MEAGHAN CARABELLO 2020-12-31 22:23:48
A Conversation with infectious diseases expert Dr. Amy Duckro As Coloradans prepare to receive a COVID-19 vaccine, they may be asking various questions related to the vaccines, their distribution, effectiveness and associated risks. We connected with Kaiser Permanente infectious diseases expert Dr. Amy Duckro to discuss the common questions being asked by the public and the company’s plan to protect its members and the community. WHAT KINDS OF CONCERNS ARE YOU HEARING FROM PATIENTS ABOUT RECEIVING THE VACCINE? This vaccine is new to us, and naturally there are a lot of questions about it. The backdrop here are the pockets of skepticism about the safety and efficacy of vaccines in general. As an infectious diseases expert, I frequently hear patients’ concerns about vaccines; it’s always important to understand more about their reservations. Here are some common questions that we are hearing about the COVID-19 vaccines: How could the COVID-19 vaccines be developed so quickly? Are they safe? Recognizing the urgent need for safe and effective vaccines during the COVID-19 pandemic, the FDA is using its various authorities and expertise to speed the development and availability of vaccines that have met the agency’s standards for quality, safety and effectiveness. In this case, the scientific community built on the foundation of previous vaccine research and expanded on it to include new methods of developing vaccines. In addition, due to the pandemic’s high infection rates, the pace of clinical trials—usually the longest part of the process—were accelerated. Also, the federal government invested significantly in the necessary manufacturing capacity to support companies as they aggressively pursue rapid development and distribution of eventual vaccines. Why are they approving a vaccine that is still in clinical trials? Phase 3 is the final phase of a clinical trial before safety and effectiveness data is provided to the Food and Drug Administration (FDA) for review and approval. The vaccines currently available were granted Emergency Use Authorization (EUA) by the FDA following a review of phase 3 data. An EUA is not an FDA approval, but it does facilitate the availability and use of countermeasures needed during public-health emergencies. Does the vaccine use a live or a dead virus? None of the COVID-19 vaccines currently in development in the United States use the live virus that causes COVID-19. It is not possible to get COVID-19 from the vaccine, and the vaccine does not interfere with the interpretation of COVID-19 test results. Can I stop wearing a mask if I get a vaccine? No. While experts learn more about the protection that COVID-19 vaccines provide under real-life conditions, it will be important for everyone to continue using all the tools available to control the spread of this virus, like covering your mouth and nose with a mask, washing hands often, staying at least 6 feet away from others and avoiding gatherings. People who are vaccinated may still be able to carry and transmit the virus to those who are not immunized. It will take a while for us to be able to vaccinate enough people to generate ‘herd immunity’, a point at which we may be able to return to a pre-COVID lifestyle. Reaching this point will only be possible if enough members of our communities opt in to be vaccinated. In addition to what we’ll learn about the effectiveness of the vaccine and the durability of immunity that follows, other factors, including how many people get vaccinated and how the virus is spreading in communities, will affect when recommendations can be changed about the wearing of masks and other preventive measures. For now, we have to stay the course. Will the vaccine require more than one injection? All but one of the COVID-19 vaccines currently in Phase 3 clinical trials require two-shots. The same vaccine brand must be used for both shots; they are not interchangeable. The shots are given several weeks apart. Are the vaccines by different manufacturers/brands interchangeable? No. Vaccines studied by each of the manufacturers have varying two shot schedules, and the vaccines cannot be switched. It is important to make sure that patients are given the same shots from the same manufacturer. Who will be eligible to receive the vaccine? The intent is ultimately to allow for everyone to receive a COVID-19 vaccine. However, everyone can’t be vaccinated at once. The federal government will oversee COVID-19 vaccine distribution in the U.S. and has issued guidelines for prioritizing those populations that should receive the vaccine first. Each state will receive a proportion of the available vaccine consistent with their population. Federal health officials have indicated that health-care workers will be among those prioritized, along with people most vulnerable to severe illness from the virus, such as those living in skilled nursing facilities. State health officials have the final authority to make decisions regarding the prioritization of populations within their state. How long will immunity from the vaccine last? Will it be longer than the natural immunity that comes from contracting COVID-19? The level of protection someone gains from having an infection (called natural immunity) varies. Since this virus is new, we don’t know how long natural immunity will last, but this is being studied. People who have had a COVID-19 infection may be vaccinated at any time following their recovery. Since it is expected