AARP Coronavirus Tele-Town Hall

Tele-Town Hall 1 PM 02-25-21 Vaccines & You

Bill Walsh:  Hello, I am AARP Vice President Bill Walsh, and I want to welcome you to this important discussion about the coronavirus. Before we begin, if you’d like to hear this Telephone Town Hall in Spanish press *0 on your telephone keypad now. AARP, a nonprofit, nonpartisan member organization, has been working to promote the health and well-being of older Americans for more than 60 years. In the face of the global coronavirus pandemic, AARP is providing information and resources to help older adults and those caring for them.

This week, of course, our nation crossed a terrible threshold. In less than a year, the COVID-19 pandemic has claimed over half a million lives and counting. Against that backdrop vaccine distribution is top of mind for everybody. But people across the country continue to experience roadblocks and confusing sign-up systems just to schedule a shot. While hospitalizations are down from their record highs, the number of people getting sick from COVID and succumbing to the disease continues to be way too high. Today, we’ll hear from experts about the vaccine, the supply, distribution efforts and how you can stay safe.

If you’ve participated in one of our tele-town halls before, you know this is similar to a radio talk show and you have the opportunity to ask your question live. For those of you joining on the phone, if you’d like to ask a question, press *3 on your telephone to be connected with an AARP staff member who will note your name and question and place you in a queue to ask that question live. If you’d like to listen in Spanish, press *0 on your telephone keypad now. And if you’re joining on Facebook or YouTube, you can post your question in the comments section.

Hello, if you’re just joining, I’m Bill Walsh with AARP, and I want to welcome you to this important discussion on the global coronavirus pandemic. We’re talking with leading experts today and taking your questions live. To ask your question, press *3 on your telephone keypad. And if you’re joining on Facebook or YouTube, you can post your question in the comments.

 Joining us today are Rekha Rapaka, M.D., Ph.D. She’s assistant professor of medicine in the Center for Vaccine Development and the Division of Infectious Diseases at the University of Maryland, Baltimore. Also, Mark Rupp, M.D. He is a professor in the Department of Internal Medicine and chief of the Division of Infectious Diseases at the University of Nebraska Medical Center. We’ll also be joined by my AARP colleague Jean Setzfand, who will help facilitate your calls today.

This event is being recorded and you can access the recording at aarp.org/coronavirus 24 hours after we wrap up. Again, to ask your question, please press *3 at any time on your telephone keypad to be connected with an AARP staff member, or if you’re joining us on Facebook or YouTube, place your question in the comments.

Now I’d like to welcome our first guest: Rekha Rapaka, M.D., Ph.D., is assistant professor of Medicine in the Center for Vaccine Development in the Division of Infectious Diseases at the University of Maryland at Baltimore. There she has been working on COVID-19 clinical trials for vaccines and for therapeutics. Welcome, Dr. Rapaka.

Rekha Rapaka:  Hi, thank you so much for having me today.

Bill Walsh: All right, thanks for being with us. I’d also like to welcome Mark Rupp, M.D, professor in the Department of Internal Medicine and chief of the Division of Infectious Diseases at the University of Nebraska Medical Center. He is also the chief of staff for the Nebraska Medical Center. Welcome, Dr. Rupp.

Mark Rupp: Thank you, Bill, it’s a real pleasure to join the group today and a real honor to share the microphone with Dr. Rapaka.

Bill Walsh: All right. We’re delighted to have both of you. And just a reminder to our listeners, to ask your question press *3 on your telephone keypad at any time or drop it in the comments section on Facebook or YouTube.

Dr. Rapaka, let’s get started with you. You know, while most people are struggling to get a vaccine dose, for those who have been able to get it, what should they expect? Is there a possibility that they could still contract and spread COVID-19 after they’ve gotten their shots? And do you need a vaccine if you’ve already had COVID?

Rekha Rapaka: Yeah, these are really good questions. So the vaccines have gone through rigorous testing and characterization in clinical trials, and we’re now at the point where 12 percent of Americans have received at least one dose of either the Pfizer or Moderna vaccine. So we have a lot of information about how people may feel after they get the vaccine. And as we know the vaccine when it’s administered, it trains the body to make an immune response so that our bodies are able to successfully fight off the virus. And these vaccines are highly effective, with 95 percent efficacy.

So as far as what one might expect as far as symptoms, they may have symptoms like mild pain at the injection sites; sometimes people have symptoms of muscle aches, fatigue; sometimes they may have symptoms of fever or chills. It’s important to note that these symptoms have been seen typically in a very self-limited capacity, so they resolve often in most individuals in 24, 48 hours. Many people don’t have any symptoms as well. But it’s all, I think, a normal sign of the body making an immune, an immune response to the vaccine. It’s important to remember this is not COVID-19 itself. It’s impossible to get COVID from the vaccine.

As far as the second question, if one’s vaccinated, can you still contract and spread COVID-19? So, in general with infections, when we reduce symptomatic disease, such as symptoms of coughing, sneezing in the setting of an infection, we reduce spread — and vaccination will reduce this. However, with COVID-19 we also know that the infection may spread in people who don’t have any symptoms of infection at all. So we actually don’t know the answer about whether asymptomatic spread can occur in the setting of vaccination, and it’s something that we’re actively trying to study and understand with the current vaccines, as well as the future vaccines that we’re developing. So at this time, given that we don’t know the full answer, we recommend all precautions that we’ve been taking to really amp up our public health protection against this infection. So, mask wearing, social distancing, avoiding congested indoor situations; things of these measures we’ve been doing to prevent infection even if you get the vaccine.

And then the question with regards to if you need a vaccine if you’ve already had COVID: Yes, you, we believe that essentially the infection, when a person naturally gets COVID-19 and gets the infection, it does provide some immunity, you know, we think on the order of about three months, but we also know that people can get reinfected with COVID-19 and we think the vaccine can help with preventing that. And so we recommend the vaccination, even if you’ve already had COVID-19.

Bill Walsh: Got it. Thank you so much, Dr. Rapaka. Dr. Rupp, let’s turn to you. As I mentioned at the outset, we’ve passed 500,000 deaths in this country. I suppose if there’s any good news, the rate of hospitalizations and deaths are declining now. Do we know why that is, what’s driving that? Is it the vaccine distribution or are people just getting better about physical distancing and mask wearing?

Mark Rupp: Well, Bill, we certainly have passed that really grim milestone of 500,000 deaths. And I think that, unfortunately, we’ve become somewhat numb to the magnitude of the pandemic. And it’s, you know, it’s useful to just reflect upon that number and realize that each and every one of those people were somebody’s mother, father, somebody loved, somebody who is truly missed.

As you mentioned, we are gratified that the rates are coming down, and so from about a month or two ago, when we were having 300,000 cases per day, new cases in the United States, we’re down to about 75,000 here in the last few days. And so that’s great progress. We don’t fully understand why we’re seeing all of that. I think part of it is the fact that we’ve been administering some of the monoclonal antibody preparations, which have been shown to decrease hospitalizations and deaths.

Likewise, the vaccine is highly effective, and I just saw a report yesterday showing this amazing divergence between nursing home residents, long-term care residents and the general population that really is completely in response to vaccination. And so, they really work, and that’s something that we need to emphasize to all the listeners today is that just as soon as you’re able to get the vaccine, get in line and get it. And then, undoubtedly, there are some influences from the non-pharmacologic interventions, as we call them. I doubt that we’re actually getting better about that, and if anything, I think people are probably just tired of the pandemic and relaxing their precautions, not wearing their mask as much as they should, not avoiding those crowded, indoor air spaces. And then there’s probably some things about viral dynamics that we just poorly understand; why the pandemic kind of ebbs and flows is still something that we’re studying.

Bill Walsh: Okay, so a good sign but maybe not the sign of things to come, depending on how things unfold. Let’s turn to vaccine distribution, Dr. Rupp. You know, we’re hearing questions from older adults who are just desperate to get the vaccine but they’re struggling either with the technology or confusing state and local enrollment systems. I know you can’t speak to specifics but, broadly speaking, what steps are you seeing state and local governments take to improve those systems and actually get shots into people’s arms.

Mark Rupp: Well, I think overall, folks need to recognize that this is a huge and complicated, logistically complicated, operation. And I think overall, the public health departments have done really a good job in getting this rolled out to people. And I think the other thing folks need to understand is this came at a time when everybody was very, very much stretched already. So getting these programs set up at the same time of trying to deal with the pandemic is an awfully heavy lift. And we probably didn’t invest in the resources to, you know, as they say, get that vaccine the last mile, as we should have. Now clearly things are improving. It is frustrating to see all the different states and local health departments have their own individual, you know, programs that they’re using. It is becoming easier to navigate. I think just about every local health department has a hotline number so if folks are having difficulty maneuvering on the websites or they lack the, you know, the actual computer or link or smartphone to get onto the websites, they can call the hotlines and make sure that they’re being cared for. So again, I think things are getting better. We’re up to somewhere between 1½ and 2 million doses a day. We just need to keep that forward progress moving.

Bill Walsh: Thanks for that update, and I’ll take your answer as an opportunity to tell our listeners about a really important resource AARP has created, which are state-by-state guides for how to get a vaccine in your state. And if you can get online, you can find it at aarp.org/vaccineinfo. You can just pull down your state and state’s information and find the toll-free numbers there — even questions to ask about the vaccines. Thank you for that, Dr. Rupp.

Dr. Rapaka, with limited supply and severe weather across the country, many vaccine appointments, including second appointments, have been rescheduled. We know that the Pfizer and Moderna vaccines require three to four weeks between doses. Is that a concern if there’s more time between doses due to the distribution problems?

Rekha Rapaka: So, you know, we have the data from the clinical trials, and we try as hard as we can for the vaccines. And we try as hard as we can to match the intervals recommended, so, with Moderna that booster coming at four weeks and with Pfizer that second dose or booster coming at three weeks. However, it’s important to remember the second dose is a booster. And what that means is it’s an immunization that’s done to enhance the initial immune response you’ve had to the first vaccine and make it stronger and better. And so, you know, obviously in the setting of delays and emergencies and, you know, weather conditions where people have had delays, we can’t get to that optimal situation; we have to make accommodations. And I would argue that receiving that booster vaccination a week later, you know, is still going to have benefit and still have an augmentation of the initial immune response. So, I think it’s great to move towards what we have data for, but when we know that the change is just on the order of days or weeks, you know, or a week, I think it’s fine to just get that booster later and know that you’re still probably enhancing that immune response. So in an emergency, just get the next available dose as soon as you safely can.

Bill Walsh: Okay. And is there a point of no return, that is, is there a span over which the initial dose just becomes ineffectual?

Rekha Rapaka: So, that’s unknown at this time but like our, we can use our knowledge from other vaccinations and I think in the, you know, the timeframes we’re talking about for delays, I see something in the range of a few weeks not really being a game changer.

Bill Walsh: Dr. Rupp, what do you think about that?

Mark Rupp: Yeah, no, I completely agree with what Dr. Rapaka has related and that is that, you know, folks shouldn’t be too concerned if they have to delay for a short period of time between their initial dose and their booster dose. And, in fact, some countries have, you know, really extended that time period out in efforts to try to get more people, you know, with at least that first vaccine. So I do want to just be reassuring to folks that getting that second dose a little bit later is not going to interfere with their vaccine response.

Bill Walsh: Okay. Well, thanks to both of you for that. And as a reminder to our listeners, to ask your question, please press *3 on your telephone keypad. We are going to get to those questions shortly but before we do, I wanted to bring in AARP Senior Vice President for State and Community Engagement Kristin Dillon. Welcome, Kristin.

Kristin Dillon: Thanks, Bill, I’m happy to be here today.

Bill Walsh: Right, we’re happy to have you. What can you tell us about what AARP has been doing to fight for older Americans on COVID-19 vaccines?

Kristin Dillon: Well, as other people have noted, we are approaching one year of living under a global pandemic that has affected all of us. Older Americans have been hit especially hard. More than 95 percent of the deaths have been among those age 50 and older. And the loss of more than 160,000 lives in nursing homes is a national tragedy. So, vaccines bring great hope for us to finally stem this tragic loss of life but, as others have noted, that hope has been tempered by an overly complicated and confusing distribution process. That is why AARP is fighting for older adults to be prioritized, and fighting to make the online process easier so that you can go to one place to get clear information about when, where and how to sign up to get vaccinated. And, recognizing that not everyone is online, or people may have difficulty navigating online systems, AARP is also urging the federal government to work with states to develop 1-800 numbers for scheduling vaccine appointments and that those 1-800 numbers are centralized, well-staffed and offer culturally competent customer service in several languages. We commend the actions that the Biden administration has made to get more vaccine supply out to states and expand where vaccinations are available to include more pharmacies, community health centers and large vaccination sites like sports arenas in some states.

In every single state, AARP staff and volunteers are fighting in state legislatures to improve the transparency and reporting about the COVID-19 vaccine rollout so we understand really what is happening. Staff and committed volunteers from 16 AARP state offices are also participating in work groups led by their governors and state health departments. This includes states like Idaho, North Carolina, Tennessee, California and many others. We’ll be showing up virtually in capitals across the country to protect funding for programs like aging services, home- and community-based care, low-income energy assistance and unemployment and job assistance programs. And we’re working with state and local officials to help provide critical information to older adults about the vaccine, where they can access it and what they need to do.

We are also expanding our efforts to provide people 50-plus with trusted information about the vaccines. For example, as you mentioned earlier, Bill, we have published online guides for every single state, the Virgin Islands, Puerto Rico and D.C., explaining how to get the vaccine where you live. You can find those at aarp.org/vaccineinfo. And then you can find your state and get the information that you need. AARP state offices are also hosting dozens of local conversations like this one each week, and volunteers are finding ways to check in on others to provide local information about the vaccine. So, as the rollout continues, we will continue to keep the pressure up on elected leaders and continue to provide critical information to our members. So, again, to stay up to date on all of these efforts and find summaries of state plans for vaccine distribution, please visit us at www.aarp.org/coronavirus.

Bill Walsh: Okay, thank you so much for that information, Kristin. Appreciate the update.

It’s now time to address your questions about the coronavirus with Dr. Rekha Rapaka and Dr. Mark Rupp. And as a reminder, please press *3 at any time on your telephone keypad to be connected with an AARP staff member to share your question. It’s now time to bring in my AARP colleague, Jean Setzfand, who will help facilitate your calls today. Welcome, Jean.

Jean Setzfand: Thanks, Bill. Delighted to be here.

Bill Walsh: All right, who is our first caller?

Jean Setzfand: Our first caller is Violet from New York.

Bill Walsh: Hey, Violet, welcome to the program. Go ahead with your question.

Violet: I asked the question before about why are they charging more than other companies, and like even the drugs or the other. I have AARP Rx, we pay for it. And the others, they don’t have to. They just got it for nothing. And dental or the, whatever have to be paid, and everything for free. But I have to pay for everything.

Bill Walsh: And I understand you’ve gotten your first shot. Is that right? Your first COVID shot?

Violet: I had the second one, and I am sick.

Bill Walsh: And you’re sick. Tell us how you’re feeling.

Violet: Well, I feel very drowsy, very weak. I am 85 years old, and I’m okay. I have, I have no diseases, but I just, getting me this one I’m just, I just want to sleep. And I feel like dizzy, I don’t know why.

Bill Walsh: Well, let’s ask our experts about that and see if they can offer any advice. Dr. Rapaka, we’ve heard some anecdotal evidence about people getting sicker in the second dose. Can you talk about that? What kinds of symptoms people experience and then what they should do if they have those symptoms, like Violet?

Rekha Rapaka: Sure, and, Violet, I’m sorry you’re feeling that way. I, yes, the second immunization often does give, in people that have received the vaccines, often more symptoms. So they may have some of the symptoms you’re experiencing, like the dizziness or discomfort and, you know, symptoms like chills, fevers, things of that nature. What we’ve seen though in most people is that, you know, sometimes taking a day to rest, or planning out a little bit of rest on the day that you get that second shot helps so you kind of know what to expect. Sometimes people will take, you know, over-the-counter medications like Tylenol, if it’s something they can safely take, or medications like Advil, to sort of temper some of those symptoms like muscle aches and things like that. But it tends to, in most patients, limit off after 24 to 48 hours. So those, that time period may be really tough and uncomfortable but I think you can rest assured that it shouldn’t last longer. And obviously, if there are, you know, changes, it’s important to talk with your doctor. But that’s been the typical course that we’ve seen, for people that have symptoms. That second booster can be sometimes where it comes out.

Bill Walsh: And just to be clear, we’ve heard some concerns from people, you know, when they see these side effects, they think, oh my God, I’m getting COVID, that, that this vaccine contains the live virus. But it doesn’t, does it.

Rekha Rapaka: Exactly, it does not. There is no way to catch COVID-19 from the vaccine preparations. So, so even though you feel unwell, and you might feel like I’m getting sick, just rest assured that it is not COVID-19.

Bill Walsh: Okay. Thank you for that. Jean, who is our next caller?

Jean Setzfand: Our next caller is Peggy from Maryland.

Bill Walsh: Hey, Peggy. Welcome to the program. Go ahead with your question.

Peggy: I, my question is, it’s not for myself, it’s for one of my friends who was unable to navigate the online registering for an appointment because — and she is very technology savvy, so it’s not that she doesn’t know how to do it — but she said when she got to a certain point, she couldn’t go any further. And, and the reason she asked me is because I had the same problem, but someone else registered for me. I was never able to reg—, it stopped at a, and I don’t remember at what point that was, but it doesn’t let you register for an appointment.

Bill Walsh: So what’s your question, how to register in the state of Maryland?

Peggy: Yeah, how do you do, how can you— yes, by phone.

Bill Walsh: Okay, well while you were talking, our excellent AARP staff has actually pulled up the toll-free number for Maryland, and I’ll give that to you if you have a pen and a piece of paper.

Peggy: Okay, I’m ready.

Bill Walsh: Okay, it’s 877-319-1525. 877-319-1525. And to our other listeners, you can look up the information for your own state at aarp.org/vaccineinfo. It’s very easy, just pull up your state. It’ll have toll-free numbers there. It’ll have websites you can visit for information and registering. It also has sample questions to ask. So hopefully that’s helpful. All right, well, let’s take another question. Jean, who’s next?

