Selected Podcast
COVID-19 Vaccines - What You Need to Know
COVID-19 vaccines are becoming available. What do we know about them. What are the differences? Should I get vaccinated? Where and when can I expect to get vaccinated.
Featured Speaker:
Carissa Bortugno, Pharm. D
Carissa Bortugno, a doctor of pharmacy, is senior director of clinical support services at Henry May Newhall Hospital, where she oversees the hospital's pharmacy, laboratory and imaging services. Transcription:
COVID-19 Vaccines - What You Need to Know
Melanie Cole (Host): Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole and I invite you to listen as we discuss COVID-19 vaccines, what you need to know. Joining me is Dr. Carissa Bortugno. She's the Senior Director of Clinical Support Services at Henry Mayo Newhall Hospital. Dr. Bortugno, it is a pleasure to have you with us. What an important topic we're discussing today. So, let's jump right in with, what do we know now about the vaccine? What vaccines have been approved and how does Moderna and Pfizer differ? Tell us a little bit about what we know right now.
Carissa Bortugno, Pharm. D (Guest): So, as far as the Moderna and the Pfizer vaccines, they actually work very similarly. They both use mRNA technology to pretty much tell your system to put a similar protein on yourselves, a spike protein. So, they work by very similar mechanisms of action. There's not really much difference, between the two.
Host: So, you mentioned the mRNA technology. Is this new? Is this not proven? As I understand, it's been around a long time, right?
Dr. Bortugno: Yeah, it's been around for, I would say at least 10 to 15 years. It's used in a lot of our immunotherapy medications that have been on the market. It's a well-researched technology. So, that's how the vaccine was able to be so quickly developed is because that information was already available to kind of jumpstart to the research process for developing these vaccines.
Host: I'm so glad you pointed that out because that's been something that's gone around. People have said, well, it was developed too quickly and I don't know that it's safe, but it isn't. This technology has been around. So, what do we know about the safety and efficacy of the vaccine itself?
Dr. Bortugno: So, as far as the studies have shown, the vaccine has proven to be very, very safe. Obviously, with any vaccination, you're going to have your typical side effects, you know, soreness of the arm, you can have fever, chills, things like that. But those are typical of most vaccinations that are already out on the market. As far as safety profile, from what we've seen from the clinical trials on these vaccines, they do appear to be very safe and as we have started vaccinating staff in our hospital and in our community, we have seen that to be true.
Host: It's so exciting and really amazing, actually. So, tell us now, some of the semantics here. How many doses do we need and how do you see this playing out? Discuss a little bit about timeline implementation of the vaccine. How is that working?
Dr. Bortugno: So, currently for the Pfizer vaccine, you do need two doses. One obviously is day one and then 21 days later. With the Moderna vaccine, it's 28 days later, but there is a lot of flexibility with those days. So, the CDC just recently came out with some further guidance that the second dose of the vaccine can be delayed for up to six weeks and still be efficacious which really isn't surprising information. So, as you know, vaccines that are currently on the market, if you miss a dose or if you're get your dose late, they don't restart your series. They just give you your second shot and you move on from there. So, this is well established immunology that goes into the decision making on extending out the window.
Host: We've heard that the flu vaccine, they say, if you get the vaccine, you wait a couple of weeks, then you know, you're immune. What about this one? How long after getting second dose, do we feel that this will provide the necessary immunity?
Dr. Bortugno: So, they feel like about from what I've seen, about two weeks after the second dose, you start to see significant immunity. So, even after the first dose, about eight to 13 days after the first dose of the Pfizer vaccine, you're already looking at about 50% immunity. And from there, it kind of climbs week to week. And then once you get your second dose, about a week or two after that, you can reach close to that 95% immunity that they found in their study. So it's pretty quick.
Host: Now tell us about as far as this level of who can get it. And we're starting obviously with our healthcare workers. Cause that's so important. They've been on the front lines and man, we just can't owe them a big enough debt, but then how does it work? Is it elderly, assisted living, immunocompromised, who can, and can't get it? How is this leveling down working?
Dr. Bortugno: So, actually I know the CDC and the state, they are currently looking to revamp the guidelines a little. Initially they had looked at the 65 and older population and then they were going to go into kind of a risk-based criteria after that, you know, immunocompromised, things like that. What we found as we've started the vaccine rollout though, is it's very difficult to kind of prove those pre-existing conditions or even if you're a healthcare worker. So, I think CDC is moving towards just more of an age-based criteria. From what I'm hearing, it's probably going to go more strictly just based on your age and proof of, proof of age moving forward.
Host: Dr. Bortugno, what would you tell people that are hesitant or nervous about taking this vaccine?