that most people have some degree of immunity for the three months after an infection, the CDC suggests that people can choose to wait for this time period after infection to be vaccinated. Regarding vaccination, experts won’t know how long immunity lasts until there is more experience with the vaccines. There are currently no recommendations to adjust quarantine recommendations after an exposure, even following vaccination. As with wearing masks and distancing, this guidance reinforces the point that vaccines are one important aspect to controlling this pandemic. Will Kaiser Permanente be administering the vaccine to nonmembers? Yes. Kaiser Permanente is pleased to collaborate with state health officials in making the vaccine available to anyone who meets the criteria for each phase of prioritization in the vaccine distribution process. So, non-members will be able to receive a vaccine from Kaiser Permanente if they are eligible by the state health department guidelines. Will there be a cost to receive the vaccine? No. Kaiser Permanente will not charge for vaccination to protect against COVID-19. This is consistent with federal rules stating that vaccine doses purchased with U.S. taxpayer dollars are required to be given at no cost. HOW WILL KAISER PERMANENTE SUPPORT COLORADANS IN GETTING VACCINATED? After living with the COVID-19 pandemic for 10 very difficult months, we’re encouraged by the arrival of vaccines that can serve as vital tools for controlling and eventually ending this public health crisis that has caused so much loss, pain and disruption around the world. Now that the Pfizer/BioNTech and Moderna vaccines have been granted Emergency Use Authorization status by the FDA, health-care providers have started vaccinating Coloradans according to the tiered plan set forth by state health officials. Kaiser Permanente is an approved vaccine provider in Colorado, which means our medical offices are designated vaccine administration sites. We are offering vaccines at select Kaiser Permanente medical offices across the Front Range. We received the Moderna COVID-19 vaccine in mid-December and are pleased to be well underway in vaccinating patient-facing healthcare workers following state guidelines. We are maximizing use of the capabilities of our electronic medical record and informing our members as we proceed through the vaccination tiers. Persons who are not insured with Kaiser Permanente and fall into the current vaccination tier are welcome to be vaccinated with us, as well, and may call us for review and scheduling. Kaiser Permanente has always focused on supporting the health of our communities. This nation-wide effort falls right in line with our skills and expertise. We have more than 600,000 members in Colorado— their health and well-being as well as the health of our communities is our priority. We excel in preventive care. Kaiser Permanente has decades of experience promoting health through vaccination and delivering vaccinations safely and efficiently. The COVID-19 vaccine initiative is a massive undertaking across the nation. We are honored to partner with our public-health colleagues in this endeavor. Kaiser Permanente will continue to educate our members, workforce, customers and communities about the safety, effectiveness and importance of the COVID-19 vaccine and to share information about how a vaccine— coupled with continued public-health measures like the wearing of masks, physical distancing, and frequent hand washing—can help control and ultimately conclude the COVID-19 pandemic. WHAT WOULD YOU SAY TO SOMEONE WHO IS WARY ABOUT RECEIVING THE VACCINATION? I would try first to better understand why they are reluctant. Sometimes hesitation can be overcome by clearing up common misconceptions. And I share with my patients my confidence in the vaccinedevelopment process and my own willingness and interest in getting myself and my children vaccinated. In medicine, risks and benefits must always be considered. The same holds for vaccines. Like most recommended vaccines, the ones for COVID-19 can produce side effects. Some people who participated in clinical trials studying these vaccines reported fevers, headaches, fatigue, muscle aches and soreness around injection sites. These minor symptoms are a sign that the body is responding to the vaccine as expected and building immunity and, in most cases, are mild and fully resolved within two days. The safety and efficacy data has not been carefully reviewed for the approved vaccines by the FDA, the CDC’s Advisory Committee on Immunization Practices, independent medical societies and our national team at Kaiser Permanente, and the same process of review and approval will follow for each subsequently available vaccine. Our infectious diseases physicians, including myself, have been tracking the available evidence for the COVID-19 vaccines in development. The scientific community across the nation has clearly expressed a commitment to assuring that any vaccine released will meet safety and efficacy standards supporting their use. After nearly a year of experiencing the profound and detrimental impacts of COVID-19 in our communities and businesses, the availability of safe and highly effective COVID-19 vaccines offers the opportunity for us to protect ourselves and our loved ones from a serious infection and keep our communities thriving. We encourage everyone to do their part to stop the COVID-19 pandemic. Stay safe, Colorado!
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