New Haven Register (New Haven, CT)

A decision to get the COVID vaccine

- DR. DAVID KATZ Preventive Medicine

The remarkable intricacie­s of our immune system are all to nature’s credit. So is SARS-CoV-2.

Assuming one becomes available to you soon, should you, or shouldn’t you, roll up your sleeve for a COVID vaccine?

Please indulge me in a thought experiment on our shared way to my conclusion.

Imagine two teams of engineers: A and B. One, Team A, is, arguably, the best that even the most vaccine reticent could possibly wish. Membership is reserved for the most experience­d, wise, and venerable. The team is methodical, meticulous, and infinitely patient. Their track record of success is recognized, respected, and celebrated by all.

Team B is comprised of much younger, less experience­d members. To be fair, however, these engineers are all highly and appropriat­ely trained, dedicated, smart, and caring. They are experience­d, but much less so than the other team. They are, if anything, impatient, rather in contrast to their counterpar­ts. While Team A occasional­ly surprises, their methods, efforts, and ends tend to follow a mostly reliable and often predictabl­e pattern. Team B also relies on precedent, and builds on prior successes. However, Team B is more prone to shop for epiphanies, and engender surprises. Team B, we might say, operates with fewer rules; they are the “cowboys” of the engineerin­g world.

We can stop there, and pull back the curtains to reveal identities. Team B is made up of scientists. Team A is…nature. We can anthropomo­rphize to facilitate the comparison, and say Mother Nature (she/her). We could detail the roster of members, evolutiona­ry biology, natural selection, adaptation, mutation, and more, but perhaps the “Science Team” versus the “Nature Team” will suffice.

Perhaps you are thinking, almost reflexivel­y, that you will go with nature. If so, imagine now, if you would, an injured impala. The injury in question is to a leg, is not too serious, would heal fully in time, but for now, is seriously affecting speed.

The remedy of science for this scenario would likely be an animal rehab center. The animal would be tranquiliz­ed, transporte­d, and treated, then given time to strengthen and mend. After that, it would be returned to the wild where it might well thrive for years, and produce offspring.

Nature, too, has a remedy for an impala with an injured leg: a hungry cheetah. Nature’s method is decisively brutal for the impala, but swift and effective. The injured leg ceases to be anyone’s problem, and proves to be the cheetah family’s boon.

You see the point? Sure, nature is a fabulous engineer. So, sure, you might prefer her products to our own. But as often as not, she is working for the other side. Nature, natural selection, designed the extraordin­ary defenses of human physiology. But she also designed rattlesnak­e venom that undoes them. Nature designed the remarkable array of lymphocyte­s that patrol our inner byways of lymph and blood — but also designed HIV that has been deluding, defying, and decimating those lymphocyte­s for the past 40 years. The remarkable intricacie­s of our immune system are all to nature’s credit. So is SARS-CoV-2.

I will be vaccinated, but not because I think the vaccine carries zero risk: I know the opposite to be true. And, sure, I would really like to have data about the longterm effects (i.e., years) of the

vaccine first. But we don’t have years-long data about the virus, either, and for all we know there could be late consequenc­es of infection. Let’s be clear, the only riskfree pandemic option is not to be in a pandemic. Once in one, our options all involve risk. The lesser risk is the best we can now do.

Taking Nature’s chances may appeal, just because they issue from nature. But let’s concede that Mother Nature is not reliably on our side; it’s our job to be on hers. Uniformly favoring the engineerin­g of nature fails to consider the nature and objectives of her engineerin­g.

We rely on nature’s engineerin­g to save us, or even necessaril­y serve us, at our peril, too. Yes, we are beneficiar­ies of Team A’s extraordin­ary engineerin­g prowess. But in that, we are not alone. Team A, after all, engineered the virus, too.

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