I have been enthusiastic about our collective recovery from the challenges of SARS-CoV-2 avoidance. See The Future's so Bright (February 2021); Vaccination Implications (February 2021); Great Hamburger with a Smile, and We're Really Back (April 2021). I have been ridiculed publicly for my support of vaccines. One lawyer, in a public meeting, laughed out loud at my enthusiasm and questioned "Judge, don't you remember Thalidomide?" Thalidomide was an interesting, and frankly tragic, pharmaceutical failure that influenced and impacted many individuals and a generation. I do not believe there is any real corollary to this vaccine though.
Vaccinations are preventative. The impact of the vaccines for SARS-CoV-2 has already been noted. In 2021, we are progressively improving socially, economically, and professionally with these scientific wonders. I continue to remind you that many "experts" said deploying a vaccine in 12 months was overly optimistic. Last year, they essentially said it could not be done. And, it takes years to deploy many medications across large populations. hundreds of millions of people have now been inoculated against SARS-CoV-2, and the rate of side effects is still exceedingly low.
The first SARS-CoV-2 vaccine was deployed in the U.S. in nine months, last December. By the 12-month anniversary of the "experts'" expressions of deployment doubt, according to Everyday Health:
"50.8 percent of the U.S. population age 65 and older has now been fully vaccinated, and almost three-quarters of those in this age group have received at least one dose of the vaccine. About one in five adults age 18 and up have been inoculated."
The doubters who said it could not be developed in 12-18 months were spectacularly wrong; "Dewey Defeats Truman" wrong. The vaccine was deployed in far less than 12 months, and 20% of the adult population was already inoculated by the 12-month mark. By 18 months, we will likely have administered the vaccine to everyone in America that wants it. By 24 months, we will likely have an oral medication to treat COVID, from Pfizer or Merck, or both.
But, the National Public Radio (NPR) pundits are cautioning that we should not be too optimistic. Let's not forget that they make their "livin' off the evenin' news" (Don Henley, Dirty Laundry 1982). They warn that the Centers for Disease Control is studying "Breakthrough COVID Cases," infections in those already vaccinated. USA Today reports that as of April 23, 2021, the U.S. has inoculated (at least partially) 41% of the population, about 134 million vaccinated. Millions more are vaccinated every day.
The NPR folks warn of "some relatively rare cases of coronavirus infection" occurring "despite vaccination." They provide anecdotal examples of individuals who obtained the vaccination, assiduously stuck to masking, sanitizing, and distancing, but became infected with SARS-CoV-2 nonetheless. Some report their reaction to becoming infected as incredulity.
NPR reports that this is referred to as "breakthrough" infection and that the Centers for Disease Control is "tracking these coronavirus infections." There have been "reports of about 5,800 breakthrough cases." These are a subset of the vaccinated public. By definition, one cannot experience a vaccination breakthrough unless he/she has been vaccinated. Thus, the 5,800 must be compared to the 134 million currently vaccinated Americans. They represent .000043 or .0043%. In practical terms, it is an exceedingly small percentage.
It is as small as the percentage of patients that suffered blood clots following injection of the Johnson and Johnson vaccination. Scientific American reported that particular vaccine was paused following the discovery of blood clots in 6 women, one of whom died. At the time, 6.8 million doses of that vaccine had been administered. The 6 clot cases equaled .00009% of uses. Notably, before SARS-CoV-2, about 274 people died daily of blood clots, according to the National Blood Clot Alliance.
That the sample is exceedingly small is no reason not to study the breakthrough cases. The CDC is looking for "demographics or vaccine characteristics." They are looking for commonalities that might explain why the vaccine is not effective for some people. The statistics demonstrate the for some reason they are more predominant among those over 60 years of age and (presumably biologically) female.
One expert was quoted by NPR says that the existence of "breakthrough" cases is not unexpected. He says that the vaccines were predicted to be "at least 94% effective." The expert explains that 94% is "not 100%." Under Florida law, we allow experts to express opinions "if scientific, technical, or other specialized knowledge will assist the trier of fact in understanding the evidence." Section 90.702, Fla. Stat. So, perhaps it is helpful to some for this expert to explain in such clear terms that 94% is not 100%. The expert also reassures us "The bottom line is: It's expected. No need to freak out."
So, the NPR headline that breakthrough cases are being studied perhaps overstates the obvious. In short, this news is not news. The SARS-CoV-2 pandemic is not "over" and we are not societally "over it." So, many will continue in coming weeks, months, and perhaps years, to wear masks, socially distance, fastidiously apply sanitizer, and otherwise exercise caution. Bless them. In the widespread relief from fear and trepidation, let us certainly rejoice and strive for a return to collective normal. Let us also remember that 94% is not 100% and some among us may continue to experience fear, anxiety, withdrawal, and worse (infection itself).
Let's remember that their feelings are their own, subjective, personal, and sincere. Moving forward through our collective return to normal, let's be understanding of those who still do not want to shake hands, embrace, or perhaps even maintain their social distance. From a time when much or all of that was "normal" for each of us, let's remember that for some it may remain normal for some time. That you are ready to embrace does not mean others share your optimism, and we can all agree to accept and respect that.
For us all, let's remember Ronald Reagan's theme in dealing with the United Soviet Socialist Republic, "Trust, but verify." We can trust the vaccine, each other, and our health. But, if we get symptoms that have been associated with COVID-19, we would each do well to remember 94% and verify. Testing may be uncomfortable or inconvenient. However, if you are among the .0043% with a breakthrough, you would be better served to know it.
