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Q&A with a doctor: Which COVID-19 vaccine should you get?

The numbers look good for Pfizer’s COVID-19 vaccine, but there is still more work to do.
The numbers look good for Pfizer’s COVID-19 vaccine, but there is still more work to do.(WVUE)
Published: Apr. 9, 2021 at 11:03 AM MDT
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COLORADO SPRINGS, Colo. (KKTV) - Dr. Jon Andrus is an adjunct professor and director of vaccines and immunization at the University of Colorado. He has an extensive history of working in global health programs, including being the deputy director of the Pan American Health Organization for 5 years. 11 News Anchor Rebekah Hoeger spoke with him over the phone to answer your questions about vaccines. The following interview is edited for clarity and length.

RH: Which vaccine is best? Pfizer, Moderna, or Johnson and Johnson?

JA: The one that’s available at the moment -- that’s the best one. That’s what I’m responding to with anybody that asks that question. Any three of those, the one that’s available, go for it. It’s a race against the variants right now, and we’re seeing with some of the let up on masking and people being a little bit less inclined to adhere to physical distancing, that there’s been a plateauing and even a suggestion in some places that the virus is coming back.

The big concern about the variants when you look at, particularly, some of the modeling data, it only takes 4 months for them to outrun the original virus. It goes to show you it’s a race, so the sooner you get vaccinated, the better you are and the better your community is. You’re helping your community.

RH: How are the vaccines holding up to variants? Should we be worried?

JA: So far, the information is optimistic. The initial reports, particularly from Pfizer and Moderna are showing that the vaccine is also protecting against infection (transmission). Remember that some people when they’re infected, they have no signs or symptoms, so they can be silent transmitters. The preliminary data is showing that it’s having a good impact on infection. When they did the original clinical trials, their outcome measures was disease -- you know, having symptoms, having to become hospitalized. But now that we have this emerging data with the vaccine being used in the real world, that is reassuring, but it’s still just preliminary. We need to monitor that. So you know, I think that’s about the best answer I can give you on that one.

RH: How long does the vaccine last?

JA: Well, that’s a good question. We won’t know how long it lasts until we have enough data to follow it prospectively. This happens with just about any new vaccine. You can make a guess, but the data has to show it.

A good example was -- remember when the human papillomavirus vaccine came out? We didn’t know how long that vaccine would last and as the years go by, each year that goes by you can say, ‘Well, now we know it lasts at least 10 years,’ and the subsequent years, ‘Now we know it lasts 15 years,’ and so it will be like that. And the data exemplifies why it is so important to use the evidence to guide the policy.

RH: Will we need boosters?

JA: It will be monitored and the use of data will help guide the best policy. With the variants emerging, it’s likely that we’ll need some booster. There are a couple of things that are moving targets.

One is that, particularly with the messenger RNA vaccines, the companies are already beginning to tweak their vaccine to be sure that it covers the variants more effectively. If we didn’t have that, then definitely booster doses, it’s likely they’ll be required, sort of like what we see with seasonal influenza.

RH: What side effects can happen when you get the vaccine?

JA: It ranges from having no side effects, to having some very mild symptoms, to having actually anaphylaxis. The mild symptoms that people may experience are things like a mild headache. And actually, you want to see some of these symptoms because it’s a sign that your body is reacting in the way we would like it to react to form the immunity, so that when you’re actually exposed to the real pathogen, you’re protected. So the mild symptoms could be the soreness of the injection, maybe a little swelling, maybe a little redness, a mild headache, even a mild fever. I know with my second vaccination, I felt tired. I had that kind of feeling like I had just done a double workout. Others may have a little nausea or just feel kind of achy. They may last a day or two and then go away. And it’s funny -- why does this person have no symptoms, and why did I get so tired? We’ll probably never know the answer to that.

The severe reaction generally comes in a form of what we call anaphylaxis, and that’s where somebody is actually allergic to one of the components in the vaccine, like stabilizers and preservatives. Fortunately, anaphylaxis is rare. The anaphylaxis is treated immediately, and that’s why they have you wait after you’re vaccinated.

RH: What’s going on with the AstraZeneca vaccine and should we be worried about it?

JA: I think the bottom line is, if this is the vaccine available, I would take it. The data has shown that it prevents death and, I mean, it doesn’t get any better than that.

And it’s a vaccine that the company has worked with countries around the world to make it accessible. I keep reminding myself that this is a global problem that needs a global solution. We could vaccinate 80 percent of the people in the United States and that would be a huge success, but as long as we have 20 percent unprotected with variants circulating all around the world, you know -- a variant anywhere is a variant everywhere. And so we would want those vaccines accessible to all places in the world where there’s a risk of variants emerging.

RH: Anything else our viewers need to know?

JA: I think the theme about a global problem needs a global solution is important for reinforcing anything that we do in our own country. We tend to hunker down and think about what’s going on in our own community, but we’re all a part of what’s happening globally.

The second thing is that we learn from this because it won’t be the last pandemic. We learn, we go forward, we sustain the capacity development so that we’re better fit for purpose for the next one. One could argue that the pathogen that will cause the next one is already here. It might be circulating in some bat population and it’s waiting for its chance to jump to infect a human.

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