Tanzina Vega: This is the Takeaway, I'm Tanzina Vega. In the first 24 hours of his administration, President Joe Biden signed a flurry of executive orders as part of his push to get the COVID-19 pandemic under control.
President Joe Biden: Our national strategy is comprehensive, it's based on science not politics, it's based on truth not denial, and its detailed.
Tanzina: President Biden's plan includes a national vaccination campaign to administer 100 million shots in his first 100 days in office. That's enough to cover 50 million people with the vaccine requiring two doses. Biden's other COVID-related executive orders range from ramping up the development of therapeutics to treat the virus, to requiring masks to be worn in federal buildings and on federal land.
He's also created two new organizations, The National Pandemic Testing Board to improve testing capabilities and a COVID-19 Health Equity Task Force. To make sure the COVID response is equitable. All of this is happening against the backdrop of a COVID-19 death toll. With President Biden himself saying it's likely to top 500,000 deaths next month. In the meantime, there's still a lot of confusion surrounding the COVID-19 vaccines and how they're being distributed across the United States. We asked you our listeners, what questions are on your minds as the new administration takes over the pandemic response.
Here to help us answer some of your questions and more are Apoorva Mandavilli, Science Reporter at the New York Times and Namandje Bumpus Director of the Department of Pharmacology and Molecular Sciences at Johns Hopkins University. Thanks to you both for joining me.
Namandje Bumpus: Thanks for having us.
Apoorva Mandavili: Thank you.
Tanzina: Namandje let's start with you. There is a question that we've been hearing whether or not once you get vaccinated, whether you can go back to life as "normal".
Namandje: That's the most common question certainly. The answer right now is even once you're vaccinated, we still have to continue with all of the social distancing measures. Face masks and being 6 feet apart, avoiding large groups. The reason for that is that while we think it's very-- These vaccines are amazing, that are authorized.
We think that it's very likely that they will reduce transmission, but in leading with science, we really need to get those data. Until we understand transmission after vaccination, we really need to maintain the distancing and the masking. In addition, we have to understand how long the protection is going to last. It's important for us to remain diligent and to really continue on with our social distancing practices,
Tanzina: Apoorva, how many people need to be inoculated in the United States in order to achieve a level of immunity that allows for us to get closer to a sense of "normalcy".
Apoorva: That number Tanzina is not a fixed number. Unfortunately, we don't have an exact estimate. We do know that we probably need to get to around 70 or 80% with the current variants of the virus circulating in the United States. The problem is that herd immunity really depends on how quickly transmissible or how transmissible the variants are. If we end up with a variant that is much more contagious, that may need to go up even more. What I can tell you is that we probably won't hit it until kids are immunized.
Tanzina: Namandje let's talk about that because there is a lot of confusion, I think for a lot of people. Not just around the vaccine, but about these new variants that Apoorva is talking about. What do we know about the effectiveness about-- We know that vaccines mutate, we just don't know, I guess, how effective some of these vaccines are against some of the new COVID-19 variants? What can you tell us about that?
Namandje: As you said, it's very normal for viruses to mutate and that's something that we expect over time. We are seeing these variants emerging and some of them actually have a substantial number of mutations. What we know so far is that the vaccines that we have, we expect to work against these variants. There is even some data released in the past few days, showing that the Pfizer vaccine was effective against one of the variants.
I think that we expect the vaccines to work. There are questions about whether they will be somewhat less effective or not against the variants, but still expected to work and to be highly effective based on the variance that we currently have. Certainly more studies and experiments are needed to test this exactly. To understand the precise numbers we're expecting as far as efficacy.
Tanzina: We're going to get into some listener calls in just a second, but before that Apoorva, I'd love to ask you about the actual manufacturing of these vaccines. Do we have enough supply right now?
Apoorva: We probably have enough supply to get to the hundred million doses and more than that. What happens later on say in June is a little bit still a much of a question. Because the problem is that it's not just the vaccine manufacturing capacity as in just the vaccines. It's also things like glass vials and other things that are short supply. Some of that may be addressed by the Biden administration invoking the Defense Production Act, but there will probably be a ceiling on how much we can produce at least for a short while.
Tanzina: Apoorva, there's been a lot of back and forth between state officials and local officials here in New York. I'm sure in other States where there's just a lot of confusion about how much vaccine should be available, who's the priority group, who isn't. Are you seeing that across the country?
Apoorva: Absolutely. It's been very chaotic everywhere. The problem has been that we haven't had really clear directions from the federal government. The CDC outlined some priority groups, but there wasn't a lot of clarity about what locality should do once the vaccine comes into their hands. It has been chaotic.
I've written about, for example, academic medical centers deciding to give the vaccine out to their own grad students who maybe don't even come in contact with patients. While at the same time, we have people who are 85 years old, who haven't been vaccinated. On the other hand, there's also an argument to be made for just vaccinating as many people as we can as quickly as we can. It's not a clear answer on which is better.
