We hosted a forum about the COVID-19 vaccine right now on our Facebook page. If you’d like to read a transcript of the forum, it’s posted below.
The forum was hosted by The Frontier’s Kassie McClung and Ben Felder.
Joining us on the panel are:
Dr. Jared Taylor, Oklahoma’s interim state epidemiologist. Taylor also is a professor at Oklahoma State University, where he works in the veterinary pathobiology department. His teachings include epidemiology and public health in the veterinary curriculum.
Dr. Eliza Chakravarty, an associate member of the Arthritis & Clinical Immunology Research Program at the Oklahoma Medical Research Foundation. She graduated from Johns Hopkins University School of Medicine medical school and received a Master of Science degree in epidemiology from Stanford University School of Medicine.
Dr. Douglas Drevets, the chief of infectious diseases at OU Health in Oklahoma City and is a member of the state’s COVID-19 Vaccine Distribution Advisory Council.
Transcript
Ben Felder: Hello, and welcome to this live virtual forum on the COVID-19 vaccine and what Oklahomans might expect in the weeks and months to come as distribution is expected to begin.
I’m Ben Felder with The Frontier, speaking to you from The Frontier’s office in Oklahoma City. My colleague, Kassie McClung, who covers health care for The Frontier, is at our office in Tulsa. Also in Tulsa is The Frontier’s editor in chief, Dylan Goforth, who is producing today’s broadcast. And today we have three experts to talk with about the vaccine in hopes of answering some of the biggest questions we all have.
We’ll introduce our three guests in a moment, but first, a few housekeeping items …
Throughout this panel, which will last about 55 minutes, viewers are invited to submit questions in The Frontier’s Facebook feed. After our initial conversation, we will turn to some of your questions to make sure we are hitting the issues that matter most to you.
If you are unable to stay for the entire panel, be sure to look for the full video, which will be posted on our Facebook page and at ReadFrontier.org.
Maybe you’re a regular reader of The Frontier, and if so, thanks for joining what we hope will be the first of many live virtual discussions moving forward. Maybe you’re one of our financial supporters, and if so, I want to say a big thanks. As a nonprofit news organization, we rely on the support of readers like you who make our work possible.
If this is the first time you have stumbled across us, then welcome. We are a news organization dedicated to in-depth and impact journalism in Oklahoma and you can find our work at ReadFrontier.org.
Since March, when the first cases of COVID-19 arrived in Oklahoma, we mobilized much of our coverage around this health crisis, the state’s response, and its impact on Oklahomans.
As cases have skyrocketed in recent months with health officials predicting more hospitalizations and deaths to come, these are tough times. But the news that vaccines are becoming available and may soon be ready for limited use in Oklahoma is a reason for hope. Obviously, the vaccine’s arrival won’t be a magic wand that instantly ends the pandemic. The state has to secure doses, execute a plan to distribute it, and work with hundreds of health care partners around the state.
Kassie McClung has been our powerhouse reporter on the coronavirus, covering the crisis facing hospitals and long-term care facilities, the state’s effort to provide PPE, and the coming vaccine.
Kassie, we recently learned that the state expects the first doses to arrive in a matter of days. What’s the latest on when the first doses might arrive in Oklahoma?
Kassie McClung: The health department expects an initial shipment of 30,000 doses of a vaccine sometime next week.
Ben Felder: There are still a lot of questions, and I think today we are going to find some answers. Kassie, I’ll turn it over to you to introduce our guests and see what we can learn about the arrival of a COVID-19 vaccine in Oklahoma.
Kassie McClung: Yes, first, thank you all for taking the time to be here to talk about the upcoming coronavirus vaccines.
We have three experts with us today: We have Dr. Eliza Chakravarty, who is an associate member of the Arthritis & Clinical Immunology Research program at the Oklahoma Medical Research Foundation.
Next, we have Dr. Jared Taylor, who is serving as the state’s epidemiologist.
And finally, Dr. Douglas Drevets, chief of infectious diseases at OU Health.
Doctors, Thank you again. I’m going to go ahead and jump in with my first question.
Dr. Drevets, I’ll start with you. Can you tell us which vaccines are expected to be available in Oklahoma, and when?
Dr. Douglas Drevets: So presumably, the first one will be the Pfizer product, which was made in combination with the German firm BioNTech. The second one will be the Moderna product. The Pfizer product is having its, so to speak, day at the FDA tomorrow where they will have their vote on it, and then it will presumably be shipped out to the states, assuming that it gets approval for emergency use.
