Your COVID Questions Answered

QUESTIONS FROM THE WEEK OF JANUARY 11
Answered by Trey Dobson, MD, chief medical officer at SVMC

Can I pick what vaccine I get?
No. Unless you would like to wait until all of the vaccines are widely available, it is not feasible for individuals at a clinic to know in advance which vaccine they will receive. All are tested, trusted, and provide the protection you need. We recommend getting vaccinated as soon as you have the opportunity.

I have already had COVID-19. Should I get vaccinated?
Yes. Please plan to get vaccinated 75 days after the onset of your symptoms. Your own immunity will protect you throughout that time. The protection from the vaccine is expected to last far longer.

Do you when we can expect a vaccine for children and teens?
The Pfizer vaccine is recommended for people age 16 and older. The Moderna vaccine is available for those 18 and older. Clinical trials of the Pfizer vaccine for children started in September, and those for the Moderna vaccine started in December. It is difficult to tell when these vaccines will be available for kids and may not be in time for the September 2021 school year.

QUESTIONS FROM THE WEEK OF DECEMBER 28
Answered by Trey Dobson, MD, chief medical officer at SVMC

Whose turn is it to get vaccinated?
SVMC is vaccinating according to Vermont state guidance. See the plan below. Currently, we are in phase 1a. We are vaccinating healthcare workers, including emergency medical personnel, and those who live or work in long-term care facilities. If you are a healthcare worker, you can sign up for a time here. Everyone else should visit this website for updates about when vaccines will begin for them. 

What are the vaccines' ingredients? 
The Pfizer BioNTech COVID Vaccine includes mRNA, lipids ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate), 2 [(polyethylene glycol)-2000]-N,N-ditetradecylacetamide, 1,2-Distearoyl-sn-glycero-3- phosphocholine, and cholesterol), potassium chloride, monobasic potassium phosphate, sodium chloride, dibasic sodium phosphate dihydrate, and sucrose. See the complete fact sheet here. 

The Moderna COVID Vaccine includes messenger ribonucleic acid (mRNA), lipids (SM-102, polyethylene glycol [PEG] 2000 dimyristoyl glycerol [DMG], cholesterol, and 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC]), tromethamine, tromethamine hydrochloride, acetic acid, sodium acetate, and sucrose. See the complete fact sheet here. 

When will firefighters be vaccinated?
Firefighters who provide medical treatment on occaision may be vaccinated as a healthcare worker. Healthcare workers who work within SVMC's service area may schedule to receive their vaccine now at https://svhealthcare.org/COVID-19/Vaccinations-HCW. 

QUESTIONS FROM THE WEEK OF DECEMBER 21

I have heard that there are extra doses in some of the vials of the vaccine. Are you using them? Why or why not?
A dose of the Pfizer vaccine is 0.3 ml. Like many pharmacies nationwide, the SVMC pharmacy observed that we could get between five and seven doses out of each vial. The vials were expected to contain just five doses. The Food and Drug Administration quickly issued guidance stating that we can use as many 0.3 ml doses as are included in the vial. There is no preservative in the vaccine, so we cannot combine an amount less than 0.3 ml with vaccine from another vial to make a complete dose. So, sadly, a very small amount of vaccine is being discarded. As always, safety is the most important factor. Answered by Rob Sherman, PharmD, director of pharmacy services

What COVID treatments are being used locally now? Do we have access to the latest treatments and are they working?
Southwestern Vermont Medical Center has access to Remdesivir, which is used for hospitalized patients before their illness has progressed to the point where they need a ventilator. This drug is being used widely nationwide and seems to work to decrease the progression of the disease. Commonly available steroids are being used to treat COVID patients at SVMC, and they also work well in many cases. Finally, monoclonal antibodies are available. They are for patients who are at high risk of developing serious illness but are not very sick yet. Patients who receive monoclonal antibodies are not sick enough to be admitted to the hospital. They have not been studied to the degree necessary to declare whether or not they are effective and many of the professional organizations our physicians trust have not yet begun to recommend them. SVMC’s Infectious Disease Department is managing the process of developing a protocol for using monoclonal antibodies in outpatients and is monitoring availability of so we can offer this treatment. Answered by Marie George, MD, FIDSA, infectious disease specialist at SVMC

Is the COVID-19 vaccine recommended for those who are pregnant, nursing, or who may become pregnant?
See the complete answer by Kimberley Sampson, MD, of SVMC OB/GYN, here. 

