Selected Podcast
COVID-19 Vaccine FAQs
Jignesh Modi, M.D., fellowship-trained infectious disease specialist, shares answers to frequently asked COVID-19 vaccine questions.
Featuring:
Jignesh Modi, MD
Jignesh Modi, MD is a Genesis Infectious Diseases Specialists. Fellowship-trained in infectious disease at the University of Maryland Hospital. Completed his residency in internal medicine at the Christiana Hospital. Transcription:
Scott Webb: News of COVID-19 vaccines reaching arms across America has brought renewed hope. It's also brought with it more questions and who better to answer those questions than Dr. Jignesh Modi, he's an infectious disease specialist at Genesis. This is Sounds of Good Health with Genesis brought to you by Genesis HealthCare System. I'm Scott Webb.
So Dr. Modi, so nice to talk to you again. I know your dance card is probably pretty full these days with the vaccines rolling out, so let's get right to it. How were the vaccines developed and really, how were they developed so quickly?
Dr. Jignesh Modi: So the vaccines were developed in a unique way, which is partly what contributes to how rapidly they were developed. Generally, this type of vaccine going back 10 years ago would have required several years to develop. But this is a genetically developed vaccine using part of the virus' RNA and replicated it, which we could not do 10 years ago.
Scott Webb: Yeah. And so let's talk about the rollout of the vaccines. How is it being handled nationally versus locally? What are you seeing there at genesis?
Dr. Jignesh Modi: Certainly, the federal government was involved in distributing the vaccine to the various states. And using two of the national private carriers, each took essentially half the country and has been distributing vaccine to each of the states.
And each of the states has been allowed flexibility in determining how to roll it out.
You have a state like Ohio that distributed to the hospitals to start with so that they could vaccinate their frontline workers and then it was distributed to nursing homes. And from here, it will be rolled out in each state as they deem appropriate, but for many of us, certainly not fast enough.
Scott Webb: That's certainly true. It's exciting news that the vaccines are reaching destinations and getting into arms. But of course, you know, with a deadly pandemic looming, it never quite seems fast enough despite the fact that it's been all hands-on deck and everybody doing their best work. And I think one of the things that's a little confusing for me anyway is the phases. Can you sort of explain? I sort of know that 1C is the beginning of, you know, the phase for people like me and my family and for most people, but maybe could you take us through those phases?
Dr. Jignesh Modi: The phases are used in a very rational manner. You want to vaccinate your highest risk people first and those tend to be people who are frontline workers, which would include people who work in hospitals, emergency room, EMS staff. You would also want to first vaccinate the people who are highest risk for serious consequences and those without a doubt have been nursing home patients. When this virus gets into a nursing home, the mortality is 5% to 10%, which is extremely high, and the morbidity is high as well. And so those people were prioritized.
The next group of people that will be prioritized will be additional frontline people who may not necessarily be healthcare workers. And those would include people who, for example, are teachers or perhaps frontline workers in retail establishments and, certainly, law enforcement would be included in there very early.
The next phase will include people, who are largely by age. And some of that depends upon vaccine availability and will vary by state. The older you are the higher your risk of complications. And so, the 75-year-olds and up would be the first group. And you would slowly move down to the 65-year-olds and up, and you work your way down as far as by age, because that is the next biggest risk factor.
Scott Webb: As far as you know, will the current vaccines protect people from the variants? And if so, how does that work exactly?
Dr. Jignesh Modi: The vaccines are targeted towards what's known as a spike protein. If you ever see an illustration of the virus, it's typically shown as a sphere or a ball with little spikes that stick out on its surface and those spikes are what help attach to ourselves, which then results in infection of that particular cell. So the vaccines are targeted against that spike protein. And the vaccines are highly effective. We have very few vaccines if any, that are as effective as these vaccines are. And the mutations have been noted in the spike protein, but fortunately to this point, the mutations have been such that it doesn't seem to affect the efficacy of the vaccines.
Now. all viruses tend to mutate. Some viruses mutate very little, just as an example, hepatitis B virus. If you go back thousands of years, they've studied viruses and found them in the mummies of Egypt, and the virus is exactly the same if you go back thousands of years as it is now. And so to develop a vaccine is very easy.
Respiratory viruses tend to have a relatively high mutation rate, which would make some sense because if these viruses didn't mutate, we would get these infections once and would tend to not get them again. So by nature, they tend to have a relatively high mutation rate. And so I think it should have been anticipated and it probably was by the people developing the vaccines. That's why every year the flu vaccine changes. And that's why every year the flu vaccine has actually several different virus components to it, because we don't know exactly which flu virus will, be prevalent that particular year. So mutation is not unexpected. But to this point, the mutations have not appear to affect the efficacy of the vaccine, which is good news.
