COVID-19 vaccines: What healthcare providers need to know
As of early January 2021, the United States has begun Phase 1 of the COVID-19 vaccine rollout. This video will help health care providers get up to date on key information regarding the vaccines.National guidelines are recommending prioritizing giving the vaccine to the public according to a person's status as an essential worker and their risk of becoming ill from COVID-19.
Based on these criteria, they have identified different categories/segments. The first category, called Phase 1a, is where residents of long-term care facilities and front-line healthcare workers, including first responders will be vaccinated, [22].
Next is Phase 1b, where essential workers and adults aged 75 and over will be vaccinated [22]. In Phase 1c, adults aged 65 and over, as well as patients at high-risk for severe COVID-19 infection caused by pre-existing health conditions will be vaccinated.In Phase 2, everyone 16 years of age or older who hasn’t received a vaccine will be eligible to receive one.
These national recommendations continue to evolve and may change over time, however, it’s ultimately up to each state to decide how vaccines will be distributed.Currently there are two vaccines approved by the FDA for use in the United States.
The first is BNT172b2. It was created by BioNTech, Fosun Pharma, and Pfizer and is colloquially called the “Pfizer vaccine”.
It’s an mRNA vaccine that must be stored long-term in -112 to -76 fahrenheit, or -80 to -60 celsius. MRNA vaccines differ from traditional vaccines as they cause our body to manufacture the spike protein of the virus we’re trying to protect against, instead of introducing remnants of the virus itself.
Once thawed and diluted, vials can be stored in a refrigerator for 6 hours. Initially, these vials were reported to hold 5 doses per vial, however, it has been discovered each vial contains 6 usable doses and official documentation has been updated.
People receiving this vaccine should receive two intramuscular doses of 0.3mL of diluted vaccine, 3 weeks apart.Phase 3 trials, done in over 44,000 people aged 16 to 91, showed that the Pfizer vaccine is 95% effective at preventing symptoms of COVID-19 seven days after the second dose has been delivered.
It’s worth noting COVID-19 infection rates in the vaccination group began to decrease when compared with the placebo group two weeks after the initial dose was administered.
Among individuals who had gotten a single dose of the vaccine but had not yet gotten a second dose, there was a 52% vaccine efficacy [19].
Just like the full two-dose vaccination schedule, we don’t know how long protection from infection will last after only a single dose.mRNA 1273 created by Moderna and the National Institute of Allergy and Infectious Diseases in the United States and colloquially called the “Moderna vaccine”, is an mRNA vaccine that works like the Pfizer vaccine, although it doesn’t need to be stored as temperatures that are as cold.
The Moderna vaccine must be stored at -13 to 5 degrees fahrenheit or -25 to -15 degrees celsius. Once thawed, an unpunctured vial can be refrigerated for up to 30 days, or left at room temperature for up to 12 hours.
Once punctured, the vial must be discarded after 6 hours. Unlike the Pfizer vaccine, no dilution is required.
People receiving the vaccine should receive two intramuscular doses of 0.5mL of vaccine, 1 month apart.Phase 3 trials, involving over 30,000 people between the ages of 18 and 95, showed that the Moderna vaccine is 94% effective at preventing symptoms of COVID-19 fourteen days after the second dose has been delivered.
2000 individuals were also given only a single dose of the Moderna vaccine, which showed 80% efficacy.ChAdOx1 nCoV-19/AzD1222 created by Oxford University and AstraZeneca and colloquially called the “AstraZeneca” or “Oxford” vaccine, is a replication-incompetent vector vaccine that must be stored between 36 to 46 degrees fahrenheit or 2 to 8 degrees celsius.
Replication-incompetent vector vaccines deliver the spike protein DNA to our cells through a separate harmless virus. Our cells then make the spike protein to build an immune response against the pathogen.
At the time of writing this, the AstraZeneca vaccine has not yet been approved in the United States. People receiving the vaccine are to receive two intramuscular doses of 0.5 mL of vaccine, 28 days apart.Phase 3 trials, involving over 11,000 people 18 years or older, showed the AstraZeneca vaccine to be 70% effective at preventing symptoms of COVID-19 fifteen days after the second dose has been delivered.
Individuals who have previously had any allergic reaction, including hives, to any components contained in the vaccine should not receive the vaccine.
Previous allergic reactions to other vaccines however are not a contraindication and administration should be handled on a case-by-case basis.
The clinical trials for these vaccines did not set out to evaluate children under age 16, immunocompromised patients, or people who are pregnant, however these populations are still recommended to get the vaccine once they’re eligible based on the rollout of the vaccine.People who have previously contracted COVID-19 should also receive a COVID-19 vaccine once their symptoms have cleared.
The side effects of these COVID-19 vaccines are similar in prevalence and severity, and include mild pain at the injection site, fever, severe fatigue, headaches, and chills.A small percentage of individuals could have an anaphylactic reaction to the Pfzer vaccine, on the order of 11 cases per million doses, with over 70% of anaphylactic reactions occurring within 15 minutes of administration [2].
The mechanism of allergic reaction is still unknown. Data on anaphylactic reactions is still being collected for the Moderna and AstraZeneca vaccines.In the event an adverse reaction to a vaccine occurs, US based health care providers should report the adverse reaction following their institutional protocols.
Recipients of the vaccine can also download the V-SAFE smartphone app from the CDC to get notifications about the vaccines and to report adverse reactions they may experience.There are a number of key points that need to be reinforced with the public.
Second, the vaccine is free to receive. Third, after receiving the vaccine, people should remain at the healthcare center for 15 minutes for monitoring in the event of anaphylaxis.
This monitoring period should be extended to 30 minutes for people who have previously had allergic reactions to other vaccines.
For these reasons, vaccinated people must still wear face masks, regularly wash their hands or use hand sanitizer, and continue to follow social distancing requirements.
Sixth, there is significant vaccination hesitancy with the public. A survey by Fisher et al.
in September 2020 revealed 43% of people in the United States would decline or are unsure if they will accept the vaccine when it becomes available to them.
The most common reasons for hesitancy include anti vaccine beliefs, beliefs the individual is not at risk of infection, and lack of trust in the healthcare system.
Healthcare providers can improve vaccine adoption by directly recommending vaccinations to patients, such as during patient visits or on the phone, to identify and address patient concerns, to educate patients on vaccine risks and benefits, and to dispel misconceptions around the COVID-19 disease and vaccine.
of infection and lack of trust in the Healthcare System Healthcare Providers can improve vaccine adoption by directly recommending vaccinations to patients such as during patient visits or on the phone to identify and address patient concerns to educate patients on vaccine risks and benefits and to dispel misconceptions around the covid-19
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