COVID-19: Stigmatising the Unvaccinated is Not Justified
Günter Kampf, THE LANCET, Correspondence Volume 398, Issue 10314, P1871, Published 20 November 2021, DOI: https://doi.org/10.1016/S0140-6736(21)02243-1
In the USA and Germany, high-level officials have used the term 'pandemic of the unvaccinated', suggesting that people who have been vaccinated are not relevant in the epidemiology of COVID-19. Officials' use of this phrase might have encouraged one scientist to claim that "the unvaccinated threaten the vaccinated for COVID-19". But this view is far too simple.
There is increasing evidence that vaccinated individuals continue to have a relevant role in transmission. In Massachusetts, USA, a total of 469 new COVID-19 cases were detected during various events in July, 2021, and 346 (74%) of these cases were in people who were fully or partly vaccinated, 274 (79%) of whom were symptomatic. Cycle threshold values were similarly low between people who were fully vaccinated (median 22·8) and people who were unvaccinated, not fully vaccinated, or whose vaccination status was unknown (median 21·5), indicating a high viral load even among people who were fully vaccinated.2 In the USA, a total of 10 262 COVID-19 cases were reported in vaccinated people by April 30, 2021, of whom 2725 (26·6%) were asymptomatic, 995 (9·7%) were hospitalised, and 160 (1·6%) died.3 In Germany, 55·4% of symptomatic COVID-19 cases in patients aged 60 years or older were in fully vaccinated individuals,4 and this proportion is increasing each week. In Münster, Germany, new cases of COVID-19 occurred in at least 85 (22%) of 380 people who were fully vaccinated or who had recovered from COVID-19 and who attended a nightclub.5 People who are vaccinated have a lower risk of severe disease but are still a relevant part of the pandemic. It is therefore wrong and dangerous to speak of a pandemic of the unvaccinated. Historically, both the USA and Germany have engendered negative experiences by stigmatising parts of the population for their skin colour or religion. I call on high-level officials and scientists to stop the inappropriate stigmatisation of unvaccinated people, who include our patients, colleagues, and other fellow citizens, and to put extra effort into bringing society together.