Dr. Bert Smith, a medical consultant with NHC, provides answers to questions that patients and family have about the new COVID-19 vaccine rollout in senior centers. Dr. Smith has spent the past few months on the frontlines during the coronavirus crisis serving patients in Northeast Tennessee and Southwest Virginia, and he has become a sought-after speaker on internal medicine for senior care. Here are some of the answers he provided. Find out more by following the link to listen to the podcast.

How was the vaccine developed?

This new vaccine is a mRNA vaccine. We have learned to speak the language of our immune system with this vaccine. Similar to cancer treatment, it gives us the ability to program our immune system to respond to a specific piece of the virus and then activate the immune system to a very robust response.

Is this a totally new vaccine?

It is similar to current cancer treatments. In cancer treatment, we are training the body’s immune system to recognize and kill cancer cells. While this is not a new technology, it is one of the first time it has been used in a vaccine. We found out it works really well and is significant in the immune response.

How does the vaccine actually work?

You have received the mRNA that codes for the spike protein of the virus and it has been put into a vaccine form. The vaccine is injected into the patient. The MRNA is passed into the cells which code for the virus protein and is recognized by the immune system. The immune system recognizes it as foreign. That immune response, which produces antibodies, is what protects us from getting infected if the real virus enters our bodies.

So later if a person is exposed to the coronavirus virus, the immune system recognizes it and now has an immune response to keep from acquiring an infection from the coronavirus. You get the first dose to prime the immune system and the second dose gets the immune system active and ready for that exposure. The second dose is administered between 21-28 days, depending on the type of vaccine.

How does this vaccine compare with the flu vaccine?

They are very different. The flu vaccine is a kill virus meaning the virus that has been killed. Some other vaccines are live virus meaning that small doses of a live virus are injected over a period of time so individuals mount an immune response. The COVID-19 virus is neither a kill or live virus. This vaccine is just the genetic code for a piece of the virus.

Can you get COVID-19 from the vaccine?

No, you can’t get coronavirus from the vaccine because there is no whole virus in this vaccine. We are only injecting a piece of the genetic code for a piece of the spike proteins. We are teaching the body to make a piece of the spike protein which then is recognized by the immune system as foreign and results in immunity. It is one of the safest ways to do a vaccine.

What kind of side effects do you see for the vaccine?

You can expect to have some kind of side effects for any vaccine. It means your immune response is working. We have not seen serious adverse side effects to the COVID-19 vaccine. Data that came out in the last month shows no serious reactions that require hospitalization or serious safety concerns that require medical care. The typical side effects are headache, pain at the site, swelling, redness, fatigue or low-grade fever. All of these typical side effects assure you that your immune system is working and doing its job.

How effective are the Pfizer and Moderna vaccines?

The new vaccines have a side effect profile like a flu shot and may be safer than the flu shot. But the best part is now that we have learned to speak this genetic code, we have found these vaccines to be 94-95% effective. That’s way more effective than a flu shot which is 50-70% effective depending on the year. We don’t have many vaccines that do as well as the COVID-19 vaccine.

Does it matter which vaccine I receive?

The Pfizer and Moderna vaccines are very similar in how they work, in their effectiveness, and in their side effect profile. I would be comfortable getting either type of vaccine. You do want to make sure that the first vaccination and the second booster are the same type.

What about reports of allergic reactions?

Out of the hundreds of thousands of vaccines already administered, there have been a few cases of anaphylaxis, or allergic reactions. This is very similar to what we have seen with other vaccines. The affected individuals have had allergic reactions in the past. The FDA is recommending that if you have a history of anaphylaxis or are allergic to any particular component of the vaccine, you not take it and talk to your doctor about it.

Once I get the vaccine, will I still need to wear the mask and practice social distancing?

We won’t be able to discontinue the mask and social distancing until we see the number of cases substantially decreasing.

If I have had COVID-19, do I need to get the vaccine?

Yes, you do need to get the vaccine, but you will need to consult your physician about the timing of the vaccine. The vaccine will result in a longer and more robust response than if you had the infection.

How long does the vaccine last?

We don’t know the answer exactly. If the virus does not mutate every year, the vaccine may result in years of immunity. It is very important for as many people as possible have the vaccine to help eradicate the disease and keep it from mutating.

Will the vaccine cause you to test positive on a COVID-19 test?

No, the people who test positive are getting a nasal swab and the virus has to be replicating in the body to be excreted in the nasal cavity. Since this vaccine results in the body making a immune response to a piece of a spike protein, the virus is not replicating in the body.

Can someone receive the vaccine if they are actively positive for COVID-19?  

The patient must meet CDC guidelines as recovered before receiving the vaccine.

What is the most important thing to consider when getting the vaccine?

Beyond your own health, the most important thing is to consider those around you. The vaccine is our best chance at protecting family and those around us.

How does the process work to get the vaccine in the senior centers?

First, we need to get consent from our patients or their primary family member. The vaccine will not be mandated. Walgreen’s will actually come out to the facility and vaccinate those who have given their consent. All the Walgreen’s team will be screened and tested, just like our partners in the centers. The team will return at a later time (21 – 28 days, depending on the type of vaccine) to administer the second vaccine.

Where should we go for additional information?

The CDC website has great information in language suitable for everybody. There are other medical resources such as the Infection Diseases Society of America and National Institute of Health. Make sure that you are using sources of reputable information.

The CDC has created the below resources regarding the COVID-19 vaccine: 
·COVID-19 Vaccines: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html 
·Benefits of getting a COVID-19 Vaccine: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/vaccine-benefits.html 
·Frequently Asked Questions about COVID-19 Vaccination: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html