A bewildering puzzle of COVID-19 is why the virus affects people so differently. Though older men seem to fare worst in the face of infection with SARS-CoV-2, younger people may unpredictably falter, too. Moreover, many people develop long-term symptoms. We dont yet understand why.
But for Akiko Iwasaki, PhD, the Waldemar Von Zedtwitz Professor of Immunobiology and Molecular, Cellular and Developmental Biology, pieces of the puzzle are emerging. Genetics, gender, and even botched timing on the part of the immune response all appear important. What she learns could help us better predict who is likely to sail through a bout with COVID and who may need targeted lifesaving care.
Theres a lot of variation in how the human immune system mounts a defense against coronavirus. For a group of people hospitalized with either moderate or severe COVID-19, Dr. Iwasakis team recently mapped out those differences in a study that appeared in Nature.
Among patients with moderate disease who recovered, proteins involved in tissue healing and repair were relatively abundant. By contrast, among those with worse disease, the cytokines were more mixed, showing up in combinations that are unusual for viral infection. More people died in that group.
Based on these immune signatures, the researchers were able to distinguish the patients disease trajectories. Further data from a larger study, Dr. Iwasaki said, could help doctors predict a patients course of disease and formulate tailored therapies.
One of the immune systems early defenses is a group of proteins called type I interferons. Produced by immune cells in response to viruses, interferons are key to the bodys initial, rapid defense against coronavirus. But some people make too much of it, others not enough, and still others neutralize it with autoantibodiesand that makes a difference.
In the early phase of the infection, if you can generate robust interferon, you will control the virus because interferon will trigger all these antiviral genes, Dr. Iwasaki explained. at is likely how people with asymptomatic or mild disease keep it under control, she added. On the other hand, if the immune system doesnt create interferon soon enough, the virus can replicate undisturbed. Later, caught o guard by uncontrolled viral replication, the immune system may respond by manufacturing large quantities of interferon.
But by that point, it might be too much of a good thing. Massive amounts of interferon can drive inflammation, which in turn recruits white blood cells to the lung and make disease worse, Dr. Iwasaki described. Patients with more severe COVID-19 have been observed to have higher levels of interferon.
What Im hypothesizing now is that the timing of the interferon really matters, Dr. Iwasaki said. Another group of people with severe COVID-19 do not mount an interferon defense at all, Dr. Iwasaki and co-author Eric Me re, PhD, Associate Professor of Immunobiology and of Medicine (Immunology), and a Yale Cancer Center member, explained in a recent commentary in Nature. For example, a recent study of 659 people with life-threatening COVID-19 found that 23 had mutations in genes known to be important in severe viral infection. These mutations left the individuals unable to either produce or to respond to interferon. By contrast, in 534 people with milder cases, only one had such a mutation. Another study found autoantibodies against interferon in some people with severe COVID, most of them older men. That finding may help explain mens overall heightened vulnerability to the disease.
Dr. Iwasaki also uncovered another such gender-based difference in work she published in Nature with viral epidemiologist Saad Omer, MBBS, MPH, PhD, of the Yale School of Medicine and of Public Health. Men who developed weak, defective T-cell immune responses suffered worse disease. Autoimmunity could also help explain why so many people experience prolonged illness after a bout with COVID-19. Long after their viral tests turn negative, these people, nicknamed long-haulers, can experience months of fatigue, shortness of breath, muscle aches, brain fog, and other symptoms.
Were trying to find out if theres any immunological mechanism that can explain long-haulers, she said. I raised three different hypotheses, none of which are mutually exclusive. One hypothesis is that these patients immune systems have turned on them, resulting in long-term autoimmunity. Another possibility is that remnants of virus, such as bits of protein or genetic material, remain to stimulate the immune system. That could result in chronic inflammatory symptoms. A third scenario is that the virus in long-haulers never goes away. Instead, it may hide somewhere in the body, far from the nasal swabs that can detect it, and continue to cause infection. Studies like these cant take place without blood and tissue samples.