Dr. Bortugno: The biggest thing is, like you said earlier, there is definitely a perception out there that this vaccine was made very quickly. So, just reassuring them that the technology behind this is not brand new technology. It was well-researched prior to the development and it kind of gave us a jumpstart on being able to develop this vaccine. Also that lot of things that I'm hearing is I don't want it to take a drug or vaccine that doesn't have any safety information on it. Like what's going to happen? Any longterm safety data, what's going to happen a year or three years from now. And what I would say to that is, every drug that comes on the market, none of them have long-term safety data available. So all we can look at is the data that is safety data for this trial period. But I think people think it's an odd thing that there is no long-term safety data.
That's how every drug is approved. There is never a long-term safety data available. But there are, well-researched methods for making these vaccines and other drugs. And I think the benefit definitely outweighs the risk of getting COVID and dying from it. So, I would definitely encourage people to take the vaccine. I know as my family becomes available to get it, I am recommending my own family receive the vaccine. And we've done a lot of research on it, so feel comfortable with recommending it to my family. So, just hopefully getting the word out there that this is not brand new information. It's really important that we get a hold of this virus and vaccination is a definite way to do that.
Host: My family too, Doctor, I'm absolutely, we're getting in line and I'm over 55. So, I'm going to get it before my husband. And I know my kids are going to be last in line, but I don't care we're in line. And so, it's really, as you say, something that we all need to do for the good of our entire country, for the good of the public health. Are there some people who cannot be vaccinated? What about women who are pregnant or nursing or people with immunocompromised situations, cancers, severe illness. What about them?
Dr. Bortugno: So, currently, the CDC guidelines actually recommends pregnant and breastfeeding women and to receive the vaccine. I believe there's really little to no risk of a breastfeeding mom receiving the vaccine. But all the gynecological and obstetrics organizations are recommending vaccination for pregnant mothers. There is not data out there in that population. But what we've seen is a lot of mothers are choosing to receive the vaccine. So, I'm sure that data will be coming out shortly because we do see pregnant mothers getting the vaccine right now. As far as immunocompromised, that's definitely a recommendation for them to receive the vaccine. They're at some of the highest risk for getting COVID and having increased mortality with those populations. So it's, definitely recommended for immunocompromised or other high risk conditions to receive the vaccine. Hopefully, as soon as they can.
Host: I only have a few more questions for you, Dr. Bortugno, but this is such important information, straight forward, from the experts, really important information. So, once we get the vaccine, people want to know then do they have to not wear a mask? Do they need to still follow safety protocols? Can they start to travel? How do you see this working out and kind of cascading down the line as far as loosening of some of the restrictions?
Dr. Bortugno: That is the big question. And I think, as we get further down the line and more and more people get vaccinated, we may see loosening of some of those restrictions. But for right now, not enough of the population has been vaccinated to stop wearing the masks and stop the social distancing.
So, I expect the masking and the social distancing and some of the restrictions to continue on until the majority of the population can be vaccinated. We're not going to start seeing a decline in our rates of COVID until we get the vaccine more out into the communities. So, I think it's important to continue with the social distancing and masking for the time being until we have more vaccine availability and more people are able to receive it. So, we might see some loosening of restrictions down the line. But right now, I think we're going to continue with what we're seeing.
Host: What about the variant? Dr. Bortugno, are we preparing for a possible second wave with this new - Do you think there'll be one? Will we be ready? Share some of the current surge plans what you're hearing among professionals and healthcare professionals about this possible variant. And while you're doing that, why don't you wrap it up with your best advice for the listeners in this very important topic that could save so many lives, about the COVID-19 vaccines and what you want us to know?
Dr. Bortugno: So, as far as the variants go, so there has been some preliminary data done by Pfizer and Moderna, and it is looking like the vaccine is going to be effective for some of those variants, but they are also in the works with a possible booster that has modifications in it to be able to quickly adjust if needed for the variants that we still may see down the line. So, they are already looking into how they can modify the vaccine slightly if needed in the future to continue protection for the population. I just really would encourage everyone to get the vaccine, if you're able. But to also please be patient. Obviously, we've heard that the vaccine supply is limited.
We definitely are seeing that at our hospital. It's not easy to get. So, please be patient. We're doing everything we can to get it out into the community as quickly as we can. But there are constraints. So, everybody just kind of has to wait for their turn and we hope we can get it out there as quickly as we can. And just encouraging everyone to definitely consider getting the vaccine. If you have questions about it, to reach out to your physician or your local pharmacist, or somebody in the area that you can talk to about your concerns, because we definitely are here to address and answer any questions anyone may have.
Host: Yes, you are. And that was excellent. So, informative, really great information. So, I hope listeners, that you will share this show with your friends and your family on your social channels. We're learning from the experts at Henry Mayo Newhall Hospital together. And this is excellent information. We all need to hear straightforward information about this vaccine to take away any confusion or hesitancy about getting it. It's good for the public health and it could save so many lives. If you have concerns, we encourage you to look for up-to-date COVID-19 information@henrymayo.com and click on the virus link at the top of the page for more information. That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. Please remember to subscribe, rate and review this podcast and all the other Henry Mayo Newhall Hospital podcasts. I'm Melanie Cole.
