Coronavirus-19 Vaccine Information
Dear Patients,
Happy New Year!
I have been waiting to send this email in hopes of providing you more information and guidance from the State regarding vaccine distribution and availability. Unfortunately many questions remain unanswered. Despite that I felt it was important to send this to you now without further delay.
The Pfizer/BioNTech and the Moderna vaccines have both received emergency use authorization. These are genetic vaccines. The vaccines deliver one or more of the virus’ genes that provides the code on how to make the virus spike protein. The genes are administered in the form of messenger RNA (mRNA). When injected our cells process the mRNA and manufacturer the virus’ spike protein. These spike proteins get released into our body that provokes an immune response. Our body’s immune response forms both antibodies and immune cells directed at the virus’ spike protein. This leads to future protection should you be exposed to the virus.
The vaccines prevent you from getting the disease and reduces how infectious you become but does not completely prevent you from getting infected and transmitting it to others who have yet to be vaccinated.
For the safety of others, please continue these practices until we can get the majority of patients vaccinated.
For the safety of others, please continue these practices until we can get the majority of patients vaccinated.
The vaccines are greater than 94% effective in preventing you from developing the disease.
Studies have shown that the cellular immunity achieved from the vaccine is more robust than the cellular immunity from the natural infection. It is possible that the vaccine may provide better protection against future infection.
Both vaccines require an injection into the muscle.
- The Pfizer/BioNTech vaccine requires two doses 3 weeks apart and requires freezer storage at - 94 degrees Fahrenheit.
- The Moderna vaccine requires two doses 4 weeks apart and requires freezer storage 30 days with refrigeration or 6 months at – 4 degrees Fahrenheit.
I have no preference which vaccine you receive.
We are exposed to many different viruses and therefore our cells and immune systems are regularly exposed to viral genetic material. These vaccines have been shown to be safe and extremely effective.
The most common side effects have been headache, joint pain, fatigue, muscle aches and injection site soreness. Some patients have reported fever. These side effects are typically mild, last a few days and then resolve. These side effects are a sign that your immune system has been provoked and is working. If you have no side effects I can assure you that your immune system is still working.
Rarely patients have experienced allergic reactions to the vaccine. Allergic reactions can be seen with any vaccine or medication and are often unpredictable. Allergic reactions can include hives/rash, swelling of the mouth/tongue and difficulty breathing. Some of those allergic reactions can be severe. The allergic response is believed to be in response to the other ingredients in the vaccine and not the virus’ genetic material. Patients who have a history of severe allergies should alert the vaccine provider. Every vaccine provider will be equipped to treat a severe allergy.
To date there have been no serious long term side effects to the vaccine however we are monitoring this closely as more people get vaccinated.
Patients who have had a previous severe reaction to these vaccines or patients who have had a severe reaction to any of the ingredients of these vaccines should NOT get the vaccine. This is rare.
- Pfizer/BioNTech: mRNA, lipids, potassium chloride, monobasic potassium phosphate, sodium chloride; dibasic sodium phosphate dihydrate and sucrose.
- Moderna: mRNA; lipids, tromethamine, tromethamine hydrochloride, acetic acid, sodium acetate, sucrose.
In the majority of cases it is safe to receive these vaccines despite having had a severe reaction to other vaccines. We can discuss any specific circumstances or questions you may have.
The best answer is we are not sure yet. Remember that the vaccines provide more than just antibody protection. Although measuring quantitative antibodies may be helpful in the future, the cellular immunity provided by the vaccine is likely more important to long term protection. At this time cellular immunity against Coronavirus-19 is difficult to measure.
Predictions:
- We may need to develop a test that easily measures cellular immunity against Coronavirus-19.
- Booster doses of Coronavirus-19 vaccine will likely be necessary particularly if there is a significant mutation.
- Length of protection will vary depending on a patient’s age and medical condition.
The current Coronavirus-19 mutation that was first discovered in the United Kingdom and was recently found in a patient in Colorado is more infectious than previous strains. The mutation does not lead to more severe disease but will likely increase the number of cases. Both vaccines appear to provide protection against this mutation.
Yes! It is recommended that you wait until you have recovered from the illness and you have completed the isolation period prior to receiving the vaccine. It is not necessary to obtain an antibody test after the infection and prior to receiving the vaccine. Studies have shown that the cellular immunity achieved from the vaccine is more robust than the cellular immunity from the natural infection. It is possible that the vaccine may provide better protection against future infection.
- Reinfection with the virus is uncommon in the 90 days after an initial infection. Therefore, patients who have been infected within the last 90 days may delay getting the vaccine.
- Patients who received monoclonal antibodies from Eli Lily or Regeneron or who received convalescent plasma should delay getting the vaccine for 90 days.
- Patients who have fever or are undergoing therapy for a significant illness or infection may need to delay the vaccine.
This changes frequently. Your best resource for vaccine eligibility and when and where to obtain the vaccine is https://www.tchd.org/866/COVID-19-Vaccines
Vaccine distribution and administration
Anytime that you allow the government to take over something that the private sector has done well for years expect delays and confusion. Our state public health departments are short staffed and not well funded to carry out the complexities of managing a pandemic as well as a mass vaccination program. I know that the staff at the various health departments are doing the best they can with limited resources and guidance.
In the private sector, we already do mass influenza vaccinations in this country every year. Physician offices and pharmacies obtain vaccines directly from manufacturers and medical supply companies. Vaccines are then administered to patients in a timely manner. Physicians and pharmacists are then tasked with administering the correct vaccine based on an individual patient’s need.
Politicians and bureaucrats decided to take the lead on rolling out the Coronavirus-19 vaccines. Physicians and pharmacists have been kept on the sidelines and in many cases in the dark. It has been messy as expected and therefore fewer patients have been vaccinated than originally predicted. I do not know when and if the process will improve.
If you receive notice from UC Health, a pharmacy, a hospital or any other healthcare entity that you are eligible to receive a vaccine please sign up and receive the vaccine. Notify our office that you have received the vaccine and provide us the date of your second shot. I recommend that you contact your pharmacy for information regarding their vaccination plans. It is likely that vaccines will be delivered first to large health care organizations who can administer vaccines to large numbers of patients before private physician offices receive an allotment.
- UC Health has begun to vaccinate phase 1B patients. Further information regarding the UC Health Coronavirus-19 vaccination program can be found at COVID-19 Vaccine | Vaccine Safety, Distribution & FAQs | UCHealth
- Safeway pharmacies are offering the vaccine at select locations. You can sign up to receive updates and schedule an online appointment at https://www.safeway.com/pharmacy/covid-19.html
- For more information on how, where, and when to access the vaccine call the Colorado Public Health Information Line at (303) 389-1687.
I share the above with you to ask for your patience and please recognize that our practice is doing everything we can to secure vaccines for our patients. This is the first time in my career that I have felt no control in trying to secure something potentially life-saving on behalf of my patients. We have applied with the State to be a COVID-19 vaccine provider and await their approval. We will not be able to administer the Pfizer vaccine due to the storage requirements. Lastly, should we receive vaccine from the State we will notify all eligible patients as soon as possible to set up your vaccine appointment. I will continue to provide periodic updates as new information becomes available.
Sincerely,
Charles H. Miranda, MD, FACP
South Denver Internal Medicine
Denver Concierge Medicine
10103 RidgeGate Pkwy, Suite 114
Lone Tree, CO 80124
(303) 799-8890
Fax: 303-799-8891
cmiranda@southdenvermedicine.com
www.southdenvermedicine.com
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