The Moderna product will have its day for a hearing a week later amnd then again poresumably if it receives emergency use authorization it will then be shipped relatively rapidly out to the states.
Kassie McClung: Thank you. Can you tell us a bit about how the vaccines are administered?
Dr. Douglas Drevets: So these are both intramuscular vaccines and that sounds horrible, but it’s the same way the flu vaccine every year is administered. It generally goes into your shoulder in the deltoid muscle. It generally goes into your shoulder in the deltoid muscle with a needle that’s based upon sorta your body size. And so it’s not anything special in that sense. It goes right into the muscle.
Kassie McClung: All right, thank you very much Dr. Drevets. Dr. Taylor, to you this is a multipart question. First, can you tell us a little bit about why it’s important for Oklahomans to get vaccinated?
Dr. Jared Taylor: Yes, so, the SARS-CoV-2 that is the causative agent of the COVID disease is novel. So no one prior to this year had immunity to it, and that means we’re all, as it’s been shown to this point, we were all susceptible to it. And the only way that we get to the point where the transmission is not an ongoing problem is to achieve adequate immunity, which may sometimes be referred to as herd immunity, such that the likelihood of a susceptible individual bumping into an infectious individual is relatively low.
The reason that that’s so important and that we just can;t go to more almost routine control measures, such as just looking out for those individuals that have symptoms is we know that asymptomatic individuals play a notable role in transmission of this virus, as well. So we’re all susceptible. We’re potentially capable of transmitting it even in the absence of symptoms and knowing that you have it otherwise. So really the only way to get this under control is to get adequate immunity across the population, and certainly there’s been some folks who’ve spoken about achieving herd immunity through natural exposure and natural infection. What we’re seeing through serologic surveys at the state, and even across the country, and honestly across the world, is such exasperation would bring tremendous intolerable costs. Or what I would hope would be intolerable for most reasonable persons, where we’re probably at a exposure rate at the state of Oklahoma of about one in 5 people, and we would have to be at least triple that to have any hope of really containing it. And then we also don’t know about the length of immunity and robustness of the immunity following natural exposure.
We to some extent don’t know about the length or duration or robustion of the immunity following the vaccination, either. But some of the preliminary work has been very reassuring that somewhat uniquely, but not unheard of, it’s very possible the vaccine will actually provide better and longer immunity than natural exposure. So the vaccine is definitely the preferred route for us to go to try to protect the citizens of our state.
Kassie McClung: OK, thank you. So how much will this vaccine cost for Oklahomans who are seeking to get it?
Dr. Jared Taylor: So at this point there will be no cost. Of course, there’s no such thing as a free lunch. But this has been born through investments and development and purchase and acquisition at the federal level, and these allotments are being coordinated through federal provisions that account for that cost. So there are systemic costs within the state in terms of we’re going to have facilities and personnel who are administering it. We as an agency at the OSDH are going to be bearing those costs, and so the citizens will be able to get these vaccines without any direct cost to them.
Kassie McClung: OK, so as far as the general public having access to this vaccine, what kind of timeline are we looking at?
Dr. Jared Taylor: That is still undetermined, and in the grand scheme of things goes to what you mentioned at the offset we had this prioritization of recipients and when we get down to the various tiers, which would include the general public, is largely going to depend upon how quickly the manufacturers can continue to replenish the supplies, as well as what uptake we have among our citizens and the priority groups ranking above. So if we get very strong uptake among our health care workers and into our long-term care residents, which are going to be the priority one recipients, then we are going to use that more of our dose allocation.
If we’re not as successful in getting those individuals into the vaccination program, then we would have more vaccines available to distribute to the lower tiers sooner, but we don’t want that. We actually want to get everyone throughout all of the tiers taking the vaccine as soon as it’s available to them.
Kassie McClung: Thank you, Dr. Taylor. I’m going to switch over to Dr. Chakravarty. Let’s talk about safety. Some people are worried that coronavirus vaccinations won’t be safe and that the development was rushed. Can you talk a little bit about what goes into approving a vaccine? Could anything go out that was unsafe? And is there any reason to believe that this vaccine might have more risk than any other?
