AARP Coronavirus Tele-Town Hall: September 23, 2021

TTH 092321 7 PM – Delta Variant, Boosters, and Self-Care

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.

(Española)

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. Eighteen months into the COVID-19 pandemic, the delta variant continues to stoke fear and uncertainty across the country. COVID-related deaths are once again trending upward as Americans continue to argue over the seriousness of the threat and how to address it. Meanwhile, a new COVID variant is on the horizon, and the nation is heading into flu season. It was against this backdrop that the Food and Drug Administration this week recommended a booster shot for people 65 and older, but the FDA’s long-anticipated announcement seemed to raise as many questions as it answered.

Today, we’ll hear from an impressive panel of experts about these issues and more. If you’ve participated in one of our tele-town halls, you know this is similar to a radio talk show, and you have the opportunity to ask your questions live. For those of you joining us on the phone, if you’d like to ask a question about the coronavirus pandemic, press *3 on your telephone keypad 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’re joining on Facebook or YouTube, you can post your question in the comments.

We have a couple of outstanding guests joining us today, including an infectious disease expert and a wellness and healthy aging expert. We’ll also be joined by my AARP colleague Kevin Craiglow, 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.

Now I’d like to welcome our guests. First, we have Steven C. Johnson, M.D., a professor of medicine in the Division of Infectious Diseases at the University of Colorado School of Medicine and Anschutz Medical Campus Multi-Disciplinary Center on Aging. Welcome back to the program, Dr. Johnson.

Steven Johnson: Thanks for having me.

Bill Walsh: All right, we’re delighted to have you with us. We’re also joined by Jane Strommen, Ph.D., a gerontology specialist at the North Dakota State University Extension. Welcome back to the program, Dr. Strommen.

Jane Strommen: Thank you. Glad to be here.

Bill Walsh: We’re glad to have you. Let’s get started. Dr. Johnson, last week the Food and Drug Administration recommended emergency use authorization for a booster dose of the Pfizer vaccine for those at high risk or age 65 and older. Now it was anticipated the booster would be approved for more widespread availability. How did they come to this decision?

Steven Johnson: Yeah, it’s a good question. I think the initial question that the FDA tackled with is whether to authorize a booster for everybody over age 16, but I think the concern was is that we don’t have a complete set of data, especially for younger, healthy individuals. So they went with a more conservative recommendation that included individuals 65 and older, and then younger individuals that have risks for severe COVID-19. And the FDA also included, recommended that individuals that have institutional or occupational exposure also get a booster shot although the CDCs Advisory Committee that met today has given somewhat different recommendations.

Bill Walsh: So with these different recommendations, where does that leave us?

Steven Johnson: Well, I think that what happened today is that the CDC’s Advisory Committee met, and they agreed with two of the FDA recommendations; the 65 and older and the 18 to 64 with underlying medical conditions. And the one area of difference was whether individuals that have a higher exposure based on occupation, like health care workers, would be candidates. It’ll be interesting because you know the FDA is what provides the authorization, and then the Advisory Committee is kind of the guidebook. So how this settles out, I actually can’t predict, and we’ll have to see over the next few days how this sorts out and who kind of wins.

Bill Walsh: I wonder if boosters for other COVID-19 vaccines become more widely available at some point. When do you expect that’s going to happen?

Steven Johnson: I expect that to happen in the next weeks to a month or two. You know, the Pfizer vaccine has kind of been ahead of the Moderna and the Johnson & Johnson vaccine just in development, you know, kind of the first to get the studies out, the first to get an emergency use authorization, the first to get FDA approval. And I think it just takes time for the FDA to kind of process the data, But I know that Moderna has submitted information on their boosters. And we also recently saw some information on the second dose of the Johnson & Johnson vaccine. So I think this will happen. My prediction is weeks to a month or two at the greatest. I think there’s a lot of pressure to get advice out about boosters for all of the individuals that got the Moderna and Johnson & Johnson vaccines.

Bill Walsh: One more follow-up question for you, Dr. Johnson. CDC model suggests that COVID hospital admissions will decrease in the next month for the first time since June 23rd. Has the delta variant run its course, and how concerned are you about the new mu variant?

Steven Johnson: So I think there are some signs kind of nationally that the number of cases is declining due to delta. Incidentally, virtually all infections in the United States right now are due to delta as the predominant variant. In saying that though, you know, different states or regions have seen the surges occur at different times. So what may happen on kind of a national scale, you may not see that in regional areas. And so, one prediction might be that the delta variant infections go down in the South, but they may surge in kind of northern areas where indoor activities start to predominate and so on. I don’t know much about the mu variant. It is a variant of interest, and we’ll have to see. It’s not a significant cause of infections right now, but of course we’ve, over the last year and a half, we’ve had alpha and beta and gamma and all of these different variants. So I think there’s a really kind of elegant approach to kind of track these variants. And we’ll just have to see over the next couple of months whether new variants, including mu, are significant.

Bill Walsh: Well, and it’s going to be interesting to see how effective the vaccines are against it as well.

Steven Johnson: I mean, so far, the three vaccines seem to do well with the delta variant — some decline in activity, but still effective, especially against severe disease. And we think actually boosters of the original vaccines will be helpful to further control the delta outbreak.

Bill Walsh: Thanks for that, Dr. Johnson. Dr. Strommen, let’s turn to you. We’re still seeing many Americans refusing to get vaccinated against COVID-19. You know, it’s an issue that’s divided the country and, in some families as well. How do we talk with family members who have declined the vaccine? Are there strategies you think are effective at convincing somebody to get vaccinated?