The other piece of good news is these vaccines are so rapidly developed, that if a mutation develops that does appear to affect efficacy of the vaccine, developing a new vaccine or a combination vaccine similar to what I described with the flu, should be a good, strong possibility.
Scott Webb: Assuming that the vaccine remains a voluntary thing for people and isn't mandated in any way, do you recommend that people get the vaccine as soon as they are eligible?
Dr. Jignesh Modi: I would strongly recommend that people get the vaccine as soon as they're eligible. Amongst hospitals staff, for example, amongst all the physicians that are frontline, the pulmonologists who see a lot of this, the hospitalist who see a lot of this, I who had seen quite a bit of it, you could feel a sense of relief. The nursing staff in the ICUs who have been overwhelmed with this for the past several months, those staff that got vaccinated, great sense of relief. And so that's what I would look to.
As far as side effects of the vaccine, I've certainly asked everybody that I could, who I know who got the vaccine, and I have yet to find anybody who regrets getting it. It would not be unusual, especially with the second vaccine to get either a low-grade temperature or even a fever of 102 once or twice, some muscle aches, headaches, but very tolerable and definitely worth it.
I personally see that as one major step towards getting our lives back to where they were 12, 18 months ago as much as possible. Things will never be the same, but it is what is necessary to get back to what we had before.
Scott Webb: Yeah, definitely. And I'm really glad to hear that frontline workers like yourself are getting the vaccine, shots in arms, that's a good thing. And do we know whether or not people will still be able to carry and transmit the virus even after they've been vaccinated? Because I know that there's some question about that and as much as we do know about COVID-19 so far, there's probably a lot that we still don't know, right?
Dr. Jignesh Modi: That would be true. But taking some lessons from other viruses that we are very familiar with just as the flu as I've mentioned a couple of times, what I would expect is-- so when someone gets vaccinated against the flu or any other respiratory virus, what it does is it creates a rapid response within your body, such that your body knows how to handle it and puts that virus down very quickly. So you actually do develop a slight infection, but if a vaccine is effective in you and it is effective 95% of the time in all populations, then that infection should be very short-lived and will very likely be asymptomatic.
Getting back to the question of whether you can transmit it or not, the absolute yes or no answer to that would be yes, but the risk of transmission is greatly reduced. If you get COVID, we right now have people isolated for 10 days, if they have a relatively mild illness. The reason for that is that's the time period during which people are felt to be most likely to transmit.
So once you get the vaccine, if you get an infection, most likely it will be asymptomatic. And your risk for transmission would be a tiny fraction of what it would have been if you had not gotten the vaccine.
Scott Webb: Yeah, that's good to know. And I think I know the answer to this, but do you recommend that people continue to wear face coverings even after they've received the vaccine?
Dr. Jignesh Modi: I think wearing face coverings is important right now for several reasons. One, it's almost a social thing in the sense that it reinforces behavior in other people. So I’ve been vaccinated and I continue to wear a mask around the hospital, but also if I go out grocery shopping, I continue to wear a mask.
So in the near term, I think it is actually very important just as a reminder, and those reminders are actually quite important to us as human beings. When you see someone wearing a mask, it changes your behavior just slightly that you may not recognize. You might be slightly more likely to wash your hands or use hand sanitizer or even take certain other precautions.
Wearing the masks certainly has benefit. And I'll go back to the flu, this has been an extremely mild flu season and the reason is the same precautions we are taking for COVID have greatly reduced the amount of flu that we're seeing. But the other part of that is we aren't seeing much flu, but we're still seeing COVID, which also should tell someone how contagious this virus is compared to flu.
So I think for the greater good, I think it is important to continue wearing a mask even if you have been vaccinated. There will be a time when we can ease off on that, and I won't make any big predictions because I don't think it's possible and I am guaranteed to be wrong, but I would hope that 12 months from now we are able to back off on some of these precautions. I have a sense that this virus will not just disappear and it may become a vaccine that is administered regularly. But that's a small price to pay in my mind for the freedoms that we want.
Scott Webb: Yeah. Especially at a 90-95% efficacy, if this becomes something-- again, no one's going to hold you to this, as far as I know, anyway -- if this becomes something that we have to get every year, like the flu shot, as you say, a small price to pay. And I love your perspective on that. Seeing people wearing face coverings and masks is a visual cue, a visual reminder of what we've been through so far, what we're still facing and really might continue to help modify people's behavior. That's going to be my takeaway from this today. I really appreciate that.
