This commentary is by Paul Manganiello, M.D., emeritus professor of obstetrics and gynecology at Geisel School of Medicine at Dartmouth, and co-medical director of theย Good Neighbor Health Clinic in White River Junction.
Unfortunately, this pandemic has exposed the worst in our citizens and residents. It has politicized what in the past would be considered common sense and empathy.
It is difficult for me to comprehend how individuals who are working, or preparing to work, in a health care setting are willing to resign from their jobs or studies so as not to be vaccinated.
I am a retired physician and professor at a teaching medical center. Students are encouraged to be skeptical and show intellectual curiosity when presented with newly published studies and new technologies. Students and practitioners need to be critical thinkers; they need to understand the scientific method; assess, or get help assessing, the data that is being presented; realize that science is constantly changing as a result of new information and discoveries.
We need to recognize our biases, and be intellectually honest when our preconceived beliefs are not shown to be valid. We certainly need to be able to assess the harms and benefits of the choices we need to make.
The July 2021 issue of Annals of Internal Medicine offers an excellent argument for mandating vaccines for health care providers. The mortality rate for in๏ฌuenza has been estimated to be 1 in 1,000, while for Covid-19 it is closer to 1 in 100 to 250. Health care workers and other essential workers have higher rates of infection than individuals working in other ๏ฌelds. Up to two-thirds of cases of Covid-19 infection are attributable to asymptomatic and presymptomatic transmissions.
So, testing everyone is not a good strategy due to cost, false negatives, false positives, and the frequency of testing, especially in the face of a safe and effective vaccine.
The estimated effectiveness of in๏ฌuenza vaccines varies annually but generally ranges from 30% to 50%. The two messenger-RNA vaccines for Covid-19 are more than 90% effective against intensive critical care and death.
Health care workers routinely tend to the elderly, ill and vulnerable, in whom Covid-19 infection is more likely to be deadly. We cannot rely on patients being vaccinated to prevent transmission because some patients cannot get the vaccine, some will decline, and vaccine may not be effective in immune-compromised patients.
More adults have now been inoculated against Covid-19 than are typically vaccinated against in๏ฌuenza in a given year. More than 300 million doses of Covid 19 vaccine have been administered in the United States. Despite the huge number of people who have received the Covid 19 vaccines, serious side effects have been exceedingly rare.
Students and practitioners need to do the hard work that is required of finding credible sources upon which to base our decisions.
Students are constantly being tested about their medical knowledge while in school. When they have graduated and are confronted with various diseases, life becomes an โopen bookโ test. Unfortunately, those who have chosen to resign or discontinue their studies because they refuse to be vaccinated have failed their most basic coursework, the study of public health.
It is better for all of us, including their patients, that they move on to seek another profession.
