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As the initial doses of COVID-19 vaccines roll out across the country, leaders at Troy Regional Medical Center are working to answer questions many area residents have about safety and timelines.

“The most important thing is to be mindful of the source of your information,” said Dr. Leeann Cline, director of Pharmacy for TRMC.

After observing the same questions repeated to her directly, on social media and to other medical professionals, Cline began preparing a Q&A document to provide answers.

“The points posed in the document are those questions and answers,” she said. “It tells you what we know and provides honesty and transparency about what we don’t know … hopefully in a way that is clear, concise and accurate.”

Among the important items of note, Cline said, is that experts still do not know how long the vaccines will remain effective. “So far, the Moderna vaccine has demonstrated immunity as far out as 119 days from the time the first dose is given,” she said.

Her Q&A guide explains the science of the vaccine – which uses your body’s own RNA – and context on the development and testing. She also provides some information on potential side effects, which are a cause for concern as a health care worker in Alaska developed a severe allergic reaction to the vaccine on Wednesday.

Rick Smith, CEO of TRMC, said while the hospital is not one of the first 15 centers pre-selected for vaccine distribution, it is on the list for disbursement. “We don’t have a date, but we are working now to get ready for distribution,” he said.

Currently, only Pfizer has received emergency authorization “Moderna likely will receive it in the next 24 hours, and then we expect to other manufacturers as time goes on,” Cline said.

First priority in the vaccine will be front-line medical professionals and individuals in high risk categories, as designated by the Alabama Department of Public Health. As for the general public, Smith said best estimates are late spring or early summer 2021 for availability.

Meanwhile, the virus continues to spread at record rates.

“We’re not seeing the same levels of testing we saw in the past, but the number of positive cases is pretty significant,” said Amy Minor, chief clinical officer at TRMC.

“The percentage of positive cases is one of the most concerning things to us,” Smith added. “While testing is not equal to the 120 a day we saw three months out, the positive rate is now 18 to 20 percent.”

According to data compiled by bamatracker.com, Pike County’s positive rate climbed to 30.96 percent on Wednesday, as the county added 19 additional cases and recorded a 17^th confirmed virus death.

Alabama, which added 4,107 cases on Wednesday, has a 35.92 percent positive rate, which is the sixth highest in the nation.

“We are seeing an upward trend for sure,” Smith said. “We are the busier with COVID cases than we have been since the pandemic began in March.”

And with a vaccine months away for the general public, health officials continue to urge the public to wear a mask, maintain a social distance, and practice good hygiene.

“You have to protect yourself and protect your family,” Minor said.

More information on the vaccine, based on Cline’s Q&A document, are as follows:

How does the vaccine work?

The COVID vaccines use your own body’s RNA to prompt the immune system to make antibodies against COVID.  Antibodies are a type of protein that the body makes from RNA to help fight off infection.  COVID antibodies recognize a part of the COVID virus and are automatically triggered to help fight the virus. 

https://www.sciencefocus.com/news/everything-you-need-to-know-about-the-pfizer-coronavirus-vaccine/

https://www.modernatx.com/mrna-technology/science-and-fundamentals-mrna-technology

How long has this “lipid nanoparticle messenger RNA” technology used to make the vaccine been around?

Researchers first began trying to use antibodies to fight disease far back as 1975.  The science was fine-tuned in 1990 and in March 2017, researchers successfully showed the ability to create a vaccine for mice infected with HIV using messenger RNA.  Following success in 2017 with using the technology in mice, researchers began to use RNA for the creation of drugs and vaccines in humans (Moderna currently has 9 other vaccines they are studying using this technology). The first FDA approved drug created using RNA technology is Onpattro, which was FDA approved in 2018.

What types of people were the vaccines studied in?

The vaccine is being studied in thousands of participants of all gender and ethnicity from ages 12 and older.  Study participants range from healthy to those with underlying health conditions (ex. diabetes, heart disease, obesity, lung disease).  The vaccines are being studied on people from the U.S. and all over the world. NOTE:  **Studies have NOT included women who were pregnant**

How long have the study participants been followed for to check side effects?

At the time of the Emergency Use Authorization request, study participants in both the Pfizer and Moderna trials have been followed anywhere from 1-4 months.  They will continue to be followed by researchers for 2 years from the time of their last dose of vaccine they received.

What side effects have been seen?

The most common ones are fever, injection site pain and redness, general fatigue, headache, and chills for a few days after receiving the shot.  Side effects are few after the first dose and are more commonly seen after the second dose.

How long does immunity last after getting the vaccine?

So far, the Moderna vaccine has demonstrated immunity as far out as 119 days from the time the first dose is given.  The longer the participants are followed in the study, the more information we will have.

If I get the COVID vaccine, do I still have to wear a mask?

Vaccines can give 2 types of immunity; we will refer to them as non-sterilizing (neutralizing) immunity or sterilizing immunity.  With non-sterilizing immunity, you are protected from getting sick should your body come into contact with the virus but you still may be able to transmit the virus to others.  There is also a small potential for you to still get sick, just not as severe as you would if you had not received the vaccine.  When a vaccine produces sterilizing immunity, YOU are protected from getting sick should your body come into contact with the virus AND you are not able to pass the virus on to others (ex.  the HPV vaccine offers sterilizing immunity).  If the COVID vaccine offers sterilizing immunity, this would mean our asymptomatic carriers would no longer be spreading COVID unknowingly.  Sterilizing immunity is what we want to happen with vaccines but it doesn’t mean that if a vaccine produces non-sterilizing immunity then the vaccine is less effective.  The polio vaccine produces non-sterilizing immunity and has decreased polio cases by 99% worldwide.  The flu vaccine also produces non-sterilizing immunity and is widely successful each year in either reducing flu cases or reducing the severity of flu cases.  So far, a small group of patients have shown to have STERILIZING immunity in the Moderna vaccine trial!!  Pfizer did not initially set up their study protocol to test for sterilizing immunity but I fully expect to see them start tracking this if they haven’t already.  So as of now, yes.  We will still ask you to wear a mask while at work until we have more concrete information on whether or not the vaccine will give sterilizing immunity.

What happens if I miss the second dose of COVID vaccine when it is due?

We are not sure.  All experts are stressing to get the second dose WHEN IT IS DUE (within 2 days before or 2 days after the exact date).  If you only get 1 dose, you are only about 54% protected compared to greater than 90% protection if you receive both doses of COVID vaccine on time at the correct timing interval (21 days for Pfizer vaccine, 28 days for Moderna).  Ways to remind yourself of when your second dose is due:  use vaccine reminder card you will be given at the time of your first dose, give us your email to enter into ImmPrint and ImmPrint will send an email reminder, set a calendar event or reminder on your phone, put it in big bold letters on your calendar at home…

If I don’t want to get the vaccine right away, can I still opt in to get it later?

YES!!  We will immunize as long as we have vaccine available and personnel to do so!