201224ind Vaccine

Last Friday, Kevin Hurley, a registered nurse who works in the emergency department at South County Hospital became the first healthcare worker at South County Health to receive the recently approved Pfizer vaccine for COVID-19.

SOUTH KINGSTOWN, R.I. — South County Hospital’s fight against COVID-19 has taken another step as front line medical staff continue this week to get first doses of a vaccine as cases of the virus continue to climb in the area.

Emergency Department nurse Kevin Hurley became the first person to get vaccinated as South County Health offered inoculations to more than 1,000 staff members.

“Me getting this vaccine, more people getting this vaccine, it’s like I’ve had enough. I’ve had enough seeing people die,” said Hurley, adding that she is comfortable with the medical studies showing no widespread adverse effects and over 95 percent effectiveness.

Indicators show area towns are now seeing increases, compared to three months ago, for those having a first positive test result for COVID-19. In mid-September, for instance, Narragansett had reports of 31 such cases and that number jumped to 73 for the week ending Dec. 12.

South Kingstown’s cases in that same time period went from seven to 52 for mid-December and in North Kingstown the number jumped from 5 to 123 in the same comparison of dates.

While the vaccine hasn’t been used before on mass public inoculations, avoiding it “doesn’t even come close to outweighing how much I think we’ve all had enough of this way of life,” said the 38-year-old Hurley.

Her partner, Nick Martirossian, who works occasional shifts at the hospital assisting nurses and doctors, received his vaccination the day after hers.

“The best thing I can think of to say to someone who says, ‘I don’t know if I trust it,’ would be I hear you, I hear the feelings and you’re nervous about it,” said Hurley, whose day job is helping to soothe fears of patients seeking emergency medical treatment.

‘If you go online and look at how this was made and what it really is, I think you’re going to find that this is a good thing in modern science,” she said.

Pointing to some of the national anti-vaccination sentiments, she said the COVID-19 vaccine “has no political agenda. The only agenda of science is the truth and facts and what can be proven.”

“Take a little bit of time, read it, trust in science and know that this is good thing,” Hurley added.

She noted that too often, whether with vaccines or other controversial issues, people look at a few instances of problems and then dismiss potential for overall benefits.  

“We have to look at all the parts that are successful,” she said, noting that with vaccines large population studies can show their overall value.

“I am a very strong believer in vaccines. We have diseases we thought we eradicated years ago,” she said about resurgences in some illnesses due to some people refusal to have a vaccine or allow their children to have them.

Aaron Robinson, South County Health president, reflected on the importance of this step in protecting healthcare workers and the general public.

“Our team is excited to embark on this momentous administration of the COVID-19 vaccine. This will be critical to protect our front line staff who have worked tirelessly to serve our community,” he said.

“After review of the Pfizer vaccine, we believe the vaccine to be safe, highly effective, and a promising turning point in the battle against COVID-19,” Robinson said.

Hospital’s Preparation

Hurley noted that before the vaccine came, the hospital held a large town-hall style virtual video conference for employees to attend. Leading state and hospital medical authorities explained how the vaccine worked, medical aspects of its development and the roll out.

The panel of experts also answered staff questions solicited in advance to have a thorough review during the video conference.

The hospital in November also formed a Vaccine Task Force to prepare for the distribution of the vaccine. That team began to meet in November to ensure resources and processes were in place even before the vaccine received FDA approval.

“Based on the information we received from the Centers for Disease Control and the Rhode Island Department of Health, we are confident that the Pfizer and Moderna vaccines will be pivotal in controlling the COVID-19 virus,” said Dr. Aaron Hattaway, chief medical officer.

“We have been assured that no steps in the evaluation of safety or efficacy were skipped in the development of this vaccine. Due to the immense public need, significant financial and human resources were made available to conduct these trials as quickly as possible,” Hattaway said.

Usual procedural delays between steps were abbreviated, resulting in less waiting between steps, but no steps skipped, hospital officials say.

According to the research leading up to the distribution of the COVID vaccine, there is a chance that side effects such as fever, aches, sore arm, body malaise may be experienced, particularly after receiving the second of two doses, they said.

With eight vaccine clinics, staff in each department is scheduled on different days to ensure that no department is left understaffed should someone have an adverse reaction or side-effect to the vaccine, they explained about the process underway in the hospital.

At the time a staff member receives the first dose of the vaccine, an appointment will be scheduled for the second dose 21 days later, they said.

Questions and answers

The following are some of the questions South County Health staff raised that mirror those posed by the public:

  • When will the COVID vaccine  (Pfizer, Moderna) be available to the general public?

Prioritization and distribution of the vaccines will be scheduled by the Centers for Disease Control and state’s departments of health. As of Dec. 14, 2020, no schedule has been released beyond the vaccine made available to healthcare workers.

  • How is efficacy determined?  I hear that Pfizer’s vaccine has 95% efficacy - how do they know that?

Assuming a COVID exposure seven days or more after your second vaccine dose, you are 95% less likely to get sick that if you did not have the vaccine.

