Have questions about the COVID-19 vaccine? So do many members of your community. We recently met with Dr. Jane Kelly, the Assistant State Epidemiologist with the Department of Health and Environmental Control (DHEC), to get those questions answered.
This blog is a transcribed Q&A from the COVID-19 Tele Town Hall on April 5, 2021, highlighting questions about the vaccines themselves. Do you know the differences between the Pfizer and Johnson & Johnson vaccines? Will these vaccines work on the coronavirus variants? Should you still get vaccinated if you've already had COVID-19? Keep reading to find out or listen to the recording.
During this Tele Town Hall, Dr. Kelly gave a presentation on the three COVID-19 vaccines currently available, talked about the safety and efficacy of the vaccines, discussed who is currently eligible to receive a vaccine shot, outlined what comes next after vaccination, and answered questions from the public. The call was facilitated by Richland Library’s Community and Media Relations Coordinator Emily Stoll.
Q:What are the comparisons and differences among the Pfizer, Moderna, and Johnson & Johnson vaccines?
A: Let me say what unifies all three of these vaccines: all three of these vaccines use just a gene, a single gene, a piece of genetic code for just one protein, the spike protein, of the virus. That’s how they work. None of these vaccines have whole virus. They cannot give you COVID-19 because they don’t have the virus in the vaccine. They just have a snippet of that genetic code. Now let’s talk about Pfizer and Moderna together because they’re very similar. And then we’ll talk about the Johnson and Johnson vaccine.
The Pfizer and Moderna vaccines have as their active ingredient that little piece of RNA, which is genetic code for the virus protein, and it is wrapped up in a bunch of inert ingredients. Its active ingredient is that genetic code. Its inactive ingredients are things like salts, sugars, oils, and one ingredient that may be giving some people allergic reactions; and that’s polyethylene glycol. Now polyethylene glycol is a common ingredient in, for example, over-the-counter laxatives, but some people are allergic to it. If they are allergic to it, they can’t take the Pfizer or Moderna vaccines. How effective are these vaccines? They are highly effective. In their Phase III studies in 2020, both Pfizer and Moderna were found to be 95% effective in preventing symptomatic disease. Now that is extraordinary. It is a rare vaccine that has that level of effectiveness.
The Johnson & Johnson vaccine is a little bit different. It also uses the genetic code for the spike protein, for that one protein in the virus, has no live virus or attenuated virus, but it’s got different inactive ingredients. It contains a weakened common cold virus because the common cold virus is very good at getting into your respiratory system, so it’s almost like a delivery truck carrying the genetic code for the COVID-19 virus into the cells. It also has inactive ingredients that are just salts, sugars, fats, and it doesn’t have polyethylene glycol, so people who are allergic to that can get this vaccine. It has something else called polysorbate 80, which is a common ingredient found in foods, in ice cream and salad oil. And I think it’s important that people realize that none of these vaccines have mercury, aluminum, preservatives, antibiotics, eggs, adjuvant—all those things that people are sometimes worried about in vaccines. None of these vaccines have those ingredients, and the Johnson & Johnson vaccine was 85% effective in preventing severe disease. I understand that’s a little less than Pfizer and Moderna, who I said were 95%, but the most important thing to know is that all three of these vaccines are 100% effective in preventing hospitalization and death. So, if you want to stay out of the hospital, stay out of the morgue, any of these vaccines will give you that.
Q: I’m hearing that if you take the Pfizer vaccine that you will have to take a third dose because that one will only last for six months.
A: Well, that’s not quite right. What we know is that the Pfizer vaccine, and Moderna vaccine for that matter, we know that they’re good for at least six months. But you have to think about how they know that. Well, remember they started studying getting it into volunteers as early as June of last year. They’ve got 6-8 months’ worth of information on those people, and they know that antibodies to those vaccines last at least 6-8 months. So, it’s not a matter of you probably will need a third vaccine. It’s a matter of we don’t know, because we haven’t had enough time to know, will these vaccines be good for years? They might be. They might be like a tetanus shot where you get one dose, and you’re good for ten years before you need a booster. We don’t know yet. What we do know is that if you get two shots of Pfizer, two shots of Moderna, or one shot of the Johnson & Johnson vaccine, your antibodies [in] your immune system will last for months. Only time is going to tell whether it’s going to last for years. We think so. We think we have good evidence that it will last a long time. The other unknown is: what about these variants? If things start to change and we get more variants, it might be like the flu where we need a different flu shot every year. It might get to the point where once a year we need a booster. But we’re not there yet. We don’t know that yet.
Q: Would you be able to provide any updates about the vaccines that AstraZeneca or Novavax have been developing?