Doctor, as we wrap up here, anything else you want to tell people about COVID-19, the vaccines, short-term, long-term? And I'm asking you to kind of look into your crystal ball, but anything else we can tell people, takeaways, about the COVID 19 vaccines?
Dr. Jignesh Modi: About the vaccines themselves, I think, as I've mentioned, these vaccines are as effective as any vaccines we've developed and we are very fortunate to have them. And it appears that they are very safe. People, as I mentioned, do get some reaction, more likely with the second shot than with the first. But to me, I would actually want to get some type of reaction to the vaccine, because that is somewhat reassuring that it may have had some uptake. Now, just because you don't get a reaction, and I've spoken to plenty of people who essentially had no reaction except for some soreness in their arm, that certainly doesn't mean that it wasn't effective.
And the other thing I would say about the vaccines is I wouldn't use the mutations as a reason not to get the vaccine for a long list of reasons. One of them being, it is highly effective against the most common virus that is in circulation right now. And if it is later found that there's a mutation that the current vaccine doesn't work for, I think there will be very rapid development of a vaccine that is effective against that particular strain. And so that shouldn't be a big fear.
The thing that could happen in that setting, if there's a mutation, it could require us to wear masks and take precautions longer. But I think we all are looking forward to the day where we can leave our homes and get back to a sense of purpose, education, whatever that might be. As human beings, this has been in my opinion as much a mental toll as has been a physical, not to take away from the 400,000 people who aren't with us any longer. But I think this has been quite a mental challenge for us as humans as well, because we are social animals.
Scott Webb: Yeah, we definitely are. And you're so right. It has been mentally and physically fatiguing. And I think we're all just pretty much over it. You know, to speak the way my kids would speak, I'm over it. I think we're all over it. And there is light at the end of the tunnel. We can see it. It's there. It's near as it's
been. And shots are going into arms and that's a good thing. Really, great having you on. Lots of great insight today. Thank you so much for your time and your expertise, and you stay well.
Dr. Jignesh Modi: Thank you. Thank you for having me and you be safe as well.
Scott Webb: Go to genesishcs.org/covid-19 for up-to-date information on the COVID-19 vaccine. And thanks for listening to Sounds of Good Health with Genesis brought to you by Genesis HealthCare System. If you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. I'm Scott Webb. Stay well, and we'll talk again next time.
Scott Webb: News of COVID-19 vaccines reaching arms across America has brought renewed hope. It's also brought with it more questions and who better to answer those questions than Dr. Jignesh Modi, he's an infectious disease specialist at Genesis. This is Sounds of Good Health with Genesis brought to you by Genesis HealthCare System. I'm Scott Webb.
So Dr. Modi, so nice to talk to you again. I know your dance card is probably pretty full these days with the vaccines rolling out, so let's get right to it. How were the vaccines developed and really, how were they developed so quickly?
Dr. Jignesh Modi: So the vaccines were developed in a unique way, which is partly what contributes to how rapidly they were developed. Generally, this type of vaccine going back 10 years ago would have required several years to develop. But this is a genetically developed vaccine using part of the virus' RNA and replicated it, which we could not do 10 years ago.
Scott Webb: Yeah. And so let's talk about the rollout of the vaccines. How is it being handled nationally versus locally? What are you seeing there at genesis?
Dr. Jignesh Modi: Certainly, the federal government was involved in distributing the vaccine to the various states. And using two of the national private carriers, each took essentially half the country and has been distributing vaccine to each of the states.
And each of the states has been allowed flexibility in determining how to roll it out.
You have a state like Ohio that distributed to the hospitals to start with so that they could vaccinate their frontline workers and then it was distributed to nursing homes. And from here, it will be rolled out in each state as they deem appropriate, but for many of us, certainly not fast enough.
Scott Webb: That's certainly true. It's exciting news that the vaccines are reaching destinations and getting into arms. But of course, you know, with a deadly pandemic looming, it never quite seems fast enough despite the fact that it's been all hands-on deck and everybody doing their best work. And I think one of the things that's a little confusing for me anyway is the phases. Can you sort of explain? I sort of know that 1C is the beginning of, you know, the phase for people like me and my family and for most people, but maybe could you take us through those phases?
