It’s a time to celebrate: the end of the Covid-19 pandemic may be within sight.
Vaccines are on their way to thousands of locations in the United States. In California, 327,00 doses of the Pfizer vaccine were received in mid-December (when this article was written). Of those, 3,000 were bound for Monterey County. 627,000 doses of the Moderna vaccine, the second one cleared for emergency use, are also on their way to the state, and allocations of this vaccine will be distributed to Monterey County. Officials said they hope to provide 2.6 million doses to California residents before the end of the year. Since each of the currently available vaccines requires two doses, more will be needed to cover all 2.4 million health care workers in the state.
What Vaccines Have Been Approved by the Food and Drug Administration?
As of this writing, two vaccines have been cleared for emergency use by the FDA, the Pfizer and the Moderna vaccines. The Pfizer vaccine has a 95 percent efficacy rate, the Moderna vaccine has a 94.1 efficacy rate, and the latter has shown an all-important additional ability to prevent serious disease, which could reduce hospitalizations. Several other vaccines are in clinical testing. It should be remembered that all but one of the vaccines in Phase 3 testing, the last phase before they can be released to the public, require two-stage dosing separated by three weeks in order to be maximally effective. It is not uncommon for vaccines where full immunity is expected only after the second dose. This means that between doses, masking, social distancing, and avoiding crowds are still required to ensure that the virus is not transmitted, and will still be required until herd immunity (see section below) is achieved.
Of the two vaccines now available for distribution, the Pfizer vaccine requires extremely low temperatures for safe shipping and storage. The County Health Department and the major hospitals and laboratories in Monterey County have all been provided freezers that can maintain the appropriate temperature. The Moderna vaccine does not require low-temperature refrigeration which makes it especially valuable for rural areas, community health centers, and doctors’ offices that do not have the special freezers required.
The duration of immunity is not yet known. Rigorous investigation and follow up will be required to answer this question after a sufficient number of vaccinations has been performed.
How Do The New Vaccines Work?
In only the last few years, a major breakthrough in vaccine development has been achieved that has made the rapid development of the Covid-19 vaccine possible. The polio vaccine, for example, took twenty-three years to develop, during which time parents were constantly threatened by the prospect of their children contracting this paralyzing disease. The vaccine, like many today, worked by introducing dead or weakened viruses to teach the immune system to recognize and wipe out the viral passenger. The new technology, called “mRNA”, for messenger RNA, works via a totally different route. Rather than a tiny bit of actual virus being introduced into the body to teach the immune system to recognize and wipe out the viral passenger, both the Pfizer and the Moderna vaccines deliver a strip of non-viral genetic material to a person’s cells. Once inside the cells, the messenger RNA builds replicas of the spike protein that studs the outside of the coronavirus. The immune system learns to recognize and block the spike. When the individual encounters the virus, the body releases cells, called T cells, which eliminate the infected cells. Then antibodies block the virus from infecting healthy cells.
What are the Side Effects?
As with most vaccines, side effects can be expected, such as soreness at the injection site and flu-like symptoms–muscle aches, fatigue–that last for a day or two. A very small number of people have strong allergic reactions to almost any vaccine, and they need to alert their medical professionals in advance about these reactions so they can be under close observation following vaccine delivery. However, in the opinion of public health experts, even in this small population, the risk-benefit ratio is favorable. Allergic reactions can be treated, and Covid-19 remains a far more dangerous predator.
Who Will Receive the Vaccines First?
The first recipients will be frontline healthcare workers who care for Covid-19 patients in ICUs or hospital Covid units, and those who come in close contact with Covid patients, such as hospital housekeepers. They will be followed by healthcare personnel and residents of long-term care facilities. They will likely be followed by people over the age of 65 and those with underlying conditions that compromise their immune systems. This priority list will be established by the CDC and the California Department of Public Health. At this time vaccinations are not to be provided to children below the age of 16. The first clinical studies in adolescents are just getting underway.
Multiple sources of information are being established for residents to keep up to date on who is being vaccinated at any particular time: Monterey County’s Health Department website offers a page on the vaccine, local hospitals also have web-based information, and the CDC makes recommendations based on input from its Advisory Committee on Immunization Practices on their web page (see Resources sidebar).
What are the Major Hurdles to Widespread Vaccination?
Although the percentage of people who have told interviewers that they will agree to be vaccinated has recently risen considerably, there are still obstacles. African-Americans and Latinos, for example, have long been particularly suspicious of vaccinations. However, in the Moderna testing, it is worth noting that a fifth of the participants were Hispanic and 10 percent were African-American, two groups that have been especially hard hit by the virus. The government recognizes that special messaging is necessary to persuade them that the vaccine is both safe and effective for them. Vaccines have long been regarded as essential tools in crushing infectious diseases such as measles, polio, diphtheria, smallpox, and other highly contagious diseases. People who are against vaccinations of any sort are difficult to persuade but, like everyone else, are subject to contracting this deadly virus.
The goal of widespread vaccination is what is known as “herd immunity.” This occurs when at least 70 percent of the population is vaccinated and thus becomes immune to a disease, making the spread of the virus from person-to-person unlikely. In that way, the entire community becomes protected, not just those who are immune. Anthony Fauci, our leading virologist, predicts that herd immunity could occur by mid 2021 if people receive Covid-19 vaccines in large numbers.
How Much Will the Vaccine Cost?
Cost will not be an obstacle to getting vaccinated against Covid-19. Doses have been purchased with U.S. taxpayer dollars, although some vaccination providers may be able to charge small administrative fees. The providers can get this fee reimbursed by public or private insurance, or for uninsured patients, by the Health Resources and Service Administration’s Provider Relief Fund.
In Summary
• Two vaccines are now cleared for emergency use by the FDA and are available first to frontline healthcare workers and those who come in close contact with Covid-19 patients. The next likely recipients will be residents and staff of nursing care facilities, assisted living facilities, and similar settings.
• Both vaccines have been thoroughly vetted for safety and efficacy by the U.S. Food and Drug Administration (FDA)
• California is receiving allocations of dosages of these vaccines; Monterey County is receiving its own allocations according to a schedule established by the state.
• Neither vaccine is approved for children under the age of 16, but both companies are running trials on children as young as 12, and have plans to start studying even younger children.
Susan Meister is a journalist, columnist, and community activist living in Pebble Beach. Susan’s writing was recognized with the 2020 Bronze Award for service writing from the Parenting Media Association.
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