Jane Strommen: I do think there are a number of strategies that we can use. And the first one I would just say is start by listening. There might be many reasons why people might be hesitant to get the COVID-19 vaccines, but one of the reasons often cited is that the vaccines were developed very quickly. So it’s important to acknowledge their concern and be empathetic, and ask if they’re willing to talk about their hesitancy and any ways that you could help. So that would be one way. And telling them that even though the vaccines were developed in record time, the vaccines available for use have gone through the same steps and requirements as other vaccines, so they’re meeting the safety standards. So that would be the first thing. And another useful strategy might be to cite history. Some people might not understand that the fastest and, in some cases, the only way to eliminate the threat of virus such as COVID-19 is through vaccination. And so it might be very helpful to share successful accounts about how vaccines have improved society in the past. Many older adults remember receiving the polio vaccine, and they’d seen how the rates of polio declined profoundly after, as a result of the vaccine. So it might be helpful to discuss that. Another strategy would be to address misconceptions. You know, some people might be scared about the possible side effects from the vaccine. So it’s important that people understand the expected reactions to a vaccine, such as maybe pain near injection site, or a fever or headache, and that these reactions are temporary, and it doesn’t mean that the vaccines have given the person the disease. So it’s important to really focus on myth versus facts. And then the last strategy would really to encourage them to talk to their doctor to learn more. This is where they’re going to get credible information that’s accurate and reliable, and somebody that can talk to them about their personal situation.

Bill Walsh: ... whether you’re optimistic that we’re going to see a significant increase in the vaccination rates. I mean the vaccines have been out there now for a while. We’ve had what, 170 million, probably more, Americans take them. Maybe it’s the largest clinical trial in the history of the world. I just wonder at some point how much more evidence people need to see.

Jane Strommen: Well, I feel like that people who are hesitant, their questions are, are the vaccines necessary? Do they work? And are they safe? And I think as we get more research data and that we can see that they are working, they are effective, they are helping people reduce those severe illnesses and hospitalizations and deaths, that hopefully over time, we’ll see more people come on board and understand that they are working.

Bill Walsh: OK, Dr. Strommen, thanks so much for that. And as a reminder to our listeners, to ask your question, please press *3 on your telephone keypad. And we’re going to get to those live questions shortly. But before we do, I want to bring in Nancy LeaMond. Nancy is the executive vice president and chief advocacy and engagement officer here at AARP. Welcome, Nancy.

Nancy LeaMond: Delighted to be here, Bill.

Bill Walsh: You know, in addition to sharing the most current coronavirus information, we’d like to take a few minutes to update our listeners on important issues facing Congress, and how AARP is fighting for them. It’s been a busy time in Congress, as I know you know better than anybody, Nancy. Can you share a little bit about that?

Nancy LeaMond: Happy to, Bill. Last week, congressional committees advanced legislation that includes a number of AARP priorities. And if enacted, these provisions would have a tremendous positive impact on Americans, age 50 and older. Specifically, we’re fighting to lower prescription drug prices, create a tax credit for family caregivers, and expand Medicare to include dental, vision and hearing, among other priorities.

Bill Walsh: These issues have been discussed for a long time, but the fact that they’re finally gaining traction is great news for older Americans. Is that right?

Nancy LeaMond: It is. It’s a good first step, but we have a long way to go, especially with the issue of out-of-control drug prices. We have a once in a generation opportunity to pass prescription drug reform, and it’s going to take all of us working hard to make that happen. Americans pay three times more for brand-name drugs than people do in other countries. And many of these drugs were developed using American tax dollars. Yet Medicare is barred from negotiating the cost of prescription drugs. Americans want fair prices for their medicines, the medicines that keep us healthy, and to do that, Medicare needs to be able to negotiate. I urge you, anybody on this call, to contact your representatives and ask them to let Medicare negotiate lower drug prices.

Bill Walsh: Nancy, we’re now a year and a half into the coronavirus pandemic, and one in 500 Americans have died from COVID. For those ages 65 and over and for communities of color, particularly African American, Hispanic, Latino, and Native American populations, those numbers are far worse. As the United States climbs toward a tragic milestone of almost 700,000 COVID deaths, especially among older Americans, what have we lost?

Nancy LeaMond: Well, as you said, Bill, the COVID death toll is just overwhelming. The numbers are so big, and it’s hard to wrap our minds around what’s happened. Families have lost loved ones, and our communities have lost their future contributors. It’s absolutely heartbreaking. These were parents and grandparents, sons and daughters, friends, neighbors, leaders, and mentors.

Bill Walsh: All right, Nancy. Thank you so much for sharing those updates. Do you have any parting thoughts for us?

Nancy LeaMond: Well, for years, AARP has fought to improve access to health care, to protect vulnerable seniors in nursing homes, and to support family caregivers. The pandemic has put a spotlight on how important this work is. We’re all deeply affected, and we need to do everything we can to prevent more harm. I know we spend a lot of time talking about vaccines, and today, most COVID deaths are occurring among the unvaccinated. So please, if you haven’t already done so, get vaccinated. We need you here. Your loved ones need you here, and take care of yourselves so that we can all take care of one another. And thanks to you, Bill, and to our guests tonight for helping us talk about this important issue.

Bill Walsh: All right. Thank you, Nancy, for being here, we really appreciate it. Now it’s time to address your questions about the coronavirus with Dr. Steven Johnson and Dr. Jane Strommen. Please press *3 at any time on your telephone keypad, to be connected with an AARP staff member to ask your question, and if you’d like to listen in Spanish, press *0 on your telephone keypad now.

(Española)

Bill Walsh: Now, I’d like to bring in my AARP colleague Kevin Craiglow to help facilitate your calls today. Welcome, Kevin.

Kevin Craiglow: Thanks, Bill. Happy to be here for this important conversation.

Bill Walsh: Happy to have you. Let’s take our first question.

Kevin Craiglow: Our first question comes from Sally in Florida.