Dr. Eliza Chakravarty: Those are great questions. So the key thing I think to remember is that vaccines have been an integral part of public health for decades. And so there are actually very structured mechanisms for reviewing vaccine research for safety and efficacy so that yes, the timeline has been accelerated for this vaccine, but it is not due to cutting corners. It’s due to No. 1, we had a couple of head starts as far as developing the vaccine. People have been working on this new technology for a long time. We’ve known other coronaviruses that have helped us identify which parts of the virus are going to make the best immune response, and we got the exact genetic structure of the virus in January. So we had some head starts in order to make this particular vaccine and we had a tremendous investment so that the finances were there, and people were working on all aspects of the research and the development of the vaccines.
So yes, it’s accelerated, but it’s not due to corners being cut. And so the studies that are before the FDA right now and have been reviewed in England and other things like that, they’ve had pretty standard numbers of participants receiving the vaccines, so in order of 40,000 and 50,000 for each vaccine that’s under development. So that’s what we see with the shingles vaccine, and that’s what we see with other vaccines. So yes, it’s accelerated but the mechanisms to evaluate safety and advocacy are rigorous and are in place, and are not going to be violated.
The way I think about it is the independent folks who are looking at this data are looking at it for public health, but they’re also looking at, would I let my children have this? Would I ask my parents to have this? Would I take this myself? So accelerate but not rushed, if that makes sense.
Kassie McClung: That does make sense, thank you for that Dr. Chakravarty. I’m going to circle back to Dr. Drevets now. Dr. Drevets, how well are these vaccines supposed to work and do we know whether they offer any long-term protection?
Dr. Douglas Drevets: So, the data that has been released so far show that they work really, really well in terms of vaccine response. And both the Moderna product and the Pfizer product appear to be around 95 percent effective in preventing an infection. So if you keep the number between 90 to 95 percent, that’s probably where they’re going to land. And that is in contrast to other vaccines, such as the yearly flu vaccine which we all take, which can be anywhere from 40 to 0 percent effective depending on the year.
So they seem to be really quite good, or as the scientific community likes to say, robust immune responses. Now obviously since the trial started in July, you don’t have one year or two year follow up on these data yet to see how long the immune response lasts. There is a paper out looking at the Moderna product where they did have a cadre of folks that were immunized early in a phase one or two study and they did have six-month follow up on those individuals. And many of them had just as robust immune responses as did folks who had had natural infection.
So I think that even though the data aren’t out, and this story is still being written, we can have a reasonable degree of hope that the vaccine will provide immunity for more than a year, perhaps three year, maybe five, maybe longer. We can always hope for better. But it seems to be a very good product at this point.
Kassie McClung: OK, and Dr. Drevets, I’ve been seeing this question a lot. How quickly could a vaccine end this pandemic?
Dr. Douglas Drevets: So, the answer to every question like that is: It depends. It depends on how fast it gets distributed, how many people say they will take it, and then it also depends on how fast the virus continues to circulate in the community and people continue to get natural infections and build up immunity that way.
With some modeling studies, I think we can be hopeful that we can start seeing serious declines in new infections by the late winter, perhaps earlier, but that would be my hope. And that could be in the February to March range, and that could be due to multiple factors. One would be vaccination, one would be just the virus is naturally infecting people and they’re becoming immune to it. And the third one would be you know, we’re still hopeful that this coronavirus will also show some seasonal pattern like other coronaviruses do, and that when the weather warms up and becomes more humid in the spring, the virus will be less persistent in the environment and that will give us an advantage there.
Kassie McClung: All right, thank you very much. Dr. Taylor, this is a multipart question for you: State officials have said that rolling out this vaccine is going to be a huge effort. What percentage of Oklahomans does the state hope to get vaccinated, and how does the state plan to hit that target?
Dr. Jared Taylor: Well, I think the easiest answer is we hope to get as many as possible, right? We hope to employ a multi-pronged effort to maximize that number. We’re committed to making available all the doses that we receive and distributing that as efficiently and effectively as possible. Ultimately it is going to be voluntary, and so we are just, I think it would be fairest to characterize it, we’re going to vaccinate as many as possible. From the medical perspective, building on what Dr. Drevets just addressed, what percentage do we need to end the pandemic? What do you mean by that, right? Do you simply mean getting to the point where we’re no longer worried about exceeding hospital capacity? Are you talking about getting to the point where we can approach more normality in our lives? Or are you talking about the point where we’ve eradicated SARS-CoV-2? You know, those are all different targets, and they’re all going to have different steps that would be required in order to get there.