Dr. Iwasakis lab contributed to the effort of the Yale COVID-19 Biorepository, which holds samples from hundreds of COVID-19 patients, including those with cancer. The biorepository, named IMPACT for Implementing Medical and Public health Action against Coronavirus (Connecticut, CT), was launched this spring by Albert Ko, MD, Yale School of Public Healths Chair of Epidemiology. Roy S. Herbst, MD, PhD, Chief of Medical Oncology at Yale Cancer Center and Smilow Cancer Hospital and a member of the IMPACT team, is leading the sample collection from cancer patients with COVID-19. This is the only way we could do our research, Dr. Iwasaki said of the biorepository. Thanks to these patient samples, Dr. Iwasaki, Dr. Herbst, and others are also able to study how cancer status affects COVID-19. Understanding cancer patients experiences with COVID-19 may help us better understand the immune system, Dr. Iwasaki explained. Some types of cancer appear to make people more susceptible to severe COVID-19, while many cancer therapies interact with specific steps in the immune responsean effect that may alter the course of COVID-19. Cancer immunotherapy has also illuminated the way cytokines can provoke damaging inflammation, Dr. Iwasaki said. For example, the cutting-edge cancer treatment chimeric antigen receptor (CAR) T-cells can lead the immune system to release too many cytokines. A drug called tocilizumab, which blocks a cytokine called IL-6, was tested for COVID-19 patients.
Though it didnt turn out to be effective, Dr. Iwasaki said, that research was important. These types of inflammatory responses that occur in cancer therapy have really shed light on how we might treat an inflammatory viral disease, Dr. Iwasaki said. Testing potentially helpful treatments for COVID-19, like tocilizumab, can take a long time. But Dr. Iwasakis lab has developed a versatile mouse model that allows for much quicker trials. Normally, mice are not susceptible to SARS-CoV-2 because they lack the ACE2 receptor that the virus uses as its doorway into cells. Mice can be bred to have this receptor, but that takes months. Instead, Benjamin Goldman-Israelow, MD, PhD, an infectious disease fellow in Dr. Iwasakis laboratory, devised a way to introduce the receptor into mice of any genetic background by delivering it into the body with a virus called AAV.
Were using this mouse model to rapidly get at these questions that people have about the importance of T cells and B cells and antibodies, she said. Whatever it is, we can do it very quickly. That speed is crucial. As the pandemic continues to rage around the world, clinical trials of therapies and vaccines have had to skip some steps, as Dr. Iwasaki and her co-authors recently explained in the Journal of Experimental Medicine. To better understand not only how the virus and immune system behave, but also to study treatments and potential vaccines, they wrote, good mouse models are urgently needed. This model provides a vital platform for testing prophylactic and therapeutic strategies to combat COVID-19.
(WREX/WBNG) Thursday marks the anniversary of the first confirmed case of the coronavirus in the United States.
The CDC confirmed the first case of the virus in Seattle, Washington.
The resident had returned from Wuhan, China, on January 15. The virus was first detected in Wuhan, China earlier in January of 2020.
After the first case was diagnosed in the U.S., the CDC soon after deployed a team to help with the investigation, including the potential use of contact tracing.
Since then, there have been more than 24 million confirmed cases of the virus in the US, along with more than 400,000 deaths in the country, according to Johns Hopkins University
CLEVELAND, Ohio - Ohios coronavirus alert map is unchanged from last week, despite decreases in the number of new cases and hospitalizations across the state.
Eighty-three counties are on Level 3 red alert over concern of the spread of COVID-19, with Hamilton County (Cincinnati) remaining one notch higher for concern at Level 4 purple.
Cuyahoga and every other county in Northeast Ohio remain on red alert in Thursdays update from the Ohio Department of Health.
The red alert designation, according to the states advisory system, means there is a public emergency for increased exposure and spread and that people should exercise a high degree of caution.
Lorain County was on watch for going purple this week, but the situation there has improved, according to the indicators tracked by the state. Lorain County was on purple alert from Nov. 25 through Dec. 9, before being dropped back down to red on Dec. 10.
Level 4 purple comes with the warning from the Ohio Department of Health to only leave home for supplies and services.
The only four counties at the lower concern level of orange are Gallia, Hocking, Monroe and Vinton - all in Southeast Ohio.
Many indicators, however, have been improving. The 3,406 coronavirus patients reported hospitalized Thursday was down 36% from the record of 5,308 on Dec. 15. And the 42,411 cases reported over the last week represented the lowest seven-day total since Nov. 13.
Yet both the number of hospitalizations and new cases far exceeds the levels of late summer and early fall.