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

Sally: Yes, thank you for these wonderful town hall meetings. They’re wonderful. I’d like to say that, first, because I’ve been on quite a few of them. But my question tonight is in relationship to the Johnson & Johnson booster. So I had the Johnson & Johnson in March, early March, when it first came out down here in Miami. And my question is since six months and eight months is really coming quickly, and since supposedly quote-unquote, all these vaccines are safe, I want to know are the boosters the same shot as what we had before, and if they are, why can’t we just go get them? Why do we have to wait for anybody to tell us?

Bill Walsh: Yeah, thanks for that question, Sally. Dr. Johnson, can you help Sally and other listeners who might have the same question?

Steven Johnson: Yeah, I think one of the issues that we mentioned earlier in the call is that we’re still waiting for some advice on booster doses, you know the third dose for the Moderna vaccine and the second dose for the Johnson & Johnson vaccine. We just saw some data released by the company that makes the Johnson & Johnson vaccine. The second dose of the Johnson & Johnson vaccine really does boost the immunity against COVID-19, so that’s very exciting. And we’re actually waiting for the FDA and the CDC to kind of come out with specific guidance. And I think it’s in, it’s in the near future. There have been some jurisdictions that have taken matters into their own hands and have offered additional doses of these vaccines, people that received a Moderna and Johnson & Johnson. But that approach currently isn’t authorized. I would talk with your own physician to get some sense about the urgency of getting an additional dose, but I really expect over the next month or two, that you’ll have, you and your doctor will have the advice that they need regarding additional doses.

Bill Walsh: Go ahead, Dr. Johnson.

Steven Johnson: No, I’m just saying this seems to be at times a little frustratingly slow. And we’ve just heard more about the Pfizer, just because it’s been out a little bit longer.

Bill Walsh: Yeah, and I think one thing Sally was getting at is the interchangeability of these vaccines and their boosters. So I know Pfizer and Moderna use the same technology in their vaccine. If somebody got a Moderna vaccine, could they, would go get a Pfizer booster? If they got the J&J vaccine, could they get a Moderna booster? Does it work that way?

Steven Johnson: Well, this is actually happening. And one of our local community health centers here is giving one of the messenger RNA vaccines, that’s either Moderna or Pfizer, to people who had received the Johnson & Johnson vaccine. But this kind of mix and match approach has not been as well studied, and so it has not been kind of officially sanctioned at the federal level. Again, I think we’re going to have some clarity in the relatively near future, and so my advice is to wait a little bit to hear, rather than going out and getting kind of the other brand of vaccine. We just know a little bit less about the safety of that approach.

Bill Walsh: Yeah, thank you for that. Kevin, let’s take another question.

Kevin Craiglow: Our next caller is also Bill from Massachusetts.

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

Bill: Very quickly. I’m in my late 70s, I am not immunocompromised. I had my second Pfizer injection in March, which was about six months before mid-September. And I have two simple questions. I’ve been advised that I should wait 30 days between my annual multivalent flu shot and my Pfizer poster. Is that 30 days delta required, that’s question one; and number two, should I get the flu shot first or the Pfizer booster first? Thank you.

Bill Walsh: Dr. Johnson, can you answer Bill’s question?

Steven Johnson: Yes, I think there’s a pretty straightforward answer. You can certainly get the flu shot and your Pfizer booster at the same time. Earlier on in the vaccine rollout, there was a recommendation from the CDC’s Advisory Committee to space the COVID vaccines two weeks apart from any other vaccines. That wasn’t really based on science, and it was just out of caution. They have removed that proviso, and so you can certainly get them both. In terms of the flu shot, you know, the CDC recommends getting the flu shot in either September or October. So we’re already there. And in terms of the booster, the recommendation is going to be six months, which you’re at. So what I would do is I would get both vaccines in the relatively near future. If you get them on a same day, there’s a recommendation that you might get them in opposite arms. But apart from that, you can get them simultaneously. And in fact, in the future, there may be work on combined vaccines that have both flu and the SARS-CoV-2 virus in the same vaccine.

Bill Walsh: Thank you very much, Dr. Johnson. Kevin, let’s take another question.

Kevin Craiglow: Our next question actually comes from social media. A YouTube user wants to know, “My elderly parents live far from me and are very isolated. What can I do to ensure they’re safe and taking care of themselves?”

Bill Walsh: Dr. Strommen, can you address that one?

Jane Strommen: Well, that’s been a big concern for people over the course of this pandemic … people who are isolated, meaning that they are maybe concerned, maybe the health concerns, or maybe ages limiting them to get out and about in the community. It’s difficult when we have long-distance family members or caregivers. So I guess just to start with, not knowing much about the situation, is that it’s important for older adults to be as connected as possible and have a social network, even if they’re in their house. And we saw a lot of technology being used early on in the pandemic, whether it was trying Skype or Zoom or some kind of videoconference for the first time with, you know, parents and grandparents connecting the old-fashioned way by phone. But I really feel like whoever, you know, if this adult child lives far away, who is in that area? Are there other relatives or other neighbors, friends? Who can she turn to to create kind of a social network for her parents so that they don’t feel isolated? If they need care, that’s a whole other topic and things like that, but there are organizations. There’s an aging and disability resource center in each state. You could contact them and find out what kind of maybe support services there might be in that area as well.

Bill Walsh: OK, Dr. Strommen, thanks very much for that. Kevin, let’s take another call.

Kevin Craiglow: Absolutely. We have Gail from Connecticut next.

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

Gail: Thank you for taking my call. My call is concerning the breakthrough delta variant. My daughter, who’s 42 and completely healthy, and had all her vaccinations, came down with the delta and it’s long haul after two and a half months. She’s still sleeping 16 hours a day, getting up, showering, and going back for another 16 hours. She has brain fog, no energy, lethargic. Is there anything you can recommend? There’s nothing in the news to, you know, about the breakthrough and long haul.

