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Prakash Chandran (Host): This Healthy Conversations COVID-19 podcast was recorded on February 18th, 2021. We've all been living in a pandemic for over a year now and after months of anticipation, COVID vaccines are now being distributed to the public. There are so many questions surrounding the vaccines and we'll get the most important ones answered today. Let's talk about it with Michelle Shoresman, a Division Manager of Healthcare Access at the County of San Luis Obispo Health Agency.   This is Healthy Conversations, the podcast from Tenet Health Central Coast. My name is Prakash Chandran. So, first of all, Michelle, it's great to have you here today. I know that there are two vaccines that are currently available. Can you talk a little bit about them and maybe the differences between them?

Michelle Shoresman (Guest): Sure. We have both the Pfizer and Moderna vaccines here in SLO County. And for most people, there are a few behind the scenes differences between the two. Those are mostly related to the freezing and refrigeration and vaccination process. But for the purposes of the average person who's receiving vaccine, there really is very little difference between the two. So, both vaccines are about 95% effective after each second dose. Both require that second dose for a maximum effectiveness. The only difference really is that the Pfizer vaccine, the manufacturers of that one, they recommend that you get the second dose a minimum of 21 days after the first dose and for the Moderna vaccine, that timeframe is 28 days. But with either vaccine, the CDC has opined that you can wait up to six weeks before you get that second dose.

Host: Okay. So, you're mentioning the second dose. I've always wondered why exactly do they require two doses?

Michelle: The two doses basically increase the efficacy and boost the ability of your body to make antibodies, to protect against the virus. So, it's like a booster shot that you got when you were a kid. With just one dose, studies are showing that the vaccine is about 80 to 90% effective after about two weeks after the first dose. Whereas two weeks after the second dose, studies are showing that the vaccines, both of them, are about 95% effective. So, that second dose just boosts your body's ability to make antibodies and helps your immunity last a little bit longer than if you just got one dose.

Host: Now we've kind of been hearing about these different strains or mutations of COVID coming down the pike. If you get vaccinated with one of these vaccines, will it protect you from those mutated strains of coronavirus?

Michelle: What we're hearing so far in California and let me be clear that so far in San Luis Obispo County, although we have had some genetic testing done of samples from SLO County cases, we haven't seen any of those variants yet here locally. But the information that I've received so far is that of those variants that have been seen in the state, the vaccines that we have currently still are presumed to be effective against them.

Host: Okay. That makes sense. So, moving back to the vaccine itself, I'm sure there are people that want to know about the different side effects. So, can you speak to those a little bit?

Michelle: Yes. It really depends on the individual. Some people receive very few side effects. It can be even less, mild than a typical flu vaccine. But what we do see when people do experience side effects is that they are relatively minor. Some people will get a sore arm you know, soreness around the injection site. And then especially what we're seeing is after the second dose, when your body has really worked already to create some immune response to the virus, we're seeing a few people get some minor flu like symptoms. So, a little bit of achiness, you know, a little bit of nausea maybe. But most of those side effects can be handled pretty well with acetaminophen or ibuprofen.

Host: Okay. And just to be clear that you mentioned some of those side effects after you get the vaccine itself, aren't you supervised for a certain amount of time after the first and second one, just to make sure nothing happens.

Michelle: Yeah, good point. Thank you for that clarification, because with a typical flu shot, you'll go to the pharmacy, you'll get a flu shot and you'll walk away. Because this is a new vaccine, it does require that you take a little bit longer at the vaccination clinic. You don't just get the shot in the arm and walk away. You're assigned an either 15 or 30 minute observation period where you'll go into a room and sit in a chair and there will be a paramedic or other medical professional there, that's just kind of monitoring the room to make sure that there aren't any adverse reactions. We have not seen any serious adverse reactions to the vaccine locally. And we're, you know, we're well over 23,000 doses administered so far at our vaccination sites. So, that's good news.

Host: Well, yeah, that is very reassuring. So, you were talking about a vaccination clinic and vaccination sites. So, maybe expand a little bit more on the current methods of vaccine distribution.

