COVID-19 Vaccine Q & A - Part II

We are continuing our questions and answers about the COVID vaccines this week with more of the common questions that I hear about the vaccines.  

Who is currently being hospitalized most often due to COVID-19?

Unvaccinated people make up the vast majority of current hospitalizations and death from COVID-19.  A recent study over a period of six months showed that among adults, those who were fully vaccinated against COVID-19 made up only 4% of hospitalizations.  87% of adults hospitalized were unvaccinated.  Partially vaccinated adults made up the other 9% of hospitalizations.

Are there any factors that make a fully vaccinated person at higher risk of hospitalization or death from a COVID-19 infection?

Yes. Studies in both Israel and the United Kingdom have recently been published, which confirm the information thus far reported to the US Centers for Disease Control and Prevention (CDC), showing the highest risk of severe illness in adults who are fully vaccinated is among those 65 or older and/or those with 3 or more underlying medical conditions.  

Are all adverse events that happen after a vaccine caused by the vaccination?

No.  Over a billion people around the world have now been vaccinated for COVID-19.  In our normal daily lives, people have colds, have heart attacks, develop any number of health problems.  When billions of people get vaccines, some of those normal illnesses might just happen to occur after a vaccination.  These adverse events are reported through a number of ways.  These events are then studied by vaccine safety experts and other health experts, who look for patterns or unusually high numbers of health problems after people receive a particular vaccine.  This is true of all vaccines that are given in the US, and the same thing is happening with the COVID vaccines.  Just because something happens after a vaccination, does not necessarily mean that it was caused by the vaccine.

Do the COVID-19 vaccines used in the US shed or release any of their components?

No.  Vaccine shedding is a term used to describe the release of any of the vaccine components in or outside of the body.  Vaccine shedding can only happen when a vaccine contains a weakened version of a live virus.  mRNA and viral vector vaccines are the two types of vaccines currently authorized in the US.  These vaccines do not contain any live virus.

Can a COVID-19 vaccine cause you to get sick with COVID-19?

No.  Because the vaccines approved in the US do not contain any live virus, they cannot cause you to get a COVID-19 infection.  They can cause you to have a fever or to feel bad for a few days, but this is not from a COVID infection.  It is because your immune system is responding normally to the vaccine and building protection against the coronavirus.  

People who develop COVID-19 after a vaccination were either already exposed before they got the vaccine or before the vaccine had a chance to build protection (two weeks after your second shot of a 2 dose vaccine or 2 weeks after the single Johnson and Johnson vaccine).

Can a COVID vaccine alter your DNA?

No.  COVID-19 vaccines do not change or even interact with your DNA in any way.  They deliver instructions to our cells to start building protection against the virus that causes COVID-19.  The material never enters the nucleus of the cell, which is where our DNA is kept.

Will the COVID-19 vaccine make it hard for you to get pregnant or cause pregnancy complications?

No.  There is a lot of data from all around the world regarding the COVID-19 vaccines, and there is no evidence that any COVID vaccine, or any other vaccine for that matter, cause fertility problems in women or men.  COVID-19 vaccines have been tested in pregnant women with no pregnancy complications documented.  

Pregnant women have a higher risk of complications from a COVID-19 infection, causing problems for both mother and baby.  Vaccination can protect you from those complications.

If you have any questions about COVID-19 Vaccines, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

COVID-19 Vaccine Questions & Answers

I have been getting quite a few questions about the COVID vaccine lately.  I understand that many people are hesitant to get the vaccine for various reasons.  There is a lot of false information about the vaccine in some media outlets and on the Internet, so I thought it might help to share some answers to common questions.

How can the vaccine be safe if it was developed so quickly for a virus that was so new in origin?

There are two parts to this question.  The first part is regarding the novel (or new) coronavirus.  Although this particular coronavirus, which causes COVID-19 (called SARS-CoV2) is a new virus, we have studied a number of coronaviruses over many years.  Prior to the emergence of SARS-CoV2, we knew of seven coronaviruses that could infect humans, and many others that infect other animals.  Two of those seven prior coronaviruses caused severe, often deadly, disease in humans.  The first was the initial SARS virus, SARS-CoV, which emerged in 2002 and caused severe disease outbreak in many countries through 2004.  The second was MERS-CoV, which emerged in 2012 and caused severe outbreak in middle eastern countries initially.  We still see some cases of this virus infection.

