(Photo: “Sandra Lindsay, an intensive care nurse at Long Island Jewish Medical Center, is inoculated with the COVID-19 vaccine by Dr. Michelle Chester on Monday morning in Queens, New York.”)
In a recent phone interview, Michigan Department of Health and Human Services [MDHHS] Chief Medical Executive, Dr. Joneigh Khaldun shared with the Michigan Chronicle current updates on the COVID-19 vaccine.
In Khaldun’s roles, she provides medical guidance for the state of Michigan and oversees the Public Health, Medical Services, Aging and Adult Services, and Behavioral Health and Developmental Disabilities administrations.
According to information from Gov. Whitmer’s press conferences and michigan.gov/vaccine, Michigan is expected to receive a small number of vaccines by mid-December. Because of the limited supply, MDHHS will have to prioritize how the vaccine will be distributed.
Supply of the vaccine will increase over the next few months. Those eligible to receive the vaccine first include frontline healthcare workers and more. Until the supply significantly increases, priority will also be given to essential workers and vulnerable populations [like adults 65 years of age and older and adults with high-risk medical conditions]. Also, individuals who are homeless will be given the vaccine through local health departments.
While Detroit’s COVID-19 numbers are significantly lower than those in neighboring communities, there is still work to be done as it relates to debunking myths about the COVID-19 vaccine, she said.
Khaldun said that the skepticism is understandable, especially in communities of color. However, these same communities are the very ones who are most susceptible to COVID-19 and she is “most concerned” about that impact.
Khaldun added that the vaccine information, once it is made available, will be communicated in different languages and delivered to communities in several ways.
“We will be doing more and more to get [the word to] all the different media outlets,” she said, adding stakeholders are involved in that translation process.
The MDHHS has also been working with local health departments and hospital leaders and healthcare providers regarding the vaccine.
Robert Swanson, MDHHS Division of Immunizations director spoke about the update regarding the COVID-19 vaccine distribution in Michigan on the heels of the Food and Drug Administration [FDA] Panel approving the COVID-19 vaccine. The recommendation would allow for the regulatory agency to approve emergency authorization soon.
During the meeting, information was also provided about the distribution of the vaccine, priority groups for vaccination, and efficacy and safety information currently available.
Swanson said that vaccines are only approved if they are held to the highest safety standards. Also, the COVID-19 vaccine’s been developed “much faster this time” because of the worldwide collaboration of health and medical doctors in a collective effort.
“No steps were skipped in this process,” he said, adding that the same steps were taken as with any other vaccine.
“What we’re hoping is the Pfizer vaccine is available next week,” Khaldun said, adding that hopefully by late spring 2021 it can be made available to the general population.
It’s also not lost on Khaldun, a Black doctor, that the Black community has undergone many healthcare disparities before and during COVID-19. That is why she said that the Michigan COVID-19 Task Force on Racial Disparities is a game-changer and is playing an important role in bridging the gap in healthcare equity.
“We have been meeting pretty regularly with the … task force,” she said, adding that the nascent task force will inform the public on the vaccine benefits and spread the word on the MDHHS policy throughout this pandemic.
The MDHHS-backed report identifies COVID-19 cases by race from March 10 through October. The data states that death rates have been higher among Black and African American people than other race categories. Black people make up 14 percent of the state’s population but accounted for 40 percent of the death rate and 32 percent of the positive cases, Khaldun confirmed. The collective death rate has been more than three times the rate in white people.
“We want to close that disparity when it comes to having disproportionate numbers of deaths,” Khaldun said. “Any success we have seen in the African American community is quite fragile. I’m concerned about vaccine hesitancy in the minority community … if you have vaccine availability and choose to not get the vaccine you will see that gap because other communities who choose to have the vaccine and take it will be protected.”
Khaldun said that she is “very excited” about the vaccine distribution.
“It means that the end of the pandemic is near,” she said, adding that the goal is to vaccinate 70% [5.4 million people] of Michigan adults over the age of 18 by the end of 2021.
“This situation is continuously evolving,” Khaldun said.
According to a report from michigan.gov/coronavirus, pregnant women and children are not included in the vaccine plan until further guidance on whether these groups will be recommended for vaccination.
“Vaccination of these groups is not recommended because of limited data on vaccine safety and efficacy for these groups at this time,” the report stated.
No fees will be charged to get vaccinated, the report added, and there will be no cost-sharing from insurance plans. Vaccine doses purchased with U.S. taxpayer dollars will be given to the American people at no cost.
COVID-19 providers agree to administer the vaccines regardless of an individual’s ability to pay and regardless of their coverage status, and may not seek any reimbursement, including through balance billing, from a vaccine recipient.
Although vaccine providers will be able to charge administration fees for giving or administering the shot to someone, the report added. It is also critical that those vaccinated receive both doses within the required time frame to ensure the best protection from COVID-19.
The MDHHS plans to use several ways to notify recipients of their second dose. COVID-19 vaccination record cards (reminder cards) will be provided to them when they receive the COVID-19 vaccine. The card provides room for a written reminder for a second-dose appointment.
Governor Gretchen Whitmer released the following statement after the United States Food and Drug Administration approved Pfizer’s Emergency Use Authorization for the COVID-19 Vaccine:
“This is great news for our families, frontline workers, small businesses, and economy. In Michigan, a state built on hard work and innovation, a safe and effective COVID-19 vaccine will be manufactured by Michigan workers at a Michigan business. I want to thank all of our dedicated Pfizer employees for their hard work. My administration, led by Dr. Joneigh Khaldun, is developing a plan to distribute the vaccine, with a focus on our most vulnerable populations. And today, I announced the bipartisan Protect Michigan Commission to help raise awareness of the safety and effectiveness of an approved COVID-19 vaccine, educate the people of this state, and help protect the health and safety of all Michigan residents. One of the most important things every adult should be doing now is planning for how they will get the vaccine when it becomes available to them. I want to remind everyone that we must not let our guard down. It will take time to widely distribute the vaccine, and we must all continue to do our part by wearing a mask, practicing social distancing, and washing our hands frequently.”
