Dr. Phillip Coule recognizes the importance of the COVID-19 vaccine as both a physician and a novel coronavirus survivor.
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Coule, chief medical officer and vice-president of the Augusta University Health System, has carefully studied the published research and data.
“I am very comfortable with the safety and effectiveness of this vaccine,” he said. “I’m a physician, I had COVID and I was first in line to get the vaccine.”
While Coule understands people may be apprehensive because of the unknown risks involved in being vaccinated, he said the health complications associated with contracting the virus are often worse, particularly for those with multiple chronic medical conditions. AU Health has already begun vaccinating its front-line health care workers as they’re at high risk for being exposed to COVID-19.
Currently, two pharmaceutical companies are manufacturing vaccines approved by the Food and Drug Administration: Moderna Therapeutics and Pfizer, but several other companies are working to develop their own versions of the vaccine. Both versions require patients to receive two doses. Each dose of the Pfizer vaccine is administered 21 days apart, while each dose of the Moderna vaccine is administered 28 days apart, Coule said.
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He said these vaccines work differently than others, such as the flu vaccine. Vaccines are typically created by isolating, harvesting and killing a strain of the virus. Once the patient receives the injection, the body produces an immune response and recognizes the virus in the future, Coule said. Instead, the COVID vaccine uses Messenger RNA to stimulate this immune response.
“Rather than injecting you with the virus, your body creates the protein” for COVID-19, which the immune system will recognize as an infection if you contract the virus in the future, he said.
Side effects of the vaccination are generally mild and include pain and itchiness at the injection site, which are caused by the body’s immune response. Some patients also develop flu-like symptoms, such as a fever and chills, after receiving the second dose, Coule said. He said these symptoms generally only last about 12 hours to 24 hours, and they indicate your body is building immunity to the virus.
The vaccine is also highly effective. In studies, patients were 95 percent protected against the virus one week after receiving the second dose, said Coule.
While patients with pre-existing health conditions may worry about the risks of being vaccinated, “There’s no absolute contraindication to getting the vaccine,” Coule said.
But Coule urges some patients, including those prone to severe allergic reactions that require them to use an EpiPen and cancer patients receiving chemotherapy, to check with their doctors before being vaccinated. The same is true for former COVID-19 patients who have received monoclonal antibody therapy, which uses synthetic antibodies to treat the virus by mimicking the role of real antibodies in the immune system, he said.
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According to guidelines from the Centers for Disease Control and Prevention, patients who have tested positive for the coronavirus can receive the vaccine after their isolation period has ended, and their symptoms have improved, Coule said.
“There may be some benefit to waiting 90 days” after recovering from the virus to receive the vaccine, he said.
That’s because reinfection rarely occurs in that time period, and these patients may experience more noticeable side effects from the vaccine. Between 90 days and 180 days after recovery and beyond, reinfection is possible, so patients may want to consider being vaccinated, Coule said.
Patients who have received the vaccine shouldn’t throw away their masks or gather in large groups just yet, he added. In fact, doctors recommend that vaccination recipients still follow all the usual precautions to prevent the spread of the virus, including frequent hand washing, maintaining social distancing and wearing a mask.
This is true for two reasons: The body doesn’t build immunity immediately after being vaccinated, and in clinical trials for the vaccine, patients were instructed to adhere to these precautions, Coule said. In clinical trials, the number of positive cases in the vaccinated group was much smaller than that of the placebo group, he said.
Some people have claimed that manufacturers and the federal government rushed to create a vaccine, but Coule said that’s not the case. He explained that no steps in the rigorous FDA approval process were skipped.
“What was omitted was a lot of wasted time from data sitting on someone’s desk for months,” he said. Coule stated that Pfizer and Moderna both used existing technology to create the vaccine, which also expedited the development process.
While millions of people worldwide have already been vaccinated, there are a few treatment options available for patients who test positive for the virus, including antibody therapy and an investigational antiviral medication called remdesivir, he said. This medicine is only given to hospitalized patients.
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Coule said doctors and researchers aren’t sure yet how long patients who receive the vaccine will be protected, or if they’ll need a yearly shot. “There’s a good chance this will provide long-term immunity, but that depends on virus mutations,” he said. Most health insurance policies cover the cost of the vaccine, but Coule said a few companies have refused to pay for the injections. “The bottom line is there’s no cost to the individual,” he said.
The vaccine has been tested in patients 16 years old and older. The federal government’s goal is to ensure all adults are vaccinated as quickly as possible, Coule said. Once this goal has been reached, “We may start to see things get back to normal,” that is, similar to the way they were before the pandemic, he said.
Coule made an analogy comparing vaccinating the U.S. population against the virus to putting out a forest fire, which are both tasks that require extensive time, effort and money. Of course, manufacturing millions of doses of the vaccine is both time-consuming and expensive. The CDC has created recommendations for who should receive the vaccine first. According to their website, on Dec. 3, 2020, the agency issued the recommendation that high-risk individuals, such as health care professionals and long-term care facility residents, should receive the first doses of the vaccine in Phase 1a.
The site also gives the CDC’s recommendations for Phases 1b and 1c. In Phase 1b, the agency recommends that essential workers, such as police officers, fire fighters and teachers, be vaccinated. This phase also includes people aged 75 and older because they’re more likely to experience negative outcomes from contracting the virus.
In Phase 1c, the CDC recommends that people between the ages of 16 and 64, including those in that age group with underlying health conditions, receive the vaccine. This phase also expands the recommendation to other essential employees, such as members of the media, information technology professionals, and construction workers.
Despite these recommendations, the website clearly explains that each state, not the CDC, is responsible for determining how doses of the vaccine will be distributed. According to the Georgia Department of Public Health website, the state’s plan is slightly different from the CDC’s recommendations. For example, Georgia’s Phase 1a+ includes law enforcement officers and fire fighters. The site also states that more than 400,000 doses of the vaccine have been administered throughout Georgia at various sites, such as doctor’s offices, pharmacies, and health departments.
In the Augusta area, people can be vaccinated at a few locations, including the Evans Medical Group and both the Richmond County and Columbia County health departments. For more information about the vaccine, including precautions, vaccination sites, and possible side effects, visit www.cdc.gov or www.dph.ga.gov.
Josh Heath is an occasional correspondent for The Augusta Press. Reach him at producers@theaugustapress.com.
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