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2nd vaccine town hall focuses on safety, efficacy

STEAMBOAT SPRINGS — In the second town hall series on COVID-19 vaccines, an expert panel weighed in Friday on what is known at this time about the efficacy and safety of the Pfizer and Moderna vaccines.

Dr. Ronald Krall, adjunct professor of neurology at the University of Rochester and former chief medical officer for GlaxoSmithKline, began by describing a “whirlwind of a vaccine week” in terms of news.

The first doses of the Pfizer vaccine were administered in the U.K. on Monday, with two significant allergic reactions reported — prompting the company to advise against giving the vaccine to people with a history of significant reactions.



In the U.S., the Food and Drug Administration advisory panel voted 17-4-1 in favor of recommending the Pfizer vaccine for emergency use authorization.

“As we speak, the (Centers for Disease Control and Prevention) advisory committee is meeting to review recommendations for immunization practices,” Krall said.

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In a presentation on what is known at this time about the Pfizer COVID-19 vaccine trials, Krall detailed some of the results.

Among 22,000 people who received the vaccine, eight contracted the virus. Among the 22,000 people who received a placebo, 162 people contracted the virus.

Between the first and second dose, Krall said, the vaccine showed a 52% efficacy rate.

Seven days after the second dose, the efficacy rate rose to 95%. The efficacy was sustained almost identically across age groups, he said. Of the participants, 42.2% were age 55 or older.

The efficacy was also consistent among vaccinated people with comorbidities, he said. Comorbidity is a condition existing simultaneously with and usually independently of another medical condition, according to Merriam-Webster.

In terms of safety, Krall said they look at reactions to the vaccine within the first seven days as well as conducting a thorough analysis of all complaints throughout the trial that could potentially be related to the vaccine.

“The symptoms were quite typical of what we see after a routine vaccine,” Krall said.

About 8% reported redness and swelling at the injection site, while 80% reported some pain at the injection site. Reports of fatigue and headaches were fairly common, he said.

In the vaccine group, there were 64 reports of lymphadenopathy — swollen lymph nodes — and six in the placebo group. There were four reports of Bell’s palsy in the vaccine group and none in the placebo group.

The Bell’s palsy and allergic reactions in the U.K. will be investigated further and followed closely as more people receive the vaccine, Krall said.

In terms of what isn’t known, Krall listed the duration of protection, whether the vaccine prevents transmission in asymptomatic cases and the effectiveness in certain populations: children, some high-risk populations, pregnant women and breastfeeding women.

Moderna and Pfizer did test the vaccine in adolescents ranging from ages 12 to 18, and more data is forthcoming, said Dr. Thomas Campbell, virologist and infectious disease specialist at UCHealth University of Colorado Hospital, who is also leading UCHealth’s clinical trial of the Moderna coronavirus vaccine.

Whether the vaccine prevents asymptomatic illness and whether vaccinated people could still spread the virus remain big questions.

“We know the vaccine prevents people from getting ill,” Campbell said. “We don’t know, yet, whether it prevents transmission. Having either vaccine does not mean you don’t have to wear a mask. It doesn’t mean you don’t have to abide by the other measures we have in place.”

That knowledge may come, he said, “but as of yet, we don’t know.”

“You could still potentially spread the virus even if you are vaccinated,” echoed Routt County Public Health Director Roberta Smith.

Campbell also said the side effect profile seems to be very favorable and not unlike what is seen with other common vaccines.

“Everything I’ve seen is very good news for moving this vaccine forward and making it available to people across the United States,” Campbell said.

Based on his personal experience with the Moderna vaccine trial, “The two vaccines and the two trials are very similar.”

“Two independent experiments are coming to the same conclusion, and that’s very reassuring from the scientific side,” he said.

The FDA committee will meet Thursday to review Moderna’s vaccine, after which more details of the trial will be released.

Campbell said the trial had a “groundswell of public support,” with more volunteers than could be enrolled.

On whether someone has higher immunity from a vaccine versus naturally contracting the disease, Campbell said the levels of neutralizing antibodies have a large range in people who contracted the virus. In vaccinated people, those levels are “all at the upper end,” he said.

“My guess is that vaccines provide better protection than most forms of natural infection,” he added.

Campbell said he would recommend people who contracted the virus to still get the vaccine to ensure those higher antibody levels.

On which vaccines will be made available locally, Routt County Chief Medical Officer Dr. Brian Harrington noted, “The intent of Operation Warp Speed was to create multiple vaccines of multiple types to increase the likelihood of a home run. We may discover certain ones are more appropriate for certain populations.”

In terms of the vaccines’ ingredients, Krall and Campbell said that information has been made public and can be found on the companies’ website.

The vaccines do not have any preservatives like Thimerosal, which contains mercury.

The next town hall will cover Routt County’s immunization plan and will be held at 10:30 a.m. Friday.

The vaccine series of panels is being held in partnership with Steamboat Pilot & Today, the city of Steamboat Springs and Routt County.

The series can be viewed on the Steamboat Pilot & Today Facebook page, the city of Steamboat Springs’ YouTube channel and Comcast TV6.

 


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