Tanzina: Namandje, let's listen to some of our questions that some of our listeners have. Corinne, gave us a call asking about antibodies. Let's take a listen to what Corinne' question is.
Corinne: What makes the vaccine's antibodies any better than my antibodies that I got from actually getting COVID? Why would I need to get a vaccine if my body has already produced antibodies?
Namandje: That's a good question. We want to do better than natural immunity essentially. It's not clear currently what the strength of the protection are and the duration of protection after you just naturally have infection with SARS-CoV-2. The idea being that the vaccine could provide stronger and longer lasting immunity than just recovering from the disease itself. We certainly have vaccines that we currently use, that we know that they provide immunity that is stronger than natural infection. We're looking to do better. That's why it's important for folks to get the vaccine even if they have been previously infected.
Tanzina: We're going to take another call from Pete in Orlando. Let's listen to what his question is.
Pete: This is Pete from Orlando, and I have a simple yes or no question. After getting vaccinated, is it still impossible to become infected and spread the disease?
Tanzina: Namandje sounds like a simple yes or no. Is it?
Namandje: Well, I wish. Like we said earlier that we don't know about the transmission piece yet, but certainly there is a very, very small possibility of infection. We know that the risk of infection is decreased 94, 95% by these vaccines. Highly, highly effective, more than we could have dreamed of, but there are still slight chances. We still aren't clear about the data after just one dose.
There is a chance of getting the disease, but the good news is that the vaccine is going to not only reduce your chance of getting sick, but if you were part of that very rare group to end up getting sick. That you won't have the level of symptoms that people have that aren't vaccinated, but we still don't know about that transmission piece.
Tanzina: Big question coming in from Brooklyn, Damani in Brooklyn. Let's take a listen to what Damani's question is. A lot of folks have this similar.
Damani: Hi, my name is Damani. I'm calling from Brooklyn. What are the side effects that we can expect from having this vaccine?
Tanzina: Namandje. Big question.
Namandje: Obviously people experience pain at the injection site and that's common. Particularly after the second dose, there are many people that experience things like headache, fatigue, and chills. That tends to be mild to moderate lasting only a couple of days. Not anything severe to be expected, but there are these side effects that we anticipate basically when you're really ramping up to some immune response.
Tanzina: Apoorva, we touched on this earlier, this who is getting the vaccine right now. I know in New York where I live and I'm trying to get my parents a vaccine, it has been complicated to say the least. There are a number of websites where people can sign up, and then we ran out of the vaccine. Thousands of appointments were canceled. Is that confusion also something that you're seeing? Just the mechanics of trying to get a vaccine across the country.
Apoorva: That is happening absolutely everywhere. One of my colleagues, David Leonhardt, who writes the morning newsletter for the Times. Actually drove his mother halfway to Colorado, and his sister met him halfway and took her to Colorado, so she could be vaccinated in Colorado instead where she was eligible to get the vaccine too, because it was just so confusing here. That's happening across the country, that people just really don't know how to get the vaccine. Some of the websites ask for a ton of information.
If we're really trying to vaccinate the elderly, who may not be very tech savvy, it's a real barrier to getting to them. We're also not vaccinating communities of color. For example, I just got an email a couple of days ago saying that, the clinics in Washington Heights are actually seeing mostly white people because they can afford to sit at a computer and keep refreshing until they get an appointment and show up. Whereas the clinic is actually intended for the communities that live nearby, which are mostly people of color.
Tanzina: Talk a little bit about that refreshing screen because someone said to me, just keep hitting refresh. I said, that's what I have to do to get an appointment for my parents. Explain that again.
Apoorva: People have been comparing this to trying to get tickets to rock concerts back in the day, where you just sit and just keep refreshing until you get a chance.
Tanzina: I wasn't the only one who compared it to trying to get tickets to Bon Jovi in 1985. I'm glad to know that Apoorva.
Apoorva: It's unfortunate. It's actually really sad that that's the system that we have. I'm not really sure why it's this bad. I'm not sure why we didn't have an app that everybody could just put their information and get a number and get a number in the queue and just know when your time is. It doesn't seem like something we can't solve, given all the other kinds of technology and apps we have available.
Tanzina: We're going to get into a little more of this in the next conversation. You mentioned David Leonhardt and her drove his mother across the country. Can people do that? Can you drive to another state and get vaccinated there?
Apoorva: Oh, I want to be clear that in his case his mother used to live in Colorado or lives in Colorado part of the time and has residency there. It's not that you can just go anywhere and get the vaccine, and you really shouldn't.
Tanzina: I was just going to say, we might start seeing a lot of movement, we need to clarify that. We have a caller, Evelyn, who has another question for us? Let's take a, listen.
Evelyn: My husband and I both tested positive for COVID on December 28th. When should we get the vaccine and should we get another test to see if we're still positive?
Tanzina: Namandje, the question I think is a very specific one, but it does beg some information about timing of the vaccine. What can you tell us?
