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Dr. Rai discusses local COVID vaccine plan and what’s in the shot

Published: Dec. 15, 2020 at 7:33 AM CST
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GREEN BAY, Wis. (WBAY) - Northeast Wisconsin health care providers are still waiting to receive shipments of the COVID-19 vaccine. Prevea Health President and CEO Dr. Ashok Rai says local health care systems are ready to administer the vaccine to frontline workers.

Dr. Rai joined us Tuesday on Action 2 News This Morning to discuss the operational plan. He also talked about what’s inside the vaccine and how it works.

Dr. Rai joins us Tuesdays and Thursdays. Have a question for him? Email news@wbay.com.

View past Dr. Rai segments here: https://www.wbay.com/health/drrai/

WHEN WILL VACCINE ARRIVE IN NE WISCONSIN?

“Don’t know yet. Soon. The state has told us to expect deliveries this week. We’ll see how that goes. As soon as we get it--it’s not just getting it, it’s also operational, giving it. And all that will be happening as soon as we get it, and the next steps to follow.

“I talked to my teams yesterday about this, and I love the movie The Patriot--’aim small, miss small.’ Do a small amount of people the first day and then continue to grow that. This is a new operation for us. We’ve not ever had to thaw something like this, put shots in arms, record that, make sure they come back for a second. We want to make sure this is done well. If we had the honor to do it this week, or even early next week, whenever we actually get to do that first shot we want to make sure we do it right. We want it to go right for the population from that point forward.”

MRNA IN VACCINE

“mRNA is a new type of vaccine. It’s a small piece of genetic code. In this vaccine, it’s got a lipid lining on it, basically it’s in a little fat bubble. It goes inside your arm. Then it’s transported inside a cell. It doesn’t enter the nucleus of the cell. It doesn’t interact with the DNA of the cell. It binds with something called a ribosome inside the cytoplasm of the cell. It makes that spike protein. Your body identifies that spike protein that’s normally on COVID, but it’s not giving you COVID. It reacts to that. It prevents you from actually having COVID-19 infect you in the future. Then mRNA just disappears. It goes away. It doesn’t stay in your body.”

KEEP MASKING

“The end point in these studies for this vaccine was, ‘will it prevent me from getting sick from COVID-19?’ And it does an amazing job. What we’ve seen--that 90-to-95 percent efficacy of you not getting sick from COVID-19. What was not studied was will you transmit it even if you don’t get sick from it? That study is going on right now. So until we know more about that, we still need to mask to prevent us from transmitting it. And there’s a lot of people in our community who will not have been vaccinated yet, so we need to keep them safe. So, for the months to come, we’ll be masking, we’ll be physically distancing, we’ll be doing all the right things while we roll out this vaccine and learn more about it. But for the short period of time, which I consider short, while we get this vaccine to people, still wear your mask, still physically distance, still quarantine if you’re exposed to somebody, even if you’ve had the vaccine.”

VACCINE, SPREAD AND SYMPTOMS

If you get the vaccine, will you be able to infect others? Will you have symptoms?

“We don’t know that yet. We do know that the virus will invade you and your body will defend itself and prevent it from replicating in your body and you won’t get sick from COVID-19, but the whole transmission part is what we’re starting to look at over the next couple of months.

“Remember, it’s not always about us. It’s not about us getting sick, but it’s about preventing the transmission to people who haven’t been vaccinated yet.”

CONVERSATIONS FOR PHYSICIANS

“There’s a very tiny population that, it’s not about who shouldn’t get it, but they should be discussing it with their physician. You’ve had an allergic reaction to a vaccine in the past, if you have severe allergies to anything that’s in this vaccine--there are certain elements, four elements outside the mRNA--that an allergist would be able to look at to make sure. Make sure you see an allergist if you’ve had severe allergies. A lot of people are asking us about pregnancy. There’s no official recommendation yet if you’re pregnant. That means you need to talk to your OB-GYN or family practitioner and understand the pros and cons of the vaccine. There’s a con to getting COVID if you’re pregnant, so preventing it is important. But it really depends at where you are in your pregnancy, what other risk factors you may have. So that’s an in-depth discussion with your provider.”

VACCINE ADMINISTRATION

No drive-through vaccines yet.

