Now that Louisiana is receiving COVID-19 vaccines each week, the state Health Department is turning its focus to a crucial part of reaching herd immunity and ending the pandemic by immunizing 70% of the states population: convincing people to get it.
The agency will spend about $475,000 on an ad campaign, produced by the Baton Rouge marketing and ad firm Feigley Communications, aimed at promoting the safety and efficacy of the available COVID-19 vaccines.
Their work will be informed in part by polling done by the Louisiana Public Health Institute, which conducted a survey about the pandemic in June and is launching another on vaccine willingness soon, in conjunction with the Louisiana Health Equity Task Force. That task force was formed by Gov. John Bel Edwards to address the pandemics disproportionate effects on minorities.
The effort by the Louisiana Department of Health to promote the vaccine is funded by a grant from the U.S. Centers for Disease Control, said LDH spokesperson Aly Neel. The ads will run on TV, radio, online and in other forums, and was titled Phase Out COVID in the states vaccine playbook, which called for it to start in October. Neel said the agency decided to start the campaign in January mostly so it could gather more input from stakeholders.
Its trying to get the facts to every Louisianan, she said. We want every Louisianan to be vaccinated. Its building on this early momentum on positive stories about frontline health care personnel getting vaccinated and why.
The campaign also likely help determine how soon Louisiana reaches the threshold Gov. Edwards has identified as needed to end virus restrictions and return to normal, which is when about 70% of the population is immunized. Several national surveys, which the Louisiana Department of Health is using to help inform its decisions, show confidence in the COVID-19 vaccines have ticked upwards recently, though a significant chunk of people still say they likely wont get it. Polls by Pew and Gallup found roughly 60% of people said they would get vaccinated; the Kaiser Family Foundation found more than 70% were willing.
In Louisiana, the only publicly-released poll on vaccine willingness came in June, when the Louisiana Public Health Institute, known as LPHI, hired the New Orleans firm MDRG, Inc. to do a 1,126-respondent online poll on COVID-19 issues. The poll found 62% of men and 51% of women were definitely or probably going to get the vaccine.
The disparate impact of the pandemic, which has hit Black communities harder, also extends to peoples willingness to get vaccinated. National surveys show African Americans are more hesitant about the COVID-19 vaccines. The LPHI survey also suggested Louisiana has work to do to convince Black people that the vaccine is safe and effective if the state wants the population to get immunized. While 59% of White respondents said they would take the vaccine, 49% of Black respondents said the same.
The governor and top health leaders say they hope to address that distrust, in a state where about a third of residents are Black.
I think this is going to be a real challenge, said Dr. Thomas LaVeist, Tulane University School of Public Health Dean and co-chair of the Health Equity Task Force. The way to approach this, I think, is to acknowledge the distrust comes from a very real place. And not to try to pursue a narrative that the distrust is illogical.
LaVeist said the distrust among minorities of the health care system isnt only rooted in historical injustices like the Tuskegee experiment, in which the U.S. government withheld diagnosis and treatment for syphilis from Black men for decades. Ongoing disparities in the health care system a Black doctor recently died battling COVID-19 after complaining of racist medical care, for instance continue to fuel that hesitancy, he said.
Louisiana also faces political polarization surrounding the virus. Gov. Edwards, a Democrat, has been under fire from Republican lawmakers and other GOP officials over what they see as government overreach in his coronavirus restrictions. State House Republican lawmakers went as far as signing a petition to revoke all of the states virus restrictions, like the mask mandate and social distancing requirements at businesses, a matter that is still being litigated.
LaVeist said the state can only use facts and evidence to combat the idea the virus isnt a serious threat. More than 7,000 Louisiana residents have died from the disease, including recently the late Congressman-elect Luke Letlow, a 41-year-old Republican with no known underlying health conditions.
One in 1,000 Americans have died from this virus over 10 months, he said. Were on a pace to capture the number of deaths seen during the civil war. If 340,000 deaths is not enough to take this seriously then I dont know whats going to make them take it seriously.