We are still in a very difficult time, Gov. Mike DeWine said in explaining why caution and restrictions needed to continue.
The state closely tracks the rate of new cases per 100,000 people, excluding incarcerated individuals. Every Ohio county exceeds the Centers for Disease Control criteria for high incidence, of at least 100 per 100,000 over the last two weeks.
The highest rates this week in Ohio are for Fayette County (872.9 per 100,000), Clermont (869.6) and Pickaway (853.6).
Lake County has the highest rate in the Cleveland-Akron area, with 692.2 cases per 100,000), topping Lorain County (685.5), Summit (626.4), Cuyahoga (583), Portage (581.7), Geauga (567) and Medina (548.6).
The lowest rate statewide is for Holmes County, with 234.3 cases per 100,000.
Fayette and Clermont County have the highest rates for new coronavirus cases per 100,000 people over the last two weeks. Also among the top 30 rates among the state's 88 counties are those for Lake, Lorain and Summit counties in the Greater Cleveland/Akron area.Ohio Department of Health
The state tracks seven measures to determine alert levels. The indicators include the number of new cases per capita, increases in visits to doctors and emergency rooms, hospital capacity levels and how many cases are originating outside congregate living facilities such as nursing homes.
Cuyahoga met the threshold for concern in three of the seven categories this week - the rate of new cases per 100,000 residents, a consecutive day streak that ended Jan. 5 with increased emergency room visits each day, and for a high share of cases in the community outside congregate living facilities. The state looks back three weeks on consecutive day tracking.
Lorain County was flagged for four metrics being tracked - the same three as Cuyahoga, plus for an increase in news cases on consecutive days through Jan. 5.
Heres a closer look at the advisory system DeWine introduced in early July.
* 1. New cases - Alert triggered when there are 50 new cases per cases 100,000 residents over the last two weeks.
* 2. Increase in new cases - Alert triggered by an increase in cases for five straight days at any point over the last three weeks. This is based on the date of onset of symptoms, not when the cases are reported.
* 3. Non-congregate living cases - Alert triggered when at least 50% of the new cases in one of the last three weeks have occurred in outside congregate living spaces such as nursing homes and prisons.
* 4. Emergency rooms - Alert triggered when there is an increase in visits for COVID-like symptoms or a diagnosis for five straight days at any point in the last three weeks.
* 5. Doctor visits - Alert triggered when there is an increase in out-patient visits resulting in confirmed cases or suspected diagnosis for COVID-19 for five straight days at any point in the last three weeks.
* 6. Hospitalizations - Alert triggered when there is an increase in new COVID-19 patients for five straight days at any point over the last three weeks. This is based on the county or residence, not the location of the hospital.
* 7. Intensive Care Unit occupancy - Alert triggered when ICU occupancy in a region exceeds 80% of total ICU beds and at least 20% of the beds are being used for coronavirus patients for at least three days in the last week.
Rich Exner, data analysis editor forcleveland.com, writes about numbers on a variety of topics. Follow on Twitter@RichExner. See other data-related stories atcleveland.com/datacentral.