Jean Setzfand: Our next caller is Janice from California.

Bill Walsh: Hey, Janice. Welcome to our show. Go ahead with your question.

Janice: My question is, when you get, you’re, you’re waiting for your, you’re waiting in line for your appointment, must you have some kind of proof that you don’t have COVID currently?

Bill Walsh: Hmm. That’s an interesting question. Dr. Rupp, can you handle that one?

Mark Rupp: Yeah, so, Janice, that’s a great question. And clearly people who are acutely ill should not be, you know, getting their vaccine. So if you have a febrile illness, if you really are feeling poorly, you know, you shouldn’t receive the vaccine. If you do have COVID, the recommendation is that you go ahead and you get through the initial illness, and then it’s okay to proceed with the vaccine. We do believe that that initial illness would have some protective effect and so some people are waiting for a period of time before they get the vaccine. But, you know, if it’s available to you and you’ve cleared that initial period of illness, it’s perfectly okay to go ahead and get that, that first shot.

Bill Walsh: And what do you think that initial period is? Would you recommend people wait the 14 days that we heard at the outset?

Mark Rupp: Yeah, they should go ahead and get through that initial period of illness and through their period of isolation. And then as soon as they’ve cleared that isolation period, they’re eligible to go ahead and get the vaccine. Again, we think there is protective effect, particularly in that first two or three months after, you know, having the viral illness, the normal COVID-19. But, again, if the vaccine is available to you, you know, it’s probably in your best interest to go ahead and get it then, because you don’t know what the logistical hassles are going to be later on.

Bill Walsh: Yeah, very good point. All right. Thank you very much. Jean, who is our next caller?

Jean Setzfand: I have quite a few questions coming in from Facebook and YouTube as well. So this question is coming from Jennifer on FaceTu—, sorry, on Facebook. And she’s asking, “Do we need to quarantine to visit my family if I have both vaccine injections? If so, how many days prior to the visit?”

Bill Walsh: Hmm. Okay. Dr. Rapaka, can you answer that question about quarantining after having gotten the shot?

Rekha Rapaka: Yeah, so the way that we’ve been— That’s a very interesting question. I think it’s going to impact the way a lot of people are thinking lately after getting the vaccine: What are the things that I can do? You know, I’ve been told I can’t do certain things for a while. You know, I would say that as it stands right now, getting the vaccine, it doesn’t really change a lot of the behaviors that we would normally have with regards to quarantining. And that’s because we want the vaccine to be, the benefits of the vaccine to occur in the setting where most people have either been exposed to the virus and infected, so have an immune response from that, or have received vaccination. We want to get more of the population vaccinated before we start to ease aspects that relate to, you know, changes in behavior. So I would say that at this time, vaccination shouldn’t change any of the practices that you would plan to use for quarantining, as it stands now. So, that’s, I think, where we are with the information. I think over time, we’ll have, you know, easing of certain restrictions but I think for now, the safest way is to just continue with the public health measures that we’re using in place regardless if the vaccine’s received.

Bill Walsh: Okay, thank you. Oh, go ahead, Dr. Rupp.

Mark Rupp: Yeah, I would certainly agree with that. I just think that one of the frustrating things that people are experiencing is that they get the vaccine and then they’re not able to immediately change their behavior. And as Dr. Rapaka related, one of the crucial pieces of data that we’re still looking for is whether people after they’ve been vaccinated are able to acquire the virus and shed it in an asymptomatic way. And until we have that crucial piece of information, it’s probably best that people go ahead and just continue those non-pharmacologic interventions of masking and distancing. But I fully expect in the very near future that we’re going to have additional information and then we will be able to give people more solid advice on when they can potentially, you know, really start to enjoy life again, perhaps not be so concerned about going to, you know, their favorite restaurant and dining and feel like they’re, they’re being protected. You know what information we have right now is certainly very supportive of that, but we’re just needing to wait just a little bit longer. So I would plead with all the listeners out there to, you know, give us a little bit more time, continue with those non-pharmacologic interventions, and let’s get through this pandemic together.

Bill Walsh: Okay, thank you both for that. And as a reminder to our listeners, if you’d like to ask a question, press *3 on your telephone keypad. Jean, let’s take another question.

Jean Setzfand: Our next caller is Eileen from South Carolina.

Bill Walsh: Hi, Eileen, go ahead with, go ahead with your question.

Eileen: Okay. Now I’ve looked this up online and tried to find answers and there’s nothing that addresses this. And I have lupus and Sjögren’s, which is an autoimmune diseases, and I’m on prednisone for it, which to me would be suppressing my immune system. How is that going to deal with taking the shot? I’ve had the first one. It’s Pfizer. I’m due tomorrow to get the second one, but then I started reading that if you have autoimmune diseases and taking medicines that it may affect it, if it takes or not.

Bill Walsh: Hmm. Well, let’s ask our experts about that. Dr. Rapaka, do you want to weigh in on that?

Rekha Rapaka: Yeah, sure. It’s a very good question. So, I mean, I think, you know, so the clinical trials for the vaccines didn’t specifically investigate, you know, different groups, for example, individuals with autoimmune diseases and how they reacted to the vaccines. However, they’re a very important group of patients for getting potential benefits from vaccines because, in the setting of Sjögren’s or taking immune suppressive medications, there’s sort of a lower, or a weaker immune response in general sometimes to infections, and maybe increased risks of getting bad infections. So in a way, I see someone like you as a person who would be a priority for getting the vaccine and seeing it through. And it’s wonderful that you got your first shot and I think, you know, getting that booster shot is going to only make the immune response that you’ve already formed a bit stronger. And so I would encourage you to go forward with it. And, as usual, as we encourage all individuals getting the vaccines, to of course monitor your response to it, see how you’re doing, how you’re feeling, checking on that very carefully. But, yes, I think, you know, it’s, I just, I want to send you some reassurance that, you know, there have been other individuals as well, you know, patients with other immune conditions that have gotten the vaccine, you know, now, and the many millions of Americans that have received it. So just also know that we’re collecting information as we speak on how it will pan out for people with different medical problems. We’ll have much more information, but I, I’m, yeah, it’s great that you’re going forward with the booster.

Bill Walsh: I know that the protocol has been to monitor people for like 15 or 30 minutes after the shots for any allergic reactions. Is there any similar protocol for people in Eileen’s situation? People who have an autoimmune disease already.

Rekha Rapaka: No, no. You know, so the thing is, is for individuals with autoimmune diseases, we don’t expect any kind of immediate reaction after vaccination. If anything, actually, there’s a concern that they may have a lower immune response to the vaccination because of the immunosuppressive medications that they’re on. So we don’t have any special monitoring typically for that.

Bill Walsh: Okay. Thank you for the clarification. Jean, who is our next caller?

Jean Setzfand: We have another question coming from YouTube and this one’s coming from Larry. Larry’s asking, “I had COVID last July and just received the first dose a week ago. I had fevers, chills, fatigue for 24 hours. Does having COVID already count as the same as having a first dose already?”

Bill Walsh: Hmm, Dr. Rupp, do you want to respond to that one?

Mark Rupp: Sure. So, the initial illness that Larry had, probably primed his immune system and so he did have a good booster effect with the first dose of his vaccine. And we actually have some reassuring data and very encouraging data that people who have had COVID in the past and then get the vaccine, do get a very nice booster effect from it. It sounds like the symptoms that Larry had were relatively mild, relatively self-limited, and he would be encouraged to go ahead and finish the course of his immunization and get that second dose.

Bill Walsh: Okay, thank you for that. And thank you for all your questions. We’re going to take more questions soon. And just a reminder, to ask your question, press *3 on your telephone keypad.

Let’s get back to our experts. Dr. Rapaka, the COVID-19 has had an absolutely devastating toll on people of color. We also know there are historical issues of trust between the medical community and Black Americans in particular. The vaccine distribution doesn’t seem to be effectively addressing this. For instance, 5 percent of the limited vaccine supply has gone to Black Americans. What’s driving this and what’s being done about it?

Rekha Rapaka: It’s a very important question. So, Black Americans have higher rates of developing COVID-19, higher rates of dying from COVID-19. So vaccination is a critical tool we need to be using to limit spread of this terrible disease. And I want people to know that the clinical trials for COVID-19 vaccines were designed to recruit a really diverse population so that people felt that, you know, they were represented in the trials and would have confidence in the vaccine safety and vaccine efficacy. So, people that look like them and from all backgrounds were included in these trials. So, you know, part of the reason for the numbers being where they are is that— I mean I think there are many; it’s really multifactorial. But I would say a few things. One is that I think the distribution process, as we, as many of the listeners have been describing and we all know, you know, they are fragmented, and it makes accessing vaccines difficult. For example, in some states, having a primary care doctor will more easily connect you to distribution of vaccines. And we know that many Black and other minority community members are less likely to have primary care doctors, so that can be a limitation. Sometimes vaccine clinics are set up in predominantly Black neighborhoods to increase uptake and remove barriers and increase rates of vaccination. But, unfortunately, it’s been seen at times that many of the appointments are occupied by people from outside of those neighborhoods because the way those slots are assigned are often, you know, computer, involve computer registration and sort of a first-come-first-serve process. And I think, you know, thirdly, there’s certainly of course hesitancy towards vaccines that may be due to distrust in the Black community related to  structural racism that’s been experienced, and challenges that the health care systems have presented with inequities that Black Americans have faced. And so I think, you know, these problems set the stage for this. And I think we, as a group, have to just be very aware and also working to change it. And, you know, I think, it’s a, it’s a kind of a group, collective effort. You know we need leadership to speak about this problem so, for example, I think many of you saw that Vice President Kamala Harris has been speaking out and encouraging vaccination. So a lot of leadership from that angle. We, you know, we need a lot of interconnection with the government and entities that are involved in trying to help, so the CDC, the NIH. I saw that there’s a group called the Black Doctors COVID Consortium that’s working on dialogues to basically, you know, Zoom meetings with individuals like Dr. Fauci to talk about barriers and hesitancy. And, you know, I think just developing better strategies at the community level for distribution to vulnerable communities is very important. So, you know, things like grassroots groups and churches being more involved — I think we have to just be more innovative in how we get to different groups of people with these vaccines.

Bill Walsh: Okay, right. Thank you, Dr. Rapaka. Dr. Rupp, let me—

Mark Rupp: Can I just interject one other thing with that? And I think that, you know, one of the reasons that we’re seeing vaccine hesitancy is also due to the misinformation that is, you know, easily accessible on the web. If people are, you know, going to not-trusted sites for their information. And so I would salute AARP and other organizations like that, to really serve as a portal to trusted information, to getting to the CDC and the FDA information, the WHO, and really learn about the vaccine. And that’s one of the important ways that we can combat this misinformation that’s out there.

Bill Walsh: That’s a great point. And for our listeners, our site is aarp.org/coronavirus. And we are doing a lot of fact-checking. We are only using primary sources and reporting information. So, you know, we’ve got a lot of very credible information there.

Dr. Rupp, let’s talk a little bit about masks. A recent CDC study showed that a single mask blocked about 42 to 44 percent of particles. However, when a cloth mask was worn over a surgical mask, roughly 90 percent of cough particles were blocked. So is a single mask effective? Should we all be wearing two masks at this point?

Mark Rupp: Yeah, Bill, so one of the things that we’ve learned over the course of the pandemic is that wearing a mask is an important ingredient in the overall recipe of fighting this pandemic; that, and making sure that you keep your distance and avoid those shared indoor air spaces. The effectiveness of any mask is going to be dependent upon what it’s made of and the filtering capacity of that material, and then how tightly it fits to the face. And, frankly, I think we would be so much better off if everybody, and I mean everybody, wore a well-constructed, well-manufactured, tight-fitting face covering anytime they were out in public, rather than having some people worrying about, Gee, should I get an N95 or wear two masks? and then having other people doing nothing. We’d be a whole lot better off if everybody would show that social responsibility and wear a mask when they were out in public and then make sure that that mask was well-constructed and tightly fitting. Now, as you mentioned, there are good data now to suggest that if you have a, you know, a procedure mask and then over the top of it you’re wearing something that helps it fit more tightly to your face, that you will get better filtration. And so if you are wearing a mask that has a lot of gaps, you know, at your cheeks or around your nose, then it may be better to actually have something that helps hold it to your face. And so there are devices out there that help to just do that, hold it more tightly to your face, but again, a well-constructed, tightly fitting, multi-ply cloth face covering is really going to function quite highly and quite well.

Bill Walsh: Okay, thank you for that. And thank you both. We are going to turn back to our listeners and take more of your questions for Dr. Rekha Rapaka and Dr. Mark Rupp. And as a reminder, press *3 at any time on your telephone keypad to be connected with an AARP staff member and get into the question queue.

Jean, who do we have on the line now?

Jean Setzfand: Our next caller is Mary from New York.

Bill Walsh: Hey, Mary, welcome to the program. Go ahead with your question.

Mary: All right. I’d like to know, I’m homebound and I was talking to someone and they told me that they’re hoping that eventually for homebound people, they’ll allow someone to come into the home, a nurse or someone, and give the patient the vaccine at home, because it’s very difficult for me to get out, especially in New York now, we’re having terrible snowstorms every week. So it’s been very difficult for me to get out. I just wondered if eventually they’re planning on doing that.

Bill Walsh: That’s a great question, Mary. And Dr. Rupp, do you want to tackle that? And I wonder if the J&J vaccine, can it with just a single dose will help people like Mary who are homebound?

Mark Rupp: Well, absolutely. It has the potential for doing that. The Johnson & Johnson vaccine is not as environmentally wimpy, if you will, so it is able to have a stability for a longer period of time, doesn’t need to be kept under those stringent freezer conditions. And so that may make it a little bit easier to get doses out to people like Mary who aren’t able to get to the vaccine centers. And it really is one of those frustrating things that, you know, we have a piecemeal system: Every state is different; every public health locality within a state also can be different. You know what I’m hearing is that most places are starting, or either have programs, are starting to develop programs where they will have folks being able to go out to people’s homes for those folks who really aren’t able to get into the vaccine clinics. Again, I know AARP has their website, has the information of how folks can access into the systems and I would urge Mary to go to the website or to call the hotline and to inquire about what’s set up for residents of New York.

Bill Walsh: Thank you for that, Dr. Rupp, and Mary, I want to give you that toll-free number in New York for the helpline if you don’t have it. It’s 833-697-4829. All right, Jean, who is our next caller?

Jean Setzfand: Oh, we have another question coming in from YouTube. And this one’s coming from Edward. Edward’s asking, “I have had two shots of the Moderna COVID-19 vaccine. Once the J&J vaccine becomes available everywhere, I want it as well. Is there a reason not to do this? Is there any reason to do this?”

Bill Walsh: Hmm, interesting question. Dr. Rapaka, do you have some thoughts on that?

Rekha Rapaka: Yeah, so it’s an interesting question. I would say that, I don’t think it’ll give you much benefit from what you’ve already received. So it, the way that the Moderna— the Moderna vaccine has really excellent efficacy and if he’s completed that course, you’ve likely achieved that level of efficacy and protection and the J&J vaccine, it would just be a booster, that it would serve as a booster of immunization essentially that you don’t really need. It’s not going to give you any extra benefit, you know. It may be the case as we learn, as we go through this pandemic, that we might need to give additional boosters later. But I think for now you can hold tight and not go for that J&J immunization when it’s available, because it won’t add anything extra to your situation as far as protection from COVID-19.

Bill Walsh: Right, and just to be clear what you were saying, you don’t need to get the J&J if you’ve already had the other vaccines.

Rekha Rapaka: Exactly.

Bill Walsh: Right. Okay, Jean, who is our next caller?

Jean Setzfand: Our next caller is Mary from Missouri.

Bill Walsh: Hey, Mary. Welcome to the program. Go ahead with your question. Hi, Mary?

Mary: Yes. My question is, I’m 69, I have COPD, I have MS, I have high blood pressure. I have registered on every available site in my area and then when I called to check on making an appointment, they just say they’re only taking 85 years old and obese. I’m just wondering, when will they get to me, or how can I make sure they’ve actually even registered me?

Bill Walsh: And you’ve, have they, when you call them, do they give you any information about when people of other ages are going to be, you know, taken for the vaccine? Eligible for the vaccine?

Mary: They just say right now, they’re just saying 85 and obese is all they’re doing now. And so I asked what, do you have any timeline, you know when, ’cause they announced on our local news, it’s 65 and older with lung issues. And since I have COPD, I thought that would include me. But when I call, they just say no, 85 and obese is all we’re doing now.

Bill Walsh: All right. Thank you for that, Mary. I wonder if Dr. Rupp, I’m sure you’re not familiar with all the protocols in Missouri, but can you talk in general about what people should do if they seem to fit the eligibility guidelines, but they haven’t been able to schedule the appointment quite yet.

Mark Rupp: Well, I think that first off Mary is right on target with, you know, having concern about the severity that COVID-19 could have in her particular situation with her underlying lung disease and her age and the hypertension. These are, you know, a number of risk factors that she has for more severe disease. And so I would salute Mary first off for just being aware of those things and trying to make sure that as soon as the vaccine is available to her, that she take advantage of it. And it sounds like she’s trying to do everything she can in order to get in line. One of the frustrating things is that people do hear these conflicting reports of, you know, anybody who’s over the age of 65, we’re ready for you. And then they try to access the vaccine only to be told that no, we really just don’t have those doses available. You know, it’s different in every locality; it’s different in every state. That’s one of the frustrating things. Again, AARP is trying to play a really good middleman clearinghouse role and trying to get people hooked into those systems to where they can get registered. I don’t know what the situation there is in her local locality in Missouri but, again, I would just encourage her to stay persistent, continue to check in online, and to call those numbers and, you know, as soon as it’s available to her for, for her to take advantage of it.

Bill Walsh: Okay, thank you. And Mary, I don’t know what line you’ve been calling, but let me give you the toll-free number there in Missouri for the state’s health and senior services hotline. That number is 800-435-8411. 800-435-8411. And that’s for Missouri.

All right, Jean, let’s take another call.

Jean Setzfand: Our next caller is Sonia from California.

Bill Walsh: Hey, Sonia, welcome. Go ahead with your question.

