COVID-19 Vaccine Update

Experts Weigh In With Reassuring Outlook

The COVID-19 vaccine rollout is in full swing around the country but many questions remain. We reveal the latest answers (as of February 2021) from nationally recognized vaccine experts Dr. Paul Sax, Professor of Medicine, Harvard Medical School and Clinical Director of Infectious Disease, Brigham and Women’s Hospital; and Michael Kinch, PhD, Director of Washington University’s Center for Drug Discovery.

How will the new variants impact the effectiveness of the vaccines?

Sax: Data is emerging daily. The UK variant has a higher level of contagiousness but is mediated just as well with the vaccine; other variants’ stories are still unfolding. Vaccine manufacturers are retooling the antigens to make them effective against a broader group of viruses. Boosters may be provided in the future.

Kinch: The variants show us that the coronavirus is very efficient at mutation, and we’ll likely need to adapt our vaccines every two to five years to provide the right protection.

Is it safe to get vaccinated at large outdoor stadiums?

Sax: Yes, absolutely. People are not being crowded into poorly ventilated indoor spaces at these events.

Which vaccine is best?

Sax: The one that’s offered to you! Don’t wait for a specific vaccine because in the interim, you’re at higher risk for getting a more severe case of COVID-19. Pfizer and Moderna, both mRNA vaccines, are 95% effective after two doses. The J&J vaccine works differently, using a virus that doesn’t reproduce in humans and stimulating an immune response after just one dose. While J&J’s 70-80% rate may not be as high as the others, it’s very effective in preventing severe disease, so you can feel confident about getting it. We are also likely to have a fourth vaccine, Novavax, available soon.

Kinch: We may not have a definitive answer to this question until later this year. But these are incredible vaccine breakthroughs, with exceptionally high rates of effectiveness.

Is delaying the second dose problematic?

Sax: Getting it too early is actually more concerning. The first dose primes the immune system and the second dose gives it a huge boost. Waiting six weeks won’t matter.

Are side effects worse after the second dose?

Sax: Yes, there are more side effects reported but this indicates your body is responding to the vaccine. I experienced headache, fatigue and trouble concentrating immediately afterwards, and then felt totally fine the next day. That’s a trade-off I’d take anytime versus the potentially life-threatening consequences of COVID-19.

What if I don’t experience side effects?

Sax: No need for concern, as the vaccines were shown to be highly effective in trials with thousands of people, including a significant number over age 55. However, older, frailer people weren’t tested, and it’s possible they may not respond as well to the vaccine.

Can I take pain relievers before or after getting the vaccine?

Sax: Don’t take any beforehand as it can blunt the immune response; afterwards, it’s fine.

What is still unknown about COVID-19 and vaccines?

Sax: We don’t know the risk of immunized people transmitting COVID-19, but we’re seeing promising evidence from Israel that vaccinated individuals carry lower amounts of virus. This will significantly reduce but not completely eliminate transmission. Also unknown is whether natural or vaccine-induced immunity is better.

Kinch: The long-term durability of the vaccine’s immune protection isn’t known, but we’ll discover that over time. Preliminary data seems to indicate that recovery from minor cases of coronavirus provides three to nine months of protection.

Is it important to vaccinate younger people?

Sax: Elementary age kids only get mildly sick from COVID-19 and they’re not very contagious, but teenagers are at higher risk for severe disease and are more contagious. The most important group to vaccinate is people in their 20s, who’ve been primary spreaders of the virus.

Should immunosuppressed patients get the vaccine?

Kinch: Yes, and in fact, patients with autoimmune conditions will be prioritized as a higher-risk group. One of the most promising and least discussed aspects of the Moderna and Pfizer trials is that while many patients became infected with the virus, not one was hospitalized, needed intubation or died. This is particularly significant for immunosuppressed patients, because if infection can’t be prevented altogether, the vaccine will lessen disease severity and result in much better outcomes.

Should pregnant women get the vaccine?

Sax: Pregnancy is a severe risk factor for COVID. While theoretically the vaccine is safe, we don’t have all the data yet. I’d recommend it, but also understand if a woman chooses to wait.

What needs to happen to resume normal life?

Sax: We have to be laser focused on mobilizing vaccinations nationally and not expect the states to just figure it out. I feel optimistic that enough vaccine will be available by summer, possibly even by late spring, for everyone to be immunized.

(sidebar)After vaccination, is it safe* to…

  • Visit family and friends? Wearing masks and social distancing is still necessary in large, public settings, but we can relax a bit in small group settings. Although the risk of interacting without masks is not zero, it is low, so go ahead and hug your grandchildren! And if you’re dining indoors with family, simply open the windows for good ventilation.
  • Exercise? Yes, and no need to wear a mask if outdoors and you’re a decent distance away from people. At indoor gyms, wear a mask, keep your distance and avoid areas that are not well-ventilated.
  • Eat at restaurants? Yes, if outdoors; no if indoors.
  • Travel by air? Yes, with precautions. Surprisingly few transmission events haveoccurred aboard planes; however, the boarding process and airport experience are not well controlled, so stay masked and distanced.

Additional post-vaccination guidelines are available from the CDC.*Dr. Paul Sax, Guest Speaker, Lown Cardiology Group Health & Wellness Webinar (2.16.2021)

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