Dr. Foster Kordisch is a pessimist by trade. He’s an ER physician after all. Hours after the fanfare of a Covid vaccine stuck painlessly in his arm, the history of the moment vanished. It was a shot. And an easy one at that.
“I’ve been immunized a lot. This is one of the most painless injections I’ve ever had,” he says.
Kordisch directs Ochsner Lafayette General’s emergency department. Over the last 10 months, his team has weathered three surges of the pandemic. That the virus could pass asymptomatically meant routine admissions created an environment for spreading Covid to vulnerable patients. The virus lurked behind each sprained ankle that came through the ER doors. The first dose of the Pfizer vaccine behind him, he’s on his way to peace of mind. In three weeks, he can do his work with much more confidence.
Pfizer’s study of 20,000 vaccine recipients showed 95% effectiveness with no serious side effects over the compressed study period. Data for the Covid vaccine produced by Moderna, which is coming close behind the Pfizer release, is yielding similar results. This is a real step forward, he says, and the first weapon mankind has had that can attack the virus without society-scale disruption.
“This is the first thing that we’ve been able to have to prevent the virus that doesn’t involve blowing up our daily life,” he says.
There’s still a lot to learn about Covid and the vaccines heralded to end its terrorizing. Uncertainty has bred anxiety that the cure could be worse than the disease, even among Americans who aren’t opposed to vaccinations altogether.
Kordisch himself walked into getting the Pfizer vaccine with a raised eyebrow. The mRna vaccine is a relatively new technology, so-to-speak, and the version created to stop Covid was developed at a breakneck speed, compared with the years of long-term trials that typically accompany American pharmaceutical development (more on this in the FAQs below). With a lot still unknown about the vaccine and the virus, he nevertheless looked at the data available and felt safe.
“The science supports that it’s safe. And it does offer some sort of immunity. If you want to get back to our way of life, we need to develop some herd immunity, which is only going to happen if, one, everybody gets sick or, two, if people get vaccinated.”
Safe, of course, is a relative term. And weighing the risk of taking the vaccine with the risk of the virus itself is a moral and scientific calculation Dr. Britni Hebert says is pretty straightforward. Yes, all vaccines come with some risk of side effects. But Covid is a proven killer.
“We do know the risk of long-term damage from this virus is real, happening now and measurable already. The vaccine has already proven itself to be the lower risk option with room to spare,” she wrote in a Facebook post she conceived as Covid vaccine 101. Hebert is an internist and a specialist in geriatric medicine. She rounds at Lourdes.
Hebert has been preparing for this moment. Earlier in the pandemic, she joined a wave of medical reinforcements that staffed a spillover field hospital outside of Manhattan when New York was an epicenter for the pandemic. Since then, she’s made a point of producing Facebook posts and videos to try and demystify the pandemic and tackle misinformation head on. Now she’s turning to the vaccine, clearly laying out the pros and cons.
“It’s OK to be skittish, suspicious or scared of this development,” she writes. “That’s human nature. The best response to that feeling is information and understanding.”
Hebert goes through some FAQs on the virus, covering issues like its effect on pregnant women and breastfeeding and even the basics of vaccination itself. An mRna vaccine, she says, is like a blueprint on a tissue paper that gives the body’s footsoldiers a plan of attack. She boils down what might otherwise seem like science fiction. The vaccine teaches the human body to create the little red protein spikes we’ve seen for months on cartoon pictures of Covid. Those are the spike proteins used to attach any coronavirus.
“Your body’s so smart. It knows right away [that] this spike protein isn’t you,” she writes with amazement. “It’s other. It’s bad. It needs to be attacked. Here come the footsoldiers: fever, aches, fatigue. And then memory. Protein destroyed and immunity made.”
Both Kordisch and Hebert have addressed some of the most common questions about the vaccine. Here are a few responses to those asked and voted on by readers in The Current’s coronavirus Facebook group. With permission, we pulled answers from Dr. Hebert’s vaccine 101 post, which you can find here.
Q: How will I know when it’s my time to get the vaccine?
Dr. Kordisch: The general public health guidelines, as I understand it, is that within this month they want to get essential healthcare personnel and long-term care residents. The next phase is going to be essential workers. That’s probably 40 million-50 million people. Factor that, going into the late spring summer and fall is adults with high-risk conditions. Those are the three phases. By next year [2022], you’ll see widespread vaccine usage for the full population, if it turns into a yearly vaccine.
Q: What’s the likelihood we’ll have to get the vaccine every year?
Dr. Kordisch: I don’t think we’re sure yet. In my opinion it’s probably going to be a yearly virus. Now, that’s my opinion. Most of it, we don’t know the research. The first case is right at 12 months old. We don’t know the antibody response to the virus. The first case showed up in the United States nine months ago. That’s very quickly to make a vaccine and then to say you have lifelong immunity.
Q: What pre-existing conditions would qualify someone to get the vaccine before the general public?
Dr. Kordisch: The high-risk factors we use for the emergency room, and it’s probably going to translate, are diabetes, renal disease, chronic obstructive pulmonary disease, age. Obesity is a big one — BMI over 35 — those are what we consider our high-risk patients.
Q: What if I’ve already had Covid?
Dr. Hebert: While previously swab-positive Covid people were excluded, baseline antibodies showed that some had been infected prior to vaccination. Numbers were small, but reinfections were noted and were seven times higher in the unvaccinated group. Vaccination after infection is recommended. In times of shortage, it is reasonable to wait until 90 days after infection to vaccinate.
Q: Was the vaccine rushed?
Dr. Hebert: No — mRNA technology was first introduced in the 1990s. This is not the first vaccine of its kind, it’s just the first that’s worked. Zero safety steps were skipped. There is a critical difference between rushing and expediting. Normally very few people are working on vaccines, maybe a handful for any given disease at a given time. They have to wait in line at every step for approval, for design, for product. Then they have to wait for enough volunteers to care about their one vaccine to get enough data. And then for those volunteers to come across the disease naturally to test the vaccine. That is what takes years normally. Rarely do we have the entire world working on the same thing, pushing it to the front of the line, giving it all the funding, all the scientists, and unfortunately plenty of disease going around to test quickly. This is what we can do when that happens. And it’s awesome.