Dr Rai: Health care ready for next phase, but vaccine supply is needed

Published: Jan. 12, 2021 at 7:36 AM CST
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GREEN BAY, Wis. (WBAY) - Health care providers are ready to start vaccinating the next group of people in Wisconsin against COVID-19, but they need to make sure the state has enough supply to ensure everyone gets their shot.

“So what the state’s saying is as we scale up, as health care providers do, and we’re just one of many in the state, as we scale up, we need to make sure the vaccines are flowing from the federal government into our sites,” says Dr. Ashok Rai, President and CEO of Prevea Health.

Dr. Rai explained this and answered questions on allergies and vaccine interactions on Action 2 News This Morning.

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

Previous Dr. Rai segments: https://www.wbay.com/health/drrai/


Police, fire and EMS will start getting vaccines on Jan. 18.

“We found out yesterday from Wisconsin Department of Health Services--that you know we have our phase 1A list that we’re working through, those are people who are frontline health care workers and affiliated health care workers, that’s anybody from and ICU doctor now to a dentist and working in a dentist office, and because we have done a really good job of getting those through, instead of just hitting pause and waiting for the next phase, the state knows that fire and police should be next, so they’ll start scheduling into next week as we try to figure out who’s going to come out as phase 1B.”


The State Disaster Medical Advisory Committee is set to announce the next phase group to get vaccinated.

“We don’t now if they’re going to vote. They’re meeting this morning. Hopefully they’re going to vote on it. They came out with their draft recommendations on Friday. That’s what we call the state’s 1B. So we just got done with 1A, now we’re going to go into 1B. Remember, the federal government gave some advice and the state committees then take that advice and create their own list. It needs to be narrowed down a little bit. So their draft recommendations at the end of last week included those over the age of 70; those who live in a congregant living situation outside of long-term care; those that are involved as first responders--not health care--such as fire and police; and importantly, those who are involved in education. We’re talking day care, pre school, K-12, and higher education, those who work in those settings to be immunized; and then a couple of other small categories along with that.”


How soon until the next group is vaccinated?

“We have no idea on how long it will take for their approval process, because it’s a subcommittee that votes this week and then it goes up to the large committee. And then the state has to make sure they have the vaccine available to us. From a health care provider standpoint, we’re ready to go. We want to do this as soon as possible. They could tell us tomorrow and we could open up schedules, as long as they had vaccine for us. So it’s really up to the state to tell us when they’re ready for us to give that next phase.”


Prevea Health teamed up with UWGB for vaccine sites in Green Bay and Sheboygan.

“This is a schematic of what the old gym and the Kress Center looks like. For GB grads, they’d know this is where they played noon ball. You come in the door up top, there’s eight different areas for you to check in and register. There’s a waiting area. There’s 23 vaccination rooms that are being built here, and a very large recovery space. It’s important to remember that we have to watch people for 15-to-30 minutes, so you need a large enough space. That grayed-out area is where we do the testing. It’s kind of a blacked out area, it’s reserved for testing for the UWGB students. On day one, we won’t have 23 vaccinator booths filled, because you have to remember it’s two shots. And I think people forget that when they do their math. So for the first three weeks, you’ll operate at 50-percent capacity, or maybe around 60-or- 65 percent capacity, because the second shot’s faster. Because you know in three weeks, half those people will be there for first shots, half of them will be there for their second shot. So it’s important to remember when you’re doing the math, and people talk about a slow rollout, in the first three weeks, your capacity is always going to be limited because you have to be ready to do more first shots and second shots at the same time. When this is humming and this is good to go, in about three weeks with first shots and second shots happening, about 10,560 shots a week in just this site. And then we’ll continue to expand this to our Sheboygan market and to other parts of the state. That’s just us, and other health systems are doing their part. So the ramp up is happening and it’s happening fast. The rate limiting step is the state making sure we have enough vaccine to get those 10,560 a week done.”


The state is asking the federal government for more vaccine. They have thousands of unused doses. Does that mean there’s a surplus?

“So it’s not really a surplus. When we did 1A, category 1A, there was really two big buckets to 1A. One was the health care workers, which you’ve all seen us get our vaccinations on TV and all of that, and then the other bucket, which was long-term care. That’s being operationalized by the CVS and the Walgreens, and going into the nursing homes. That’s a little bit more complicated. That’s not people coming to you. That’s trying to take this on the road. Remember all the complications of that. That takes a little longer. So the surplus really is the vaccine as dedicated to the other 1A, which will get used very quickly as that’s operationalized. So what the state’s saying is as we scale up, as health care providers do, and we’re just one of many in the state, as we scale up, we need to make sure the vaccines are flowing from the federal government into our sites.”