The higher the number as far as getting them into arms the better, we have already been engaging in a variety of communication efforts and continue to do that — this forum, we’re appreciative of the opportunity to be speaking here. We’ve obviously been coordinating very closely with all of our health care providers who are in that first tier priority group for immunization. We know that they are very much aware of the science of all topics related to COVID, not at least being the vaccines. So we’re confident there will be good uptake there.
We’ve been working closely with our long-term care facility providers, as well. Since the beginning, it was very unfortunate just how devastating this virus was to those facilities and the residents early in the pandemic. So they understand the significance of this and we’ve built a great collaborative and supportive relationship with them, so we’re going to build on that as we roll this out.
Obviously the harder lift comes in as we spin out to those other priority groups. We’ve had a great deal of interest from the governor’s office down through the educational groups and everyone in between to prioritize teachers, as an example. We hope to do that. We would love to do that, but ultimately it depends on the teachers, and we want to answer their questions, reassure them, all the information has just been provided about the safety and the efficacy of the vaccine. It’s just going to come down to the individuals choosing to pursue this when it’s made available to them.
Kassie McClung: Right, that makes sense. You mentioned trying to get that messaging out there and working with different groups and organizations, and it ultimately being left up to the individual. So, how big of a concern is vaccine skepticism in rolling out this vaccine and making sure enough people take it for it tobe effective?
Taylor: That’s definitely a concern and something that we’re combating every day at every opportunity that’s provided to us. I feel there’s going to be a minority, it tends to be a vocal minority, but I think a relatively small minority who are just not gonna be open to the prospect of receiving a vaccine or vaccinating their family members at all. There’s probably not much utility in investing time and resources in trying to convince them otherwise. I think the majority of Oklhmans, and indeed Americans, are open to considering receiving this vaccine. They just want to be reassured and sort of, I’m sure there’s a certain degree of hesitancy to not be the first person and sort of a misperception there of being a guinea pig, but we respect that and understand that.
The fact that we’re rolling out with our health care providers upfront I think is going to be beneficial in that regard. But we certainly want to publicize the uptake and the comfort of those individuals from leadership going down through our frontline workers. At the same time, we don’t want to dismiss or delegitimize the legitimate concerns, right? And one thing to say is that everything has risks. When you get out of bed in the morning you’re taking a risk, right? When you drive to work or whatever, there are risks involved with any activity and that includes vaccine uptake. The outcomes that we’re seeing in the trial were for those risks, the outcomes tend to be extremely minimal and should not in any way discourage folks from taking it.
But we want to be honest about that. We want to make folks aware that there might be what could be perceived as side effects. Tohse typically mean that the vaccine is working. It’s achieving what we want it to achieve, and so we want people to understand that. T’s not that the vaccine gave them the infection or gave them the virus. When they ache and when they feel not great and a little lethargic and maybe even develop a fever, that’s OK. That, again, means the body is responding to that vaccine and being prepared for when they encounter the real virus.
I think that’s our goal: to be emphatic to those concerns, to try to address them reasonably and have confidence in the judgment of Oklhomans in weighing those balances of benefits and risks.
McClung: Thank you, Dr. Taylor. Dr. Chakravarty, this kind of into what Dr. Taylor was just saying about people being concerned about side effects. Can you tell us a little bit about what kind of side effects might be associated with either the first or second dose of these vaccines?
Chakravarty: So as far as my understanding goes, there weren’t any surprises in the studies, and remember these studies were tens of thousands of people. There weren’t any surprises about the side effects or effects of the vaccination, and those are what we see typically with any vaccine. It’s just like what Dr. Taylor said, where people will have felt some soreness or redness, feel achy, feel kinda flu-ish and have some fever, And that’s just, again, it’s not the virus, it’s actually your immune system working well and making a good response to the vaccine, so we expect that. In the studies it’s been shown to be, as far as I know again, about similar to what you might see in other vaccines. And it’s important to remember that no vaccines that have come far in the process, especially the first two, contain any actual virus particle. So these vaccines are designed in a lab, there’s no actual virus in it, so there’s no way to actually get the virus from the vaccine.
McClung: OK, and that kind of touches on my next question. There’s people who are concerned that after getting vaccinated they might be contagious, and it sounds like that’s not the case.