Bill Walsh: Gail, let me ask you. Have you been vaccinated?

Gail: Oh, yes, of course.

Bill Walsh: Dr. Johnson, can you address this? This is something we hear about increasingly about these long haul symptoms. Is there anything that people can do?

Steven Johnson: Well, let’s talk about, first, breakthrough infections. We are seeing breakthrough infections, of course. And on average, they are milder than individuals who have not been vaccinated, by a great measure. And so, for example, at our hospital here, some of our hospitalized patients have been vaccinated, but very few, if any, are in the intensive care unit. So the infections on average are milder in those that have been vaccinated. And what we’ve learned about boosters, at least with the Pfizer vaccine, is that infections are less common after boosting compared to people that just got the primary series. In terms of what this means in terms of the long COVID syndrome, I think we’re still trying to sort that out. As this caller’s situation illustrates, you know, there are people who have been vaccinated that get ill. Some develop severe disease, some develop long COVID. And so it, it isn’t absolute that it’s protected, that the vaccines protect you from this condition. I think it would be important if it’s not happened already, that your daughter be under medical care with somebody who’s knowledgeable about COVID-19 and its complications just to make sure that there’s not a specific complication for which there might be a specific treatment. This long COVID syndrome is an area of very heavy study. I think we’re still learning kind of what types of interventions may be helpful here. There actually have been some anecdotal reports that people that had long COVID and then got vaccinated noted improvements in their symptoms, but I don’t think that’s really been demonstrated in large enough trials to be sure. So, you know, I think we have to stay tuned for the research, but in the meantime, I wouldn’t just make sure that your daughter is in the hands of a very good physician. My particular specialty, infectious disease, will sometimes see these individuals in consultation just to make sure that we’re not missing some discrete complication that might require a specific treatment.

Bill Walsh: All right, Dr. Johnson, thank you very much. Kevin, who’s next on the line?

Kevin Craiglow: Bill, lots of questions online as well, and that’s where our next one comes from. Lisa asks, “What are some self-care activities I should continue to maintain, for example, should I keep doctor’s appointments? Should I continue to see my therapist?”

Bill Walsh: Interesting question. We hear this one a lot. Dr. Strommen, can you address that for Lisa and others?

Jane Strommen: Yes, I sure can. I tell you that, you know, we all thought we were coming out of the pandemic with the vaccinations and then infection rates going down, and we were gathering in large groups and then the delta variant was identified, and warnings were growing. So, the delta variant really has amplified our anxiety about our life activities and decisions about our well-being, masks and vaccines, they’re all back in our thoughts. And so we really long for that definitive answer; when is this all going to be over, and we’re not getting it. So we’re really calling this that we’re in a flux, we’re in a pandemic flux. So we kind of find ourselves in a feeling of a need to escape from a threat that we can’t control. But this is really kind of a shared humanitarian crisis that’s going along across the globe, and it’s normal for us to feel this way. So I’d say the first thing is that we need to be gentle with ourselves and allow ourselves to feel the emotions as normal in this collective experience that we have. You know, I always say, let’s take what we’ve learned from this first shutdown and apply it now. What worked well? What did not? What should we not be doing? And kind of reassess along the way. We really do need to create a kind of a feeling of control as well as support. So, one of the things that I’d say for some other strategies, you know, the caller mentioned keeping regular routines and schedules as much as possible, keeping those doctor appointments, getting those screenings, staying physically active. There’s so many benefits from that that keeps us strong, gives us more energy. We have more, a better balance that delays or prevents some of our chronic diseases, and really important, it perks up our mood and reduces depression. So I’d say those are really important things to be doing.

Bill Walsh: I don’t know if this was on Lisa’s mind, but I know a lot of folks were worried about upcoming doctor visits or dentist visits, simply because you’re going into a place where there are sick people, right, and we don’t want to put ourselves at risk. What should people do with their preventative health care, regular checkups, if they’ve got chronic illnesses, should they keep those appointments? How do they ensure that they’re getting the health care they need in the safest way possible?

Jane Strommen: Well, I can talk to some of that. And maybe Dr. Johnson has some better advice as well, but every person’s situation is different, and I think they need to assess the risks. If it’s important that they continue with the health care that they’re getting, or the preventative visits, and the precautions are in place at those health care facilities. And we were doing this during the earlier part of the pandemic, then it probably makes sense based on their risk assessment. So I think those are important individual choices that people need to make, based on their age, their health, who’s living in their household, all of those types of things.

Bill Walsh: Right. OK, Dr. Strommen. Thanks very much. Kevin, let’s go back to the lines. Who do we have next?

Kevin Craiglow: Absolutely, we have Carolyn from Oregon.

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

Carolyn: Hi there. I have two questions. Is the Moderna vaccine more effective and if so, if your first two shots were Pfizer, since they’re both mRNA, what are the risks of switching to Moderna for the third shot?

Bill Walsh: OK, and you had a second question?

Carolyn: Yeah, are they modifying any of the vaccines more towards the delta and mu variant?

Bill Walsh: Dr. Johnson, can you weigh in on that? Carolyn seems to be asking about the issue we talked a little bit about before, which is kind of switching out the various of vaccines and also what kind of modifications are being made to the vaccines to keep up with the various variants?