He also said the risks associated with the vaccine an extremely small share of the people who have received the vaccines so far have reported severe adverse reactions should be weighed against the risks from COVID-19.
Dr. Keith Ferdinand, of both Tulane University and the Health Equity Task Force, said the best way to overcome distrust of vaccines is with trusted messengers, or people who have a history of working for the Black community, like Black doctors, nurses, educators, ministers and political leaders.
But the state cant simply approach leaders and tell them to promote the efficacy and safety of the vaccine, Ferdinand said. There must be a process in place to let them vet the science and concerns, he said.
Ferdinand also said the gender disparity women were less likely to say they would take the vaccine than men in the Louisiana survey could be explained by the fact that women are often gatekeepers of health in their families.
They have a history of being more informed consumers of medications and therapies, he said, and need to have data and clear explanations of the risks and benefits of the COVID-19 vaccines.
The decision to take a vaccine is an individual choice and must be respected, Ferdinand said. But we should make our decisions based on science and reason and avoid rumor, unsubstantiated social media reports and concepts that are not based in science.
While decisions on alternative dosing regimens reside with health authorities, Pfizer believes it is critical health authorities conduct surveillance efforts on any alternative schedules implemented and to ensure each recipient is afforded the maximum possible protection, which means immunization with two doses of the vaccine, Mr. Danehy said.
With distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:
Both Pfizers and AstraZenecas vaccines introduce into the body a protein called spike that, while not infectious itself, can teach immune cells to recognize and fight off the actual coronavirus.
But the vaccines impart their immunological lessons through different methods, and do not contain equivalent ingredients. While Pfizers vaccine relies on a molecule called messenger RNA, or mRNA, packaged into greasy bubbles, AstraZenecas shots are designed around a virus shell that delivers DNA, a cousin of mRNA.
Both vaccines are intended to be doled out in two-shot regimens, delivered three or four weeks apart. While the first shots of each vaccine are thought to be somewhat effective at preventing Covid-19, its the second dose intended as a sort of molecular review session for the immune system that clinches the protective process.
While its possible that swapping out one vaccine for another may still school the body to recognize the coronavirus, it is still a scientific gamble. With different ingredients in each vaccine, its possible people will not benefit as much from a second shot. Mixing and matching could also make it more difficult to collect clear data on vaccine safety.
Without evidence to back it, the hybrid vaccination approach seems premature, said Saad Omer, a vaccine expert at Yale University. Still, its not without precedent: Health authorities like the C.D.C. have previously said that if its impossible to give doses of a vaccine from the same manufacturer, providers should administer the vaccine that they have available to complete an injection schedule.
In a controversial move, the British government this week also decided to frontload its vaccine rollout, delivering as many first doses to people as possible a move that could delay second shots up to 12 weeks.
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Two new COVID-19 vaccines are now available in limited supply in Alaska, but many details about the vaccine rollout are still being finalized.
In the meantime, were continuing to answer readers virus and vaccine-related questions. Have a question of your own? Ask it in the form at the bottom of this article.
By Saturday, fewer than 14,000 people had received a shot of vaccine less than a quarter of the total vaccine allocated to the state for the month of December.
I know that this looks like this is not a super fast process, said Kelsey Pistotnik, a program director with the state immunization program. But theres a lot of planning that has to go into this.
Every single dose has been earmarked for use, she said. But the strict temperature requirements for the vaccines make careful planning essential.
The time that we have to store this vaccine at certain temperatures is really limited, Pistonik said. So we want to make sure we have as much possible time on that vaccine in the providers office when theyre actually going to be administering it.
The Pfizer vaccine must be stored at minus 70 degrees Celsius, and can then only be refrigerated for five days after its thawed. The Moderna vaccine has a temperature range around minus 20 thats a bit easier to manage.
