COVID-19 Vaccine: Some Basic Questions and Answers

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The COVID-19 pandemic has now been with us for a year and is currently surging out of control. During the past year, we have learned a lot, and the virus has continued to mutate, requiring us to continue learning.

One of the biggest lessons is that misinformation can be a powerful negative force, especially when it is conveyed from high levels and able to reach large numbers of people. What follows are answers to basic questions related to where we are today in the pandemic. The source for these answers is the federal Centers for Disease Control, which is staffed by some of the best minds in our country who, like everyone else, also continue to learn.

(Sources for the responses that follow are listed at the conclusion.)

Who is Currently Eligible for a Vaccine in the USVI? 

Currently, essential workers and those over age 65 are eligible for the vaccine under Phase 1B of the territory’s rollout. Phase 1A included health care workers, residents and staff in long-term care facilities, those in congregate living facilities outside of nursing homes and the elderly throughout the islands, according to the Health Department.

Under Phase 1B, essential workers include grocery store employees, taxi drivers, teachers, police, firefighters and government workers, among a list of dozens of others that can be found along with more information at the Department of Health website.

Residents also can call 340-774-7447 on St. Thomas or 340-718-1311, ext. 3895 on St. Croix.

The first phase of vaccinations began on Dec. 16 and will continue throughout the upcoming phases, said Health Commissioner Justa Encarnacion, addressing residents who fear they might have missed their opportunity if they fall into that category but have not received a shot.

For those who have been trying to get a shot from their doctor but have been met with busy phone lines or delays, government officials stressed that providers have simply been overwhelmed by the demand.

Where Can I Get the Vaccine in the USVI? 

The Health Department says the following providers are actively vaccinating by appointment:
– V.I. Department of Health Community Health, St. Croix: 340-718-131;
– V.I. Department of Health Community Health, St. Thomas: 340-774-7477;
– Neighborhood Pharmacy: 340-718-6784 ;
– Carolyn Jones MD PC: 340-774-2331;
– Delgiacco Medical LLC: 340-772-1551;
– Inter-Island Pharmacies: 340-777-1400;
– Pediatric Care Center: 340-719-0681;
– Partners 4Kids: 340-774-5437;
– St. Croix Obstetrics and Gynecology LLC: 340-719-9876;
– Red Hook Family Practice PC: 340-775-2303;
– Frederiksted Health Care Inc., North Shore: 340-772-0260;
– V.I. Urologic Center, Inc.: 340-774-9655;
– Plessen Urgent Care: 340-715-7720;
– Yacht Haven Family Practice: 340-776-1511;
– Frederiksted Health Care Inc., Ingeborge Nesbitt: 340-772-0260;
– Cruz Bay Family Practice: 340-776-6789;
– Wilson Healthcare Consultants: 340-776-5507;
– ProHealth Urgent Care LLC: 340-998-2404;
– St. Thomas East End Medical Center Corporation: 340-775-3700;
– Frederiksted Health Care, Mid-Island: 340-772-0260;
– St. John Agape Wellness Center & Wound Care LLC: 340-778-1932;
– Island Health & Wellness Center, Inc.: 340-714-4270;
– Virgin Islands Ear, Nose & Throat, St. Thomas: 340-774-8881;
– B & S Medical: 340-713-0348;
– Acute Alternative Medical Group: 340-772-2883;
– Transform KM (Kmart Pharmacy): 864-991-9643;
– Risa M. Nielsen MD LLC: 340-778-6680; and
– Virgin Islands Ear, Nose & Throat, St. Croix: 340-773-8801.

Why Do We Need a Vaccine?
Consider the death statistics attributed to COVID-19 in the U.S.A. since January 1, 2020: as of January 9, 2021 – total cases: 21,853,491 – total deaths: 367,652, or roughly four times the population of the U.S. Virgin Islands.

Looking at those figures in the context of what will be 22 million cases by the time most people read this, most deaths are in people aged over 75 years – 20.8 percent of the deaths are people aged 65-74 and 14 percent age 60-64, likely with co-morbidities. There have been negligible deaths in children and young people.

The current exponential increase in coronavirus disease 2019 (COVID-19) is reaching a calamitous scale in the United States, potentially overwhelming health care systems and causing even greater loss of life. The news media dutifully report each day’s increase in new cases and deaths, but putting these numbers in perspective may be difficult. The daily U.S. mortality rate for COVID-19 deaths is equivalent to the 911 terrorist attacks of Sept. 11, 2001, which claimed 2,988 lives, occurring every 1.5 days, or 15 Airbus 320 jetliners, each carrying 150 passengers, crashing every day. And these are only the deaths.

