A Lunchtime Virtual D.C. Town Hall On COVID-19 Vaccines 

A lunchtime virtual D.C. Town Hall on COVID-19 vaccines 

Questions asked live during the Town Hall: 

  • Any idea how long the vaccine might provide protection? How do we know how effective it will be long term?
  • What’s the guidance on wearing masks, even after being vaccinated or if you’re with people who haven’t been vaccinated?
  • When will cancer patients qualify for the vaccine?
  • What about homebound people? Will they have an opportunity to get a vaccination?
  • When are Latinos scheduled to receive vaccinations?
  • I’m a 67-year-old woman of color, trying to get vaccinated and I have not been able to secure an appointment. What is the best way to secure an appointment?
  • Is it discrimination if it’s [vaccine] passed out by zip code.
  • When is the vaccine available to Kaiser [Permanente] members in DC?

Any idea how long the vaccine might provide protection? How do we know how effective it will be long term?

Answer: [Dr. Ashlee Williams] So, for right now what we know is that the vaccine produces neutralizing antibodies and that will likely provide protection for at least one year, but studies are still ongoing to determine whether additional boosters will be needed. So, more research and information forthcoming but for what we know right now – at least one year.

What’s the guidance on wearing masks, even after being vaccinated or if you’re with people who haven’t been vaccinated?

Answer: [Dr. Williams] We still need to be wearing a mask. Mask are still very important to wear every day, even if you have received the vaccine.

When will cancer patients qualify for the vaccine?

Answer: [Dr. Nesbitt] In the District of Columbia, we have an approach that uses both phases and tiers for eligibility for the vaccine that follows very closely the CDC’s Advisory Committee on Immunization Practices. And that takes into consideration the risk for severe illness hospitalization and death, as well as the amount of vaccine that we have available for our population. And we have looked at the things that are risk factors in the District of Columbia, including age, as well as underlying health conditions. And so, our chronic diseases or preexisting conditions population we have classified in our phase 1C, tier 1. And so that’s the process by which we will go. We cannot provide anyone a tentative date by which any phase or tier will become eligible for vaccination in the District, because we do not have a good sense of how much vaccine we will receive from the federal government and when, but our commitment is that we will continue to advocate for more vaccine for the District of Columbia that can help us increase the pace of vaccination, or for all of our most vulnerable populations and high risk groups.

What about homebound people? Will they have an opportunity to get a vaccination?

Answer: [Dr. Nesbitt] So, an important thing that we haven’t talked about is that there are two vaccines that are approved for use in the US, the Moderna vaccine and the Pfizer BioNtech vaccine. And those vaccines have storage and handling requirements that are very different than many of the other vaccines that are used to prevent other infectious diseases. Those storage and handling requirements make it difficult for healthcare providers that operate house call programs to be able to provide vaccines to their homebound patients, especially on a one to one basis. So a doctor or nurse practitioner or PA, who would go visit a single patient and provide them a one hour long visit in the home, and give them a vaccine during that one hour visit is not able to use these vaccines in that same way. To do so would cause a tremendous amount of waste in vaccines that would not be able to be used for other individuals.

What we are able to do is when a high number of individuals who have mobility limitations or transportation barriers live in the same apartment building complex, for example, and meet current eligibility requirements we can bring vaccines on site to them; and still meet those storage and handling requirements that allow us to still ensure that the vaccine is safe and effective.

When are Latinos scheduled to receive vaccinations?

Answer: [Dr. Nesbitt] We have some data in terms of geography. Our equity lens that we’re applying to our vaccine distribution program does not prioritize populations by race or ethnicity. So, a Latina, or person who identifies as Latinx in the District of Columbia, currently has access to vaccines if they are a member of phase 1A, phase 1B, tier one or tier two. For our individuals who are Latinx, who live in some of the District’s neighborhoods that have experienced highest burden of disease; for individuals who are Latinx of Wards 1, 4, and to a lesser extent, Ward 5, we have created a program that allows them to have a preferential access to scheduling appointments, as well as some of the community health centers that provide services to the Latinx population. So, members of the District of Columbia’s community who identify as Latinx are eligible to receive the vaccine now. They have been according to their phase of eligibility since the program launched in December 14.

I’m a 67-year-old woman of color, trying to get vaccinated and I have not been able to secure an appointment. What is the best way to secure an appointment?

