Crowded airplanes, skeptics and other things you need to know about the COVID-19 vaccine

So many variables go into a meeting these days. 

Will it be outside? Inside? Are there going to be lots of people there? How many are vaccinated? Do any of them listen to Nickelback? Two trains are driving toward one another. The first train leaves Town A at 5 a.m. traveling at 60 miles per hour. The second train … 

You get the point. It’s complicated. No two situations are seemingly ever similar. 

 

Each week in this space we try to delve into the most relevant topics in the world of vaccine. In light of how complex navigating life outside the home seems to be these days, we thought we’d lead off this week by sharing a really cool tool put together by the New York Times. (Just enjoy it; don’t feel obligated to leave feedback.) Think of it as a choose your own adventure book but with yes/no questions relevant to living life outside our own walls. It asks things like, “Will you be there for more than an hour?” or “Will there be more than 10 people there?” Each answer leads you to another question until eventually you are given a risk rating.

Of course, most people will straight up ignore any advice if it isn’t what they want to hear, but isn’t it nice to have somebody that isn’t your know-it-all cousin doling out a little guidance for a change?

With the vaccine landscape changing almost daily, each week we are checking in with Danielle Scheurer, M.D., MUSC Health System chief quality officer to ask her the most pertinent questions that are hanging in the balance.

Q. Coronavirus cases are going up again. In nine states over the past two weeks, virus cases have risen more than 40%. Michigan led the way with a 133% increase. In light of that, President Biden is calling for reinstating mask mandates. How do you feel South Carolina is doing on that front?

A. On the whole, I think our state has been doing pretty well, so I guess I was a little surprised by the “back to work” mandate issued recently. I think businesses have to make individual decisions based on their unique local conditions – you know, things like local epidemiology, open day cares, etc., so a blanket mandate can be really hard to conform to.

Q. Brazil is a very scary place right now. I read that 125 people are dying every hour from COVID. Do you think we tend to focus more on us as a country and not enough as a globe?

A. I do. It’s a global economy that we live in today, and people are traveling constantly. So what’s happening in Brazil and India affects us here in the United States. As long as there is international travel, we’re always going to continue to have clusters and outbreaks because we have to look at the whole globe. 

Q. New York has done the digital passport thing we’ve talked about. How long before South Carolina – or better yet, the U.S. – rolls out its own version? 

A. I think it’s not too far out on the horizon. They are becoming more and more popular in many states, so I suspect it’s not long before we have one here as well. 

Q. It looks like that by June, airlines will go back to putting passengers in every seat. How spooky is that, or will we be in a much better spot by then, making domestic less scary?

A. Air travel should still be approached with some reservations, as there is no way to socially distance. Airlines are also likely going to pursue some combination of vaccine passports and/or negative rapid testing in order for passengers to board a flight. Couple that with the fact that most of these airplanes have really good air filtration systems, I’d say that if you’re smart it should be OK. 

Q. How did Pfizer and Moderna get through their trials and to emergency use authorization so fast and AstraZeneca didn’t?

A. The crazy thing is that all three of them started trials in July. Then AZ had a small hiccup, followed by another much longer (seven weeks) pause. That almost two-month hiatus really set them back, and I think it was just really difficult to recover enrollment after their trials came back online.

Q. I’ve heard that some folks with long COVID have experienced relief from their symptoms after they got the vaccine. Have you seen any of this?

A. Just anecdotally. There’s nothing in the literature yet. We’ll just have to see what pans out. It’s a good question though; it’s just unanswerable right now. 

Q. How great is the Pfizer trial news about kids 12 to 15? Better results than adults and no virus infections after receiving the vaccine. Why do you think that is? And do you think this will help sway people who were on the fence about vaccinating their kids?

A. The short answer is immunity becomes more complex the older you get. It’s basic science: The more things we are exposed to over time, the more nuanced our immune system becomes, as opposed to kids who have fewer comorbid conditions. From an immune system standpoint, they are just more predictable. So it shouldn’t really be all that surprising that it’s working so well. It’s still great news, though. 

Q. Italy is now forcing health care workers to get vaccinated. Is this something we as a country might be forced to do in the future?

A. That is just such a thorny subject. I saw a survey published in the New York Times last week that focused on vaccine hesitancy. In it they asked health care workers if they were forced to be vaccinated, would they do it or quit their jobs. Sixteen percent of the people surveyed said they would quit. So it’s really all about risk ratios and how organizations make those type of decisions. Hospitals have to ask themselves if they are willing to risk a 16% departure to get to that goal. I think the public expects – regardless of their own personal beliefs – that health care workers should protect themselves so they can protect their patients. That’s certainly my feeling. Patients have to trust us, and in this pandemic era, what better way to gain that trust than by getting vaccinated?

Q. I’ve asked you this in the past, but what do you think is the best approach for getting vaccine skeptics to say “yes”? One-on-one talks with a trusted person? Money? Days off work? Allowing for greater freedoms (less masking/social distancing) for those who get it?

A. What the literature points to right now seems to be that the most convincing way to get people to get vaccinated is through a trusted colleague or community member. Having them – it could be a family member, a pastor, a small-town mayor, that kind of person – get vaccinated and then show the skeptic that they are fine. That seems to be the most impactful. When somebody whose opinion you value says it’s OK, that seems to work best. As far as incentives go, I do think some allowance of freedoms might point people toward getting it. This gets into the concept of passports, allowing those with them to attend larger gatherings, take advantage of air travel without testing, stuff like that. And I think it’s good that the CDC is finally saying to people who have been fully vaccinated that they can actually do more.

**Have a question you'd like answered? Email it to donovanb@musc.edu with the subject line “Vaccine Q.”