A: AstraZeneca is pretty similar to the Johnson & Johnson vaccine. It takes a little snippet, again, of the genetic code for this protein and puts it in kind of a delivery truck. It uses a different common cold virus to get it in. And AstraZeneca is being used in over 50 countries around the world, including multiple countries in Europe. It’s used in Canada. It’s used in Australia. They just recently finished their Phase III human studies in the United States and found that it was 76% effective in preventing severe disease and 100% effective in preventing death. Now listeners might be thinking, well wait a minute, you said Pfizer and Moderna were 95%, Johnson & Johnson’s 85%, and AstraZeneca’s only 76%? I’d ask you to bear in mind that these vaccines were all tested at different times. AstraZeneca has been tested during a time where we have these variants that are circulating—the South African variant, the Brazilian variant, the British variant—and that makes it a little bit more challenging. So, I would consider any of these vaccines highly effective [and] highly efficacious. AstraZeneca has not put in its application yet, but when I’m sure that they will, when they put in their application to the Food and Drug Administration, it will probably take the FDA at least three weeks to go through all the paperwork, to review all the studies and including reviewing what’s going on in other countries right now with the AstraZeneca vaccine. I suspect that the earliest we might see AstraZeneca would be May, and by May, we would have lots more doses of Pfizer, Moderna, and the Johnson & Johnson vaccine. It may be that AstraZeneca won’t even be a really big player in the United States, because when I say May is the earliest, it could be even later than that depending upon what sort of analysis the FDA does.
Novavax is the one outlier. Novavax does not use genetic code. It just uses the spike protein itself. So, no whole virus, just the spike protein itself. It’s really telling that all five of these vaccines focus on this same protein because they know that that is a weak spot for this virus. All of these vaccines focus on that. Novavax is still doing their Phase II and III studies right now, so it’s going to be a few months before we hear from Novavax.
Q: Dr. Kelly, are there any updates on possible vaccines for children?
A: Yes! We have good news on that front. Just recently, Pfizer has announced, just in a press briefing so we don’t have all the results yet, but they announced that they have tested their vaccine in children aged 12-15 and found it was 100% effective in preventing SARS-CoV-2 infection. They had zero kids in that 12-15 age group who got COVID-19 after being given the vaccine, so that’s very good news. They will be submitting an amendment to their Emergency Use Authorization, so they won’t have to go through this huge approval process again. It’s an amendment in which they demonstrate, “Yes, in this age group, here’s the safety profile. We had no problems with safety in this vaccine for these children, and this is how effective it was.” I think, by this summer, if not earlier, we will have vaccine[s] available for ages 12-15. And I know, Pfizer, Moderna, and Johnson & Johnson, they are all working to test vaccine[s] in younger age groups—down to as young as six months. It may be a while before we have a vaccine for that six months to 11 years of age, but it’s possible that we would have that even by this fall.
Q: There is a question about—I know, we know, that the vaccines are successful with different variants. But I heard about the recent variant from Brazil, particularly from Manaus, … [and] I am not sure these vaccines actually work with this Brazilian strength or not?
A: Yeah, thank you for that question. There are several different variants that are circulating, and just to mention some of the other ones… [there] is the one sometimes called the British variant. We definitely have that one here in South Carolina. There’s another one that’s sometimes called the South African variant. We definitely have that here in South Carolina. We have not detected the Brazilian variant here, but I wouldn’t be surprised if it crops up in South Carolina. It is in other places in the United States. The things that are worrisome about these variants are two things. Number one, they all spread more easily, they’re more contagious, and they’re more contagious because of a change in that one protein that makes it, basically, get into cells more easily. But there’s another risk with some of these variants, especially the Brazil variant. You know, you mentioned the city of Manaus in Brazil that is having another epidemic, and they have a variant that has not only that ability to spread more easily, it is also better at escaping from antibodies. Meaning that not all antibodies can attach to it as well.
Here’s where I want to go into a little bit of biology though. Antibodies are not the whole story when it comes to your immune system responding to an infection. They are an important part in the beginning, but there are also cells called “memory cells” or “killer T cells” or a bunch of other components that are important in your immune system. So, the critical question I think you’re asking [is], do we think vaccines are going to work or these variants? Yes, and here’s why I can say that. They are doing tests in the test tube to try and test whether our immune systems, whether antibodies, can still work with these variants, but they are also [testing] among people who have been exposed to these variants. And what they found is that … all three vaccines prevent severe disease, and they prevent death from these variants. But they don’t necessarily prevent you from getting mild illness. So, there is a little bit of an escape from the antibodies where you may get mild infection, but then your T cells and all those other pieces of your immune system kick in. So, the vaccines do work for the variants that are circulating now, including the Brazil variant, and if we start getting more variants that are more of a problem, one of the nice things about these vaccines, by using that piece of genetic code, they [scientists] can switch out some of the molecules in that genetic code to make it tailor-made to attack the variants also. … they’re working on that so they will have it set to go in case we need it. We don’t think we need that yet in the United States because we still have low levels of variants.
Q: If you have a positive coronavirus test, does your body naturally build up antibodies to this virus?