Answer: [Deputy Mayor Turnage] The challenge we have with the vaccine is supply. No states are receiving the level of vaccines that we thought we would a couple of weeks ago. The challenge has been that there was an assumed reserve that supposedly existed at the federal level and turned out not to be there. In some states, they lost supply. So, what we’ve done is we’ve identified (as Dr Nesbitt pointed out) certain neighborhoods by zip code, where we have high risk populations and where we have issues with equity. In other words, populations that have expressed a low likelihood of taking the vaccine. For those neighborhoods, when we get the first 75% of our supply, those vaccines are made available for appointments by phone or by the Internet. Once those appointments are filled in for the remaining 25% of the vaccine, the appointment line is opened up to all zip codes. I would say that in Ward 6, there will be several zip codes added to the first group this coming week to reflect some populations that have a high risk for an adverse outcome should they get COVID-19.

So, the best way to try to get the vaccine is to go online or get to a telephone, when the Department of Health announces that the appointments will be released and try to get your appointments scheduled. And if you’re not successful, you’d have to keep trying. And it’s not a function of us denying a vaccine to anybody, it’s a function of us not having a supply we thought we would.

Is it discrimination if it’s [vaccine] passed out by zip code.

Answer: [Deputy Mayor Turnage] We don’t use race or ethnicity in any algorithm that we put in place to decide who gets early access to the vaccine. It’s based on where we believe people who are at the highest risk and have data to show low utilization. So, we’re trying to get folks from an equity standpoint, the opportunity. Folks who typically having trouble getting the vaccine, we’re trying to give them first dibs and then we move to the larger population.

When is the vaccine available to Kaiser [Permanente] members in D.C.?

Answer: [Dr. Williams] So, for our members, we are currently vaccinating members over 65. And we also have a website that you can go to which is kp.org. There, patients that are interested in receiving the vaccine should fill out the COVID-19 vaccine interest questionnaire. And then once that’s been completed, there’ll be added to our list of patients who are interested in receiving the vaccine. And then once they qualify for the vaccine, and when we have enough supply (as Deputy Mayor Turnage told us there is a limited supply) we will reach out to our members to schedule a vaccination appointment.

 

Additional questions asked before and during the Town Hall:

  • In what phase can I be vaccinated?
  • What phase is DC in now?
  • I live in Ward (x), and we are at higher risk. How are populations prioritized?
  • For those minorities living more affluent zip codes, like Ward 3, how can people of color, over 65 with underlying health conditions be given the same opportunity to get the vaccine as other lower-income Wards? Instead we are lumped in with everyone else for 25% of the weekly supply.
  • Will people of color/at-risk communities get prioritized for the vaccine? Many are essential workers yet not on the official CDC list of vaccine priority.
  • What if I am under 65 years old with health issues, which phase?
  • Other than the DC.gov website, how can I schedule an appointment?
  • Can you choose which vaccine?
  • Will I be able to get my second dose on schedule? Is there a shortage?
  • How long afterward the second shot to build immunity?
  • What if you miss your second dose?
  • What about long-term effects? What do we know?
  • Will boosters be required with new strains or annual shots, like the flu?
  • How long does the immunity last?
  • I had a bad allergic reaction to the Moderna vaccine. Went to an infectious disease specialist. They advised to not get second shot. What say you?
  • How are side effects tracked locally? Severe reactions?
  • What should you do if you are concerned about a potential reaction based on your personal history?
  • Does the COVID-19 vaccine produce blood clots? What if you are on blood thinning drugs?
  • Should you take aspirin after your vaccine?
  • Does the vaccine temporarily weaken your immune system making you more vulnerable to other illnesses?
  • Are the side effects the same for both vaccines?
  • Is the vaccine needed if you had COVID-19?
  • Will the vaccine prevent asymptomatic spread?
  • Are you still able to transmit COVID-19 once vaccinated?
  • Have African Americans been under-represented in clinical trials?
  • When is the Johnson & Johnson available?
  • Is the vaccine mandatory?
  • What mask is the best choice for educators?
  • Should I wear the n95 health care workers wear or double mask?
  • Are there different side effects for people of color?
  • Is someone contagious while going through the vaccination process?
  • Is there a history of deaths associated with vaccinations (in general) and with this one?
  • What are the differences between the two current vaccines? Are the ingredients the same?
  • Please clarify mRNA does not change your DNA.
  • What is herd immunity? How can we achieve it?
  • Can out of state caregivers be vaccinated here?
  • Do the vaccines protect against the new strains?
  • When will there be a vaccine for pregnant or nursing?
  • When will there be a vaccine for Children under 18?

