How does employee vaccination help protect St. Jude patients?

St. Jude leadership recently announced that all employees (unless otherwise accommodated) must be vaccinated against COVID-19 by Thursday, September 9.

Over the last few months, the hospital has worked to help get the employee population vaccinated and to provide education about the vaccine’s benefits. The St. Jude intranet features COVID-19 Vaccine FAQs covering a wide variety of topics such as safety, side effects, pregnancy and fertility. Faculty and staff can choose from any of the three COVID-19 vaccines. Walk-in, no appointment-needed COVID-19 vaccination events were held on campus where all three vaccines were available and experts answered questions.

To explain why getting vaccinated is critical to our mission, St. Jude scientists—among the most renowned scientists in the world—have discussed the safety of the COVID-19 vaccine and how it protects us from the virus. Diego Hijano, MD, a pediatric infectious disease specialist and deputy medical director for Occupational Health, offered some insight on what it means for our patients to be immunocompromised from a biological perspective. In this Q&A, he explains how employee vaccination protects patients. 

Q: Are St. Jude patients more likely than other kids to be diagnosed with COVID-19?

Dr. Hijano: Yes. Generally, all our patients are at risk for catching the SARS-CoV2 virus and developing severe COVID-19. Those at risk include our patients with cancer, sickle cell disease or those undergoing bone marrow transplantation. Severely ill COVID-19 patients are more likely to be admitted to the hospital and are more likely to develop life-threatening complications.

Q: Can you explain how the SARS-CoV2 virus becomes a severe COVID-19 infection?

Dr. Hijano: The SARS-CoV-2 virus enters through the nose and the upper respiratory tract. That’s where the immune system will try to eliminate the virus. But in some cases, the virus spreads into the lungs and causes pneumonia or spreads to other organs. That is when antibodies become important. 

It is much harder for immunocompromised patients to clear SARS-CoV-2 infections. The virus is more likely to spread into their lungs. Patients with low white blood cell counts cannot mount a robust immune response, including the B cells to produce antibodies that help contain the virus.

Most healthy kids recover—though some have complications—and they are eventually able to get a grasp on infection and get rid of the virus. In our immunocompromised patients, the virus will continue to replicate and will stay with them. They do not have tools to fight it.

Q: Why is COVID-19 a greater risk for St. Jude patients than for other children?

Dr. Hijano: The same disease that brought patients and families to St. Jude also explains why COVID-19 poses a greater threat. Their disease or its treatment have weakened their disease-fighting immune system, depleting the T cells and B cells that recognize and eliminate infections. That makes it harder for patients to fight off infections, including the virus that causes COVID-19. The virus is more likely to spread from the nose and upper respiratory tract to deeper in the lungs and other organs. That can lead to pneumonia and other serious, life-threatening complications.

Q: Why is the delta variant of COVID-19 so concerning?

Dr. Hijano: I am extremely concerned about the delta variant. It is clear the delta variant is responsible for the surge in pediatric COVID infections, particularly in younger children who are not eligible for the current SARS-CoV-2 vaccines. Severe pediatric cases of COVID-19 are on the rise in our area, with about 1,500 active pediatric cases in Shelby County alone. Even children who are not immunocompromised are being hospitalized with this variant. In recent weeks, children have accounted for about one quarter of active cases. This is the most dangerous time during the pandemic so far for our children.

Q: Why do employees who don’t interact with patients need to get vaccinated?

Dr. Hijano: Our responsibility is to provide our patients, their families and everyone on the St. Jude campus with a safe treatment and work environment. This requires that we are all vaccinated. Vaccination rates in Tennessee and Shelby County are below the national average. Across the country we see the most cases in areas with the lowest vaccination rates. We are always a reflection of the community.

Q: Who else should get vaccinated?

Dr. Hijano: Every person over the age of 12 (who is eligible) should get vaccinated for COVID immediately. And if a child is not yet eligible, those in close contact should be taking additional precautions such as masking up to protect them. Every COVID-19 vaccination on campus and across our community helps protect our vulnerable patients. 

Q. What about our other patients who do not have cancer but have another catastrophic disease?

Dr. Hijano: Some of our patients may have more healthy immune systems, especially as compared to cancer patients. However, these patients may have underlying cardiopulmonary co-morbidities, such as our patients diagnosed with sickle cell disease. These patients are clearly predisposed to poor outcomes if they become infected with SARS-CoV-2. In addition, infections, such as COVID-19 can trigger further sickle cell disease–related complications such as pain and acute chest syndrome. It is important to understand that each of our patients is at risk of complications due to COVID-19.