Transcription:

(Spanish Translation coming soon)

Prakash Chandran: This COVID-19 podcast was recorded on August 25th, 2021.

In the midst of this pandemic, in many ways, we've seen American life start to return to normal. Masks are no longer required in many locations, schools and universities are reopening and social distancing has begun to fade as concerts and sporting events resume.

But with the surge of the Delta variant, especially among the unvaccinated, there still remain a lot of questions surrounding the vaccines that are available. And we're going to get the most important ones answered today.

Let's talk about it with Dr. Valerie McLaughlin. She's board-certified in emergency medicine at St. Francis Medical Center.

This is the St. Francis Medical Center Podcast. My name is Prakash Chandran. So Dr. McLaughlin, great to have you here today. Let's start by asking you a little bit more about what your experience has been with COVID and treating patients who come into the ER.

Dr. Valerie McLaughlin: So like many places, the experience has evolved over time. In the very beginning, we were seeing many critically ill COVID patients coming in requiring ventilators, requiring ICU care. As time has gone on, we're seeing less of those critically ill patients. More of our patients are younger. Many of them are getting diagnosed and, fortunately for them, are candidates for the monoclonal antibody therapy. We're seeing pockets of clusters of patients that are getting diagnosed with COVID, most of who have been unimmunized and that's sometimes very distressing. We see entire families, entire households coming in with the disease.

But fortunately, more and more patients are being discharged. Most of the patients who are being hospitalized at this time are older, sicker, more vulnerable patients and a lot of the unimmunized patients.

Prakash Chandran: Yeah. You know, I can understand how frustrating that is. And still though I think that for those people that have not gotten the vaccine yet, there seem to be a lot of questions about the vaccine and maybe even a lot of misinformation out there. So I wonder if you might be able to tell us a little bit more about its safety, its efficacy and how it works.

Dr. Valerie McLaughlin: Sure. I understand it's confusing. We've gotten so much information, that so much has changed over the last 18 months that, you know, that people are always looking for the best source of information.

The first thing I'll say is that most major health and medical professional organizations have said that the vaccine is safe and effective and that's been demonstrated over and over by science. As most of you probably know, the Pfizer vaccine is now fully approved by the FDA. And the vaccines were developed rapidly by focusing the energy of the entire scientific community and removing the bureaucratic red tape to move them along faster.

While many of us were sheltering in place during the beginning of the pandemic, these scientists were hard at work trying to develop the vaccine. Over 360 million doses of the vaccine have been administered to date. Both the Moderna and Pfizer vaccines were about 95% effective in preventing COVID in those who were vaccinated compared to those who did not get the placebo shot in the initial studies.

The Johnson & Johnson vaccine was a little less effective, but very effective against preventing severe illness and hospitalization. And quite frankly, that is the most important thing. If somebody gets a little bit sick or gets infected, that's concerning, that's not ideal. But really what we're trying to prevent is serious illness and hospitalization. Of note, there were no COVID-19 deaths among those who were vaccinated in the clinical trials. And that's really just focusing on the initial trials.

Over the time that the vaccines have been out, they have been intensely monitored for side effects. Historically, when vaccines were developed, side effects were expected to be seen within six to eight weeks. And really any side effects seen are considered minor. Most of the side effects are pain or redness at the injection site, headaches, fatigue, muscle or joint aches, fevers, and they respond to over-the-counter medications like acetaminophen or ibuprofen.

There's been intense post-launch monitoring of the vaccines, both from the CDC and the Vaccine Adverse Event Reporting System. And the serious side effects are extremely rare, mostly allergic reactions to people who are allergic to the vaccine components and not really reacting to the vaccine per se. Deaths among vaccine recipients is also exceedingly rare.

I think some of the concern or the confusion about the vaccines is that they've been developed using technology that the public has not really been exposed to in the past. The technology is actually not new. Some of it's been around for more than 10 years. It's just now being used on a wide scale.

