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Piedmont physicians answer your top COVID-19 vaccine questions

Piedmont physicians Charles Brown, M.D., Jayne Morgan, M.D., Saju Mathew, M.D., and Jesse Couk, M.D., respond to frequently asked questions about the COVID-19 vaccine.

Dr. Brown

Good morning. We are here to discuss Piedmont Healthcare's COVID-19 vaccine program and address some of the concerns we've heard expressed along the way to our healthcare workers within Piedmont.

We've seen now one in four Georgians infected with COVID-19. The only way to effectively stop the spread of this pandemic is to vaccinate not only our healthcare workers, but also our population.

Dr. Morgan, how do we know that vaccines are safe? And what is the history of developing these vaccines?

Dr. Morgan

We know the vaccines are safe because quite a bit of research has been done. In fact, 17 years is the span during which this research has been done between the two SARS virus outbreaks.

The first time that we saw the SARS virus, severe acute respiratory syndrome, was in 2003. Since that time, we learned an awful lot about the SARS viruses.

We discovered all of the preclinical data, all of the preclinical work, we completed all of the bench work research. We identified the spike protein as the primary route via which the virus enters the body. We identified the complete genomic sequence, all 30,000 base pairs and analyzed those.

All of that was completed before we even had our first confirmed case of COVID-19 here in the United States. All of that comes to bear prior to us beginning the development of this research program, of this vaccine development that seems incredibly rapid, when in fact it built on 17 years of steady work from that very first outbreak of the SARS virus in 2003.

Dr. Brown

That's a great point, and I think it's poorly understood that this is not just a nine-month program. That this is actually something that was built on years of research. Thank you for clarifying that. What does science tell us about how effective these vaccines are?

Dr. Mathew

It's incredible that from the first time we got the genomic sequence of this virus eight months ago, now we have two safe and effective vaccines less than a year later, the Pfizer and Moderna vaccine. The way it was studied is, 30,000 to 40,000 people in phase three were studied, and we found out that [the vaccines were] 95% effective in preventing COVID disease, which is pretty incredible.

You might remember back in March, Dr. Fauci saying that we would accept a 50% protection. And not only that, the studies also found out that 100% of people did not get severe COVID disease.

We know that the way vaccines work is to prevent disease and not infection, but to really show how important it is for 80% of Americans to get the vaccine: If you get the vaccine and somebody else doesn't, you could still potentially transmit the infection to someone who's not vaccinated. So for people who are saying, "Hey, listen, I just want to see how this vaccine works. I'm apprehensive," 80% of Georgians have to get the vaccine so that I protect you and you protect me.

Dr. Brown

That's a great point. Some people are worried that they will get sick or have COVID-19 symptoms after they get the vaccine. Should this really be a concern?

Dr. Couk

Some people will have side effects, and I think the important thing to realize is that that's normal. That's the body responding to the vaccine. And when that happens, I think the thought should be, this is making my body safe. This is preparing my body. Should I encounter the virus, then I'll be protected.

Some common side effects include a sore arm, a headache, fatigue and muscle aches. And I've advised people who are getting the vaccine to schedule a light day for the day after the first injection. But I think the important thing to realize is that the vaccine does not contain any live virus at all. It's just the spike protein that Dr. Morgan talked about, and it trains your body to respond to the virus should you encounter it.

Dr. Brown

I think that's a very important point that there is no COVID virus injected into the body, which seems to be a misconception.

Why do people need to get both shots of the vaccine? The flu vaccine, I just get one. Can't I get one shot and be done with this? What's the reason for two?

Dr. Mathew

It's really important to follow the way the trials were conducted, and the way the trials were conducted for both Pfizer and Moderna is that if you do get one shot, two weeks after getting one shot you only get 50% protection, but if you get that second shot three to four weeks later, a week or two after that, you get 95% protection. With the way this virus is so contagious and transmissible, you want to be able to get the maximum protection. So just getting one shot only gives you 50%, but if you get both shots like the trials have been conducted, you get 95%, which is pretty incredible.

Dr. Brown

A lot better than flu, which is a common misconception that the flu [vaccine] prevents all flu and it does not. This is actually probably one of the most effective vaccines we've had for any viral disease. Let's go onto one more.

This will be [for] Dr. Couk. Some people have misinformation about the ingredients of the vaccine. What's in it? Is there anything people should be concerned about? Are there ethical concerns? Are there concerns about the actual constituency of the vaccine itself?

Dr. Couk

I think that's a great question. There have been two vaccines authorized so far by the FDA. Those are mRNA-based vaccines by both Moderna and Pfizer. And as significant technology as this is, the vaccines themselves are pretty simple.

Each one contains an mRNA with instructions to make a spike protein, and both vaccines pretty much contain the same sequence. Pfizer simply licensed the same sequence that Moderna is using. These mRNA sequences are put in something called a lipid nanoparticle, which doesn't roll off the tongue and is something that I think most of us learned about, about a year ago as this was all happening. All that does is help deliver the mRNA to the cell so that your body's ribosomes can make the spike protein.

