Former GlaxoSmithKline medical officer joins local health care officials in first COVID-19 vaccine town hall
STEAMBOAT SPRINGS — The first of three town hall panels devoted to the upcoming coronavirus vaccines on Friday dove into the science of how vaccines work, how they are made and how they are tested.
“The best hope for ending this pandemic lies in vaccines,” said Dr. Ronald Krall, a former chief medical officer of British pharmaceutical company GlaxoSmithKline.
“That we have vaccines just around the corner of the New Year is nothing short of spectacular. It’s a testament to the era of science that we are so fortunate to live in and to have invested in. But vaccines — even unbelievably effective vaccines — are worthless unless we are comfortable being vaccinated.”
And that is the intent of the virtual seminars — to provide people with the knowledge they need to be comfortable in making their own personal decisions about getting vaccinated, Krall said.
And while it is a personal decision, “it affects not only us as individuals, but it affects everyone around us,” Krall said.
Krall began the conversation with a detailed slide presentation on how viruses invade the body and what vaccines do to defend against that invasion.
He discussed the two broad categories of traditional vaccines — one that uses the whole inactive or weakened virus and another that uses just a portion of the virus.
The Pfizer and Moderna vaccines, which appear to be the first two that will be approved, use a newer technology.
“These vaccines present instructions for our own body’s cells to make our own vaccine,” Krall said.
Instead of using a weakened form of the virus, they use part of the virus’ own genetic code to stimulate an immune response.
Both use the mRNA, or messenger RNA, delivery system, and transmit a piece of genetic material that tells our cells to make that spike protein to which we then develop antibodies.
Other vaccines in the works use DNA as the delivery system, which transmits the genetic information to the mRNA, so the Pfizer and Moderna vaccines essentially skip a step.
“It’s incredibly fortuitous these platforms are ready for production at the time of the coronavirus outbreak,” Krall said.
The mRNA as a platform is very fragile, noted Routt County Chief Medical Officer Dr. Brian Harrington, thus why it must be stored at extremely low temperatures.
Krall described the three phases of a “methodical, rigorous testing sequence developed over 60 years and defined by both law and FDA regulation” — the pre-clinical (tested on animals), clinical (tested on humans) and approval process.
Moderna, Krall said, enrolled 30,000 human participants with 15,000 given the vaccine and 15,000 given a placebo. They were then released into the community. Out of the placebo group, 185 contracted COVID-19. Out of the vaccinated group, 11 contracted the virus.
Krall talked about the things the testing process cannot detect, like very rare adverse side effects (greater than one in 5,000 in the case of Moderna trial). Those will have to be monitored for as the vaccines are administered after approval, he said, and require much larger and more diverse numbers of people in order to detect.
Thus far, said Harrington, the data released on the first two vaccines is “very reassuring” in terms of risks. And in terms of efficacy, “On the surface things look very good,” he said, though “we still do need to see additional data.”
The new technology is exciting, Harrington said, and “may hold fewer risks than other vaccines.”
As with any vaccine, people could experience soreness around where the shot was given, body aches and mild fever, Harrington noted. But “that’s the body’s immune system responding,” he said.
It is not possible to contract COVID-19 from the vaccine, he said.
Asked about the need to continue wearing masks and social distance after getting vaccinated, Routt County Public Health Director Roberta Smith said because there is not 100% effectiveness, and there could be a percentage of people who get a mild infection that could still infect others, it is too soon to say whether vaccinated people, or how many of them, may still be able to transmit the virus.
That will be closely monitored, Smith said.
“In the short term, we still have to continue wearing masks,” she explained.
Dr. Laura Sehnert, chief medical officer at UCHealth Yampa Valley Medical Center, said it is too early to know the efficacy of the vaccination and it will be rolled out in a phased approach.
“We would all love to get back to normal life,” she said, but the vaccine is “just one tool to fight the virus,” and until more time has passed, other tools must continue to be used to reduce the spread.
The panel also discussed how second doses — Pfizer and Moderna both have two — can boost a person’s immunity. Needing a series of shots is “pretty much the norm,” Harrington said, and based on “well-established principles.” However, it may be determined that higher risk people need more than two doses and lower risk only need one, he added.
They discussed the differences between the U.S. and the U.K.’s approval system, where the vaccination has already been approved.
On how long immunity will last, Sehnert said that is also something that will require more time and data, but at this point, they do know people — including locally — who have contracted the virus and then been reinfected.
Sehnert said she suspects people will need to get the vaccine annually.
Harrington added that immunity depends both on the virus and how it works and changes, and an individual person’s immune system, which can be impacted by things like age and health issues.
“In general, human immunity only lasts about a year,” Harrington said, referencing experience with other coronaviruses.
The next town hall will be held at 10:30 a.m. Dec. 11, and will go deeper into the safety and efficacy of the vaccines. It is possible at that time the Pfizer vaccine will have received emergency use authorization, following the Dec. 10 review.
The final town hall will take place Dec. 18 and will cover Routt County’s plan for immunization.
Questions for the upcoming panels can be submitted in advance to Steamboat Pilot & Today Editor Lisa Schlichtman at lschlichtman@SteamboatPilot.com.
To reach Kari Dequine Harden, call 970-871-4205, email kharden@SteamboatPilot.com or follow her on Twitter @kariharden.
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