It has been months, but I still can’t stop thinking about him.
I met Mr. Franco* — a nursing student, as luck would have it — about a year and a half ago when he came to my clinic with cancer that had spread to every part of his body. He seemed destined to live only a month or so.
Happily, however, he responded with unusual vigor to chemotherapy and was soon back on his feet: working part time (though from home in an administrative role) and able to enjoy Thanksgiving and then Christmas with his family.
Just after the holidays, however, he was admitted to the hospital with difficulty breathing. COVID-19 was ravaging his lungs. Though initially stable, after three days his condition suddenly worsened. I spoke to the team caring for him numerous times over the phone that day. Within 12 hours he went from stable, to seriously ill, to critically sick, to dead.
His counts as one of the three most precipitous and terrifying deaths I’ve witnessed in 15 years of practice.
Just like that, his life was snuffed out by the virus — even though he had been monastic in avoiding exposures.
He died just as vaccines were about to become available, but it is entirely possible he would not have benefited even if he had gotten one.
You see, as his oncologist, I had spent the previous year giving him chemotherapy. My treatments unquestionably extended his life but also depleted his immune system. Increasing evidence demonstrates many such patients simply do not respond to the vaccine. Receiving the vaccine, for them, is like plugging a computer into a broken outlet — nothing happens. And to make matters worse, cancer patients are already at abnormally high risk of serious illness and death if they contract the virus.
It’s not just cancer patients who are vulnerable. Patients who take immunosuppressive medications for any reason may be at similar risk (for instance, those who’ve undergone organ transplantation and those with autoimmune diseases like rheumatoid arthritis or inflammatory bowel disease). It is also possible that the elderly — whose immune systems are simply no longer as robust as they were in earlier years — may also see their immunity wane more quickly (even after vaccination or previous infection).
The only way these patients can be effectively protected from COVID-19 is by the rest of us getting vaccinated and wearing masks.
Of course, it may not surprise you to hear that a doctor is shouting at people to wear masks and get their vaccines. But my conviction about the importance of this vital public health measure actually flows as much from my religious identity as from my medical one.
And really, this should come as no surprise at all.
Virtually all religious traditions, after all, emphasize our moral obligation to protect the vulnerable.
In my own tradition — The Church of Jesus Christ of Latter-day Saints — Benjamin, a beloved ancient prophet-king, summed this up simply: “When you are in the service of your fellow beings, you are only in service of your God.” A modern church leader, apostle Dale Renlund, pointed out the second great commandment is to love our neighbors as ourselves and then reminded us that in the pandemic “that means social distancing, wearing a mask, and not gathering in large groups.” And, finally, speaking of vaccines specifically, multiple modern LDS leaders have counseled “available vaccines have proven to be safe and effective” and have urged all who are eligible to receive them.
Amid this pandemic, vaccinations give those of us who are immunocompetent the chance to circle the wagons of our collective immunity around those whose immune systems no longer function normally. Our sense of charity and responsibility can thus speed the world to becoming safer for the medically vulnerable once again.
To be clear, I do not question the motives or charity of those who have not yet been vaccinated. Vaccines have become inexplicably politicized and find themselves in the eye of a swirling storm of misinformation. I know many good people either believe the virus itself is not dangerous or the vaccines represent a grave threat.
But my religion also teaches me I have a moral obligation to seek out facts and to seek to understand the world as it is — our scriptures teach that “truth is knowledge of things as they are, and as they were, and as they are to come.” Conspiracy theories, unsubstantiated rumors and baseless opinions do not constitute truth.
While acknowledging science never deals in certainty, we can rightly claim great confidence in these twin facts: 1) The virus has killed more than 670,000 Americans, or 1 in every 500 people; and 2) the mRNA vaccines work superbly well at preventing serious infections and have been convincingly linked to no untoward effects in adults.
Given this, we are left with this stark reality: Even if your risk of serious illness from the virus is relatively low (and that may not be as low as you hope, especially with the delta variant), getting vaccinated can be a powerful choice in the name of the vulnerable. By the same token, evidence demonstrates masking, too, powerfully protects the vulnerable against this deadly disease.
At a time of such great suffering, with a plague stalking the most medically at risk at every turn, we as a people cannot turn to hollow cries of “freedom” or to myopic focus on personal rights. This is especially true for people of faith. While reasonable questions can be asked about the legality and ethics of mandating vaccines or masks, such mandates should, for us, be moot.
Our religious code — and our collective conscience — compel us to mask and to be vaccinated because in doing so we protect those who cannot protect themselves.
Let our masks be signs of compassion, and our jabbed arms tokens of lovingkindness toward those who cannot protect themselves.
For my patients and for all of us: Please wear a mask and go get the vaccine.
* Medically insignificant personal details have been altered to protect the identity of the deceased.
Tyler Johnson is a clinical assistant professor of medical oncology at the Stanford University School of Medicine, where he also helps lead the oncology fellowship program. In The Church of Jesus Christ of Latter-day Saints, he has been a bishop, institute teacher, ward service co-chair, Primary teacher and member of a bishopric.
To combat misinformation, Johnson invites you to visit this link, where he has posted a 17-page, independently researched summary of information regarding the vaccines’ efficacy and safety. He has no commercial ties to any entity involved in conceptualizing, producing or distributing the vaccine and will not profit financially by a person reading this or being vaccinated.
