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Your Vaccine Questions Answered

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The coronavirus vaccine distribution has been confusing at best and messy at worst. Not to mention the vaccine is new and you want to know more about it before deciding whether or not you will sign up to get it. KPBS Health Reporter Tarryn Mento asked Dr. Christian Ramers to answer your questions.

Speaker 1: 00:00 The Corona virus, vaccine distribution has been confusing at best messy at worst. Not to mention the vaccine is new and you want to know more about it before deciding whether or not you'll sign up to get it. Well, KPBS health reporter Taryn mento asked Dr. Christian Ramers to answer your questions. Dr. Ramers specializes in infectious diseases as an assistant professor at SDSU and sits on San Diego counties, vaccine clinical advisory group. Here's that interview,

Speaker 2: 00:28 Dr. Ramers. Thanks for joining me to answer questions from the audience. Thank you for having me. I want to begin with a question that's on a lot of minds, Doug Szymanski of Rancho Penasquitos asks about vaccine distribution here in San Diego. Okay.

Speaker 3: 00:50 And they're 65 and older. Why do we have the delay in San Diego or so that's a really good question. And I understand it's been quite chaotic for people to watch what's going on. Part of the reason is because you have several different entities, uh, giving their own guidelines of, of who gets the vaccine next. Remember this started with the national Academy of sciences and then the CDC has the advisory committee on immunization practices. The state of California has now stepped in and, and they're pushing some guidelines out as well. And it's trying to balance many competing factors. We don't want these guidelines to slow down the distribution of vaccines. And then vaccine numbers are being distributed at different rates to different counties. So the reason some people in lower tiers may be getting vaccine first is because a vaccinating entity may have leftover doses that they wanted to reserve for a higher tier, such as phase one, a or healthcare workers.

Speaker 3: 01:49 And let's say some people miss the appointment or decline the vaccination. What do they do with those leftover doses? I think everybody has said that you are encouraged to use them into lower tiers. There's also been a little bit of mixed messaging coming from the state where the state says phase one B is age 65 and up. Whereas we know that people age 75 and up are higher risk. And that's what the original recommendation was. So different counties in different entities are at slightly different levels. There we're all moving towards the same thing. And I think it's going to be just a matter of the supply pushing through where we're going to get through these phases in an orderly fashion

Speaker 2: 02:22 Quick follow-up what do you know about supply as it varies from jurisdiction to jurisdiction?

Speaker 3: 02:27 I don't know much. I know that it's coming in through the state. It's coming out to the counties. I can just say for sure, overall, we don't have enough vaccine to move forward as quickly as we want to be doing

Speaker 2: 02:37 A common question we get from people is when will they be able to get the vaccine? We know there's a tiered system, healthcare workers, and those in long-term care facilities where first the County recently allowed people 75 years and older at its sites. You sit on the county's vaccine clinical advisory group that is supposed to inform rollout eligibility in these later tiers. What input did the group provide ahead of the county's announcement this week to expand to people 75 and older?

Speaker 3: 03:04 So the advisory committee, you know, puts forth recommendations and we're getting it from all sides as well from CDC and from the state and from what we think should be done. Um, we understand that it's been very confusing for everybody. One of the main recommendations that we had to the County was to create a website or an app or a simple place where you could go to find out, um, when your, when your turn is up. But right now it's information, that's on the website by phases and by tears, uh, coronavirus, hyphen SD, uh, dot gov, I believe, but an app would be much more convenient and San Francisco has started rolling this out and the state of California has started rolling this out as well. It's my Very simple. You say your age, your underlying conditions, your occupation. And then it will let you know what tier you're in that I'm told is coming very soon.

Speaker 3: 03:50 And that has been a major recommendation of the committee to back to the County is that we need to do this right now. Now to answer a little more deeply in your question phase one B clearly when you broaden the group down to age 65, you get hundreds of thousands of more people. And yet we know that those that are older and 75 and older are the highest risk. So there's this sort of two, two tiered thing where we want to open as fast as we can. We don't want the rules to slow people down so much, but we still need to be prioritizing those who are at most risk. And then moving into further phase one B by occupation. We just don't have enough vaccine doses really available to get too deep into that

Speaker 2: 04:28 Debra Mendelson who lives in San Marcos wants to know when she will be eligible. She wrote it online that she is 60 years old, works as an independent home health caregiver and cares for two elderly individuals each in their own homes. She's wondering what tier does that put her in and what documentation would she need to see?