Chakravarty: No. Now, people may have been exposed and actually have the infection around the same time they got vaccinated, so I think even if we’ve been vaccinated we still need to remember that we could have before our immune response is robust and strong and protected, we may still be contagious. We may still be susceptible and we may still pass it on to other people. The important thing to know is you can’t get it from the vaccine, but you can still get it separately around the time you’re vaccinated. So particularly if you’ve only had one of the series, you may still be contagious just from being alive and in the community. We need to keep up with all our other practices as far as mask wearing and physical distancing and things like that. But you cannot directly get it from the vaccine itself.
McClung: If someone knows that they’ve had COVID-19 before, should they still get a vaccine?
Chakravarty: Yes. The recommendation is people should get the vaccine, even if they’ve had COVID before for a couple of reasons. No. 1, when people have had the infection I think there’s probably a lot of variety in how strong the immune response and how longlasting it is, so that getting the vaccine will only enhance the immune response even on top of the natural immune response. In some of the studies they were able to look back and see if some of the participants in the studies had actually been exposed to the virus in the past before getting the vaccines, and the outcomes were not different. There were no safety concerns, it’s not going to be dangerous to get the vaccine if you’ve been infected and really can only help boost your immune response. So we’re recommending that everybody receive the vaccine, whether or not they think or know that they’ve had the infection before.
McClung: OK, thank you Dr. Chakravarty. Dr. Taylor, I think this is my last question before we go to reader questions. We’re talking about the initial rollout of the vaccine, and we talked about there’s still a lot of unknowns about how long the vaccine might last. Does the state expect that the coronavirus vaccine will be something that people get annually like the seasonal flu vaccine?
Taylor: I believe Dr. Drevets spoke to this earlier and certainly would defer to him if he would want to repeat that or have anything different. I think we would be saying the science is quite early in that. Our focus at this point is to get the initial vaccination and the required booster into folks, allow the science to catch up on that and issue the guidance from CDC and even the manufacturers in terms of duration of immunity, and make those decisions later. I think as Dr. Drevets spoke to earlier, I think the science indicates right now that immunity is actually going to be pretty robust and hopefully, reasonably long lived and not something that requires an annual booster.
It’s important to recognize that the primary reason we require an annual vaccination for influenza is not that the immune response wanes, right? It’s that the virus changes that dramatically. We saw this a handful of years ago — I lose track of time so I don’t remember when it was. But there was an influenza strain that came through that actually had relatively low morbidity and mortality than expected among the older population, and it was determined that was because it was very similar to a virus that had circulated decades earlier. So even for something like influenza, the immune system has a good ability to maintain a memory. That’s not always true in that the common cold virus, we don’t retain a very good memory to, but it’s not very invasive, it stays local and those kinds of things. It’s reasonable to believe that we’re going to have a lengthy residual impact of this vaccine. But what the final recommendations are remain to be determined based upon the science.
McClung: OK, thank you Dr. Taylor. I think that’s all the questions I have for you all, but I’ll go ahead and hand it back over to Ben for our reader questions.
Felder: Thanks Kassie and our panelists. That was some great insight. We have received a lot of reader questions and I want to go through some of the most common ones we have received.
A lot of people are asking about the second dose because this is a two-dose vaccine. What happens if someone misses the second dose and then what’s the process for getting people to come back for that second dose?
Taylor: Like with all of this, there’s a lot that remains to be determined. These vaccines were investigated with very specific booster times and so that’s what is coming out as the advisement, and we want to follow that as closely as possible, and we would certainly encourage each Oklahoman to abide by that. That being said, we don’t want to become a slave to silliness, right? If you say well the booster is supposed to be in 21 days, well does that need to be to the a.m. p.m.? Does that need to be the exact hour? Let’s get it within that reasonable time period and the immune system’s gonna do what the immune system does very well.
The evidence that I’ve seen so far is that there is a benefit to actually only receiving one dose. We don’t want to stop there. We want people to get the booster because it gets better following that booster vaccination, but we don’t want folks to delay getting a vaccine because they’re not necessarily going to be able to come back exactly 21 days later or 28 days later, depending on which product you’re using, and let’s work out those logistics for the individual as we go through.