Sonia: Yes, thank you. I was wondering for the Moderna vaccine, they said it’s 94.1 percent effective, I think. But they said that for people age 65 and over, it’s only 86.4 effective. So does that mean that 13.6 percent of people will not be protected at all?

Bill Walsh: Let’s ask Dr. Rapaka. Dr. Rapaka, there’s been a lot of confusion about what these efficacy rates mean. Can you talk about that a little bit?

Rekha Rapaka: Yeah. So, the measurements of vaccine efficacy really come to like looking at the percent reduction in COVID-19 in the vaccinated group and comparing it to the unvaccinated group. And to Sonia’s question, it was looking, she’s looking at the efficacy in older individuals compared to the younger groups that were vaccinated. And, you know, it is true that the efficacy is slightly lower, as seen in older individuals. But we, it’s not in the range that we, I think should be very concerned about a significant difference. It’s on the order of 10-ish percent and efficacy measurements are a bit involved.

I would say a separate thing is that usually older individuals tend to have in response to different vaccines, they tend to have sometimes a weaker immune response. And that’s just because as we age, our immune systems get a little bit weaker. So that’s one of the reasons why in these clinical trials, we’ve worked hard to get a sense of what, you know, how an older person might react to the vaccine compared to a younger person and what percent of efficacy we might see. So it is true that there is that slight difference in the efficacy. The Pfizer vaccine, it’s pretty much similar. So I would say overall, there is that slight difference but it’s not something that I think should make anyone concerned about, you know, like, Oh, it’s not going to work for me. I’m going to forgo getting this vaccine. To give you all context as well, when you think about vaccines in general, the flu vaccine efficacy number tends to be around 40 to 60 percent. Sometimes in a given year it can be a bit higher, but that’s what we often are working with. So when we’re in the numbers of 70 percent, 80 percent, 90 percent, I think I would feel very confident that the immune response that you’re getting from the vaccine is something that will help protect you.

Bill Walsh: Okay, thank you for that, Dr. Rapaka. Jean, who is our next— Oh, go ahead, doctor. Did you want to add to that?

Mark Rupp: Can I jump in again. As, you know, we’ve mentioned, I completely agree with what Dr. Rapaka just related, but I would also reassure Sonia that the data, you know, is very, very reassuring that even if, you know, people develop COVID-19 after vaccination, the vaccines have been almost a hundred percent effective in preventing those most severe manifestations of disease, so, hospitalization and death. And so even if she were to break through and have COVID-19, it’s very likely that, you know, it would still be very protective against her progressing and needing to be hospitalized, or even dying from the condition. So those, those data are very, very reassuring and supportive of vaccination.

Bill Walsh: Great point, Dr. Rupp, thank you for that. Jean, let’s take another caller.

Jean Setzfand: Our next caller is Joan from Pennsylvania.

Bill Walsh: Hey, Joan. Welcome to the program. Go ahead with your question.

Joan: Yes, good afternoon. My concern and question is for those of us who are in the age group between 65 and 75. I still have not been able to secure an appointment here in Pennsylvania, but what are your thoughts about people in this age group being a greater concern of getting one of the variants of COVID-19? I did do some reading. It was, you know, a correct reading that that was a concern within the next three to four weeks.

Bill Walsh: Interesting question, Dr. Rupp, can you, tackle that one?

Mark Rupp: Yeah, Joan. First off, you’re absolutely correct, that age is truly the driving force in the morbidity and mortality, as the most important risk factor that we’ve identified. So, you being in that age group, 65 to 75, you know, again, I would encourage you just as soon as you can, to make sure that you, take avail—, take advantage of the availability of the vaccine. One of the wild cards right now is with regard to the variants, as you’ve mentioned, and whether they are going to start gathering steam in the United States and really start to spread. You know, that’s an unknown right now, but the data does suggest that some of these variants can be more transmissible, and there’s even a little bit of data suggesting they may be more virulent or more dangerous and, you know, may have some capacity to evade the defenses that we, that we get from vaccination. So, these are of tremendous concern and we’re going to have to keep our eyes wide open and really be watching the data to see what’s going on. And that’s why it’s so incredibly important right now that even though the numbers are coming down, that people continue to use those non-pharmacologic interventions — the masking, the distancing, the avoiding shared indoor air spaces — until we can get the vaccine more widely distributed in the community, including the age group that you represent. And then, you know, get this pandemic under the most control that we possibly can. So we all have to work together to get the vaccine and to also continue to practice those things that we know are going to help to prevent the transmission.

Bill Walsh: Okay, well, thank you very much for that. And we’re coming to the top of the hour. Dr. Rapaka and Dr. Rupp, I wonder if you have any closing thoughts or recommendations that our listeners should understand most from our conversation today. Dr. Rapaka, why don’t we start with you?

Rekha Rapaka: Yeah, I mean I just want everyone to really take advantage of the tools. I know it’s difficult and challenging, right now with the, you know, the fragmentation and accessing vaccines, but when you are able to get one, I think, you know, getting that vaccine is going to help prevent you from getting COVID-19 and help us get these numbers down and move into a better situation. So, thank you for doing your part and helping yourself and others.

Bill Walsh: Okay, thank you for that, Dr. Rapaka. Dr. Rupp, any closing thoughts or recommendations?

Mark Rupp: Sure. It’s been a real honor for me to be involved with the presentations and the talk today. And, boy, oh boy, it’s been a long year for everybody. You know, I know all of us are tired of this pandemic but, you know, we are seeing the light at the end of the tunnel, but the problem is we’re still in the tunnel, and we just have a little bit longer to go. And so just like I said, just recently, you know, maintain the masking, the distancing, avoiding those shared indoor air spaces, get the vaccine as soon as you can. And if we all work together on this, we are going to get to that better spot here in another few months where I hope we’re able to open up society, you know, get back to going to the theater and going to the restaurants and doing all those things with our family and our loved ones that we so much crave.

Bill Walsh: Okay, and thanks to both of our experts for answering our questions. This has been a really informative discussion. And thank you, our AARP members, volunteers and listeners for participating in the discussion today. AARP, a nonprofit, nonpartisan member organization, has been working to promote the health and well-being of older Americans for more than 60 years. In the face of this crisis, we’re providing information and resources to help older adults and those caring for them protect themselves from the virus, prevent its spread to others while taking care of themselves. All of the resources referenced today, including a recording of the Q&A event can be found at aarp.org/coronavirus starting tomorrow, February 26th. Again, that web address is aarp.org/coronavirus. Go there if your question was not addressed, and you will find the latest updates as well as information created specifically for older adults and family caregivers. We hope you learned something that can help keep you and your loved ones healthy. Please tune in March 11th for two live events. The first at 1 p.m. Eastern Time, we’ll discuss the latest on COVID-19 and vaccines, and at 7 p.m. Eastern Time, we’ll discuss taxes and your finances. Thank you very much for participating and have a great day. This concludes our call.

Coronavirus TTH-2021-02-25-With Timings

Bill Walsh:  Hello, I am AARP Vice President Bill Walsh, and I want to welcome you to this important discussion about the coronavirus. Before we begin, if you’d like to hear this Telephone Town Hall in Spanish press *0 on your telephone keypad now. AARP, a nonprofit, nonpartisan member organization, has been working to promote the health and well-being of older Americans for more than 60 years. In the face of the global coronavirus pandemic, AARP is providing information and resources to help older adults and those caring for them.

[00:00:35] This week, of course, our nation crossed a terrible threshold. In less than a year, the COVID-19 pandemic has claimed over half a million lives and counting. Against that backdrop vaccine distribution is top of mind for everybody. But people across the country continue to experience roadblocks and confusing sign-up systems just to schedule a shot. While hospitalizations are down from their record highs, the number of people getting sick from COVID and succumbing to the disease continues to be way too high. Today, we’ll hear from experts about the vaccine, the supply, distribution efforts and how you can stay safe.

[00:01:17] If you’ve participated in one of our tele-town halls before, you know this is similar to a radio talk show and you have the opportunity to ask your question live. For those of you joining on the phone, if you’d like to ask a question, press *3 on your telephone to be connected with an AARP staff member who will note your name and question and place you in a queue to ask that question live. If you’d like to listen in Spanish, press *0 on your telephone keypad now. And if you’re joining on Facebook or YouTube, you can post your question in the comments section.

[00:01:51] Hello, if you’re just joining, I’m Bill Walsh with AARP, and I want to welcome you to this important discussion on the global coronavirus pandemic. We’re talking with leading experts today and taking your questions live. To ask your question, press *3 on your telephone keypad. And if you’re joining on Facebook or YouTube, you can post your question in the comments.

[00:02:14] Joining us today are Rekha Rapaka, M.D., Ph.D. She’s assistant professor of medicine in the Center for Vaccine Development and the Division of Infectious Diseases at the University of Maryland, Baltimore. Also, Mark Rupp, M.D. He is a professor in the Department of Internal Medicine and chief of the Division of Infectious Diseases at the University of Nebraska Medical Center. We’ll also be joined by my AARP colleague Jean Setzfand, who will help facilitate your calls today.

[00:02:47] This event is being recorded and you can access the recording at aarp.org/coronavirus 24 hours after we wrap up. Again, to ask your question, please press *3 at any time on your telephone keypad to be connected with an AARP staff member, or if you’re joining us on Facebook or YouTube, place your question in the comments.

[00:03:11] Now I’d like to welcome our first guest: Rekha Rapaka, M.D., Ph.D., is assistant professor of Medicine in the Center for Vaccine Development in the Division of Infectious Diseases at the University of Maryland at Baltimore. There she has been working on COVID-19 clinical trials for vaccines and for therapeutics. Welcome, Dr. Rapaka.

[00:03:35]Rekha Rapaka:  Hi, thank you so much for having me today.

[00:03:37]Bill Walsh:  All right, thanks for being with us. I’d also like to welcome Mark Rupp, M.D, professor in the Department of Internal Medicine and chief of the Division of Infectious Diseases at the University of Nebraska Medical Center. He is also the chief of staff for the Nebraska Medical Center. Welcome, Dr. Rupp.

[00:03:56]Mark Rupp:  Thank you, Bill, it’s a real pleasure to join the group today and a real honor to share the microphone with Dr. Rapaka.

[00:04:02]Bill Walsh:  All right. We’re delighted to have both of you. And just a reminder to our listeners, to ask your question press *3 on your telephone keypad at any time or drop it in the comments section on Facebook or YouTube.

[00:04:15] Dr. Rapaka, let’s get started with you. You know, while most people are struggling to get a vaccine dose, for those who have been able to get it, what should they expect? Is there a possibility that they could still contract and spread COVID-19 after they’ve gotten their shots? And do you need a vaccine if you’ve already had COVID?

[00:04:36]Rekha Rapaka:  Yeah, these are really good questions. So the vaccines have gone through rigorous testing and characterization in clinical trials, and we’re now at the point where 12 percent of Americans have received at least one dose of either the Pfizer or Moderna vaccine. So we have a lot of information about how people may feel after they get the vaccine. And as we know the vaccine when it’s administered, it trains the body to make an immune response so that our bodies are able to successfully fight off the virus. And these vaccines are highly effective, with 95 percent efficacy.

[00:05:10] So as far as what one might expect as far as symptoms, they may have symptoms like mild pain at the injection sites; sometimes people have symptoms of muscle aches, fatigue; sometimes they may have symptoms of fever or chills. It’s important to note that these symptoms have been seen typically in a very self-limited capacity, so they resolve often in most individuals in 24, 48 hours. Many people don’t have any symptoms as well. But it’s all, I think, a normal sign of the body making an immune, an immune response to the vaccine. It’s important to remember this is not COVID-19 itself. It’s impossible to get COVID from the vaccine.

[00:05:54] As far as the second question, if one’s vaccinated, can you still contract and spread COVID-19? So, in general with infections, when we reduce symptomatic disease, such as symptoms of coughing, sneezing in the setting of an infection, we reduce spread — and vaccination will reduce this. However, with COVID-19 we also know that the infection may spread in people who don’t have any symptoms of infection at all. So we actually don’t know the answer about whether asymptomatic spread can occur in the setting of vaccination, and it’s something that we’re actively trying to study and understand with the current vaccines, as well as the future vaccines that we’re developing. So at this time, given that we don’t know the full answer, we recommend all precautions that we’ve been taking to really amp up our public health protection against this infection. So, mask wearing, social distancing, avoiding congested indoor situations; things of these measures we’ve been doing to prevent infection even if you get the vaccine.

[00:06:59] And then the question with regards to if you need a vaccine if you’ve already had COVID: Yes, you, we believe that essentially the infection, when a person naturally gets COVID-19 and gets the infection, it does provide some immunity, you know, we think on the order of about three months, but we also know that people can get reinfected with COVID-19 and we think the vaccine can help with preventing that. And so we recommend the vaccination, even if you’ve already had COVID-19.

[00:07:32]Bill Walsh:  Got it. Thank you so much, Dr. Rapaka. Dr. Rupp, let’s turn to you. As I mentioned at the outset, we’ve passed 500,000 deaths in this country. I suppose if there’s any good news, the rate of hospitalizations and deaths are declining now. Do we know why that is, what’s driving that? Is it the vaccine distribution or are people just getting better about physical distancing and mask wearing?

[00:07:59]Mark Rupp:  Well, Bill, we certainly have passed that really grim milestone of 500,000 deaths. And I think that, unfortunately, we’ve become somewhat numb to the magnitude of the pandemic. And it’s, you know, it’s useful to just reflect upon that number and realize that each and every one of those people were somebody’s mother, father, somebody loved, somebody who is truly missed.

[00:08:22] As you mentioned, we are gratified that the rates are coming down, and so from about a month or two ago, when we were having 300,000 cases per day, new cases in the United States, we’re down to about 75,000 here in the last few days. And so that’s great progress. We don’t fully understand why we’re seeing all of that. I think part of it is the fact that we’ve been administering some of the monoclonal antibody preparations, which have been shown to decrease hospitalizations and deaths.

[00:08:52] Likewise, the vaccine is highly effective, and I just saw a report yesterday showing this amazing divergence between nursing home residents, long-term care residents and the general population that really is completely in response to vaccination. And so, they really work, and that’s something that we need to emphasize to all the listeners today is that just as soon as you’re able to get the vaccine, get in line and get it. And then, undoubtedly, there are some influences from the non-pharmacologic interventions, as we call them. I doubt that we’re actually getting better about that, and if anything, I think people are probably just tired of the pandemic and relaxing their precautions, not wearing their mask as much as they should, not avoiding those crowded, indoor air spaces. And then there’s probably some things about viral dynamics that we just poorly understand; why the pandemic kind of ebbs and flows is still something that we’re studying.

[00:09:46]Bill Walsh:  Okay, so a good sign but maybe not the sign of things to come, depending on how things unfold. Let’s turn to vaccine distribution, Dr. Rupp. You know, we’re hearing questions from older adults who are just desperate to get the vaccine but they’re struggling either with the technology or confusing state and local enrollment systems. I know you can’t speak to specifics but, broadly speaking, what steps are you seeing state and local governments take to improve those systems and actually get shots into people’s arms.

[00:10:19]Mark Rupp:  Well, I think overall, folks need to recognize that this is a huge and complicated, logistically complicated, operation. And I think overall, the public health departments have done really a good job in getting this rolled out to people. And I think the other thing folks need to understand is this came at a time when everybody was very, very much stretched already. So getting these programs set up at the same time of trying to deal with the pandemic is an awfully heavy lift. And we probably didn’t invest in the resources to, you know, as they say, get that vaccine the last mile, as we should have. Now clearly things are improving. It is frustrating to see all the different states and local health departments have their own individual, you know, programs that they’re using. It is becoming easier to navigate. I think just about every local health department has a hotline number so if folks are having difficulty maneuvering on the websites or they lack the, you know, the actual computer or link or smartphone to get onto the websites, they can call the hotlines and make sure that they’re being cared for. So again, I think things are getting better. We’re up to somewhere between 1½ and 2 million doses a day. We just need to keep that forward progress moving.

[00:11:44]Bill Walsh:  Thanks for that update, and I’ll take your answer as an opportunity to tell our listeners about a really important resource AARP has created, which are state-by-state guides for how to get a vaccine in your state. And if you can get online, you can find it at aarp.org/vaccineinfo. You can just pull down your state and state’s information and find the toll-free numbers there — even questions to ask about the vaccines. Thank you for that, Dr. Rupp.

[00:12:19] Dr. Rapaka, with limited supply and severe weather across the country, many vaccine appointments, including second appointments, have been rescheduled. We know that the Pfizer and Moderna vaccines require three to four weeks between doses. Is that a concern if there’s more time between doses due to the distribution problems?

[00:12:43]Rekha Rapaka:  So, you know, we have the data from the clinical trials, and we try as hard as we can for the vaccines. And we try as hard as we can to match the intervals recommended, so, with Moderna that booster coming at four weeks and with Pfizer that second dose or booster coming at three weeks. However, it’s important to remember the second dose is a booster. And what that means is it’s an immunization that’s done to enhance the initial immune response you’ve had to the first vaccine and make it stronger and better. And so, you know, obviously in the setting of delays and emergencies and, you know, weather conditions where people have had delays, we can’t get to that optimal situation; we have to make accommodations. And I would argue that receiving that booster vaccination a week later, you know, is still going to have benefit and still have an augmentation of the initial immune response. So, I think it’s great to move towards what we have data for, but when we know that the change is just on the order of days or weeks, you know, or a week, I think it’s fine to just get that booster later and know that you’re still probably enhancing that immune response. So in an emergency, just get the next available dose as soon as you safely can.

[00:14:08]Bill Walsh:  Okay. And is there a point of no return, that is, is there a span over which the initial dose just becomes ineffectual?

[00:14:17]Rekha Rapaka:  So, that’s unknown at this time but like our, we can use our knowledge from other vaccinations and I think in the, you know, the timeframes we’re talking about for delays, I see something in the range of a few weeks not really being a game changer.

[00:14:36]Bill Walsh:  Dr. Rupp, what do you think about that?