Many of the 60,000 December doses are going to be used beginning Monday when the final tier of Phase 1A begins, Pistonik added. The state also didnt receive its December shipment until midway through the month, which means officials have only had about two weeks so far to get the vaccine distributed.
Health officials said it was likely that the pace of vaccine distribution would pick up in January once the process is smoothed out and the delays associated with the holidays are over.
According to a national tracker, Alaska has the fourth-highest per capita vaccination rate.
Alaska will begin vaccinating those in the final tier of the first phase on Monday. The states website, covidvax.alaska.gov, lays out the specific criteria: This group includes workers in health care settings at highest risk of contracting COVID-19 who are essential to the health care infrastructure and who regularly provide health care services that cannot be postponed or provided remotely.
In addition, Indian Health Service beneficiaries should contact their providers to see if they are eligible for vaccine now, even if they dont fit into these initial tiers. Tribes have authority to determine the order and pace of distributing doses allocated by IHS.
This new phase will begin with Alaskans 65 and older, who will be followed by frontline essential workers 50 and older who work in close proximity with each other and/or the public.
Because the state is still in the process of vaccinating front-line health care workers and others in the earlier groups, in most cases, it is not yet possible for older Alaskans to begin making appointments to get vaccinated, said Zink.
By the end of the month, seniors will likely also be able to make appointments via the link on the states vaccination webpage, covidvax.alaska.gov. That link will go to a list of available providers and clinics based on ZIP code who are accepting appointments. The state will announce soon the date and time seniors will be able to start making appointments.
No. Second doses of Pfizer and Moderna vaccine will arrive soon in addition to the federal allotment assigned to the state in January, which is 52,900. Providers are currently in the process of ordering their second doses from the federal government.
Eventually and in some cases, yes. When you become eligible for vaccine and make an appointment, you will be able to see which vaccine is available, and it may be possible to indicate a preference. If you want to wait until the spring and summer, when future vaccines are likely to be approved, that is an option, said Tessa Walker Linderman, who heads the states vaccine task force.
With patience and time, you could likely receive the vaccine you are most interested in, Walker Linderman said.
Dr. Liz Ohlsen, a physician with the state, noted that very few differences have been identified so far between the Pfizer and Moderna vaccines, which are both mRNA-based vaccines.
Given that no vaccine is 100% effective, if you develop COVID-19 symptoms at some point post-vaccination, officials still recommend you get tested, said Joe McLaughlin, an epidemiologist with the state health department.
The same goes for quarantining after a potential exposure with someone who has COVID, and continuing to wear a mask when youre in public, state officials say.
Another important point is that getting vaccinated wont make your COVID-19 test come back positive, and a test result wont tell you anything about the effectiveness of the vaccine.
In 2020, we lost musical legends Charley Pride, John Prine, Trini Lopez and Bruce Williamson, former lead singer of The Temptations, to the ravages of COVID-19.
Tony award-winning playwright Terrence McNally had survived lung cancer but succumbed to the illness on March 24 at the age of 81.
Olympic gold medalist track star Arnie Robinson Jr., Olympic pentathlete Bob Beck and baseball Hall of Famer Tom Seaver all died from complications related to COVID-19 last year.
Herman Cain, erstwhile Republican presidential candidate, died in July at 74 after a long battle with the illness.
Roy Horn of Siegfried & Roy fame died in May at age 75, and Ellis Marsalis, 85, jazz pianist and patriarch of a renowned musical family, died from complications of the coronavirus on April 1.
Broadway star Nick Cordero, who spent months hospitalized with COVID-19, was just 41 when he died on July 5. God has another angel in heaven now, wrote his wife Amanda Kloots.
And last Wednesday, actress Dawn Wells, famous for her role as Mary Ann in the classic TV series Gilligans Island died from COVID-19 complications. She was 82.
The second wave of the coronavirus in New Jersey continued to recede this week as new cases of COVID-19 dropped by almost 10%.
On the whole, New Jersey added 30.5 coronavirus cases per 10,000 residents for the week of Dec. 24-30. That was down from 33.8 new cases during the week of Dec. 17-23, a 9.8% decline.
