New Hampshire’s rollout of vaccines to senior citizens – a massive subset of the state’s population – has been hailed as a “roaring success” by state officials and a nightmare by some who struggled to secure their place in line for a shot.
While the prospect of a vaccine offers hope, it also can create confusion and concern. To help parse through the abundance of information about the vaccine, the Monitor’s health reporter sat down with Michael McLeod, the associate chief clinical officer at Concord Hospital. The following transcript has been edited for clarity and brevity.
Can you explain how these vaccines work to protect us from COVID-19?
I think the first piece is standard vaccines that we look at, for example, the flu shot that folks will typically get every year in the injection are small pieces of the virus, not the actual virus itself, that your body will identify as being foreign and ultimately build antibodies to identify each one of those pieces.
If the actual live virus were to show up, you have antibodies that can lock on to those pieces, take it out of your system, and ultimately keep you from getting sick or having a much milder case. When we don’t have those antibodies present, your body has to figure out how to fight off that infection.
So when we talk about now the vaccines from Pfizer and Moderna that are approved for emergency use authorization, they’re called messenger RNA vaccines, and those are a little bit different.
So just like we talked about in the flu shot, you had different protein that are made in a lab. Essentially what the Moderna (vaccine) does is there’s a small strip of messenger RNA that you can think about as either a blueprint or a recipe that is encased in the little fat bubble that is absorbed through the cells in your body. Your body will look at that blueprint or recipe and say, ‘I don’t know what that is, but I’m supposed to make it’. Ultimately, we’ll make the protein that in a flu shot, we would inject it to people. So essentially, these vaccines just have one of the steps that would be done in a lab done in our own bodies. And then once that protein is made, your body then can make antibodies to lock on to it.
Those antibodies are what will lock on to the actual virus, should be we’d be exposed to it and take it out of our system.
Why do we need two shots of the the COVID-19 vaccine?
So actually, with most of the vaccines that we do, you actually do need multiple shots.
So for example, when children are old enough, which is typically six months, to get the flu shot their first time they actually get two shots separated by four weeks in between. After that they get a yearly booster, which is ultimately one shot. When we think of measles, mumps, rubella – that’s a series of two vaccines separated over time.
We’ll talk specifically about the COVID vaccine, what they’ve done is identified that after the first shot about, there’s about a 53% likelihood that you won’t get COVID-19, which, at that point, you’d say 53% is better than 0%. But it’s not really what we would want to accomplish.
We know from studies that with both doses of Pfizer and Moderna there’s about a 95% chance that you won’t get severe COVID, you won’t be hospitalized and you won’t die from it, which are really three of the biggest components that I think most people would care about.
What you’re likely going to ask as a follow up question, though, would be, but what I really want to know is, does that mean I can no longer get COVID-19, or spread it to others. And at this point, we really don’t know that those studies are ongoing, they have enrolled thousands of healthcare workers in those studies who received the vaccine. And they’ll follow that over time. But that is information that will take longer to truly figure out if that is actually the case.
So that would seem to suggest that even after you’re vaccinated, you should continue to wear a mask and socially distance to protect others around you.
Absolutely, because at this point, until we know that information, we want to make sure that people who are vaccinated are still protecting themselves, so that they’re not going to get infected, but at the same time, reducing the risk that they might spread to others until we know that information.
Can we expect these COVID-19 vaccines to be a part of regular life as flu shots?
Yeah, we’ll have to see, I think, again, it is entirely possible that if COVID becomes a part of our reality, just like measles is a part of our reality. But because the majority of people are vaccinated, you rarely hear about measles being a problem that people would typically be faced with, where we’ll often see things like measles show up is in pockets of people who haven’t been vaccinated. So it’s not that the virus necessarily will disappear from the world once everybody is vaccinated. But if it doesn’t have a place to live, ultimately it will be much harder for it to spread from person to person, because people are immune to it. So part of it will depend on vaccination uptake.
How many people need to be vaccinated in order to achieve herd immunity?
We truly don’t necessarily know the answer. I think that as you look at the different answers to that, and we’ll take someone who’s probably most prominent Dr. Fauci who has said somewhere between 70% and 90% will likely be what we’ll need to see before we have some level of herd immunity.
What can you tell me about the safety of these vaccines?
I often get asked, “What about long term side effects? That’s what I’m worried about.” When I hear vaccine hesitancy, you know, it’s a concern for long term side effects. And I think, you know, the answer is like a lot of the answers I’ve given you already: We don’t know. But with this one, at least, typically, with most reactions to vaccines, they’ll show up in the first two weeks when they’re studied. We don’t typically see (long term effects) with most other vaccines.
The things that you should expect and the things that that we know do happen: you should bank on the fact that most people will get arm soreness.
If you said, how about things like fatigue, headache? Just feeling generally achy. About 50% of folks will have that. And if you said, well, how about things like diarrhea or chills, most people don’t get those side effects.
The side effects are more after the second dose than the first dose; that I could speak from my own personal experience. After the first dose of the Pfizer vaccine, my arm was a little sore after the second dose of the vaccine. In the next day, I definitely felt tired. I definitely felt achy, and even had a little bit of chills that night. By the next day it was gone. So I think that’s really what we see with most folks.
We haven’t seen any other annex unexpected side effects and I think the one piece that has gotten some press lately is just allergic reactions or anaphylaxis. severe allergic reaction. We have seen, I think the numbers that are out now that about 2.5. out of a million people with Moderna and 11 out of a million with Pfizer did have a severe allergic reaction.
Health officials in New Hampshire have said new COVID-19 variants are inevitable in our state. What do we know about how effective the vaccines are against those new variants?
The shorter answer is we don’t necessarily know.
I often ask patients to imagine the vaccine, instead of going against a virus, was against your Chevy pickup truck. And we know from year to year Chevy will change the ultimate appearance of the truck.
But our vaccine is designed against the Chevy emblem that’s on the grill of the trucks, so that even if it’s a two-door or four-door, even if it’s blue or green, we feel like the vaccine should work because it’s really locking in on that emblem on the front.
Now if one day you walked out your driveway and you looked and it said Ford on the front of your truck, then I don’t think that will be effective anymore.
That’s sort of what they’re looking at now.
When is life going to go back to normal? Will we still have to wear masks after we are vaccinated?
It’s a great question. I think it’s the question that’s on everybody’s mind. I will say that, you know, if I could predict the future, I probably wouldn’t be doing this job.
In the grand scheme of things, I think right now, where we’re at in terms of having a vaccine, having the rollout plan, what we know about not only the vaccines that are available today – I think all of that bodes well for us to see that by summertime, things are really starting to seem to be a little bit more normal.
To your question about if we have to wear a mask, I don’t know, we’ll have to see really, what rates of transmission we have in communities. I think what we’ve seen all along is states and the federal government have made recommendations to increase or decrease sort of precautions based on what we’ve seen in the community.
I’m hopeful that if the vaccination rates continue as they are, we’ll see that summer might look a little bit more normal than then the the winter months have looked for us. When that actual day will be we’ll just have to see – but I’m looking forward to summer.