[00:14:40]Mark Rupp:  Yeah, no, I completely agree with what Dr. Rapaka has related and that is that, you know, folks shouldn’t be too concerned if they have to delay for a short period of time between their initial dose and their booster dose. And, in fact, some countries have, you know, really extended that time period out in efforts to try to get more people, you know, with at least that first vaccine. So I do want to just be reassuring to folks that getting that second dose a little bit later is not going to interfere with their vaccine response.

[00:15:12]Bill Walsh:  Okay. Well, thanks to both of you for that. And as a reminder to our listeners, to ask your question, please press *3 on your telephone keypad. We are going to get to those questions shortly but before we do, I wanted to bring in AARP Senior Vice President for State and Community Engagement Kristin Dillon. Welcome, Kristin.

[00:15:33]Kristin Dillon:  Thanks, Bill, I’m happy to be here today.

[00:15:36]Bill Walsh:  Right, we’re happy to have you. What can you tell us about what AARP has been doing to fight for older Americans on COVID-19 vaccines?

[00:15:47]Kristin Dillon:  Well, as other people have noted, we are approaching one year of living under a global pandemic that has affected all of us. Older Americans have been hit especially hard. More than 95 percent of the deaths have been among those age 50 and older. And the loss of more than 160,000 lives in nursing homes is a national tragedy. So, vaccines bring great hope for us to finally stem this tragic loss of life but, as others have noted, that hope has been tempered by an overly complicated and confusing distribution process. That is why AARP is fighting for older adults to be prioritized, and fighting to make the online process easier so that you can go to one place to get clear information about when, where and how to sign up to get vaccinated. And, recognizing that not everyone is online, or people may have difficulty navigating online systems, AARP is also urging the federal government to work with states to develop 1-800 numbers for scheduling vaccine appointments and that those 1-800 numbers are centralized, well-staffed and offer culturally competent customer service in several languages. We commend the actions that the Biden administration has made to get more vaccine supply out to states and expand where vaccinations are available to include more pharmacies, community health centers and large vaccination sites like sports arenas in some states.

[00:17:35] In every single state, AARP staff and volunteers are fighting in state legislatures to improve the transparency and reporting about the COVID-19 vaccine rollout so we understand really what is happening. Staff and committed volunteers from 16 AARP state offices are also participating in work groups led by their governors and state health departments. This includes states like Idaho, North Carolina, Tennessee, California and many others. We’ll be showing up virtually in capitals across the country to protect funding for programs like aging services, home- and community-based care, low-income energy assistance and unemployment and job assistance programs. And we’re working with state and local officials to help provide critical information to older adults about the vaccine, where they can access it and what they need to do.

[00:18:37] We are also expanding our efforts to provide people 50-plus with trusted information about the vaccines. For example, as you mentioned earlier, Bill, we have published online guides for every single state, the Virgin Islands, Puerto Rico and D.C., explaining how to get the vaccine where you live. You can find those at aarp.org/vaccineinfo. And then you can find your state and get the information that you need. AARP state offices are also hosting dozens of local conversations like this one each week, and volunteers are finding ways to check in on others to provide local information about the vaccine. So, as the rollout continues, we will continue to keep the pressure up on elected leaders and continue to provide critical information to our members. So, again, to stay up to date on all of these efforts and find summaries of state plans for vaccine distribution, please visit us at www.aarp.org/coronavirus.

[00:19:59]Bill Walsh:  Okay, thank you so much for that information, Kristin. Appreciate the update.

[00:20:04] It’s now time to address your questions about the coronavirus with Dr. Rekha Rapaka and Dr. Mark Rupp. And as a reminder, please press *3 at any time on your telephone keypad to be connected with an AARP staff member to share your question. It’s now time to bring in my AARP colleague, Jean Setzfand, who will help facilitate your calls today. Welcome, Jean.

[00:20:29]Jean Setzfand:  Thanks, Bill. Delighted to be here.

[00:20:32]Bill Walsh:  All right, who is our first caller?

[00:20:35]Jean Setzfand:  Our first caller is Violet from New York.

[00:20:39]Bill Walsh:  Hey, Violet, welcome to the program. Go ahead with your question.

[00:20:44]Violet:  I asked the question before about why are they charging more than other companies, and like even the drugs or the other. I have AARP Rx, we pay for it. And the others, they don’t have to. They just got it for nothing. And dental or the, whatever have to be paid, and everything for free. But I have to pay for everything.

[00:21:24]Bill Walsh:  And I understand you’ve gotten your first shot. Is that right? Your first COVID shot?

[00:21:31]Violet:  I had the second one, and I am sick.

[00:21:34]Bill Walsh:  And you’re sick. Tell us how you’re feeling.

[00:21:38]Violet:  Well, I feel very drowsy, very weak. I am 85 years old, and I’m okay. I have, I have no diseases, but I just, getting me this one I’m just, I just want to sleep. And I feel like dizzy, I don’t know why.

[00:22:00]Bill Walsh:  Well, let’s ask our experts about that and see if they can offer any advice. Dr. Rapaka, we’ve heard some anecdotal evidence about people getting sicker in the second dose. Can you talk about that? What kinds of symptoms people experience and then what they should do if they have those symptoms, like Violet?

[00:22:20]Rekha Rapaka:  Sure, and, Violet, I’m sorry you’re feeling that way. I, yes, the second immunization often does give, in people that have received the vaccines, often more symptoms. So they may have some of the symptoms you’re experiencing, like the dizziness or discomfort and, you know, symptoms like chills, fevers, things of that nature. What we’ve seen though in most people is that, you know, sometimes taking a day to rest, or planning out a little bit of rest on the day that you get that second shot helps so you kind of know what to expect. Sometimes people will take, you know, over-the-counter medications like Tylenol, if it’s something they can safely take, or medications like Advil, to sort of temper some of those symptoms like muscle aches and things like that. But it tends to, in most patients, limit off after 24 to 48 hours. So those, that time period may be really tough and uncomfortable but I think you can rest assured that it shouldn’t last longer. And obviously, if there are, you know, changes, it’s important to talk with your doctor. But that’s been the typical course that we’ve seen, for people that have symptoms. That second booster can be sometimes where it comes out.

[00:23:48]Bill Walsh:  And just to be clear, we’ve heard some concerns from people, you know, when they see these side effects, they think, oh my God, I’m getting COVID, that, that this vaccine contains the live virus. But it doesn’t, does it.

[00:24:01]Rekha Rapaka:  Exactly, it does not. There is no way to catch COVID-19 from the vaccine preparations. So, so even though you feel unwell, and you might feel like I’m getting sick, just rest assured that it is not COVID-19.

[00:24:16]Bill Walsh:  Okay. Thank you for that. Jean, who is our next caller?

[00:24:20]Jean Setzfand:  Our next caller is Peggy from Maryland.

[00:24:23]Bill Walsh:  Hey, Peggy. Welcome to the program. Go ahead with your question.

[00:24:28]Peggy:  I, my question is, it’s not for myself, it’s for one of my friends who was unable to navigate the online registering for an appointment because — and she is very technology savvy, so it’s not that she doesn’t know how to do it — but she said when she got to a certain point, she couldn’t go any further. And, and the reason she asked me is because I had the same problem, but someone else registered for me. I was never able to reg—, it stopped at a, and I don’t remember at what point that was, but it doesn’t let you register for an appointment.

[00:25:11]Bill Walsh:  So what’s your question, how to register in the state of Maryland?

[00:25:15]Peggy:  Yeah, how do you do, how can you— yes, by phone.

[00:25:19]Bill Walsh:  Okay, well while you were talking, our excellent AARP staff has actually pulled up the toll-free number for Maryland, and I’ll give that to you if you have a pen and a piece of paper.

[00:25:30]Peggy:  Okay, I’m ready.

[00:25:31]Bill Walsh:  Okay, it’s 877-319-1525. 877-319-1525. And to our other listeners, you can look up the information for your own state at aarp.org/vaccineinfo. It’s very easy, just pull up your state. It’ll have toll-free numbers there. It’ll have websites you can visit for information and registering. It also has sample questions to ask. So hopefully that’s helpful. All right, well, let’s take another question. Jean, who’s next?

[00:26:14]Jean Setzfand:  Our next caller is Janice from California.

[00:26:17]Bill Walsh:  Hey, Janice. Welcome to our show. Go ahead with your question.

[00:26:22]Janice:  My question is, when you get, you’re, you’re waiting for your, you’re waiting in line for your appointment, must you have some kind of proof that you don’t have COVID currently?

[00:26:36]Bill Walsh:  Hmm. That’s an interesting question. Dr. Rupp, can you handle that one?

[00:26:41]Mark Rupp:  Yeah, so, Janice, that’s a great question. And clearly people who are acutely ill should not be, you know, getting their vaccine. So if you have a febrile illness, if you really are feeling poorly, you know, you shouldn’t receive the vaccine. If you do have COVID, the recommendation is that you go ahead and you get through the initial illness, and then it’s okay to proceed with the vaccine. We do believe that that initial illness would have some protective effect and so some people are waiting for a period of time before they get the vaccine. But, you know, if it’s available to you and you’ve cleared that initial period of illness, it’s perfectly okay to go ahead and get that, that first shot.

[00:27:26]Bill Walsh:  And what do you think that initial period is? Would you recommend people wait the 14 days that we heard at the outset?

[00:27:34]Mark Rupp:  Yeah, they should go ahead and get through that initial period of illness and through their period of isolation. And then as soon as they’ve cleared that isolation period, they’re eligible to go ahead and get the vaccine. Again, we think there is protective effect, particularly in that first two or three months after, you know, having the viral illness, the normal COVID-19. But, again, if the vaccine is available to you, you know, it’s probably in your best interest to go ahead and get it then, because you don’t know what the logistical hassles are going to be later on.

[00:28:08]Bill Walsh:  Yeah, very good point. All right. Thank you very much. Jean, who is our next caller?

[00:28:14]Jean Setzfand:  I have quite a few questions coming in from Facebook and YouTube as well. So this question is coming from Jennifer on FaceTu—, sorry, on Facebook. And she’s asking, “Do we need to quarantine to visit my family if I have both vaccine injections? If so, how many days prior to the visit?”

[00:28:33]Bill Walsh:  Hmm. Okay. Dr. Rapaka, can you answer that question about quarantining after having gotten the shot?

[00:28:44]Rekha Rapaka:  Yeah, so the way that we’ve been— That’s a very interesting question. I think it’s going to impact the way a lot of people are thinking lately after getting the vaccine: What are the things that I can do? You know, I’ve been told I can’t do certain things for a while. You know, I would say that as it stands right now, getting the vaccine, it doesn’t really change a lot of the behaviors that we would normally have with regards to quarantining. And that’s because we want the vaccine to be, the benefits of the vaccine to occur in the setting where most people have either been exposed to the virus and infected, so have an immune response from that, or have received vaccination. We want to get more of the population vaccinated before we start to ease aspects that relate to, you know, changes in behavior. So I would say that at this time, vaccination shouldn’t change any of the practices that you would plan to use for quarantining, as it stands now. So, that’s, I think, where we are with the information. I think over time, we’ll have, you know, easing of certain restrictions but I think for now, the safest way is to just continue with the public health measures that we’re using in place regardless if the vaccine’s received.

[00:30:10]Bill Walsh:  Okay, thank you. Oh, go ahead, Dr. Rupp.

[00:30:14]Mark Rupp:  Yeah, I would certainly agree with that. I just think that one of the frustrating things that people are experiencing is that they get the vaccine and then they’re not able to immediately change their behavior. And as Dr. Rapaka related, one of the crucial pieces of data that we’re still looking for is whether people after they’ve been vaccinated are able to acquire the virus and shed it in an asymptomatic way. And until we have that crucial piece of information, it’s probably best that people go ahead and just continue those non-pharmacologic interventions of masking and distancing. But I fully expect in the very near future that we’re going to have additional information and then we will be able to give people more solid advice on when they can potentially, you know, really start to enjoy life again, perhaps not be so concerned about going to, you know, their favorite restaurant and dining and feel like they’re, they’re being protected. You know what information we have right now is certainly very supportive of that, but we’re just needing to wait just a little bit longer. So I would plead with all the listeners out there to, you know, give us a little bit more time, continue with those non-pharmacologic interventions, and let’s get through this pandemic together.

[00:31:30]Bill Walsh:  Okay, thank you both for that. And as a reminder to our listeners, if you’d like to ask a question, press *3 on your telephone keypad. Jean, let’s take another question.

[00:31:42]Jean Setzfand:  Our next caller is Eileen from South Carolina.

[00:31:46]Bill Walsh:  Hi, Eileen, go ahead with, go ahead with your question.

[00:31:50]Eileen:  Okay. Now I’ve looked this up online and tried to find answers and there’s nothing that addresses this. And I have lupus and Sjögren’s, which is an autoimmune diseases, and I’m on prednisone for it, which to me would be suppressing my immune system. How is that going to deal with taking the shot? I’ve had the first one. It’s Pfizer. I’m due tomorrow to get the second one, but then I started reading that if you have autoimmune diseases and taking medicines that it may affect it, if it takes or not.

[00:32:32]Bill Walsh:  Hmm. Well, let’s ask our experts about that. Dr. Rapaka, do you want to weigh in on that?

[00:32:38]Rekha Rapaka:  Yeah, sure. It’s a very good question. So, I mean, I think, you know, so the clinical trials for the vaccines didn’t specifically investigate, you know, different groups, for example, individuals with autoimmune diseases and how they reacted to the vaccines. However, they’re a very important group of patients for getting potential benefits from vaccines because, in the setting of Sjögren’s or taking immune suppressive medications, there’s sort of a lower, or a weaker immune response in general sometimes to infections, and maybe increased risks of getting bad infections. So in a way, I see someone like you as a person who would be a priority for getting the vaccine and seeing it through. And it’s wonderful that you got your first shot and I think, you know, getting that booster shot is going to only make the immune response that you’ve already formed a bit stronger. And so I would encourage you to go forward with it. And, as usual, as we encourage all individuals getting the vaccines, to of course monitor your response to it, see how you’re doing, how you’re feeling, checking on that very carefully. But, yes, I think, you know, it’s, I just, I want to send you some reassurance that, you know, there have been other individuals as well, you know, patients with other immune conditions that have gotten the vaccine, you know, now, and the many millions of Americans that have received it. So just also know that we’re collecting information as we speak on how it will pan out for people with different medical problems. We’ll have much more information, but I, I’m, yeah, it’s great that you’re going forward with the booster.

[00:34:29]Bill Walsh:  I know that the protocol has been to monitor people for like 15 or 30 minutes after the shots for any allergic reactions. Is there any similar protocol for people in Eileen’s situation? People who have an autoimmune disease already.

[00:34:46]Rekha Rapaka:  No, no. You know, so the thing is, is for individuals with autoimmune diseases, we don’t expect any kind of immediate reaction after vaccination. If anything, actually, there’s a concern that they may have a lower immune response to the vaccination because of the immunosuppressive medications that they’re on. So we don’t have any special monitoring typically for that.

[00:35:10]Bill Walsh:  Okay. Thank you for the clarification. Jean, who is our next caller?

[00:35:16]Jean Setzfand:  We have another question coming from YouTube and this one’s coming from Larry. Larry’s asking, “I had COVID last July and just received the first dose a week ago. I had fevers, chills, fatigue for 24 hours. Does having COVID already count as the same as having a first dose already?”

[00:35:35]Bill Walsh:  Hmm, Dr. Rupp, do you want to respond to that one?

[00:35:39]Mark Rupp:  Sure. So, the initial illness that Larry had, probably primed his immune system and so he did have a good booster effect with the first dose of his vaccine. And we actually have some reassuring data and very encouraging data that people who have had COVID in the past and then get the vaccine, do get a very nice booster effect from it. It sounds like the symptoms that Larry had were relatively mild, relatively self-limited, and he would be encouraged to go ahead and finish the course of his immunization and get that second dose.

[00:36:19]Bill Walsh:  Okay, thank you for that. And thank you for all your questions. We’re going to take more questions soon. And just a reminder, to ask your question, press *3 on your telephone keypad.

[00:36:30] Let’s get back to our experts. Dr. Rapaka, the COVID-19 has had an absolutely devastating toll on people of color. We also know there are historical issues of trust between the medical community and Black Americans in particular. The vaccine distribution doesn’t seem to be effectively addressing this. For instance, 5 percent of the limited vaccine supply has gone to Black Americans. What’s driving this and what’s being done about it?

[00:37:01]Rekha Rapaka:  It’s a very important question. So, Black Americans have higher rates of developing COVID-19, higher rates of dying from COVID-19. So vaccination is a critical tool we need to be using to limit spread of this terrible disease. And I want people to know that the clinical trials for COVID-19 vaccines were designed to recruit a really diverse population so that people felt that, you know, they were represented in the trials and would have confidence in the vaccine safety and vaccine efficacy. So, people that look like them and from all backgrounds were included in these trials. So, you know, part of the reason for the numbers being where they are is that— I mean I think there are many; it’s really multifactorial. But I would say a few things. One is that I think the distribution process, as we, as many of the listeners have been describing and we all know, you know, they are fragmented, and it makes accessing vaccines difficult. For example, in some states, having a primary care doctor will more easily connect you to distribution of vaccines. And we know that many Black and other minority community members are less likely to have primary care doctors, so that can be a limitation. Sometimes vaccine clinics are set up in predominantly Black neighborhoods to increase uptake and remove barriers and increase rates of vaccination. But, unfortunately, it’s been seen at times that many of the appointments are occupied by people from outside of those neighborhoods because the way those slots are assigned are often, you know, computer, involve computer registration and sort of a first-come-first-serve process. And I think, you know, thirdly, there’s certainly of course hesitancy towards vaccines that may be due to distrust in the Black community related to structural racism that’s been experienced, and challenges that the health care systems have presented with inequities that Black Americans have faced. And so I think, you know, these problems set the stage for this. And I think we, as a group, have to just be very aware and also working to change it. And, you know, I think, it’s a, it’s a kind of a group, collective effort. You know we need leadership to speak about this problem so, for example, I think many of you saw that Vice President Kamala Harris has been speaking out and encouraging vaccination. So a lot of leadership from that angle. We, you know, we need a lot of interconnection with the government and entities that are involved in trying to help, so the CDC, the NIH. I saw that there’s a group called the Black Doctors COVID Consortium that’s working on dialogues to basically, you know, Zoom meetings with individuals like Dr. Fauci to talk about barriers and hesitancy. And, you know, I think just developing better strategies at the community level for distribution to vulnerable communities is very important. So, you know, things like grassroots groups and churches being more involved — I think we have to just be more innovative in how we get to different groups of people with these vaccines.