COVID-19 Vaccine FAQS
(Contributed by Teena Chopra, M.D., professor of Medicine in the Division of Infectious Diseases at the Wayne State University School of Medicine)
When can I expect to have the vaccine available to me?
The U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices has set criteria to determine the priority of distribution of vaccination. When you specifically get a vaccine will depend on your age, underlying conditions and occupation, as outlined by the CDC.
If I have a choice, which vaccine should I get?
At this time, only the Pfizer vaccine has been granted approval by the Food and Drug Administration. Any vaccine approved by FDA should be considered safe for use. Early on, people will not have a choice as to which vaccine they can pick. They will get what is available. But as vaccine manufacturing and distribution picks up, most likely by the end of 2021, we may get to choose the vaccine we receive.
How effective are the vaccines?
Both the Pfizer and Moderna vaccines are 95% efficacious. Efficacy is a term that means how many cases of infections of a disease are prevented in the clinical trial. We have yet to find out if the vaccine helps in preventing disease transmission.
Should I be concerned about the speed with which these vaccines were developed and approved?
Even though the vaccines were developed and approved very quickly, we need to know that the mRNA technology used for the two vaccines (Pfizer and Moderna) has taken years of research and development. Also, we need to realize that the FDA and the pharmaceutical companies have not cut any corners to develop COVID-19 vaccines. The process of reviewing the safety and efficacy of the vaccine trials has been the same as with previous vaccines. The only difference is the process, which this time was concurrent rather than one after the other. For example, Phase 1and 2 trials have been conducted concurrent to Phase 3 trials, which sped up the process. This was possible because of an abundance of financial resources allocated to the COVID-19 vaccine development.
Will a vaccine solve everything?
A vaccine is not the answer but vaccination is! Vaccination acceptance by the community will help us achieve herd immunity or community immunity. However, it is too early to predict what percentage of the community has to be vaccinated before we can say herd immunity is achieved. It is advisable to achieve herd immunity through vaccination. This number is close to 80%, which will help slow transmission and gradually end the pandemic. We need to wait to evaluate if COVID vaccines prevent disease transmission, how long the immunity lasts and which type of people it will not work on before we can know that number.
Do both the Pfizer and Moderna vaccines require two injections?
Yes, both vaccines are a two-shot series. The second dose of the Pfizer vaccine is given after three weeks and the second dose of the Moderna vaccine should be administered after four weeks.
Why is a second injection necessary?
The second dose is very important as it boosts the immune response. If people don’t receive the second dose, the vaccine won’t be effective.
How long after the injection do the vaccine’s properties take effect in me?
Based on trials, the best protection will come seven days after the second dose, but there will be some level of protection about 12 days after the first injection.
Can someone get COVID-19 from the vaccine itself?
None of the COVID-19 vaccines in development contain the complete SARS-CoV-2 virus, so it is impossible for them to cause COVID-19.
After I’m vaccinated, can I still catch the virus?
No. The vaccine is very effective. There may be some people who get the vaccine but still may not be protected against infection. But we may not know who those people are. Hence it is even more important that we vaccinate as many people as possible to build up herd immunity.
After I’m vaccinated, can I be immune but still pass the virus to someone else?
We don’t know the answer to this question yet. We need to wait for additional studies to answer that.
How long will the vaccine last? Will I need boosters?
We don’t know that yet but based on the antibody response seen in the Pfizer and Moderna vaccines, which are both mRNA vaccines, it appears that it is unlikely we will need it every year. We need the flu vaccine every year because flu viruses change at a rapid rate. On the other hand, coronaviruses do change, but not with the same speed as flu viruses. We may need boosters, but they may not be annual.
What are some of the possible side effects after the injection? What should I watch for if I don’t have any allergies?
All vaccines can have some reactions and, rarely, side effects. Reactions include soreness redness and swelling at the site of the injection. Other reactions that were reported by some people who received COVID-19 vaccines during trials were fever, headache, nausea, muscle aches — all of which have been previously reported with other vaccines.
These are not really side effects but reactions, which mean that the vaccine is doing what it is supposed to do — induce an immune response in our body. So, while these reactions may make you feel uncomfortable or even miserable for a couple of days, the good news is that your immune system is working.
Based on the Pfizer vaccine trials, 11% of younger people (12-15 years) were likely to report a fever as compared to only 1% of older adults (>= 55 years), which again points to the fact that as we get older our immune system responds less efficiently to threats.
Once I receive a vaccine, can I stop wearing a mask and practicing social distancing?
No, not at all. Vaccine is an added tool to our prevention tool box. We still need to mask, wash hands and socially distance. Remember, we still don’t know if vaccinated individuals can transmit the disease. It’s possible that when vaccinated individuals are exposed to the virus, it replicates within them and doesn’t cause the disease, but they can still spread to others.
Is the vaccine safe for my child?
The current vaccines were not tested and are not indicated for children. Trials in children are now beginning. Pfizer has begun testing in children 12 and older, and Moderna recently announced plans to test its vaccine in 3,000 teens. Hopefully, by the end of 2021, we will have a vaccine for children.
Learn more at michigan.gov/COVIDVaccine.
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