COVID-19 Vaccine Q&A Call for North Oaks Employees ...

[Pages:4]COVID-19 Vaccine Q&A Call for North Oaks Employees | January 20, 2021 | 10 a.m.

Panelists include: President/CEO Michele Sutton; Chief Medical Officer Robert Peltier, MD; Chief Operating Officer Michael Watkins; and Chief Human Resources Officer Jeff Jarreau.

Goal: Today's Q&A session aims to provide you with information so that you can make an informed decision as to whether or not to receive the COVID-19 vaccine.

Question: I am pregnant and due soon. Should I wait until I deliver to take the vaccine?

Answer from Dr. Peltier: Vaccine studies did not include pregnant or lactating women in the trials. Therefore, there is no data to support safety in this case. Naturally, it's understandable that women may decide to wait on vaccination until after delivery or breastfeeding is ended. However, we also don't have a full understanding of the risk of pregnant women contracting COVID-19. It's all about weighing risk and doing what's comfortable for you. -Question: If you have recovered from COVID-19, is there a certain amount of time that you should wait to get the vaccination?

Answer from Dr. Peltier: According to the Centers for Disease Control and Prevention (CDC), you should not get the vaccine if you think you have an active COVID-19 infection and/or are experiencing symptoms. (The same is true in the situation of flu and the flu shot and other vaccinations.) When you are fighting an infection, your response to vaccines sometimes won't be as robust as it would be when you are well. It is possible to be asymptomatic and not even know you are infected at the time of your scheduled dose. But if you are experiencing fever, chills or other symptoms, you should wait to receive the vaccine and seek medical attention. If you are having symptoms or are recovering from an infection, the best advice is to wait 1 week. Soon after, proceed with vaccination.

If you get the first dose and begin to experience symptoms or are diagnosed with COVID-19 a couple of days later, this most likely means you were exposed in the days surrounding vaccination and had not built an antibody response to the virus yet.

The CDC also advises that if you develop COVID between the first and second dose, you should wait until you are out of quarantine before you receive the second dose. If you exceed the 21-day window, you should schedule to receive the second dose as soon as possible. If you are released from quarantine within the 21-day window, proceed with getting the second dose as scheduled. If you have to delay because you are still symptomatic, wait until you are symptom-free before getting your second dose.

Vaccine studies do indicate that more than 99% of individuals who recover from COVID-19 develop antibodies that we can confirm in lab work at least 90 days out from their infection. Because of this, the CDC advises as a matter of good citizenship that these individuals postpone vaccination for 90 days to allow others who want the vaccine to get some immunity too.

What is not known is whether or not a prior infection with COVID absolutely protects you from getting it in the future. As a result, the CDC still recommends that individuals with a prior COVID infection receive the vaccine. This is especially true for health care workers because of the high risk of repeat exposure due to our line of work.

-Question: Is the CDC anticipating that this will become a yearly vaccine, and if so, will North Oaks provide it for its employees again? Or do we anticipate using our health care provider and insurance to receive it?

Answer from Dr. Peltier: The vaccine is too new to know. What we do know is that the group that received the vaccine in the trials got COVID a whole lot less than the placebo group.

We also know that viruses can mutate. We do not know if this virus will mutate at a rate fast enough to require booster doses or a change in vaccine (like annual flu vaccines which offer protection against the strains predicted to be most prevalent in any given year).

If it becomes necessary for the COVID-19 vaccine to be offered annually, North Oaks will do what is necessary to offer this protection to our employees. -Question: Do you know when vaccinations will begin for North Oaks specialty clinics' patients, age 70 and older?

Answer from Dr. Peltier: Let's talk about the different phases. Phase 1 included health care workers, nursing homes, first responders, etc. Phase 1B includes individuals, age 70 and older, and certain other groups like dialysis patients. We have been actively pursuing vaccination of these groups by reallocating vaccine not used for staff and additional supplies as received. With the leadership of Chief Health Informatics Officer Herbert Robinson, MD, we were able to use computer modeling to identify and prioritize the most vulnerable of our patients, ages 70 and older. We also reach out to all physicians on the North Oaks Medical Staff to help identify their patients, ages 70 and older, most at risk. We actively contacted these individuals to schedule them for vaccination through our Immunization Clinic at Hammond Park Professional Plaza and have vaccinated 1,400 individuals to date. If we continue to receive vaccine from the state, we will open appointments up to the public (like pharmacies have been able to do) according to priority groups identified by the state. -Question: I have a rather large, noticeable indentation in my left arm at the sight of the first injection which was given on Dec. 22. Have you ever seen this? Is this common?