Michelle: Yeah. We currently have three County sponsored vaccination clinics that have been set up across the County. We have one at Arroyo Grande High School. We have one at Pasa Robles Event Center, and we have one set up kind of centrally at Cuesta College. So, those are the three locations that probably a majority of people are getting their doses right now. There are a few other providers that have signed up to become certified vaccine providers, and we have those listed on our website at recoverslo.org/vaccines. And as new providers come online, we are adding those to the list. So, people have kind of a one-stop shop where they can go to find out who is distributing vaccine and get links to make appointments at those locations.

Host: Okay. So, you had talked about that recoverslo.org/vaccines, being the place to look at the different distribution sites. But what about the list of people or knowing when they're able to be vaccinated? Can you talk a little bit more about like the priority list and how it's decided and who gets the vaccine when?

Michelle: Yeah. So, I know that has been confusing for people. We locally, are following the federal and state guidance around how vaccines should be distributed when they are in short supply. I think as most people know, the vaccine has been coming more slowly than any of us would like. And so under those circumstances, there is a tiered phased priority system for giving out vaccine. We are, as I said, we are following the state and federal guidelines. So far in our County, we are currently vaccinating those 65 and older. In addition to those, we are vaccinating groups that were approved before the 65 and older age group, which includes most different types of health care workers or people that take care of individuals that are medically compromised or have disabilities.

So, that's you can get it right now in our County. There is, as I said, a tiered system that will be coming next and we've also established locally, a local vaccine task force, that while supplies are limited, are trying to help us interpret and differentiate with a limited amount of vaccine, which groups locally are most important to go and what order they should go in.

Host: So, speaking of the different tiers, how might someone know that their tier is up and then how can they then make an appointment?

Michelle: We have a number of methods to kind of stay informed with what's happening here locally. If you have access to the internet, that's the best way to get all of our information at your fingertips. We have a couple of websites. One of them is readyslo.org. That website has all kinds of information about how we've been responding to the pandemic, how we've been dealing with the different limitations on activities, the different guidances for different sectors of our economy that have been coming down from the state.

We also post all of our press releases, media briefing videos, all of that can be found on readyslo.org. We have a second website called recoverslo.org/vaccines. And at that website, you can find all the information about who's able to get vaccine now, who's coming up next, information about the taskforce deliberations and how to provide them public comment. We also have a link that you can go to, it's emergencyslo.org/subscribe, where you can sign up to email for email alerts on all of the different changes that are happening as they happen.

Host: Okay, that's great. And so that's ready.slo.org for general response information and how you're responding to it. Recoverslo.org/vaccines for information about the vaccine distribution as well as any other information around your tiers. And then emergencyslo.org/subscribe to get email alerts. Is that correct?

Michelle: Correct. Wow you got all that good. I will add too though, that people that do not have access to the internet or just really need to talk to somebody, we know that a lot of the population that is currently eligible for vaccine may not be the most computer savvy group out there. So, we also have a phone assistance center that's staffed by wonderful individuals, seven days a week, between 8:00 AM and 5:00 PM. And there, you can talk to somebody. They can answer any kind of question for you about the virus or about vaccine availability, and they can also help people who don't have internet access make appointments for the vaccine clinics and that number is (805) 543-2444. So, those are really the best ways to stay up to date with all of our information for SLO County.

Host: Very helpful. So, moving on, there's inevitably going to be people that will have already had COVID-19 and they're probably wondering, do I even need to get vaccinated? Have I built up an immunity because I've had it already? So, can you speak to that question?

Michelle: Yes. The short answer is yes. If you've had COVID, you should still definitely get vaccinated. However, because your body has already built up antibodies to the virus because you were sick, you don't need to worry about getting the vaccine right away while maybe vaccine is in very short supply. Instead, we ask that while the vaccine quantities are limited, people who have had COVID-19, they can wait at least 90 days before signing up for an appointment to get vaccinated. And that will give those who don't have any immunity to the virus an opportunity to sign up for those appointment slots first.

Host: Okay. And, you know, you mentioned the two vaccines Pfizer and the Moderna one. You mentioned they're 95% efficacy, especially after that second shot. But if someone, for example, has a preference, like they've heard better things about the Moderna vaccine, are they able to choose which one they get?

Michelle: You know, we've had that question before and because of the way the vaccine distribution is rolling out and coming to us, we really can't allow people to have that option at this point. The good news is, as I said, both vaccines are equally effective. Both have been put through very rigorous testing in order to get to the point where we can put them in the arms of members of the public. So, there really are no safety concerns about either one. The reality is that the distribution of two different vaccines, pose some logistical challenges in terms of the backend stuff that I was mentioning at the beginning of our interview, freezing, refrigeration, transporting of the vaccine. And because of all those limitations, we often only have one vaccine type available at each site.

