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“When can we go back to Starbucks?”

My brother, Anmol, asks me that question every time I’m home for a visit.

It’s our tradition. When I’m home, the two of us go to a nearby Starbucks. Anmol doesn’t know a venti from a grande or a mocha from a hot chocolate, so I order whatever I think he’ll like and something for me. As we sit inside the cozy cafe, he nurses his drink and tells me what time the recycling truck came by the house, how many paper bags he’s added to his collection, what random person’s birthday is coming up, and much, more more.

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Anmol really looks forward to this ritual. He doesn’t get out of the house much, and only sees me every few months.

He doesn’t actually see me. Anmol has been blind since he had a stroke before he was 2 years old, a complication of the congenital kidney disease that caused his intellectual disability and necessitated a kidney transplant at age 3. He’s been on drugs to suppress his immune system for the past 33 years.

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The pandemic has interrupted our ritual. Anmol lives with our parents, both in their 70s, and I live more than 400 miles away, working as a doctor on inpatient medical wards taking care of patients with Covid-19 at the hospital in New England that has treated the most Covid-19 patients. I come home for a visit only when I feel comfortable I won’t be bringing the virus with me.

As a physician, I was in the first wave of people to be vaccinated. My family got their shots a few months later. Now that we are all vaccinated, Anmol wants to go to Starbucks.

I’m not sure we’re ready to do that.

The Centers for Disease Control and Prevention recently decreed that fully vaccinated people no longer need to wear masks outdoors or indoors. If the CDC, led by someone I personally trust — the former head of infectious diseases at my hospital — says that going maskless is okay as long as you’re fully vaccinated, I’m on board with that.

But as I see businesses — including Starbucks — start dropping masking requirements for customers, I’m pretty sure people aren’t hearing the “as long as you’re fully vaccinated” part.

As people start celebrating the so-called return to normalcy, vaccination rates have dropped. I worry that Americans are going to stop getting vaccinated, thinking that with falling case numbers and death rates, and the new guidelines, the CDC has sounded the “all-clear.”

A friend said to me, “People who don’t get the vaccine now only have themselves to blame if they get Covid-19.” It’s a common refrain, though one I don’t believe. My bigger concern is for those who can’t get the vaccine for medical reasons and those for whom vaccines probably won’t work — like Anmol.

A week before the CDC mask announcement, a major study showed that almost half of people living with organ transplants produce zero antibodies after two doses of vaccine, including nearly 60% of people on the drugs that Anmol takes. The very drugs keeping his body from rejecting his kidney make him vulnerable to infection from SARS-CoV-2 and other pathogens.

There are a lot of Americans like my brother. There have been more than 850,000 organ transplants in the U.S. since 1988, including 39,000 during 2020. An estimated 2.7% of all Americans are immunocompromised, many of them because they are taking the same drugs as transplant recipients for Crohn’s disease, psoriasis, and other autoimmune diseases.

President Biden said, “If you’re fully vaccinated and can take your mask off, you’ve earned the right to do something that Americans are known for all around the world: greeting others with a smile.” Anmol is vaccinated, and always greets people with a smile. But he can’t show it in public. Not yet.

Instead, his doctors say he should keep wearing a mask and social distancing when he is outside of the house, and to follow the guidelines for people who aren’t vaccinated. I ask them if Anmol should be tested for antibodies. They say no: we don’t know at what level of antibodies he’s truly protected. The antibody test will only give a “false sense of security.”

The disappearance of Covid-19 from the community will slow as people stop wearing mask, stop social distancing, and stop getting vaccinated. In March 2020, when vaccines were just a glimmer in pharmaceutical companies’ eyes, we worried that Covid would blaze through the population like a wildfire. Today, with about half of Americans vaccinated, we’ve got the fire contained, but if we stop fighting now it will burn steadily for a long time. To put it out, unvaccinated Americans need to get their shots.

The sooner they do, the sooner I can take Anmol to Starbucks. America, please help me fulfill his simple wish.

Hemal N. Sampat is an internist and pediatrician at Massachusetts General Hospital and an instructor in medicine at Harvard Medical School.

  • I had a liver transplant May 2020 I’ve had my vaccine … John Hopkins tested my blood, I have antibodies ..false security? I haven’t been wearing my mask. Thought I was safe. Going next week for 1 year check up.. guess I’ll see what my liver doc says. 😢

  • Many Ignoramouses in the US are either too chicken or too selfish to get vaccinated. It might take a couple of Covid deaths in their families or groups of friends to rattle them into reality. A sizeable chunk of the US population has sunk so low that they don’t care that their un-vaccinated egoistic liberties force many like Anmol into a limbo, without a return to normal life. I truly appreciate that many countries, businesses, air lines, and employers want to see proof of vaccination. Those who refuse vaccination should be blocked from a return to normal life, not people like Anmol.

  • Thank you for trying to help raise awareness on this issue. My wife has a kidney transplant. She’s been home for 14 months. A big day out is a walk in a park when we’re confident it won’t be crowded or a trip to the grocery store to pick-up curbside. Restaurants are out of the question as are parties, barbecues, etc. She had both doses of Pfizer’s mRNA vaccine but tested negative for antibodies. We’re in the southern US and I know our local vaccination rate is about 30% at best. Even though I’m immune competent and vaccinated l, I still have to be careful to make sure I don’t bring it home; I’m an essential worker and the breadwinner/benefits provider for our family. I’m growing more fatigued; but she’s more than with what ever I have to do.

  • My heart goes out to you.

    My partner, who has leukemia, is in a similar boat. But I feel the world has changed, and until there is more data that would indicate otherwise, we will mask up and distance and take some limited risks (doctors, dentists, optometrists, and so forth) while substituting some more recently learned behaviors for old ones in environments that seem safer to us (takeout instead of dining in).

    And yes, please continue to say, write, and do what you can to get more folks to vaccinate. Thanks.

  • Regardless of how you want to frame this, other people’s personal health decisions are not a determining factor of how you live your life. You are responsible for your health. Other people are responsible for their own health.

    At this point, the focus/outcome of the current vaccines is not sterilizing immunity. In fact, they are unsure if this is even a possibility. They have induced the production of neutralizing antibodies but are still establishing what level of antibodies are necessary to prevent illness after exposure. You clearly have access to this information and yet you seem to be overlooking these key points. A central tenet of these particular products is that they reduce symptoms, not prevent transmission.

    From the policy perspective, these products are liability-free.【85 Fed. Reg. 15198】

    You may want to turn your attention back to the details of these products instead of pointing figures at others.

    You seem to have followed everyone’s rules and yet you refuse to budge an inch. Take him to Starbucks or hold him hostage at home — these are YOUR choices. Other people will be living in ways that meet their personal health needs.

    I am unsure if you thought an emotional plea would help your message but it truly makes me question your knowledge base.

    I wish you the very best with Anmol. I really hope he has his coffee treat soon. I would gladly take him for you…or bring him a coffee!

    • Interesting as my husband is a kidney transplant recipient and on immunosuppression drugs and he will not be getting this or any other “vaccine.” It is alarming to me that people have limited knowledge on this emerging mRNA /spike protein information as well as the numerous side effects and yet are still touting and bragging about their participation . Some even going as far as shaming others for not “buying into ” false security regarding a virus that has a survival rate of 99% . If you are vaccinated what are you afraid of ? The fact that your inate immune system is destroyed by taking these shots , you will have to get booster after booster to facilitate these variants . I feel bad that your brother has to suffer out of fear , go live your life and help him live his .

  • Go to Starbucks buy your brother a drink and bring it to him .you can’t sit in the Starbucks stores right now.

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