CORONAVIRUS RESOURCES: Live map tracker | Businesses that are open | Homepage
Fifteen of the states 21 counties saw new infections decrease. The biggest declines came in Mercer County (-25.8%) and Passaic County (-25.6%).
Ocean was the county with the highest rate of new infections for the week, adding 40.8 cases per 10,000 residents. The county with the lowest rate was Cape May, which recorded 17 new cases per 10,000 residents.
Both of those counties were among the six that saw new cases grow, though Oceans rose by just 0.8% and Cape Mays by 0.6%.
The other counties with a week-over-week increase were Somerset County (+15.8%), Burlington County (+10.5%), Warren County (+2.5%), and Hudson County (+1.2%).
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Nationally, new cases also fell. They dropped by 14.5% from the week prior, down to 38 per 10,000 residents from 44.5 per 10,000.
State officials have warned that there could be a post-Christmas bounce in new cases, as there was after Thanksgiving. The TSA scanned over 1 million travelers each day of Dec. 26, Dec. 27 and Dec. 28. That broke pandemic records for air travel, and could translate to further outbreaks in the coming weeks.
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Nick Devlin is a reporter on the data & investigations team. He can be reached at ndevlin@njadvancemedia.com.
The Peabody Award-winning broadcaster was among Americas most prominent interviewers of celebrities, presidents and other newsmakers during a half-century career that included 25 years with a nightly show on CNN.
He has had medical issues in recent decades, including heart attacks and diagnoses of diabetes and lung cancer.
Last year, King lost two of his five children within weeks of each other. Son Andy King died of a heart attack at 65 in August, and daughter Chaia King died from lung cancer at 51 in July, Larry King said then in a statement.
Many basic questions about the coronavirus were answered quickly. A pressing set of questions, however, remain unanswered. Here are five gaps needing answers in 2021.
1) Does "viral load" matter?
Up until now, the diagnostic result of a COVID-19 test has been an either-or outcome -- you provide the lab with a sample, and the lab comes back with a yes or a no.
This assumes the course of illness is the same whether the virus is found in large quantities or small, and that any difference in how a person fares under COVID-19 comes down to personal characteristics. But what if the degree to which people did worse was driven in part by how much COVID a person had at diagnosis?
This metric is known as "viral load."
It is identified in most diagnostic tests, and it is increasingly believed to offer a signal as to whether the patient will need hospitalization, or is more likely to infect others.
Viral load changes throughout a person's course of illness, however. It rises as the virus incubates, and falls as the immune response kicks in. Some research even shows an inverse relationship between the amount of virus in the body and outcome.
Recently, regulators have begun to advise testing centers to report the metric with a person's PCR status.
2) Does "viral load" cause worse outcomes for persons with underlying conditions?
The data is clear that minority communities fare worse under COVID-19, both in terms of incidence and severity of illness.
Higher incidence rates among minorities are attributed to jobs lacking the freedom to work from home, as well as larger households and smaller living quarters that make quarantine impossible.
Poor outcomes among minorities are believed to be driven by a complex set of variables, including delayed care, poor care, chronic, stress-driven inflammatory states causing a state of heightened immunoreactivity, and a higher prevalence of underlying medical conditions.
But research shows this vulnerability among minorities is not associated with higher viral loads upon diagnosis. What research has shown is that patients with underlying conditions are admitted with higher viral loads. So it is possible that something about these underlying conditions isn't the problem, rather, that they cause COVID-19 to load in greater quantities.
3) What does the new strain of COVID-19 tell us about lockdowns?
A new strain of COVID-19, first identified in southern England, is now in circulation in the U.S. It is almost twice as infectious, albeit not associated with worse outcomes. (It is associated with higher viral loads.)
More infectiousness increases cases, however, and that increases bad outcomes on a population basis.
