A recent study found fewer than 20% of solid organ transplant patients mounted detectable antibodies to SARS-CoV-2 following a first dose of COVID-19 vaccine, raising questions about vaccine protection in this population compared to immunocompetent people.
In the first part of this exclusive MedPage Today video, Editor-in-Chief Marty Makary, MD, MPH, of Johns Hopkins University in Baltimore, speaks to Dorry Segev, MD, PhD, associate vice chair of surgery at Johns Hopkins University School of Medicine and professor of epidemiology at Bloomberg School of Public Health, who authored the study. They discussed the study's findings, their applicability to those with chronic medical conditions on immunosuppressive therapies, and whether CDC's post-vaccination guidelines should be adjusted for these patients.
Following is a transcript of their remarks; note that errors are possible.
Makary: Hi, I'm Marty Makary with MedPage Today. I'm here with Dr. Dorry Segev, a professor and transplant surgeon at Johns Hopkins, a good friend and colleague. Dorry released a big study out this week that's making a lot of headlines and I thought we could talk to him about it. Dorry, welcome. Good to see ya.
Segev: Thanks Marty. Thanks for having me on.
Makary: Let's talk about the study that you have. It's an amazing study, it's on immunocompromised, immunosuppressed patients and you found that their antibody response is far weaker, almost a small fraction of what immunocompetent people have. Can you describe your study for the viewers here?
Segev: Yeah. So for context if you look at the big randomized trials, you know, tens of thousands of patients, basically 100% of immunocompetent people after dose one of the two-dose mRNA series already have detectable antibodies.
Makary: And how long, how long does that take, Dorry, to form, about a week and a half? Two weeks?
Segev: Two to three weeks is when they tested. It may form a little bit earlier, but certainly by two to three weeks after your first dose, nearly 100% of people have detectable antibodies. Obviously it goes up after your second dose, but it's detectable enough for us to consider it positive antibody by that early time period. Now in transplant patients, what we found is that only 17% have detectable antibody after dose one. Only 17%. And I'll just give you a little bit, a little overview of how we did the study.
So, we don't have access to vaccine like the big vaccine companies. So we did a post-marketing real world study. The day the first EUA became approved, we announced over social media that we were opening this study and that any transplant patient who was interested in participating can register on our website, transplantvaccine.org, and can send us their pre-vaccine samples, and then as soon as they get vaccinated, we can follow them post vaccine. We have more than 3,000 participants.
The first thousand came in like the first week, it was truly amazing. And a lot of the people who participated particularly early are healthcare workers. So, you know, to those watching who are healthcare workers, thank you for always contributing to research, even with your own participation in studies. And so we caught people as early as we possibly could, who had access to the vaccine. And so now we have data on hundreds of people who already got the vaccine, already got dose one, already got dose two, who are immunosuppressed, and we are able to follow what's happening to their antibodies. And so, we know that only 17% get detectable antibodies after dose one and worse, if you're on an antimetabolite like MMF or azathioprine, only 8% of people on an antimetabolite will have antibody after dose one. Which, as you might imagine, is quite scary as a transplant patient.
Makary: So your study was published this week in JAMA, and pretty remarkable, by the way, how you've been able to creatively recruit and find these people using social media. Is that recruitment process still open if somebody has transplant patients that they'd like to send your way in terms of the data?
Segev: Yeah, our recruitment is ongoing. And a lot of the reason for that is that there are new vaccines. So now the J&J is out, and we're certainly looking for transplant patients who are about to receive the J&J vaccine. But also we're looking at subgroups like people who are transplanted quite recently, people with more rare phenotypes. So basically we're encouraging any transplant patients to go to transplantvaccine.org and register if they want to participate. And we will tell them if we are recruiting people of that phenotype at that time.
Makary: What does this mean? You studied organ transplant recipients. What does this mean for say non-organ transplant recipients who are on immunosuppressive medications for other reasons?