We need a vaccine, along with other critical measures to bring this pandemic to an end.

Why Isn’t This “JUST Like the Flu?”
Both are viruses. What is important is that hundreds of thousands of Americans have died, and many others have long-term effects. These are known as “long haulers.” They are just beginning to get the attention they deserve. They display a wide range of symptoms from muscle aches and fatigue to teeth falling out and cognitive issues.

We are just now beginning to distribute a vaccine. Also, “flu season” usually begins to abate after the month of February. We don’t know if that is going to happen with COVID-19 this year.

If the purpose of making this comparison has been to minimize COVID-19, it was a big mistake.

What Does Asymptomatic Transmission Mean?
With the COVID-19 virus, asymptomatic transmission is a huge problem. Simply stated, “asymptomatic” means no symptoms. When someone has an infection, there is a period of time after they catch the germ before they have symptoms. This is called the incubation period. In some cases, people can catch the infection and never have any symptoms. Even with no symptoms, it’s possible to spread an infection.

For example, the flu is contagious a day before someone develops symptoms. For COVID-19, the disease caused by the novel coronavirus, it is most contagious when someone has symptoms, but it is still possible to spread the infection from person to person even when there are no symptoms.

This is why the basics, face masks, physical distancing, avoiding large gatherings and practicing good hygiene are so important.

Do I Need A Mask if There Is a Plexiglass Barrier Between Me and Others?
Yes, viral particles can find their way around plexiglass shields.

Are All Masks the Same?
Basic point: any mask is better than no mask. That being said, there are important differences, and they are becoming more important with the arrival of the more transmissible mutant virus. Second basic point: masks not only protect others, they protect you. Do some basic research and seek out the most effective mask.

But Won’t We All Just Get What They Call “Herd Immunity”?
Herd immunity occurs when enough people become immune to a disease to make its spread unlikely. As a result, the entire community is protected, including those who are not themselves immune. Herd immunity is usually achieved through vaccination, but it can also occur through natural infection.

Now the bad news. Experts initially estimated that somewhere between 60 to 70 percent of the population needs to be immune in order to achieve herd immunity. More recently, they have raised that estimate to near 90 percent. As of now, we are nowhere close to the numbers needed to achieve herd immunity.

Achieving herd immunity through natural infection means many people would become ill and many would die. These risks may diminish as we develop effective treatments. However, we still don’t know how long people who recover from COVID-19 will remain immune to reinfection. We will achieve herd immunity as more people around the world receive vaccines that will confer lasting immunity.

Do These Vaccines Really Work?
The new vaccines help our bodies develop immunity to the virus that causes COVID-19 without us having to get the illness. Different types of vaccines work in different ways to offer protection, but with all types of vaccines, the body is left with a supply of “memory” T-lymphocytes as well as B-lymphocytes that will remember how to fight that virus in the future.

It typically takes a few weeks for the body to produce T-lymphocytes and B-lymphocytes after vaccination. Therefore, it is possible that a person could be infected with the virus that causes COVID-19 just before or just after vaccination and then get sick because the vaccine did not have enough time to provide protection.

Sometimes after vaccination, the process of building immunity can cause symptoms, such as fever. These symptoms are normal and are a sign that the body is building immunity.

And, a final note, in clinical trials, these vaccines have proven highly effective.

How Do I Know Which Vaccine I Am Getting and if It Is the Right One for Me?
Right now, both approved vaccines, Moderna and Pfizer, are known as “Messenger RNA” vaccines. Each acts in essentially the same way, and each is given via injection into the upper arm.

Messenger RNA vaccines – also called mRNA vaccines – are some of the first COVID-19 vaccines authorized for use in the United States. The benefit of mRNA vaccines, like all vaccines, is those vaccinated gain this protection without ever having to risk the serious consequences of getting sick with COVID-19.

Moderna’s coronavirus vaccine is similar to the Pfizer-BioNTech vaccine, which was the first COVID-19 vaccine authorized and first shipped out to Americans. But there are a few key differences. Most importantly, Moderna’s vaccine can be stored in normal freezers and does not require a super-cold transportation network, making it more accessible for smaller facilities and local communities. Both Moderna‘s and the Pfizer-BioNTech vaccine have shown similar efficacy levels of near 95 percent.

