This is a weekly COVID-19 Q and A column written by Dr. Lydia S, Segal in conjunction with Chaffee County Public Health. The column focuses on questions readers have about COVID-19. As Dr. Segal points out, “Everything I write today is valid for today. COVID-19 news and science are rapidly evolving; assume updates will be made.”
Vaccine phases and the associated fairness of distribution, the numbers, and waitlists are the focus of this week’s Q and A. Currently, in Colorado and most of the country, there is a phased rollout of vaccines based on age, medical conditions, and employment where people such as health care providers may be at higher risk.
QUESTION: What phase are we in?
ANSWER: As of March 5, Chaffee County is going to phase 1B.3 expanding eligibility to those over 60, those with two or more high risk medical conditions between 16 and 59 and essential agricultural and frontline grocery workers. (For more details on the phases see http://covid19.colorado.gov/forcoloradans/vacine-for-coloradans)
QUESTION: Is it better to give more people a single dose or have less people get the full series?
ANSWER: There is an ongoing debate as to the best way to roll out the limited supply of vaccines. There is no simple black and white answer. The first two vaccines that were FDA-approved were developed and tested as a two-dose series. As a result, the CDC, FDA, and other infectious disease experts have been hesitant to suggest a one dose now and one dose later plan as has been done in the United Kingdom. From a public health point of view, I don’t have a clear-cut answer.
QUESTION: What happens to my immune response if the timing of the second dose is stretched out? And if it is stretched out, how far apart would still produce a robust immune response?
ANSWER: In general our immune responses to viruses appear to increase in the first weeks to months post-vaccine. There is some data from the Pfizer and Moderna clinical trials of people who either had to postpone or did not get their second dose. Additionally, one of the new vaccines just approved by the FDA, Johnson & Johnson (J & J) demonstrated increasing immune function at two and three months after the first dose. These findings suggest, though do not prove that waiting 8 or 12 weeks after the first of a two-dose series would not be harmful and in fact might be beneficial.
However, as with other multi-dose vaccines given to adults, there is a percentage of people that do not return for their second dose. So at this point, the CDC and state and local public health departments are encouraging all of us to get our two-dose series on the prescribed schedule of Pfizer at three weeks apart and Moderna at four weeks apart. The concern is people will not show up for dose two if the interval is stretched out.
QUESTION: Where does Colorado stand in percent immunization compared to the country as a whole?
ANSWER: Based on the CDC numbers on March 2, 2021: The USA: 16 percent of people given at least one shot, 8% have been given two shots. Colorado is slightly better than the national numbers.
Location Percent given 1st dose Percent given two doses
USA 16.0 8.0
Colorado 16.2 8.4
QUESTION: Is the county getting the doses promised?
ANSWER: So far supplies that have been promised have been delivered. Chaffee County Public Health Director, Andrea Carlstrom states, “there are no guarantees”. In general, supplies are projected to increase over the next several months as more vaccine makers have their vaccines approved by the FDA.
QUESTION: How many people in the county have been immunized?
ANSWER: The Chaffee County Public Health Department (CCPH) and Heart of the Rockies Medical Center (HHRMC) compile their data separately. Also, local pharmacies do get small supplies and currently, those numbers are not included. These include both the Moderna and Pfizer vaccines. The data is current as of March 2, 2021. For updated county-level data, the state has a new dashboard with information: https://covid19.colorado.gov/vaccine-data-dashboard.
ORGANIZATION FIRST SHOT FULLY VACCINATED
CCPH 3,485 2,243
HRRMC 2,322 2,257
QUESTION: I hear there are vaccines going to waste, is that true?
ANSWER: Carlstrom of Public Health states, “not one vaccine has gone to waste”. Allison Gergley of HRRMC also states that ” all doses are used”. The hospital pharmacy department keeps careful control of all doses.
QUESTION: I hear some counties have wait lists for any unused vaccines, how come we don’t have that here?
ANSWER: Public Health states that they and HRRMC do not currently use wait lists. Public Health does allow people who are in the current phase who do not have an appointment to wait at the end of a clinic shift for any vaccines that were not used by people who did not show up. There are no plans currently to create a wait list as this system is currently working. HRRMC states they are going to create a wait list for people who are in the current phase. People who are not in the current phase may place themselves on the list and when their phase comes up they will be moved into an appointment. The HRRMC online waitlist is due to go live in March.
QUESTION: People state that there are some getting immunized who are not in the current phase.
ANSWER: While both the county and HRRMC are working to only immunize people who are eligible, there may be a handful who have not been eligible who may have gotten an extra dose that would be unused otherwise. This is the rare exception and not the rule as the demand is exceeding the supply.
For more information about COVID-19 and the vaccines, eligibility, and appointments, see the links below. Pharmacies will be getting small shipments of vaccines in the near future. Information will be posted on AVV and on the county public health web pages.
http://chaffeecounty.org/Public-Health-Coronavirus
https://www.hrrmc.com/covid-19-updates/covid-19-vaccine/
Buena Vista resources for vaccines: Buena Vista Drug and Valley-Wide Health
Should you have a COVID-19-related question, please send it to arkvalleyvoice@gmail.com and I will attempt to address it in the next few weeks.
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