Segev: So we are studying that. So we have a parallel study, vaccineresponse.org, which covers people with chronic conditions. A lot of which either the condition itself or the medications they take are immunosuppressing. And so we're studying people with autoimmune disease, IBD, cirrhosis, ESRD, HIV, et cetera. We're just starting to get data from that. I'll give you kind of the, the gestalt is that if you are on immunosuppression agents, such as mycophenolate, azathioprine, you will probably have a blunted immune response, no matter what reason [there] is for taking those immunosuppression agents.
Makary: And what's your pretest hypothesis in terms of how blunted relative to the significantly blunted response that organ transplant recipients have had?
Segev: Pretty blunted. I think that's our pretest hypothesis. I mean, these agents, they work, they blunt the immune response. And part of that is blunting the immune response to a vaccine, which is, it's kind of a catch-22, because I want my transplant patient immunosuppressed so that they don't get a rejection, they don't get development of de novo donor specific antibodies, et cetera. But I also want them to respond to the vaccine.
I'll tell you some other interesting things. In transplant patients who had COVID-19, in convalescent transplant patients, we do see an immune response that is actually relatively durable. So we published another paper a couple months ago, looking at people who are three to six months out from getting COVID who were transplant patients. And they actually had detectable antibody. I will say though, that the first thing we do when a transplant patient develops COVID, now they're sick with COVID, we turn off their MMF. And so it could very well be that by dropping their MMF so that they could recover from the disease, we also allowed their immune system to develop a durable, natural immunity to that disease.
We're also seeing in people who are convalescent, who then get the vaccine, they also have a very good response to the vaccine. So I think it's some combination of the natural priming from the initial COVID infection, then the vaccine can do some of its work. It could very well be that if we gave transplant patients a third dose, that they may be as responsive to the vaccine as immunocompetent people. But right now we're just not able to do that because that's not how the vaccine rollout is working.
Makary: Sounds like a great study to consider for somebody. There's a body of literature on those who may be immune without antibodies. Their T-cells may be activated and elevated, and it may be more common in these European studies, among people who are asymptomatic, they had the infection, but felt great. Any thought about whether or not there may be some immunity, either partial or minimal among people that have been vaccinated, but have no antibodies?
Segev: Yeah. I mean, certainly T-cell immunity is really important as we know. There's a reason we have T-cells and they help. And we just don't know in transplant patients. Part of what we're doing in our study is looking at T-cell responses. Now, I call this real science, right? There's measuring antibodies -- I can send somebody and get an antibody test and think I'm doing science, but really to do real science, you have to actually study the repertoire of T-cells, the activation of T-cells and things like that. Real science obviously takes more time. So we're still trying to understand what is happening in the T-cell repertoire of these transplant patients. But it's quite possible that they're getting an immune response that's T-cell mediated that's not antibody mediated.
I will tell you though, anecdotally, half of medicine is done through science and half of medicine is done through, "Well, this is what happened to my last patient, so I'm going to change my practice entirely based on this anecdote."
You know, anecdotally I have like last week, there were new guidelines released that said that vaccinated individuals can relax their public health measures. And just yesterday, I talked to one of my colleagues in New York who told me about two patients, transplant patients, who completed their vaccine series, read the guidelines last week and said, "Oh, wow, we're great." Went out, got COVID and are now hospitalized with COVID infection.
So, you know, there are breakthroughs, there are known breakthroughs through the current vaccination practices. And I would certainly let this be a strong caveat that transplant patients should not assume they have immunity just because they finished vaccination. And I'm worried that people will relax their public health behaviors as that's what the talk is. But if you're immunosuppressed, if you are a transplant patient, that is not a wise thing to do today, without at least checking your antibodies and understanding what kind of immune response you got.
Makary: Dorry, roughly how many people in the United States have had an organ transplant and how many more have some degree of immunosuppression, is it about 10 million people that have had some immunosuppression?
Segev: Yeah. So the estimates are about half a million people are walking around with an organ transplant who are on some amount of immunosuppression. And there are about 11 million people taking immunosuppression for other conditions like autoimmune conditions.