Lost in the news about this new form of COVID-19 is whether the virus mutated to a higher level of infectiousness due to evolutionary pressures created by the circumstances of lockdown, or the lack thereof.
Evolutionary biology looks at viruses from the point of view of the pathogen's search for survival and replication. Because COVID-19 is airborne and not waterborne, if we shelter, mask and distance in a strict lockdown, the virus risks its survival by evolving to more deadly strains. When you can't travel, you don't want to kill your host.
Currently, the new virus has shown up heavily in two places with divergent approaches to lockdown -- England (high lockdown), and South Africa (low lockdown). It's unchanged virulence, suggest that the lockdown in England held the virus in check as it learned to better attach to spike proteins.
That is good news, because if COVID-19 were to mutate in regions where it could travel more easily, evolutionary pressures should cause it to mutate towards faster spread (to push out other strains), and possibly more death.
The arrival of vaccines will almost certainly cause the virus to mutate again. Scientists believe any mutations that invalidate the current antibodies will happen over a course of years, however, not months.
4) Can you transmit the virus after becoming vaccinated?
Just because the new vaccines have 94-95% effectiveness in preventing mild illness does not mean they prevent infectiousness, serious illness, or even death.
The manufacturers did not study those outcomes, because that would have required a much larger trial than was possible.
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Instead,. they effectively placed a bet that any vaccine which prevents mild illness will also prevent death and your ability to give it to others.
But those remain unknowns.
As a result, the first year of the new vaccines will require close study of infection and death rates. If they begin falling, the manufacturers' bet will have proven correct, and the masks can come off.
5) Where did COVID-19 come from?
A very close form of the virus exists in horseshoe bats found in China, and has for decades. But that virus appears to have mutated before jumping to humans, likely via an intermediate host.
The leading suspects for that host are pangolins, endangered, scaly anteaters that are the most trafficked species in the world, traded for the supposed medicinal qualities of its scales (which are really just keratin, the material in fingernails).
To definitively trace COVID-19 to pangolins, the scientific community would need to find a pangolin with the same virus discovered in Wuhan, something that has not yet happened. Complicating this question -- humans can give COVID back to animals. Meaning, it's possible any animal found with COVID-19 got it from us.
Preventing the next COVID-19 will have as much to do with shutting down the wildlife trade as anything carried out in a pharmaceutical laboratory.
NEW YORK, NEW YORK - DECEMBER 23: Members of the FDNY EMS speak in the waiting area receiving the ... [+] coronavirus (COVID-19) vaccine at the FDNY Fire Training Academy on Randalls Island in New York City. Members of FDNY EMS were given doses of the Moderna coronavirus (COVID-19) vaccine allotted for the department. The vaccine will not be mandatory for EMS workers or firefighters.(Photo by Michael M. Santiago/Getty Images)
The latest figures from the Centers for Disease Control and Preventions (CDC) show that between 431,000 and 470,000 excess deaths have occurred since the Covid-19 pandemic began. An additional 200,000 deaths are projected by April.
Along with strong mitigation measures to curb the spread, vaccines are powerful tools that will enable us to subdue and eventually end the pandemic. Last months emergency use authorization of two vaccines offers real hope in this regard. But, availability of vaccines is not the same thing as actual uptake.
Trump Administration officials had previously predicted there would be 20 million first dose vaccinations by the end of December, but as of January 2nd, only about 4.2 million people have had their first dose, according to a CDC tracker.
At an average of 225,000 administered doses per day, the U.S. daily new infection total often exceeds the daily rate of first dose vaccinations.
It is encouraging that the pace of first dose vaccinations has picked up in recent days. Nonetheless, at the current daily level of uptake its going to take years to vaccinate the American people.
Is this a supply problem? A demand issue, such as vaccine hesitancy? Or both?
Clearly, there have been supply problems. Ten days ago, General Gustave Perna of Operation Warp Speed, said he took sole responsibility for confusion regarding allotment of the Pfizer/BioNTech Covid-19 vaccine to states, shortly following its emergency use authorization by the Food and Drug Administration. More than a dozen governors complained that they had received far fewer doses than originally promised.
