as high and thus are not as contagious or contagious for as long, Hampton said.

If a 22-year-old in perfect physical condition elects not to get vaccinated, he would hesitate to criticize, Hampton said.

It’s “a personal decision,” he said. “I get that argument.”

But because unvaccinated people are more likely to require hospital care, they can potentially overwhelm medical facilities, Hampton said.

Hospital care must be available not only for other COVID-19 patients but also for those with other problems like heart attack and stroke. “If my mother has a stroke, I want her to be able to see a doctor in less than 18 hours,” Hampton said.

At this point, with omicron spreading, it’s all about “preventing hospitalization and death,” said local primary care doctor Zane Gates. Vaccination does that.

It’s not about counting cases now, Gates said. Hospitalization and death are what made COVID-19 a big deal anyway, he said.

“The risk of hospitalization and death is miniscule if you’re vaccinated twice,” he stated. Boosters can additionally prevent people from getting symptoms, which can help prevent the spread.

Boosters may especially benefit older and weaker people by preventing mild symptoms that could require them to be hospitalized, when added to their existing problems.

But people shouldn’t rely on vaccinations to prevent infections, Gates said.

Ultimately, everybody is going to become infected with COVID-19, unless “you sit in your house and nobody comes to see you,” Gates said. “The cat’s out of the barn.”

That’s actually a good thing because it helps distribute immunity, he said.

The UPMC doctors didn’t deal with the question of community responsibility directly.

“(But) the durable message about protecting yourself and everybody around you has not changed with the arrival of omicron,” said Donald Yealy, UPMC’s chief medical officer. “Still, far and away the best protection is vaccination, no matter what variant you’re talking about, against serious illness and death. Period.”

At least two doses, he added. And a booster to get optimal advantage. Plus masking, for all the old reasons.

The goal remains to get the unvaccinated vaccinated, Yealy said.

At all UPMC sites, including UPMC Altoona, the old pattern continues: “unvaccinated people are much more often admitted, much, much more often in an ICU and they die more frequently,” Yealy said.

If people do get sick from COVID-19, and by day 4 of the onset of symptoms, they’re getting worse, they should call their primary care doctor, so they can get treatment with monoclonal antibodies, Gates said.

“Don’t wait until day 10,” he said.

Tests by UPMC recently showed that only one of the several monoclonal antibody “cocktails” the organization has been using is effective against omicron, so UPMC has gone to that one alone, said Erin McCreary, director of antimicrobial stewardship innovation and infectious disease pharmacist.

That one is Sotrovimab from GlaxoSmithKline, she said.

“Awesome” medicines like that, however, are no substitute for vaccinations, McCreary said, pointing out that they are one-dimensional in antibody effects, whereas the body’s immune response to vaccination is multidimensional.

Mirror Staff Writer William Kibler is at 814-949-7038.

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