COVID-19 Vaccines - What You Need to Know
Melanie Cole (Host): Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole and I invite you to listen as we discuss COVID-19 vaccines, what you need to know. Joining me is Dr. Carissa Bortugno. She's the Senior Director of Clinical Support Services at Henry Mayo Newhall Hospital. Dr. Bortugno, it is a pleasure to have you with us. What an important topic we're discussing today. So, let's jump right in with, what do we know now about the vaccine? What vaccines have been approved and how does Moderna and Pfizer differ? Tell us a little bit about what we know right now.
Carissa Bortugno, Pharm. D (Guest): So, as far as the Moderna and the Pfizer vaccines, they actually work very similarly. They both use mRNA technology to pretty much tell your system to put a similar protein on yourselves, a spike protein. So, they work by very similar mechanisms of action. There's not really much difference, between the two.
Host: So, you mentioned the mRNA technology. Is this new? Is this not proven? As I understand, it's been around a long time, right?
Dr. Bortugno: Yeah, it's been around for, I would say at least 10 to 15 years. It's used in a lot of our immunotherapy medications that have been on the market. It's a well-researched technology. So, that's how the vaccine was able to be so quickly developed is because that information was already available to kind of jumpstart to the research process for developing these vaccines.
Host: I'm so glad you pointed that out because that's been something that's gone around. People have said, well, it was developed too quickly and I don't know that it's safe, but it isn't. This technology has been around. So, what do we know about the safety and efficacy of the vaccine itself?
Dr. Bortugno: So, as far as the studies have shown, the vaccine has proven to be very, very safe. Obviously, with any vaccination, you're going to have your typical side effects, you know, soreness of the arm, you can have fever, chills, things like that. But those are typical of most vaccinations that are already out on the market. As far as safety profile, from what we've seen from the clinical trials on these vaccines, they do appear to be very safe and as we have started vaccinating staff in our hospital and in our community, we have seen that to be true.
Host: It's so exciting and really amazing, actually. So, tell us now, some of the semantics here. How many doses do we need and how do you see this playing out? Discuss a little bit about timeline implementation of the vaccine. How is that working?
Dr. Bortugno: So, currently for the Pfizer vaccine, you do need two doses. One obviously is day one and then 21 days later. With the Moderna vaccine, it's 28 days later, but there is a lot of flexibility with those days. So, the CDC just recently came out with some further guidance that the second dose of the vaccine can be delayed for up to six weeks and still be efficacious which really isn't surprising information. So, as you know, vaccines that are currently on the market, if you miss a dose or if you're get your dose late, they don't restart your series. They just give you your second shot and you move on from there. So, this is well established immunology that goes into the decision making on extending out the window.
Host: We've heard that the flu vaccine, they say, if you get the vaccine, you wait a couple of weeks, then you know, you're immune. What about this one? How long after getting second dose, do we feel that this will provide the necessary immunity?
Dr. Bortugno: So, they feel like about from what I've seen, about two weeks after the second dose, you start to see significant immunity. So, even after the first dose, about eight to 13 days after the first dose of the Pfizer vaccine, you're already looking at about 50% immunity. And from there, it kind of climbs week to week. And then once you get your second dose, about a week or two after that, you can reach close to that 95% immunity that they found in their study. So it's pretty quick.
Host: Now tell us about as far as this level of who can get it. And we're starting obviously with our healthcare workers. Cause that's so important. They've been on the front lines and man, we just can't owe them a big enough debt, but then how does it work? Is it elderly, assisted living, immunocompromised, who can, and can't get it? How is this leveling down working?
Dr. Bortugno: So, actually I know the CDC and the state, they are currently looking to revamp the guidelines a little. Initially they had looked at the 65 and older population and then they were going to go into kind of a risk-based criteria after that, you know, immunocompromised, things like that. What we found as we've started the vaccine rollout though, is it's very difficult to kind of prove those pre-existing conditions or even if you're a healthcare worker. So, I think CDC is moving towards just more of an age-based criteria. From what I'm hearing, it's probably going to go more strictly just based on your age and proof of, proof of age moving forward.
Host: Dr. Bortugno, what would you tell people that are hesitant or nervous about taking this vaccine?
Dr. Bortugno: The biggest thing is, like you said earlier, there is definitely a perception out there that this vaccine was made very quickly. So, just reassuring them that the technology behind this is not brand new technology. It was well-researched prior to the development and it kind of gave us a jumpstart on being able to develop this vaccine. Also that lot of things that I'm hearing is I don't want it to take a drug or vaccine that doesn't have any safety information on it. Like what's going to happen? Any longterm safety data, what's going to happen a year or three years from now. And what I would say to that is, every drug that comes on the market, none of them have long-term safety data available. So all we can look at is the data that is safety data for this trial period. But I think people think it's an odd thing that there is no long-term safety data.