Vaccines in general work by exposing the body to parts of the virus, so the body can develop an immune reaction. So in the future, if the body is exposed to the actual virus, the body can fight it very efficiently. Actually, most of the side effects that we see are the expected immune response. Personally, I didn't get much side effects. And I was concerned that I really didn't develop an immune response and felt much better after I was exposed to COVID and didn't get COVID because I knew that my vaccine had worked. The COVID vaccines don't contain the live virus. You absolutely cannot get COVID-19 from getting the vaccine. You just might get the immune response.

One of the big myths is that the COVID vaccine somehow changes the DNA. It doesn't change the DNA of cells. The DNA, our genetic material, is located in the nucleus of the cell and the COVID vaccine or its components don't ever enter the nucleus of our cells. The DNA is never changed.

Prakash Chandran: Yeah. You know, thank you so much for that breakdown. And I have heard a lot of the myths that you mentioned there, you know, what might you say to people maybe that are questioning the efficacy of these vaccines? Especially now that we have a Delta variant floating around, because we have heard of some of these breakthrough cases. Is there anything that you can share regarding the vaccines' efficacy with this? I know there's some people that are like, "Why even get the vaccine? Because you need a new type of vaccine to fight this Delta variant." What might you say to them?

Dr. Valerie McLaughlin: I think the most important thing is that the reason that I got vaccinated and I'm encouraging people that I know to get vaccinated is to prevent serious illness and hospitalization. So the Delta variant is very transmissible. It means it's very contagious. But it doesn't necessarily make people sicker than the initial variants that we saw. The vaccine will protect you if you're exposed to Delta from getting serious illness or hospitalization, and really that's the most important thing, that's what's devastating about this disease is the number of people that have required hospitalization overwhelming our healthcare system and, you know, frankly, devastating families who've lost a lot of loved ones to the disease and the vaccination will prevent against that even with the Delta variant.

Prakash Chandran: So, what might you say to people with medical concerns such as cancer or they're pregnant, or maybe even they're looking to become pregnant? You know, for example, my sister is not getting vaccinated, because that's something that is in her future and she doesn't want to compromise the baby's health. So what might you say to people that are thinking in this way?

Dr. Valerie McLaughlin: So the first thing I say to people was just what I say about everything when they ask for medical advice is you really should talk to your primary care doctor or your doctor because they know you and your situation and your health the best. And they can use that information combined with the medically known information to make a recommendation.

But what I can say in general is that the risk of any side effects or adverse events from the vaccine are far smaller than the risks of serious illness or hospitalization, particularly in some of the groups that you've described. So somebody who's immunocompromised has a very high risk of having serious illness or hospitalization from COVID-19. So they may have a small risk from getting the vaccine, but we already know they have a significant risk of serious illness or death from COVID-19.

The same holds true for pregnant women. From what we know so far, pregnant women are at a higher risk of having severe illness and requiring hospitalization or dying from COVID-19 than the general population. So there are no known risks in a pregnant woman who receives the COVID-19 vaccine. However, there is a significant benefit in protecting them against contracting the disease.

You mentioned your sister being concerned about future pregnancy or fertility issues, and I get it. I understand that people are concerned about that. But there's no evidence that the vaccine has any long-term consequences on things like pregnancy or fertility. And it's being really studied heavily in individuals who've gotten the vaccines, particularly individuals who received the vaccine and then become pregnant.

But again, there are known risks of serious illness or hospitalization for everybody, particularly people who might get pregnant in the future from having the disease. We have to use the information that we have. The information that we have demonstrates that there's risks of serious illness and death in individuals who contract COVID-19. There is no information, there is no evidence that there's any chance of anything negative happening in people who received the vaccine, particularly pregnant women or women who want to become pregnant. You have to weigh known things and then you're trying to kind of guess what could happen in the future, but nobody really knows. So you have to make a decision based on the evidence that's available.

