Hot Topic #38 | Vaccine FAQ 2.0

||| FROM BRENDAN COWAN, for DEPARTMENT OF EMERGENCY MANAGEMENT |||

This information expands and updates the initial vaccine FAQ from November 19, 2020. Understandably, there are a host of community discussions, concerns, and expectations about the vaccine. Before digging in, here are some general qualifiers:

• Patience and flexibility are required. As with all things COVID, the details, timing, and understanding of everything about the COVID vaccine effort are still coming into focus. The picture will shift from week to week, if not day to day. Many details are only estimates at this time.
• No single organization is responsible for the vaccine effort. It will take a well-coordinated effort between pharmaceutical companies, healthcare providers and pharmacies, delivery services, all levels of government, response agencies, and a range of non-profit community organizations. There will be bumps in the road – this is a complex effort.
• Due to the incredible amount of attention being placed on the vaccine effort, there will be a wealth of complicated and sometimes conflicting information to sort through. This may be in the news, on social media, from medical or public health authorities, or in discussion within your community. It is important to remember that statistics matter more than raw numbers. It is important to understand the potential bias of an information source. And it is important to be suspicious of anyone who, at this early date, speaks with absolute certainty.

QUESTION: WA Department of Health (DOH) says that individuals in Phase 1a will be first to be vaccinated. What exactly is Phase 1a and who qualifies?

This guidance document from WA State Department of Health provides detailed information about who falls into Phase 1a.

The basic answer is that Phase 1a includes healthcare professionals (including medical emergency responders) who are at a high risk for infection. It also includes staff and residents of nursing homes and assisted living facilities.

QUESTION: What is the allocation plan for phases beyond 1A?

Guidelines have not yet been released by DOH. We’ll know more about who will be vaccinated in later phases as DOH reviews guidance made by the CDC’s Advisory Committee on Immunization Practices(ACIP) and makes any required adjustments for equitable distribution in WA State. You can view the interim DOH plan and other updates at www.CovidVaccineWA.org.

We will provide updates on the allocation plan and other critical information as it becomes available.

QUESTION: What is timeline for Phase 1a distribution in WA?

WA DOH anticipates there are 500,000 WA residents in group 1A. Current DOH estimates are there will be 222,000 doses of the Pfizer vaccine in WA by the end of December. In addition, should the Moderna vaccine be approved (as seems likely), there will be another 183,000 vaccine doses on hand by the end of the year. Regular weekly shipments of both vaccines should ramp up in January.

Keep in mind that two doses are required to vaccinate an individual, so the approximate 400,000 doses that could be on hand by end of year will vaccinate 200,000 Phase 1a Washington residents.

t will likely be at least January before all Phase 1a individuals are vaccinated, depending on the number of people who choose to get the vaccine, actual vaccine supply, and distribution capabilities.

QUESTION: When can we expect to get vaccine in the islands?

On a broad level, this remains to be seen. Some local healthcare staff may receive a very limited supply of doses from their employer as early as this week. It’s likely additional Phase 1a individuals in the islands will be vaccinated before the end of the year. It may be late January or February before Phase 1a is complete.

Bottom line: even those who are high risk might not see the vaccine until several months into 2021, and the general population might not have access until summer.

The key to surviving this uncertainty with our well-being intact is to avoid rigid expectations, understand that this pandemic is going to end much more slowly than it started, and recognize that the basic precautions we have in place now are going to be with us for a long time to come (even if we’re fortunate enough to be vaccinated).

QUESTION: Are there only two types of vaccine?

o, there are a number of other vaccines in various stages of development and review. The clinical trials for some of these are expected to conclude in January, which could lead to regulatory approval early in 2021.

QUESTION: What are the current biggest unknowns regarding the vaccine?

There are a handful of key questions where the information is incomplete:

• The amount of time that someone who receives the COVID vaccine will be protected against the virus. The sense is that it will provide protection for 1-2 years, but that will only be clear as we move forward through the vaccine distribution effort.
• Whether someone who has the vaccine can continue to transmit COVID. Vaccines will protect most individuals from the severe impacts of COVID infection. However, it is possible that vaccinated individuals may still be asymptomatic carriers. Additional clinical trials are underway to help understand this further. Even if vaccinated persons are potential carriers of the virus, vaccination is still a critical tool to fight the pandemic
• The effectiveness and risks of the vaccine for certain groups of people, particularly children and pregnant women. Studies to assess this are underway but will not be complete for some time.
• What the long-term effects of the vaccine might be. There simply hasn’t been time to fully understand the risk. That said, we do understand that COVID is a very serious illness, and we’re beginning to have a better understanding of significant neurological and cardiac effects from the disease, even in younger and healthy individuals who might have had mild symptoms to start. The known risk from COVID infection is almost universally thought to be greater than the unknown long-term risk of the vaccine.

QUESTION: So, can we be sure this vaccine is 100% safe?

Short answer: like all vaccines there is no reason to think the COVID vaccine is 100% safe for 100% of the people it is given to. Very small numbers of people have reactions to nearly all medications, vaccines, and even many foods. The COVID vaccine will be the same.

However, it is certain that the risks to individuals and our communities from COVID are many times greater than from the very rare side effects of the COVID vaccine.

Nothing about this situation is absolute, and the decision to get vaccinated comes down to a calculation of risk and benefit. We know that the health impacts from COVID can be extremely dangerous, and we’re now learning more about long term impacts that are very serious and debilitating. We also know through the clinical trial process that the short-term and anticipated long-term risks of a COVID vaccine show that getting COVID is the riskier outcome, by far.

There are ongoing reviews being conducted around the world to understand and assess the risks and benefits of all COVID vaccines. As time passes, we’ll have more and more information about the safety of the COVID vaccine that will hopefully reassure us even more. But for now, just know that for the vast majority of people, not getting COVID should be their one and only priority.

QUESTION: If I get the vaccine, are there routine side effects that aren’t serious?

Potentially. As with the flu shot, some people may experience very mild and temporary symptoms. These could include aching, fatigue, or mild pain around the site of the injection. These symptoms resolve within a few days.

QUESTION: How will potential more serious side effects be detected and reported?

As the vaccine rolls out, there will be a number of tools in place at both state and federal level that will allow those vaccinated to report any symptoms or effects, and to help public health authorities keep a close eye on any trends.

In addition, numerous ongoing studies are closely tracking the effectiveness and risks of all vaccines, in an effort to constantly improve our understanding.

QUESTION: Will all healthcare providers and pharmacies in San Juan County be administering the vaccine?

The decision to provide vaccination services locally begins with the willingness of a provider or business to provide the service. Those that do wish to distribute COVID vaccine to the community must apply in advance with the WA State Department of Health (more info HERE and HERE). They’ll be required to provide key details about the number of patients served, their ability to safely store and distribute the vaccine, their willingness to comply with requirements, and a host of other factors.

Decisions to allocate vaccine to providers will be made by WA Department of Health and will depend on the ability to meet these requirements and vaccine availability. Not all providers or jurisdictions will receive vaccine at the same time. Prioritization decisions made at the state and federal levels will impact local availability. The ability to have the greatest impact on disease spread, hospitalizations, and fatalities will drive these decisions.

QUESTION: Where can I learn more?

• CDC’s COVID-19 vaccine information page
• WA State Department of Health’s COVID Vaccine Info Page
• WA State’s DRAFT COVID Vaccination Plan
• San Juan County’s Vaccination Info Page