Steven Johnson: Well, I think the, thank you, I think the first part of the question too was comparing the efficacy of these different vaccines. And there have been some recent data, studies looking at the immune response, but then also large studies looking at the effect of vaccines that seem to suggest that the Moderna vaccine might be a little bit more effective than the Pfizer vaccine. We don’t know whether the strategy of boosting now will remove that difference or magnify that difference. And it also depends on what you’re looking at because all three vaccines really do a very good job of preventing severe disease. Because the Moderna vaccine has had some recent studies that suggest it might be a little bit more powerful, there has been an interest in looking at this kind of mix and match approach. Again, I don’t think we know enough about the safety of this approach. I know anecdotally some of the people that I take care of have elected to get a Moderna dose after the Pfizer series. But if they ask me for my advice, I stuck with the advice from the FDA and the CDC recommending that if you get a third dose, for example, if your immune system is weakened, or now get a booster dose with the Pfizer vaccine, that you use the same vaccine. We’ll see in subsequent studies about the safety of using more than one vaccine type. It may turn out that is an important strategy. We do that with some other diseases; we have two types of pneumonia vaccines, and so on. In terms of whether vaccines with new strains and then are being developed, the answer is yes. And I think the companies are looking at some of the new variants and using them as the backbone for newer vaccines. But I would say, you know, that we still feel that our current vaccines that were initially developed, especially now with plans for boosting, are still very effective against the delta variant.

Bill Walsh: Thank you, Dr. Johnson, and thanks to our listeners for all those questions. We’re going to take more questions shortly. …

Now let’s turn back to our experts. Dr. Johnson, we talked about the FDA recommendations about the Pfizer vaccine. What does this mean for those at high risk or over 65 who received Moderna and J&J vaccines? We’ve talked a little bit about this already. I guess we’re waiting on more advice about whether they should get the Pfizer vaccine or they should wait. But if these folks who are at high risk, what would you advise them to do?

Steven Johnson: I think there’s always room to work with your primary care physician who’s well aware of your underlying medical conditions and how at risk you are. But I do think, you know, if we’re looking at kind of the advice from the CDC and advice from the FDA, that the only real advice we have now for boosters is from Pfizer. Remember though, that we have an earlier advice from the FDA and the CDC about third doses in individuals whose immune system is weakened. And those recommendations are both for Pfizer and Moderna recipients. So if you have like an underlying transplant or are on cancer treatment and so on, and have gotten two doses of either Pfizer or Moderna, you can actually get an additional dose now under the previous authorization. We consider these third doses in immunocompromised people, as opposed to booster doses. That still leaves the group that have gotten the J&J vaccine without any official advice. And as I mentioned before, I know of some jurisdictions that are offering second doses of other vaccines to J& J recipients, but they’re doing so without really any kind of federal authorization. It’s interesting how a lot of local and state programs have kind of instituted some of these policies ahead of actually them being sanctioned at the federal level.

Bill Walsh: Yeah, all right. Thanks for that, Dr. Johnson. Let me follow up quickly. You know, while the COVID vaccines are in the headlines, of course, they aren’t the only vaccine. Why is it important for folks to have the traditional flu vaccine even if you’re fully vaccinated for COVID?

Steven Johnson: Yeah, we kind of forget that prior to COVID-19, influenza was the illness that we feared each season. And influenza has been associated with 20,000 to 60,000 deaths in the U.S. each flu season. So again, prior to COVID-19, this was the illness to fear. And, of course, this can especially attack the same types of individuals that COVID-19 is severe in. So people who are older, people with underlying comorbidities like obesity, hypertension, lung disease, heart disease, and so on, and then people with a weakened immune system. The other issue is that because of the social distancing and masking and other measures last year, it was actually a very mild flu season, which on the surface is a good thing, but one of the things about flu is that we give annual flu shots to kind of build up immunity. And part of that immunity is probably also triggered by being exposed to the flu virus. So there’s some concern that this year could actually be a worse flu season because people have lost some of that partial immunity, and, of course, I think people are also have, some have grown tired of the measures such as masking and social distancing. The other issue is, as a health care provider, we would like individuals vaccinated against influenza because we’d like to avoid kind of the confusion between these two respiratory diseases. They have signs and symptoms that overlap significantly. So for all of those reasons, that you should get your flu shot this month and next month, and I actually, for people over 65, I actually recommend the high dose influenza vaccine.

Bill Walsh: OK, thank you for that, Dr. Johnson. Dr. Strommen, let’s turn to you. According to the National Law Enforcement Officers Memorial Fund, COVID-19 is the leading cause of death for police officers through June 30th for the prior 18 months, more than firearm- and traffic-related incidents combined. How substantial is COVID’s toll on our frontline workers, and is our safety and quality of care compromised as a result?

Jane Strommen: You know, going to work during the COVID pandemic has really placed our frontline workers under immense and just really unprecedented pressure. It puts them at more physical, mental and social well-being risk. So exposure to excessive stress for prolonged periods can really have many harmful consequences on people’s emotional, mental well-being, and especially for our frontline workers. It can lead to burnout, the onset of mental disorders, such as depression and anxiety and trauma, and all these things can result in … unhealthy behaviors like using tobacco and alcohol, other substances, perhaps frequent absences from work, reduced productivity while at work, increasing the risk of suicide among frontline workers, especially health care workers. So to answer your question in the context of COVID-19, and especially in our health care settings, this may mean compromised in quality and safety of care, maybe a breach of protocols and guidelines, increased risk of infections, just a compromised capacity for the health system and our emergency response system. So it’s a serious problem. Our frontline workers have been under extraordinary stress for a prolonged period of time, and it is a concern.

Bill Walsh: The effects of COVID-19 continue to ripple across the country. Thank you for that, Dr. Strommen. Now it’s time to address more of your questions with Dr. Steven Johnson and Dr. Jane Strommen. Kevin, who do we have next on the line?

Kevin Craiglow: Bill, we’re going next to Joanne from Minnesota.