Namandje: I think, always talk to your healthcare provider, but essentially the suggestion is to, if you have a history of SARS-CoV-2 infection. That vaccination should be deferred until after you've recovered from the acute illness or after you don't have symptoms and you've met criteria to discontinue isolation. If your doctor says you don't need to be in isolation anymore, you've recovered from those acute symptoms, then you certainly can and would be eligible for vaccination as long as you meet other local eligibility criteria, based on the rollout.
People also are asking about other vaccinations that they're getting, for various things. The recommendation right now, since we don't know the interaction between this vaccine and other vaccines, just from a pharmacology perspective. It's being recommended to wait 14 days in between vaccinations if possible. Sometimes there will be a need maybe to get another vaccine more quickly and so folks can work with their healthcare provider on that.
Tanzina: Apoorva, I'm going to give this next question to you because it really talks about timelines and distribution. Let's take a listen to what Tim asked.
Tim: Hello, this is Tim from Jacksonville, Florida. I definitely agree with the priority being placed that, medical personnel, emergency personnel and seniors get the first wave of the vaccine. That's the low hanging fruit, that's the easy choice. Now my question is who's the second group, third group, fourth group to get the vaccine?
Tanzina: Apoorva, how are we managing here rollouts to wider populations?
Apoorva: After the elderly, we sort of had a next category of 65 plus. The idea is to also vaccinate people with underlying conditions, essential workers of all types, that could be subway employees, I mean metro, underground employees. All kinds of people who will differ from state to state for some states those essential workers will be meatpacking plant employees and that's the ideal.
Then there is what's actually happening as we've discussed. It's not actually unfolding in that way. There are people who are getting signed up. Hospitals are vaccinating all of their patients, not just people who are really in need and so it will be inequitable. I think that seems almost inevitable right now. Maybe that's okay, because like I said earlier, there is a real argument to be made for just vaccinating as many people as possible so we can inch a little closer to herd immunity.
The thing about vaccinating people is that it's not just the ultimate herd immunity point at which we start to see benefits. We will start to see a decline in the number of cases and hospitalizations and deaths as we vaccinate more and more of the population.
Tanzina: Apoorva there are certain populations that have become a little bit controversial in whether or not they should be prioritized among them are people who are incarcerated and agricultural workers. You mentioned meat factory workers, but a lot of workers who are working in those factories and working in agriculture are also people who tend to be undocumented. Have both of those groups had any clarity around whether or not they will be eligible and if so, when for the vaccine?
Apoorva: This has differed really state by state. Some states have decided that for example, in their prisons, only the staff will be vaccinated and the prisoners will not. Some states have decided that that's not exactly equitable. It's a human rights violation in a way to deny them the vaccine when they're living in congregate settings and they are choosing to vaccinate all of their prisoners.
It's really been variable and I'm sure you can tell from my answer that I sort of side on the side of, yes, we should be vaccinating all the prisoners. Because we know that when people live in close quarters, they are at high risk
Tanzina: Namandje, some listeners are saying that they were trying to get the vaccine. They were on very long lines to get the vaccine or at least the first dose of that vaccine and they're wondering how safe that process is. Is there a way that people can protect themselves while trying to get the vaccine?
Namandje: Certainly and I think at most vaccination sites now people are still being told to adhere to the social distancing. Definitely wearing your mask, while you're waiting, while you're being vaccinated, maintaining the distancing, washing hands, all of that. That's really important definitely while you're waiting for vaccination and while you're receiving the vaccine doing the best you can, at least to stay masked.
Tanzina: Namandje, from your perspective, in terms of there have been lots of concerns about equity and access to the vaccine, especially for communities of color. What are your thoughts on that? Have we seen anything to indicate that there needs to be better distribution or better information to communities of color?
Namandje: I think, as Apoorva mentioned, there certainly have been reports of inequities as far as distribution. For me as a scientist and I'm a Black woman, I think a lot about equity even in how we develop these vaccines. I think one thing that's important in the messaging and the education about them. Is that these studies that were done to establish the safety and efficacy of these vaccines were actually pretty diverse, more diverse than the studies used for many drugs that are approved, that we take all the time.
I think we do need education around the fact that in African-Americans, in Latinx folks, that these vaccines, were the studies enrolled people in high numbers. That these studies were about 9 to 10%, African-American, much higher than many drug studies. That we're not seeing differences in safety and efficacy. I definitely think that science needs to be communicated. Then the logistic issues, is a little bit of a different thing, but at least we educate folks. I hope that people will be comfortable, trying to pursue getting the vaccine at least.
Tanzina: Namandje Bumpus is Director of the Department of Pharmacology and Molecular Sciences at Johns Hopkins University. Apoorva Mandavili is a science reporter at the New York Times. Namandje, Apoorva, thank you for answering our questions.
Apoorva: It's my pleasure.
Namandje: Thank you.
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