Merced County Times Newspaper
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Pfizer vaccine roll-out underway in Merced County as COVID cases surge

 

Pfizer-BioNTech Coronavirus vaccine sufficient for 975 doses was scheduled to arrive in Merced County on December 17 or 18, and its roll-out will soon be well underway.

Salvador Sandoval, M.D., MPH, Merced County Health Officer, told the Times, “Over 21,000 deaths in the State from March 2020 to now meant drastic measures needed to be taken.

“That number doesn’t take into consideration the number of people hospitalized.  The impact is more than just deaths.  Other impacts are people dying because they were afraid to go to the hospital for illnesses like cancer.  The mortality rate for non-COVID deaths has definitely increased from last year or the year before.

“I’m glad we’re at this point where we have a vaccine, and it is faster than most of us expected.  It’s very hopeful.”

Although the vaccine was approved for emergency use on December 11 by the Food and Drug Administration (“FDA”) and the Centers for Disease Control and Prevention (“CDC”) which consider it safe and effective, the fact it was developed so rapidly is a concern to some residents who are in the process of making the important decision about whether to take it.

California Governor Gavin Newsom tasked the 11-member Western States Scientific Safety Review Workgroup, a scientific group evaluating COVID-19 vaccines, with providing an additional layer of review beyond the FDA to reassure residents who might be afraid to take the vaccine.

The Workgroup concluded on December 13 that the Pfizer-BioNTech vaccine should be made available to the people without delay.

Dr. Sandoval told the Times, “It’s a no-cost vaccine.  If we can reach 60% to 70% of people with the vaccine, which is how we achieve herd immunity, we can start really seeing a tremendous change and probably the start of the end of the pandemic.  It is projected by Spring and Summer, we will be in Tier 3, vaccinating the general population.”

The virus was new and very contagious, and no one in the world was ever exposed to it, so it was able to spread rampantly.

Dr. Sandoval explained that herd immunity is important.  The concept is if you get enough people that are immune to the virus, then it can’t transmit as easily.

“It will still linger in the community, but it won’t be as easy for it to spread,” he said.

“We encourage everyone to get the vaccine to protect the general public, which is the most humane way to address a pandemic.

“There probably will be people who don’t want to get vaccinated initially, but we will make sure as many as want it get vaccinated to provide a measure of protection so the virus can’t spread so easily.

“Moderna is expected to be approved by the FDA on December 21.  Both Pfizer and Moderna are going to require a second dose.  Pfizer is three weeks and Moderna is four weeks.  It’s best to get the same vaccine to boost the power of the initial injection.

“Other vaccines are entering Phase 3 trials so by the Spring and Summer, we might have other options besides these two vaccines.

 

Is the Pfizer vaccine safe?

Dr. Sandoval responded, “There is no absolute guarantee, but there are safety measures in place.  The V-Safe app, which people are informed about as they are being vaccinated, allows them to report symptoms or reactions, and get a response.  They can also call the CDC Vaccine Adverse Effects Response System, another site to report symptoms.

“This vaccine has been promoted quickly but it was based on experiences we’ve had with previous epidemics, SARS (Severe Acute Respiratory Syndrome) Middle East Respiratory Syndrome (MERS) and Ebola.

“The technology developed in previous epidemics was used, and the study that shows the vaccine is 95% effective is tremendous.  There were mostly low side effects.

“Some of the vaccines coming down the pike are building off experience with these epidemics.  The Ebola vaccine is a model for making a Coronavirus vaccine, and there’s one for SARS which uses protein subunits and there are different strategies, all based on science and experience, which has shaped the development of this vaccine.

“The Moderna vaccine will be ready after the 21st of December and may be rolling out in January.  But Pfizer is available now and with our skyrocketing numbers, I think we should start with what’s available.”

In what order will people receive the vaccine?

“The way the vaccine is being rolled out is really important.  It’s being rolled out based on vulnerability.

“It is targeting the hospital staff that is critical.  One of the difficulties is when the hospitals are overwhelmed and you don’t have staff, there is more morbidity.  So targeting ICU’s and ER Departments and the floors is key.

“Some of the vaccine is going to be sent by Merced County Public Health to two hospitals – – Los Banos Memorial and Mercy Merced.  The time clock will start ticking and they have to arrange the vaccinations to make sure they get them done within the time frame.  Public Health is handling the distribution to hospitals and a number of Emergency Response staff, such as paramedics and Emergency Medical Technicians (EMT’s).

“Also, since 40% of the deaths nationally have been in nursing homes, those are the other places to start.

“The pharmacies, Walgreens and CVS, are going to be receiving an allotment to give out to nursing homes.

“The next targeted groups include the essential workers, such as grocery workers, and workers in shops that are essential.  Teachers are going to be targeted earlier on and health staff in schools.  Those will be targeted after initial Tier 1.

“The next group is age-related, as well as those with pre-existing conditions like diabetes, cancer survivors, those with heart and lung disease, and people with lower defenses.

“Then, the general public will be vaccinated.

“The vaccine has been studied in groups age 16 and above, and approved by the FDA for that group.

“Older children such as 16-year-olds can transmit it and get sicker than younger children so they may be a targeted focus later on in the roll out.”

 

What are the issues with the Pfizer vaccine roll out?

“Rolling out the Prizer vaccine is just a logistical issue.

“This first vaccine, Pfizer, is very temperature sensitive.  It must be stored at a temperature between 112 and 176 degrees below zero Fahrenheit, so you need an ultra low temperature refrigerator for that.  That has been a logistical issue complicating the distribution of the vaccine.

“Ways to keep the temperature within that range include dry ice, so that can be used when shipping the vaccine from the distribution center to the sites administering the vaccine.

“The refrigeration for the vaccine initially coming to Merced is available starting today [December 16].  All the temperature adjustments will be worked out to make sure the vaccine stays viable so it can be distributed to the hospitals.

“The vaccine has to be given out fairly quickly to make sure it’s effective.  Once it is taken out of the refrigeration and put in dry ice, it’s good for five days so the sites have to have in place those people who are going to be vaccinated.

“The plan is they are going to stagger them.  For example, they don’t take out all their ER staff at the same time to be vaccinated.  The hospitals will make sure they have only a portion of their ER and ICU staff and janitorial staff and other staff that is in direct contact with COVID patients receiving the vaccine at one time.  Because of their important duties, they can’t afford to have the staff leave at the same time.”

 

The risk of contracting the virus versus the risk of taking the vaccine

“The disease has ramifications, like people developing strokes and heart trouble at a young age and blood clots in the legs.

“We know the virus has long-term effects in all age groups.  It looks like it has taken people months to recover from it.

“We’ve also seen people who have gotten the disease and then developed it again several months later.

“People don’t usually think about these issues associated with a respiratory virus but it has many other manifestations.

“Also, younger people can transmit the virus to their elderly parents or older family members or friends.  On holidays, we’ve seen elderly people exposed by their children or grandchildren.”

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