Evidently, there are glaring demand issues as well. For instance, 60% of people working in nursing homes in Ohio are electing not to be vaccinated. This begs the question why taking a vaccine is elective for those working in nursing homes. Given that for many decades schools primary, high school, and college - require proof of multiple vaccinations prior to enrollment, as do many employers in the private and public sectors, its puzzling that nursing homes wouldnt require that caregivers be vaccinated for Covid-19.
But, ultimately resolving supply and demand issues related to a public good like the Covid-19 vaccine requires adequate planning and logistics.
The Trump Administration purposely did not establish a national plan for the distribution and administration of vaccines. On December 29th, President Trump tweeted: It is up to the States to distribute the vaccines once brought to the designated areas by the Federal Government.
The logistics of the rollout have therefore largely been left up to states to navigate. But most states lack the capacity to properly administer the rollout. Moreover, hospitals and pharmacies are scrambling, trying to figure out where to set up vaccination sites. And, long-term care facilities are sorting out who can administer vaccinations, to whom, and where.
For quite some time, state and local public health officials have warned that they would need more than $8 billion in additional funding to create the infrastructure required to administer vaccines. Instead, the Trump Administration provided states with a paltry $340 million in funding to prepare for vaccinations. This implies that on average states have received less than $7 million each for vaccine readiness.
As Professor Jha, Dean of Brown Universitys School of Public Health, lamented the worst part is no real planning on what happens when vaccines arrive in states. No plan, just hope that states will figure this out.
Perhaps this reflects a larger problem in the U.S. in which medical advances, such as the Covid-19 vaccines, capture an inordinate amount of attention from the media, the public, and politicians. But, ensuring breakthroughs are given to patients in a timely, efficient manner is equally important. Yet, this requires a universally well-functioning system to deliver care, which the U.S. doesnt have. The federal government invests billions of dollars in the development of breakthroughs enterprise, but much less in the delivery side. The saying all breakthrough and no follow-through may be a slight exaggeration, but it gets the point across that there is insufficient investment in the follow-through part.
Many leaders have chimed in on the need for more federal involvement in follow-through, as certain issues like the Covid-19 pandemic are uniquely federal because of their interstate and international scope. Senator Romney (R Utah) bemoaned the fact that comprehensive inoculation plans have not been developed at the federal level and sent to the states as models. He considers this as incomprehensible as it is inexcusable.
Sooner rather than later the nation is going to have to vaccinate people at a rate thats much faster than the current pace of infections. President-elect Biden is pushing for 100 million vaccinations in his first 100 days, which he said would require a pace five to six times as fast as is currently the case.
Perhaps the Biden Administration can learn from Israels warp speed inoculation of its population.* Israels daily vaccination rate of nearly 2% of the population is astonishing. Israel has already vaccinated 12% of the population, including 42% of people over the age of 60. By comparison, it was pointed that Israel, with roughly the same population as New York City, has at least 10 times as many people.
While vaccinating round the clock, the Israeli government is simultaneously carrying out an extensive public education campaign against anti-vax dis- and misinformation.
As a relatively small nation with a national health insurance and patient registration system Israel has a distinct comparative advantage. Nevertheless, there are other small countries with similar health insurance and patient registration systems which are not (yet) doing nearly as well.
Several European countries, for example, havent even begun to vaccinate, including the Netherlands. It appears, however that government officials there as well as other European nations want to first ensure that theyve got an executable plan in place for comprehensive, mass vaccinations of priority groups to take place safely in, among other sites, long-term care facilities, hospitals, clinics, arenas, convention centers, school gyms, and libraries.
Covid-19 vaccines are public goods. As such, their appropriate distribution isnt governed by free market principles. Ideally, inoculation programs are informed by a system carefully planned by federal and state authorities for distributing vaccines as effectively and equitably as possible. A lesson to be drawn from the bumpy rollout is that prior to vaccine emergency use authorization there ought to have been a comprehensive distribution plan that included continuous federal assistance to help states establish and maintain a robust vaccination infrastructure.