Makary: So your study just published has a lot of implications for the CDC. And one of the reasons I wanted to give you a platform here to say something is that, I would hope that the CDC could modify those guidelines they just put out on what vaccinated people can do based on your study. If you were to modify those guidelines, what do you think the stipulation should be?
Segev: Yeah, I mean, you know, in fairness, there is a small fine print caveat in the CDC guidelines that say immunocompromised patients, we don't know what's going to happen with the vaccine. I would love for it to be stronger, for it to cite the JAMA paper that we just published. So we published it two days ago and we've gotten 55,000 views on this paper. And I think all 55,000 have emailed me with questions about it, which is fine. Anyone's welcome to email me. But it may take me some time to get back to them.
I would love for the CDC to say much more firmly, if you are taking immunosuppression do not assume you have immunity because you have been vaccinated. I would also love for this country to prioritize the caregivers' immunization, to prioritize vaccines for caregivers of people who are not going to have a good immune response to the vaccine. So transplant patients live with family members who take care of them. They should be vaccinated to protect the transplant patient because the transplant patient can't necessarily mount their own protection.
And the third thing I would love to see is some way for transplant patients who, after two doses, have had no immune response, to either get a third dose or to get a different agent. So maybe if the mRNA approach didn't work, get the Johnson and Johnson or something like that, to either cross over to a different system of vaccination or to just get a third dose of the vaccine they've already gotten. And I would love for that to be available to people.
Officials in Montgomery County, Maryland, said they will expand eligibility for COVID-19 appointments at county clinics to those 60 and older, saying new state rules have forced their hand.
Officials in Montgomery County, Maryland, said Tuesday they will expand eligibility for COVID-19 vaccine appointments at county clinics to those 60 and older starting Tuesday saying new state rules have forced their hand in lining up with Marylands vaccine timeline.
Dr. Travis Gayles, the countys health officer, told members of the Montgomery County Council that a newly issued directive from the Maryland Department of Health orders all vaccine providers in the state, including county health departments, to follow the states vaccine rollout schedule.
Previously, the county had moved more slowly than the state in expanding eligibility at county-run clinics, citing the limited numbers of doses the county receives each week and the need to prioritize the most vulnerable residents.
But the amended March 22 order from acting Maryland Health Secretary Dennis Schrader states all Marylanders that fall in the states current Phase 2a guidelines shall be eligible to receive COVID-19 vaccines and that political subdivisions shall not make orders or rules to the contrary.
In the wake of that directive, the county is now allowing residents ages 60 to 64 to preregister for vaccine appointments on the countys preregistration website, Gayles said.
We can get them in the queue to provide opportunities for them to be vaccinated, Gayles said during a virtual council meeting Tuesday. Now, lets be clear, however as weve said all along just because someones eligible doesnt mean you will get an appointment right away.
Gayles said the change by the state requiring local health departments to follow the states timeline was made without consulting with local health officers and that no rationale was given.
Mike Ricci, a spokesman for Gov. Larry Hogan, said in an email the health secretarys order, formalizes the states distribution plan to comply with the federal directive to broaden eligibility and make all adults eligible by May 1.
Last week, the governor laid out a timeline under which all Marylanders 16 and older would be eligible for vaccine starting April 27, meeting a goal of May 1 set by President Joe Biden to open up access to COVID-19 vaccines to all adults by May 1.
Still, Gayles cautioned that even though eligibility at county clinics is expanding, the county health department still isnt seeing a big enough boost in vaccine doses to be able to able start putting shots in the arms of those newly eligible.
There is still going to be some time to wait before youre able to get an appointment, he said.
This week, the county health department received 8,000 vaccine doses from the state, which is up from 6,600 last week and nearly double the 4,500 doses a week for several weeks before that.
Overall, more than 25% of the countys population has received at least one dose of a coronavirus vaccine, although many residents are going outside the county to get vaccinated, including through appointments at the mass vaccination site at Six Flags America theme park in neighboring Prince Georges County.