Dr. Jignesh Modi: The phases are used in a very rational manner. You want to vaccinate your highest risk people first and those tend to be people who are frontline workers, which would include people who work in hospitals, emergency room, EMS staff. You would also want to first vaccinate the people who are highest risk for serious consequences and those without a doubt have been nursing home patients. When this virus gets into a nursing home, the mortality is 5% to 10%, which is extremely high, and the morbidity is high as well. And so those people were prioritized.
The next group of people that will be prioritized will be additional frontline people who may not necessarily be healthcare workers. And those would include people who, for example, are teachers or perhaps frontline workers in retail establishments and, certainly, law enforcement would be included in there very early.
The next phase will include people, who are largely by age. And some of that depends upon vaccine availability and will vary by state. The older you are the higher your risk of complications. And so, the 75-year-olds and up would be the first group. And you would slowly move down to the 65-year-olds and up, and you work your way down as far as by age, because that is the next biggest risk factor.
Scott Webb: As far as you know, will the current vaccines protect people from the variants? And if so, how does that work exactly?
Dr. Jignesh Modi: The vaccines are targeted towards what's known as a spike protein. If you ever see an illustration of the virus, it's typically shown as a sphere or a ball with little spikes that stick out on its surface and those spikes are what help attach to ourselves, which then results in infection of that particular cell. So the vaccines are targeted against that spike protein. And the vaccines are highly effective. We have very few vaccines if any, that are as effective as these vaccines are. And the mutations have been noted in the spike protein, but fortunately to this point, the mutations have been such that it doesn't seem to affect the efficacy of the vaccines.
Now. all viruses tend to mutate. Some viruses mutate very little, just as an example, hepatitis B virus. If you go back thousands of years, they've studied viruses and found them in the mummies of Egypt, and the virus is exactly the same if you go back thousands of years as it is now. And so to develop a vaccine is very easy.
Respiratory viruses tend to have a relatively high mutation rate, which would make some sense because if these viruses didn't mutate, we would get these infections once and would tend to not get them again. So by nature, they tend to have a relatively high mutation rate. And so I think it should have been anticipated and it probably was by the people developing the vaccines. That's why every year the flu vaccine changes. And that's why every year the flu vaccine has actually several different virus components to it, because we don't know exactly which flu virus will, be prevalent that particular year. So mutation is not unexpected. But to this point, the mutations have not appear to affect the efficacy of the vaccine, which is good news.
The other piece of good news is these vaccines are so rapidly developed, that if a mutation develops that does appear to affect efficacy of the vaccine, developing a new vaccine or a combination vaccine similar to what I described with the flu, should be a good, strong possibility.
Scott Webb: Assuming that the vaccine remains a voluntary thing for people and isn't mandated in any way, do you recommend that people get the vaccine as soon as they are eligible?
Dr. Jignesh Modi: I would strongly recommend that people get the vaccine as soon as they're eligible. Amongst hospitals staff, for example, amongst all the physicians that are frontline, the pulmonologists who see a lot of this, the hospitalist who see a lot of this, I who had seen quite a bit of it, you could feel a sense of relief. The nursing staff in the ICUs who have been overwhelmed with this for the past several months, those staff that got vaccinated, great sense of relief. And so that's what I would look to.
As far as side effects of the vaccine, I've certainly asked everybody that I could, who I know who got the vaccine, and I have yet to find anybody who regrets getting it. It would not be unusual, especially with the second vaccine to get either a low-grade temperature or even a fever of 102 once or twice, some muscle aches, headaches, but very tolerable and definitely worth it.
I personally see that as one major step towards getting our lives back to where they were 12, 18 months ago as much as possible. Things will never be the same, but it is what is necessary to get back to what we had before.
Scott Webb: Yeah, definitely. And I'm really glad to hear that frontline workers like yourself are getting the vaccine, shots in arms, that's a good thing. And do we know whether or not people will still be able to carry and transmit the virus even after they've been vaccinated? Because I know that there's some question about that and as much as we do know about COVID-19 so far, there's probably a lot that we still don't know, right?
Dr. Jignesh Modi: That would be true. But taking some lessons from other viruses that we are very familiar with just as the flu as I've mentioned a couple of times, what I would expect is-- so when someone gets vaccinated against the flu or any other respiratory virus, what it does is it creates a rapid response within your body, such that your body knows how to handle it and puts that virus down very quickly. So you actually do develop a slight infection, but if a vaccine is effective in you and it is effective 95% of the time in all populations, then that infection should be very short-lived and will very likely be asymptomatic.