In what phase can I be vaccinated?

Answer: Because the U.S. supply of COVID-19 vaccine is expected to be limited at first, CDC is providing recommendations to federal, state, and local governments about who should be vaccinated first. CDC’s recommendations are based on those from the Advisory Committee on Immunization Practices (ACIP), an independent panel of medical and public health experts.

The recommendations were made with these goals in mind:

  • Decrease death and serious disease as much as possible.
  • Preserve functioning of society.
  • Reduce the extra burden COVID-19 is having on people already facing parities.

While CDC makes recommendations for who should be offered COVID-19 vaccine first, each state has its own plan for deciding who will be vaccinated first and how they can receive vaccines. Please contact your local health department for more information on COVID-19 vaccination in your area.

What phase is D.C. in now?

Answer: Phase 1b and tiers 1 and 2. In addition to long term care residents and essential workers including healthcare personnel, fire and emergency personnel and frontline public health workers (Phase 1a), on January 19th, the DC Government opened vaccines up to DC residents 65 and older and others in Phase 1b, and tiers 1 and 2. More information on the initial phases, click here.

I live in Ward (x), and we are at higher risk. How are populations prioritized?

Answer: Two resources to review for more information:

  • Because the U.S. supply of COVID-19 vaccine is expected to be limited at first, CDC is providing recommendations to federal, state, and local governments about who should be vaccinated first. CDC’s recommendations are based on those from the Advisory Committee on Immunization Practices (ACIP), an independent panel of medical and public health experts. For more information, click here.
  • Additionally, on Friday, October 2, 2020, the National Academy of Medicine released the “Framework for Equitable Allocation of COVID-19 Vaccine” consensus study report, which includes recommendations for ensuring equity in distribution, administration, and access to the vaccine; for effective community engagement, risk communication, and strategies to promote vaccine acceptance; and for equitable global allocation. DC Health will use this report to inform our planning and thinking for how we prioritize vaccine while there is a limited initial supply.

Will People of Color/at-risk communities get prioritized for the vaccine? Many are essential workers yet not on the official CDC list of vaccine priority.

Answer: “Essential workers” is a broad category. To find out where you fall in the phases, click here.

What if I am under 65 years old with health issues, which phase?

Answer: For those DC residents under 65 and older than 16, with a chronic medical condition and with increased risk of complications for COVD-19, look for announcements on Phase 1c, tier 1. Additionally, in this phase:

  • Food service workers
  • Local government agency employees
  • Public utility employees
  • Employees of non-governmental health, human, and social services organizations, or agencies
  • Individuals working in commercial/residential property maintenance and environmental services.
  • For more specific information, click here.

For more information, click here.

Other than the DC.gov website, how can I schedule an appointment?

Answer: Recommendations on how to schedule your appointment:

Can you choose which vaccine?

Answer: No. There are two vaccines that have received an Emergency Use Authorization (EUA) by the U.S. Food and Drug Administration (FDA): the Pfizer-BioNTech vaccine and the Moderna vaccine. Both are mRNA (messenger RNA) vaccines. There are more vaccines that are being studied and may eventually become available. DC Health and Kaiser Permanente recommend that you take the first vaccine available to you.

Will I be able to get my second dose on schedule? Is there a shortage?

Answer: You must receive your vaccine in the locale where you live. A second appoint should be scheduled during your first vaccination. Yes, supplies are currently limited.

How long afterward the second shot to build immunity?

Answer: People might get some protection after receiving one dose, but full protection is expected about 1-2 weeks after receiving the second dose. You will still need to wear a mask and take precautions even after fully vaccinated.

What if you miss your second dose?

Answer: You should receive your second dose as close to the timelines recommended from the clinical studies.  It takes two doses of the Pfizer and Moderna vaccines to build up your immunity. 

What about long-term effects? What do we know?