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Looking for more information? D.C., Maryland and Virginia are each releasing more data every day. Visit their official sites here:Virginia|Maryland|D.C.
The shift to align with the states timeline was welcomed by at-large Council member Hans Riemer, who said it would reduce confusion about whos eligible for a shot.
But at-large Council member Will Jawando, who was working on a since-scrapped county regulation that would have lowered eligibility requirements specifically for residents in high-risk ZIP codes, slammed the move, saying it would make it harder for the county to ensure vaccine doses are distributed equitably, given the still-limited supply of doses.
Requiring local health departments to follow the states expanded eligibility has hampered our ability in taking a tool out of the toolbox to target those who are most vulnerable, Jawando said. I think its disgusting. I think its playing politics with peoples lives. Its shameful.
Council member Craig Rice, who represents District 2 on the council, was heavily critical of Gov. Larry Hogan, suggesting the governor wasnt sufficiently consulting local health officials in making pandemic-related decisions and lacked a strong plan for vaccine equity.
Its a dereliction of duty, Rice said. I hope folks remember this, remember the fact that there are Black and brown people that are dying, there are Black and brown people that are getting affected by this disease more than anyone else. And you can hold a press conference, Gov. Hogan, all you want, to talk about equity. Wheres the damn plan? Because I havent seen it.
Officials in the county have sought to emphasize racial equity in the countys vaccine rollout, including prioritizing residents in the areas hardest hit COVID-19, identified as those areas with high coronavirus case rates and high death rates.
Dr. Raymond Crowel, the head of the countys Department of Health and Human Services, said the countys focus on priority ZIP codes, so far, has led to real progress in getting folks vaccinated in our more highly-impacted communities.
Still, disparities remain in the distribution of the vaccine. While Black people make up 19% of the countys population, they make up only 12% of those who have received at least one vaccine dose. Similarly, Latino residents make up 20% of the countys population and just 10% of those who have received a vaccine dose in the county, according to the countys vaccine dashboard.
You can see we still have a ways to go, Gayles said.
Lawmakers and county officials also blasted the governors office for keeping local officials in the dark before making sweeping announcements.
On Tuesday afternoon, Hogan announced plans for six additional mass vaccination sites. But beforehand,officials said they had no idea what the governor would announce.
Its sort of an unfortunate thing with the way the relationship is right now. And, you know, we try and make it work, to the extent that we can, said Dr. Earl Stoddard, the director of the countys Office of Homeland Security and Emergency Management.
About a week after elementary school students in kindergarten through third grade returned to classrooms under Montgomery County Public Schools phased reentry plan, Gayles, the county health officer, said his office is continuing to track a few coronavirus cases involving school students.
Most of the incidents are single cases without possible contacts in the school, which Gayles said suggests they were exposed to the coronavirus at home. However, there have been two outbreaks related to school sports, he said.
An outbreak at Walt Whitman High School involved three football players, as well as two other players with possible contacts. At Winston Churchill High School, Gayles said there were a number of student athletes across multiple sports who were exposed toa student at a nonpublic school.
The update on cases involving sports comes less than a week after county lawmakers loosened rules on the playing of youth sports previously deemed high-risk, including football.
WTOPs Kate Ryan contributed to this report.
TREASURE ISLAND, Calif. (KRON) Treasure Island now has its own drop-in COVID-19 vaccination site.
Its open to residents in the 94130 zip code.
Ship Shape Community Center
It is crucial that we have drop in, neighborhood based vaccine sites accessible to people in our most high need, vulnerable communities. Residents of Treasure Island have had among the least access to vaccines in the City for months, said Supervisor Matt Haney, who represents Treasure Island.
The Treasure Island mobile vaccine site will open this weekend.
It'll be open 9:30-3:30 on Saturday at Ship Shape for at least next 3 weeks.
TI residents can drop in if they're currently eligible.