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

Joanne: Yes, thank you. I’m calling; I have two grandsons, one is 13. And he has asthma and gets croup every year and is on a NEB machine. But his mother is afraid to have him get the vaccine because she’s heard that young men in that age group have gotten that peritonitis or carditis around the heart. Her other one, who is 12, was born under 2 pounds. He doesn’t seem to have health problems, but should they receive the vaccine or should they not? And one other quick one I’d like to stick in, I’m due for a shingles shot. How close can I have my third COVID shot, and how long would I have to wait to have the shingles shot? Thank you.

Bill Walsh: All right. Thank you, Joanne. Dr. Johnson, do you want to address that? Maybe you can address the shingles shot question first, and then we can get into whether vaccines would be appropriate for these youngsters.

Steven Johnson: Yeah, so in terms of the shingles shot, it can be given at the same time as the COVID-19 vaccine. As we had talked about earlier, the recommendation to space COVID 19 vaccines at least two weeks apart from other vaccines has been removed. I would say that that the shingles vaccine can cause significant side effects. It’s a very powerful vaccine, as I like to tell people it’s really, if you’re feeling poorly after it, it’s really a sign that it’s really making your immune system attack the shingles virus and develop immunity. And, of course, some of our COVID-19 vaccines also have reactions that include fever and so on. So, it’s certainly fine to space out the two by a couple of days and so on, just so you’re not dealing with the symptoms of both at the same time, but on the other hand, it’s certainly not wrong to get them on the same day. And we’ve certainly done that in our practice. In terms of the questions about vaccines for the 12- and 13-year-old, for specific situations like this that involve specific people, I always encourage you to talk with their pediatrician just because they would have a clear background of the medical history, and so on. But I would say that why we recommend vaccines in people, in adolescents of this age, is that we feel that the benefits outweigh the risks. And, of course, anything in medicine, there’s always a risk benefit analysis. And so, individuals that have asthma, that’s a potential risk factor for difficulties with COVID-19, so as an across the board statement, it sounds like you should get the vaccines, but for your specific grandchildren, I would want you to have them talk directly with their pediatrician.

Bill Walsh: Dr. Strommen, I wonder if you could weigh in on this as well. I mean, Joanne’s the grandmother here and obviously wants to protect her grandkids as much as possible. Clearly their mother has some concerns about the vaccination. What advice would you give to Joanne about how to deal with this? I mean she could be in a situation where she feels her grandkids need a vaccination, but the mother of the children really resists that.

Jane Strommen: I think it’s going back to really understanding why she is really hesitant to get the vaccine for her sons. And is it because of the potential side effects or does it go beyond that? Are there other concerns that she has, and really, I think, as Dr. Johnson said, really encouraging her daughter to visit with the pediatrician, because that is a trusted source of information that they can listen to. I think sometimes there’s too much information out on social media and every place, that people really don’t know what to know is truth versus a misconception, or a myth. So, I would really encourage her to visit with her daughter, visit with the pediatrician, to get the full information and maybe address some of her concerns.

Bill Walsh: OK, very good. Thank you both, Dr. Johnson and Dr. Strommen. And if you’re looking for facts on the vaccines or COVID writ large, you can also check out aarp.org/coronavirus. We monitor the latest news from the FDA and the CDC. We provide tips on how to talk to your doctor, questions to ask in how to keep yourself and your family safe. Kevin, let’s take another question.

Kevin Craiglow: Absolutely, Bill. I’m going to apologize in advance for pronunciation, but I think it’s Zani from Florida.

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

Zani: Hi, thank you. I’ve waited so long to ask this question. I have a question about lupus, people with lupus. I’m surprised no one has ever discussed this on this program. What are your opinion about that, the vaccines for people who have lupus?

Bill Walsh: Have you been vaccinated Zani?

Zani: Now, you’re not supposed to ask me a question, you’re supposed to answer my question.

Bill Walsh: (laugh) Well, we’re just trying to get the context.

Zani: No, I have not.

Bill Walsh: You have not, and probably because you’re concerned, you’re not sure, right, about the interactions.

Zani: Yes.

Bill Walsh: OK. Can I ask how old are you?

Zani: 77.

Bill Walsh: I know that’s an, that’s an impolite question, but just ballpark.

Zani: You should never ask a lady those questions.

Bill Walsh: (chuckles) OK, Dr. Johnson. I wonder if you can help Zani and others out there who might have questions like this. She’s got lupus, wondering about taking the vaccination.

Steven Johnson: Yeah, I think her situation as a high priority to get the vaccine. So individuals with underlying medical conditions like lupus are often treated with different medications, some of which weaken the immune system. So that is actually an indication for the vaccines, and it’s actually going to be an indicator for a third dose or a booster dose. So I definitely think that a person with lupus should get vaccinated. The other thing about all three vaccines, of course, is that they’re not live vaccines. They don’t have a specific danger for people whose immune system is weakened. The one concern might be that if you were on medications that weaken your immune system to control lupus, it may prevent or blunt your response to vaccines. It would be important to work with your personal physician, perhaps a rheumatologist that’s helping you to take a take care of your lupus. What we’ve done with some individuals that are on medications that weaken the immune system is that we may actually give the vaccine during a holiday from those medications, like the steroids are stopped for a period of time or something like that to maybe give the immune system a better chance to develop a response to the vaccine. So in short, I would definitely recommend the vaccine for you, and I would talk with your personal physician about the timing of it.

Bill Walsh: OK, thank you very much, Dr. Johnson. Kevin, let’s take another question.

Kevin Craiglow: Absolutely. Bill, we’re going to go to social media for this one. Sharon on YouTube asks, “What’s the treatment if you do contract COVID? You’re told to quarantine, but not given any advice on what to do to lessen the effects or prevent progression of COVID to its critical form.”