Answer: Because all COVID-19 vaccines are new, it will take more time and more people getting vaccinated to learn about very rare or possible long-term side effects. The good news is, at least 8 weeks’ worth of safety data were gathered in the clinical trials for all the authorized vaccines, and it’s unusual for vaccine side effects to appear more than 8 weeks after vaccination.

Will boosters be required with new strains or annual shots, like the flu?

Answer: It is still too early to know. Ongoing studies should answer this question.

How long does the immunity last?

Answers: We won’t know how long immunity produced by vaccination lasts until we have more data on how well the vaccines work and new strains that are emerging.

I had a bad allergic reaction to the Moderna vaccine. Went to an infectious disease specialist. They advised to not get second shot. What say you?

Answer: You might also consider consulting with an allergy doctor before making a decision on the second dose.

How are side effects tracked locally? Severe reactions?

Answer: Vsafe.cdc.gov is a smartphone-based tool was developed to allow people to report how they are feeling after COVID-19 vaccination to CDC in almost real time. The voluntary system is in addition to existing safety monitoring programs. Reports to v-safe indicating a “medically significant health impact” are followed up by trained personnel. CDC vaccine experts may contact the person’s health-care provider to request more information.

What should you do if you are concerned about a potential reaction based on your personal history?

Answer: Consult your personal physician or an allergist to make an informed decision.

Does the COVID-19 vaccine produce blood clots? What if you are on blood thinning drugs?

Answer: The COVID-19 vaccine does not cause blood clots, but the COVID-19 virus can sometimes lead to blood clots. Especially if you have underlying health conditions, it is important to get vaccinated.

Should you take aspirin after your vaccine?

Answer: Existing research suggests that it is ok to take ibuprofen or acetaminophen after your coronavirus vaccine injection, as long as you don’t exceed the recommended amount. If you take these medications, your body will still develop the immunity that the vaccine provides.

Does the vaccine temporarily weaken your immune system making you more vulnerable to other illnesses?

Answer: There is no evidence the vaccine will make you more vulnerable to other illnesses.

Are the side effects the same for both vaccines?

Answer: In clinical trials, the side effects for the two vaccines were similar.

Is the vaccine needed if you had COVID-19?

Answer: Yes. Due to the severe health risks associated with COVID-19 and the fact that re-infection with COVID-19 is possible, vaccine should be offered to you regardless of whether you already had COVID-19 infection.

Will the vaccine prevent asymptomatic spread?

Answer: In clinical trials, the vaccines were tested to determine how well they prevented people from developing COVID-19.  They were not tested to see how well they prevented the spread of the virus.  This is why even after getting the vaccine, people need to continue to practice safety precautions like frequent hand washing and wearing masks.

Are you still able to transmit COVID-19 once vaccinated?

Answer: See answer from previous question.

Have African Americans been under-represented in clinical trials?

Answer: While the COVID-19 vaccines were developed in record time, they are still being held to the same safety standards of all vaccines. The vaccines went through the standard phases of clinical trials and have been tested on tens of thousands of people from different races and ethnicities. While these trials may not uncover rare adverse events (that you may see when millions of people get the vaccine), we can be comfortable that these trials were large enough to detect any major safety concerns. Due to the pandemic, the vaccine was manufactured and planned for mass distribution while the trials were still happening, which usually doesn’t occur as it may result in a significant waste of money if the product doesn’t get approved. This meant that once the data from the trials was reviewed and approved by the Food and Drug Administration (FDA), the vaccines were very quickly ready for use. Clinical trial participants will continue to be monitored to gain more information about the vaccines, including such things as how long immunity lasts.

When is the Johnson & Johnson available?

Answer: It is too early to tell as they have not applied for emergency use authorization from the Food and Drug Administration.

Is the vaccine mandatory?

Answer: No. It is highly recommended.

What mask is the best choice for educators?

Answer: The CDC recommends that members of the public use simple cloth face coverings when in a public setting to slow the spread of the virus, since this will help people who may have the virus and do not know it from transmitting it to others. For more information, see the CDC’s Recommendation Regarding the Use of Cloth Face Coverings, Especially in Areas of Significant Community-Based Transmission.

Should I wear the N95 health care workers wear or double mask?