It's a collaboration b/t DPH, my office, TI residents, One TI, TIDA & @SFFDPIO.
Having this low-barrier vaccine site on Treasure Island is critical to the Citys recovery and meeting our equity goals. Im grateful for the community leaders, SF Fire Department, and Treasure Island partners for working with us to launch this innovative community-focused site, he added.
Treasure Island ranks in the bottom quartile of Californias Healthy Places Index, which is based on metrics such as household income, education level and access to health care.
Officials said they will also be helping residents of Treasure Island sign up for appointments by going door-to-door. San Francisco Fire Department staff are helping administer the vaccines. Haney said there are opportunities to volunteer to help with the outreach.
A full list of publicly accessible vaccine sites and eligibility can be found here.
CROSS LANES, W.Va. Karen Meadows plans on Wednesday did not involve leaving her house, and they certainly did not involve a Covid-19 vaccination. Wired to an oxygen tank and largely homebound with chronic obstructive pulmonary disease, its a challenge for Meadows to make it up her driveway. The voyage to her countys mass vaccination site, at a basketball arena 10 miles to the east, is all but impossible.
But then came a stroke of luck. Down the block, a local doctor was administering a vaccine to her mother-in-law, who is homebound herself. She called Meadows, who, clad in a pink bathrobe, welcomed the doctor into her living room. Fifteen minutes later, she was sporting a smile and a Band-Aid.
For Meadows, it was a life-changing encounter. She had largely given up on receiving the shot not for lack of interest, but for the simple logistical reasons that could keep hundreds of thousands, if not millions, of highly vulnerable, homebound Americans from getting vaccinated.
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I could not stand in line and go to the Civic Center, Meadows told Sherri Young, the countys top health official, as she administered the single-dose Johnson & Johnson shot. The waiting in line, the parking theres no way I could have done it.
Grateful as Meadows was for the house call, the time and energy it required highlights a bleak reality. Homebound individuals, who are among the countrys most at-risk, have little chance of receiving a vaccine if not for the heroism from individual health workers, and their choice to spend precious hours making painstaking, door-to-door treks to administer doses one at a time. Youngs journey to deliver barely a dozen vaccines required a day of driving and hours of planning beforehand, too, to gather names from local senior services organizations and to chart the most efficient route from house to house on Google Maps.
That effort also underscores just how far other counties and states have to go. While most homebound Americans have been vaccine-eligible for months, many have been forgotten by a system that prioritized mass vaccination sites and assisted living facilities. More than three months into the U.S. vaccination campaign, there is still no national plan to vaccinate those confined to their home by illness, frailty, or disability. In most cases, the infrastructure for reaching them consists of little more than a doctor, a car, and a cooler.
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For Young, however, the benefits far outweigh the costs. In a single 20-minute span, she immunized not only Meadows and her son, but also her 84-year-old mother-in-law, Anna Hull, and her 83-year-old husband, Billy. All four knew they wouldnt have been vaccinated anytime soon if not for the doctors visit, and none was shy about communicating their thanks.
Ive seen you on TV, Meadows told Young before she left. What you do, its a wonderful thing. You work your butt off.
While the countrys early vaccine campaign has outwardly focused on the most vulnerable, in practice, it has skipped over many of the oldest and sickest Americans. While over two-thirds of Americas seniors have received at least one vaccine dose, the rest wont be nearly as easy to reach.
Roughly 2 million people in the U.S. are either partially or fully homebound, recent studies estimate. Many are elderly, and those younger than 65 typically have a severe illness or disability. In effect, any homebound American, and each of the West Virginians who Young visited last week, has been eligible for a shot since January. But being eligible and being vaccinated are sometimes unrelated concepts.
Its no surprise that the vaccination effort is missing homebound people, experts say. The federal government and local health departments are facing immense public pressure to boost vaccination rates. As a result, their effort to stamp out Covid-19 has led them to largely focus on a single metric: total doses given.