After I Am Vaccinated, Am I Exempt From Lockdown and Distancing Requirements?
There is not sufficient information available to say if – or when – CDC will stop recommending that people stop wearing masks and distancing to help prevent the spread of the virus that causes COVID-19. Experts need to understand more about the protection that COVID-19 vaccines provide before making that decision. Other important factors, including how many people get vaccinated and how the virus is spreading in individual communities, will also affect this decision.

Basic answer: after vaccination, we should continue current practices and stay tuned for what we hope is good news to come in the near future. During the period when we are learning more about the protection that COVID-19 vaccines provide under real-life conditions, it will be important for everyone to continue using all the tools available to us to help stop this pandemic: covering your mouth and nose with a mask, washing hands often, staying at least 6 feet away from others, and avoiding large gatherings that can become “super-spreaders”.

Together, COVID-19 vaccination and following CDC’s recommendations will offer the best protections from getting and spreading COVID-19

Do I Have to Wear My Mask When I Go For My Vaccination? What About After I’m Vaccinated?
Yes. When you get the vaccine, you and your healthcare worker will both need to wear masks that cover your nose and mouth. Stay at least six feet away from others if inside and in lines.

Experts need to understand more about the protection that COVID-19 vaccines provide before deciding to change recommendations on steps everyone should take to slow the spread of the virus that causes it. Other factors, including how many people get vaccinated and how the virus is spreading in communities, will also affect this decision.

Also, it will take time for everyone who wants a COVID-19 vaccination to get one. A vaccine that is 95 percent effective means that approximately 1 out of 20 people who get it may not have protection from getting the illness.

What About Wearing a Mask After I’ve Been Vaccinated?
We are still in a learning phase about post-vaccine protections, particularly with respect to whether someone who has been vaccinated can spread the disease. Basic message at this point: continue to engage in all of the basic practices that will bring this pandemic under control, including wearing a mask and physical distancing.

What Are the Side Effects of Being Vaccinated? How Long Do They Last? Who Should I Not Believe about These Questions?
The side effects from COVID-19 vaccination may feel like flu and might even affect your ability to do daily activities, but they should go away in a few days. Many people experience few if any side effects. Severe side effects have been rare.

There is a strong anti-vaccine movement in our country. Much of it is driven by misinformation and disseminated on-line. We have also come to mistrust “experts,” also correctly known as people who know what they are talking about. The Centers for Disease Control continue to be the most reliable and trusted source of solid information about this pandemic.

If I Have Had the Virus, Should I Still Get Vaccinated?
Yes. Due to the severe health risks associated with COVID-19 and the fact that re-infection with COVID-19 is possible, vaccine should be offered to you regardless of whether you already had COVID-19 infection

How Many Doses Will It Take? After My First Dose, What Happens If I Don’t Get the Second One?
Depending on the specific vaccine you get, a second dose three to four weeks after your first shot is needed to get the most protection the vaccine has to offer against this disease. Therefore, if the second dose is administered within three weeks after the first Pfizer-BioNTech vaccine dose or within one month after the first Moderna vaccine dose, there is no need to restart the series. Vaccine administration errors should be reported to the Vaccine Adverse Event Reporting System (VAERS). The first dose helps the body recognize the virus and primes the immune system to defend against it, while the second shot strengthens that immune response.

– Pzifer 2nd dose: 3 Weeks after the first dose
– Moderna 2nd dose: 4 weeks after the first dose

Once I Am Vaccinated, Can I Still Spread the Virus?
While the vaccine will prevent you from getting sick, it is unknown at this time if you can still carry and transmit the virus to others. That is why, until more is understood about how well the vaccine works short and long-term, continuing with precautions such as mask-wearing and physical distancing will be important.

Are There Any Other Vaccines that Will Prevent the Spread of the Virus?
Not at present. Only Pfizer and Moderna are currently authorized for COVID-19 by FDA.

Can I Drink Alcohol after I Have Been Vaccinated?
Yes, but we need to further research CDC guidelines in this regard.

Will I Have to Be Vaccinated Every Year?
A few people who have had COVID-19 have apparently had a second, often milder case of the disease. Researchers are exploring what this means in terms of how long immunity from the coronavirus lasts. Vaccine developers are looking at ways to boost the effectiveness of a vaccine so that it provides longer immune protection than a natural infection with the coronavirus.

When Will This End?
Uncertainty has been one of the sources of anxiety, depression and grief during this pandemic. With the arrival of the vaccines, it appears that we can see the “end game” sometime during the second half of 2021. But that means several more difficult months. During this time, mental health practices will be as important as the physical practices that we know about. These include basics like prayer, meditation and exercises that help us sleep. Staying connected to, and helping others, are also really important in helping us all get through