In Hawaii, the intensive care units (ICUs) are at full capacity — and elective surgeries, which means surgery for anybody who is not at risk of immediate death, have been largely suspended. SARS-Cov-2 infections, so-called “COVID cases,” are higher than ever; people are panicking.

What should we do?

Look, the solution is simple: This is the pandemic of the unvaccinated — two days ago, virtually 100% of those sick in the Hawaii ICUs were not vaccinated.

The fact is that about one-third of people refuse to get COVID vaccines. I do not think that the state should mandate people to get the COVID vaccine; trying to force people to do something does not work in a democracy. So what can we do?

Most of those who refuse vaccination are afraid of RNA vaccines. Many of them say that they are afraid because this is the first time these types of vaccines are being used, so we cannot be sure that there will be not be long-term negative side effects. At this time, late negative side effects are very unlikely because we have not seen adverse effects that would make us suspect that; still, we should respect their concerns.

I was also concerned, for example, when this past winter the RNA vaccines first appeared. So I choose to take the Johnson & Johnson COVID vaccine. J&J’s is not an RNA vaccine; it is a well-established, safe, type of vaccine that has been used in the past to make vaccines for other diseases. We all got these types of vaccines as we grew up and they did not harm us. Therefore, there is an available safe alternative to RNA vaccines.

Are J&J vaccines 100% safe? Of course not. There is no medicine that is 100% safe. Aspirin, the most used drug in the world, has been the cause of thousands of hemorrhages over the years, some of them fatal. Yet we take aspirin — but please, on a full stomach! In other words nothing in this life, including drugs, is 100% safe.

However, the risk that you will get infected if you are not vaccinated is close to 100% because the new variants are very infectious. Inevitably some of those infected will end up in the ICU, and some of them will die. Compared to the risk of getting COVID, the risk that the J&J COVID vaccine would cause any harm to you is minuscule.

Moreover, we live in a society and we have responsibilities toward others. Because the ICUs are full, we have to delay cancer surgeries, heart valve replacements, etc. Many people are dying and will die because of this, and many others will require much more invasive therapies because their cancer will be advanced by the time they finally can be treated.

So the decision of not getting vaccinated, is not just a personal decision; it is a decision than will cost the lives of many others who no longer have access to the medical care they need because unvaccinated people get COVID and saturate the ICUs. So please, get the J&J vaccine, as I did, or any other vaccine if you prefer, to save your own life and to be respectful of the life of others.

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For more information, see the COVID article in the Journal of Thoracic Oncology, https://doi.org/10.1016/j.jtho.2020.12.014.

Michele Carbone, M.D., Ph.D., is the William & Ellen Melohn Chair in Cancer Biology, and director of thoracic oncology at the University of Hawaii Cancer Center.