Answer from Dr. Peltier: This is the first that I'm hearing of any reactions of this type to the COVID vaccine. What we do know is that any injection into a muscle sometimes can cause an inflammatory response. This is a common side effect of steroid injections and why they are usually given in the hip instead. Most indentations do go away with time.

That being said, this is not known to be a common side effect of the COVID-19 vaccine, nor is it listed in the vaccine trials literature as a complication of vaccination. --

Question: Eventually, will the masking requirement follow the same guidelines we have for flu where if you have been vaccinated, then you do not have to wear a mask?

Answer from Dr. Peltier: Eventually ... maybe ... but we are a long way from that. To achieve herd immunity, we will have to get 66% of the population vaccinated and start to see less cases. It could be years that we are required to wear masks in certain situations ? like international travel for instance. We just don't know yet.

We do know that only 95% of people who get vaccines are immune according to initial studies. So there are 5% of people that can still spread it, and it just takes a small amount of people to spread it. That being said, you will probably need to mask for the foreseeable future. -Question: Is it safe for someone over 70 years of age and on blood thinner to take the vaccine?

Answer from Dr. Peltier: Yes, it is safe. There are no contraindications to blood thinners or other medications listed in the trial literature at this time. That could change in the future if reactions are found. We do know that some people who contract COVID experience some coagulation issues, so getting COVID and being on blood thinners is a risk. As I said in response to the pregnancy question, it's all about weighing risk and doing what's comfortable for you. -Question: Is it too late for me to get my vaccine if I am a North Oaks employee?

Answer from Dr. Peltier: No, it's not too late. Just because the state moves from one priority group to another does not mean that the individuals in the first group become excluded. You are still eligible and should contact Employee Wellness at ext. 5717 for an appointment to receive your vaccine. -Question: If you have had an allergic reaction to a medication in the past, what's the likelihood that there would be a problem with this vaccine?

Answer from Dr. Peltier: Just because you have had a reaction to a medication in the past does not necessarily mean you can't take the vaccine. However, if you have had a severe anaphylactic allergic reaction to a vaccine in the past, you should not get the COVID vaccine. Your risk of a repeat reaction is higher, and vaccination is not worth the potentially deadly risk. -Question: I ended up the ER after getting the first injection. Less than a week later, I got real sick and got tested for COVID twice--both negative. I'm still fighting a bad cough, and I'm scheduled to get the second injection today. But I was on steroids and finished them yesterday. Is there a chance of me getting the second dose later if I hold off today?

Answer from Dr. Peltier: In cases where you are prescribed steroids and have the ability to put off vaccination at least 1 week, I would recommend that you do so ? whether for the first or second dose. Contact Employee Wellness at ext. 5717. They will work with you to get you rescheduled. --

Question: If I am taking steroids or have taken steroids in the past few weeks, does that stop me from getting the vaccine?

Answer from Dr. Peltier: Yes and no. If someone has just been sick and was prescribed a short stint of steroids, my suggestion would be to wait 7-10 days after finishing the steroids if it is at all possible because you want to make sure you get the best result. If it's not possible to wait, then proceed with vaccination.

I would tell you that people who are immunocompromised with steroids or rheumatologic drugs are at risk of bad outcomes with COVID. So go ahead and get your vaccine, especially if you expect to be taking steroids or rheumatologic drugs for a long time.

Bottom line ... Taking steroids does not mean that you shouldn't get the vaccine. It's all about weighing risk and doing what's comfortable for you. -Question: How long does it take for the vaccine to be effective?

Answer from Dr. Peltier: Full immunity at 95% is expected to develop 14 days after the second dose. -Question: Is North Oaks going to maintain its position that the COVID vaccination is not mandatory for employment?

Response from Michele Sutton: We will not require the COVID-19 vaccination as a condition of employment. That has not changed.

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