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A resident of Henry County is the latest victim of COVID-19 in the West Piedmont Health District. The death was revealed Thursday morning by the Virginia Department of Health, but it could've occurred weeks ago because VDH waits to review death certificates before adding a death to its database. Not much is know about deaths or cases, but VDH tracks them by a person's residence. This is the 65th victim from Henry County and the 151st in the health district. There were 94 new cases and 3 hospitalizations reported this morning in the district. Henry County had 39 of those cases and 2 of the hospitalizations. Franklin County had 34 cases and the other hospitalization. Martinsville had 10 cases, and Patrick County had 11. There have been 8,772 cases and 526 hospitalizations districtwide since the pandemic began....The West Piedmont Health District announced Wednesday that it is moving to Phase 1b of the states COVID-19 vaccination protocol, meaning a wider distribution of vaccine to citizens but dont expect your vaccination immediately. There's a paucity of vaccine....There has been another death and an increase in hospitalized cases caused by COVID-19 in the West Piedmont Health District....Wednesday was the second deadliest day in the U.S., with more than 4,200 having died from COVID-19....The number of people seekingunemployment aid soared last week to 965,000, the most since late August, offering evidence that the resurgent virus has caused a spike in layoffs....President-elect JoeBidens coronavirus action planaims to bring new urgency to the nations vaccination campaign coupled with another round of economic relief. The Biden plan being unveiled Thursday comes as a divided nation remains caught in the grip of the pandemics deadliest wave yet....The rapid expansion ofCOVID-19 vaccinations to senior citizenshas led to bottlenecks, system crashes and hard feelings in many states because of overwhelming demand for the shots. The minimum age varies from place to place 65, 70 or higher....The U.S. is averaging about 246,000 new cases and more than 3,300 deaths each day....The Federal Emergency Management Agency will set up vaccination centers, aiming to have 100 up and running in a month. Biden ordered the CDC to make vaccines available through local pharmacies starting next month....Biden revoked a Trump administration order that would have pulled the U.S. out of the WHO, and his top medical adviser on the pandemic, Dr. Anthony Fauci, was dispatchedto show new U.S. support....The Virginia Department of Health reportsthis morning there have been 459,604 cases and 5,940 deaths statewide -- up by 79 since Wednesday. Some 20,405 people have been hospitalized. Henry County has had 3,458 cases, with 245 hospitalizations and 65 deaths. Martinsville has had 1,273 cases, with 109 hospitalizations and 29 deaths. Patrick County has had 962 cases including 75 hospitalizations and 28 deaths. Franklin County has had 3,079 cases, 97 hospitalizations and 29 deaths. Danville has reported 3,209 cases (63 deaths), and Pittsylvania County has had 3,735 (42 deaths).Johns Hopkins University's real-time mapshowed 96,971,229 cases worldwide and 2,077,628 deaths. In the U.S. there have been 24,440,100 cases and 406,196 deaths because of COVID-19.
(124) updates to this series since 6 hrs ago
6:59 PM ET
ESPN
The Washington Wizards announced on Wednesday night that they've been cleared to return to practice. Washington's past five games have been postponed because of a coronavirus outbreak within the team.
The Wizards haven't played since Jan. 11, and they are scheduled to play next at the Milwaukee Bucks on Friday.
The Wizards said Deni Avdija, Davis Bertans, Troy Brown Jr., Rui Hachimura, Ish Smith and Moritz Wagner are listed as out for that game because of health & safety protocols.
Thomas Bryant (left ACL) and Russell Westbrook (left quad) are also listed as out.
The NBA has postponed 16 games this season because of the coronavirus.
It depends on vaccine production and how quickly other vaccines become available. Here's the state's best guess.
HOUSTON As the American public grows anxious and tires of the ongoing coronavirus pandemic, searches are up in Texas for "When will the pandemic end?" and "When will the coronavirus vaccine be available to everyone?"
Editor's note: the video in this story is from a Jan. 18 broadcast about frustrations over the vaccine registration process
The Lone Star State, as of January 2021, remained in Phase 1 of its vaccine distribution plan. This meansTexas frontline/health workers (Phase 1A) and older citizens as well as those with health risks (Phase 1B) will remain the priority for vaccinations for now.
Phase 1B recipients include:
When will the general public be able to get the coronavirus vaccine in Texas?
Because of the variables involved, at this time there's no specific date for the end of Phase 1 and when we would move on to another phase or the general public. But state leaders have a guess. As of Jan. 19, 2021, the state offers this guidance for those looking to get the vaccine: "Spring 2021 is the best estimate of when vaccine will be available for the general public, but that may change. It depends on vaccine production and how quickly other vaccines become available. The Expert Vaccine Allocation Panel (EVAP) is considering what criteria could be used for later stages of vaccine distribution. This webpage will be updated when those decisions are completed."
Where can I get a COVID-19 vaccination?
Texas is directing most of its COVID-19 vaccines received to large sites or hubs around the state to vaccinate more than 100,000 people.
If you are in Phase 1 and eligible to receive the vaccine, please check the COVID19 Vaccination Hub Providers page to find a hub near you and learn how to register.
Alternately, you can also check the websites of vaccine providers listed on the Texas COVID19 Vaccine Availability map to see if they have enough vaccine supply at this time.
Remember: you should not go to any vaccination sites unless you have registered and have been given a specific location and time/day to get vaccinated.