The COVID-19 vaccines have been touted as the beginning of the end of the deadliest pandemic in recent U.S. history. But many residents are still wondering: Are the vaccines that were developed in record time safe?
In December, the U.S. Food and Drug Administration approved emergency use of COVID-19 vaccines made by Moderna and Pfizer-BioNTech. Unlike many other vaccines that use a killed or weakened virus, these new COVID-19 vaccines harness a groundbreaking technology called synthetic messenger RNA mRNA for short that directs cells to produce proteins that trigger the immune system to create antibodies. Those antibodies fight the real virus if a person becomes infected.
We interviewed Dr. Ruth Berggren, an infectious disease specialist at UT Health San Antonio, to learn more about the vaccines safety. She served on a UT Health working group that examined the safety of the Pfizer vaccine and considered how it should be distributed among front-line health care workers.
She also received the vaccine herself in December and has since been feeling just fine.
This interview has been edited for length and clarity.
Lets start by talking about what we know about the safety of the Moderna and Pfizer vaccines for the general population.
Anything we know is clearly limited to the sizes and the distributions of the study populations for the Pfizer and Moderna vaccine trials. With any drug and with any vaccine, there are always post-marketing findings. When you expand from populations of 30,000 to 40,000 people to 30 million to 40 million, youre going to expect that youre going to find some things that you hadnt found previously. That having been said, the safety concerns have been pretty minor.
What safety concerns have come up so far?
The biggest is the possibility of having a severe allergic reaction to one of the vaccine components and a severe allergic reaction we call anaphylaxis. Thats the allergic reaction where your throat closes up, and because of swelling back in your throat area, you cant breathe. Because the vaccine is being given in a closely-monitored medical setting, we treat people who are showing even a glimmer of an anaphylactic reaction with appropriate treatments that can include antihistamines, steroids and then even epinephrine if theres a real danger of the throat closing off.
Thats the big concern. What are people being allergic to thats causing this? The ingredients of the vaccine are publicly available in multiple places including FDA and CDC documents. Probably the most important ingredient is polyethylene glycol or PEG, which is not a weird or new compound. Polyethylene glycol is what is in the prep that people take when theyre going to go for a colonoscopy, that liquid stuff that you drink. Its been used chemically to modify drugs that we give people, such as interferon. So this is not a new thing. There are decades and decades of safety information about it, but like everything else, some people could become allergic, just like some people can become allergic to a bee sting.
Can you talk about the safety of these vaccines for people who are immunocompromised, such as people who have lupus or Type 1 diabetes?
I want to make it clear this vaccine is not harmful for people whose immune system is weakened for one reason or another. The issue is that people who are immunocompromised need to know that their response to the vaccine may not even come close to being as protective as it is for other people. If my immune system is weak and I get vaccinated, Ill probably mount some immune response, but I might not mount enough of one to fully protect me from getting infected or to fully protect me from severe disease.
We have that note of caution, and people get asked prior to being vaccinated, Are you pregnant? Are you immunocompromised?, so that they can be informed of what this vaccine could or could not do for them.
Its important for the public to know that in the Pfizer vaccine trial, people with well-controlled HIV, as well as people with controlled Hepatitis B and Hepatitis C, were included. And there was no problem in people with well-controlled HIV.
Does that also apply to folks with other chronic conditions, such as high blood pressure or diabetes?
Right. In fact, people who have diabetes or hypertension should be prioritized to get the vaccine. Why? Because people with diabetes and hypertension are the ones that are getting severely ill with COVID-19 and more likely to die. So those are the very people that we would put ahead of others to get vaccinated so we can make sure that theyre protected.
Can you talk about what we know about the safety of these vaccines for people who are pregnant or breastfeeding?
