The COVID Vaccine: A Q&A for Seniors

COVID 19 Vaccine

For most of us, 2020 couldn’t get off the calendar quickly enough. Abundant memes depicted its annihilation (sledgehammers smashing 2020 and such) and even an entire film, “Death to 2020,” was produced.

As such, expectations for 2021 are running particularly high, even among those not prone to making resolutions or anticipating changes once the clock rolls from 11:59 p.m. to midnight. While weight loss, improved fitness and disposing of bad habits are still on the wish list for many on the brink of a new year, 2021 comes with unique hopes and possibilities.

For older adults and their families, the brightest beacon in the night is the COVID-19 vaccine. Senior living communities that were feared danger zones are becoming some of the safest places to be, as staff and residents in care environments are among the first to receive the vaccine.

“Our [senior] facilities could be islands of immunity,” said Dr. Thomas Lawrence in a December 29th videoconference with staff from Kendal Crosslands Communities and Barclay Friends. Dr. Lawrence is system medical director of geriatric medicine and long-term care for Main Line Health as well as the longtime medical director of Kendal Communities and Barclay Friends.

“It looks like 100 percent of residents in long-term care facilities will choose to get vaccinated and will be pretty much immune in contrast to the general population who won’t achieve herd immunity for months,” he continued.

Still, there are several questions and misconceptions about the vaccine that need answers and clarification.

Q1: When are the vaccines going to be administered to residents and staff in senior living communities?

A: Per CDC recommendations, staff and residents in senior living across the U.S. are among the first to receive the vaccine. Several have already had the first dose and are scheduled for the second a few weeks later. At Barclay Friends, the first dose was administered to residents, staff, volunteers, and clinical consultants on January 6; the second will be given on January 27.

Q2: How safe and effective is the vaccine?

A: Safety is the number one criterion for the vaccine to receive emergency use authorization. “The FDA has one of the most critical approval processes in the world,” said the above-mentioned Dr. Lawrence. The vaccine must meet intense safety requirements in four phases, each of which must achieve specific goals before the next phase can begin. The FDA requires eight weeks of safety monitoring among at least 3,000 people. Some 80,000 people have received the vaccine in phase three of clinical trials, with no significant reported side effects. Vaccines from Pfizer and Moderna are showing 94-95% efficacy against the virus in these trials. Phase four involves continued safety monitoring and data gathering.

Q3: What are the side effects of the vaccine?

A: For the vast majority of people who have received the vaccine, including Dr. Lawrence, the side effects of the first dose involve no more than a sore arm at the injection site for a day or so. Other possible side effects are headache, fatigue, fever and chills, muscle aches. The second dose can be more likely to produce side effects, with an increase of about 10 to 15 percent. Discomfort from either dose means the vaccine is doing its job!

Q4: Can the vaccine give me COVID or make me sick?

A: No! The vaccine does not inject a live, or even a dead, virus. See #11 below for more about how the vaccine works.

Q5: How long will the vaccine protect us?

A: More time and research is needed before this can be determined. Experts say that it might be like the annual flu vaccine, which needs to be administered each year.

Q6: I’m not feeling sick; why should I get the vaccine?

A: COVID-19 is an extremely contagious virus; it threatens everyone in our path, and even if we have no symptoms, we can still be carriers. “We have no prediction of how COVID can affect any one of us, but we know it affects everyone around us,” said Dr. Lawrence. “It’s a killer.”

Q7: What if I want the vaccine but my neighbor in senior living doesn’t?

A: While getting the vaccine is not mandatory in senior living or elsewhere, every possible effort is being made among staff (and fellow residents, if appropriate) to educate residents and their families about the efficacy of the vaccine and the utmost importance of everyone in the community receiving it. For those residents with cognitive impairment, decision-making guardians or family members must be made aware of the imperative. The CDC is providing ongoing communications to long-term care facilities to assist staff in the education process.

Q8: What if I want to take my time and wait for another opportunity to get the vaccine?

A: We don’t know when, if ever, that “other opportunity” will come. Taking advantage of first-round availability of the vaccine in senior living is critical, as it is not known when seniors will be able to receive it again after the next waves of the population. “Stay alert for when it’s offered; jump on it,” advises Dr. Lawrence.

Q9: What if I get the first dose and don’t want the second?

A: The vaccine is not effective unless both doses are received. While some may experience discomfort from the first dose, that only means the vaccine is doing what it should. Except in the rare incident of a severe anaphylaxis allergic reaction to the first dose, side effects should not dissuade people from receiving the necessary second dose. Keep in mind, the second dose is likely to cause more noticeable side effects, but this is normal.

Q10: What if I’ve already had COVID? Should I still have the vaccine?

A: Yes. Even for those who’ve had the virus (and consequent antibodies against it), it is safe and advisable to get the vaccine after being COVID-free for 30 days. It can also provide additional protection from future COVID infections.

Q11: How does the vaccine work?

A: Unlike traditional immunizations that involve injecting a pathogen into the system to build antibodies to it, the COVID vaccine operates on messenger RNA. Basically, it tells our cells to make a harmless piece of the “spike protein” on the surface of the virus. Our bodies then recognize that the protein shouldn’t be there and build antibodies to it.

Q12: How many people were included in the clinical trials? How many of them were seniors?

A: A broad diversity and distribution of some 80,000 people were included in the clinical trials, one quarter of whom were seniors 65+, but few were over the age of 80. Said Dr. Lawrence, “One question is how effective the vaccine will be in a 95-year-old. We don’t know, but we do know the impact of the infection on someone that age.”

Q13: What if the vaccine manufacturers are just in it for their own gain? Is anyone else evaluating it?

A: Yes. Two independent advisory committees to the FDA with no connection to the manufacturing companies (whether monetary, political or otherwise) are monitoring the vaccine. These committees have also been vetted to ensure that there are no conflicts of interest. Note too that in addition to Pfizer, BioNTech and Moderna, several other manufacturers are developing COVID immunizations.

Q14: What is herd immunity?

A: Herd immunity occurs when enough (about 70 percent) of the population is invulnerable to a virus that there is virtually no one to pass it on to. According to Dr. Lawrence, this is accomplished in two ways: 1) get infected; 2) get the vaccine. As he sagely observed, senior communities in which everyone has been vaccinated will operate as their own “islands of immunity,” even as early as mid-winter.

Q15: Will I still have to wear a mask and practice social distancing after I get the vaccine?

A: Yes, at least until everyone around us has received the vaccine or we develop herd immunity. As we’ve said, this is likely to occur in senior communities sooner than other environments.

Q16: Should I still get a flu vaccine?

A: Yes. It’s especially important now to get a flu vaccine because you can get COVID and the flu simultaneously. What’s more, protection against the flu will decrease the onus on the healthcare staff caring for people with the coronavirus.

“The COVID vaccine is nothing short of a medical miracle,” said Dr. Lawrence, whose emotional response to receiving the vaccine flooded him with a sense of relief, hope, and light at the end of the tunnel.

It can be that for all of us, beginning with those in senior living.

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