Letter From the Health Officer: Answering Questions About COVID-19, Vaccines


I am excited for the beginning of summer. This week I wanted to answer some of the questions I have received from the community.

Why is there a discrepancy between the case counts Thurston County reports on their COVID-19 dashboard versus what is reported on the Risk Assessment Dashboard?

A number of folks have reached out to me regarding a discrepancy between the case counts that have been coming out both for Thurston County and other counties in Washington state and the calculated transmission rates on the governor’s Roadmap to Recovery/Risk Assessment Dashboard. This was caused by delayed reporting by several labs in the state. Thurston County Public Health and Social Services reports cases on the COVID-19 dashboard when cases are reported to us, based on the date we receive the information. The Washington State Department of Health reports cases based on the specimen collection date. While delayed reporting from labs has happened before, the number of cases in prior instances has been significantly smaller. In Thurston County, our cases transmission rates have plateaued and as of June 11, there were 118.9 cases per 100,000 population over 14 days, per the Risk Assessment Dashboard.

If there is a delay in lab reporting, how do we ensure disease transmission is contained?

Congregate care settings like schools, daycares, long-term care facilities and corrections facilities are required to report positive cases to us within 24 hours. This ensures we are able to identify cases and close contacts quickly to reduce disease transmission. Additionally, employers are required to report two or more cases in the workplace that occur within 14 days of each other or if they have reason to suspect COVID-19 is spreading throughout the facility. Lab reporting and facility reporting are both essential to slowing the spread of COVID-19.

How does herd immunity work for COVID-19?

I have been getting a number of questions about herd immunity and COVID-19 vaccinations. Herd immunity occurs when enough people are immune to an illness either through vaccination or previous illness that the spread of the illness becomes unlikely. The percentage of the population required to achieve this varies depending on the characteristics of the disease. We do not yet know what that percentage is for COVID-19. The Centers for Disease Control and Prevention and the Washington State Department of Health recommends vaccination for everyone over the age of 12. I would strongly encourage anyone who has not been vaccinated yet, to get the COVID-19 vaccine, even if you have previously tested positive for COVID-19. Getting the vaccine will not only increase your protection, but it also helps your community and reduces the likelihood of disease transmission. In Thurston County, 59 percent of our population aged 16 years and older have received at least one dose of a COVID-19 vaccine and 51.9 percent have completed a COVID-19 vaccination series. We still have a ways to go to reach 70 percent of people over 16 initiating vaccination, a goal set by Gov. Jay Inslee for reopening before June 30.

While reinfection with Sars-CoV-2 is rare within the first 90 days after infection, we do not know how long antibody protection lasts. We do know that in some instances protection from vaccines is stronger than that acquired from natural infection. A recent study from UC Irvine showed that the antibody titers of individuals who received an mRNA vaccine were up to 10 times higher than those isolated from the plasma of individuals who had previous infection. For more information about this study, visit www.biorxiv.org/content/10.1101/2021.04.15.440089v2.full.pdf.

Will I need to get a COVID-19 vaccine booster dose?

At this time, we do not yet know whether booster doses will be necessary. The CDC reports the currently available vaccines each offer protection against most variants. We are still learning about the protection offered from natural infection against the variants as well as the duration of antibody protection, which is believed to be about 90 days.

I enjoy answering your questions, so if you have more questions about COVID-19 or public health issues, please send them to tcphss.pio@co.thurston.wa.us.


Dimyana Abdelmalek, MD, MPH, is the Thurston County health officer.


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