[00:40:25]Bill Walsh:  Okay, right. Thank you, Dr. Rapaka. Dr. Rupp, let me—

[00:40:30]Mark Rupp:  Can I just interject one other thing with that? And I think that, you know, one of the reasons that we’re seeing vaccine hesitancy is also due to the misinformation that is, you know, easily accessible on the web. If people are, you know, going to not-trusted sites for their information. And so I would salute AARP and other organizations like that, to really serve as a portal to trusted information, to getting to the CDC and the FDA information, the WHO, and really learn about the vaccine. And that’s one of the important ways that we can combat this misinformation that’s out there.

[00:41:07]Bill Walsh:  That’s a great point. And for our listeners, our site is aarp.org/coronavirus. And we are doing a lot of fact-checking. We are only using primary sources and reporting information. So, you know, we’ve got a lot of very credible information there.

[00:41:26] Dr. Rupp, let’s talk a little bit about masks. A recent CDC study showed that a single mask blocked about 42 to 44 percent of particles. However, when a cloth mask was worn over a surgical mask, roughly 90 percent of cough particles were blocked. So is a single mask effective? Should we all be wearing two masks at this point?

[00:41:53]Mark Rupp:  Yeah, Bill, so one of the things that we’ve learned over the course of the pandemic is that wearing a mask is an important ingredient in the overall recipe of fighting this pandemic; that, and making sure that you keep your distance and avoid those shared indoor air spaces. The effectiveness of any mask is going to be dependent upon what it’s made of and the filtering capacity of that material, and then how tightly it fits to the face. And, frankly, I think we would be so much better off if everybody, and I mean everybody, wore a well-constructed, well-manufactured, tight-fitting face covering anytime they were out in public, rather than having some people worrying about, Gee, should I get an N95 or wear two masks? and then having other people doing nothing. We’d be a whole lot better off if everybody would show that social responsibility and wear a mask when they were out in public and then make sure that that mask was well-constructed and tightly fitting. Now, as you mentioned, there are good data now to suggest that if you have a, you know, a procedure mask and then over the top of it you’re wearing something that helps it fit more tightly to your face, that you will get better filtration. And so if you are wearing a mask that has a lot of gaps, you know, at your cheeks or around your nose, then it may be better to actually have something that helps hold it to your face. And so there are devices out there that help to just do that, hold it more tightly to your face, but again, a well-constructed, tightly fitting, multi-ply cloth face covering is really going to function quite highly and quite well.

[00:43:37]Bill Walsh:  Okay, thank you for that. And thank you both. We are going to turn back to our listeners and take more of your questions for Dr. Rekha Rapaka and Dr. Mark Rupp. And as a reminder, press *3 at any time on your telephone keypad to be connected with an AARP staff member and get into the question queue.

[00:43:59] Jean, who do we have on the line now?

[00:44:02]Jean Setzfand:  Our next caller is Mary from New York.

[00:44:05]Bill Walsh:  Hey, Mary, welcome to the program. Go ahead with your question.

[00:44:09]Mary:  All right. I’d like to know, I’m homebound and I was talking to someone and they told me that they’re hoping that eventually for homebound people, they’ll allow someone to come into the home, a nurse or someone, and give the patient the vaccine at home, because it’s very difficult for me to get out, especially in New York now, we’re having terrible snowstorms every week. So it’s been very difficult for me to get out. I just wondered if eventually they’re planning on doing that.

[00:44:42]Bill Walsh:  That’s a great question, Mary. And Dr. Rupp, do you want to tackle that? And I wonder if the J&J vaccine, can it with just a single dose will help people like Mary who are homebound?

[00:44:57]Mark Rupp:  Well, absolutely. It has the potential for doing that. The Johnson & Johnson vaccine is not as environmentally wimpy, if you will, so it is able to have a stability for a longer period of time, doesn’t need to be kept under those stringent freezer conditions. And so that may make it a little bit easier to get doses out to people like Mary who aren’t able to get to the vaccine centers. And it really is one of those frustrating things that, you know, we have a piecemeal system: Every state is different; every public health locality within a state also can be different. You know what I’m hearing is that most places are starting, or either have programs, are starting to develop programs where they will have folks being able to go out to people’s homes for those folks who really aren’t able to get into the vaccine clinics. Again, I know AARP has their website, has the information of how folks can access into the systems and I would urge Mary to go to the website or to call the hotline and to inquire about what’s set up for residents of New York.

[00:46:07]Bill Walsh:  Thank you for that, Dr. Rupp, and Mary, I want to give you that toll-free number in New York for the helpline if you don’t have it. It’s 833-697-4829. All right, Jean, who is our next caller?

[00:46:26]Jean Setzfand:  Oh, we have another question coming in from YouTube. And this one’s coming from Edward. Edward’s asking, “I have had two shots of the Moderna COVID-19 vaccine. Once the J&J vaccine becomes available everywhere, I want it as well. Is there a reason not to do this? Is there any reason to do this?”

[00:46:45]Bill Walsh:  Hmm, interesting question. Dr. Rapaka, do you have some thoughts on that?

[00:46:49]Rekha Rapaka:  Yeah, so it’s an interesting question. I would say that, I don’t think it’ll give you much benefit from what you’ve already received. So it, the way that the Moderna— the Moderna vaccine has really excellent efficacy and if he’s completed that course, you’ve likely achieved that level of efficacy and protection and the J&J vaccine, it would just be a booster, that it would serve as a booster of immunization essentially that you don’t really need. It’s not going to give you any extra benefit, you know. It may be the case as we learn, as we go through this pandemic, that we might need to give additional boosters later. But I think for now you can hold tight and not go for that J&J immunization when it’s available, because it won’t add anything extra to your situation as far as protection from COVID-19.

[00:47:47]Bill Walsh:  Right, and just to be clear what you were saying, you don’t need to get the J&J if you’ve already had the other vaccines.

[00:47:58]Rekha Rapaka:  Exactly.

[00:47:59]Bill Walsh:  Right. Okay, Jean, who is our next caller?

[00:48:04]Jean Setzfand:  Our next caller is Mary from Missouri.

[00:48:08]Bill Walsh:  Hey, Mary. Welcome to the program. Go ahead with your question. Hi, Mary?

[00:48:20]Mary:  Yes. My question is, I’m 69, I have COPD, I have MS, I have high blood pressure. I have registered on every available site in my area and then when I called to check on making an appointment, they just say they’re only taking 85 years old and obese. I’m just wondering, when will they get to me, or how can I make sure they’ve actually even registered me?

[00:48:53]Bill Walsh:  And you’ve, have they, when you call them, do they give you any information about when people of other ages are going to be, you know, taken for the vaccine? Eligible for the vaccine?

[00:49:12]Mary:  They just say right now, they’re just saying 85 and obese is all they’re doing now. And so I asked what, do you have any timeline, you know when, ’cause they announced on our local news, it’s 65 and older with lung issues. And since I have COPD, I thought that would include me. But when I call, they just say no, 85 and obese is all we’re doing now.

[00:49:36]Bill Walsh:  All right. Thank you for that, Mary. I wonder if Dr. Rupp, I’m sure you’re not familiar with all the protocols in Missouri, but can you talk in general about what people should do if they seem to fit the eligibility guidelines, but they haven’t been able to schedule the appointment quite yet.

[00:49:55]Mark Rupp:  Well, I think that first off Mary is right on target with, you know, having concern about the severity that COVID-19 could have in her particular situation with her underlying lung disease and her age and the hypertension. These are, you know, a number of risk factors that she has for more severe disease. And so I would salute Mary first off for just being aware of those things and trying to make sure that as soon as the vaccine is available to her, that she take advantage of it. And it sounds like she’s trying to do everything she can in order to get in line. One of the frustrating things is that people do hear these conflicting reports of, you know, anybody who’s over the age of 65, we’re ready for you. And then they try to access the vaccine only to be told that no, we really just don’t have those doses available. You know, it’s different in every locality; it’s different in every state. That’s one of the frustrating things. Again, AARP is trying to play a really good middleman clearinghouse role and trying to get people hooked into those systems to where they can get registered. I don’t know what the situation there is in her local locality in Missouri but, again, I would just encourage her to stay persistent, continue to check in online, and to call those numbers and, you know, as soon as it’s available to her for, for her to take advantage of it.

[00:51:16]Bill Walsh:  Okay, thank you. And Mary, I don’t know what line you’ve been calling, but let me give you the toll-free number there in Missouri for the state’s health and senior services hotline. That number is 800-435-8411. 800-435-8411. And that’s for Missouri.

[00:51:39] All right, Jean, let’s take another call.

[00:51:42]Jean Setzfand:  Our next caller is Sonia from California.

[00:51:45]Bill Walsh:  Hey, Sonia, welcome. Go ahead with your question.

[00:51:48]Sonia:  Yes, thank you. I was wondering for the Moderna vaccine, they said it’s 94.1 percent effective, I think. But they said that for people age 65 and over, it’s only 86.4 effective. So does that mean that 13.6 percent of people will not be protected at all?

[00:52:19]Bill Walsh:  Let’s ask Dr. Rapaka. Dr. Rapaka, there’s been a lot of confusion about what these efficacy rates mean. Can you talk about that a little bit?

[00:52:28]Rekha Rapaka:  Yeah. So, the measurements of vaccine efficacy really come to like looking at the percent reduction in COVID-19 in the vaccinated group and comparing it to the unvaccinated group. And to Sonia’s question, it was looking, she’s looking at the efficacy in older individuals compared to the younger groups that were vaccinated. And, you know, it is true that the efficacy is slightly lower, as seen in older individuals. But we, it’s not in the range that we, I think should be very concerned about a significant difference. It’s on the order of 10-ish percent and efficacy measurements are a bit involved.

[00:53:15] I would say a separate thing is that usually older individuals tend to have in response to different vaccines, they tend to have sometimes a weaker immune response. And that’s just because as we age, our immune systems get a little bit weaker. So that’s one of the reasons why in these clinical trials, we’ve worked hard to get a sense of what, you know, how an older person might react to the vaccine compared to a younger person and what percent of efficacy we might see. So it is true that there is that slight difference in the efficacy. The Pfizer vaccine, it’s pretty much similar. So I would say overall, there is that slight difference but it’s not something that I think should make anyone concerned about, you know, like, Oh, it’s not going to work for me. I’m going to forgo getting this vaccine. To give you all context as well, when you think about vaccines in general, the flu vaccine efficacy number tends to be around 40 to 60 percent. Sometimes in a given year it can be a bit higher, but that’s what we often are working with. So when we’re in the numbers of 70 percent, 80 percent, 90 percent, I think I would feel very confident that the immune response that you’re getting from the vaccine is something that will help protect you.

[00:54:39]Bill Walsh:  Okay, thank you for that, Dr. Rapaka. Jean, who is our next— Oh, go ahead, doctor. Did you want to add to that?

[00:54:46]Mark Rupp:  Can I jump in again. As, you know, we’ve mentioned, I completely agree with what Dr. Rapaka just related, but I would also reassure Sonia that the data, you know, is very, very reassuring that even if, you know, people develop COVID-19 after vaccination, the vaccines have been almost a hundred percent effective in preventing those most severe manifestations of disease, so, hospitalization and death. And so even if she were to break through and have COVID-19, it’s very likely that, you know, it would still be very protective against her progressing and needing to be hospitalized, or even dying from the condition. So those, those data are very, very reassuring and supportive of vaccination.

[00:55:36]Bill Walsh:  Great point, Dr. Rupp, thank you for that. Jean, let’s take another caller.

[00:55:41]Jean Setzfand:  Our next caller is Joan from Pennsylvania.

[00:55:45]Bill Walsh:  Hey, Joan. Welcome to the program. Go ahead with your question.

[00:55:49]Joan:  Yes, good afternoon. My concern and question is for those of us who are in the age group between 65 and 75. I still have not been able to secure an appointment here in Pennsylvania, but what are your thoughts about people in this age group being a greater concern of getting one of the variants of COVID-19? I did do some reading. It was, you know, a correct reading that that was a concern within the next three to four weeks.

[00:56:23]Bill Walsh:  Interesting question, Dr. Rupp, can you, tackle that one?

[00:56:27]Mark Rupp:  Yeah, Joan. First off, you’re absolutely correct, that age is truly the driving force in the morbidity and mortality, as the most important risk factor that we’ve identified. So, you being in that age group, 65 to 75, you know, again, I would encourage you just as soon as you can, to make sure that you, take avail—, take advantage of the availability of the vaccine. One of the wild cards right now is with regard to the variants, as you’ve mentioned, and whether they are going to start gathering steam in the United States and really start to spread. You know, that’s an unknown right now, but the data does suggest that some of these variants can be more transmissible, and there’s even a little bit of data suggesting they may be more virulent or more dangerous and, you know, may have some capacity to evade the defenses that we, that we get from vaccination. So, these are of tremendous concern and we’re going to have to keep our eyes wide open and really be watching the data to see what’s going on. And that’s why it’s so incredibly important right now that even though the numbers are coming down, that people continue to use those non-pharmacologic interventions — the masking, the distancing, the avoiding shared indoor air spaces — until we can get the vaccine more widely distributed in the community, including the age group that you represent. And then, you know, get this pandemic under the most control that we possibly can. So we all have to work together to get the vaccine and to also continue to practice those things that we know are going to help to prevent the transmission.

[00:58:06]Bill Walsh:  Okay, well, thank you very much for that. And we’re coming to the top of the hour. Dr. Rapaka and Dr. Rupp, I wonder if you have any closing thoughts or recommendations that our listeners should understand most from our conversation today. Dr. Rapaka, why don’t we start with you?

[00:58:22]Rekha Rapaka:  Yeah, I mean I just want everyone to really take advantage of the tools. I know it’s difficult and challenging, right now with the, you know, the fragmentation and accessing vaccines, but when you are able to get one, I think, you know, getting that vaccine is going to help prevent you from getting COVID-19 and help us get these numbers down and move into a better situation. So, thank you for doing your part and helping yourself and others.

[00:58:56]Bill Walsh:  Okay, thank you for that, Dr. Rapaka. Dr. Rupp, any closing thoughts or recommendations?

[00:59:00]Mark Rupp:  Sure. It’s been a real honor for me to be involved with the presentations and the talk today. And, boy, oh boy, it’s been a long year for everybody. You know, I know all of us are tired of this pandemic but, you know, we are seeing the light at the end of the tunnel, but the problem is we’re still in the tunnel, and we just have a little bit longer to go. And so just like I said, just recently, you know, maintain the masking, the distancing, avoiding those shared indoor air spaces, get the vaccine as soon as you can. And if we all work together on this, we are going to get to that better spot here in another few months where I hope we’re able to open up society, you know, get back to going to the theater and going to the restaurants and doing all those things with our family and our loved ones that we so much crave.

[00:59:48]Bill Walsh:  Okay, and thanks to both of our experts for answering our questions. This has been a really informative discussion. And thank you, our AARP members, volunteers and listeners for participating in the discussion today. AARP, a nonprofit, nonpartisan member organization, has been working to promote the health and well-being of older Americans for more than 60 years. In the face of this crisis, we’re providing information and resources to help older adults and those caring for them protect themselves from the virus, prevent its spread to others while taking care of themselves. All of the resources referenced today, including a recording of the Q&A event can be found at aarp.org/coronavirus starting tomorrow, February 26th. Again, that web address is aarp.org/coronavirus. Go there if your question was not addressed, and you will find the latest updates as well as information created specifically for older adults and family caregivers. We hope you learned something that can help keep you and your loved ones healthy. Please tune in March 11th for two live events. The first at 1 p.m. Eastern Time, we’ll discuss the latest on COVID-19 and vaccines, and at 7 p.m. Eastern Time, we’ll discuss taxes and your finances. Thank you very much for participating and have a great day. This concludes our call.

[01:01:18]

Bill Walsh: Hola, soy el vicepresidente de AARP, Bill Walsh, y quiero darles la bienvenida a esta importante discusión sobre el coronavirus. Antes de comenzar, si deseas escuchar esta teleasamblea en español, presiona * 0, en el teclado de tu teléfono ahora.

AARP, una organización de membresía sin fines de lucro y no partidista, ha estado trabajando para promover la salud y el bienestar de los adultos mayores durante más de 60 años. Frente a la pandemia mundial de coronavirus, AARP brinda información y recursos para ayudar a los adultos mayores y a quienes los cuidan.

Esta semana, por supuesto, nuestra nación cruzó un umbral terrible. En menos de un año, la pandemia de COVID-19 se ha cobrado más de un quinto de millón de vidas y contando. En ese contexto, la distribución de vacunas es una prioridad para todos, pero las personas en todo el país continúan experimentando obstáculos y sistemas de registro confusos, solo para programar una inyección.

Si bien las hospitalizaciones han bajado de sus máximos históricos, la cantidad de personas que se enferman de COVID-19 y sucumben a la enfermedad sigue siendo demasiado alta. Hoy, escucharemos a expertos sobre la vacuna, el suministro, los esfuerzos de distribución y cómo mantenerse a salvo. Si ya han participado anteriormente en alguna de nuestras teleasambleas, saben que esto es similar a un programa de entrevistas de radio y tendrán la oportunidad de hacer su pregunta en vivo.

Para aquellos de ustedes que se unan por teléfono, si desean hacer una pregunta, presionen * 3 en su teléfono para comunicarse con un miembro del personal de AARP, quien anotará su nombre y pregunta, y los colocará en una cola para hacer esa pregunta en vivo. Si desean escuchar en español, presionen * 0 en el teclado de su teléfono ahora y si se están uniendo a través de Facebook o YouTube, pueden publicar su pregunta en la sección de comentarios.

Hola, si acabas de unirte, soy Bill Walsh de AARP y quiero darte la bienvenida a esta importante discusión sobre la pandemia mundial de coronavirus. Estaremos hablando con expertos líderes hoy y respondiendo sus preguntas en vivo. Para hacer una pregunta, presiona * 3 en el teclado de tu teléfono y si te estás uniendo a través de Facebook o YouTube, puedes publicar tu pregunta en los comentarios.

