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COVID-19 Vaccine Q&A
Dr. Shalika Katugaha discusses COVID-19 booster shots, breakthrough cases, and the flu vaccine.
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Learn more about Shalika Katugaha, MD, FACP
Shalika Katugaha, MD, FACP
Shalika Basnayake Katugaha, MD, FACP, is a board-certified and fellowship-trained infectious diseases specialist with more than 10 years of experience. Dr. Katugaha is a former medical director of transplant infectious diseases, associate professor of medicine and clinical researcher who has been published in numerous professional medical journals and presented at international specialty meetings.Learn more about Shalika Katugaha, MD, FACP
Transcription:
Caitlin Whyte: Every day, there seems to be a new update or recommendation about the COVID-19 vaccine. Today, Dr. Shalika Katugaha, System Medical Director of Infectious Diseases at Baptist Health is here to help clear up some of the confusion.
This is Baptist Health Radio. As the most preferred healthcare provider in Northeast Florida, we are here to help you stay informed with the latest news, views and resources for your health and wellbeing. So doctor, we've heard that most Americans may need a COVID-19 booster shot at some point. But I've also heard the term third dose. So are these the same thing?
Shalika Katugaha, MD, FACP: Yes. That is an excellent question. So they are technically two different things. So what an additional dose or a third dose is, is when individuals who are moderately or severely immunocompromised don't build enough protection when they got the first two, then we usually call that the third or additional dose. And that is indeed what happened in terms of clinical trials, many immunocompromised individuals, including transplants didn't develop enough antibody when they just got the two doses.
So in August, what be FDA did is authorized this additional dose, which is a third dose for this immunocompromised or weakened immune system population, where they go 28 days after they got the second shot and get the third shot of either Moderna or Pfizer vaccine. So that's the third dose and then the booster is a little bit different. And that's what we're hearing about that we'll hear about more in the coming days and that's for the American population at large.
So now, we're talking about booster shots and what that means is that the individuals got the first two and they developed antibodies, we presume and we know from clinical studies and they built enough protection, but then the protection decreases over time, which is called waning immunity. And so the plan is to give these COVID-19 boosters when this waning immunity happens to boost their immune system. So that's what that is.
And I know we're hearing a lot about it. The Food and Drug Administration Vaccines and Related Biological Products Advisory Committee is meeting on September 17th to kind of give us more information about the plan, meaning who will go first in terms of the rollout? Will it be Pfizer and Moderna at the same doses? All these technical details that we're going to work around will hopefully be sorted at that time.
Caitlin Whyte: Now let's talk about breakthrough cases. How common are they? And what would you tell someone who says, "You know, why should I get the COVID vaccine if I can still get COVID?"
Shalika Katugaha, MD, FACP: All right, here we go. So, breakthrough infections, just to define them, they're any positive tests for infection with the virus that causes COVID occurring more than two weeks after someone has gotten the final dose of a COVID vaccine. So these breakthrough infections are not common, though we're seeing more of it in the news and the media, they are not very common. So your likelihood of getting a breakthrough infection is probably one in five to 10,000. People say that's around 0.02%.
So basically, we are seeing around 35,000 breakthrough infections a week, and that is in context of the 171 million vaccinated Americans that we have. So it's actually a smaller number than we think. Breakthrough infections are expected when more of a population gets vaccinated. Then, we'll see more of these breakthrough infections. But the thing to remember is that vaccines are still doing exactly what they were intended to do, which is protecting and preventing severe illness. So what we really want vaccines to do is to prevent people from getting severely ill, hospitalized, and dying. And they're actually doing that quite well. In fact, so much so that with Delta, COVID has become a pandemic of the unvaccinated. So really vaccines are doing what they were intended to do, which is saving lives.
Next point is that yes, vaccinated people can transmit the virus, but they do it for a shorter amount of time. That's because you already have an army of antibodies ready to fight the virus when the virus enters your system. So, yes, while there may be very high viral loads of Delta in the nares of vaccinated and unvaccinated, the vaccinated group will shut it for a shorter period of time.
So I know the thought is it's tempting to say, "Well, I got the vaccine. I'm going to get COVID anyway, what's the point?"? But actually, the point is that you will be less severely ill. And the point is you will have less symptoms. And in fact, there's been a recent study showing that you are half as likely to have long COVID, which is symptoms lasting more than a month if you get the vaccine.
