COVID-19 Vaccines Q&A
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Get answers, be informed: COVID-19 Vaccine information session
DRNC was fortunate to have family physician and DRNC board member Dr. Crystal Bowe, and infectious disease specialist Dr. Cameron Wolfe of Duke University join us on March 3rd to answer community questions in this engaging discussion about COVID-19 vaccines.
In this recorded webinar, you will learn about:
- Access to vaccination for people with disabilities
- Vaccine hesitancy, with particular focus on historically marginalized communities
- Vaccine safety
About the Panelists
Crystal Bowe, MD, MPH, FAAFP, is a family physician currently practicing in Gastonia. Dr. Bowe attended North Carolina A&T University for her undergraduate studies, University of North Carolina – Greensboro for graduate studies, and East Carolina University for medical school and residency. Her patient population is diverse, and includes a large Spanish-speaking population, children and adults with developmental disabilities, as well as patients from a variety of cultural and socio-economic backgrounds. Dr. Bowe’s interest in disability rights stems from her experiences caring for her aunt and uncle, who both have intellectual and developmental disabilities, and her participation in a program aimed at teaching family medicine residents how to better serve adults with developmental disabilities. She is a strong advocate for her patients and works to help them achieve the goal of full inclusion and independence in life. We are very fortunate to have Dr. Bowe as the vice-chairperson of DRNC’s board of directors.
Cameron Wolfe, MBBS, is an Associate Professor of Medicine in the Division of Infectious Disease at Duke University, specializing in Transplant Infectious Diseases and emerging biothreats, including COVID-19. Dr. Wolfe also serves as medical director for Duke’s Emerging Pathogens Unit, which focuses on clinical management of threats such as Ebola, pandemic influenza, and more recently COVID-19. In this role, he led Duke’s efforts to participate in multiple NIH research efforts and led the University campus efforts to mitigate the COVID pandemic. His research interests are in the management of viral infections, especially respiratory viruses, in the immunocompromised, and control of HIV and hepatitis C during organ transplant. Dr. Wolfe received his MBBS from the University of Melbourne, Australia, and was previously a Fellow in Infectious Diseases, at Duke University. He lectures at the University of North Carolina, School of Public Health, as well as the Duke University Medical School.
During this Q&A, we were not able to get to all the submitted questions, but Dr. Wolfe and Dr. Bowe generously sent us written responses to all of the remaining questions. Here are those questions, and their responses.
Questions about vaccine safety and efficacy
Question: Are there findings related to efficacy and safety for disabled and immunocompromised individuals, for example people with lupus? People with neurological problems? People with kidney disease (my daughter has only one functioning kidney and it is weak)? People with Down Syndrome? People who take Trileptal/Keppra for seizure control? People with special needs who take a lot of behavior medications?
Dr. Bowe: So, individuals with medical issues have increased risk of complications from COVID, so avoiding the virus with the vaccine is generally recommended. However, always check with your doctor first!
Question: Did people with disabilities participate in the clinical trials?
Dr. Bowe: We don’t have any data to prove this is the case that I know of.
Question: Will there be an alternative method of administering the vaccine, such as an oral vaccine? My daughter will not take injections.
Dr. Wolfe: Unfortunately not in the short term. These are all going to be injections. I’m not aware of any imminent prospect of oral vaccines unfortunately.
Question: How do the different types of vaccines [mRNA (Pfizer, Moderna) vs adenovirus viral vector (J&J)] affect immunocompromised people?
Dr. Wolfe: We don’t believe there’s going to be a difference. Because the studies were so different in the way they were set up, it’s too early to compare. The National Cancer Network, and the American Society of Transplantation have both recommended them equally at this point, while we continue to gather data on the longevity of protection.
Question: Should we be concerned about new variants of the virus when it comes to vaccine efficacy?
Dr. Wolfe: Yes, in the long run. But at the moment, none of the variants commonly found in the USA have less vaccine protection. The quicker we get people vaccinated, the less the risk. And the vaccine companies are already working on looking at potential future tinkering of doses, so I wouldn’t be afraid of this.
Question: Are there any impacts to fertility with the vaccines?
Dr. Bowe: There is the myth, but there is no data that the vaccine causes infertility. In fact, women have gotten pregnant after the vaccine.
Dr. Wolfe: There was an unfortunate email circulated from a long-since previous employee of Pfizer to suggest there was a link with fertility. It was just scientifically wrong, and therefore absolutely no data to support fertility issues; it just doesn’t biologically make sense given the way they work. This was a sadly perpetuated myth that just needs to be put to rest.
Questions regarding precautions following vaccination
Question: When someone is vaccinated, do they still need to wear masks and take other precautions? Why is that?
Dr. Bowe: They have to continue wearing masks because there is still a 5 percent chance they could catch the virus and thus spread it (Pfizer and Moderna have 95% efficacy).
Question: Can you transmit the virus after you have been vaccinated? Thinking of people with medically fragile children.
Dr. Wolfe: It’s much less likely. Certainly for the first 10 days after the first dose, we don’t expect you to be protected, so we have to be careful there. But after that the risk progressively falls.
Question: How long after getting the vaccine are you safe to be around others who have also had the vaccine?
Dr. Wolfe: CDC now says indoors we can feel safer around asymptomatic people who are also vaccinated. Remember that’s 2 weeks AFTER the second dose of Pfizer/Moderna, or 2+ weeks after the J&J vaccine.
Question: Once all members of a group, family, community have received their 2nd vaccination and waited the allotted time, is it safe to be unmasked and not distanced with those members whether they live together or are just visiting?
Dr. Wolfe: Yes, provided they’ve had enough time between the dose and their immune system to improve.
Questions regarding vaccine prioritization and logistics
Question: At what age can a person get vaccinated right now in NC? Does it make a difference if a child has asthma or another high-risk medical condition?
Dr. Wolfe: 16 and above. There are research trials collecting data in an ongoing fashion from 12-15 years of age. There’s about to be a trial from 5-11. But at this stage we cannot vaccinate individuals under 16.
Question: What should I do if I need assistance getting to a vaccination site?
Dr. Bowe: Please let your primary care provider and the vaccine administrator know! Now that the Johnson and Johnson vaccine is out, it is easier for vaccines to be brought to people, and there are other services that can help get folks to the vaccination sites.
Question: Is it possible to receive the vaccine at home?
Dr. Bowe: Possibly, with the J&J vaccine (some counties are doing it). You will need to ask your county health department to find out if it is possible in your area at this time.
Question: How long are you protected with the vaccine?
Dr. Wolfe: We don’t know yet. We have to continue to follow patients who were in the original trials and see how long their protection lasts. This is the one piece we just haven’t had enough time to figure out yet.
Question: The numbers of Black people who have taken the vaccine is very low compared to the number of white people who have taken the vaccine. Has anyone considered setting up hubs in communities that are economically disadvantaged to increase education and access for this population?
Dr. Bowe: Yes, and in fact this is being done in some counties in North Carolina, and educational events are also being continuously executed across the state.