Credit: Lompoc Valley Medical Center

It’s early days for seeing any increase in COVID-19 vaccination numbers after California’s extraordinary announcement last Thursday of $1.5 million giveaways to vaccinated residents. Anecdotally, around Santa Barbara County, nothing has changed: People are getting vaccinated pretty much as before, enjoying the ability to make same-day appointments and the seeming abundance of vaccine of any type, or staying away for various reasons.

With the county’s vaccination rate currently at 52 percent — or 183,822 residents still to go — and ratcheting upward slowly, masks have come off in outdoor places, though most people continue to wear them indoors in stores. For some, however, typically those with lymphoma or very serious autoimmune conditions, the vaccine tends to be thwarted by the anti-B cell meds they take, so continuing to wear a mask gives necessary protection.

A quick survey of the county’s hospitals found no immediate increase in vaccinations, though Cottage Hospital noted the governor’s announcement came after its clinic scheduled that Thursday morning. (The next one is this Thursday, June 3.) Public Health’s walk-in clinic at the Santa Maria Fairgrounds was routine. (Another is Thursday at Earl Warren.) Over at Sansum, appointments that would have filled in 30 minutes when vaccines first became available are going vacant.

“Even if 100 people come to be vaccinated, that’s great for them and good for us all,” said Dr. Lynn Fitzgibbons. She has a wide experience with infectious disease at Cottage, with Public Health, and worldwide, and has been a part of the UC Santa Barbara variant research team since its inception in February. Hundreds of people are still getting vaccinated at pharmacies and clinics around the county, she noted, where same-day appointments and walk-up clinics are popular.

The cash incentive was a good idea given the moment, Fitzgibbons thought, as first doses have declined across the state and in Santa Barbara. The groups most enthusiastic to be vaccinated had already completed their shots, and that group, Dr. Fitzgibbons said, had a lot of former patients who’d suffered from COVID; they positively did not want to get it again.

However, for Hesu Whitten, a chiropractor in Santa Barbara, the cash incentive was a form of coercion by the state. “In some states, children are being coerced with ice cream cones,” he said, and when vaccines were given at or through schools, it became a hard-to-resist type of peer pressure. COVID vaccines are still on an emergency use authorization, and Whitten considered that to be less than the informed consent necessary for medical procedures.

Whitten also echoed concerns that vaccine-induced antibodies are less effective than those that result from infection: “natural killer (NK) cells,” or lymphocytes, which are in the family of T and B cells. Discussions of the role of antibodies and T and B cells are among the new medical literature coming out before peer review, as are papers on disease among children and the progress of variants. Several Santa Barbara pediatricians discussed these issues with Dr. Fitzgibbons in a webinar that took place on May 21 (and can be viewed here). The pediatricians agreed with Whitten’s contention that children got less disease. While he found that a reason to argue against vaccinations, for the pediatricians on the panel, the severe COVID cases the hospital had seen in children and the unknowns with the variants would be arguments in favor of being cautious and getting vaccinated.

Fitzgibbons also emphasized the necessity of following up on newly published reports. For instance, Vietnam reported on Saturday that it saw a new mutation that combined characteristics of both the U.K. and Indian variants, each of which is more contagious than the original, “wild” SARS-CoV-2. The development was worth noting, she said, but it was also still a “maybe” at this point.

Locally, the most recent set of variants analyzed at UCSB found that the West Coast mutation had disappeared entirely, Fitzgibbons said, displaced by the U.K. variant — recently renamed by the World Health Organization as the Alpha variant. The variant surveillance data for the county now includes not just the UCSB sequencing but also results from the state and the CDC, a total of 858 samples as of today. For May, the small sample size lists primarily the U.K., or Alpha, variant, and the P.1, or Gamma, first detected in Brazil and Japan.

In April, two samples containing the variant that is devastating India were found in the county. Now called Delta, it represented 4.1 percent of samples sequenced in California as of May 21. “Delta” wasn’t detected in Santa Barbara County in May, but it’s likely due to the fewer than two dozen samples sequenced — and a matter of time; Delta reportedly displaced the U.K. variant in the U.K. in recent days.

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