To your point and what I can speak to definitively in regards to the state, is it actually is a pretty heavy logistical lift to figure out that boostering requirement because if you get the Pfizer vaccine up front, you need to get the Pfizer booster. We don’t want you to get the Pfizer vaccine at the first time and then the Moderna vaccine at the second or vice versa. We within the agency are working to develop systems that are going to keep track of who received what vaccine product at what time and we will be in charge of tracking that and making that information available to the patients and working with them to schedule those follow up appointments to get the booster at the interval that’s appropriate to them at the product they received.
We’re also working with the manufacturers when we talk about 30,000 doses of the Pfizer vaccine rolling out, we’ve been assured there will be 30,000 booster doses coming at the appropriate interval following that, and so we don’t need to hold half of those vaccines back with the intention of boostering. We’re going to go ahead and get as many of those into our patients as possible and trust that the system will get the boosters to us.
So there is a tremendous logistic lift going on. We’ve been invested in that since September, and we feel very comfortable we’re going to have a system in place that will allow us to do that as the time comes.
Drevets: Let me jump in. I think more than likely when you get your first dose of vaccine, you will then make an appointment for your second dose of vaccine and that way it will be the same product at the proper interval. And I agree with Dr. Taylor, you know the studies were done in a very particular fashion and a very particular interval between the two doses, 21 to 28 days. In practicality, can you got 22 days and have it be just as good as 21? Yes, probably. We do want to stick as closely as possible to the recommendations, but have a little bit of room in there for wisdom and flexibility. But again, we’re all waiting for the guidance from the FDA on that particular item.
Felder: Great, thank you. Once again, I’m going to ask a question and defer to our panelists, whoever would like to jump in.
We have a lot of people who want to know how to go about getting vaccinated if they’re immunocompromised, where they fall in the state’s priority plan. Specifically, will immunocompromised persons who are on an immunosuppressive biologic drug be able to safely take a vaccine once it’s available to the public? And without having to temporarily having to stop taking their prescribed medications? So kind of a mouthful question there, but one that we’ve gotten a lot.
Chakravarty: I think I’ll jump in there because I deal with immunosuppressed people all the time, and this is another one where we sort of need to wait and see. We don’t have a lot of data on vaccine responses in people who are severely immunocompromised due to an underlying disease or their medications. But one thing we do know is that, again, the vaccine doesn’t contain any live virus. So in the past, for example with the early shingles vaccine, not the current shingles vaccine, it was a live attenuated virus. So we were worried that people with immunocompromised conditions might be at higher risk of getting the actual virus from the vaccine. That is not the case for this vaccine.
We need to remember these are all initial studies we’re basing it on, so relatively healthy adults. There haven’t been focused studies performed yet on particular populations such as pregnant women or people who are immunocompromised, and that kind of thing. Right now, there doesn’t appear to be a risk to getting the vaccine if you’re immunocompromised. There’s no risk of, again, getting the infection from the vaccine itself. What we don’t know is how strong the immune response is going to be depending on the underlying condition or the medication.
Drevets: It’s also safe for folks with HIV and many other conditions: lymphomas, chemotherapy, as well as biological agents for arthritis and things. This will be something that we want everybody to take.
Felder: Great, thank you. We have a lot of parents asking questions about vaccinating their children. When can we expect kids to have access to the vaccine, and do we know anything about how this vaccine works with children?
Drevets: So the data that’s been released by Pfizer, and I only had a few hours of uninterrupted time to look at that. They did have a cohort of adolescents in that trial; several hundred I think or maybe up to a thousand of folks below the age of 16. I think between 12 and 16.
They tended to respond just as well. They had a few more local side effects I think then the older age group, but it would still be deemed safe. At this point, there’s no other information available about younger children and what to do. So I think that will be forthcoming also from FDA.
Felder: Great. We’ve kind of talked about the known side effects and kind of the unknown part of this, but a lot of people are asking about practically, how should they structure their days after getting the vaccine? Some are asking should I plan to take the day off of work that day because of some possible side effects? It sounds like there’s still a lot of unknowns about that, but what kind of advice would you say to people who are kind of concerned just about what that next day or two would be like after taking the first dose?
Drevets: So this is, again, somewhat speculative because the data are just coming out. Most of the reactions are considered mild to moderate, and in the language of the clinical trials, that means they weren’t severe enough to interrupt anybody’s acts of daily living or their job. And I think that less than 10 percent of the reactions were considered severe, so to speak, where you might have to stop working or stay at home. So the vast majority of people will be able to carry on with minor inconvenience, probably not unlike receiving other vaccines such as Shingrix or the high-dose flu vaccine. Again, I think we’ll get much more data from this when it’s all released in the next week.