That's how every drug is approved. There is never a long-term safety data available. But there are, well-researched methods for making these vaccines and other drugs. And I think the benefit definitely outweighs the risk of getting COVID and dying from it. So, I would definitely encourage people to take the vaccine. I know as my family becomes available to get it, I am recommending my own family receive the vaccine. And we've done a lot of research on it, so feel comfortable with recommending it to my family. So, just hopefully getting the word out there that this is not brand new information. It's really important that we get a hold of this virus and vaccination is a definite way to do that.
Host: My family too, Doctor, I'm absolutely, we're getting in line and I'm over 55. So, I'm going to get it before my husband. And I know my kids are going to be last in line, but I don't care we're in line. And so, it's really, as you say, something that we all need to do for the good of our entire country, for the good of the public health. Are there some people who cannot be vaccinated? What about women who are pregnant or nursing or people with immunocompromised situations, cancers, severe illness. What about them?
Dr. Bortugno: So, currently, the CDC guidelines actually recommends pregnant and breastfeeding women and to receive the vaccine. I believe there's really little to no risk of a breastfeeding mom receiving the vaccine. But all the gynecological and obstetrics organizations are recommending vaccination for pregnant mothers. There is not data out there in that population. But what we've seen is a lot of mothers are choosing to receive the vaccine. So, I'm sure that data will be coming out shortly because we do see pregnant mothers getting the vaccine right now. As far as immunocompromised, that's definitely a recommendation for them to receive the vaccine. They're at some of the highest risk for getting COVID and having increased mortality with those populations. So it's, definitely recommended for immunocompromised or other high risk conditions to receive the vaccine. Hopefully, as soon as they can.
Host: I only have a few more questions for you, Dr. Bortugno, but this is such important information, straight forward, from the experts, really important information. So, once we get the vaccine, people want to know then do they have to not wear a mask? Do they need to still follow safety protocols? Can they start to travel? How do you see this working out and kind of cascading down the line as far as loosening of some of the restrictions?
Dr. Bortugno: That is the big question. And I think, as we get further down the line and more and more people get vaccinated, we may see loosening of some of those restrictions. But for right now, not enough of the population has been vaccinated to stop wearing the masks and stop the social distancing.
So, I expect the masking and the social distancing and some of the restrictions to continue on until the majority of the population can be vaccinated. We're not going to start seeing a decline in our rates of COVID until we get the vaccine more out into the communities. So, I think it's important to continue with the social distancing and masking for the time being until we have more vaccine availability and more people are able to receive it. So, we might see some loosening of restrictions down the line. But right now, I think we're going to continue with what we're seeing.
Host: What about the variant? Dr. Bortugno, are we preparing for a possible second wave with this new - Do you think there'll be one? Will we be ready? Share some of the current surge plans what you're hearing among professionals and healthcare professionals about this possible variant. And while you're doing that, why don't you wrap it up with your best advice for the listeners in this very important topic that could save so many lives, about the COVID-19 vaccines and what you want us to know?
Dr. Bortugno: So, as far as the variants go, so there has been some preliminary data done by Pfizer and Moderna, and it is looking like the vaccine is going to be effective for some of those variants, but they are also in the works with a possible booster that has modifications in it to be able to quickly adjust if needed for the variants that we still may see down the line. So, they are already looking into how they can modify the vaccine slightly if needed in the future to continue protection for the population. I just really would encourage everyone to get the vaccine, if you're able. But to also please be patient. Obviously, we've heard that the vaccine supply is limited.
We definitely are seeing that at our hospital. It's not easy to get. So, please be patient. We're doing everything we can to get it out into the community as quickly as we can. But there are constraints. So, everybody just kind of has to wait for their turn and we hope we can get it out there as quickly as we can. And just encouraging everyone to definitely consider getting the vaccine. If you have questions about it, to reach out to your physician or your local pharmacist, or somebody in the area that you can talk to about your concerns, because we definitely are here to address and answer any questions anyone may have.
Host: Yes, you are. And that was excellent. So, informative, really great information. So, I hope listeners, that you will share this show with your friends and your family on your social channels. We're learning from the experts at Henry Mayo Newhall Hospital together. And this is excellent information. We all need to hear straightforward information about this vaccine to take away any confusion or hesitancy about getting it. It's good for the public health and it could save so many lives. If you have concerns, we encourage you to look for up-to-date COVID-19 information@henrymayo.com and click on the virus link at the top of the page for more information. That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. Please remember to subscribe, rate and review this podcast and all the other Henry Mayo Newhall Hospital podcasts. I'm Melanie Cole.