Caitlin Whyte: Now, another vaccine that we're talking about is the flu vaccine. As we head into fall, the CDC recommends everyone over six months old get one by the end of October. So do I really need a flu vaccine if I have the COVID vaccine?
Shalika Katugaha, MD, FACP: Yes. They do not cross react and you don't get protection from the flu from getting the COVID vaccine. So let me say a little bit, the flu virus circulates annually in the United States, most commonly from the late fall to the early spring. Flu, usually people recover without serious complications, but it can cause serious illness in those who are older, very young, pregnant, or have underlying medical conditions.
So people say, "The flu season essentially disappeared last year. So why do I really need the flu shot?" Well, that's true. We had a record low in terms of flu cases last year. But last year, people were wearing masks with dedication, physical distancing, and then remotely working and remotely going to school. But now schools have opened, most people are actually going in for work, and people have become lax with regards to masking and social distancing. So we don't know what kind of flu season we're going to have this year. So it's still is to your benefit to prevent you from getting severely ill to get the flu shot.
So anyone who is over six months old to get the flu vaccine, the timing is, you know, it's offered by the end of October, so it's best to get it by the end of October. But if you miss that time, still by all means, go and get the flu vaccine. The 2021-2022 flu season will coincide with the continued circulation of the SARS-CoV-2, the virus that causes COVID. Getting the flu vaccine in general will prevent symptoms that can be confused with COVID. It'll prevent outpatient visits, hospitalizations, and ICU admissions as well, which could decrease the stress to the US healthcare system.
So there are many types of flu vaccines out there. They are all quadrivalent this year. That means they all work against four different antigens. There are types that do not use eggs, so that, you know, people with an egg allergy can go get them. So, yes, the flu vaccine is very important this season.
Another big question that I get is that can we co-administer the COVID vaccine with the flu vaccine, and the answer is absolutely. And we're doing that here at Baptist. There is no reason to think that efficacy or safety of either vaccine would be different. If you get them together. If they are given together, they should just be at different injection sites. We are preparing our COVID flu vaccine clinics as I speak.
Caitlin Whyte: Well, thank you for your time today, Dr. K. For more expert answers to your COVID-19 questions, visit covid19.baptist.jax.com. Baptist Health reminds you to wear a mask, social distance and get your COVID and flu vaccines. And thank you for listening. This has been Baptist Health Radio. I'm Caitlin Whyte. Stay well.
Caitlin Whyte: Every day, there seems to be a new update or recommendation about the COVID-19 vaccine. Today, Dr. Shalika Katugaha, System Medical Director of Infectious Diseases at Baptist Health is here to help clear up some of the confusion.
This is Baptist Health Radio. As the most preferred healthcare provider in Northeast Florida, we are here to help you stay informed with the latest news, views and resources for your health and wellbeing. So doctor, we've heard that most Americans may need a COVID-19 booster shot at some point. But I've also heard the term third dose. So are these the same thing?
Shalika Katugaha, MD, FACP: Yes. That is an excellent question. So they are technically two different things. So what an additional dose or a third dose is, is when individuals who are moderately or severely immunocompromised don't build enough protection when they got the first two, then we usually call that the third or additional dose. And that is indeed what happened in terms of clinical trials, many immunocompromised individuals, including transplants didn't develop enough antibody when they just got the two doses.
So in August, what be FDA did is authorized this additional dose, which is a third dose for this immunocompromised or weakened immune system population, where they go 28 days after they got the second shot and get the third shot of either Moderna or Pfizer vaccine. So that's the third dose and then the booster is a little bit different. And that's what we're hearing about that we'll hear about more in the coming days and that's for the American population at large.
So now, we're talking about booster shots and what that means is that the individuals got the first two and they developed antibodies, we presume and we know from clinical studies and they built enough protection, but then the protection decreases over time, which is called waning immunity. And so the plan is to give these COVID-19 boosters when this waning immunity happens to boost their immune system. So that's what that is.
And I know we're hearing a lot about it. The Food and Drug Administration Vaccines and Related Biological Products Advisory Committee is meeting on September 17th to kind of give us more information about the plan, meaning who will go first in terms of the rollout? Will it be Pfizer and Moderna at the same doses? All these technical details that we're going to work around will hopefully be sorted at that time.
