The delta COVID mutation is at least twice as contagious as the original strain. In a recent study in Israel, roughly half of the adults infected in a delta outbreak were fully vaccinated with the Pfizer vaccine.

Fortunately, for now, vaccines reduce severe disease and deaths in people with all known mutations. In the U.S., 57% of those over 18 are now fully vaccinated. Hawaii is at 63%. The CDC director just reaffirmed that vaccinated people don’t need masks in most cases, but this could change. For now, mask use has plummeted, and most of the vaccinated behave as though the risk is nil. New Orleans is in full party mode, and Hawaii visitors are back in droves. Summer has come on with a vengeance for travel and the desire to slake the thirst for human interaction brought on by a year of relative isolation.

However, the delta mutation has spread rapidly through India and Britain, and case rates are increasing. Delta poses a threat especially where vaccinations rates are low, such as Africa, which sits at 2-3%. Rates are also low in India, Russia, South America and much of Asia. The only way to get COVID under control is collective attention to ensure vaccination for the entire global population. Unless and until this happens, places with low vaccination rates will see continuing mutations resulting from high case rates. These new mutations will come back around, and the vaccinations that work for us today might not work tomorrow. Approximately 2.5-3 billion of nearly 8 billion people on the planet have been vaccinated. During the recent G7 meeting, rich nations pledged 500 million vaccines to nations with low rates, but this is not enough. A population must reach a vaccinate rate of 70-90% to achieve herd immunity, and few areas are yet at this level.

While hampered access to COVID vaccinations is a serious issue, there are also many who can get the shots but won’t. In fact, vaccination rates in the U.S. and Hawaii have slowed, and many populations are still short of herd immunity for this reason. It is disturbing that identity politics, conspiracy theories, obtuse definitions of liberty and bizarre views of pseudoscience place not only individuals, but the public at risk. It is critical we realize that a personal decision to decline vaccination places others at risk. It is a question of social justice.

I’ve written previously that I lost my own mother to COVID in September. She had been fully secluded except when going for dialysis, where impeccable care is taken to prevent infection. But there was a family member who often came to her home without a mask, boasting that “I am just going to live my life and take my chances.” The problem is that COVID precautions and vaccinations are not only about us.

Are there risks to COVID vaccinations? Definitely. There are also risks to drinking too much water. There are risks to driving a car and of getting knocked out by a falling coconut. Personally, I would not quickly take a brand-new vaccine for an uncommon illness that is not serious. There is no question, however — absolutely no question — that the risk of COVID is far greater than the risk of any known vaccine.

Just as we open schools and businesses and celebrate life with sports events, concerts and weddings, news of the delta mutation is the last thing we want to hear. Yet, even in populations nearing herd immunity, the risk for micro-surges of the delta mutation, especially in the unvaccinated, is quite real. Remember, the more COVID spreads whether near or far, the more it replicates, and the more chance it has to mutate. There is a real possibility that we will need boosters or even a new vaccine as COVID continues to mutate as it winds around the world. As we have seen, especially with delta, the more contagious a mutation, the more quickly it becomes the dominant strain. Already in Russia, delta represents 89% of new cases, and in Britain and India more than 90%. Delta has now been found in all 50 states.

Lockdowns have already begun again in Israel, which has among the highest vaccination rates in the world. Because of delta, Australia also now has nearly half the country under lockdown once more.

Getting vaccinated and bringing populations to the point of herd immunity is now more important than ever. But even when vaccinated, we must not fall into a false sense of security that all risk of COVID has passed. We must think not only of ourselves, but also of our families, schools and workplaces. As a medical officer during the Hokule‘a’s around-the-world voyage, we sailed with the mission of Malama Honua, “caring for the world.” The COVID pandemic affects us all, and each of us must do our part to prevent its spread.

Ira Zunin is a practicing physician. He is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.