The only thing people are really measuring or paying attention to is how many vaccines are being administered, said Marcus Plescia, a North Carolina-based doctor and chief medical officer for the Association of State and Territorial Health Officials. That doesnt really provide opportunity, or an environment, where states and local governments can afford to put a lot of emphasis on populations like the homebound.
After a recent increase in supply, however, many states have devoted new resources to vaccinating those hardest to reach.
Last week, Texas began deploying National Guard troops to administer vaccines to homebound older adults. Earlier this month, Florida began assembling strike teams that reached 1,500 homebound older adults in the programs first weeks, and has since launched a dedicated email service for others to request a house call.
Cities have also organized their own efforts. Health officials in St. Louis, Mo., launched a homebound vaccination service on Thursday. New York City announced a similar program and dedicated website last week, and aims to vaccinate its entire homebound population by the end of April.
The timing, however, illustrates just how far behind many of Americas most vulnerable older adults are. The end of April will mark nearly four months since most Americans 65 and over first became eligible for a vaccine.
Its a work in progress, at best, said Ruth Katz, the senior vice president for policy at LeadingAge, an advocacy group that represents thousands of nonprofit aging services providers. Theres still a lot of frustration out there.
When it comes to vaccinating homebound individuals, the success in West Virginias Kanawha County is exceptional. But the labor required for the campaign here only illustrates how difficult it will be to execute similar campaigns across the country.
To begin with, a targeted homebound vaccination campaign requires planning and good fortune. Young, who served previously as West Virginias first-ever immunizations czar, began charting out this countys vaccination campaign months before any vaccine received approval for emergency use. Thanks to a highly successful rollout, Young said, shes more credible than ever with the West Virginia National Guard officials helping to determine vaccine allocation.
As a result, Kanawha County was the first in the state to receive an initial supply of one-dose Johnson & Johnson vaccines, which the Food and Drug Administration authorized on an emergency basis in early February.
Im not afraid to beg for a vaccine, she said. Every vaccine we get, we get it all in arms within a week.
The doses are being put to good use. During a brief span on Wednesday, Young visited an 86-year-old who, without the use of his legs, rarely left the hospital bed in his living room. A later stop brought her to a 70-year-old mostly confined to her bed with Parkinsons disease, whose daughter had considered but decided against making the long drive to Charleston, the state capital.
Machine, not man, had kept a wheelchair user effectively trapped in his home for weeks: The hydraulic lift he used to skip over his front steps was broken. The maintenance company hadnt returned his calls.
In every case, they made clear to Young that were it not for her efforts, they never would have been vaccinated.
Beyond the vaccines and syringes, the homebound vaccination process didnt require much equipment beyond transportation in this case, an undercover, cobalt-gray Dodge Durango courtesy of the county sheriff. It doesnt cost much, either. The federal government provides vaccines to states, and in turn to cities and counties, at no cost.
Vaccinating homebound people in large numbers, however, is dramatically more complicated and time-consuming than the dollar cost suggests.
On Wednesday, Young, the county health executive, spent seven hours traveling from house to house in a car driven by Capt. Jeff Meadows of the Kanawha County Sheriffs Department. The day before, Meadows (no relation to Karen) had made roughly 15 calls to those who had requested a vaccine visit, establishing a preliminary schedule for his and Youngs trip. He later spent an hour on Google Maps charting the most efficient routes between roughly a dozen homes in Charleston and its suburbs, some of which were separated by nearly 40 miles.
Young and Meadows, who have worked together on the countys pandemic response since May, have turned their recent home visits into a routine. Throughout the day, Young took brief medical histories, drew vaccine doses from vials, administered the shots, applied bandages, and monitored patients for allergic reactions for roughly 10 minutes afterward. Often, she also offered vaccines to family members and caregivers, who, regardless of their age or health status, represent homebound individuals main connection to the world outside their doors, and therefore their biggest risk of contracting Covid-19.