Now to how quickly the vaccine was developed.

Because so much research has been done on these prior coronaviruses, we already knew which protein from the virus was most likely to cause an immune response.  The process of figuring out which protein or piece of a virus to use in a vaccine to get an adequate immune response can sometimes take years.  We already knew this from extensive research on these prior coronaviruses, so that saved years right there.

Most people don't realize this, but the messenger RNA vaccine technology has been developed and perfected over almost 40 years, with the initial work starting in the mid-1980s.  A lot of kinks have been worked out throughout those years.  With this technology as it stands today, all you need know is which  protein to use and vaccine production can start, then the clinical trials can be done very soon after.

The combination of years of prior research in both of these areas allowed this vaccine to be developed rapidly.

Do fully vaccinated adults need a booster shot?

This week, the FDA approved, and the CDC has now recommended booster doses of the Pfizer vaccine.  The recommendation says that a booster should be offered to people 65 and older, nursing home residents, frontline workers, and certain adult who have risky underlying health problems.  The extra dose would be given once they are at least six months past their last Pfizer shot.

Data from Israel, where nearly 3 million people have already received a third Pfizer dose, has uncovered no serious health risks.

If we need a booster dose, does that mean the vaccines aren't working?

No.  COVID-19 vaccines are working very well to prevent severe illness, hospitalization, and death from COVID-19, even against the more severe Delta variant.  CDC data shows the vaccines still offer strong protection for all ages, but there is a slight drop in protection among older adults after 6 months.  The booster shot helps vaccinated people maintain protection for a longer period of time.

What is the difference between a booster dose and an additional dose?

The US has already authorized third doses of both the Pfizer and Moderna vaccines for certain people with weakened immune systems, such as cancer patients and transplant recipients.  This third dose is given at least 28 days after the second dose.  This is recommended because people who are immunocompromised may not develop enough protection from the usual 2 dose regimen.  Because this third dose is necessary for them to build up their initial immunity, it is not considered a booster.

We will continue with more questions and answers about the COVID vaccines next week.

If you have any questions about COVID-19 vaccines, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Brisk Walking is Good for Your Brain

You probably have a family member or friend who has had some memory problems as they have gotten older, or maybe someone with serious dementia.  I'm sure many of us are a little scared of developing memory problems or dementia when we got older.  It can be a scary thing to think about.  A recent study gives us something we can do to improve our odds. 

What is mild cognitive impairment?

Most of us, as we get older, will have a little trouble remembering things.  This is considered normal, although it certainly is annoying.  If the memory loss worsens, it may become what is known as mild cognitive impairment (MCI).  MCI is a medical condition in which the loss of thinking skills and memory grows obvious enough that it becomes worrisome to you and others around you.  MCI is not dementia, but people with MCI are at a higher risk of developing Alzheimer's disease later in life.  

What causes mild cognitive impairment?

Scientists have not yet been able to pinpoint the exact underlying cause of MCI.  But there is evidence that changes in the blood flow to the brain is a contributing factor.  That blood flow is responsible for bringing oxygen and nutrients to the brain.  If the flow of oxygen and nutrients slows down, this can lead to damage to or even death of brain cells.  

Most people do experience some decline in the flow of blood to their brains as they get older.  This is due to a combination of things, which can include blockages in the arteries, stiffness of the arterial walls, or weakness of the heart.

What can we do about it?

The simple answer is exercise.  Now let me get into the details about the studies and what exercise can do for you.

Past research studies have shown that the brains of physically active older men had much better blood saturation than the brains of men who were sedentary, even when everyone was quietly resting.  They have also found that people who exercise had better scores on tests of memory and thinking skills than sedentary people did.  But these studies focused primarily on people with relatively normal brain function at baseline.  Exercise strengthened their reasonably sound baseline function.

The latest study, published in March 2021 in the Journal of Alzheimer's Disease, started with people who had already been diagnosed with mild cognitive impairment.  They studied men and women aged 55 and older with a diagnosis of MCI and asked them to start moving more.  They first did baseline testing of the cognitive function, aerobic fitness, and general health.  They measured the stiffness of their carotid arteries and the amount of blood flowing to and through their brains.

They then divided them into two groups.  One group started a program of light stretching and toning exercises, to serve as the active control group.  The other participants started a program of aerobic exercise, walking briskly on treadmills at the lab.

