COVID-19 Vaccine—It’s About Community

Here’s what community looks like where I live in Washington state’s San Juan Islands. We make meals when a new baby arrives or when someone goes through a health crisis.  When a family’s house burns down, we give shelter and help build a new one. Some of us mentor school kids, others drive shuttles for seniors, and many serve on the boards of local non-profits and government entities. I know the same actions happen lots of places.

Soon, there’ll be another important way to demonstrate community—receiving COVID-19 immunizations.

With FDA (Food and Drug Administration) approval of two COVID vaccines, some emergency services personnel, health care providers, and long-term care staff and residents are already being immunized. In the coming weeks and months, the vaccine will be available to increasing numbers of people, and it’s possible more vaccines will be approved.  

Many wonder, though, if enough people will take this step to prevent COVID spread. 

“Herd immunity,” a term developed by U.S. livestock veterinarians in the 1910s, moved into human medicine in the 1920s. I first learned about it in nursing school in the 1970s and then in the 1980s when I began work in public health. By then, the term related to the portion of a population that had to be vaccinated to control or eradicate a disease. For many highly contagious diseases such as measles and chickenpox, 90-95% of a community (or herd, if you like) needs to be vaccinated to protect people who CAN’T receive immunizations for medical reasons. When it comes to COVID-19, there’s growing evidence disease control will require a similar high percentage of vaccinated people. 

Here’s where “community immunity” comes in. When enough of us are immunized against COVID-19, we benefit even those who aren’t. Just as with masking, social distancing, and avoiding contact with groups of people indoors, our actions help protect the vulnerable. That’s usually elders and people with conditions such as autoimmune diseases, diabetes, and chronic lung disorders like asthma. With this pandemic, we’re also recognizing those at greatest risk also include people of color.If childhood immunization rates in the San Juans are an indication, achieving community immunity for COVID could be challenging. In 2012, the New England Journal of Medicine reported my county was among the worst in the nation for vaccinating children. That year, only 28% of kindergarteners and 11% of sixth graders in San Juan County met school vaccine requirements for diseases like chicken pox, measles, and pertussis (whooping cough). According to the  Washington Department of Health, rates have improved, but there’s still a long way to go for our community’s immunity to protect us. Immunization records for the 2018-19 school year indicated fewer than 50% of children were fully immunized, a requirement for school attendance. 

So far, residents and visitors have followed mask-wearing, social distancing, and handwashing recommendations to protect vulnerable families and neighbors in San Juan County. 

Hopefully, we’ll embrace community immunity here when COVID-19 vaccines become available widely. 

Lopez Island nurse Kai Sanborn created beautiful reminders of why masks are so important. She created holiday ornaments using New York Times newsprint listing the 100,000 names of people who had died of COVID as of May 2020.  

“The inspiration was in response to the questions and challenges about the ‘why’ of masks,” Kai says, “and awareness of the signals (beyond the personal benefit) we send when we wear them.”

I think the same reasons explain why many of us will seek COVID-19 immunization; maybe Kai will figure out how to folk newsprint into the shape of syringes. 

Now’s a good time to gather more information about the new vaccines. This information will help you consider your part in promoting community immunity.

• Spend a minute watching this explanation about how the vaccine works:

• Remember, two doses are required to vaccinate an individual. It likely will be at least January before all Phase 1a individuals (frontline healthcare providers) are vaccinated, depending on the number of people who choose to get the vaccine, actual vaccine supply, and distribution capabilities. 

• Those who are high risk might not receive vaccine until several months into 2021, and the general population might not have access until summer. Until then, and until we achieve community immunity, to protect others we’ll still need to follow the same practices that Kai’s ornaments encourage.

• The amount of time that someone who receives the COVID vaccine will be protected against the virus is still uncertain. However, the sense is it will provide protection for 1-2 years.

• It’s uncertain if someone who’s immunized can continue to transmit COVID. Vaccines will protect most individuals from the severe impacts of COVID, but it’s possible vaccinated individuals may still be asymptomatic carriers. Even if they’re potential carriers of the virus, though, vaccination is still a critical tool to overcome the pandemic 

• There hasn’t been time to fully understand the vaccine’s risk. However, the known significant neurological and cardiac effects from the disease, even in younger and healthy individuals who might have had mild symptoms to start, are almost universally thought to be greater than the unknown long-term risk of the vaccine.  For now, scientists believe for the vast majority of people, not getting COVID should be their one and only priority. 

• Here are more resources about the vaccine:

CDC’s COVID-19 vaccine information page

Facts About COVID-19 Vaccine

WA State Department of Health’s COVID Vaccine Info Page

I’m grateful vaccines have been developed so quickly. As soon as I’m eligible, I’ll join others who seek immunization. Because… community.