Nos acompañan hoy Rekha Rapaka, M.D., Ph.D. Es profesora asistente de Medicina en el Centro para el Desarrollo de Vacunas en la División de Enfermedades Infecciosas de University of Maryland-Baltimore. Además, Mark Rupp, M.D. Es profesor en el Departamento de Medicina Interna y jefe de la División de Enfermedades Infecciosas del Centro Médico de University of Nebraska. También nos acompañará mi colega de AARP, Jean Setzfand, quien ayudará a facilitar sus llamadas hoy.

Este evento está siendo grabado y podrán acceder a la grabación en aarp.org/elcoronavirus, 24 horas después de que terminemos. Nuevamente, para hacer una pregunta, presionen * 3 en cualquier momento en el teclado de su teléfono para conectarse con un miembro del personal de AARP o si se unen a nosotros a través de Facebook o YouTube, coloquen su pregunta en los comentarios.

Ahora, me gustaría dar la bienvenida a nuestros primeros invitados. Rekha Rapaka, M.D., Ph.D. Es profesora asistente de Medicina en el Centro para el Desarrollo de Vacunas en la División de Enfermedades Infecciosas de University of Maryland-Baltimore. Allí, ha estado trabajando en ensayos clínicos de COVID-19 para vacunas y para terapias. Bienvenida, Dra. Rapaka.

Rekha Rapaka: Hola, muchas gracias por invitarme hoy.

Bill Walsh: Muy bien, gracias por estar con nosotros. También me gustaría dar la bienvenida a Mark Rupp, M.D. profesor en el Departamento de Medicina Interna y jefe de la División de Enfermedades Infecciosas del Centro Médico de University of Nebraska. También es el jefe de Personal del Centro Médico de Nebraska. Bienvenido, Dr. Rupp.

Mark Rupp: Gracias, Bill. Es un verdadero placer unirme al grupo hoy y un verdadero honor compartir el micrófono con la Dra. Rapaka.

Bill Walsh: Está bien. Estamos encantados de tenerlos a los dos. Y solo un recordatorio para nuestros oyentes, para hacer preguntas, presionen * 3 en el teclado de su teléfono en cualquier momento o escriban en la sección de comentarios en Facebook o YouTube.

Dra. Rapaka, comencemos con usted. Mientras que la mayoría de las personas están luchando por recibir una dosis de la vacuna, para aquellos que han podido obtenerla, ¿qué deben esperar? ¿Existe la posibilidad de que todavía puedan contraer y propagar COVID-19 después de recibir sus inyecciones? Y ¿necesitas una vacuna si ya has tenido COVID-19?

Rekha Rapaka: ¡Sí! Son muy buenas preguntas. Bueno, las vacunas han pasado por rigurosas pruebas y caracterizaciones en ensayos clínicos. Y ahora estamos en el punto en el que el 12% de las personas han recibido al menos una dosis de la vacuna Pfizer o Moderna. Entonces, tenemos mucha información sobre cómo se sienten las personas después de recibir la vacuna. Y como sabemos, la vacuna, una vez administrada, entrena al cuerpo para producir una respuesta inmunitaria. Para que nuestros cuerpos puedan combatir con éxito el virus, y estas vacunas son altamente efectivas con un 95% de eficacia.

Entonces, en cuanto a lo que uno podría esperar en cuanto a síntomas, pueden tener síntomas como dolor leve en el lugar de la inyección. A veces, las personas tienen síntomas de dolores musculares, fatiga, a veces pueden tener síntomas de fiebre o escalofríos. Es importante tener en cuenta que estos síntomas se han observado típicamente en una capacidad muy autolimitada. Por lo tanto, en la mayoría de las personas suelen resolverse en 24 a 48 horas.

Muchas personas tampoco presentan ningún síntoma, pero creo que todo es un signo normal de que el cuerpo está respondiendo inmunológicamente a la vacuna. Es importante recordar que esto no es COVID-19 en sí. Es imposible contraer COVID-19 de la vacuna. En cuanto a la segunda pregunta, si uno está vacunado, ¿aún puedes contraer y propagar COVID-19?

Bueno, en general con las infecciones, cuando reducimos una enfermedad sintomática como los síntomas de tos, estornudos, en el contexto de una infección, reducimos la propagación. Y la vacunación reducirá esto, sin embargo, con COVID-19, también sabemos que la infección puede propagarse en personas que no tienen ningún síntoma de infección en absoluto. Entonces, en realidad no sabemos la respuesta sobre si la propagación asintomática puede ocurrir en el contexto de la vacunación y es algo que estamos tratando de estudiar y comprender activamente con las vacunas actuales, así como con las futuras vacunas que estamos desarrollando.

Entonces, en este momento, dado que no sabemos la respuesta completa, recomendamos todas las precauciones que hemos estado tomando para realmente ampliar nuestra protección de salud pública contra esta infección. Por lo tanto, uso de mascarilla, distanciamiento social, evitar situaciones de lugares cerrados congestionados, son medidas que hemos estado tomando para prevenir infecciones, incluso si recibes la vacuna. Y luego, esta pregunta con respecto a si necesitas una vacuna si ya has tenido COVID-19... ¡sí!

Creemos que, esencialmente, la infección, cuando una persona contrae naturalmente COVID-19 y contrae la infección, proporciona algo de inmunidad. Pensamos que aproximadamente por tres meses, pero también sabemos que las personas pueden volver a infectarse con COVID-19, y creemos que la vacuna puede ayudar a prevenir eso. Por eso recomendamos la vacunación incluso si ya has tenido COVID-19.

Bill Walsh: Entendido. Entendido. Muchas gracias, Dra. Rapaka. Dr. Rupp, volvamos a usted. Entonces, como mencioné al principio, hemos superado las 500,000 muertes en este país. Supongo que, si hay alguna buena noticia, es que la tasa de hospitalizaciones y muertes está disminuyendo ahora. ¿Sabemos por qué es eso? ¿Qué está impulsando eso? ¿Es la distribución de la vacuna? ¿La gente está mejorando con el distanciamiento físico y el uso de mascarillas?

Mark Rupp: Bueno, Bill, ciertamente hemos superado ese hito realmente sombrío de 500,000 muertes y creo que, desafortunadamente, nos hemos vuelto algo insensibles a la magnitud de la pandemia, y es útil simplemente reflexionar sobre ese número y darse cuenta de que todas y cada una de esas personas eran la madre, el padre o el ser querido de alguien, alguien a quien realmente se extraña. Como mencionaste, nos complace que las tasas estén bajando, por lo que desde hace aproximadamente un mes o dos, cuando teníamos 300,000 casos nuevos por día en Estados Unidos, hemos bajado a alrededor de 75,000 aquí en los últimos días. Y eso es un gran progreso.

No entendemos completamente por qué estamos viendo todo eso, creo que parte de ello es el hecho de que hemos estado administrando algunas de las preparaciones de anticuerpos monoclonales que se ha demostrado que disminuyen las hospitalizaciones y las muertes. Del mismo modo, la vacuna es muy eficaz, y acabo de ver un informe ayer, que muestra esta sorprendente divergencia entre los residentes de hogares de ancianos, los residentes de centros de cuidados a largo plazo y la población en general, que realmente es completamente en respuesta a la vacunación.

Y entonces, realmente funcionan y eso es algo que debemos enfatizar a todos los oyentes de hoy, es que, tan pronto como puedas recibir la vacuna, haz fila y póntela. Y luego, sin duda, hay algunas influencias de las intervenciones no farmacológicas, como las llamamos. Dudo que estemos mejorando con eso y, en todo caso, creo que la gente probablemente está cansada de la pandemia y está relajando sus precauciones. No usan su mascarilla tanto como deberían, no evitan esos espacios cerrados abarrotados, y luego, probablemente haya algunas cosas sobre la dinámica viral que simplemente entendemos mal. Por qué la pandemia tiene altibajos es algo que todavía estamos estudiando.

Bill Walsh: Está bien. Entonces, una buena señal, pero tal vez no sea la señal de lo que vendrá. Dependiendo de cómo se desarrollen las cosas. Pasemos a la distribución de vacunas, Dr. Rupp. Estamos escuchando preguntas de adultos mayores que simplemente están desesperados por recibir la vacuna, pero están luchando con la tecnología o con los confusos sistemas de inscripción estatales y locales. Sé que no se puede hablar de los detalles, pero en términos generales, ¿qué pasos está viendo que toman los Gobiernos estatales y locales para mejorar esos sistemas y realmente vacunar a las personas?

Mark Rupp: Bueno, creo que, en general, la gente debe reconocer que se trata de una operación enorme y complicada, logísticamente complicada. Creo que, en general, los departamentos de salud pública han hecho un buen trabajo al implementar esto para la gente y creo que la otra cosa que la gente debe entender es que esto llegó en un momento en que todo el mundo estaba muy, muy estresado, ya. Por lo tanto, establecer estos programas al mismo tiempo que se intenta lidiar con la pandemia es una tarea tremendamente pesada, y probablemente no invertimos en los recursos, ya sabes, como dicen, “Reciban esa vacuna en la última milla”, como deberíamos haberlo hecho.

Ahora, claramente, las cosas están mejorando. Es frustrante ver que todos los diferentes estados y departamentos de salud locales tienen sus propios programas individuales, ya sabes, que están usando. Se está volviendo más fácil de navegar, creo que casi todos los departamentos de salud locales tienen un número de línea directa. Por lo tanto, si las personas tienen dificultades para maniobrar los sitios web, o carecen de la computadora, el enlace o el teléfono inteligente para acceder a los sitios web, pueden llamar a las líneas directas y asegurarse de ser atendidos. Entonces, nuevamente, creo que las cosas están mejorando. Estamos entre 1.5 y 2 millones de dosis al día, solo tenemos que seguir avanzando.

Bill Walsh: Gracias por esa actualización, tomaré su respuesta como una oportunidad para contarles a nuestros oyentes acerca de un recurso realmente importante que AARP ha creado, que son guías estado por estado sobre cómo hacer para recibir una vacuna en su estado. Y si puedes conectarte en línea, puedes encontrarlo en aarp.org/infovacuna. Y puedes simplemente consultar la información de tu estado y encontrar los números de teléfono gratuitos allí, incluso preguntas para hacer sobre las vacunas. Gracias, Dr. Rupp.

Dra. Rapaka, con un suministro limitado y un clima severo en todo el país, se han reprogramado muchas citas de vacunas, incluidas segundas citas. Sabemos que las vacunas Pfizer y Moderna requieren de 3 a 4 semanas entre dosis, ¿es preocupante si hay más tiempo entre dosis debido a problemas de distribución?

Rekha Rapaka: Bueno, tenemos los datos de los ensayos clínicos y nos esforzamos al máximo por las vacunas, y nos esforzamos lo más que podemos para igualar el intervalo recomendado. Entonces, con Moderna, el refuerzo llegará a las cuatro semanas, y con Pfizer, la segunda dosis o refuerzo llegará a las tres semanas. Sin embargo, es importante recordar que la segunda dosis es un refuerzo, y eso significa que es una inmunización que se realiza para mejorar la respuesta inmunitaria inicial que has tenido a la primera vacuna y hacerla más fuerte y mejor. Y entonces, obviamente, en el contexto de retrasos y emergencias, y condiciones climáticas donde la gente ha tenido retrasos, no podemos llegar a esa situación óptima y tenemos que hacer adaptaciones.

Y yo diría que, ya sabes, recibir esa vacuna de refuerzo una semana después, todavía va a tener beneficios y aún tendrá un aumento de la respuesta inmunitaria inicial. Entonces creo que es genial avanzar hacia lo que tenemos datos, pero sabemos que el cambio es solo en el orden de días y semanas. Creo que está bien recibir ese refuerzo más tarde, y saber que probablemente todavía estás mejorando esa respuesta inmunitaria. Entonces, en una emergencia, simplemente busca la siguiente dosis disponible tan pronto como puedas.

Bill Walsh: Está bien y ¿hay un punto sin retorno? Es decir, ¿hay un período en el que la dosis inicial simplemente se vuelve ineficaz?

Rekha Rapaka: Eso es desconocido en este momento, pero podemos usar nuestro conocimiento de otras vacunas y creo que en los plazos de los que estamos hablando para retrasos, no veo que en el rango de unas pocas semanas realmente cambie el juego. Entonces...

Bill Walsh: Dr. Rupp, ¿qué piensa de eso?

Mark Rupp: Sí, estoy completamente de acuerdo con lo que la Dra. Rapaka ha relatado y es que, ya sabes, la gente no debería preocuparse demasiado si tienen que retrasar un período breve entre su dosis inicial y su dosis de refuerzo, y de hecho, algunos países realmente han extendido ese período de tiempo, en un esfuerzo por tratar de que más personas tengan al menos esa primera vacuna. Entonces, yo quiero simplemente tranquilizar a la gente de que recibir esa segunda dosis un poco más tarde no va a interferir con su respuesta a la vacuna.

Bill Walsh: Está bien. Bueno, gracias a ambos por eso y como recordatorio a nuestros oyentes, para hacer su pregunta, por favor presionen * 3 en el teclado de su teléfono. Vamos a responder esas preguntas en breve, pero antes de hacerlo, quería traer a la vicepresidenta sénior de Participación Estatal y Comunitaria de AARP, Kristin Dillon. Bienvenida, Kristin.

Kristin Dillon: Gracias, Bill. Estoy feliz de estar aquí hoy.

Bill Walsh: Muy bien, estamos felices de tenerte. ¿Qué puedes decirnos acerca de lo que ha estado haciendo AARP para luchar por los adultos mayores que reciben las vacunas contra la COVID-19?

Kristin Dillon: Bueno, como han señalado otras personas, nos acercamos a un año de vivir bajo una pandemia global que nos ha afectado a todos. Los adultos mayores se han visto especialmente afectados. Más del 95% de las muertes se han producido entre personas de 50 años o más, y la pérdida de más de 160,000 vidas en hogares de ancianos es una tragedia nacional. Por lo tanto, las vacunas nos brindan una gran esperanza para finalmente poner fin a esta trágica pérdida de vidas, pero como han señalado otros, esa esperanza se ha visto atenuada por un proceso de distribución demasiado complicado y confuso.

Es por eso que AARP está luchando para que los adultos mayores sean priorizados y para que el proceso en línea sea más fácil. Para que puedan ir a un lugar para obtener información clara sobre cuándo, dónde y cómo registrarse para vacunarse, y reconociendo que no todos están en línea o que las personas pueden tener dificultades para navegar por los sistemas en línea, AARP también insta al Gobierno federal a trabajar con estados para establecer números 1-800 para programar citas para vacunas. Y que esos números 1-800 estén centralizados, bien dotados de personal y ofrezcan un servicio de atención al cliente cultural y seguro en varios idiomas.

Elogiamos las acciones que ha realizado la Administración de Biden para llevar más vacunas a los estados y ampliar nuestra disponibilidad de vacunas, para incluir más farmacias, centros de salud comunitarios y grandes sitios de vacunación como estadios deportivos en algunos estados. En todos los estados, el personal y los voluntarios de AARP luchan con los legisladores estatales para mejorar la transparencia y la presentación de informes sobre el lanzamiento de la vacuna contra la COVID-19. Entonces, entendemos, realmente, lo que está sucediendo.

El personal y los voluntarios comprometidos de 16 oficinas estatales de AARP también están participando en grupos de trabajo dirigidos por sus gobernadores y departamentos de salud estatales. Esto incluye estados como Idaho, Carolina del Norte, Tennessee, California y muchos otros. Estaremos presentes virtualmente en las capitales de todo el país para proteger la financiación de programas como servicios para personas mayores, atención domiciliaria y comunitaria, asistencia energética para personas de bajos ingresos y programas de asistencia laboral y de desempleo.

Y estamos trabajando con funcionarios estatales y locales para ayudar a brindar información fundamental a los adultos mayores sobre las vacunas. Dónde pueden acceder a ellas y qué deben hacer. También estamos ampliando nuestro esfuerzo para brindar a las personas mayores de 50 años información confiable sobre las vacunas. Por ejemplo, como mencionaste anteriormente, Bill, hemos publicado guías en línea para todos los estados, las Islas Vírgenes, Puerto Rico y D.C., que explican cómo obtener las vacunas donde vives. Puede encontrarlas en aarp.org/infovacuna, luego puedes encontrar tu estado y obtener la información que necesitas.

Las oficinas estatales de AARP también están organizando decenas de conversaciones locales como esta, cada semana, y los voluntarios están encontrando formas de controlar a otros para proporcionar información local sobre la vacuna. Por lo tanto, a medida que continúe el despliegue, continuaremos manteniendo la presión de nuestros líderes electos y continuaremos brindando información crítica a nuestros socios. Entonces, nuevamente, para mantenerse actualizados sobre todos estos esfuerzos y encontrar resúmenes de los planes estatales para la distribución de vacunas, visítennos en www.aarp.org/elcoronavirus.

Bill Walsh: Bien, muchas gracias por esa información, Kris. Agradezco la actualización. Ahora es el momento de abordar sus preguntas sobre el coronavirus con la Dra. Rekha Rapaka y el Dr. Mark Rupp. Como recordatorio, presionen * 3 en cualquier momento en el teclado de su teléfono para comunicarse con un miembro del personal de AARP para compartir su pregunta. Ahora es el momento de traer a mi colega de AARP, Jean Setzfand, quien ayudará a facilitar sus llamadas hoy. Bienvenida, Jean.

Jean Setzfand: Gracias, Bill, encantada de estar aquí.

Bill Walsh: Muy bien, ¿de quién es nuestra primera llamada?

Jean Setzfand: Nuestra primera llamada es de Violet de Nueva York.

Bill Walsh: Hola, Violet, bienvenida al programa. Continúa con tu pregunta.

Violet: Hice la pregunta antes sobre por qué cobran más que otras empresas. ¿Incluso los medicamentos o el otro? Yo tengo el otro. Nosotros lo pagamos. Y los demás, no tienen que hacerlo, simplemente las obtienen por nada. Y dental o lo que sea, hay que pagar y todo es gratis, pero tengo que pagar por todo.

