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Brian Lehrer: Brian Lehrer on WNYC and at least we can say vice president Mike Pence is not an anti-vaxxer. At least he's not playing one on TV today. He received the COVID Pfizer vaccine on live television this morning, assuring viewers, it is safe and effective.

Mike Pence: We gather here today at the end of a historic week to affirm to the American people that hope is on the way. Karen and I were more than happy to step forward before this week was out, to take the safe and effective Coronavirus vaccine.

Brian: The Vice President Mike Pence and his wife Karen Pence getting the vaccine on TV this morning. That was the vice president just afterwards. Moderna's vaccine is expected to become the second to get The Food and Drug Administration's greenlight. A decision could come within days after a unanimous advisory panel vote, if you haven't heard this yet, 20 to nothing yesterday, recommending emergency use authorization, but as with much of 2020, each piece of good news seems to come with some bad.

Even as more Americans get vaccinated, we continue to reach grim milestones more than 3,000 COVID deaths a day in this country now for the first time, certainly in a sustained way. Choices about who to treat and who not to treat in ICUs that we avoided by a hair in the spring may now be eminent in some parts of the country. With me now, mostly on the vaccine news and to take your questions and your reports, listeners, if you've gotten a vaccination already, we want to hear from you, how did it go? How was your reaction if any, is Dr. Angela Rasmussen, Virologist, and affiliate at the Georgetown Center for Global Health Science and Security. Hi Dr. Rasmussen, welcome back to WNYC.

Dr. Angela Rasmussen: Thanks for having me back, Brian.

Brian: Listeners, our phones are open at 646-435-7280 for your questions, but also listeners help us report this story. If you are one of the healthcare workers who has already received one of these first doses of a COVID-19 vaccine, would you call-in and tell us about it? 646-435-7280. I don't know if anybody in that relatively small group happens to be listening, but if so, what was it like to receive? How are you feeling physically and emotionally? Are you experiencing any of the normal unexpected side effects?

Like for some people fever and fatigue? Are you relieved? Are you proud? Did you post vaccination selfie like a lot of people do? What would you say the people out there who say they won't get it? First-line health care workers have already gotten a vaccine, we would love to hear your stories and your pitches for that matter to the rest of the public 646-435-7280, 646-435-7280. Dr. Rasmussen, have you gotten the vaccine yet, or do you know when it will be available to you?

Dr. Angela: I have not. I don't know when it will be available to me. I am a PhD and not a frontline healthcare worker. I'm not an older person, so I am not sure. I'll probably get it when everybody else has access to it. I would imagine that will be sometime next spring.

Brian: Can you talk about the side effects for a minute because that's on a lot of people's minds? We already know that these vaccines will have on average, stronger side effects than the typical flu shot, why is that? And why should that not deter people if I assume that's your position?

Dr. Angela: That is my position. And that definitely should not deter people, but people should be aware that they may have some flu-like symptoms when they get the vaccine. Not everybody will have it many people have reported that they've received the vaccine and essentially is like any other vaccine where they're experiencing some injection site pain maybe some muscle pain in the arm where they actually got the shot, but they are not having severe symptoms.

That said people can expect to have potentially a headache, a fever, some nausea potentially when they get some body aches and fatigue. That's actually a sign that the vaccine is working. When our immune systems respond to a viral infection and in this case, a vaccine that's tricking them into thinking they have a viral infection. It's usually the host response, the effective immune response to that pathogen that causes the symptoms and so that's what's happening when people are getting these vaccine shots. It's not that they are getting COVID, it's just that they are having some unpleasant side effects from their immune system, actually responding to the vaccine and working.

Brian: What if I don't get side effects? Does that mean my immune system isn't kicking into high gear?

Dr. Angela: No, that doesn't mean that either. This vaccine, as many people are aware is showing 94%, 95% efficacy, you don't always necessarily have those symptoms when your immune system is responding, but people should be aware that even if they haven't had those symptoms after the first shot, they may actually have them after the second shot because the second shot is effectively a booster. It may be that they're priming their immune system with the first shot and they may have more severe adverse events when they have the second shot and that immune system is essentially ready to go.