“For right now it’s not. The CDC is worried, as we all are, to make sure that this is done well. So after every single person is vaccinated, they’re watched for 15 minutes. If they have a history of an allergic reaction, we’re told to watch them for 30 minutes. And watch means to actually watch this person to make sure they don’t have a reaction. So it’s not something we can just have people in their car right now. We’ll see what happens to the recommendations as we immunize hundreds of thousands of more people and get the data.”

HOW LONG IS VACCINE EFFECTIVE?

“I think it’s important to understand the steps to get immunity. You’re going to get one shot. You’re not immune. You’re going to get a second shot, about 21-to-28 days after, it really depends on the vaccine you get of the first two we’re seeing, then about two weeks after that is when your immunity period starts. It’s thought and hoped that that would go for a year. We really won’t know that, as Dr. [Anthony] Fauci said, for some time. Those that were in the initial vaccine trials were registered this summer and fall. We’ll start to see what they look like a year after, because they’ll still be followed. And then the bulk of America being immunized starting now. It will be about nine months to a year before we know how long it’s going to last. We hope at least a year, and it may be even longer.”

VACCINE AND PRE-EXISTING CONDITIONS

Viewers with pre-existing conditions such as COPD, high blood pressure, and allergic reactions ask about vaccine priority and safety.

“Those that have chronic medical diseases, COPD, diabetes, hypertension, those are all people we worry about if they get COVID, they’re going to do worse. So those are people who are going to go higher on the list of when to get the vaccine. We don’t know when that’s going to be. We don’t exactly know how that’s going to break apart. The government will help us through that and local health care officials will also work through that to make sure that happens and people are identified. We don’t know what that list is. We know the general part about it. The normal comorbidities we think about. It’s important to understand, the United States, especially in Wisconsin, almost 40 percent of this country has one of those issues that qualifies for that.

“You mentioned penicillin allergies. That’s a whole different story. We start talking about those who’ve had allergic reactions to vaccines. Severe allergic reactions to vaccines or other severe allergic reactions. The societies for immunizations and for allergies and immunology have talked about this. If you’ve had a severe reaction it’s important that you actually have an appointment with an allergist to go over that before you get the vaccine. This is a great time to schedule that appointment because we’re starting to find out what’s in the current vaccines, what you may have had a reaction to in the past, and what you need to be evaluated for before you get this. So if you’ve had a severe allergic reaction, and by that we’re talking the kind that required epinephrine or an epi-pen and you’ve had bad allergic reactions, meet with your allergist. That’s really the recommendation right now.

“A big bulk of our patients are hopefully going to come to us for the vaccination, but there’s people who might get health care in other areas or we don’t have their medical records. It’s going to be really important that they go over that with us when we start to schedule for those patients. That’s a month or two out, or maybe even longer, depending on supply. So we need to work through those situations now, make sure you’ve established with the health care provider so you’re ready to get that vaccination.”

GENERAL PUBLIC TIMELINE

When will the average person get the vaccine?

“Best guess is early spring for everybody. That’s optimistic, not best. It could be later spring. It’s important to know this is being done in phases that are in the best interest of public health. Our most vulnerable are those in long-term care because it spreads so quickly. When they get it, they get very sick. We start talking about nursing homes and assisted livings. You also want to make sure that you have enough health care providers to continue to take care of us because COVID is not gone. It’s continuing to hurt people and unfortunately kill people in the coming months. You need health care to stand up to be able to take care of those patients. That’s why they’re getting vaccinated. Then you start moving into essential workers, the next phase. That definition has not been set. Before everyone calls me, I have no input into that. Then we start getting into our sickest population that’s not in the nursing home right now but still needs to be vaccinated. Then we start getting into other people who have diseases that need the shot. Then we start getting into different layers of people who are healthy.”

NO HEALTH CARE PROVIDER

A viewer who has no health care provider wants to know how he’ll be able to get the vaccine.

“That’s all things that are being worked on. We’re having meetings with public health. We’re trying to understand what public health is going to do, what health care providers are going to do, what we’re going to do in partnership. We want as many people vaccinated as fast as possible. To do that, we need to be organized and to have this done in an organized fashion. We also need to know what we’ll be receiving from the government so we can schedule those shots in arms. All that’s being worked on this whole week, for months prior to this, and then months coming forward.”

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