The coronavirus pandemic is wreaking havoc on every sense of normal life.
Now roughly nine months into it, the country is one step closer to a vaccine.
On Friday, Pfizer Inc. and BioNTech SE applied for an emergency use authorization from the U.S. Food and Drug Administration for its COVID-19 vaccine and another company, Moderna is expected to follow suit.
But the question on everyone’s mind is if either company receives the EUA, who will get the vaccine first?
“That’s a good question,” said Dr. Mike Dacey, president and chief operating officer at Riverside Health System, adding the decision is up to the federal government. “The guidance on that is not clear.”
“I think everybody does expect frontline workers to be first,” he added.
Dacey defined frontline health care workers as those who have “direct patient contact or frequent contact with hospital staff at work” such as nurses, doctors, environmental service workers and EMS workers.
Each person who receives the COVID-19 vaccine actually needs two doses three weeks apart and it must be the same vaccine both times.
“You can’t get the Pfizer first and the Moderna vaccine second the time,” he added. “And after the person has received the first dose of the vaccine, presuming they get the second, the immunity seems to be really present 5 to 6 weeks after the dose.”
The good news: The vaccine will be free.
The bad news is with multiple doses needed, it will take longer for the average person to receive a vaccine unless they fall into the high risk category or are considered frontline health care workers.
The timeline for the general public will depend on when the FDA approves the vaccine, Dacey wrote in an email Friday.
“Pfizer submitted their application for approval this morning, and the advisory board has thousands of pages of data to review,” he noted. “However, what I saw noted that a decision could be made in early December, which would make the first wave of vaccines available to health care providers and vulnerable patients by the end of the year, with other populations following.”
Dacey said Pfizer expects to have 50 million doses by the end of the year, so with roughly 18 million frontline health care workers in the United States each receiving two doses, most if not all of the vaccines will go to them first.
He hopes soon after frontline workers receive the vaccine, people in high risk categories such as those in nursing homes or people who are considered elderly can get the vaccine next, but the government needs to define what age a person is considered old.
Those who are considered low risk for the virus such as younger people without medical conditions “certainly won’t be the first people to get it,” he added.
Typically, vaccines are made up of a small dose–– weaker version of a disease–– which triggers the body to create antibodies helping the person build immunity in case they come in contact with the disease.
But the Pfizer and the Moderna COVID-19 vaccines are different because instead of getting a low dose of the coronavirus, the person will get proteins which act like the virus and trigger an immune response.
The technology is new and known as messenger RNA.
“So they are no virus in these at all,” Dacey said. “It’s a very, very amazing scientific accomplishment.”
What is even more impressive is the vaccines’ reported effectiveness rate of 95 percent — nearly double the flu vaccine effectiveness rate.
“If in fact, it really proves that 95 percent of them are effective, that’s amazing,” Dacey said. “Most typical influenza vaccines are 50 percent effective.”
But there are some “mild” side effects more apparent than if one were to get a flu vaccine, he said.
“From what we understand, we’re expecting some patients may feel, temporarily, more pronounced headaches or body aches,” Dacey wrote. “The side effects appear to be similar to other vaccines, such as Shingles.”
How will the vaccine be distributed?
The Pfizer COVID-19 vaccine has some storage requirements and must be kept cold. Once the doses thaw out, there is a certain timeframe the vaccine must be administered.
“We’ve heard anywhere from six hours to 36 hours,” Dacey said.
Dacey said according to the Virginia Department of Health, there are 25 health care facilities in the state, including Riverside, which have the “ultra cold freezer capacity” needed to keep the Pfizer vaccine at the right temperature.
Riverside has four of those freezers and they, along with the other facilities, are working with VDH and the local health districts to finalize their distribution plans.
“We’re expecting it to be similar to COVID-19 testing, where there will be a variety of options (i.e. public facilities, clinics, pharmacies, etc.) for patients to receive the vaccine in a way that is easy and convenient for them,” Dacey wrote in an email, adding he expects the facilities to be in charge of distributing the vaccine. “The initial priority for vaccination will be determined by the CDC and Virginia Department of Health, but anticipate that healthcare providers and the elderly living in congregate settings will be in phase 1.”
But just because the vaccine is available does not mean everyone is going to take it.
Last week, Sentara Healthcare announced the COVID-19 vaccine will not be mandatory for its employees.
Riverside surveyed its hospital staff to see how many people would be interested in taking the COVID-19 vaccine and “only about a third wanted to take the vaccine when it was first available,” Dacey said.
He said the number was higher among doctors with half of them planning to take the vaccine.
While Riverside won’t require staff to take the vaccine either, Dacey said it’s going to be “highly encouraged” they do.
In fact, Dacey plans to take the vaccine and encourages everyone to do the same.
“Absolutely, I trust the FDA and Dr. Fauci’s direction and look forward to receiving a vaccine,” he wrote in an email. “I also encourage everyone to get one when they become available.”
“I just think it’s viewed to be very safe and people should seriously consider taking it when it becomes available,” Dacey added.
But before they do, he recommends they get a flu vaccination first.
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