A Discussion With A Vaccine Expert

Dec 18, 2020


This week, Wyoming Public Radio's Maggie Mullen hosted a Facebook Live event with Dr. Rupali Limaye of Johns Hopkins Bloomberg School of Public Health to discuss the COVID-19 vaccine. In case you missed it, we've put together some highlights for you to hear, starting with what it means that a recent survey found that most — but not all — Wyomingites say they would be willing to get vaccinated against the virus.

Rupali Limaye: Vaccines are really amazing medical innovations that we've had, but vaccines don't save lives; vaccination saves lives. And what we have found in this pandemic, there has been some modeling that has shown about 70 percent of the population needs to gain immunity. Meaning you can really get an immunity in two ways: you can either be exposed to the virus and then have antibodies because your body has been exposed to it, or you can get the vaccine. So it's a combination of these two things that we need to be really looking at to get to herd immunity. And if we can get to herd immunity that means essentially the virus will die out because the whole reason a virus lives is to replicate, right? It wants to just find another host, a susceptible host, and then continue to replicate onward. And so what the vaccine helps us do is it helps us reach that herd immunity much more quickly. We need to have a sizable proportion of the population accept the vaccine and get the vaccine for us to be able to reach herd immunity.

Maggie Mullen: This idea of herd immunity, it really reminds me of what's been said--even Dr. Anthony Fauci has really pointed this out that--even after someone is vaccinated, it's still really important to wear a mask, to take all these social distancing precautions that a lot of us have been taking since March. Can you explain why that might be?

RL: Even if you get a vaccine, which a lot of healthcare workers are starting to get the vaccine now, even if you get a vaccine, it's still important to continue to wear a mask, if you can, social distance, continue to stay at home as much as possible, until we reach that herd immunity, right? Because the issue is going to be until we get enough people to that threshold, and to that level, it's still important for us to continue these other public health recommendations, which, as you mentioned, a lot of people have been doing since March. We know people are tired, but I think if people can wait just a few more months, we will start to be able to see some semblance, I would say, of getting back to normal.

MM: Looks like we got one of our first questions. Why are they suggesting you get the vaccine when you have already had COVID?

RL: It's a great question. And I think part of it has to do with antibodies, and how long your immune system remembers something. And so for some people, if they've gotten COVID, they still have antibodies in their system for several months. For other people, they don't have antibodies for several months. So what the vaccine does is it makes sure that even if you've had COVID in the past, that it introduces that pathogen into your body so that your body is therefore ready if it encounters it again, to be able to fight it. So that's really the reason why.

MM: Of course, vaccine hesitancy is not new. It's something we've seen well before COVID-19. In fact, I saw there was a poll that was taken regarding the Polio vaccine, way back then, folks were hesitant to take that vaccine. But I'm wondering, it seems like there are more factors at play with this one. What's your sense of that?

RL: So I would say pre-COVID, I think the reasons why people might be hesitant about vaccines could sort of fall into four domains or four categories. So people were concerned about ingredients in vaccines; people were concerned about the vaccine schedule (so this is in relation to childhood vaccines, so how many shots a child gets at two months, four months, etc); people had typically lower levels of risk perception, meaning they didn't think that they were susceptible to the disease that the vaccine was preventing they thought that if they got the disease, it wasn't severe. And then the last piece is sort of the major safety issue, people were afraid of side effects from vaccines.

I think, since then, it has evolved over time with regards to what's happening with COVID. And I think there is a perception that the process has been maybe politicized a bit because of what has happened over the last nine months. So there's that piece.

The other piece is also this whole issue of, as you mentioned, that people are concerned that perhaps the process cut corners because it was expedited. And then the third is really this idea that it's a new vaccine, it's also a now novel pathogen. So you're dealing with not only a new vaccine, which tends to sometimes lead to more people hesitating about it, but it's also a pathogen that we don't know as much about. And so thinking about all of this together, and then this information on social media that has had a lot of misinformation, and just a lot of challenges that Americans have had, I think with regards to adhering to public health recommendations are really causing, I would say, the perfect storm as to why we're seeing this different type of hesitancy.

MM: Because of your expertise, you're a trusted source. So I'm imagining there's probably people in your life, whether professionally or outside of work, that maybe have come to you with questions about this vaccine. What have you been hearing anecdotally?

RL: I have been getting a lot of questions and I've been trying to answer them the best that I could. I think a lot of it has to do with, you know, the fact that, "first of all, would you get it?" That seems to be the first question that I'm getting, like, "Well, do you feel comfortable?" And you know, and I kind of talked about the data, and that this hasn't been tested in a small population. I mean, we're talking thousands of people have gone through the trial process. So there's that.

I think the other question that I had been asked, is essentially the question that you asked earlier, "What's the duration of immunity?" So how long will this confer protection, which is, again, we don't know yet. A lot of it will depend on once it starts rolling out and what it looks like, what the pandemic looks like in the United States.

I think the other question that we're getting also a lot is, "Are you concerned about sort of the safety and the side effects?" So in the Pfizer product, there were some clinical trial participants that talked about, a couple of them felt unwell for a couple of days. We've heard that before, particularly with regards to the flu vaccine, where people will get the influenza vaccine and then they will say, "you know what, I don't feel really good for a couple of days." And sometimes people think that that means that they got the flu. So I'm just trying to explain that in any of the vaccines that will be available here in the United States, there's absolutely no way that you would get the virus from the vaccine. So if you do feel unwell, that is normal, but to continue to talk to your doctor, right? Or whoever you get the vaccine from, whether that's a pharmacist, whoever, so that you feel comfortable with what the side effects are and don't have cause for concern. It's really important for you to have a trusted source to talk to you and ask questions.