Answer: The CDC recommends that members of the public use simple cloth face coverings when in a public setting to slow the spread of the virus, since this will help people who may have the virus and do not know it from transmitting it to others. For more information, see the CDC’s Recommendation Regarding the Use of Cloth Face Coverings, Especially in Areas of Significant Community-Based Transmission.

Additionally, The Centers for Disease Control and Prevention (CDC) does not recommend that the public wear N95 respirators to protect themselves from respiratory diseases, including coronavirus (COVID-19). Those are critical supplies that must continue to be reserved for health care workers and other medical first responders, as recommended by current CDC guidance.

Are there different side effects for people of color?

Answer: Common side effects of all study participants in the COVID-19 vaccine studies are pain at the injection site, fever, feeling tired, headache, chills, muscle aches and joint pains. Most symptoms are mild to medium intensity, appear within 3 days after receiving the vaccine (with most occurring the day after vaccination), and go away within 1 or 2 days. Symptoms may be worse in people younger than age 55 and after the 2nd dose of the vaccine. Having any of these common side effects shows that the vaccine is working as intended and stimulating an immune response from your body.

Is someone contagious while going through the vaccination process?

Answer: People who get an mRNA vaccine will not be able to spread the virus because of getting the vaccine, as it does not introduce the virus to your body. However, we are still learning if the vaccine prevents someone from showing symptoms because of becoming infected with the virus, or if it prevents infection entirely. If it only prevents someone from showing symptoms, it is possible that someone who has the vaccine may be able to get infected without knowing it and spread the virus to other people. Therefore, it is important to keep practicing everyday prevention measures even after getting the vaccine until we learn more.

Is there a history of deaths associated with vaccinations (in general) and with this one?

Answer: Vaccines overall have proven to be very safe, with serious adverse reactions rarely occurring.  The diseases/virus themselves carry a much higher risk of serious complications or death than the vaccines do.  The COVID-19 vaccines approved have shown to be safe in clinical trials, following the long established pattern of the efficacy and safety of other vaccines.

What are the differences between the two current vaccines? Are the ingredients the same?

Answer: The only active ingredient in both the Pfizer and Moderna vaccines is mRNA (messenger ribonucleic acid) which is what triggers the body to develop an immune response to the virus that causes COVID-19.  Overall the other ingredients in the vaccines are very similar with both containing lipids, salts and sugar.  The Moderna vaccine also includes acetic acid and some acid stabilizers.

Please clarify mRNA does not change your DNA.

Answer: COVID-19 mRNA vaccines do not change or interact with your DNA in any way. Messenger RNA vaccines—also called mRNA vaccines—are the first COVID-19 vaccines authorized for use in the United States. mRNA vaccines teach our cells how to make a protein that triggers an immune response. The mRNA from a COVID-19 vaccine never enters the nucleus of the cell, which is where our DNA is kept. This means the mRNA cannot affect or interact with our DNA in any way. Instead, COVID-19 mRNA vaccines work with the body’s natural defenses to safely develop immunity to disease.

What is herd immunity? How can we achieve it?

Answer: Herd immunity occurs when a large enough percentage of a given population is immune to a certain infection such that when someone gets the infection, the microbe has difficulty finding new people to infect. When herd immunity is reached, epidemics die out. The amount of the population that needs to be immune to reach herd immunity varies for every infection. It can vary from 50-90% for viral infections. It is not yet known what percentage of people would need to be immune to COVID-19 to reach herd immunity. Widespread vaccination is the safest and best way to reach herd immunity, to stop the COVID-19 pandemic and to return life to normal.

Can out of state caregivers be vaccinated here?

Answer: No. You must be vaccinated in the state in which you live.

Do the vaccines protect against the new strains?

Answer: Current scientific evidence indicates that the vaccines will work on the mutant strains of COVID-19. All viruses mutate over time. The mutant strains so far are not different enough from the original COVID-19 virus to make the vaccine not work. Scientists are watching and monitoring this issue closely. It may mean that more people will have to be vaccinated to achieve herd immunity.

When will there be a vaccine for pregnant or nursing?

Answer: While the clinical trials do not have enough information on pregnant or lactating women, patients may opt-in. These patients should be given information about the current lack of data but can choose to receive the vaccine.

When will there be a vaccine for Children under 18?

Answer: Trials studying the vaccine in children are currently in progress. As more information becomes available, the age groups eligible for the COVID-19 vaccine will be adjusted.

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