Felder: Thank you. Dr. Taylor, this might be a question directed to you. Once we get to phase two, how will the state and health care organizations identify and contact qualifying patients? Will this be delegated to the discretion of the enrollment providers or will the state kind of commandeer the process?
Taylor: I’m not sure I can speak fully to that question. We’ve got a team of folks who have been just dedicated basically nonstop to the logistics of this and I’ve not heard that question in my involvement.
I think at that point it’s largely, my anticipation is, that it’s going to be a cooperative effort. It’s going to be a matter of us communicating with the population and making them aware of where we’re at, and working close to our providers because just because we enter into phase two or tier two, doesn’t mean that we’re still not going to be providing it for tier one persons who didn’t get vaccinated or whatever. It’s sort of going to become this adaptive rolling process where we’re going to certainly abide by the priorities that we’ve established, but have enough flexibility that we can continue to provide the most good for all the individuals. So I don’t think we have any intention of commandeering this, so to speak, and going in and trying to apply rigorous criteria ourselves. We’re going to count on our partners who are assisting. Obviously, some of the vaccinations are going to be done by our department or the county health departments, but we’re going to have lots of other partners who are participating as well and we’re going to be respecting their judgment and following the criteria and prioritization that we laid out, as well.
Felder: Dr. Drevets, earlier in our panel you kind of answered this question, but we’re getting this question asked a lot, so there might have been some people who missed it or would like a little bit more detail. Can you explain once again the logistical process of receiving the vaccine, where the shot will be administered, how it will be administered? Kind of what’s the process for health care professionals? What kind of training are they going to receive? What information will they receive in terms of actually administering the vaccine?
Drevets: So it will be like most other vaccines. There will be very specific product information that is released by the manufacturer in accord with FDA regulations showing them exactly how to prefill the syringe, how to treat the vaccine, when to thaw it, how long you can store it and many other things. There will also be information on the size and the shape and the bore of the needle.
As I mentioned earlier, both the Pfizer product and the Modenra product are also intramuscular vaccines. This is the same way that you receive the flu vaccine. It’s in the muscle, and most of the time it’s given in the shoulder muscle in the deltoid muscle. Beyond that, I think that we just wait for the guidance, but in general there more than likely won’t be anything special about this unless there’s a special injection device, and again that waits to be seen as to what the manufacturer puts out and everybody will be trained on that.
Felder: Thank you. Another question we referenced earlier, but what do we know about continuing to spread the coronavirus after being vaccinated? Should people who get that first dose still be participating in social distancing practices?
Drevets: So in the studies that were done they looked at symptomatic cases of coronavirus. So you had to have symptoms, at least one or more symptoms of coronavirus, and then positive coronavirus test. The manufacturers did not assess the efficacy or how well the vaccine worked on this whole issue of asymptomatic spread. There’s many germs that we can carry up in our nasal passages that don’t infect us, but yet we make antibodies too and this is how we get immune to things in the environment. Again, this is a well-known process.
It’s just not yet known if folks who receive the vaccine can also at least harbor or carry the virus up in their nasal passages even if they don’t have symptoms. The hope would be, and the presumption is, that because the vaccine prevents people from actually getting sick, we in general people who are ill are going to have higher amounts than people who are not getting ill, and more than likely people who get vaccinated are going to have lower amounts than people who have never been vaccinated. That said, this is just one of those things, we’re walking through this in real time, and we’ll just have to see. So my advice is to continue to participate in masking where appropriate and social distancing.
Chakravarty: I would echo that and I think it’s also important to recognize that it does take time for the immune system to process the vaccine and to make a robust response so that being vaccinated doesn’t instantly provide protection. It does take a series of weeks to months even, and we need to be cognizant of that so we still may be partially susceptible for some time after we received the full vaccine dose.
Drevets: That’s right. You shouldn’t have the idea that you can get the vaccine at 4 o’clock and then go out and party all night because you’re immune. It doesn’t work that way.
Felder: Great, well thank you. This has been incredibly informative. Obviously, as we said there are still many unknowns. I really appreciate you all offering some specific answers as to what we do know as we prepare for the next chapter of this pandemic. That’s going to do it for today’s live panel discussion.
