Get vaccinated to reduce risk, boost health

By Dr. Bryan Alsip

For the Express-News

We are seeing more COVID-19 breakthrough infections among the fully vaccinated in San Antonio, and some people understandably are asking whether the vaccine really protects them.

There are several factors that influence this shift. None of the current vaccines is 100 percent effective; some patients with underlying medical conditions do not develop a strong immune responses to the vaccines; other patients may be on immunosuppressive medications that make them more susceptible to infection; and some patients admitted for other conditions may test positive even though they are not symptomatic or sick with COVID-19.

We also know the risk of infection can rise with increased rates of community transmission. The highly infectious delta variant, which now causes nearly all COVID-19 infections in the United States, has fueled significantly high rates of community transmission. This results in a greater frequency of total infections, including some “breakthrough” infections among people who are fully vaccinated.

A Sept. 13 Express-News story — “Rate of vaccinated in hospitals rises,” Front Page — accurately reported a slight increase in the percentage of hospitalized COVID-positive patients who were vaccinated. This percentage rose across all San Antonio hospitals from around 11 percent to 15 percent between mid-August and mid-September.

Nevertheless, the public health message remains the same – being fully vaccinated is the best way to reduce your risk of severe illness and to improve your chance of survival if you become infected with COVID-19.

In hospitals, unvaccinated patients vastly outnumber vaccinated patients. They are much sicker, occupy most of the ICU beds, and experience higher rates of mortality.

Since June 1, when we began to see the impact of the delta variant locally, 91 percent of all patients admitted to University Hospital with a COVID infection were unvaccinated, including 92 percent of all COVID-positive ICU admissions, and 85 percent of all COVID-positive inpatient deaths.

The significant vulnerability of unvaccinated individuals to COVID-19 has also been demonstrated in other parts of the country. A recent publication by the Centers for Disease Control and Prevention studying SARS-CoV-2 in Los Angeles indicated that unvaccinated people were 29 times more likely to be hospitalized compared to those fully vaccinated.

What is more noteworthy than the presence of breakthrough infections that so many preventable COVID hospitalizations continue to occur among those who remain unvaccinated. Health care staff endure this reality every day and it is immensely discouraging. People with conditions other than COVID-19 also require timely health care or clinical procedures, many of which have been postponed because hospitals are at capacity. These patients continue to suffer needlessly to a great extent from widespread apathy and pervasive ambivalence to an effective, safe, and widely available vaccine that can protect our community’s health.

When University Health reopened our mass vaccine site at Wonderland of the Americas last week to provide COVID-19 booster shots, 250 of the 2,100 people who stood in line were receiving their very first COVID-19 vaccine.

Those numbers give us hope that as data continue to support the vaccines’ safety and effectiveness, more people will come to the realization that by getting vaccinated they are saving lives.

Dr. Bryan Alsip is chief medical officer and executive vice president of University Health.