If 80% of eligible Vermonters get at least one dose of the COVID-19 vaccine, Gov. Phil Scott says he'll lift all remaining pandemic restrictions. In our weekly health update, we talk with Deputy Health Commissioner Tracy Dolan about when this might happen and what it means for all Vermonters.
Our guest is:
- Tracy Dolan, deputy commissioner for the Vermont Department of Health
Broadcast live on Wednesday, May 26, 2021 at noon; rebroadcast at 7 p.m.
The following has been edited and condensed for clarity.
Bob Kinzel: What's the magic of 80%? Because it doesn't represent fully vaccinated people; only folks who have gotten at least one dose.
Tracy Dolan: This is all about really trying to reach our herd immunity or community immunity.
We know that vaccines work best at a community level. While they're effective at an individual level, their effectiveness in some ways depends upon how much infection is in your community. So when we have fewer cases, and we have more people vaccinated, the vaccine is even more powerful …
We don't have an exact number on exactly what percentage will protect us, [but] we know the higher the better. We know that between 70- and 80% is likely effective, but closer to 80% is better.
"We know that vaccines work best at a community level. While they're effective at an individual level, their effectiveness in some ways depends upon how much infection is in your community." - Tracy Dolan, deputy commissioner of health
The governor mentioned that, with winter coming up later this year, we want to have as many people vaccinated as possible. And while Vermont, with its very low cases and high vaccination rate, feels quite secure, we do have plenty of states that have very much lower vaccination rates and higher case rates. And of course, we live in a world where only 22% of adults in the world who are eligible are vaccinated. And with our global lifestyle, for a lot of people, it's so important to get that vaccine now to protect our communities and ourselves.
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There might be some listeners who are wondering, “Why not wait until 80% of Vermonters are fully vaccinated?” Would that make a difference?
It would. If we chose to wait until 80% were fully vaccinated, it would provide even more protection. However, we're also trying to balance the other important issues we're seeing here.
If our case rates were higher, we might say “OK, let's wait ‘til full vaccination.” But with the declining case rates [we’ve seen], that tells us that we have less virus circulating in our community. So we're feeling comfortable, given what we know about what happens after the first dose.
After first dose, with these vaccines, there is a very high rate of protection – even higher, of course, once you get your second dose. But because of what we know about first doses, and what we're seeing in other countries who have chosen to do the first dose method, we're feeling comfortable that that will provide a sufficient protection to move forward on opening up Vermont more.
But of course, that second dose is really what brings it home and really gives you the maximum protection.
What would you say to those folks who feel the state's taking a risk here, and that it's too early to eliminate some of these restrictions?
Well, first of all, I would say: I understand where you're coming from.
We have been living in a state of heightened concern and heightened caution for a long time, rightly so.
But really, in Vermont, we have really been directed by the data, over and over. And if we go back to the data now, we see low hospitalizations. We see no deaths in the last week, and we've seen much lower deaths. And most importantly, we see very low cases. All of that gives us more confidence in being able to lift some of these restrictions.
And we are probably one of the most cautious states in the country. Even with our vaccination rates, the governor has really been hesitant to move forward too quickly. And so it feels like for all of those reasons, we have been cautious, but we also want to catch up to other states in our region, when it makes sense to do so. And we think this is about the time it makes sense to do so, particularly once we reach that 80% mark.
My question … is about the young children. I feel like in all this rush to open … people seem to have forgotten that there's a whole world of families with children under 12 [who can’t yet get vaccinated] – you know: toddlers, babies. What about them? How can we address the need to keep those kids protected and support those families? – Betsy, Bristol
Tracy Dolan: That's a great question. I think I have four points to sort of address that.
The first point being that the most protective thing that's happening in Vermont right now is vaccination. And so, as vaccination occurs, we see a more protected population on the whole, which protects people on the whole, even the unvaccinated.
It doesn't mean that it confers full protection, but the more people we get vaccinated, it increases the protection even for the unvaccinated, because it's simply less virus moving around. So we have very low rates; our positivity rate is around 1%. But the actual case rate is very low – much lower than the rest of the country.
Another piece here is that among children, we simply don't see the number of cases [we do among adults]. It appears that children, for whatever reason – their biological makeup? – appear to be less susceptible to COVID-19, compared to adults, and that may be related to receptors.
The third piece is that they appear to be less likely to be passing it along, compared to adults.
But I would say the bigger overarching piece there is that, with our higher vaccination rates and lower case rates, they're simply not at the same risk that they would have been several months ago.
"... With our higher vaccination rates and lower case rates, [children] are simply not at the same risk that they would have been several months ago." - Tracy Dolan, deputy commissioner of health
And then finally, of course, we've got the 12-to-15-year-olds getting vaccinated now. And likely in the fall, we will probably see Pfizer coming through with a vaccine approval for two-to-11-year-olds. So it's coming.
But balancing everything, including the need for people to be able to get together, to move about, to engage with each other to socialize. And then looking, of course, at that bigger picture of the protection we've already got with vaccination and low case rates, we don't think there is a high risk to children.
In fact, there's a very low risk to children moving forward in this way.
Bob Kinzel: Should children be wearing a mask if they're interacting with unvaccinated adults?
I would say that children should be following the same guidance as everyone else, other than in the school setting, where we are still masking throughout the end of the year.
So if you're outside, you don't need to wear a mask.
Right now, if you're indoors, and you're unvaccinated in a crowded area and you're above the age … I believe it's four-years-old and younger [that] we said no masks – so if you're at the age where you should be wearing a mask, then you should wear that, if you're in an indoor, more crowded setting, and you are unvaccinated.
I also saw that CDC research shows that schools are not a major source of community transmission, but that extracurricular activities are a different story. Tell us about that.
Yes, we know that schools – because of the great work they've done in actually ensuring physical distancing and ensuring mask-wearing and really the remarkable job the teachers have done in ensuring that they follow all the rules and don't bring the virus into the school schools – have been relatively low, in terms of cases and transmission within schools.
But outside of school, you have more connections. So when people are going to a sports event or another event, they may be in the car in an enclosed area, much closer and for longer periods, where they may be gathering in ways that they might not gather at school – and with a lot more adults.
School is pretty protected. You know, you've got primarily the teachers and the other staff at the school, who have all been, as I say, very careful. When you have a mix of more adults involved, you will see a different outcome.
Now, of course, that's radically changing. Particularly in Vermont, as you see many, many adults getting vaccinated, that risk goes down even in the extracurricular environment.
"... in Vermont, as you see many, many adults getting vaccinated, that risk [of transmission] goes down even in the extracurricular environment." - Tracy Dolan, deputy commissioner of health
We've mentioned on a number of occasions that the state is really putting on the full-court press to bring the vaccine to people, in order to get the rate up as high as possible. There are walk-in clinics, drive-in clinics, places where you don't need reservations. How is the state ensuring that the folks who get their first vaccine this way actually get the second one as well?
Well, for the most part, almost everywhere, where we're giving a first dose, we're going back to get the second dose. And so, that is the best way. It's easiest for people to remember to come back three weeks later, for example, if it's a Pfizer, preferably at the same time at the same location. So up until now, that's what we've been doing.
We do allow for walk-ins, obviously, for first dose, but even for second dose. So some people may choose not to go back to the original location for their second dose. And they may walk in and get a second dose in another location.
Now as we move forward, and as we have smaller and smaller numbers, and we do more and more to get to people and help them access [vaccines], we may be able to see even more ways to get a second dose at a different location. But we have found it really successful and simple for people to come back to the same location, same time for their second dose.
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