About the two vaccines approved in the U.S.:
Coronavirus vaccines using mRNA technology were developed and authorized for use in a record-setting 10 months, an accomplishment that will surely make up a chapter in the history books of the future, and while the speed may give some people pause, theres no need to worry.
It may seem like the vaccines were created at lightning speed and they were but mRNA technology has actually been in development for decades, like a diamond in the rough just waiting for its moment to shine.
Messenger ribonucleic acid, or mRNA, is a molecule in cells that carries codes from DNA to make proteins. An mRNA vaccine, such as the coronavirus vaccines made by Moderna and Pfizer, encode proteins of a virus, which is inserted into a cell to trigger an immune response and create antibodies.
The first report of the successful use of transcribed mRNA in animals was published in 1990 when reporter gene mRNAs were injected into mice and proteins were produced, as cited in a National Center for Biotechnology Informationreport.
In the following decades, an improved understanding of the mRNA pharmacology, together with novel insights in immunology have positioned mRNA-based technologies as next-generation vaccines, wrote researchers in a 2019 edition of Nano Today Journal.
Just take a look at what Moderna says is its guiding premise: If using mRNA as a medicine works for one disease, it should work for many diseases.
Moderna, founded in 2010, has a team of several hundred scientists and engineers solely focused on advancing the companys mRNA platform technology.
Its no wonder the company, which calls mRNA the software of life, was well-poised to take on the COVID-19 pandemic.
Both Pfizer, Moderna and the U.S. government via Operation Warp Speed have also pumped significant funding into the development of mRNA coronavirus vaccines.
The Department of Health and Human Services gave billions to Moderna and Pfizer to support their vaccine candidates along with manufacturing and distribution costs.
Another factor that accelerated coronavirus vaccine clinical trials was the high rate of community spread which resulted in infections among trial participants as they moved through daily life amid the pandemic.
As Barry Bloom, professor and former dean of the Harvard T.H. Chan School of Public Health said, data is more important than time in clinical trials, and there was a lot of data to work with as case counts continued to climb during the time of the studies.
It can be nerve-wracking to know that the vaccines were developed so quickly, but it shouldnt be cause for fear, worry, or serve as a reason not to get vaccinated.
Scientists across the world have worked on mRNA technology for years, and although it has never been in the spotlight like it is now, the platform is sure to change vaccinology forever not to mention go down in history as a top miraculous medical achievement.
In addition to vaccine hubs, there are also smaller community vaccine providers throughout Texas, such as pharmacies, that may also have the vaccine available. (Eva Vigh/Community Impact Newspaper)
To answer these questions, Douglas Loveday, press officer for the Texas Department of State Health Services, spoke with Community Impact Newspaper about the vaccination process. While Loveday said vaccine supply is limited in Texas as of Jan. 19, the state is still receiving more vaccine doses on a weekly basis, meaning those who want to get inoculated should continue to stay in contact with their local vaccine provider.
"Also, other vaccines may soon be approved for use in the next several weeks, promising even more vaccine doses available for Texas weekly," Loveday said. "But until all who want a vaccination receives one, continue to wear a mask, avoid crowds and keep a safe distance from others, and get vaccinated when able."
The following information comes from Community Impact Newspaper's interview with Loveday and the Texas Department of State Health Services.
Who can get vaccinated when?
In an effort to provide the most protection to vulnerable populations and critical state resources, the Texas Department of State Health Services has developed vaccine allocation guidelines, which outline who will get vaccinated when. Currently, Texans in Phase 1A and 1B are eligible to receive a COVID-19 vaccine. Once these individuals are inoculated, the vaccine will become more readily available to the general public, which will likely occur in spring 2021, according to the Texas Department of State Health Services.
Phase 1A and 1B individuals are as follows:
Phase 1A
Vaccination hubs were set up throughout Texas in January to assist with rolling out the COVID-19 vaccine. According to Loveday, the hubs aim to simplify the vaccination process and are designed to serve all people who are eligible to receive a vaccine, regardless of what county they live in.
As of press time, there are no vaccination hubs located in the counties of Brazoria, Comal, Guadalupe or Waller counties, which Community Impact Newspaper also covers. For a complete list of vaccination hubs and COVID-19 vaccine providers, click here.
AUSTIN
Hays County
Collin County
Fort Bend County
How can I get vaccinated?
