I have been under treatment for bone marrow cancer (multiple myeloma) since 2013. The therapy was working until recently, but my abnormal blood proteins had begun creeping up again. Finally my physician decided to recommend adding in dexamethasone, a powerful steroid. I am hoping that this medication will help suppress the cancerous cells in my body, but it will also suppress my immune system and make me more susceptible to the coronavirus.

So, I will be joining the tribe of the immunosuppressed.

People with immune system abnormalities or immunosuppression are all around us in the tens of millions. In the young it may be due to childhood cancer, or to the treatment of diseases such as asthma. In adulthood or middle age, people tend to develop autoimmune conditions such as multiple sclerosis, rheumatoid arthritis or inflammatory bowel disease. Almost all treatments for these conditions affect the immune system. The elderly are probably the most numerous. Just aging tends to lead to a slowly weakening immune system. We recently lost former Secretary of State Colin Powell to complications of COVID-19; at age 84 and with both multiple myeloma and Parkinson’s disease, he must have been quite frail.

Interestingly, despite the vast numbers of people who have to deal with this issue, there is no organization that speaks for us – no “National Alliance of the Immunosuppressed.” If you look around the checkout line at the supermarket, it shouldn’t be hard to spot someone who has abnormal immune system function. All of us are much more sensitive to infection by the SARS CoV-2 virus as long as it circulates in the community. It’s agonizing waiting for the pandemic to fade, like it seemed to for a few weeks earlier this summer.

In the meantime it’s vitally important that we get the COVID pandemic under control as fast as possible, while also protecting the most vulnerable among us. Achieving both goals will require very high levels of vaccination, especially with the delta variant circulating. I walk my dog, Lucy, every day at a local recreation area, and have a great deal of fun joking with my circle of human friends while our dog friends play with balls and sticks. I don’t ask the question, but I hope every time I go there that I am surrounded by a “bubble” of vaccinated individuals who will keep the deadly virus at bay.

We frequently talk about the claims of individual liberty that many bring up when refusing to get vaccinated, even in the face of vaccine mandates for health care workers. Of course it’s everyone’s individual choice whether or not to get vaccinated. But a safe workplace for coworkers, customers and medical patients is essential. I would argue that the crisis is so dire that individual liberties and decisions pale in comparison with the need to vanquish the viral enemy. It’s a war against an unseen enemy who takes no prisoners. We’ve lost so far over 750,000 Americans, a death toll more than double the U.S. combat deaths in World War II, with more succumbing every day the pandemic rages on.

A great deal of sacrifice is called for in situations like this. I think we should consider it our patriotic duty to mask up, socially distance and get vaccinated, even if there is a small risk. Another generation of Americans put up with a great deal of rationing because they realized that was the only way to defeat the Nazis and the militant Japanese. Imagine what would have happened if there had been widespread resistance to the war effort. Our individual freedoms are meaningless unless we can also, at appropriate times, put those freedoms second to collective action to achieve a common goal.

Finally, as I write this, the Pfizer mRNA vaccine is in the midst of being approved for children ages 5 to 11. I fear the uptake will be significantly lower for this age group than for adults. I would be surprised if we reach 60 percent vaccinated. But in trying to reach a decision, parents should keep in mind that is a disease that can kill. How many of the hundreds of thousands of children who have already been infected will suffer from the childhood version of “long COVID”? In adults this seems to frequently be associated with troublesome neurological symptoms such as difficulty concentrating, fatigue and memory lapses. We still have no idea whether long COVID can affect developing brains in the same way.

I hope all parents will choose to vaccinate their children. It literally might save their lives. And every new person vaccinated is a step toward the herd immunity that will finally put an end to the pandemic.

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