  •  Is it safe to give the COVID vaccine  (Pfizer, Moderna) to pregnant women or women planning to become pregnant?  

The Emergency Use Authorization (EUA) allows pregnant women to be offered the vaccine. There is very little data around the use of this vaccine in the pregnant population. The risks and benefits should be weighed by the employee, in conversation with their primary care physician or obstetrician.

  • Has research been done around the vaccine and how it affects those with autoimmune conditions?

Patients with autoimmune diseases, and immune deficiencies including Hepatitis B, Hepatitis C, and HIV/AIDS were included in the trials.  No significant differences were observed in safety or efficacy in these groups compared to the general population.  Based on data from other vaccines, it is possible that immunocompromised persons may have a diminished response to the vaccine (i.e. It may be less effective in this group).

  • Are we still going to have to quarantine and follow current COVID prevention practices after an exposure once we are vaccinated?

This may change, but at this time the usual quarantine period will still apply and COVID prevention must still be practiced (masking, hand hygiene, social distancing, etc.).

 If you previously had COVID-19 and fully recovered, particularly within the last 3 months, should you still receive the vaccine?

Yes. However, you should not receive the COVID-19 vaccine within 14 days of active infection (you must wait until your isolation period ends).

  • What steps did they/are they skipping in the creation and testing process for the vaccine, that are typically required important steps with other vaccine and med approvals?  Why was this one able to be processed and approved so quickly in comparison to others in the past?

No steps in the evaluation of safety or efficacy were skipped in the development of this vaccine.  Due to the immense public need, significant financial and human resources were made available to conduct these trials as quickly as possible.

  • What are the expected side effects to the vaccine that are different than an allergic reaction?

In the clinical trials there were the following: 84% pain at injection site, 63% fatigue, 55% headache, 38% malaise, 32% chills, and 14% fever.

  • If I get the vaccine, and then experience side effects such as fever, aches, cough, should I stay home from work until my symptoms resolve?

There is a chance you may experience side effects such as fever, aches, sore arm, body malaise. It is advisable to schedule your vaccination 24-48 hours prior to a day off in case you do not feel well enough to work. Because these side effects also are similar with COVID illness, you may want to have a COVID test during that day or next day to ensure you do not have COVID at the same time as getting vaccinated. The vaccine does not give you COVID illness and will not cause you to test positive, it does not work that way.

  • Long term side effects – particularly of the one that changes the RNA?

Long-term side effects, from a theoretical medical perspective, are unlikely since two very low doses of a highly unstable (leaves your body quickly) molecule are administered. Trials began in July, and as such, we only have data spanning (at most) 6 months, so there is no long-term data, but the short-term safety data is encouraging.

  • Is there a mechanism to confirm the vaccine has effectively produced antibodies, particularly in staff with underlying immune issues? IgM &/or IgG antibody testing.

There is no recommendation for this sort of monitoring at this time.

  • Vaccines administered in the UK found there to be issues will allergic reactions in some patients. Can you elaborate more on that?

In the course of administering tens of thousands of doses to a population consisting mostly of healthcare workers, two vaccine recipients experienced anaphylactic reactions. This can occur with any vaccine and appears to be a rare adverse event.

  • I have been hearing that people with allergies should not get the vaccine. Do you have any info regarding this vaccine? I get the flu shot every year but have a lot of other allergies.

The only group of patients we are recommending additional monitoring or consideration of postponing vaccination in is patients who have had previous anaphylactic reactions to another vaccine or injectable medication.

  • Once the injection is given is there a period of waiting to see if a reaction develops?

In most patients, we will monitor you for 15 minutes for reaction. In the group of patients above (previous anaphylactic reactions to another vaccine or injectable medication) we will monitor you for 30 minutes.

  • If a person has taken the first of two shingles vaccinations and is due for the second shot in the time between the two COVID vaccine doses, is it still okay to receive the first shot of the COVID vaccine too?

Each COVID vaccine should be spaced at least 14 days apart from any other vaccines.

  • Is this vaccine safe for those who have egg allergies?

The COVID vaccine does not contain egg.

  • Can I get the vaccine if I take Humira?

Please contact the provider who prescribes Humira (or any other medication of concern) and discuss the risks and benefits.  

  • I had an allergy to penicillin and erythromycin when I was in my 20s. I’m in my 50s and I haven’t had any reactions recently but just wondering if that is an issue.

The vaccine does not contain penicillin or erythromycin.  If you have ever experienced an anaphylactic reaction to an injectable medication, we will monitor you for 30 minutes (rather than the usual 15) for reaction following your injection.

  • What if you have asthma? Will you still be able to get the vaccine?

Yes, patients with lung disease were included in the clinical trials and saw no significant difference in efficacy or safety.

  • Will the COVID vaccine be offered annually?

At this time, there is (limited) evidence to suggest that the vaccine may offer multiple years of protection.  Whether an additional “booster” dose will be required is still being evaluated.

Bill Seymour is a freelance writer covering news and personality feature stories in Narragansett, North Kingstown and South Kingstown. He can be reached at independent.southcountylife@gmail.com.

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