I have been asked by a number of people so far, whether or not human stem cells have been used. And the reality is the vaccine itself, it doesn't contain any human stem cells at all. Anytime you do research with a virus, you need to grow that virus and so the virus is grown in various different human tissue lines, but the vaccine itself doesn't have any human cells at all.

Dr. Brown

Thank you. Dr. Morgan's point, this really represents kind of next generation of vaccine development technology, which is really quite exciting. One of our last questions I'll direct to Dr. Morgan. The vaccine deployment is great news, but what do we need to keep doing now to stay safe for this next several months as we wait for this vaccination program to roll out?

Dr. Morgan

Right. We've been really encouraged with the vaccine rollout. Many people have been able to receive the vaccine. We want to make certain that if you're offered the vaccine, you opt in, you say yes and you receive the vaccine and that you receive both doses of the vaccine.

In the meantime, as we also have already identified, you still could be carrying the virus even if you develop immunity, even if you have immunity from your immunization. So it's important to continue to wash your hands thoroughly, continue to wear a mask and also continue to social-distance, because you could be carrying it in your nose or in your throat, even though you're asymptomatic, you do not manifest the symptoms, but you could be making other people sick. People want to make certain that we all work together in a community to keep us all safe as we roll out this vaccine.

Dr. Brown

That's a really important point, because I think people automatically assume they got that shot and they take the mask off and they're great to go, but you're not, you really can continue to infect people.

What do we know about why some people are so resistant to getting the COVID-19 vaccine? And what do you think we could collectively do as healthcare providers to make them more comfortable and go ahead and get vaccinated?

Dr. Morgan

Yeah, certainly these conversations are very germane and right up front with regard to sort of the tenuous relationship between populations of color and the healthcare system, and an even more tenuous relationship between populations of color and research and government. And so all of these things come together in this vaccine, and so it's not so difficult to understand why not only is there vaccine hesitancy, the word is more of a complete, “never-ancy” maybe is a better way to explain it. And a lot of that has to do with historical context, research that's been done in populations of color, specifically the African-American populations where atrocities have been committed. And there's been a breach of trust, and there has not been a bridging of that trust in the interim.

And so now we have a vaccine that's come out very quickly, and it's unclear if we were participating in the trials, whether any of the data is relevant to our populations, whether or not the data that is being presented to us is something that we can trust, whether it's coming from a trusted source. And so all of these are hurdles that we have to overcome in order to bring everybody to the fold such that we can begin to develop this herd immunity. Everyone has to be able to understand it and receive it.

Dr. Mathew

I just wanted to piggyback to Dr. Morgan, [because what she] said was really important. We have to realize that it's important to talk to the elephant in the room, with minority populations, the Tuskegee syphilis experiment. There's a lot of vaccine hesitancy. In fact, the latest poll shows that only 50% of Americans will get the vaccine, but I think it's really important to model behavior.

It's important for us, especially as healthcare providers that are taking care of COVID patients, to let people know that do not mistake the fact that this vaccine was developed quickly for any worry about safety. They're two different things. This was not developed quickly. No corners were cut. So this is a safe and effective vaccine.

And all my patients, Dr. Brown, always ask me, "Hey, listen, how can we get back to normalcy?" The only way that we could go to proms again and we can attend graduations again and maybe even sit in a movie theater is if 80% of Americans get this vaccine and we attain herd immunity. That's the only way that we can get to some level of normalcy.

And what's really interesting with the vaccines that you'll find out that once a good percentage of the population gets vaccinated, the death rates will go down first, then hospitalizations and then the transmission in the community. We have something to look forward to if each one of us becomes a part of the solution and not a part of the problem.

Dr. Brown

Yeah. Great comments. Thank you. Dr. Couk, anything else we should address?

Dr. Couk

I think that it's important to realize that people are going to have questions. It started a year ago when there was a new virus that none of us had heard of before and we were rapidly finding out new information. The science was changing rapidly. And so as the virus is new, the vaccine is new and [we’re] trying to talk to people about it and answer their questions, and so I think it's really important that people feel heard, that we take the time to listen to the questions that they have and do our best to answer those questions.

Address questions about how this was developed so rapidly, and try to convey the point that the amazing thing is all of the hard work that happened beforehand so that we could develop this vaccine as rapidly as we could. That all of the hard issues with this vaccine, the difficult challenges were done before we even heard of this virus based on other similar viruses. And help people understand that the vaccine's safe, that it's effective and that it's going to help them protect them and protect their family and the people that they care about.

Dr. Brown

We would encourage you to take this information, hopefully with a new level of comfort and talk to folks about getting vaccinated.  

Let's try to get back to normal as a population, and it's going to take vaccination and immunity amongst our friends and colleagues.

We all assembled early in the morning here. We'd like to thank everybody for being here. Thank you for answering those questions, and hopefully we've answered questions and concerns for everybody.

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