WESTFIELD — Megan Avallone, Westfield Regional Health director, hosted an open forum March 9 focusing on Covid-19 vaccinations. With the assistance of local healthcare workers, Ms. Avallone fielded questions about how the vaccines work, their effectiveness and their limitations.
Dr. Britney Alexander, second-year family medicine resident at Overlook Medical Center in Summit, explained that the Moderna and Pfizer vaccines are mRNA vaccines. These vaccines use mRNA that codes for the spikes that the Covid-19 virus has to trigger an immune response from the body. The body destroys the mRNA after recognizing the spikes and learning how to fight them.
The Johnson & Johnson vaccine uses DNA, Dr. Alexander said, and an adenovirus, similar to the Ebola vaccine. An adenovirus usually causes the common cold, but in this case has been altered to not cause any symptoms and is instead used as a method for the vaccine to enter the body. She emphasized that the vaccine does not alter the body’s DNA in any way and is broken down once the body notices and fights it.
Moderna and Pfizer are among the first mRNA vaccines, she said, but the concept of using mRNA in vaccines has been studied for more than 10 years. The amount of funding for a Covid-19 vaccine helped scientists create the vaccines, which have been “tested by the FDA vigorously,” she said.
Dr. Alexander said the vaccines have very few contraindications, or conditions that serve as reasons to not get the vaccines. “The big contraindications are an allergic reaction to any component of the vaccine,” she said. She said the allergic reaction rate is 4.7 people per million for Moderna and 2.5 per million for Pfizer.
Dr. Janice Baker, associate director with Overlook Medical Center and Chatham Medical, said common side effects of the vaccines include sore arms, fatigue, headaches, nausea and fevers. These effects demonstrate that the immune system is “mounting a response,” she said.
More serious reactions are rare, but one is Bell’s Palsy, a temporary facial nerve palsy, although the rates are not higher than the general population rate so it is not clear if the vaccine causes the palsy.
“The (vaccine) production is very new — the technology is not, … but these particular vaccines have been in existence for a very short period of time, so ongoing studies are continuing, but at this time there are no long-term side effects of the vaccine,” Dr. Baker said. She said scientists know that Covid-19 itself can have long-term effects like fever, fatigue, joint pain, depression and shortness of breath, so “the disease is worth preventing.”
Dr. Baker said one rumor she wanted to address is the idea that the vaccine could make people infertile. “There’s absolutely no evidence and no theoretical reason why a Covid vaccine, or any vaccine, could affect fertility in men or women,” she said.
Dr. Baker said all three vaccines are “unbelievably effective.” Pfizer is 95 percent effective in preventing symptomatic Covid-19 cases two weeks after its second dose. Moderna is “virtually the same” — 94.1 percent effective in preventing symptomatic Covid-19 infections. However, she noted, the studies for Pfizer and Moderna were done before the emergence of the U.K., South African and Brazilian Covid-19 variants.
The Johnson & Johnson vaccine is 72 percent effective against moderate to severe disease in the United States.
“One’s first reaction is, ‘Eh, 72 percent? That’s not so good,’” Dr. Baker said. “It’s unbelievable — like I said, it’s much, much higher than almost any of the other vaccines we have. … And it was tested three weeks after one dose.”
A one-dose vaccine is much easier to produce and to distribute to residents, she said. She said that it is 85 percent effective against severe disease with no difference across eight countries and that there were no hospitalizations or deaths in the 28 days following the vaccinations.
The vaccines were all tested very differently so it is difficult to compare them, Dr. Baker said. Dr. Alexander said the best vaccine a resident can get is “any vaccine you can get in your arm.”
“We don’t know yet — there’s a lot we don’t know yet — if the vaccines can prevent asymptomatic infection because the trials were testing for symptomatic disease,” Dr. Baker said. She said public health officers also do not know if vaccinated people can still transmit Covid-19. She said that tests are ongoing and that early data from Israel, where a large percentage of the population is vaccinated, hints that the vaccine will help lower transmission, but more research is needed. Vaccinated individuals should still wear masks in places where people may not be fully vaccinated, she said.
Ms. Avallone reminded viewers that nonessential travel is still highly discouraged even if residents are vaccinated. If residents must travel outside the immediate area, she said, they are expected to quarantine for seven days upon their return after receiving a negative Covid-19 test.
A resident asked how the vaccine will be a solution to the pandemic if it does not prevent Covid-19 infections, just symptomatic cases. Dr. Baker said that while scientists remain hopeful that the vaccines will decrease both symptomatic and asymptomatic cases, decreasing the overall number of cases will help hospitals control serious illness. Ms. Avallone echoed that public health officials are optimistic that the vaccine will help people avoid Covid-19 asymptomatically.