Brian: Right, if you don't have side effects-- it's not like those Listerine commercials where they say the burn means it's working.

Dr. Angela: That's right. It definitely does not mean that if you have no side effects at all, that the vaccine isn't working and certainly the clinical trial data shows that.

Brian: I've read that the Moderna vaccine might have more side effects than the Pfizer one, according to an FDA analysis, about 16% of people who get the Moderna shot in clinical trials, experienced "Severe adverse reaction." I don't know what severe means do you? 16% is a lot.

Dr. Angela: Severe can mean a lot of things and it can actually mean things that most people would not think are that severe. It can just mean a high fever. It can mean a headache that's quite uncomfortable. Yes, I've certainly seen that from the Moderna trial data that the side effects can be potentially more unpleasant, but it's the same situation, they will pass within about 48 hours. I really do encourage people to stick it out. Maybe take some over the counter medication to deal with any pain they're experiencing, take some time off work if they are able to do so, but to go ahead and still get the vaccine, it does seem to be safe.

Brian: Anita, in Monmouth County, you're on w NYC with Dr. Rasmussen. Hi Anita.

Anita: Good morning Dr. Rasmussen, my mom is living in an assisted living facility. We've been unable to visit her for quite some time doing window visits, but no physical contact for quite a long time. When they receive the vaccine, will this open up the facility now, so that we'll be able to go in and visit? Will she be able to lose the facility now that she is immunized?

Dr. Angela: First of all, Anita that that's really difficult that I know a lot of families are in this situation and I'm sorry to tell you that immediately, this actually probably won't change those protocols very much. The reason for that is that while these vaccines, the trials were conducted to look at their ability to protect against severe COVID or symptomatic COVID-19, we don't know yet how well they affect actual transmission or infection.

It is possible that you could be vaccinated or your mother could be vaccinated and still become infected and capable of transmitting the virus, even if she's protected against having more severe disease, which is a huge public health win, but we don't know yet how well it protects against transmission or infection. My suspicion is that it probably does offer some protection, at least against infection, but until we find that out, we're going to need to continue taking the same precautions that we've been taking. Also, until we can get enough people vaccinated, that we are approaching the herd immunity threshold, we will need to continue to be cautious and vigilant, and probably some of those same protocols will remain in place.

Brian: I read an article in the New York Post today about a study by the conservative think tank, The Empire Center based in Albany. It said nursing home residents in New York state accounted for a quarter of all COVID-19 deaths in a recent three-week period, late October into mid-November that they measured.

The recent surge, a quarter of all COVID 19 deaths in New York state according to the survey taking place in nursing homes, despite nursing homes making up less than one-half of 1% of the total state population, does that stat sound right to you and how are we still failing our elderly and nursing homes in such a catastrophic way, if that's true with everything we already knew after the spring?

Dr. Angela: That does sound right to me just because by far age is one of the strongest predictors of negative are severe COVID-19 outcomes and it's really unfortunate that that is the case. I think many states nationwide are going through this. I think that the reason why we failed older people is why we failed really everybody and that is that we have transmission that's out of control. Unlike in the spring, it's not just in New York, now it's Nationwide.

This is happening in every state, every community in the country. It’s not just because we didn't learn anything from the first surge in terms of nursing home specifically. We didn't learn anything from the first surge in terms of how we should be behaving to reduce transmission in the community overall. That unfortunately is the reality that we're living in right now.

Brian: Now we have a couple of callers on the line who have gotten vaccinated. Here is Ricky, an ER doc in Brooklyn. Ricky, doctor thank you so much for calling in. Hello.

Ricky: Hey, how are you, Brian?

Brian: Good, what would you like to tell everybody about your experience?

Ricky: I actually got the first dose of the vaccine on Wednesday. The only symptom that I had was some soreness in the injection site. Other than that, I'm feeling great. I'm about to go into an ER shift now. It was a good experience. Definitely, is something that is giving us guys on the front line some much-needed hope. The last nine months have been pretty terrible and this vaccine is kind of a light at the end of the tunnel really.