To receive a vaccine, Loveday said Texans have a few options. While each vaccination hub and community vaccine provider operates differently, Loveday said individuals wanting to be vaccinated should first check the provider's instructions for scheduling a vaccination, either online or by phone. Depending on the provider, patients may be placed on a waiting list or contacted by the provider via phone, email or text when vaccines become available.
Loveday urged Texans to not show up at a vaccination provider without an appointment, as waiting lists are already filling up and vaccine supply is limited.
"Remember, vaccine is still in limited supply, so there may be long waiting lists," Loveday said. "Please, don't just show up there. Check out the provider's website to learn how to sign up for a vaccine. Call if the provider's site doesn't answer your question."
In addition to vaccination hubs and community vaccine providers, Loveday said Texans should also stay in touch with their personal health care providers for updates on when they will be vaccinating patients. Older adults can also reach out to their Area Agency on Aging for assistance. To find a local Area Agency on Aging, click here.
Additionally, Loveday said the Texas Department of State Health Services has also established a COVID-19 Nurse Call Center, which Texans can contact by calling 877-570-9779 Monday-Friday from 8 a.m.-5 p.m., calling Texas 2-1-1 and selecting Option 6, or emailing coronavirus@dshs.texas.gov.
For more information about the COVID-19 vaccine, click here.
CLEVELAND, Ohio The U.S. rollout of the COVID-19 vaccine has been rocky, hindered by a lack of supply and shipping delays.
What happens if those delays cause a delay for someone who is waiting for a second dose of the vaccine?
Our readers have questions about the coronavirus vaccine, and cleveland.com is getting answers from health care experts.
Q: If coronavirus vaccine shipments are delayed and you need to wait longer for a second dose, will it be less effective?
Both coronavirus vaccines approved by the U.S. require two doses spaced out over several weeks. The Pfizer/BioNTech vaccine doses should be given at least 21 days apart, and the Moderna vaccine doses should be given at least 28 days apart.
The U.S. Centers for Disease Control and Prevention recommends getting the second dose as close to those schedule as possible. After you wait the required 21 or 28 days, there is no maximum interval between the two doses.
There is a minimum to wait, said Dr. David Margolius, MetroHealths division director of internal medicine. But youre OK delaying the booster.
In fact, Margolius said MetroHealth is delaying the second dose by design. The Pfizer vaccine in particular is more likely to cause side effects like pain, tiredness and fever after the second dose, according to the U.S. Food and Drug Administration. MetroHealth is scheduling the second dose on Fridays to avoid side effects during the work week, Margolius said.
However, health care experts recommend getting the second dose as close to the 21- or 28-day schedule as possible. The vaccines were approved based on data from clinical trials, and those clinical trials did not consider the effects of a significant delay, said Dr. Shanu Agarwal, an infectious disease physician at Summa Akron City Hospital.
If its something thats out of your control and they dont have it available, just get it as soon as they do, Agarwal said.
Some countries have opted to delay the second dose of the vaccine in order to give the first dose to a greater number of people. Last month, the U.K. announced that it planned to give doses of the Pfizer vaccine 12 weeks apart, four times longer than Pfizer has recommended.
The FDA said earlier this month that it has been following those types of discussions but does not recommend altering the vaccine schedule. There is no data to support changing the vaccine schedule, the FDA said in a news release.
Without appropriate data supporting such changes in vaccine administration, we run a significant risk of placing public health at risk, undermining the historic vaccination efforts to protect the population from COVID-19, the FDA said in the news release.
Do you have questions about the COVID-19 vaccine that youd like an expert to answer? Send it in a brief email to cleveland.com reporter Evan MacDonald at emacdonald@cleveland.com.
Your coronavirus vaccine questions answered:
If the coronavirus vaccine is 95% effective, how will you know if youre in the other 5%?
Why do I need to keep a mask on if Ive been vaccinated for coronavirus?
Syracuse, N.Y. A year into the coronavirus pandemic, Americans are eager to get back to normal life. A pair of Covid-19 vaccines approved last month hold promise that we might be able to do that soon.
But it will be months before everyone who wants a vaccine will be able to get one, and before America achieves herd immunity, when enough of us have had the vaccine or the disease that the virus has a hard time finding new people to infect.