And so if you make an appointment, you're really making an appointment for a vaccine. We can't necessarily differentiate or maybe even know more than a week in advance, which vaccine will be at which site. The only caveat to that I would say is that if you've had one type of vaccine for your first dose, you need to get that same type for your second dose.

So, in those situations, while we generally say, go back to wherever you got your first dose to get your second dose, you really have to go to a place where the vaccine that you're being provided or that is available, is the same vaccine that you got for your first dose. So, we make that clear in the process when you're signing up for a second dose appointment. That process is completely different from the way you sign up for our first dose appointment. So, we're pretty careful to make sure that everybody gets the right vaccine. But we just don't have the quantities available and the logistics available to offer you whichever one you choose.

Host: Yeah, that totally makes sense. So, you know, just as we close here, from everything that I've heard and everything that you said today, there really is you know, no downside to getting the vaccine. I know my parents have gotten it and I'm really grateful for that. I'm very excited to get it for myself, but still there's going to be a group of people that they're just apprehensive about getting it for whatever reason. What might you say to them?

Michelle: Yeah, I hear a lot of concern from people. This is a new vaccine. The creation of it, some people perceive was rushed, maybe. Those are all really myths. These vaccines have gone through, as I said earlier, very rigorous testing. They have been tested over and over again in multiple laboratories. The mRNA vaccine types, there was some controversy around that in the early days of the pandemic, because we don't have, haven't seen this type of vaccine before. It's completely new. But the reality is that the science that goes into creating these mRNA vaccines has been around for a very, very long time. So, it's not really as new as people might perceive it to be.

And giving the vaccine has been such that there is very little to fear from this. I think it is truly one of our main ways out of this pandemic, in addition to all of the different efforts that we've been encouraging all along now, staying home if you're sick, frequent hand-washing, wearing a mask if you have to be out in public. But creating widespread immunity against COVID-19 is the way that we're really going to finish this thing off.

Host: Absolutely. And final question. Is there anyone who should not get the vaccine? For example, if you're pregnant or if you are of a certain age group or have a certain co-morbidity, can you speak to if there's anyone at all who should be considering not getting it?

Michelle: You know, there is a very, very small percentage of the population that I wouldn't even say that you for sure shouldn't get it. I would say you should be aware of what your potential impacts might be, and you should go through the screening process to see if the medical professionals there at the vaccination clinic, at the distribution site think that it's safe for you to get or not. They will advise you. Nobody wants to see anybody who shouldn't have this vaccine get it and have a problem with it. So, there is a screening process at our vaccination clinics. You have to fill out a form when you make your appointment. You have to answer a series of questions about previous history with allergic reactions to vaccine and related questions like that. Ask about it asks about pregnancy, I believe too. So, you fill out that form, you have it reviewed by a medical professional. If they have any concerns, they will consult with the CDC guidance to make sure before they put you forward through the rest of the process and put a dose in your arm. So, I think there's really no. There's no downside to, to trying and see if it's appropriate for you or not. And if you, if the medical professionals deem that you're not appropriate, then you won't get the vaccine.

Host: Well, Michelle, I really appreciate all of the information that you shared today. Thank you to you and your team just for taking care of us and making us feel reassured that this vaccine is the right way to go. And there's only upside really to it. So, thank you so much. That's Michelle Shoresman, a Division Manager of Healthcare Access at the County of San Luis Obispo Health Agency. For more information and I'm going to give you a couple of resources here. You can visit readyslo.org. And that's going to give you more information about the response and the vaccine rollout. You can also visit recover.Slo.org/vaccines to learn more about the different vaccine distribution sites, as well as when your group is ready to get vaccinated.

And then finally you can visit emergencyslo.org/subscribe to get email alerts. And if you don't have access to the internet, or you just want to talk to someone on the phone, we're definitely here for you. You can call (805) 543-2444 from 8:00 AM to 5:00 PM and there will be people ready to answer any questions that you might have.

Finally, if you found this podcast helpful, please do share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. This has been Healthy Conversations, the podcast from Tenet Health Central Coast. Thank you so much. And we'll talk next time.