Should people with allergies still get the COVID-19 vaccine?

“Not being involved in that clinical case, there’s a lot of different--the spectrum of what a severe allergic reaction is, but if somebody had a true anaphylactic reaction--that’s the type of severe, whole body immune response to that where you can’t breathe, your lips swell, your tongue swells and you require epinephrine to reverse that effect,--that’s an anaphylactic reaction. Many people have anaphylactic reactions to different things--bee stings, peanuts, shellfish. Those components aren’t in the vaccine. So what we would say when it comes to getting the vaccine, if you have one of those issues or allergies to that, that we’re going to watch you longer. That’s the category that’s going to get watched for 30 minutes, not 15 minutes. Now if this person had a true anaphylactic reaction, and happened to have another allergy, such as nickel, the two really aren’t tied together. The vaccine components are separate. But this person is more prone to anaphylactic reaction, and if it was a true anaphylactic reaction, her treating physicians would then contact the FDA, it’s about five pages of paperwork that you would do, and the FDA would investigate what this person is allergic to, and they have a history of severe allergies in the past. So the correlation of ‘I’m allergic to X and I had an allergic reaction to the vaccine’--it’s not correlated. But you could be allergic to one of the four components in the vaccine. That’s something that needs to be looked at, and that would be a contraindication to getting that second shot.

“When you’ve had a reaction in the past to something that’s been injected, an injectable--a vaccine, IV contrast dye, IV medication--we take that a little bit differently. Those are people that we send to the allergist just to make sure they didn’t have an allergic component to something that could be in the vaccine. But if you had a general reaction to something that’s not injected, like I mentioned the peanuts, the shellfish, those are people we’re going to watch for more than 15 minutes. That’s why giving this vaccine in, say, a drive-up type of situation isn’t the most ideal. You want to be able to give the vaccine and watch people. Safety and quality are always number one in health care. The safest thing to do is get this vaccine in an environment where somebody can take care of you if you had that super super rare allergic reaction.”


A viewer and his wife got COVID-19 and suffered hair loss. Is this a symptom?

“Not in a general population have we seen that, but there are a lot of things about COVID we don’t know yet. Especially when it starts to come to some of the long-term effects, whether we call them the long-hauler effects or whatever it may be, we keep discovering new aspects to it. At this time, that’s not one that I think has been well published.”


A viewer is getting Hepatitis B vaccines. Can she get the COVID vaccine at the same time?

“With any vaccine associated with the COVID vaccine, the FDA and the CDC has recommended that there is a 14-day window before and after the COVID vaccine that no other vaccine is given. So depending one where you’re scheduling and where you’re at in the Hepatitis B series, if it works out for you to get your COVID vaccine, and there’s no Hepatitis vaccine given on the first 14 days or the second 14 days, then yes. But please remember when you’re scheduling that, the COVID vaccine is two vaccines 21 days apart. That’s a lot of math. So it’s important to sit down and really march that out, to make sure that both vaccines have a 14-day window on either side.”


Is it safe for people who’ve been vaccinated to gather with family?

“Since now that people have got their second shot, it’s going to be the most popular question this week. Let’s remember that this is a highly efficacious vaccine. We are very excited that it’s 94-or-95 percent efficacious. I didn’t say 100 percent. There’s still that five percent chance. If you have not had COVID, there is a risk. The end point of the studies for this vaccine was, ‘Do I produce antibodies to neutralize and kill COVID-19 so it doesn’t affect me?’ It wasn’t about transmission. Those studies are being done. The safest thing you can do is make sure that you’re masked and distanced right now, even if you’ve been vaccinated. If the parents were vaccinated and the daughter was vaccinated and they’ve both received both shots, and it’s about two weeks after both shots, then it technically could be safer to be together. But there’s always that small risk, and you need to understand that.”


A viewer wants to know why the National Guard isn’t called in to help vaccinate people.

“It’s a great question. There’s a lot of COVID vaccine being given right now, and I think people just don’t understand some of the aspects to the numbers. There’s some confusion out there. There’s some frustration out there. Completely understandable. The National Guard should be coming in to help and augment what we’re doing, not replace. Health care providers have the medical record, they have the ability to take care of a reaction, and we have the staff. There are certain areas where we need more staff, or areas where we need to take our show on the road, and the National Guard can help with that. We’ll see that in the coming weeks. Right now, the most important thing to do is let health care continue to scale up and not confuse that picture.”

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