A: Yes, it does. If you get COVID-19 and you recover from it, your test was negative, your body, your immune system, still remembers. By that I mean you do have antibodies to the SARS-CoV-2. You do have other immune system responses, things called memory cells, but we still recommend you get the vaccine because the vaccine is engineered to give you even higher levels of antibodies than natural infection. If you had COVID-19 before, you do have partial immunity, but you would like that immunity to be even stronger. That’s why we recommend getting the vaccine even if you had COVID-19 previously.
Q: Is the vaccine available in SC for ages 16-40 years old, and where can you get it if so?
A: It is available for everybody age 16 and up. Now if you’re 16 or 17, you can only get the Pfizer vaccine. The other vaccines are approved for 18 and up. There are two ways you can search for [a] vaccine. One way is to go on our DHEC website at the Vax Locator. … In fact, if you just Google “vax locator,” it’ll pop up. But the exact URL … [is] vaxlocator.dhec.sc.gov. That page will say on it “Find Location by Zip code.” You can put your zip code in there, press the search button, and it’ll give you a long list of all the different places where vaccine is available to you. Places like CVS, Harris Teeter, some private doctors’ offices, some medical centers—a number of different places. You can begin there to find a place where you can make an appointment. But I’m going to give you a second suggestion because this other one I find personally a little bit easier to use, and this one is … cvas.dhec.sc.gov. And it too has a list of available appointments. So, I just pulled it up on my screen for example, and it has a list of Abbeville County Health Department, Beaufort Health Department, you know, DHEC office, and all these different places, mobile clinics, … a number of different places throughout the state. Now this not complete. … These are just some of the locations, but it’s an easier one to use. And you can click on the place that interests you, and it’ll take you to that clinic. You can answer a few questions like whether you’re 18, if this is your first dose, you know, and then you click on the place and it’ll say, okay, we’ve got appointments open Thursday, April 8th. And you click on it and [it’ll] say, okay, which time do you want? And, in fact, I’m doing that right now, and there are lots of appointments available. …
Q: There are many coworkers and neighbors who are undocumented aliens, and many of them have not been able to get the vaccine. When [applying] to Prisma, they require either your health insurance and your social security number. Would you have availability of vaccine for this population in your coming April 14 max vaccination? It’s important to know so that persons can call some number because nobody knows about where to make an appointment. Thank you.
A: There is no DHEC requirement for citizenship and no requirement to show ID. You do not have to have health insurance. They may ask if you have insurance, and they can bill insurance for an administrative fee, but insurance is not required. We will follow up with our vaccine providers to make sure they know this. Anyone age 16 and up can be vaccinated in SC, no insurance and no ID required.
Q: Do you find that people who are currently eligible to get the vaccine are getting the vaccine? Are signing up to register to get their appointments?
A: So far, we have more demand than we have supply. Our limiting factor continues to be [that] every week we get [a] new allocation, new amounts of vaccine, and it is used up pretty quickly. Right now, in South Carolina, about 90% of the vaccine that we receive is utilized within the first week. We’ve got a few doses that we save for special events like mass vaccination clinics, but by and large, as quickly as we get vaccines in, it is getting out into arms.
Q: What would you say to people who are still trying to decide whether or not to get vaccinated?
A: Well, I would ask, what is the information that you need? And once you identify what is it that you don’t know, that you need to know to make an informed decision, then go out and find that information. Maybe, for example, a person might be worried about “I’ve heard about these symptoms and I can’t afford to take a day off from work”. Well, talk to your employer. A lot of employers are offering time off that does not cut into your sick leave because they can take a tax break if somebody took time off for COVID-19. Other times people are thinking, well, I don’t know anybody [who has] been vaccinated. Well, do you know we’ve had more than two million doses of vaccine given in South Carolina? You probably do know somebody who has been vaccinated. Ask around and find someone who’s been vaccinated and ask them: Why did you do it? What was your reasoning? Why did you want to get vaccinated? And what did you experience? I think people who are still trying to decide have to think—all right, I understand in the beginning being in the “I want to wait and see” camp. When it first came out, there were a lot of unknowns, but we’ve got so many people [now] who’ve been vaccinated. You have to ask yourself, what is it that you are waiting to see? Because maybe there’s information, maybe there are facts out there that you could get. For example, if you were worried about, is it safe in pregnancy? Well, we do have good data now to show that these vaccines, any of these three vaccines, are safe in pregnancy. If you’re trying to decide, it’s a good thing to question and be skeptical. Make sure you have all the facts, all the information you need, but if there’s still things you wonder about, [then] ask questions and do things like you’re doing tonight. Join an information session and ask your question.
Q: Dr. Kelly, if people would like to get in contact with you directly, how can they do that?
A: Thank you for asking that. Please, if you have further questions, please email me because if you have a question, many other people do as well, so it helps me understand what learning needs are out there or what information we need to get out to people. So, I’m going to give you my email address. It is email@example.com. That’s my email address, and you’re more than welcome to email me and thank you for participating tonight
Still have questions that weren’t answered? Email Dr. Kelly at firstname.lastname@example.org. For more information about receiving the COVID-19 vaccine in South Carolina, click here. For additional COVID-19 resources and information, click here.