While Vermont has rolled out its initial Covid-19 vaccine plan, questions remain about when a vaccine will be available and how many doses the state will receive. Which at-risk populations will receive it first? How does immunity after contracting the virus compare to immunity from the vaccine?
Chris Finley, the immunization program director at the Vermont Department of Health, joined VTDigger on Wednesday to answer reader questions about the vaccine. Below is a partial transcript, condensed for length and clarity.
Anne Galloway: You're in charge of the state's immunization program. I wonder if you could talk about the efficacy of these two new vaccines by Moderna and Pfizer.
Chris Finley: I'm happy to have some good news to talk about. The two new vaccines, just this week, have released data that they have from what's called phase three. One vaccine was tested among 44,000 people, the Pfizer vaccine, and the other, the Moderna, was tested among 30,000 people. Either a half or two-thirds received the vaccine, and then the other group received a placebo. So it really allows you to compare how it worked. The Pfizer vaccine, I think you saw at 94.5% efficacy. The Moderna vaccine, as news came out early this morning, they showed 95% efficacy also.
The other important part is there aren't any safety concerns. There's been fatigue and some arm soreness and some different things, but no safety signals that really are concerning anyone at this point. That's really important news, I think.
Patricia from Manchester: I'm asking about myself — 69 years old with asthma — and my husband, 68 years old with COPD. Would we be in the group that would be able to get the vaccine after the first responders?
Thomas: I'm a 71 year old retired male. I have diabetes. I have asthma, I have high blood pressure. My lungs are in very poor shape due to having pneumonia many times. I want to know if I can get early on a list for vaccines. What do I have to do?
Chris Finley: You are the people that we really would like to see vaccinated in the early phase. Patricia, you knowingly identified that we expect vaccine to be limited in the beginning. And the very first group we're looking at — that the National Academies of Science, Engineering and Math, and the Advisory Committee on Immunization Practices for the CDC, have looked at and made recommendations — is for health care workers. But then within that first phase, it's called 1B, is looking at people with chronic disease, and those that are 65 years and older. And we know that we want to decrease the risk among those that get severe disease. So yes, you would be in one of the first groups. Health care workers is where I believe we'll be starting, and then moving on.
Anonymous reader: My question is about people who've had Covid-19, tested positive, but now test negative: Should they get vaccinated? Or do they already have their own immunity?
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Chris Finley: Remember that with this vaccine, there's a lot that isn't known. I think that sometimes people want things to be exact. And we're still learning so much with this, that we don't always have the exactness that we need.
There's not enough information currently available to infer for how long after infection someone's going to be protected from getting Covid. You've probably heard that it's called “natural immunity.” But it's such a new disease that we don't know that much. The early evidence suggests that the natural immunity might not last very long. There's studies going on to look at that. And so until we have a vaccine available, the ACIP isn't going to comment on it.
This advisory committee is meeting on Monday to review the vaccines. I think within two weeks or so we'll have some recommendation on whether you should be vaccinated if you've had the disease or not.
Anne Galloway: Are Vermonters going to get their fair share of the vaccine? If so, how is that going to work? And when might that happen?
Chris Finley: The vaccine will be distributed what they're calling pro rata based on population. We anticipate that Pfizer and Moderna will submit these applications very soon, and that they'll be reviewed over two weeks. It may take longer if there's questions.
We definitely expect vaccine. And on calls with CDC today and yesterday, we had some indication that if both make it through, we may get a little bit, or we may get our pro rata piece of both of those.
When it will be here is the $1 million question. Everybody wants to know. In order to be prepared, we're trying to think about the beginning of December. If it comes a little later, maybe we'll be even better prepared. But we're working on this to try and prepare for the beginning of December.
Anne Galloway: We also have a lot of questions about the logistics in terms of refrigeration and keeping the vaccine frozen. Apparently, it needs to be negative 94 degrees for a period of time. Our readers want to know, how can we be assured that will stay at the proper temperature through its chain of custody? Are there enough freezers around the state for distribution, especially to rural hospitals?
Chris Finley: The Pfizer vaccine is what's known as an ultra cold vaccine, and you're right, negative 94 degrees Fahrenheit or negative 70 centigrade. But it's being delivered in what's known as a specific thermal shipper that allows it to stay cold. Once we receive it, it will be put in ultra cold freezers, and we have a listing of where they're available in terms of hospitals here. The health department has one, and we're borrowing some from the UVM College of Medicine so that we will have an adequate supply.
That vaccine can be maintained with dry ice for up to 15 days and can be in a refrigerator for five days. So there's ways that you can work around it to be able to use it in both urban and rural areas. We're working with the state emergency operations committee, and they actually just developed a whole vaccine depot plan for really developing in intricate detail how those distributions will go.
The Moderna vaccine is a freezer vaccine. That's easy. We're looking at scenarios where we get one, we get the other, or if we get both, so that we're prepared for whatever we receive.
Rebecca from Dummerston: How will the state prep for large scale clinics if the vaccine needs to be frozen?
Chris Finley: Right now, we're working on enrolling hospitals, and then we'll be working on enrolling pharmacies. All states are initially distributing the vaccine through mass vaccination clinics just because there'll be limited doses and it’s hard to reach those people. But there's also a federal program that's providing vaccine directly to CVS and Walgreens for use in those patients in long term care facilities. That was about two weeks ago, they needed to sign up, and we had an overwhelmingly positive response: 100% of our skilled nursing facilities and assisted living facilities signed up for that program. Those two pharmacies will come into the facility and vaccinate people, and they'll do the second vaccine. They're going to actually commit a total of three clinics — you only need two doses, but they want to make sure that they catch everybody.
What we're seeing is that the national program may actually enroll more pharmacies. This is literally changing day to day. But the good part of that means the more places that we can have vaccine available, the better off we're going to be.
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FAQ Live is sponsored by Burlington-based Garnet, which provides both rapid antigen and PCR Covid-19 testing.
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