This is a bi-weekly Q and A column written by Dr. Lydia S. Segal in conjunction with Chaffee County Public Health. This column is focused on questions readers have about COVID-19 news and sciences. As Segal points out, ‘Everything I write today is valid for today. COVID-19 news and science are rapidly evolving, assume updates will be made.”
QUESTION: What is happening with FDA approval of COVID vaccines for children under 5 years of age?
ANSWER: In a surprising decision, the FDA announced last week they would postpone approval of the Pfizer vaccine that is currently under clinical trials for children under 5 years of age. Although the vaccines have no adverse side effects at the two-dose regime, preliminary data showed rather disappointing results on efficacy at the tiny dose calibrated for young children. There is hope that instead of a two-dose course that a three-dose course might be effective. The earliest projected time for review and hopeful approval under EUA status (Emergency Use Authorization) would be April 2022.
QUESTION: Andrea Carlstrom, Chaffee County Public Health Director and COVID Incident Commander wrote recently that we need to look forward to a new life as we move from pandemic to endemic status. What does this mean to me and my family?
ANSWER: It means COVID will be in the background and its impact on our personal health and health care systems will lessen. And it means we will start to make choices to participate in more activities beyond the safe bubbles we created over the last two years. Each person and family will need to weigh their own risk tolerance based on age, existing other illnesses, and those they are in close contact with who may be at risk for serious COVID such as the frail, elderly, and or the immunocompromised.
QUESTION: What are vaccines actually designed to do? Can they prevent infections altogether?
ANSWER: In general vaccines are designed to ward off severe disease and death. This means that if you are vaccinated, should you catch the disease, you will likely get a milder form. You would almost certainly avoid hospitalization.
For an example of milder disease, one only has to look at the recent Omicron variant. Those who were vaccinated may have gotten the disease but had a much milder version. Additionally, they were extremely unlikely to be hospitalized. But those who were not vaccinated were more likely to get a severe form of Omicron and end up in the hospital. Keep in mind we are still seeing the highest number of deaths per day in the USA, over 2,000 except last winter since the pandemic started. Some deaths and severe hospital stays were prevented by a better understanding of how to treat COVID patients including monoclonals and antivirals.
There are some vaccines, like those for smallpox and polio, that actually prevent those diseases from infecting people altogether. Those particular vaccines worked so well that both polio and smallpox have been eradicated from the face of the earth.
QUESTION: How long does immunity from the vaccine booster last?
ANSWER: Very preliminary data from Israel and the United Kingdom, shows a marked decrease in immunity in those over 65 and those who are immune-compromised four months after their boosters. This decrease in protection is not as marked for those who are young and well. But you must always keep in mind that all vaccines are highly effective in reducing hospitalizations and death. Yes, there is a reduction in antibodies after four months, but clinically it appears the other parts of the body’s immune system hold up far longer.
QUESTION: Are there any long-term cardiovascular complications of COVID?
ANSWER: See a recently published article in Nature Medicine: (https://www.nature.com/articles/s41591-022-01689-3) In an analysis of more than 150,000 veterans enrolled in the VA health care system, researchers found post-COVID rates of cardiovascular disease including heart attacks, strokes, and arrhythmias substantially higher than those who had not had COVID. It is not yet clear how the virus is damaging the heart and blood vessels. The researchers also corrected for age, pre-existing diseases, and lifestyle choices such as smoking. Unfortunately, even people with mild disease were not able to escape this increased cardiovascular risk.
For more information about COVID and the vaccines, eligibility, and appointments, see the links below. Pharmacies and doctors offices are getting small shipments of vaccines. Information will be posted in this digital news source and on the county public health and hospital web pages.
If you have questions you would like Dr. Segal to address in a future COVID Q and A column, please write to arkvalleyvoice@gmail.com
Helpful resources:
http://chaffeecounty.org/Public-Health-Coronavirus
https://www.hrrmc.com/covid-19-updates/covid-19-vaccine/
Pharmacies with vaccine clinics:
Salida: Safeway, Walmart and Salida Pharmacy
Buena Vista: Mt. Shavano (LaGree’s), City Market, BV Drug and Valley-Wide Health
By Lydia S. Segal, M.D., MPH
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