Meadows did the driving, and plenty more. After pulling into a new driveway and making another phone call to announce the teams arrival, hed lug the vaccine cooler and a first-aid kit indoors, fill out CDC-branded yellow cards that show proof of immunization, and use an iPad to enter patient data into the Center for Disease Control and Preventions nationwide vaccination database.
Young, too, had spent hours planning. In recent weeks, she has scrambled to reverse-engineer a list of homebound patients in her county. To help, she enlisted local nonprofits, including Paralyzed Veterans of America and Kanawha Valley Senior Services, to spread the word. Local emergency services companies helped, too, by giving a heads-up to the many locals with kidney failure who require an ambulance ride to reach their dialysis clinic.
The current wait list of people whove requested at-home vaccination numbers around 200, Young said. While shes still adding names almost every day, the list is shrinking faster than its growing, thanks to her weekly house calls and those of other local health workers.
For Young, the work is personal. Growing up, she recalled, her late grandfather was fully homebound, paralyzed due to a spinal injury that occurred during a long-ago cancer treatment. She didnt need extra inspiration to help those confined to their homes in her county today, she said. Still, though, memories of her grandmothers daily slog to turn, bathe, and feed him have only magnified the urgency of her recent work.
Yesterday was Zoom after Zoom after Zoom, Young said. This is a heck of a lot more gratifying.
In most cases, vaccinating homebound people would be impossible if not for the February authorization of Johnson & Johnsons single-dose Covid-19 vaccine.
Unlike the two-dose vaccines developed by Moderna and, especially, the Pfizer-BioNTech partnership, the shot is easy to store. Early in the states vaccine rollout, the difficulties of transporting the ultra-cold Pfizer vaccine made giving shots anywhere besides a clinic impractical.
Johnson & Johnsons vaccine, Young said, is a game-changer. Beyond its relatively lax storage requirements, the fact that it requires only one dose means it takes half the labor to administer. The detailed logistical effort needed to schedule second vaccine appointments at specific intervals, she said, was also a deal-breaker.
I love having the J&J for home visits, Young said. Otherwise youd have to wait 21 days for [a second dose of] Pfizer, 28 for Moderna.
Without exception, every person Young immunized was thrilled to be receiving the Johnson & Johnson shot. Their reasons varied, but many expressed concern about the side effects reported by those who received Pfizer or Moderna doses. Among them was Pamela Doss, 61, Youngs first visit of the day.
They way everybody talked when they had two vaccines the second one made them sicker, Doss said.
Young warned, however, that the Johnson & Johnson jab can have side effects, too. She departed each house with a reminder to stay hydrated and to treat potential chills or headache with over-the-counter painkillers.
She also used concerns about new variants of the SARS-CoV-2 virus as a selling point.
You know those variants you see on the news? Young asked Doss. This is one of the best ones against those variants. (Some data shows the Johnson & Johnson vaccine is highly effective at protecting against severe disease and death regardless of viral strain, though its hard to directly compare them.)
Easily the best perk, however, was the sheer convenience of a single-shot vaccine.
Do I have to have two of these? one man asked, just as Young prepared to leave.
Youngs reply became a refrain that she and Meadows, the sheriffs deputy, used throughout the day: One and done.
Vaccinating homebound individuals doesnt just depend on heroism from health workers. Even in Kanawha County, the people seeking vaccines must work just as hard to secure a dose, often with limited success. Those who did succeed, however, said they would have kept trying as long as they needed to.
Doss, Youngs first visit of the day, said she had been trying to schedule an at-home vaccination appointment since January.
You dont know how long Ive been waiting for this shot, she told Young as she entered.
But her phone calls, she said, were well worth it once she secured a vaccine appointment and once she told her friends and family it wouldnt require an impossible trip downtown. The most frequent reaction, as she recalled, was disbelief: You mean theyre coming to your door?
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KANSAS CITY, Kan. (WDAF) The state of Kansas announced plans to shift the way its handing the COVID-19 vaccination plan. The change could make many people more comfortable with getting a vaccine.
