I’m Going Into Labor Any Day Now, and I Don’t Care if My Healthcare Team Is Unvaccinated.

Let’s stop blaming the unvaccinated. We know better now.

“Biden administration again debating whether to provide COVID vaccines for asylum seekers and undocumented immigrants.” — @TheLeadCNN, Twitter, Jan. 21, 2022

Guys, I’m done. Biden wants to mandate vaccines for healthcare workers but prevents others from getting them? Meanwhile, our country has thrown out 15 million doses. Don’t talk to me about the unvaccinated (American) minority “causing” the variants when so many around the world who want vaccines still can’t get them. What’s the endgame here?

I have never been in favor of broad vaccine mandates but up until recently I did support them in healthcare settings. I’ve since changed my mind. I have no doubt that many people will disagree with me for very good reasons. But I feel compelled to share my thoughts. It is no longer obvious to me that vaccine mandates provide the protection they were intended to, and increasingly apparent that they may do more harm than good. Here are my reasons.

Vaccines don’t prevent transmission of the virus. Vaxxed or unvaxxed, anyone with an infection has similar viral loads, though the vaccinated will have less severe disease. Areas of high vaccination have not fared any better against Omicron transmission than areas with low or moderate vaccination. I can catch covid from an unvaccinated person as much as from a vaccinated person. Hospital workers who served throughout the pandemic likely have one of the highest rates of natural immunity and, while not as good as vaccine-induced immunity, still provides some degree of protection against reinfection.

Masks do prevent transmission. KN95’s and better are widely available these days, and I can choose to wear a mask to protect myself if I’m worried my booster shot won’t cut it. And healthcare workers are universally masked these days. The CDC has said recently that KN95-level respirators provide very strong protection to the wearer. The 2020 adage that “my mask protects you and me” is already outdated.

Healthcare workers are not disposable. We need them more than ever. The hospital workforce is not only handicapped by near- and at-capacity ICU’s and overwhelmed by staffing shortages. As of last October, 18% of healthcare workers had quit their jobs since the beginning of the pandemic due to a combination of safety concerns, burnout, and insufficient pay. Another 12% were laid off. The remaining staff are left with an even bigger burden, leading to fatigued workers and substandard care. In upstate New York, one hospital had to stop delivering babies because they lost too many workers over the vaccine mandate. We have to ask ourselves, is that really the best thing for those expectant mothers? How many more can we afford to lose?

Covid-19 will never be eradicated, even with 100% vaccination. Only one human virus has ever been eradicated: Smallpox. Unlike Smallpox, Covid-19 looks like other common illnesses and can pass back and forth from animals to humans. Covid has a longer period of infectiousness and can spread during the presymptomatic phase. Smallpox vaccines are highly effective and confer lifelong immunity. Covid vaccines, while effective, don’t. A vaccinated healthcare worker can still get me sick.

Getting vaccinated isn’t a litmus test for being a competent healthcare provider. Before 2021, I had no idea which of my healthcare providers “believed” in vaccines or not. They were competent enough to finish school. They were competent enough to be hired. I work in long-term residential care and in the past year have seen my share of bad healthcare decisions by fully vaccinated healthcare workers. Being a terrible doctor and being vaccinated are not mutually exclusive.

They deserve to make a living regardless of their personal beliefs. Many people I care about have chosen not to receive the vaccine. I disagree with their decision and I’m frightened for them should they get infected, but ostracizing them from society is wrong and certainly will not coax them into making a better decision. They don’t deserve to lose their livelihood over it.

I’ve chosen to take this virus seriously. I got vaccinated before getting pregnant because I was worried it would not be approved for pregnant women. Then I got boosted at 6 months to protect my unborn baby. And I’ve tried to live my life while trusting the science and not losing my mind to variant hysteria. This is not me being cavalier. I got married in June of 2020 and had 11 people at my wedding. My first dance was on zoom. I would never do anything to jeopardize the health of the vulnerable people I’m responsible for where I work. But I also have a responsibility to see how ultra-restrictive policies may inadvertently cause more damage than good. I have said before, the safest choice may not always be the best choice. Let’s stop treating the unvaccinated as Covid villains in order to comfort the worried well. Instead, let’s focus on supporting the needs of the truly vulnerable who have already lost the most.

Thanks to these sources that helped me formulate my thoughts on this: Monica Gandhi, MD, MPH, Peter Attia, MD, @TheLeadCNN, NPR.org, Morning Consult.