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COVID variants and vaccine hesitancy are changing the public health game

person receives COVID vaccine shot
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Federal health officials recently declared the current COVID-19 spike to be a “pandemic of the unvaccinated”. The announcement is a national public reminder that the pandemic is not yet over. 

Dr. Emily Martin, associate professor of epidemiology at the University of Michigan School of Public Health, noted that Michigan hospitals aren’t seeing a surge as big as those in some Southern states. However, the slight bump in case numbers is still worth discussing. 

“And it's particularly concerning because we know that testing isn't what it was a few months ago, six months ago,” she said. “So we're less likely to find out about cases when they appear. And so, any sort of movement upward in the numbers is a bit concerning and something to keep an eye on.”

How much concern do the Delta and B.1.1.7 variants pose?

Large gatherings of unvaccinated people are a primary area of concern. If the virus is introduced to a network of unvaccinated people, illness can spread quickly, Martin said. 

Another group of concern is travelers who may bring variants into the state. 

“Michigan has been a really popular travel destination this year. And so that kind of speaks to our need to be vigilant and watchful as we have people move in and out of the state, both visitors coming in. . . or people from Michigan going to these states that are having really high transmission rates, picking up variants that they might bring back to Michigan,” she said.

Smatterings of COVID-19 variants, including the B.1.1.7 and Delta variants, have appeared in Michigan, but haven’t been “major players,” according to Martin. Research shows that the vaccines currently being distributed are effective in preventing hospitalizations and fatalities due to the Delta variant. Nationwide, adults that are being hospitalized with COVID-19 are unvaccinated. However, as cases overall increase, so will the number of rare cases among vaccinated people. 

“And so that's why we often talk about having a good, robust vaccination campaign, but then doing the other things that we need to do when we see spikes or clusters of illness to try to keep the overall numbers down,” Martin said.

Can vaccinated people anticipate a booster shot later this year?

As cases increase throughout the country, so has talk of the possibility of issuing booster shots. Advances in research and technology have made it possible for researchers to respond far more quickly than they could have in past years. Today, identification and characterization of variants may take mere weeks rather than months. 

“Now, the fact that the mRNA platform has the ability to just swap new variants in and out of it if we need to, means that something could roll out very, very quickly compared to what we're used to,” Martin said. 

Can we expect another mask mandate?

L.A. County issued a mask mandate that applies to even vaccinated residents. In Michigan, attitudes toward masks vary by city, and it’s difficult to predict how another statewide mask mandate might be accepted. 

“You could see particular employers or particular schools wanting to go in that direction, because it's easier than trying to figure out who's vaccinated and who's not and try to use that to drive your masking recommendations,” Martin said. 

Combating misinformation 

Misinformation campaigns have discouraged many from getting vaccinated, but research supports both the vaccines’ effectiveness and safety. Martin added that the sheer number of people that have gotten vaccinated over a short period of time have allowed for a massive body of data for researchers to analyze.

“It strikes me [that] we've never had this huge amount of experience of vaccinating this many people all at one period of time, right? I mean, we've got hundreds of millions of people that we can learn from now. . .” said Martin. “Basically tons of data behind this vaccine compared to other products that would be on the market at this stage.”

Martin also offered a strategy to those having conversations about the vaccine with friends and family members who may be wary. She suggested presenting misinformation in a “fact sandwich.”

“You say, ‘You know, we know these vaccines are safe, and that almost all people that are getting hospitalized right now are unvaccinated. So we know that the vaccination prevents hospitalization.’ You can talk about the myth, but at the end of the day, you've got to follow up and say, ‘But even though people are saying Myth X about the vaccine, we still know that they're safe and that they're preventing hospitalization,’” Martin said.

Addressing lack of access 

Since mass COVID-19 vaccination clinics have largely closed down, some are turning to their primary care doctors for the vaccine. However, many doctors are reluctant to offer it due to the hassle of extra paperwork, arranging for storage, and educating patients. 

Many doctors, she explained, are accustomed to partnering with outside vaccination clinics to whom they would refer patients. Even before the pandemic, these offices were ill-equipped to offer in-house vaccinations. 

“I think even before the pandemic, primary care offices were under a lot of stress in terms of trying to handle a really high workload of patients, with not necessarily all of the resources that they needed. . .And we’ve got to figure out how to resource them.”

What to expect as fall approaches

A linear decline in cases isn’t expected anytime soon. Martin said that we can continue to see different areas have cases flare up, break out, and die down. 

“And that's going to be true for vaccinated people and for unvaccinated people. This is not going to really end for one group of people with a moment in time where a bell rings and we don't have to think about COVID anymore. It's always going to be in the background. We're always going to be watching it,” she said. 

Vaccination, she said, is the best way to individually manage the virus, but scientists will continue to research other strategies to manage the pandemic, taking into account the hesitations and concerns that many still have. 

“We're still all in it together. We still have to take care of everybody,” Martin said. “There's a whole population, and I would hate to see we have this kind of schism where we've got vaccinated people living in this other level without taking population-based strategies into account.”

This post was written by Stateside production assitant Ronia Cabansag.

Stateside is produced daily by a dedicated group of producers and production assistants. Listen daily, on-air, at 3 and 8 p.m., or subscribe to the daily podcast wherever you like to listen.
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