How’s it going in Los Angeles with the pandemic?
The numbers in LA are absolutely dreadful. Daily new cases, hospitalizations, and deaths are at all-time highs.
The current case numbers make the mountain of cases this summer look like a molehill. In July I worried that a COVID death rate in the 40s per day would make COVID a contender for the leading killer in LA County. The current death rate is twice that. Many LA ICUs are at or near capacity.
But a vaccine is on the way. Everyone’s talking about it!
Actually, several vaccines are on the way. A vaccine developed by Pfizer-BioNTech has just been approved. Healthcare workers and residents of long-term care facilities have been receiving it for about a week. Moderna’s vaccine was authorized this week, and its first doses should be in peoples’ arms by the time you read this. Other manufacturers have vaccine candidates that will seek approval once their testing trials are complete.
I’m worried that the vaccines were developed so quickly. I don’t want to get a vaccine if they’re cutting corners in the testing.
No corners have been cut. The candidate vaccines are going through the same phases of trials that any other vaccines have gone through. These trials are subjected to the same peer-review and published in the same journals that other new vaccines and medications are published in. The trial of the Pfizer vaccine involved more than 40,000 participants and was published in the New England Journal of Medicine. The speed to market wasn’t accomplished by skimping on the research. It was accomplished by starting the manufacturing of doses while the trials were still going on. Operation Warp Speed guaranteed purchase of hundreds of millions of doses of candidate vaccines, so that the manufacturers could start working immediately. That way, as soon as the vaccine is approved, lots of doses are already available.
Does the vaccine work?
Yes. The Pfizer vaccine involves two doses given 21 days apart. (Different vaccines might have different dose schedules.) In the randomized trial, the vaccine was 95% effective in preventing COVID-19.
I’m worried about side effects. Is it safe?
It’s very safe. In tens of thousands of doses there were no serious side effects. The most common side effects are pain, swelling and redness in the arm, and fatigue, headache and chills. The informal hubbub from my doctor friends who have already received the first dose is that it’s much less side-effecty than Shingrix, the vaccine that prevents shingles. There was a single report of a mild allergic reaction, so everyone will be watched for 15 minutes after administration to monitor for that. I’m scheduled to get my first dose on Thursday. I wouldn’t do it if I didn’t think it was safe.
Will I grow a third eye?
That hasn’t been reported yet. However, that would be very cool. Having two eyes gives you depth perception, so, if I’m doing my math right, a third eye should let you see in the fourth dimension.
Where do I get it? Will your office give it out like the flu shot?
Unfortunately, the Pfizer vaccine has very complex storage, distribution and reporting logistics. Because of that, it’s being distributed primarily through large medical centers. Cedars-Sinai has received tens of thousands of doses and has begun vaccinating healthcare workers and long-term facility residents. Future vaccines by other manufacturers will have different requirements. If any are appropriate for distribution in a small doctors’ office, we’ll definitely ask to get some.
Do I have to get the vaccine?
No. COVID vaccination will be completely voluntary, but you should get it, both to protect you and those around you.
When can I get the first shot?
The goal is to vaccinate everyone who wants to be vaccinated by the middle of 2021. So you’ll get it in the next six months. Since that many doses are not available now, local and national health authorities are making priority lists of groups of patients. The details of those lists are not yet known, but it’s assumed that older and sicker patients will be prioritized.
As soon as I know that doses are available to the general public, I’ll email all my patients with all the information I have. I know many of you are very eager to get the first dose ASAP. I’m eager to help you do that. We just don’t know anything yet.
I’m a 107-year-old essential worker. Can I get the vaccine before everyone else? I don’t want the hoi polloi getting it before me.
Everyone who wants to be vaccinated will be vaccinated. I’m not the one making up the priority list of which groups get the vaccine first. Even if a future vaccine is distributed through our office, it will be done according to recommendations from the LA County Dept of Health and the CDC. We’ll give it in whatever order they say. Please stop calling me to remind me how important you are. I love all of you the same. This is a race against time, not a race against your neighbor. We’re all going to get there.
I know this holiday season will be disappointing for many of us. But the end is in sight. Please help keep the ICUs less full by staying out of other peoples’ homes and avoiding gathering with people who don’t live with you. I know that we’re bored and lonely and frustrated. But we just need to keep our most vulnerable loved ones from getting infected for a few more months.
In the midst of all this loss, we might forget what has been achieved. A novel virus made the leap to infecting humans in December 2019. Within one year of that event, multiple safe and effective vaccines have been developed. That is an extraordinary scientific, technical and logistical accomplishment. Distributing it to hundreds of millions of people will be another one.
I hope your Hannukah was bright. I hope your Christmas is merry. I wish all of you a much much better New Year.
Frequently Asked Questions about COVID-19 Vaccination (Centers for Disease Control and Prevention)
Information about the Pfizer-BioNTech COVID-19 Vaccine (Centers for Disease Control and Prevention)
Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine (New England Journal of Medicine, by subscription)