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COVID-19

To V or not to V? That Is the Question

By Dr. Martin Lustick

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The recent approval of a COVID-19 vaccine for children over 5 years old means that 94% of Americans have the opportunity to be vaccinated. With the addition of these nearly 25 million children, we now have a realistic chance to attain herd immunity. That said, recent data suggest that approximately 25% of adults in the U.S. have still not been vaccinated.  Contrast that with a June survey by the American Medical Association (AMA) of U.S. physicians in which 96% of physicians reported having already been vaccinated.

Despite this overwhelming physician support of COVID vaccination, why are so many people still hesitant? A recent Pew research poll shed some light on this issue. By comparing the perspectives of vaccinated to unvaccinated populations they uncovered some critically important insights. Hesitancy seems to be driven by a lack of confidence in the process used to develop the vaccines, distrust and confusion regarding information about the vaccines, and feeling there is too much pressure to get vaccinated.

Know Your History

While 91% of vaccinated respondents expressed confidence in the research and development of the vaccine, 88% of the unvaccinated expressed a lack of confidence. There has been so much media focus on the “miraculous” development of a vaccine in less than one year, that the 60-year history behind this first mRNA vaccine seems under-appreciated. There is an early span of research starting with the discovery of mRNA in 1960 and the first mRNA synthesized in 1984. The first mRNA vaccine was tested for cancer in 1995 and Katalin Karikó’s work culminated in her 2005 demonstration that modified mRNA could avoid the immune system and thus enter the cells to produce the proteins required for immunity. In addition to this basic science work, the original SARS outbreak in 2002-2003 resulted in an intense research focus specifically on the coronavirus and how to design a vaccine to protect against future, more virulent, versions.  All of this laid the groundwork for the rapid development of an mRNA vaccine specific to COVID-19.

While explaining this history is fairly straightforward, overcoming distrust and confusion regarding information about the vaccines presents the most difficult challenge for healthcare providers. In the Pew survey, 81% of those remaining unvaccinated felt that we don’t really know the risk of vaccination, and 80% said that public health officials aren’t telling us everything about vaccines. Beyond that, 70% said it’s just hard to make sense of all the information that is out there.

Overwhelming Numbers

the numbers are almost too big to absorb. In the U.S. alone there have been over 46.7 million confirmed cases of COVID-19, over 3 million hospitalizations, and over 757,000 deaths. On the vaccination side of this equation 430 million doses have been administered (7.3 billion worldwide). A recent study published in Science demonstrated 86% effectiveness in preventing hospitalization. The vaccines have proven extremely safe with estimates of a side-effects rate at 2 per 100,000 doses of which the overwhelming majority are easily managed allergic reactions. Comparing this risk of a serious reaction to the vaccine to the risk of being hospitalized for the illness itself is equivalent to comparing a 96 lb. women to a 320,000 lb. blue whale. Perhaps this picture will help people appreciate this comparison. 

Learn more about NextGen Healthcare’s COVID-19 resources here.


Dr. Martin Lustick

Senior Vice President, NextGen® Advisors

Dr. Martin Lustick is a principal and senior vice president with NextGen Healthcare focused on supporting provider organizations in their successful transition from volume to value-based care…

Dr. Martin Lustick is a principal and senior vice president with NextGen Healthcare focused on supporting provider organizations in their successful transition from volume to value-based care.

Dr. Lustick earned a BA in History from Cornell and an MD from Columbia. After completing his pediatric residency at Children’s Hospital National Medical Center in Washington, DC, he was in clinical practice for 17 years with Kaiser Permanente of the Mid-Atlantic States. While there, Dr. Lustick held various management and leadership roles, including chief operating officer for the 800-physician medical group. He oversaw development of their hospitalist program, population health capability, and open access delivery model.

Dr. Lustick then served as chief medical officer for ThompsonHealth—a small health system in Canandaigua, NY—where he provided clinical oversight for hospital, SNF, nursing home, IT, and out-patient physician practices.

In 2005, Dr. Lustick assumed the role of SVP & CMO for Excellus BCBS which covers 1.6 million lives comprised of Medicare, Commercial, and Medicaid. In his 13+ year tenure there he led a variety of strategic initiatives, including a patient-centered medical home program which served as the foundation for the plan’s value-based payment strategy. He also led the implementation of an automated authorization program for care management services, development of a clinical quality improvement strategy, and creation of innovative programs in management of low back pain, screening and prevention, opioid addiction, and chronic disease management.

Dr. Lustick has also been very active in the community, serving on boards and committees confronting issues such as: healthcare capacity planning, Health Information Exchange, mental health, substance use disorders, social determinants of health, and childhood obesity.

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