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Fellow caregivers,
vaccines are the most important public health measure we have
to end the COVID-19 pandemic.
By following public health guidelines,
we're developing plans to distribute vaccines to caregivers
in a safe, equitable, and efficient manner.
Receiving the vaccine will be a personal choice
and not a mandate.
Today I'm joined by clinical leaders
who will share information about vaccine science
and our caregiver vaccination program in Ohio.
We have Dr. Steve Gordon, who is Chair of Infectious Disease,
Dr. Paul Terpeluk, Chair of Occupational Health,
and Dr. Michelle Medina, Associate Chief of Clinical Operations.
Thank you all for being with us today.
Let's start with you Steve.
Can you please tell us how the COVID-19 vaccines work,
and what do we know about their safety and efficacy?
Of the two hundred COVID-19 vaccine candidates,
it is likely that the messenger RNA vaccines
produced by Pfizer Moderna
will be the first to be distributed in the homeland.
And each will take a piece of the virus genetic code,
called the messenger RNA.
This provides instructions to code what we call,
'a corona virus spike protein.'
And after immunization, the vaccine enters the cell
and then instructs the cell to produce a spike protein.
And this spike protein then elicits an immune response
which consists of antibodies and T cells,
which then helps fight the virus when exposed.
We should point out
both of these platforms require two immunizations
21 to 28 days apart.
And a vaccine efficacy,
which is a measurement of protection against COVID-19
in the trials, was a remarkable 95%.
And this contrast to maybe 40 to 60% for seasonal influenza.
And also, importantly Tom,
is that across age, weight, and race,
there was no difference in the vaccine efficacy.
But Steve, there is also a conversation
about the speed at which these vaccines were developed
as well as the conversation
about some of the reported side-effects.
Can you address these concerns?
This has been a global collaborative, to make widely available,
safe and effective vaccines across the world
so we can end this pandemic.
And when we look at FDA data submission,
say for the Pfizer product,
which involved thousands of patients
it's just a very favorable safety profile
and there was no specific identified safety concerns.
Having said that, the most commonly reported adverse effects
do relate to immunization site in the arm.
These are intramuscular injections, pain, and swelling.
And then there has been some persistent, what we say,
'malaise fever' or headache that can also occur.
Because of this, we will stagger immunizations in individuals
amongst our health care teams.
And I should also point out
there is a mandatory 15 minute observation period
for all recipients, to protect against
the rare possible immediate hypersensitivity reaction.
Thank you very much Steve.
Paul, what do we know about the early vaccine supply,
and how we're ensuring
an equitable distribution to our caregivers?
It is important to recognize here in United States
there are four vaccines in FDA clinical trials.
Pfizer vaccine is the first to apply to the FDA
for their emergency use authorization.
With approval granted Pfizer will ship the vaccine to Ohio.
And since Cleveland Clinic is a pre positioned site in Ohio,
we should receive our first allotment soon.
Unfortunately, it appears that the first allotment
will be limited to about a thousand doses.
Because of this limited supply,
we have taken our guidance for who to vaccinate first
from both the federal and state governments
where they have built a distribution system
based on vaccine availability.
The good news is our caregivers are first in line
according to this guidance.
In order to have a fair and equitable distribution
of this first limited allotment,
we have identified those caregivers in Northeast Ohio
who are essential to maintain our current operations.
This includes our COVID ICU's,
ED's and our COVID units.
This is a voluntary vaccination program
and those caregivers identified within those units
will be invited to schedule an appointment via My Chart.
So look out for those invitations.
When can we expect that all Cleveland Clinic caregivers
will have the opportunity to be vaccinated in your estimate?
Well I would say soon.
Having this vaccine available in such a short time
is truly amazing.
Remember, we did our first COVID test for the virus
just nine months ago.
Because the vaccine production is a manufacturing process
where millions of doses are being made,
it will be slow in the beginning but rapidly accelerate.
It will take time.
But rest assured, every caregiver who wants the vaccine
will be given the opportunity to get it.
I ask for your patience as this process unfolds.
In the meantime,
remember vaccination is only one of many layers
of protection against this virus.
Continue to utilize all of our layers,
including the COVID pass,
UPP, hand hygiene, social distancing,
and calling our COVID hotline when feeling unwell.
Thank you Paul.
Michelle, once a caregiver is eligible for vaccination,
what is the process for vaccination?
Caregivers will receive a My Chart invitation
to schedule their first and second dose appointments
in one of the vaccination sites.
They will need to complete their Ready Set questionnaire
prior to arriving at their appointment,
similar to how we do it now for employee flu vaccines.
As each vaccine location opens,
they will see those options become available for scheduling on My Chart.
Caregivers, however, who have had a Covid-19 treatment
with either monoclonal antibodies or convalescent plasma
in the last 90 days, or currently have active COVID-19 infection
should wait to be vaccinated.
If they've had a COVID infection in the last 90 days,
they may choose to defer the vaccine
because reinfection is uncommon in those first 90 days.
Now if they are pregnant, breastfeeding, or immune compromised,
they should discuss having the vaccine with their provider
before scheduling it
Now then Michelle,
the frequently asked question from our neighbors,
friends from the community,
is about when will patients and community members in general
be able to receive the vaccine?
Similar to a phased approach with health care workers.
The first members of the public who will be allocated vaccine
are essential workers, seniors, and those with chronic medical conditions
who may get severe COVID or die from it.
The distribution process for this next group
is also being determined at the federal and state level.
Beyond that, as more vaccines are produced
we can expect that it will become available to the general public.
And early estimates from the CDC
now a lot of this depends on vaccines becoming approved and produced
does show that publicly available vaccine
may be here in late spring or summer of 2021.
Now going back to Steve, frequently asked question
it relates to the immunity to COVID-19 following the vaccination.
Is a person who's vaccinated immune,
and how long will that immunity last?
We do not know the durability of the response to the vaccinations
because at this point we only have
that two-month follow up data past that second immunization.
But that will be studied.
In addition, as you know,
we still don't have a good blood test
to provide us correlation of protection
whether you get a natural COVID or from a vaccine.
And the third thing is,
we still don't know whether receiving the vaccine
has influenced its transmission dynamics.
We know it protects against disease,
but it still may allow people to transmit asymptomatically.
And for those reasons, we are still recommending
our health care providers who successfully receive vaccination,
to still distance, mask, and hand hygiene.
I would like to thank you all for joining us today.
This is a challenging effort,
but one that is critical to the health and safety
of our caregivers, patients, and communities.
Thank you for everything you are doing to ensure its success.
Thank you.
Vaccines offer great hope of a future without COVID-19.
Scientific data around these vaccines' efficacy
is absolutely remarkable.
The vaccine distribution process will be,
without any doubt, a complex undertaking.
We will continue to provide transparent information
throughout this effort.
Thank you for your perseverance.
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