A Personal Decision on the Fireline - Are You Willing to Roll the Dice?

By Dr. Jennifer Symonds

Fire and Aviation Management Medical Officer

U.S. Forest Service

The decision on whether or not to get your COVID-19 vaccine is a personal one; we must all make our own choice. Clearly, we all have different motivators for where we land on this issue, but my intent here is to arm you with as much information as I can as you consider this important decision.

Let’s start with explaining exactly what a vaccine is and how it works.

A vaccine is a substance created using part of a disease organism that is weakened, killed, or modified. When introduced to the body, this substance stimulates the production of antibodies that provide immunity against that disease.

Once vaccinated, the body will produce a response to the invasion of an infectious organism that destroys or stops the reproduction of that organism, ultimately preventing the disease from infecting the body. In other words, vaccines are a preventative measure for a disease process.

As effective as they are, vaccines do not prevent an infectious organism from entering the body; they do not create a “protective bubble” around you. Vaccines prepare your body to mount an impressive and effective defense against the infectious organism that enters the body before disease occurs.

When it comes to the COVID-19 vaccines, a lot of bad information has been circulated. Here are some helpful facts, true of all the available COVID-19 vaccines:

• The current COVID-19 vaccines do not have nano-trackers (a GPS tracking device) within them.
• COVID-19 vaccines cannot give you COVID-19. There is no live virus in the vaccine.
• COVID-19 vaccines will not alter your DNA. It never enters the nucleus of your cells which is where the DNA is located.
• COVID-19 vaccines do not affect fertility. The vaccine creates immunity similar as normal immunity obtained from having the COVID-19 disease. If fertility were going to be affected, we would have seen it affected in those who have had COVID-19, which we have not.
• The immune response obtained from having had COVID-19, non-Delta variant, has been found to not protect those individuals against the Delta variant. Therefore, those individuals are at risk for getting COVID-19 a second time with the Delta variant—unless they get vaccinated.

The Medical Realities

From a medical standpoint, one of the biggest concerns with COVID-19 is that given two individuals with the same risk factors—from no risk factors to multiple ones—there is no reason or logic as to why one individual ends up in the ICU on a ventilator, and possibly dead, and another individual only becomes mildly ill.

It is not known why and who will get severely sick or experience long-term symptoms (COVID long-hauler syndrome) to include possible life-altering physical and psychological effects.

What is known is vaccinated individuals are avoiding COVID-19 related hospitalizations and ICU stays. In fact, unvaccinated younger individuals are the population experiencing the highest number of COVID-19 hospital stays because this is the population that tends to have the lowest vaccination rate. It is also worth noting that the death rate of those 55 years old and greater has plummeted due to vaccinations. Vaccines are effective!

The Dangers of New Variants

Variants occur when the virus mutates to increase its ability to spread and reproduce more efficiently. This can be in response to different barriers the virus has experienced while attempting to proliferate such as meeting species that are not receptive to its infection, antibiotics or antivirals, temperature, etc., or as an adaptation to stay contagious longer.

The longer the virus that causes COVID-19 is circulating, the more chance of new variants being created—or variants of variants in the case of the new Delta variant. These variants can cause new outbreaks and possibly increases in severe disease and death, especially among those who are not vaccinated. An infectious organism’s only purpose is to spread, reproduce, and spread some more. The easier it can spread, or infect, the more it propagates. The Delta variant has become very efficient with spread or contagiousness!

I’d Rather Not Roll the Dice

We are all aware of the medical conditions that increase our risk for a bad outcome from COVID-19. For more information on this reality, please see: Certain Medical Conditions and Risk for Severe COVID-19 Illness | CDC . While the majority of wildland firefighters are young, many have medical conditions. In addition, all fire personnel are at an increased risk of creating lung inflammation from smoke exposure when on a fire. This can be a risk factor for severe complications if COVID-19 is contracted.

The tests for COVID-19 only tell you yes, there are viral particles in your body. These tests don’t tell you whether they are live and contagious viruses or dead ones. So, a vaccinated individual without symptoms who tests positive for COVID, is likely not contagious. The test is detecting dead virus and not live, contagious virus. This is probably the reasoning behind the CDC guidance that vaccinated individuals exposed to COVID-19 do not need to be quarantined unless they become symptomatic.

There are a small percentage of individuals for which the vaccine does not provide immunity. Therefore, if a vaccinated person becomes symptomatic, they need to be tested. There are many individuals who, even though they have received a vaccination, are still at increased risk of contracting COVID-19 due to their immunocompromised health state—such as cancer treatment, organ transplant, etc.

People who get vaccinated help protect those who cannot get vaccinated, such as young children, and those people for which vaccination does not provide good immunity.

Whether you get vaccinated or not is ultimately your choice. Please make it an informed one. If you choose not to get vaccinated, you have a duty to continue to practice COVID-19 prevention and mitigation measures—such as wearing masks and physical distancing—to protect yourself and your fellow wildland firefighters.

I personally don’t like rolling the dice.