QUESTIONS FROM THE WEEK OF DECEMBER 6
Answered by Marie George, MD, FIDSA, infectious disease specialist at SVMC

How will I learn when I can get my vaccine?
The first wave of vaccine will go to healthcare workers and those who live and work in skilled nursing facilities. See the chart below for additional details on the estimated roll out. Note that this timeline could change. We will use our professional networks, medical practices, local media, our website, social media, our e-newsletter, and other means to notify people how and when they can get their vaccine. We are not collecting names for a "waiting list." 

Is the vaccine for COVID a “live” vaccine? 
None of the COVID-19 vaccines currently in development in the United States use the live virus. Instead, they use just a small piece of the virus, either a protein or genetic material, to teach our immune systems how to recognize and fight it. The small piece of the virus used cannot multiply in the way necessary to make us sick.

What does “Emergency Use Authorization” mean?
In an emergency, like a pandemic, the FDA can issue an emergency use authorization, or EUA, to provide faster access to medicines and tests that may help. They can do this only during an emergency and only when there are no adequate, approved, and available alternatives. EUAs have been used to make COVID tests available to the public, and soon, we expect a few vaccines will be made available in this way. While less data is needed to get a EUA than FDA approval, it still takes tons of data. The benefit is that an EUA takes weeks, rather than months or years. EUAs are continuously evaluated and can be revoked if (a) the emergency ends, (b) the product is found to be unfit, or (c) the product is officially approved, cleared, or licensed by the FDA.

I have heard that vaccines can make you sick with the disease. Is that true?
No. A small percentage of people who received the vaccine will get fatigue, soreness, inflammation, or headache. While these symptoms are similar to those experienced by those with COVID, they are a result of the vaccine teaching your body to respond to the virus, if it enters your body. These reactions have universally resolve in a short amount of time, usually less than one day. 

It does take about 2 weeks for the vaccine to provide immunity. A person could encounter the virus and become infected just before or just after receiving the vaccine, before the protection takes effect, which could lead to someone thinking that the vaccine had made them ill. 

I have heard that the vaccine is delivered in two doses. If it works, why do we need to get two shots?
All but one of the vaccines in Phase III clinical trials requires two shots. The first shot starts building protection. A second shot, a few weeks later, is needed to get the most protection. Think of it as a one-two punch.

I live in Williamstown, Massachusetts, but my primary care doctor is in Vermont. Will I get my COVID vaccine in Vermont or Massachusetts?
People who live in one place and receive care in another should take their first opportunity to receive the vaccine. It could be offered by the Department of Health or health system in their own state or through their medical provider in a neighboring state. You should receive the second shot with the same provider with whom you received the first one.

Does obesity count as a high-risk medical condition?
In some cases, yes. We will rely on primary care providers or other medical professionals who work with individuals to help determine whether a person falls into the high-risk category.

Where will vaccines be given?
Just like SVMC provided flu vaccines throughout October, we are planning to provide the COVID vaccine during drive-up clinics in a parking lot on our Bennington Campus and eventually at primary care clinics.

Once I get the vaccine, I can go back to normal life, right?
There are many considerations that will help determine if we can quit wearing masks, get together with friends, and travel again. It is best to look to the experts at the Vermont Department of Health or your state’s department of health. Continuing a (maybe slightly loosened) set of precautions will help ensure our entire community is protected before we relax. And remember, you’re never fully protected and the best protection you can get from the vaccine will be  after your second shot.

If you have a question, e-mail it to wellness@svhealthcare.org. We’ll get our experts to answer it in an upcoming e-newsletter.

