TRANSCRIPT: Dr. Balser on VUMC's Highest Responsibility, to Care for Its People and Patients

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Hi, everyone.

In the 12 days since we last spoke, we’ve gone from 120 patients in our hospitals to about 150 patients. The latest report from our Health Policy Department to state and local officials shows that the rate of increased hospitalizations at this time is higher than at any point in the pandemic.

The report also shows that the highest rates of COVID-19 are concentrated in younger age groups than in prior surges – those below age 60. While older Tennesseans are vaccinated at high rates, unfortunately, the rates in younger age groups are far lower.

The Pfizer vaccine is now fully approved by the FDA, and across all age groups we still see much milder illness in those who are vaccinated. The only exception is patients who are immunocompromised and can’t mount a response to the vaccine. This group of patients is already being contacted and is receiving 3rd shots at VUMC and medical centers nationwide.  

There is now even more hope for those patients, as AstraZeneca just reported on their results of a long-awaited study of more than 5,000 patients, most of whom were immunocompromised. The study showed that monoclonal antibodies developed by our Vaccine Center, led by Dr. James Crowe and licensed to AstraZeneca, are highly effective at preventing infection in these immunocompromised patients. We hope to see this treatment approved soon in the U.S. and worldwide.

The CDC is now reporting trends showing the vaccine’s effectiveness decreases over time. It’s important to say this was not unexpected. More vaccinated patients are experiencing mild disease than earlier this year, particularly those immunized first during the vaccine rollout last winter. On the other hand, it’s still the case that we are not seeing severe disease, hospitalization, or death in vaccinated patients. So, the vaccine is still doing its most important job – keeping us from becoming severely ill and hospitalized.  

Nonetheless, as you hear on the news, government agencies are making plans to provide booster shots to people this fall. A nationwide booster program of this kind will still require approvals by the CDC and the FDA, and we are following those developments closely. However, if a rollout does occur, those who were vaccinated first — elderly patients and health care providers — would very likely be prioritized.

This pandemic has been hard on people, including our people. I know that many of you are exhausted by the stresses of caring for COVID patients while managing the economic, child care, and health crises you are experiencing at home.

Our highest responsibility is to care for people, and that includes you, the people of VUMC. We announced almost 2 weeks ago that everyone working and learning here will be fully vaccinated by no later than September 30 or have an approved exemption. By requiring the vaccine, we intend to create the safest possible environment for not only our patients, but for you — everyone working at this medical center.  

Another way VUMC can care for you is to provide economic security. In spring of 2020, when health systems in our region and nationwide did layoffs, furloughs and salary reductions, we took a different approach. We made sure everyone at VUMC remained employed and fully paid, and we accelerated hiring to better support our health system and the people of Nashville during the crisis. Please know that we are committed to you in this way, no matter how long the pandemic continues. And as announced earlier this year, merit salary increases will be delivered on schedule across all VUMC divisions effective January 1.

Finally, we are hearing and seeing things — in the media and even in our clinics — that those of us on the front lines of health care find intolerable. Hearing people speak against masking or vaccination when we are working day and night to save the lives of patients who choose not to be vaccinated causes anger — and sometimes despair. Yet we rise above the frustration and care for all — as we always have and always will.

And know this. Throughout the pandemic, as we’ve cared for so many, we’ve played another role. In times of turmoil, the voices of great institutions grow even stronger and become a source of hope for the millions of people who really are anxious to hear the truth.

What I hear every day is that all of us at Vanderbilt are a source of reassurance. We are trusted to provide credible information — for people across the region and often the entire nation. So now more than ever, VUMC will continue to speak clearly about what we know is real and  true in health and disease.

Leadership can be challenging and at times risky, as we sometimes must endure negative comments — even from friends and family. But as we provide clear, sensitive, informed — and, above all, compassionate guidance, we are caring for people — and giving confidence and reassurance to millions. And as we do this, we also affirm our support for one another.

Our guidance will always be based on evidence, and as that evidence evolves — and it will — our guidance will as well. So I will continue to share what I know, and more importantly, what our scientists, clinicians and educators know, about what is real and what can be trusted.

Stay safe, and thanks for listening. We’ll talk again.