Bill Walsh: Hmm. Dr. Johnson, do you want to weigh in on that one?

Steven Johnson: Yes, I’d be happy to. In the outpatient setting, there’s really only one intervention right now apart from just managing symptoms, staying well-hydrated, and perhaps taking medications to alleviate symptoms and fever. The one intervention in the outpatient setting are these monoclonal antibody infusions. And these are intravenous infusions, sometimes they can be given under the skin, that combat the virus, and they’re specifically indicated in individuals who are at risk for progression to more severe disease to be hospitalized, and so on. And there is a list that the FDA and the CDC have about those conditions. If you don’t have those conditions, then the outpatient management is really just monitoring for symptoms and having a low threshold to be seen if you’re feeling worse. On the inpatient side, there are more treatments. There is an antiviral medication called Remdesivir. There are several drugs that combat the inflammatory response that sometimes overwhelms individuals, so steroid medications and other types of medications. And, of course, there is work in both the outpatient/inpatient setting, clinical trials, trying to find additional strategies to kind of manage COVID-19 and try to prevent the severe complications.

Bill Walsh: You know, Dr. Johnson, I’ve read a lot recently about folks who don’t take the vaccine, who develop COVID, and … get the antibody treatment. Do you, I assume you don’t recommend that as a course to follow. What are the concerns you might have about that?

Steven Johnson: Well, I think because individuals have not been vaccinated, who have not been vaccinated, are at risk for more severe disease than those individuals who have been vaccinated, the monoclonal antibodies take on a special importance in that group because they do, they can prevent progression of disease, prevent hospitalization, and so on. I think it is an intervention in that setting. And it’s also an important intervention in those individuals that have been vaccinated but may not respond to the vaccine because their immune system is weak. One of the recommendations for people that receive the monoclonal antibodies is they actually wait 90 days after the monoclonal antibodies to get vaccinated. And that’s so that the antibody preparation in the bloodstream doesn’t interfere with the vaccine response. That is a policy that may be revisited at one point. But if you’re unvaccinated and you have risks for developing severe COVID-19, then I would really recommend the monoclonal antibodies, and then once you get about three months out, then maybe a rethinking and getting the vaccine. One of the things that we know is if you get a vaccine after having the infection, it’s a very strong boost to the immune system.

Bill Walsh: But just to be clear, you’re not recommending the monoclonal antibodies as a first line of defense. You’re recommending people get the vaccine if they’re able to.

Steven Johnson: The vaccine is definitely the primary intervention, but if individuals have not been vaccinated and get ill, then the monoclonals are there, but I would not rely on that approach. I would say as a strategy, the vaccine series is more effective in saving your life than the monoclonal antibodies.

Bill Walsh: Yeah. OK, Kevin, let’s take another question.

Kevin Craiglow: Absolutely, our next question comes from Lynette in Massachusetts.

Bill Walsh: Hey, Lynette, welcome to the program. Go ahead with your question. ... Lynette, are you with us? Go ahead with your question. ... It seems like we may have ...

Lynette: Can you hear me?

Bill Walsh: Oh, I got you now. Hey, Lynette, how are you? Go ahead with your question.

Lynette: Hi, I’m fine. Thank you. I’m an individual who has remitting-relapsing MS. I’ve gotten my Pfizer shots. I’ve gotten my booster shot, and I’ll be taking my flu vaccine this coming month in October. My concern is, I don’t know, the lack of education or the push by the CDC and others, and attending to the lackadaisical attitude of people; one, we have tours going on here like in Salem, Massachusetts, that start today, and it was about 40 or 50 people. No one had a mask on. I know when I limit, I limit myself to the restaurant, there was a gentleman who asked me, “You brought your own utensils?” I said, “Yeah.” And I said, “And I have my Lysol spray can, and my Lysol wipes to wipe the table.” He says, “Well, why do you do that?” I said, “Because I’m not inviting delta or COVID into my body.” Now that’s just me, but what I’m saying is that overall there is a lackadaisical attitude, and it’s just concerning to me. And what [does] the medical community have to say about that?

Bill Walsh: You know, Lynette, I had the exact same thought. I’m a huge college football fan, and when I tune in to see 100,000 people packed into stadiums, none of them with masks on, I have the exact same thought. Dr. Johnson, I wonder what, let’s answer Lynette’s question. What does the medical community have to say about that?

Steven Johnson: Well, I think that the vast majority of the medical community, of course, feels like our vaccination rates need to be higher, first of all. I actually attended a presentation last night and was told that the United States is on the list of most vaccinated countries, is now 45th. So there’s 44 other countries that have higher rates of vaccination. So we definitely need to improve our vaccination rates above what they are. That’s a big strategy. And I think, like it or not, these other types of strategies that we used earlier in the epidemic, such as social distancing and masking and not going places if you’re sick, and things like that, those are strategies that are also important in the delta era. So, I think it’s frustrating sometimes, and it’s sometimes it’s more than frustrating, it’s sad actually to see, you know, somebody who’s unvaccinated or is infected by somebody who was unvaccinated and now is in the hospital on a ventilator. There’s a lot of really sad stories about these illnesses, including illnesses that we feel should be preventable.

Bill Walsh: Yep. All right, let’s take another question. Kevin.

Kevin Craiglow: Absolutely. Our final question comes from Pat in Tennessee.

Bill Walsh: Hey, Pat, you’re on the program. Go ahead with your question.

Pat: Thank you for taking my call. What I need to know is, my husband and I are fully vaccinated as far as the … all vaxed up. That was close to seven months ago now, we went and had the first part of the Moderna, we went back March the 1st and had the rest of that done. And that’s been about seven months. So, that’s out a ways six months, and we’re told now it’s going to be eight months before the booster. We’ve been told about the third shot, which would be Moderna for us. Is it OK to have that now and wait for the booster, because we don’t know when the booster’s going to come. It seems they keep changing. You know, they have the (inaudible), they change, and they change back, but I guess they’re trying to get this taken care of and figure out something, but what do we do about that? We’re waiting to get the booster, and then we need to, I was told by my primary care doctor to wait two weeks after the booster to get my flu shot.