QUESTIONS FROM THE WEEK OF NOVEMBER 26

I saw a public official wearing two masks, an N95 under a surgical mask. Should I?
The best way to protect yourself is to leave home for essential reasons only. When you do, wear a cloth facemask. Please save the procedure and N95 masks for those working in high-risk jobs. They are still in short supply at many hospitals nationwide. Additionally, an N95 is the most protection you can get. There are no studies, that I am aware, that indicate that a procedure mask over an N95 would be more effective. The only reason one might want to wear a procedure mask over an N95 is to keep the outside of the N95 clean.
Donna Barron, RN, Infection Preventionist, Southwestern Vermont Medical Center (SVMC)

Is an anterior nares test as reliable as the nasopharyngeal test?
First of all, let’s define these two complicated medical terms. The nasopharyngeal test is the one most commonly offered up until this point. It is administered by a medical professional. The sample collector puts a long swab up the patient’s nose and gathers the sample from very deep in the throat. If you haven’t experienced this sort of test yet, it makes your eyes water. The anterior nares test gathers the sample from the back of the mouth or inside the nose, not as deep. The benefit of the anterior nares test is that the patient, using simple directions, can collect the sample themselves. This saves valuable protective equipment. When the samples collected with both methods are processed the same way, they are believed to be similarly accurate.  Differences in accuracy do exist between antigen and PCR tests, different manufacturers, and whether or not the person has symptoms.
Marie George, MD, FIDSA, Infectious Disease Specialist, SVMC Infectious Disease

In the spring and summer, we could meet a neighbor outside for a distanced walk without wearing a mask. Now the Department of Health is recommending we mask in this situation. What changed?  Cases went up! Some of those distanced walks may have turned into distanced gatherings and then maybe not-so-distanced gatherings. If you’re wearing a mask, it’s a good reminder to stay apart and not hang out in the yard after the walk is over.
Donna Barron, RN, Infection Preventionist, SVMC

Is it safe to go to my medical or dental appointment at SVMC?
Yes. It's safe to come to SVMC for your appointment. Check with your provider to see if a telemedicine appointment would work for you. When you come to SVMC for your appointment. You will see signs for the virtual waiting room. Dial the number, wait in your car, and you’ll get a text when your provider is ready to see you. You’ll answer some COVID-related questions and get your temperature taken when you enter. Everyone will be masked properly. Practices that see patients who have respiratory symptoms or those who do aerosolizing procedures (like Dentistry) have been outfitted with negative-pressure rooms. This airflow-management system vents airborne particles safely outside. With all of these precautions, SVMC and its practices are the safest public places anywhere.
Michael Brady, DDS, SVMC Dentistry

Can I travel or host family at my house? 
Doctors and nurses get this question all of the time. It usually involves a few extra details that people mistakenly believe will make their trip or visitor the exception to the rule. Sadly, all non-essential travel should be avoided. While it is difficult for us to say this, it is the simple truth. While it is possible to pull off the quarantining and testing regimen necessary, it is neither easy nor a guaranteed protection. It's best to stay put and encourage others to stay put, as well.
Marie George, MD, FIDSA, Infectious Disease Specialist, SVMC Infectious Disease

How long will the immunity we get from the COVID vaccine last? Will we need a new vaccine every year, like we do for the flu? 
There are still unknowns, like how long the protection will last and how often we will need to be revaccinated. We trust that science will answer those questions, once the data is available.
Trey Dobson, MD, chief medical officer, SVMC

Do air purifiers work to stop the spread of COVID? 
If everyone you live with is staying home and following other COVID precautions, you have no need for an air purifier at home. An air purifier may be helpful if someone in your house has COVID-19 or needs to quarantine. Look for one with a HEPA filter or sanitizing capability. Some have both. Put it in the same room with the ill or quarantining person with the door closed. It will provide a small amount of protection for others who need to enter the room. Masks are still required. And those who are ill or quarantining should still spend as little time as possible with those who are not. Alternatively, you could open a window or use a fan to push air outside.
Marie George, MD, FIDSA, Infectious Disease Specialist, SVMC Infectious Disease

If you have a question, e-mail it to wellness@svhealthcare.org. We’ll get our experts to answer it in an upcoming e-newsletter.