Dr. Lee Norman, secretary of the Kansas Department of Health and Environment, explained what the shift means during a Facebook Live with doctors at the University of Kansas Health System Tuesday morning.
Hundreds of doctors offices, clinics, and other sites across the state of Kansas signed up to help vaccinate people. They havent given vaccines yet because there just hasnt been enough supply.
Dr. Norman said that will change starting this week.
We are going to do a lot of additional providers alerting this week, because we expect 100,000 additional Johnson and Johnson doses to be ordered this week and to come in next week, he said.
The state plans to include medical practices, primary care, and specialty offices across Kansas that previously sighed up to become vaccinators. As the offices receive doses of the vaccine, the locations will be added to the states vaccine finder website. The tool is also offered in Espaol.
Norman said the smaller doctors offices are going to be a key part of the vaccination process moving forward.
But its important to get vaccine in the hands of the primary care and specialty providers who know patients, they know the people really well and are going to be the ones to talk with them and hopefully defuse hesitations and fear, Norman said.
If you hope to get a vaccine from your doctors office, you may want to check your patient portal for an invitation to get a vaccine starting next week. Or you could call to see if they expect to become a vaccinator in the coming days or weeks.
ANDREWS, Texas The Andrews Fire Station will be holding drive-thru COVID-19 vaccine clinics on March 24 and 25.
The events will only be for second doses of the vaccine. Hours of Operations will be from 9:00 a.m. to 4:00 p.m. on March 24 and 4:00 p.m. to 9:00 p.m. on March 25.
If you need your first dose of the vaccine, you can go back to the fire station on March 3 and 4.
You must bring your vaccination card to the clinic.
The state health department said every Oklahoman will be eligible to receive COVID-19 vaccines starting Monday.
Many factors play into how the state chooses who is eligible for vaccines, but a big part of the equation is how rural health departments are doing.
Related Story: All Oklahomans Will Be Able To Get COVID-19 Vaccine Starting Monday
Oklahoma's move into phase four is a huge step towards getting all of Oklahoma's nearly four million people vaccinated.
Keith Reed, the deputy health commissioner of the Oklahoma State Department of Health wants to keep the ball rolling.
"It's remarkable to consider that we are approaching 1.7 million doses given to Oklahomans," he said.
"We wanted to maintain a steady demand. We want to make sure that there's always somebody available to get vaccinated. We're opening it up because we want to get as many people vaccinated as possible, Reed said.
Reed said one factor in the change was a slowed demand in rural counties, due in part to the number of people already vaccinated in earlier phases.
Kaitlan Thatcher with the Wagoner County Health Department said proximity to Tulsa and Broken Arrow has kept their vaccine demand consistent, but another phase is another step towards normalcy.
"Moving into phase four is just really going to benefit us," she said."I just think it's really going to help them get back to a normal way of life."
With the invitation extended to 16 and 17-year-olds, Thatcher and Reed both encourage younger Oklahomans to step up and get the vaccines as soon as possible.
"We are poised to finish strong, but we haven't crossed that finish line yet. If you haven't yet been vaccinated, please take action to do so now. Let's not give this virus the opportunity to resurge. Let's shut it down," Reed said.
Pfizer is the only vaccine approved for people 16 and older. Reed said if you're under 18, you must choose a vaccination site that carries it and get parent or guardian permission.
JACKSONVILLE, Fla. Those eligible to receive the COVID-19 vaccine now have another location to get it.
The Legends Center, located at 5130 Soutel Drive in Jacksonville, that has been operating as a COVID-19 testing site, is now operating as a vaccination site, too, the City of Jacksonville announced Wednesday.
The site is offering the Pfizer vaccine at this time. City officials said an appointment is NOT necessary.
[QUICK LINKS: How to make a COVID-19 vaccine appointment in the Jacksonville area]
The site is open daily from 9 a.m. to 5 p.m.
See criteria to receive a vaccine at this site below:
Rapid testing for COVID-19 at the site is free and no symptoms are required.