Prakash Chandran: The most compelling argument that I've heard is that people are like, "Look, this vaccine, for reasons that might be extremely understandable, was rushed." And they got that emergency use authorization by the FDA to move forward with it. And because of that reason, there really hasn't been that longitudinal study that is typically done on many vaccines, right? Because how could there be? This was rushed pretty quickly. So I think the concern that I've heard is that, "Hey, if we don't know how this vaccine affects the body three, five years out, why is this something that I should put into my body? Should I just hold off and wait?" Is there anything that you might say to people that are concerned about the long-term effects of this vaccine?

Dr. Valerie McLaughlin: There's two things. First of all, that historically with vaccines, there are no real long-term effects. Historically, the effects that are seen are within the first six to eight weeks of the vaccine being administered. So, that's the one thing.

And the second thing is it could take years, many years, before any of that information is available. And in the meantime, more and more people are contracting COVID-19 and a subset of those people are getting sick and a subset of those people are dying. So it's probably more likely that people will get COVID-19 before they get the reassurance that they're looking for.

Prakash Chandran: Yeah. I think that's well said. And like I always say, it's like how long is long enough? You know, like how long will you wait until you will take this protection and get vaccinated. And another thing that people don't realize that I've learned, and you can correct me if I'm wrong, is that the FDA, the minimum bar for efficacy for many vaccines is actually 50%. And a lot, and actually, I would say most vaccines that are out there are only 50% or a little bit over effective where these vaccines that have come out recently are a medical marvel, because they're at, you know, 90 plus percent and it's really incredible. So, first of all, am I correct in saying that?

Dr. Valerie McLaughlin: Oh, yes. You're absolutely correct in saying that. And as you're talking, it also is kind of reminding me of the first part of your question, which is about the concern about being rushed. We all know about government red tape and the reason that they were able to accelerate the approval of the vaccines was by eliminating the barriers and eliminating the red tape. The rigorous scientific research that's expected before they can give the emergency use authorization and then give the final approval, like Pfizer has gotten, all of that was maintained. It was trying to eliminate any barriers, unnecessary barriers, that would have held up the development of the vaccine.

Prakash Chandran: Right. So one of the last things that I wanted to talk to you about is, you know, we don't have herd immunity yet. So what else can people do to protect themselves in addition to getting vaccinated?

Dr. Valerie McLaughlin: Well, I hate to say I don't have any earth shattering or new information. I'm going to sound like a broken record compared to everything else you've heard before. We need to wear our masks, we need to social distance and we need to continue with good hygiene. That's the way to slow the spread of the disease and the more we can slow the spread of the disease, the less infections there's going to be and the less people we're going to lose from the disease in the future.

Prakash Chandran: Yeah, makes lots of sense to me. So just before we close here, do you have anything else that you want to share with our audience regarding this vaccine or getting vaccinated?

Dr. Valerie McLaughlin: I just want to make a general statement. I want to encourage people to make sure that they're making their decisions based on good information. There's a lot of misinformation out there and it's sometimes confusing to me how people will believe myths or misinformation that they hear from unknown sources and then not believe information they've heard from more trusted sources. So I really just encourage everyone to make sure that they research the source of the information that they're given and make sure that they're comfortable trusting that over what's considered a well-respected source.

I was shown a very compelling video about the dangers of the vaccine that, you know, actually made me question things. And then when I actually researched the person who had put together the video, I saw how the person had been, you know, their credibility had been questioned time and time again in the past. And really it was sensationalism kind of attempted theme. So I just encourage people to make sure that they're making their decisions with good information and checking their resources and making sure that they're trusted sources.

Prakash Chandran: Well, Dr. McLaughlin, I think that is really good advice and the perfect place to end. Thank you so much for educating us today.

Dr. Valerie McLaughlin: Thank you for having me.

Prakash Chandran: That's Dr. Valerie McLaughlin. She's board-certified in emergency medicine at St. Francis Medical Center. For more information, you can visit stfrancismedical.org. And if you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you.

This was a podcast from St. Francis Medical Center. My name is Prakash Chandran. Thank you so much for listening.