Caitlin Whyte: Now let's talk about breakthrough cases. How common are they? And what would you tell someone who says, "You know, why should I get the COVID vaccine if I can still get COVID?"
Shalika Katugaha, MD, FACP: All right, here we go. So, breakthrough infections, just to define them, they're any positive tests for infection with the virus that causes COVID occurring more than two weeks after someone has gotten the final dose of a COVID vaccine. So these breakthrough infections are not common, though we're seeing more of it in the news and the media, they are not very common. So your likelihood of getting a breakthrough infection is probably one in five to 10,000. People say that's around 0.02%.
So basically, we are seeing around 35,000 breakthrough infections a week, and that is in context of the 171 million vaccinated Americans that we have. So it's actually a smaller number than we think. Breakthrough infections are expected when more of a population gets vaccinated. Then, we'll see more of these breakthrough infections. But the thing to remember is that vaccines are still doing exactly what they were intended to do, which is protecting and preventing severe illness. So what we really want vaccines to do is to prevent people from getting severely ill, hospitalized, and dying. And they're actually doing that quite well. In fact, so much so that with Delta, COVID has become a pandemic of the unvaccinated. So really vaccines are doing what they were intended to do, which is saving lives.
Next point is that yes, vaccinated people can transmit the virus, but they do it for a shorter amount of time. That's because you already have an army of antibodies ready to fight the virus when the virus enters your system. So, yes, while there may be very high viral loads of Delta in the nares of vaccinated and unvaccinated, the vaccinated group will shut it for a shorter period of time.
So I know the thought is it's tempting to say, "Well, I got the vaccine. I'm going to get COVID anyway, what's the point?"? But actually, the point is that you will be less severely ill. And the point is you will have less symptoms. And in fact, there's been a recent study showing that you are half as likely to have long COVID, which is symptoms lasting more than a month if you get the vaccine.
Caitlin Whyte: Now, another vaccine that we're talking about is the flu vaccine. As we head into fall, the CDC recommends everyone over six months old get one by the end of October. So do I really need a flu vaccine if I have the COVID vaccine?
Shalika Katugaha, MD, FACP: Yes. They do not cross react and you don't get protection from the flu from getting the COVID vaccine. So let me say a little bit, the flu virus circulates annually in the United States, most commonly from the late fall to the early spring. Flu, usually people recover without serious complications, but it can cause serious illness in those who are older, very young, pregnant, or have underlying medical conditions.
So people say, "The flu season essentially disappeared last year. So why do I really need the flu shot?" Well, that's true. We had a record low in terms of flu cases last year. But last year, people were wearing masks with dedication, physical distancing, and then remotely working and remotely going to school. But now schools have opened, most people are actually going in for work, and people have become lax with regards to masking and social distancing. So we don't know what kind of flu season we're going to have this year. So it's still is to your benefit to prevent you from getting severely ill to get the flu shot.
So anyone who is over six months old to get the flu vaccine, the timing is, you know, it's offered by the end of October, so it's best to get it by the end of October. But if you miss that time, still by all means, go and get the flu vaccine. The 2021-2022 flu season will coincide with the continued circulation of the SARS-CoV-2, the virus that causes COVID. Getting the flu vaccine in general will prevent symptoms that can be confused with COVID. It'll prevent outpatient visits, hospitalizations, and ICU admissions as well, which could decrease the stress to the US healthcare system.
So there are many types of flu vaccines out there. They are all quadrivalent this year. That means they all work against four different antigens. There are types that do not use eggs, so that, you know, people with an egg allergy can go get them. So, yes, the flu vaccine is very important this season.
Another big question that I get is that can we co-administer the COVID vaccine with the flu vaccine, and the answer is absolutely. And we're doing that here at Baptist. There is no reason to think that efficacy or safety of either vaccine would be different. If you get them together. If they are given together, they should just be at different injection sites. We are preparing our COVID flu vaccine clinics as I speak.
Caitlin Whyte: Well, thank you for your time today, Dr. K. For more expert answers to your COVID-19 questions, visit covid19.baptist.jax.com. Baptist Health reminds you to wear a mask, social distance and get your COVID and flu vaccines. And thank you for listening. This has been Baptist Health Radio. I'm Caitlin Whyte. Stay well.