Brian: It may take a booster shot in three weeks for the immunity to fully kick in, but it's a booster shot to boost your morale right now.

Ricky: Exactly. Absolutely. I'm scheduled on January 6 to get my three-week booster and I can't wait. I can't wait for it to roll out to the general public so we can really put all of this behind us.

Brian: Ricky, thank you and thank you for your service in an emergency room in these times.

Ricky: Not a problem. I'm happy to do it. Take care.

Brian: You too. Here is another doctor. This is Mark calling from Ponce, Puerto Rico. Hi, Mark. Doctor, you're on WNYC.

Mark: Hi, Brian. Thanks for putting me on. I got the first shot on Tuesday here in Ponce, but I had already been scheduled to get it at another hospital in Mayaguez. I'm a pathologist. I'm not a frontline medical worker. I do come in contact with potentially contaminated tissue, but they don't allow patients to get surgery if they test positive for COVID-19 here. I'm second line, but they've just put doctors to the head of the line here.

Brian: How are things vaccine-wise or I should say COVID-wise where you practice?

Mark: The incidence in Ponce is around 8%. It's been pretty steady like that since the fall. It’s here. It’s around, but people have been very compliant with social distancing, and wearing masks. The supermarkets started requiring masks before the governor mandated it.

Brian: Thank you very much for checking in with us. I appreciate it a lot. Good luck down there and thank you for your service. Becca in Grand Rapids, Michigan is in a trial for yet another vaccine, I think. Hi, Becca. You're on WNYC.

Becca: Hi, thank you. How are you?

Brian: Okay, you're in a Johnson & Johnson vaccine trial?

Becca: Yes, I am here in Grand Rapids. It's not quite out yet and available, but I signed up for the trial here. Actually, it's the one-shot vaccine and I'm pretty sure that I did get the actual vaccination as opposed to the saltwater placebo. I had some mild effect for the next maybe 24 hours after I got the shot. Mild fever, and some shakes and chills and stuff. It went pretty good actually.

Brian: What are they telling you about when they'll reveal to you or if they'll reveal to you whether you were in the vaccination group or the placebo group? What that would mean for you going forward?

Becca: From what I've gathered so far from what I've heard, they've basically said that when-- I believe after the shot comes out and it's approved and it's available on the market and whatnot. They will actually unblind the study at which point they will tell everybody. I'm not sure quite where the people that volunteered for the study are going to fall into place as far as the priority for the true vaccine, but they're going to be in there somewhere.

Brian: Becca, thank you so much for reporting on that to us. I think it's really helpful. I've read Dr. Rasmussen that they are fully enrolled now in the Johnson and Johnson vaccine trial and hoping to have results by the end of January then what they call Phase three. I guess what I want to ask you about that after Becca's call is there are these various vaccines that are coming out in addition to the Pfizer one that people are already getting. What is that going to mean eventually? It seems they have different strengths and weaknesses. The Moderna one, it doesn't have to be frozen at minus 84 degrees.

They don't have to establish these special freezers all over the country, which is not easy to do, but it has more side effects recently reported and we talked about that. The Johnson and Johnson, the caller just told us you only need one vaccine. Is there going to be ultimately a race for the superior vaccine and that's by four months from now, what everybody else is going to be getting? Or what do you think this is going to mean in terms of shaking out?

Dr. Angela: I think that this is really important to think about because these vaccines as you pointed out have various strengths and weaknesses. That’s going to have a big impact on distribution. Distribution, as you mentioned, is a pretty big challenge for the mRNA vaccine such as Pfizer and Moderna especially Pfizer because it has to be kept, as you pointed out, at such an ultra-cold temperature. This Moderna vaccine has, as you pointed out, a more reactive genic meaning more side effects profile, and the Johnson & Johnson vaccine, as the caller just pointed out, is only one shot. It also doesn't need to be kept as cold as the Pfizer vaccine.