Speaker 3: 04:48 Yeah, that's a really good question. And you may have heard that phase one a, which has healthcare workers, our health officer, Dr. Wooten has defined a healthcare worker in the broadest sense possible. So somebody who is a certified in home caregiver, uh, in my opinion, uh, and I think in most vaccinators opinions would be, uh, uh, as a healthcare worker, uh, you know, by all intents and purposes, it should be included in phase one, a, um, that's where we come with this number of about, you know, 500,000 or so people that really should be in phase one a and we're still trying to work through that as we move forward into the next phase,

Speaker 2: 05:21 A specie of Ortega wanted to know when he too can get the vaccine. He is 69 years old and diabetic. So he's wondering when and how pre-existing conditions will be factored in, in the order of vaccine distribution.

Speaker 3: 05:34 It's a really good question. And it's evidence of just how confusing this can be because the state has said, phase one B actually can move down to 65 years old and above, but we don't have enough vaccine to cover all of those people. And so the County has prioritized 75 and above in that specific, uh, phase one B pre-existing conditions are not really even being considered right now at this phase. We're just going based on age. And what, if you look at the county's website, we're at phase one B now doing 75 and older, we're going next to 65 and older. So really a, this person is going to be next in line. Once that announcement happens, preexisting conditions don't really get factored in until phase one.

Speaker 2: 06:13 So him at 69 years old would likely wouldn't be able to get at first, when we expand to those that are 65 years and older,

Speaker 3: 06:21 That's correct. So that, that doesn't in phase one B the state has lowered this to 65 and older, even though earlier on, it was 75. So again, there's a two two-pronged thing here where we're saying that, uh, when it, when you're in one B you can go to age 65 and above, but 75 and above should be reasonably prioritized.

Speaker 2: 06:39 And now from Oceanside, Joyce Malloy has two questions for you. The first one is about storage,

Speaker 4: 06:45 The state of California, how are they keeping all these Pfizer vaccines at the correct temperature?

Speaker 3: 06:50 Yeah. So this question gets at part of the logistic problem. There's been many logistic, uh, uh, difficult things to, um, to go through minus 70 degrees is tough. And then as soon as you take it and thought out from minus 70 degrees, there's a limited half-life for that, uh, that vaccine is still be viable. And really this is the work, the, the really difficult implementation work from the state and the County working together, where are those freezers? Where can they reasonably store the vaccine? And then when you need to get it out to further and further away from that, uh, freezer, how can you ensure that there's going to be enough people there to receive the vaccine? This is why, you know, me as a, as a, somebody that works in clinics in some of our smaller clinics, it may not be the best place to give vaccine, because let's say you have five high risk people that need to be vaccinated. We thought a vile of that vaccine, and we can only find five. We need another five people to get vaccine. And one thing that has been emphasized over and over and over is we cannot waste this vaccine. So if you have five people in front of you that are high risk, and you open a vial, you need to find another five, maybe by going down a tier or so to make sure those vaccines end up in people's arms.

Speaker 2: 07:55 And now to Joyce, a second question, given that the U S is rushing to give people their first shot, without a guarantee that the second dose will be available. She asks, do we have evidence showing that the vaccine will be effective if the second shot is given after the 21 to 28 day window?

Speaker 3: 08:13 Yeah, the answer to that is we don't have evidence. We have our scientific assumptions. We have a little bit of evidence from the clinical trials where they tested people in that short period between dose one and dose two. And we saw maybe a 50 to 80 or 90% efficacy in that very short period, but there are no guarantees how long that immunity is going to last and, and my own opinion. And that of many other scientists is, is that we really should use these vaccines as they were studied, uh, which is 95% efficacy with two doses. And it doesn't even start until about a week or two after that second dose.

Speaker 2: 08:46 Well, thank you very much, Dr. Ramers for answering these questions from our audience. Absolutely appreciate it. Thanks for having me. That was Dr. Christian. Ramers speaking with KPBS health reporter.

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Maureen Cavanaugh and Jade Hindmon host KPBS Midday Edition, a daily radio news magazine keeping San Diego in the know on everything from politics to the arts.