The Society for Maternal-Fetal Medicine got up front with a statement recommending that pregnant women who are at risk for getting COVID-19 should not be prevented from getting the vaccine and that they should be allowed to make the decision in conjunction with their doctor. There is no evidence that the vaccine harms the fetus, but we also dont have any large-scale evidence of intentionally giving this vaccine to pregnant women to watch what happens.
It needs to be an individualized decision. If a pregnant mom is on the front lines of health care lets say she is intubating patients who have SARS-CoV-2 infection that is a high-risk situation. If you add on that that pregnant woman may have gestational diabetes or hypertension some of the risk factors for a bad COVID-19 disease outcome it would be a bad thing to prevent such a woman from getting vaccinated. She should be allowed to have access to it.
It was reported that some women got pregnant over the course of the Pfizer vaccine trial. Can you talk about what we learned through that?
There were around 23 pregnancies that happened in spite of the fact that enrollees were instructed to take precautions to not get pregnant during the Pfizer vaccine trial. In a sense, if you want to take the silver lining or a glass-half-full attitude towards this issue, at least we know that there doesnt seem to have been a problem with fertility, which has been an issue thats been raised really by the internet not by scientists. But clearly if women unintentionally got pregnant while theyre on the Pfizer vaccine study, that would argue against there being any impact on fertility.
Moreover, there have been no adverse outcomes reported so far as the Pfizer vaccine continues to be studied. So we have an extremely limited number of pregnant women who have been vaccinated, and this is why theres not a full blown guidance for them to get it. Its simply that we lack data. However, people need to know we dont have negative data.
Can you address some of those myths youve seen circulating on the internet?
The first is that this vaccine is going to mess with my DNA and its going to change my genetic structure for the rest of my life. Heres what you need to understand about the biology of the mRNA vaccine: The mRNA is an encoded message that gets slipped into an envelope, which is made out of lipid or fatty substance. That fatty lipid envelope permits the vaccine to get onto a cell, merge with the cell membrane, and then the mRNA gets delivered into the inside of the cell in a place called the cytoplasm, if you remember from your high school biology.
Now the cytoplasm isnt just an open swimming pool. The cytoplasm is highly compartmentalized, and theres a great big separation between the cytoplasm and the nucleus. The nucleus of the cell is a highly protected area, which contains our DNA. Thats where our genetic code is, OK? The mRNA does not go into the nucleus.
What the mRNA message does, it stays in the cytoplasm and it gets directed towards the ribosomes, which are the places where proteins are made. I like to use the analogy of a 3D printer: The mRNAs has a message for your 3D printer your ribosome for what kind of protein the ribosome should make. That protein thats being encoded is the spike protein from the coronavirus.
What other concerns have you heard from people that youd like to address?
People were questioning whether there was a possibility that the spike protein could cause women to miscarry because of what they call homology (similarity in structure) between the spike protein and Syncytin-1, which is a protein that is involved in the development of the placenta.
A patient sent me a message through my chat saying, Were reading this, and could you tell us if this is a problem? Ive already told you why people shouldnt be concerned about it because people actually got pregnant while getting the coronavirus vaccine protocol from Pfizer.
Theres no reason to think that because little pieces of one protein resemble little pieces of another protein that the antibodies generated on the first protein are going to be specific to the second protein. Heres an analogy: It would be like saying, youre looking at two different types of shelter, and one is a log cabin in the wilderness and one is the White House. Lets say that you had had a smart weapon that was being targeted to destroy the log cabin or destroy the White House. What people need to know is that our immune system is super smart and its not so random that it would just start destroying anything that had the same function. Its going to be very specifically targeted to the exact size and shape of the danger signal.
marina.riker@express-news.net
The county says once it starts taking appointments, itll give vaccines out at the Solomon Calhoun Center from 9 a.m. to 4 p.m. First doses will be given out Mondays, Wednesdays and Fridays, and second doses will eventually be given on Tuesdays, Thursdays and Saturdays.
