Dr. Robin’s Covid-19 Updates

Vaccines…One Giant Step

But Still a Long and Winding Road

Photo by Dan Meyers on Unsplash

We are living in the age of miracles.

No one, not even Tony Fauci, dreamed we could go from learning the virus’ genetic sequence in January to putting vaccines into health care workers’ arms this week.

Things have happened fast — not dangerously fast, just amazingly fast — because of a ton of pre-planning. The technology for making vaccines with mRNA has been evolving for over a decade and the Phase I safety testing and the Phase 2 and 3 “effectiveness” (efficacy) trials were launched early and well.

Two important groups of scientists over the past few weeks reviewed data from Pfizer’s vaccine trials. On Thursday, the independent committee that advises the FDA reviewed the data publicly and recommended the FDA approve it.

Last Friday, December 11, the FDA said the Pfizer vaccine was a go. Next Friday it’s very likely they’ll say the same thing about the Moderna vaccine.

Some say Friday December 11, 2020 will go down in history as the day we began to recover from the pandemic.

I say Friday December 11, 2020 will go down in history as the beginning of the start of the first part of the initial phase of someday having things go back to something like normal.

Health care workers (and janitors and ward clerks) will get the first shots because they are the people who keep the hospitals running. Vaccines will also go right away to residents of long-term-care facilities.

The trucks carrying the vaccines are literally en route.

So everybody is now working overtime trying to figure out the logistics of getting those shots distributed: creating clinics, computer code, staff schedules, overnight.

Massachusetts General Hospital (MGH) is hoping they’ll give their first shots this THURSDAY, and aims to have their health care workers vaccinated by February. Other places started on Monday!

Even though it’s a huge logistical job to vaccinate all those people that fast, it’s going to be a cakewalk compared to vaccinating the rest of us hopefully starting in March.

First off, who is high priority and who gets it later? Talk about tricky.

It’s actually the individual states who decide who goes next. In Massachusetts the second phase will include teachers, transit workers, medically high-risk people, those with, for example, two co-morbidities. In adjacent states they may decide other groups have priority.

So where is your older Aunt Petunia going to be in all this? Will she be first in line because she’s got two risk factors, or later on because they’re not that bad? Nobody knows yet.

It’s also still unclear how and where she’ll get it. Will she need to line up at CVS, six feet apart at Town Hall, or at a mobile Vaccine Truck in a local park? Nobody knows yet.

Will it be March, or April, or May? How will she be reminded to go back for the second shot? Nobody knows yet.

How many kinds of vaccines will be available by March? Nobody knows yet. What about kids, pregnant women or women who are nursing? Nobody knows yet.

We are still building the plane while we fly it.

And this is a biiiiiiiiiiiiiiig plane — the largest public health project in the history of our world.

We do know that in the short-term the vaccines have seemed safe on the more than 70,000 people who have been scrutinized by hundreds of scientists and researchers. And we know there are protocols in place watching for side effects.

We do know lots of people get really sore arms, and in some groups more than 50 percent have a day of varying levels of misery due to fever, headache, body aches. So it’s not a free lunch. But so far, so good — the discomforts go away with in a day or so.

We do know it’s rare to see bad side effects happen more than six weeks after administering any vaccine — and so far that hasn’t happened with these vaccines. Time will tell.

We do know it looks like it works — boy oh boy, it looks like it works.

There were two groups of roughly 18,000 people in the Pfizer trial. One group got two doses of the vaccine and the another received placebos. If you got both vaccine shots, 8 people got Covid. If you didn’t get them, 162 got Covid.

Biiiiiiiiiiiiiiig difference.

And if you got the vaccine, your disease was much less likely to be severe.

There’s a lot we don’t know for sure. Data will accumulate — with longer follow-up, with more trials, with more time — and we’ll know more.

But we definitely know now we are living in the age of miracles.

On Thursday MGH announced they are opening clinics next week. They’re going to vaccinate our beloved heroic health care workers six days a week, twelve hours a day for weeks and weeks.

And then our time will come.

Nobody, not even Dr. Fauci, thought it could happen this fast.

Unfortunately, this won’t result in an instant return to normal. For a long time, more people will be unvaccinated than not and we don’t yet know if vaccines will have an impact on transmission.

We also don’t know how good the immunity will be, what kind of immunity it will be, or whether that immunity will last. We don’t even know yet for sure what’s the best test for immunity.

The bottom line is we have a lot to learn before we get to go back to some semblance of our old lives.

For now — until we do know more about all these things — we will have to continue to wear our masks, physically distance and avoid crowds.

But still, it’s a start. And it’s a biiiiiiiiiiiiiiig miracle.

{Robin Schoenthaler, MD is a Boston-based cancer doctor who has been writing straightforward fact-based no-blame-no-rumors-all-science-all-the-time essays about Covid-19 since March 2020.}

Covid-Translator. Cancer doc: ~Three decades at MGH. Writer and storyteller: Moth Grand Slam Champion. Mom. www.DrRobin.org, @robinshome, robinshome2@gmail.com

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