Questions regarding the COVID-19 Vaccines: Update 2/6/2021

Absolutely. I am encouraging EVERYONE to have a vaccine.   

Please be aware that there is NO VACCINE WAITING LIST being created and my office is NOT going to have any access to vaccines anytime soon.

The State of California has approved anyone who is in the healthcare field, first responders and people over 65 to get vaccinated based on Tiers but currently vaccines in Los Angeles County are limited to Tier 1A and 1B.   

Tier 1A-Health care workers, First responders and now over anyone over age 65 in LA County Area can sign up 

http://publichealth.lacounty.gov/acd/ncorona2019/vaccine/hcwsignup/pods/

 or call 833-540-0473 between 8:00 am and 8:30 pm 7 days a week.

The County of Los Angeles has contract with Carbon Health to provide easier registration to patients for its super sites listed below, for example Dodgers Stadium

https://carbonhealth.com/covid-19-vaccines

Long Beach residents or people who work in Long Beach sign up at:

http://www.longbeach.gov/health/diseases-and-condition/information-on/coronavirus/vaxlb/itsyourturn/

Tier 1B-  "are workers in the transportation and logistics, industrial, commercial, residential and critical manufacturing sectors. People who are incarcerated or homeless are also listed in the second tier of Phase 1B."
Once these groups are vaccinated, doses will be available to people in Phase 1C. 

Tier 1C-This group consists of people "between the ages of 50 and 64, as well as people 16 and up who have serious medical conditions. Workers in defense, energy, IT, water and wastewater, chemical and hazardous materials, communications, financial services, government operations are also listed in Phase 1C."  is not expected to start till March and go through June.

Tier 2C-This is anyone who is 16 to 49 who is healthy and has not received a vaccine.

COVID Vaccines will likely be distributed primarily in the community through community centers, local pharmacy chains and super vaccination sites:

The new super sites will be located at:
- Fairplex in Pomona
- The Forum in Inglewood
- Cal State University in Northridge
- L.A. County office of Education in Downey
- Six Flags Magic Mountain in Valencia 

-Dodgers Stadium in Los Angeles

Some pharmacies now have been giving appointments and vaccines to people over 65 but appointments are hard to find.  Keep checking the individual pharmacies daily.  You can sign up for pharmacies online at the county public health website above.

I will continue to notify patients about who, when and where to obtain vaccine.  

Keep in mind that our office is UNLIKELY to be able to provide any COVID-19 Vaccines anytime soon, but Cedars Sinai Medical Center is has started to provide vaccines to higher risk patients who are part of the Cedars Sinai Health Care system and expects to expand soon.  

Cedars Sinai patients are encouraged to sign up for MyCS-Link on https://www.mycslink.org. 

If you have any problem singing up, do not call my office for an ACCESS CODE.

Please call 1-855-427-5465 for help. 

Pfizer vaccine approved December 11th.

Moderna Vaccine approved December 18th.

Oxford/AstraZeneca Vaccine probably February or March

Johnson & Johnson has a one dose Vaccine that is in Phase 3 trial but data is not yet available but expected February and March

Pfizer Vaccine:  "after the first dose is about 52 percent, according to Dr. William C. Gruber, senior vice president of Pfizer Vaccine Clinical Research and Development. After the second dose, that rises to about 95 percent. “Two doses of vaccine provide maximum protection,” he said. 

Moderna " According to a document the company submitted to the FDA, the Moderna vaccine can provide 80.2% protection after one dose, compared to 95.6% after the second (in people aged 18 to 65 – it's 86.4% in those over 65). "

Oxford-Astra Zeneca data is a bit murkier due to dosage errors but appear to be in the 60 to 90% effective range.   "For the Oxford-AstraZeneca vaccine, things are a bit different. In a paper published in January, the authors explain that the vaccine offers protection of 64.1% after at least one standard dose. This compares to 70.4% if you've had two full doses, or – oddly – 90% in people who have had one half dose followed by one full dose. "  

Johnson and Johnson Vaccine maybe available as early as March.

Data obtained from https://www.bbc.com/future/article/20210114-covid-19-how-effective-is-a-single-vaccine-dose

 The Pfizer vaccine is currently indicated for people 16 and older.

The Moderna vaccine is currently indicated for people 18 and older

Children under 16 have not been studied in sufficient numbers to be sure of the risk and benefits but studies are ongoing.

Pregnant women have not been studied so its safety is unclear so the decision about receiving vaccine has to be individualized and discuss with the health care provider.  Please be aware that the mRNA is anticipated to be safe for expectant mothers given that it simply mRNA is not able to replicate itself.  The American College of Obstetrics and Gynecology are recommending that mothers who qualify for vaccine consider getting the vaccine as COVID-19 infection is riskier for the mother and family.

People who had allergic reaction to other vaccines may still get the COVID Vaccine but require careful monitoring.

People who are immunosuppressed are encouraged to get the vaccine. 

Pfizer and Moderna use mRNA newer technology. 

Johnson and Johnson and Oxford/Astra Zeneca use a modified adenovirus to induced an immune response. 

Current information is limited but appear to be minimal statistical differences in effectiveness which means they are essentially equally effective and main issue is the storage and delivery of each which does not concern you but more for public health and health officials to worry about.

Everything in life has risk but the vaccine has been determined to be safe by all measures used to approve ALL VACCINES. It is certainly less risky than getting COVID or having you get COVID and transmitting it to your elderly, frail, sick, young relatives and friends. 

There have been 2 reported cases of allergic reaction in people who were prone to have allergic reaction.  As a result, if you have had an allergic reaction to a vaccine in past, you should be monitored for 30 minutes and you may want to talk to a health professional about taking something before the vaccine to prevent a reaction.

Like all vaccines, it is intended to create an immune response that in some cases mimic an infection.  According to published data, the Pfizer vaccine is associated with significant short lived mild side effects, from arm pain to headache to fevers, particularly after the second dose.

 The Moderna vaccine has higher side effects ranging from 2% localized rash to nearly 10% of patients had muscle aches and fatigue for few days.  

Still the percentage of people who have a reaction, the severity of the reaction and time it last,  is minimal compared to the actual COVID-19 Infection.   

Like all vaccines, there is NO evidence that COVID -19 vaccination gives long term effects any more than the actual infection but no one has had COVID-19 or vaccine for very long. Most vaccine reaction even if bad, such as allergy, Guilliam Barre Syndrome will occur within 60 days of the vaccination. 

This has not happened in ANY of the vaccine trials so far involving over 100,000 patients. 

Currently approved vaccine requires 2 shots.  

Pfizer vaccine will be 3 weeks apart. 

Moderna vaccine 4 weeks apart.   

Astra Zeneca will be a 2 dose vaccine.

Johnson and Johnson's Vaccine will be single dose, but they are looking into the possibility of 2 vaccine dosing, ie booster shot at a later point.

No one knowns but studies have shown at least strong response 90 days after 2nd injection. There is some suggestion based on T Cell immune function that it can last many months and maybe years.      

 Probably, but no one knows.