Getting back to the question of whether you can transmit it or not, the absolute yes or no answer to that would be yes, but the risk of transmission is greatly reduced. If you get COVID, we right now have people isolated for 10 days, if they have a relatively mild illness. The reason for that is that's the time period during which people are felt to be most likely to transmit.
So once you get the vaccine, if you get an infection, most likely it will be asymptomatic. And your risk for transmission would be a tiny fraction of what it would have been if you had not gotten the vaccine.
Scott Webb: Yeah, that's good to know. And I think I know the answer to this, but do you recommend that people continue to wear face coverings even after they've received the vaccine?
Dr. Jignesh Modi: I think wearing face coverings is important right now for several reasons. One, it's almost a social thing in the sense that it reinforces behavior in other people. So I’ve been vaccinated and I continue to wear a mask around the hospital, but also if I go out grocery shopping, I continue to wear a mask.
So in the near term, I think it is actually very important just as a reminder, and those reminders are actually quite important to us as human beings. When you see someone wearing a mask, it changes your behavior just slightly that you may not recognize. You might be slightly more likely to wash your hands or use hand sanitizer or even take certain other precautions.
Wearing the masks certainly has benefit. And I'll go back to the flu, this has been an extremely mild flu season and the reason is the same precautions we are taking for COVID have greatly reduced the amount of flu that we're seeing. But the other part of that is we aren't seeing much flu, but we're still seeing COVID, which also should tell someone how contagious this virus is compared to flu.
So I think for the greater good, I think it is important to continue wearing a mask even if you have been vaccinated. There will be a time when we can ease off on that, and I won't make any big predictions because I don't think it's possible and I am guaranteed to be wrong, but I would hope that 12 months from now we are able to back off on some of these precautions. I have a sense that this virus will not just disappear and it may become a vaccine that is administered regularly. But that's a small price to pay in my mind for the freedoms that we want.
Scott Webb: Yeah. Especially at a 90-95% efficacy, if this becomes something-- again, no one's going to hold you to this, as far as I know, anyway -- if this becomes something that we have to get every year, like the flu shot, as you say, a small price to pay. And I love your perspective on that. Seeing people wearing face coverings and masks is a visual cue, a visual reminder of what we've been through so far, what we're still facing and really might continue to help modify people's behavior. That's going to be my takeaway from this today. I really appreciate that.
Doctor, as we wrap up here, anything else you want to tell people about COVID-19, the vaccines, short-term, long-term? And I'm asking you to kind of look into your crystal ball, but anything else we can tell people, takeaways, about the COVID 19 vaccines?
Dr. Jignesh Modi: About the vaccines themselves, I think, as I've mentioned, these vaccines are as effective as any vaccines we've developed and we are very fortunate to have them. And it appears that they are very safe. People, as I mentioned, do get some reaction, more likely with the second shot than with the first. But to me, I would actually want to get some type of reaction to the vaccine, because that is somewhat reassuring that it may have had some uptake. Now, just because you don't get a reaction, and I've spoken to plenty of people who essentially had no reaction except for some soreness in their arm, that certainly doesn't mean that it wasn't effective.
And the other thing I would say about the vaccines is I wouldn't use the mutations as a reason not to get the vaccine for a long list of reasons. One of them being, it is highly effective against the most common virus that is in circulation right now. And if it is later found that there's a mutation that the current vaccine doesn't work for, I think there will be very rapid development of a vaccine that is effective against that particular strain. And so that shouldn't be a big fear.
The thing that could happen in that setting, if there's a mutation, it could require us to wear masks and take precautions longer. But I think we all are looking forward to the day where we can leave our homes and get back to a sense of purpose, education, whatever that might be. As human beings, this has been in my opinion as much a mental toll as has been a physical, not to take away from the 400,000 people who aren't with us any longer. But I think this has been quite a mental challenge for us as humans as well, because we are social animals.
Scott Webb: Yeah, we definitely are. And you're so right. It has been mentally and physically fatiguing. And I think we're all just pretty much over it. You know, to speak the way my kids would speak, I'm over it. I think we're all over it. And there is light at the end of the tunnel. We can see it. It's there. It's near as it's
been. And shots are going into arms and that's a good thing. Really, great having you on. Lots of great insight today. Thank you so much for your time and your expertise, and you stay well.
Dr. Jignesh Modi: Thank you. Thank you for having me and you be safe as well.
Scott Webb: Go to genesishcs.org/covid-19 for up-to-date information on the COVID-19 vaccine. And thanks for listening to Sounds of Good Health with Genesis brought to you by Genesis HealthCare System. If you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. I'm Scott Webb. Stay well, and we'll talk again next time.