As you would expect, after 12 months, the group that was doing aerobic exercise was found to be more fit, with higher aerobic capacity.  

The brisk walking group also showed much less stiffness in the carotid arteries, with greater blood flow to and throughout their brains.  They also performed significantly better than the stretch and tone group on tests of their thinking skills involving planning and decision-making.  These skills tend to be the first to decline in patients developing dementia.

Both groups had raised their scores slightly on most tests of memory and thinking to about the same extent.  This would indicate that being more active in any way appeared to have improved thinking skills and helped keep those skills from declining.  

We should look at this as a gentle reminder that moving your body is good for your brain.  You should take every opportunity to move your body more.  Take the stairs instead of the elevator or escalator.  Park further away when you go shopping.  Make sure you are increasing your heart rate when you exercise.  These small things may protect your memory and thinking skills over your lifetime.  This will help you to remain independent throughout your life.

Please consult with your doctor before starting an exercise program.

If you have any questions about exercise for brain health, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Help Your Teenager Take More Health Care Responsibility

Part of the transition to adulthood is shouldering more responsibility for your own health care.  Most teens who are in high school, may still rely heavily on parents for managing their health care.  As they become more independent as young adults, making health care decisions can be daunting for some.  They also need to become more independent when it comes to managing minor or more serious medical problems.  This is particularly true for kids who have chronic medical problems.  It helps if they can make this transition gradually with guidance along the way.  Let's talk about how to help them make this transition to adult health care.

When and how should you start the process?

Many healthy college students have never had any responsibility for their health care.  They have never had to decide when they need to seek medical care, or who they should call if they are sick.  Some don't know what it's like to see a doctor by themselves.  It can be scary to be faced with an illness away from home without knowing what to do.

If your child is in high school, you should already be coaching them in this transition.  If they are already at college, you can still provide guidance on the transition while letting them take on responsibility.  You can help your teen by encouraging them to do some of the following tasks (with supervision if you feel it is required):

• Call to make their own doctor or dentist appointments.
• Pick up their own prescription from the pharmacy.
• Become more knowledgeable about their own chronic medical problems.
• Set a timer or reminder to take their own medication without you prompting them.
• Read the immunization requirements for their chosen college or trade school and go through their immunization record to be sure they have all required vaccines.  If they don't, they can make an appointment to get them.
• Go into the doctor or dentist office alone for simple issues, such as a flu shot or tooth cleaning.
• If they are heading to college, they should take on the responsibility of researching the college health center to learn where it is located on campus, how to make an appointment, what services they offer, and whether they see walk-in patients.

What else should you know and make sure they know?

• Be sure to check the family health insurance policy before kids go off to college. Even though adult children can stay on their parents' health insurance up to age 26 under the Affordable Care Act, don't assume they're automatically covered on campus.  Some network plans may not extend out of state.  Some colleges offer health insurance plans for students.  Determine whether your college student will need this well in advance.
• Talk to your teen about their insurance coverage, such as what things are covered, how much they will need to pay for the copay, if there are limits on what doctors they can see, etc.
• They need to have their insurance information with them.  Will they carry the insurance card in their wallet or take a picture of both sides of the card to keep on their phone?
• Discuss the importance of guarding their insurance information. Teens need to know that their insurance information in the wrong hands can put your insurance at risk for fraudulent claims.

What special things should you consider for teens with chronic medical problems going to college?

• Will they continue to see their specialist near home, or do they need to find a doctor close to their college?
• How much should they share about their chronic medical problem with roommates or the dorm RA?  If they have diabetes and occasionally have low blood sugar that makes them pass out, or if they have a seizure disorder, someone in the dorm should be aware of the condition and what to do in case of a medical emergency.  This should be discussed well ahead of time.
• If your teen has ADD/ADHD or other mental health issues, will they need to access the college study center for help with organization and study habits?  They should figure out how to access these services themselves.  There also should be a plan for who will prescribe their medications or counseling.  Medical doctors are licensed by their state and cannot legally prescribe medications in another state.  If college is out of state, they may need to find a doctor near school.  The school health center may have a doctor who can do this.  Your child can research this and let you know what they find out.

I know it can be hard to let your teen take on some of these responsibilities but if the transition is more gradual, both you and your teen will be less stressed about the process.

If you have any questions about teen health care responsibility, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor