Drs. Wilbur Chen and James Campbell of the School of Medicine and the Center for Vaccine Development and Global Health enlighten a “Baltimore” magazine audience on vaccine-related issues.
Two physician-scientists from the University of Maryland School of Medicine (UMSOM) lent their expertise on the COVID-19 pandemic to Baltimore magazine’s Jan. 26 virtual event “Community Conversations: COVID-19, Health, and Vaccines.” The gist of the one-hour discussion: The vaccines are safe and extremely effective and their side effects are manageable, but once you’ve received your doses, don’t let your guard down.
“These vaccines have among the highest efficacies of any vaccine we have available,” said James Campbell, MD, MS, professor in the Department of Pediatrics at UMSOM and a pediatric infectious diseases specialist at UMSOM’s Center for Vaccine Development and Global Health (CVD). “When you are talking about a vaccine that is 95 percent effective against COVID-19 infection and almost 100 percent effective at preventing severe disease, the efficacy is phenomenal.”
(Watch a video of the event.)
The two vaccines that have received Food and Drug Administration (FDA) emergency use authorization — from Pfizer-BioNTech and Moderna — have been administered for about a month in Maryland and throughout the United States, with one vaccination site at the University of Maryland, Baltimore’s (UMB) SMC Campus Center. Campbell’s colleague, Wilbur Chen, MD, MS, spoke about the reported side effects, relating his experience after receiving the vaccine.
“We’ve been pleased to see that the adverse reactions have been rather minimal,” said Chen, who is a professor in the Department of Medicine at UMSOM, chief of the Adult Clinical Studies sections at CVD, and a member of Gov. Larry Hogan’s Coronavirus Response Team. “Some reactions can last for about three days, and there can be achiness, pain, arthritis, headache, or fever. But they are temporary, they go away. I can say that I felt some of those as well. And I took some ibuprofen and felt much better.
“So the trade-off is this: You can either get the COVID-19 infection and suffer the consequences of the disease, or you can receive the very high levels of protection shown with this vaccine.”
The event was sponsored by UMB and moderated by University President Bruce E. Jarrell, MD, FACS. In addition to asking about vaccine efficacy and side effects, Jarrell posed questions about the status of clinical trials for children, whether pregnant women should get the vaccine, and post-vaccination protocols, before relaying questions from the audience.
Campbell, the pediatrician, said the Pfizer-BioNTech and Moderna clinical trials compiled data from people as young as 16 and 18 years old, respectively, and that both companies are conducting trials in children as young as 12. Once those trials are concluded and data presented to the FDA and Centers for Disease Control and Prevention (CDC), vaccine authorization is likely to follow for that age group.
“What we’ll do then is move down to the next age level, and 5- to 11-year-olds probably will be the next group to be studied, then down to the preschoolers, and then down to infants,” Campbell said. “We move stepwise in age, thinking that teenagers probably have a similar safety and immune response to young adults. What’s important in those studies is to see: Is the safety profile exactly the same? Is the vaccine dose required the same? Is the time interval between doses the same?
“As for dosage, vaccines tend to require pretty much the same dose in adults and children, but we need to do these studies in children to see whether or not we need to make any adjustments.”
Regarding the vaccine and pregnancy, Campbell noted that the American College of Obstetricians and Gynecologists recommended that COVID-19 vaccines should not be withheld from pregnant or lactating women who meet CDC-approved criteria for vaccination. He suggested that pregnant women or women planning to get pregnant consult with their health care provider to decide their best course of action.
“There’s no theoretical reason to believe that the vaccines would lead to any additional risks for mother or baby compared to what the risks are to the general population,” Campbell said. “But there also is not a lot of data at this point.
“It’s a balancing act,” he added. “How high risk are you? If you’re pregnant, working from home most of the time, and don’t have a lot of contact with others, you may not want to get vaccinated. If you’re pregnant and work in an emergency department or an intensive care unit and you’re exposed to COVID every day, you may say that your risk/efficacy balance is that you definitely want to get vaccinated.”
Said Chen: “As we’ve said, these vaccines are highly effective, and they’re both based on messenger RNA [mRNA] technology, and mRNA does not integrate into a person’s DNA. So there’s not any fear that the vaccine could alter the fetus.”
Jarrell, who was a volunteer in the Moderna clinical trials at CVD and received the vaccine rather than a placebo, asked about post-vaccination protection and safety protocols, essentially: When will those who are vaccinated achieve the 95 percent protection from COVID-19 infection?
Campbell replied that studies have shown that two weeks after receiving your second dose is the inflection point for protection from COVID-19 infection, so vaccine recipients should remain vigilant with the type of safety measures that have been recommended since the start of the pandemic for those two weeks and beyond.
“We don’t want people to let their guard down,” Campbell said. “We want to make sure that while we’re still in the phase where only a small proportion of the population is vaccinated that all of us are still wearing masks, practicing physical distancing, washing our hands, and staying out of closed spaces with large groups.
“And while we know that the vaccine prevents disease, we’re not sure that it completely prevents you from getting any of the virus in your nose or in your mouth that you could give to someone else. So that’s a good reason to continue the protections.”
(To learn more or participate in a CVD trial, click here.)