Bill Walsh: Tengo entendido que has recibido tu primera vacuna. ¿Es así? ¿Tu primera vacuna contra la COVID-19?

Violet: Tengo la segunda y estoy enferma.

Bill Walsh: ¿Y estás enferma? Cuéntanos cómo te sientes.

Violet: Bueno, me siento muy somnolienta, muy débil. Tengo 85 años y estoy bien. No tengo enfermedades, pero me está afectando, esta. Solo quiero dormir, y me siento mareada, y no sé por qué.

Bill Walsh: Bueno, preguntemos a nuestros expertos sobre eso y veamos si pueden ofrecer algún consejo. Dra. Rapaka, hemos escuchado algunas pruebas anecdóticas sobre personas que se enferman más con la segunda dosis. ¿Puede hablar de eso? ¿Qué tipo de síntomas están experimentando las personas y qué deben hacer si tienen esos síntomas, como Violet?

Rekha Rapaka: Claro, y Violet, lamento que te sientas así. Sí, la segunda inmunización a menudo produce más síntomas en las personas que han recibido las vacunas. Por lo tanto, pueden tener algunas de los síntomas que estás experimentando, como mareos y malestar, y, ya sabes, síntomas como escalofríos, fiebre, cosas de esa naturaleza. Sin embargo, lo que hemos visto en la mayoría de las personas es que, a veces, tomarse un día para descansar, planificar un poco de descanso el día en que recibes esa segunda inyección ayuda, así que sabes qué esperar.

A veces la gente toma medicamentos de venta libre como Tylenol, si es algo que pueden tomar brevemente. O medicamentos como Advil, en cierto modo, atenúan algunos de esos síntomas como dolores musculares y cosas así, pero en la mayoría de los pacientes tiende a limitarse después de 24 a 48 horas. Entonces, ese período de tiempo puede ser realmente difícil e incómodo, pero creo que puedes estar segura de que no debería durar más y, obviamente, si hay cambios, es importante hablar con tu médico, pero ese ha sido el curso típico que hemos visto para las personas que tienen síntomas. Ese segundo refuerzo puede ser a veces cuando surgen.

Bill Walsh: Y para ser claros, hemos escuchado algunas preocupaciones de la gente, cuando ven estos efectos secundarios, piensan: “¡Dios mío! Estoy contrayendo COVID-19”. Que esta vacuna contiene el virus vivo, pero no es así, ¿verdad?

Rekha Rapaka: Exactamente, no es así. No hay forma de contraer COVID-19 de las preparaciones de la vacuna. Así que, aunque no te sientas bien, puedes sentirte como, “Oh, me estoy enfermando”, tengan la seguridad de que no es COVID-19.

Bill Walsh: Bien, gracias. Jean, ¿de quién es nuestra próxima llamada?

Jean Setzfand: Nuestra próxima llamada es de Peggy de Maryland.

Bill Walsh: Hola, Peggy. Bienvenida al programa, continúa con tu pregunta.

Peggy: Mi pregunta no es para mí, es para una de mis amigas que no pudo navegar en línea para registrarse para una cita, y ella es muy experta en tecnología. Entonces, no es que ella no sepa cómo hacerlo, pero dijo que cuando llegó a cierto punto, no podía ir más lejos. Y la razón por la que me preguntó es porque yo tenía el mismo problema, pero alguien más se registró por mí. Nunca pude hacerlo, se detiene y no recuerdo en qué momento fue eso, pero no te permite registrarte para una cita.

Bill Walsh: Entonces, ¿cuál es tu pregunta? ¿Cómo registrarse en el estado de Maryland?

Peggy: ¿Cómo lo haces? ¿Cómo puede hacerlo? Si, ​​sí, por teléfono.

Bill Walsh: Está bien, bueno, mientras hablábamos, nuestro excelente personal de AARP buscó el número gratuito de Maryland. Te lo daré, si tienes un bolígrafo y un papel.

Peggy: Está bien, estoy lista.

Bill Walsh: Muy bien, es 877-319-1525, 877-319-1525, y para nuestros otros oyentes, pueden buscar la información de su propio estado en aarp.org/infovacuna. Es muy fácil, solo busca tu estado, tendrás números gratuitos allí, tendrás sitios web que puedes visitar para obtener información y registrarte. También tendrás ejemplos de preguntas para hacer, así que espero que sea útil. Bien, bien, tomemos otra pregunta. Jean, ¿quién sigue?

Jean Setzfand: Nuestra próxima llamada es Janice de California.

Bill Walsh: Hola, Janice, bienvenida a nuestro programa. Continúa con tu pregunta.

Janice: Mi pregunta es, cuando estás esperando para tu cita, ¿debes tener algún tipo de prueba de que no tienes COVID-19 actualmente?

Bill Walsh: Esa es una pregunta interesante. Dr. Rupp, ¿puede manejar eso?

Mark Rupp: Sí, Janice, esa es una buena pregunta, y claramente las personas que están gravemente enfermas no deberían recibir la vacuna. Entonces, si tienes una enfermedad febril, si realmente te sientes mal, ya sabes, no deberías recibir la vacuna. Si tienes COVID-19, la recomendación es que superes la enfermedad inicial, y luego está bien proceder con la vacuna. Creemos que la enfermedad inicial tendría algún efecto protector y, por lo tanto, algunas personas están esperando un período antes de recibir la vacuna, pero si está disponible para ti y has superado ese período inicial de enfermedad, está perfectamente bien recibir esa primera vacuna.

Bill Walsh: ¿Y cuál cree que es ese período inicial? ¿Recomendaría que la gente espere los 14 días que escuchamos al principio?

Mark Rupp: Sí, deberían superar ese período inicial de enfermedad y su período de aislamiento, y luego, tan pronto como hayan superado ese período de aislamiento, son elegibles para recibir la vacuna. Nuevamente, creemos que hay un efecto protector, particularmente en los primeros dos o tres meses después de tener la enfermedad viral, la COVID-19 normal, pero nuevamente, si la vacuna está disponible para ti, probablemente sea mejor recibirla en ese momento, porque aún no sabemos cuáles serán los problemas logísticos más adelante.

Bill Walsh: Muy buen punto. Muy bien, muchas gracias. Jean, ¿de quién es nuestra próxima llamada?

Jean Setzfand: También tenemos algunas preguntas provenientes de Facebook y YouTube. Entonces, esta pregunta proviene de Jennifer en Facetube, lo siento, en Facebook. Y ella pregunta: "¿Necesitamos ponernos en cuarentena para visitar a mi familia, si tengo ambas inyecciones de vacunas? Si es así, ¿cuántos días antes de la visita?"

Bill Walsh: Muy bien, Dra. Rapaka, ¿puede responder esa pregunta sobre la cuarentena después de haber recibido la vacuna?

Rekha Rapaka: Bueno, esa es una pregunta muy interesante. Creo que va a afectar la forma en que mucha gente piensa últimamente después de recibir la vacuna. “¿Cuáles son las cosas que puedo hacer? Me han dicho que no puedo hacer ciertas cosas por un tiempo”. Sabes, yo diría que tal como está ahora, recibir la vacuna no cambia realmente muchos de los comportamientos que normalmente tendríamos con respecto a la cuarentena y eso es porque queremos que... El beneficio de la vacuna se produce en el entorno donde la mayoría de las personas ya sea han estado expuestas al virus y se han infectado y tienen una respuesta inmunitaria por eso o se hayan recibido una vacuna.

Queremos vacunar a una mayor parte de la población antes de comenzar a aliviar los aspectos que se relacionan con los cambios de comportamiento. Entonces, diría que en este momento, la vacunación no debería cambiar ninguna de las prácticas que planeamos usar para la cuarentena, tal como hacemos ahora. Creo que hasta ahí llegamos con la información. Creo que con el tiempo tendremos una reducción de ciertas restricciones, pero creo que, por ahora, la forma más segura es simplemente continuar con las medidas de salud pública que estamos aplicando, independientemente de la recepción de la vacuna.

Bill Walsh: Muy bien, muchas gracias. Oh, adelante, Dr. Rupp.

Mark Rupp: Sí. Ciertamente estoy de acuerdo con eso. Simplemente creo que una de las cosas frustrantes que las personas están experimentando es que reciben la vacuna, y luego no pueden cambiar inmediatamente su comportamiento y, como dijo la Dra. Rapaka, uno de los datos cruciales que seguimos observando es si las personas, después de haber sido vacunadas, pueden adquirir el virus y eliminarlo de forma asintomática.

Y hasta que tengamos esa información crucial, probablemente sea mejor que la gente continúe con esas intervenciones no farmacológicas de uso de mascarilla y distanciamiento, pero espero que en un futuro muy cercano tengamos información adicional y entonces podremos dar a las personas consejos más sólidos sobre cuándo pueden comenzar a disfrutar de la vida de nuevo. Quizás, no se preocupen tanto por ir a su restaurante y cena favoritos y sentir que están siendo protegidos. Sabes que la información que tenemos en este momento ciertamente apoya eso, pero solo necesitamos esperar un poco más. Entonces, suplicaría a todos los oyentes que nos den un poco más de tiempo. Continúen con esas intervenciones no farmacológicas y superemos esta pandemia juntos.

Bill Walsh: De acuerdo, gracias, y como recordatorio para nuestros oyentes, si deseas hacer una pregunta, presiona * 3 en el teclado de tu teléfono. Jean, tomemos otra pregunta.

Jean Setzfand: Nuestra próxima llamada es Eileen de Carolina del Sur.

Bill Walsh: Hola, Eileen, sigue adelante con tu pregunta.

Eileen: Bien, ahora, busqué esto en línea y traté de encontrar respuestas y no hay nada que lo resuelva. Y tengo Lupus y Sjögren, que es una enfermedad autoinmunitaria, y estoy tomando prednisona para eso, lo que para mí sería inhibir mi sistema inmunitario. ¿Cómo va a lidiar eso con tomar la vacuna? He recibido la primera, es Pfizer, tengo que recibir la segunda mañana, pero luego comencé a leer que si tienes enfermedades autoinmunes y tomas medicamentos, puede afectarla, si funciona o no.

Bill Walsh: Bueno, preguntemos a nuestros expertos sobre eso. Dra. Rapaka, ¿quiere opinar sobre eso?

Rekha Rapaka: Sí, claro. Es una muy buena pregunta. Bueno, los ensayos clínicos para las vacunas no investigaron específicamente, diferentes grupos, por ejemplo, individuos con enfermedades autoinmunitarias y cómo reaccionaron a las vacunas. Sin embargo, son un grupo muy importante de pacientes que obtendrían potenciales beneficios de las vacunas porque en el contexto de Sjögren, o tomando medicamentos inmunosupresores, hay una respuesta inmunitaria más baja, más débil, en general, a veces a infecciones y puede haber mayores riesgos de contraer esa infección.

Entonces, en cierto modo, veo a alguien como tú como una persona que sería una prioridad para recibir la vacuna y llevarla a cabo, y es maravilloso que hayas recibido tu primera inyección, y creo que, recibir esa vacuna de refuerzo solo hará que la respuesta inmunitaria que ya has formado sea un poco más fuerte. Y entonces, te aconsejo, como de costumbre, como animaríamos a todas las personas que reciben la vacuna, a que, por supuesto, controlen su respuesta.

Fíjate cómo estás, cómo te sientes, controlando eso con mucho cuidado, pero sí, creo que quiero enviarte un poco de seguridad de que ha habido otras personas, también pacientes con otras enfermedades inmunitarias han recibido la vacuna ya, y muchos millones de personas en el país la han recibido. Entonces, también ten en cuenta que estamos recopilando información mientras hablamos sobre cómo se desarrollará para las personas con diferentes problemas médicos. Tendremos mucha más información, pero sí, es genial que continúes adelante con el refuerzo.

Bill Walsh: Sé que el protocolo ha sido monitorear a las personas durante 15 o 30 minutos después de las inyecciones para detectar cualquier reacción alérgica. ¿Existe algún protocolo similar para las personas en la situación de Eileen? ¿Personas que ya tienen una enfermedad autoinmune?

Rekha Rapaka: No, no. La cuestión es que, para las personas con enfermedades autoinmunes, no esperamos ningún tipo de reacción inmediata después de la vacunación. En todo caso, en realidad, existe la preocupación de que puedan tener una respuesta inmunitaria más baja a la vacuna debido a los medicamentos inmunosupresores que están tomando. Entonces, por lo general, no tenemos ningún monitoreo especial para eso.

Bill Walsh: Está bien. Gracias por la aclaración. Jean, ¿de quién es nuestra próxima llamada?

Jean Setzfand: Tenemos otra pregunta proveniente de YouTube y esta proviene de Larry. Larry pregunta: "Tuve COVID-19 en julio pasado y acabo de recibir la primera dosis hace una semana. Tengo fiebre, escalofríos y fatiga durante 24 horas. ¿Tener COVID-19 ya cuenta lo mismo que tener la primera dosis?"

Bill Walsh: Dr. Rupp, ¿quiere responder a eso?

Mark Rupp: Claro. La enfermedad inicial que tuvo Larry, probablemente preparó su sistema inmunitario y, por lo tanto, tuvo un buen efecto de refuerzo con la primera dosis de su vacuna, y de hecho tenemos algunos datos tranquilizadores y datos muy alentadores que las personas que han tenido COVID-19 y luego recibieron la vacuna, obtienen un efecto de refuerzo muy bueno de ella. Parece que los síntomas que tenía Larry eran relativamente leves, relativamente autolimitados, y le animaría a seguir adelante y terminar el curso de su inmunización y recibir la segunda dosis.

Bill Walsh: Bien, gracias por eso y gracias por todas sus preguntas. Pronto responderemos más preguntas. Y solo como recordatorio, para hacer una pregunta, presiona * 3 en el teclado de tu teléfono. Volvamos a nuestros expertos. Dra. Rapaka, la COVID-19, ha tenido un costo absolutamente devastador para las personas de color. También sabemos que existen problemas históricos de confianza entre la comunidad médica y los afroamericanos, en particular. La distribución de la vacuna no parece estar abordando esto de manera efectiva. Por ejemplo, el 5% del suministro limitado de vacunas se ha destinado a los afroamericanos. ¿Qué está impulsando esto y qué se está haciendo al respecto?

Rekha Rapaka: Esa es una pregunta muy importante. Los afroamericanos tienen tasas más altas de desarrollar COVID-19, altas tasas de muerte por COVID-19. Por lo tanto, la vacunación es una herramienta fundamental que debemos utilizar para limitar la propagación de esta terrible enfermedad y quiero que la gente sepa que los ensayos clínicos de las vacunas contra la COVID-19 fueron diseñados para reclutar una población realmente diversa. Entonces, la gente sintió que, ya sabes, estaban representados en los ensayos y confiarían en la seguridad y eficacia de la vacuna.

Entonces, en estos ensayos se incluyeron personas como ellos y de todos los orígenes. Entonces, parte de la razón por la cual los números están donde están es que, creo que es realmente multifactorial. Pero diría algunas cosas. Uno, es que creo que el proceso de distribución como muchos de los oyentes han estado describiendo, y todos sabemos, está fragmentado y dificulta el acceso a las vacunas. Por ejemplo, en algunos estados, tener un médico de atención primaria te conectará más fácilmente con la distribución de vacunas. Y sabemos que es menos probable que muchos negros y otros miembros de comunidades minoritarias tengan médicos de atención primaria. Entonces, eso puede ser una limitación.

A veces, las clínicas de vacunación se establecen en vecindarios predominantemente negros para aumentar la aceptación y eliminar las barreras y aumentar las tasas de vacunación, pero desafortunadamente, a veces se ha visto que muchas de las citas están ocupadas por personas de fuera de esos vecindarios debido a que la forma en que esos espacios que se asignan a menudo implican el registro por computadora y una especie de proceso por orden de llegada.

Y creo, en tercer lugar, que ciertamente hay vacilación hacia las vacunas que puede deberse a la desconfianza en la comunidad negra, relacionada con el racismo estructural que se ha experimentado y los desafíos que los sistemas de salud han presentado con las inequidades que los afroamericanos han enfrentado. Entonces, creo que estos problemas preparan el escenario para esto, y creo que nosotros, como grupo, tenemos que estar muy conscientes y también trabajar para cambiarlo. Y, sabes, creo que es una especie de esfuerzo colectivo de grupo. Necesitamos liderazgo para hablar sobre este problema. Entonces, por ejemplo, creo que muchos de ustedes vieron que la vicepresidenta Kamala Harris ha estado hablando y alentando la vacunación. Entonces, mucho liderazgo desde ese ángulo.

Sabemos que necesitamos mucha interconexión con el Gobierno, y ya saben, las entidades que están involucradas en tratar de ayudar: los CDC, los NIH. Vi que hay un grupo llamado Black Doctors, Covid Consortium, que está trabajando en diálogos, reuniones de Zoom con individuos como el Dr. Fauci para hablar sobre barreras y vacilaciones. Y creo que, simplemente crear mejores estrategias a nivel comunitario para la distribución, la comunidad vulnerable es muy importante. Entonces, cosas como grupos de base e iglesias que estén más involucradas. Creo que tenemos que ser más innovadores en cómo llegamos a diferentes grupos de personas con estas vacunas.

Bill Walsh: Está bien, claro. Gracias, Dra. Rapaka.

Mark Rupp: ¿Puedo agregar otra cosa?

Bill Walsh: Oh, claro, adelante. Adelante.

Mark Rupp: Y creo que una de las razones por las que estamos viendo dudas sobre las vacunas también se debe a la información errónea que es, ya sabes, de fácil acceso en la web. Si la gente va a sitios no confiables para obtener información. Por lo tanto, felicitaría a AARP y otras organizaciones como esa por servir realmente como un portal a información confiable. Por llegar a la información de los CDC y la FDA, la OMS, y aprender realmente sobre la vacuna, y esa es una de las formas importantes en que podemos combatir esta información errónea que existe.