So what happens in the meantime? If you get the two-shot sequence for the vaccines, can you resume that longed-for normal life? We talked with two of Central New Yorks leading infectious disease experts Dr. Helen Jacoby at St. Josephs Health and Dr. Stephen Thomas at Upstate Medical University about what the vaccine will let you do, and what it wont.
Once I get the vaccine, can I take off my mask and stop social distancing?
No.
Until further notice, people need to continue the public health interventions that we try to encourage: practice masking, do not gather and, if youre sick, stay home, said Thomas, who was the lead investigator for the Pfizer vaccine, the first to be released. Its not going to be, I have proof of vaccination on my phone or Ive got my yellow card, and I can now go around without a mask.
Thats because its still unknown if vaccinated people can transmit the virus without knowing it, Jacoby said. The principal reason for a vaccine is to keep people from getting sick, and from overwhelming hospitals. Preventing infection outright is a much higher bar, and is much harder to test for.
We know that the vaccines currently licensed are very effective at preventing symptomatic disease, but what we dont know for sure is how good they are at preventing asymptomatic infections or your ability to catch the virus, feel fine and give it to somebody else, Jacoby said. We dont think its safe for people who have been vaccinated to go out and act like Covid never happened.
Thomas is hopeful that the vaccines will prevent people from passing along the illness, but that remains to be studied.
I will say that the way these vaccines are supposed to work, it is highly feasible that an effective vaccine could impact a persons ability to transmit to another person, he said.
How long will we have to keep up the mask-wearing and distancing? It could be months or even well into 2022. That depends on how quickly people get vaccinated and how well vaccines work.
Can I see my grandchild after I get the vaccine?
Thats a personal judgment call, Jacoby said. The two vaccines that have won emergency approval are about 95% effective in keeping people from getting sick: not a guarantee, but a big step forward.
Visiting that grandchild can become significantly safer, Jacoby said. You would be much less likely to get sick if you caught Covid from that grandchild. For those personal things, it does make a persons life safer.
Can I visit grandpa in the nursing home?
That will ultimately depend upon state regulations, individual nursing home policies and the comfort level of families, Jacoby said.
Even when visitors are allowed, she said, families should remember that the vaccine will not be as effective for nursing home residents as it will be for younger, healthier people. The Covid-19 vaccine, like those for flu and other illnesses, works by triggering the bodys immune system to produce antibodies. Older people have weaker immune systems that simply arent as prolific at producing antibodies.
The trick, especially in nursing homes, is that the vaccine may not work quite as well in the very elderly, Jacoby said. We know they work, but it might not the 95% efficacy weve heard about.
Do I still have to quarantine if I go out of state or get exposed?
Yes, because, again, health officials dont know yet if you can pass along the virus without knowing it.
None of the rules have been changed for people who have been vaccinated, Jacoby said. At St. Josephs we have vaccinated a large percentage of our staff, but they are expected to follow the same precautions as if they hadnt been vaccinated. They have to wear masks and face shields, they have to socially distance at lunch; if they travel, they have to follow the same rules, and if theyre exposed, they have to quarantine.
If Ive had Covid-19, do I still need the vaccine?
Yes. Thomas said that while having had Covid-19 gives some resistance to the disease, its not clear yet how strong that resistance is or how long it will last. People who were sicker with Covid-19 had stronger immune responses and might have greater immunity than those who had a mild case of the disease, he said. In addition, there have been reports of people getting infected twice.
The vaccine also appears to protect people better than if theyve had the disease, Jacoby said.
We think the vaccine gives better immunity than a naturally occurring infection, she said. People who have had Covid should get immunized.
Jacoby said you should wait until you completely recover from the illness, then get the vaccine within 90 days.
Will the vaccine last a lifetime, or will I need one every year?
Covid-19 is only a year old, so its too soon to know how long the vaccine lasts. It probably wont be like the measles vaccine, which confers lifetime immunity after a sequence of two shots in childhood. The Covid-19 vaccine is also not likely to be needed annually, because the coronavirus doesnt mutate as rapidly as the flu virus, Jacoby said. The Covid-19 vaccine could fall somewhere in between, like tetanus, she said, which requires a booster shot every 10 years.
I dont anticipate a yearly shot, but are we going to need a booster every two or three years? she said. Thats something we dont know at this point.
Pfizer is conducting a two-year study of how well the vaccine works, she said, so well know more at the end of that review.
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