That’s going to really shake out in terms of being able to vaccinate more people in places where they might not have those ultra-cold freezers. It may be able to vaccinate more people who aren't willing to come back for the second shot, particularly, if they have unpleasant side effects that they don't find very tolerable after the first shot. I think that having more vaccines on the market is really a good thing. What is important for people to understand too is that the FDA is not approving these vaccines. It’s issuing emergency use authorization because right now we are in a public health emergency.

Full FDA approval though requires a better understanding of both the safety and the efficacy profiles of these vaccines. It may well be that by the time vaccines become widely available. There's evidence that shows that one of them is better than another and that is the vaccine that will get full FDA approval. There’s really a lot of balls up in the air right now. We don't really know how it's all going to shake out. I think for now having more options for vaccines that can be distributed to more places and get more shots in people's arms is really a great thing. I'm looking forward to seeing how that Johnson & Johnson trial turns out.

Brian: News came out this week that two health care workers at the same hospital in Alaska developed severe allergic reactions to the Pfizer vaccine after taking it. They did not necessarily have a history of allergic reactions to medication from what I read. Does that concern you and is it a coincidence that it happened twice in the same hospital and apparently no where else?

Dr. Angela: With only two cases, it's really, really hard to say. You can't necessarily say that that's something that has to do with that hospital or that vaccine or those people. You really can't say anything about it with just two cases. There were two cases of anaphylaxis as well in the UK, in people who both did have a history of severe allergic reactions. It’s definitely something to watch, particularly, if you have had an unpleasant reaction to a vaccine in the past or if you're prone to allergic reactions to things. The good news is that these vaccines right now are being primarily administered in hospital settings. Somebody does have a severe allergic reaction. They can be rapidly treated.

Brian: What's the recommendation right now for-- Let's say I know somebody who's allergic to nuts to the point that they carry an EpiPen with them. Should that person get vaccinated?

Dr. Angela: I think that that person should talk to their provider and find out whether they should get vaccinated or not. Right now in the UK anyways, they are recommending that people do not get vaccinated for the Pfizer vaccine if they do have a history of allergic reaction so severe that they need to carry an EpiPen. People who do have that history should at the very least talk to their provider, their physician before trying to get vaccinated.

Brian Lehrer: Does your age predict whether or not you might have more pronounced side effects?

Dr. Angela: That's something that didn't appear in the clinical trials anyways, that that adverse effects were age-dependent. I don't think so, no, but again, these trials were done in an expedited manner. In general, phase three clinical trials, even though they involve tens of thousands of patients aren't representative of the whole population. As we start vaccinating more and more people, we might be able to see emerging data that suggests that some people are more at risk of adverse events than others.

Brian Lehrer: One more question from a caller and rosemary in New Jersey, I don't have time to actually put you on on the air because we're running out of time in the segment, but I'm going to succinctly ask your question, which is why are we getting vaccinated if we're not sure it contains the spread of the illness? In other words, we're hearing that it will stop people from getting severe illness from COVID, but not necessarily getting infected, and they could still spread it.

Dr. Angela: This is a great question. I'm so glad that Rosemary asked it because this is really important for people to understand. Knowing that this protects against symptomatic COVID-19 is going to be a huge public health benefit on its own. Right now we are at a stage in multiple parts of the country, hospital systems are being overwhelmed. We're at severely reduced ICU capacity. Care is being rationed in many places, so keeping people out of hospital, keeping them from getting sick is really, really important right now for COVID-19.

My suspicion is that these vaccines probably do prevent infection and transmission to a certain degree, but that's not what the trials looked at, so we really need to get that data. Getting that data is a very high priority for everybody. People are looking at that right now, and when that data is available, that will be immediately communicated with the public, but for the time being, people should understand that the protective advocacy of the vaccine against symptomatic COVID-19 is in itself a huge benefit to public health.

Brian Lehrer: Dr. Angela Rasmussen Dr. Angela Rasmussen, Virologist, and affiliate at the Georgetown Center for Global Health Science and Security. Thank you so much for all the information today. We really appreciate it.

Dr. Angela: It's always a pleasure, Brian. Take care.

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