Bill Walsh: Ese es un gran punto y para nuestros oyentes, nuestro sitio es aarp.org/elcoronavirus y estamos haciendo una gran cantidad de verificación de hechos, solo estamos usando fuentes primarias y reportando información. Entonces, tenemos mucha información muy creíble allí. Dr. Rupp, hablemos un poco sobre mascarillas. Un estudio reciente de los CDC mostró que una sola mascarilla bloqueaba entre el 42 y el 44% de las partículas. Sin embargo, cuando se usó una mascarilla de tela sobre una mascarilla quirúrgica, aproximadamente el 90% de las partículas de tos se bloquearon. Entonces, ¿es efectiva una sola mascarilla? ¿Deberíamos llevar dos mascarillas en este momento?

Mark Rupp: Sí, Bill. Bueno, una de las cosas que hemos aprendido durante el transcurso de la pandemia es que usar una mascarilla es un ingrediente importante en la receta general para combatir esta pandemia. Eso y asegurarse de mantener la distancia y evitar espacios cerrados compartidos. La eficacia de cualquier mascarilla dependerá de su composición y de la capacidad de filtrado de ese material, y de qué tanto se ajuste a la cara. Y, francamente, creo que estaríamos mucho mejor si todos, y me refiero a todos, usaran una cubierta facial bien construida, bien fabricada y ajustada cada vez que estuvieran en público, en lugar de que haya personas que se preocupen por “Vaya, ¿Debería conseguir un N95 o usar dos mascarillas?” Y luego tener a otras personas sin hacer nada.

Estaríamos mucho mejor si todos demostraran esa responsabilidad social, usaran una mascarilla cuando estén en público y luego se aseguraran de que esté bien construida y ajustada. Ahora, como mencionaste, ahora hay buenos datos que sugieren que si tienes una mascarilla de procedimiento y encima de ella estás usando algo que te ayude a ajustarse más a tu cara, obtienes una mejor filtración. Entonces, si estás usando una mascarilla que tiene muchos espacios en las mejillas o alrededor de la nariz, entonces puede ser mejor tener algo que ayude a sujetarla a la cara. Entonces, existen dispositivos que ayudan a hacer eso, a sujetarla con más fuerza a la cara, pero nuevamente, una cubierta facial de tela multicapa bien construida y ajustada realmente funcionará bastante bien.

Bill Walsh: Está bien. Gracias a ambos. Vamos a volver a nuestros oyentes y responder más preguntas para la Dra. Rekha Rapaka y el Dr. Mark Rupp. Y como recordatorio, presiona * 3 en cualquier momento en el teclado de tu teléfono para conectarte con un miembro del personal de AARP y entrar en la lista de preguntas. Jean, ¿a quién tenemos en línea ahora?

Jean Setzfand: Nuestra próxima llamada es Mary, de Nueva York.

Bill Walsh: Hola, Mary, bienvenida al programa. Continúa con tu pregunta.

Mary: Muy bien, me gustaría saber, estoy confinada en casa, y estaba hablando con alguien, y esperaban que eventualmente para las personas confinadas permitirían que alguien entrara a la casa. Una enfermera o alguien, y darles la vacuna a esos pacientes en casa porque es muy difícil para mí salir, especialmente en Nueva York, tenemos terribles tormentas de nieve cada semana. Entonces, ha sido muy difícil para mí salir. Me preguntaba si eventualmente planean hacer eso.

Bill Walsh: Esa es una buena pregunta, Mary. Dr. Rupp, ¿quiere abordar eso? Me pregunto si la vacuna candidata - J y J con una sola dosis ayudará a personas como Mary, que están confinadas en casa.

Mark Rupp: Bueno, absolutamente. Tiene el potencial de hacerlo. La vacuna de Johnson y Johnson no es tan débil para el medio ambiente, por así decirlo. Entonces, puede mantenerse estable durante un período de tiempo más largo. No es necesario mantenerla en esas estrictas condiciones de congelación, por lo que puede facilitar un poco la administración de dosis a personas como Mary que no pueden ir a los centros de vacunación. Y realmente es una de esas cosas frustrantes que tenemos un sistema fragmentario, cada estado es diferente.

Cada localidad de salud pública dentro de un estado también puede ser diferente. Lo que estoy escuchando es que la mayoría de los lugares están comenzando, tienen programas o están comenzando a desarrollar programas en los que la gente podrá ir a las casas de la gente para aquellas personas que realmente no pueden ingresar a las clínicas de vacunas. Una vez más, sé que AARP tiene su sitio web, tiene la información de cómo la gente puede acceder a los sistemas y le pido a Mary que vaya al sitio web o llame a la línea directa y pregunte qué hay organizado para los residentes de Nueva York.

Bill Walsh: Gracias, Dr. Rupp, y Mary, quería darte el número gratuito en Nueva York para la línea de ayuda si no lo tienes. Es 833-697-4821. Muy bien, Jean, ¿de quién es nuestra próxima llamada?

Jean Setzfand: Tenemos otra pregunta proveniente de YouTube, y esta proviene de Edward. Edward pregunta: “He recibido dos inyecciones de la vacuna Moderna contra la COVID-19. Una vez que la vacuna J y J esté disponibles en todas partes, también la quiero. ¿Hay alguna razón para no hacer esto? ¿Hay alguna razón para hacerlo?”

Bill Walsh: Pregunta interesante. Dra. Rapaka, ¿tiene alguna idea al respecto?

Rekha Rapaka: Sí. Bueno, es una pregunta interesante. Diría que te beneficiará mucho lo que ya has recibido. La vacuna Moderna tiene una eficacia realmente excelente y si has completado ese curso, probablemente hayas logrado ese nivel de eficacia y protección y la vacuna J y J, sería simplemente un refuerzo, que serviría como una vacuna de refuerzo, esencialmente, que realmente no necesitas. No le dará ningún beneficio adicional. ¿Sabes?

A medida que aprendemos, puede ser el caso, mientras atravesamos esta pandemia, es posible que necesitemos dar refuerzos adicionales más adelante, pero creo que, por ahora, puedes mantenerte firme y no optar por la vacuna J y J cuando esté disponible porque no agregará nada adicional a tu situación en cuanto a protección contra la COVID-19.

Bill Walsh: Bien y para ser claro, lo que estás diciendo es que no necesitas recibir la J y J si ya has recibido otras vacunas.

Rekha Rapaka: Exactamente.

Bill Walsh: Correcto. Bueno. Jean, ¿de quién es nuestra próxima llamada?

Jean Setzfand: Nuestra próxima llamada es Mary de Misuri.

Bill Walsh: Hola, Mary. Bienvenida al programa, continúa con tu pregunta. ¿Hola Mary?

Mary: Sí, mi pregunta es, tengo 69 años, tengo EPOC, tengo EM, tengo presión arterial alta. Me he registrado en todos los sitios disponibles en mi área y cuando llamo para verificar cómo programar una cita, dicen que solo toman desde 85 años y obesos. Me pregunto cuándo llegarán a mí, o cómo puedo asegurarme de que realmente me hayan registrado.

Bill Walsh: Y ellos, cuando los llamas, ¿te dan alguna información sobre cuándo las personas de otras edades podrán recibir la vacuna?

Mary: Solo dicen que ahora, solo dicen 85 años y obesidad es todo lo que están haciendo ahora. Y entonces, pregunto, “¿Qué? ¿Tienes algún programa con plazos para saber cuándo?” Debido a que anunciaron en nuestras noticias locales, mayores de 65 años con problemas pulmonares y, como tengo EPOC, pensé que eso me incluiría, pero cuando llamo, simplemente dicen: “No, 85 y obesidad es todo lo que hacemos ahora”.

Bill Walsh: Está bien. Gracias por eso, Mary. Me pregunto si Dr. Rupp, estoy seguro de que no está familiarizado con todos los protocolos en Misuri, pero ¿puede hablar en general sobre lo que las personas deben hacer si parecen cumplir con las pautas de elegibilidad pero no han podido programar la cita todavía?

Mark Rupp: Bueno, creo que, en primer lugar, Mary está en lo correcto al estar preocupada por la gravedad que podría tener la COVID-19 en su situación particular. Con su enfermedad pulmonar subyacente, su edad y la hipertensión, estos son una serie de factores de riesgo que tiene para una enfermedad más grave. Así que, en primer lugar, felicitaría a Mary por estar al tanto de esas cosas y tratar de asegurarse de que tan pronto como la vacuna esté disponible para ella, la aproveche. Y parece que está tratando de hacer todo lo que puede para ponerse en fila.

Una de las cosas frustrantes es que la gente escucha estos informes contradictorios como “Toda persona que tenga más de 65 años, estamos listos para ti” y tratan de acceder a la vacuna, solo para que les digan: “No, realmente no tenemos esas dosis disponibles”. Sabes, es diferente en cada localidad, es diferente en cada estado. Esa es una de las cosas frustrantes. Una vez más, AARP está tratando de desempeñar un papel de intermediario realmente bueno, aclarando reglas y tratando de que las personas se enganchen a esos sistemas para que puedan registrarse. No sé cuál es la situación en su localidad de Misuri, pero nuevamente, la animaría a que sea persistente. Que continúe registrándose en línea y llamando a esos números, y tan pronto como esté disponible para ella, que aproveche.

Bill Walsh: Bien, gracias, y Mary, no sé a qué línea has estado llamando, pero déjame darte el número gratuito allí, en Misuri, para la línea directa de servicios de salud y personas mayores del estado, ese número es 800-435-8411, 800-435-8411. Y eso es para Misuri. Muy bien, Jean. Tomemos otra llamada.

Jean Setzfand: Nuestra próxima llamada es Sonia de California.

Bill Walsh: Hola, Sonia. Bienvenida, y continúa con tu pregunta.

Sonia: Sí, gracias. Me preguntaba, para la vacuna Moderna, dijeron que tiene un 94.1% de efectividad, creo, pero dijeron que para las personas de 65 años o más, es solo 86.4. Entonces, ¿eso significa que el 13.6% de las personas no estarán protegidas en absoluto?

Bill Walsh: Preguntémosle a la Dra. Rapaka. Dr. Rapaka, ha habido mucha confusión sobre lo que significan estas tasas de eficacia. ¿Puedes hablar un poco sobre eso?

Rekha Rapaka: Sí, la medición de la eficacia de la vacuna consiste básicamente en mirar el porcentaje de reducción de COVID-19 en un grupo vacunado y compararlo con el grupo no vacunado. Y a la pregunta de Sonia, está mirando la eficacia en personas mayores, en comparación con los grupos más jóvenes que fueron vacunados. Y, es cierto que la eficacia es ligeramente menor, como se ve en personas mayores, pero no creo que esté en el rango en el que deberíamos estar muy preocupados por una diferencia significativa.

Es del orden del 10% y las mediciones de eficacia están un poco complicadas. Yo diría que una cosa aparte es que, por lo general, las personas mayores tienden a tener en respuesta a diferentes vacunas, a veces tienden a tener una respuesta inmunitaria más débil y eso es solo porque a medida que envejecemos, nuestro sistema inmunitario se debilita un poco. Entonces, esa es una de las razones por las que en estos ensayos clínicos trabajamos arduamente para tener una idea de cómo podría reaccionar una persona mayor a la vacuna en comparación con una persona más joven y qué porcentaje de eficacia podríamos ver.

Entonces, es cierto que existe una pequeña diferencia en la eficacia. La vacuna Pfizer es bastante similar. Entonces, diría que, en general, hay una pequeña diferencia, pero no es algo que debería preocupar a nadie, como, ya sabes, “Oh, no va a funcionar para mí, voy a renunciar a recibir esta vacuna”. Para darle contexto, también, cuando piensas en las vacunas en general, el índice de eficacia de la vacuna contra la influenza tiende a estar alrededor del 40-60%, a veces en un año determinado, puede ser un poco más alto, pero eso es con lo que a menudo estamos trabajando. Entonces, cuando estamos en los números del 70%, 80%, 90%, creo que me sentiría muy segura de que la respuesta inmunitaria que estás recibiendo de la vacuna es algo que te ayudará a protegerte.

Bill Walsh: Bien, gracias por eso, Dra. Rapaka. Jean, ¿quién es nuestro próximo...? Oh, adelante, Dr., ¿desea agregar algo más?

Mark Rupp: Sí, y como sabes, lo hemos mencionado, estoy completamente de acuerdo con lo que acaba de decir la Dra. Rapaka, pero también quiero asegurarle a Sonia que los datos son muy, muy tranquilizadores. Que incluso si las personas contraen COVID-19 después de la vacunación, las vacunas han sido casi 100% efectivas para prevenir las manifestaciones más graves de la enfermedad, como hospitalización y muerte. Entonces, incluso si ella tuviera COVID-19, es muy probable que aún sería muy protectora contra su progreso y la necesidad de ser hospitalizada, o incluso morir a causa de la afección. Entonces, esos datos son muy, muy tranquilizadores y apoyan la vacunación.

Bill Walsh: Gran punto, Dr. Rupp. Gracias por eso. Jean, tomemos otra llamada.

Jean Setzfand: Nuestra próxima llamada es Joan de Pensilvania.

Bill Walsh: Hola, Joan, bienvenida al programa. Continúa con tu pregunta.

Joan: Sí, buenas tardes. Mi preocupación y pregunta son para aquellos de nosotros que estamos en el grupo de edad entre 65 y 75 años. Todavía no he podido conseguir una cita aquí en Pensilvania, pero ¿qué piensan acerca de que las personas de este grupo de edad estén más expuestas a contraer una de las variantes de COVID-19? Leí un poco, ya sabes, la lectura correcta de que era una preocupación en las próximas 3-4 semanas.

Bill Walsh: Pregunta interesante. Dr. Rupp, ¿puede abordar eso?

Mark Rupp: Sí, Joan. En primer lugar, tienes toda la razón en que la edad es realmente la fuerza impulsora de la morbilidad y la mortalidad como el factor de riesgo más importante que hemos identificado. Entonces, al estar en ese grupo de edad, de 65 a 75 años, te alentaría a que tan pronto como puedas te asegures de aprovechar la disponibilidad de la vacuna. Uno de los factores impredecibles en este momento es con respecto a las variantes, como mencionaste, y si comenzarán a ganar fuerza en Estados Unidos y realmente comenzarán a extenderse. Sabes, eso es algo desconocido en este momento, pero los datos sugieren que algunas de estas variantes pueden ser más transmisibles, e incluso hay un poco de datos que sugieren que pueden ser más virulentas o más peligrosas, y sabes, pueden tener alguna capacidad para evadir las defensas que obtenemos de las vacunas. Entonces, estos son de gran preocupación.

Tendremos que mantener los ojos bien abiertos y realmente observar los datos para ver qué está pasando. Y es por eso que es tan increíblemente importante en este momento, que a pesar de que los números están disminuyendo, la gente continúe usando esas intervenciones no farmacológicas. Usar mascarillas, mantener el distanciamiento, evitar los espacios cerrados compartidos hasta que podamos conseguir que la vacuna se distribuya más ampliamente en la comunidad, incluso el grupo de edad que representas y luego, ya sabes, tener esta pandemia bajo el mayor control posible. Entonces, todos tenemos que trabajar juntos para obtener la vacuna y también continuar practicando aquellas cosas que sabemos que ayudarán a prevenir la transmisión.

Bill Walsh: Bien, muchas gracias por eso, y estamos llegando al final de la hora. Dra. Rapaka y Dr. Rupp. Me pregunto si tienen algún pensamiento o recomendación final que nuestros oyentes deberían entender más de nuestra conversación de hoy. Dra. Rapaka, ¿por qué no empezamos por usted?

Rekha Rapaka: Sí. Solo quiero que todos realmente aprovechen las herramientas. Sé que es difícil y desafiante en este momento con la fragmentación y el acceso a las vacunas, pero cuando puedas obtener una, creo que recibir esa vacuna ayudará a evitar que contraigas COVID-19 y nos ayudará a bajar estos números y pasar a una situación mejor. Entonces, gracias por hacer su parte y ayudarse a sí mismos y a los demás.

Bill Walsh: Está bien. Gracias por eso, Dra. Rapaka. Dr. Rupp, ¿algún pensamiento o recomendación para el cierre?

Mark Rupp: Claro. Ha sido un verdadero honor para mí participar en las presentaciones y la charla de hoy. Y vaya, vaya, ha sido un año largo para todos. Sé que todos estamos cansados ​​de esta pandemia, pero, ya sabes, estamos viendo la luz al final del túnel, pero el problema es que todavía estamos en el túnel y simplemente nos falta un poco más de tiempo. Así que, como dije, hace poco, ya sabes, sigue usando mascarilla, mantén el distanciamiento, evita los espacios cerrados compartidos, ponte la vacuna tan pronto como puedas. Y si todos trabajamos juntos en esto, llegaremos a ese lugar mejor, de aquí a unos meses más, donde espero que podamos abrir la sociedad, ya sabes, volver a ir al teatro e ir a los restaurantes, y hacer todas esas cosas con nuestra familia y nuestros seres queridos que tanto anhelamos.

Bill Walsh: Bien, y gracias a nuestros dos expertos por responder a nuestras preguntas. Esta ha sido una discusión realmente informativa, y gracias a nuestros socios, voluntarios y oyentes de AARP por participar en la discusión de hoy.

AARP, una organización de membresía sin fines de lucro y no partidista, ha estado trabajando para promover la salud y el bienestar de los adultos mayores durante más de 60 años. Frente a esta crisis, estamos brindando información y recursos para ayudar a los adultos mayores y a quienes los cuidan a protegerse del virus, prevenir su propagación a otros mientras se cuidan.

Todos los recursos a los que se hizo referencia hoy, incluida una grabación del evento de preguntas y respuestas, se podrán encontrar en aarp.org/elcoronavirus, a partir de mañana 26 de febrero. Nuevamente, esa dirección web es aarp.org/elcoronavirus. Ve allí si tu pregunta no fue respondida y encontrarás las últimas actualizaciones, así como información creada específicamente para adultos mayores y cuidadores familiares.

Esperamos que hayas aprendido algo que pueda ayudarte a ti y a tus seres queridos a mantenerse a salvo. Sintoniza el 11 de marzo para ver dos eventos en vivo. El primero a la 1:00 p.m., hora del este. Discutiremos lo último sobre la COVID-19 y las vacunas. Y a las 7:00 p.m., hora del este, hablaremos sobre los impuestos y tus finanzas. Muchas gracias por participar y que tengan un gran día. Con esto concluye nuestra llamada.