Bill Walsh: So, we’ve had a lot of questions on boosters and the interchangeability. Pat, can I ask how old you are? You and your husband, are you over 65?

Kevin Craiglow: OK, Bill, I’m sorry, we accidentally lost Pat.

Bill Walsh: Got it, no worries, no worries. Dr. Johnson, I wonder if you can address Pat’s question. Obviously, this is top of mind for a lot of people.

Steven Johnson: Well, one of the questions I wanted to ask, is whether either her or her husband had a medical condition for which they might qualify for those third doses. In other words, there’s a separate initiative from the booster initiative for people with weakened immune systems. And in that setting, you don’t wait a specific amount of time. You have to wait actually 28 days after the second dose, but you can go ahead and get a third dose. If they don’t fall into that category, then they have two choices. They can either find a pharmacy or a clinic or so on that will kind of give them a third dose, kind of off-line or kind of without federal guidance, and some people have done that. But I think probably what we’re all waiting for that we’ve talked about on some of these other calls, is advice on the Moderna boosters, which again, I think will be here next month, the following month, that kind of thing. … And I think there’s room for people to talk with their personal physicians. We have some people who are profoundly, have a profoundly weakened immune system, and have really gone out and sought third doses before the federal government has made up their mind how to put this together. It seems like a lot of local pharmacies and clinics are kind of willing to give additional doses out of sequence.

Bill Walsh: OK. Well, thanks for that, Dr. Johnson, and thank you also Dr. Strommen. And thank you, our AARP members, volunteers and listeners for participating in this discussion. AARP, a nonprofit, nonpartisan membership 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 Sept. 24. 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 today. Please join us again on Oct. 7 at 1 p.m. Eastern Time for another live event answering your questions about the coronavirus. We hope you can join us then. Thank you and have a good day. This concludes our call.

Delta Variant, Boosters & Self Care With Timestamps

[00:00:00] 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.

[00:00:16] [Española]

[00:00:16] 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. Eighteen months into the COVID-19 pandemic, the delta variant continues to stoke fear and uncertainty across the country. COVID-related deaths are once again trending upward as Americans continue to argue over the seriousness of the threat and how to address it. Meanwhile, a new COVID variant is on the horizon, and the nation is heading into flu season. It was against this backdrop that the Food and Drug Administration this week recommended a booster shot for people 65 and older, but the FDA’s long-anticipated announcement seemed to raise as many questions as it answered.

[00:01:21] Today, we’ll hear from an impressive panel of experts about these issues and more. If you’ve participated in one of our tele-town halls, you know this is similar to a radio talk show, and you have the opportunity to ask your questions live. For those of you joining us on the phone, if you’d like to ask a question about the coronavirus pandemic, press *3 on your telephone keypad 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’re joining on Facebook or YouTube, you can post your question in the comments.

[00:02:15] We have a couple of outstanding guests joining us today, including an infectious disease expert and a wellness and healthy aging expert. We’ll also be joined by my AARP colleague Kevin Craiglow, 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.

[00:02:55] Now I’d like to welcome our guests. First, we have Steven C. Johnson, M.D., a professor of medicine in the Division of Infectious Diseases at the University of Colorado School of Medicine and Anschutz Medical Campus Multi-Disciplinary Center on Aging. Welcome back to the program, Dr. Johnson.

[00:03:14] Steven Johnson: Thanks for having me.

[00:03:15] Bill Walsh: All right, we’re delighted to have you with us. We’re also joined by Jane Strommen, Ph.D., a gerontology specialist at the North Dakota State University Extension. Welcome back to the program, Dr. Strommen.

[00:03:28] Jane Strommen: Thank you. Glad to be here.

[00:03:30] Bill Walsh: We’re glad to have you. Let’s get started. Dr. Johnson, last week the Food and Drug Administration recommended emergency use authorization for a booster dose of the Pfizer vaccine for those at high risk or age 65 and older. Now it was anticipated the booster would be approved for more widespread availability. How did they come to this decision?

[00:04:05] Steven Johnson: Yeah, it’s a good question. I think the initial question that the FDA tackled with is whether to authorize a booster for everybody over age 16, but I think the concern was is that we don’t have a complete set of data, especially for younger, healthy individuals. So they went with a more conservative recommendation that included individuals 65 and older, and then younger individuals that have risks for severe COVID-19. And the FDA also included, recommended that individuals that have institutional or occupational exposure also get a booster shot although the CDCs Advisory Committee that met today has given somewhat different recommendations.

[00:04:59] Bill Walsh: So with these different recommendations, where does that leave us?

[00:05:03] Steven Johnson: Well, I think that what happened today is that the CDC’s Advisory Committee met, and they agreed with two of the FDA recommendations; the 65 and older and the 18 to 64 with underlying medical conditions. And the one area of difference was whether individuals that have a higher exposure based on occupation, like health care workers, would be candidates. It’ll be interesting because you know the FDA is what provides the authorization, and then the Advisory Committee is kind of the guidebook. So how this settles out, I actually can’t predict, and we’ll have to see over the next few days how this sorts out and who kind of wins.

[00:05:48] Bill Walsh: I wonder if boosters for other COVID-19 vaccines become more widely available at some point. When do you expect that’s going to happen?

[00:05:59] Steven Johnson: I expect that to happen in the next weeks to a month or two. You know, the Pfizer vaccine has kind of been ahead of the Moderna and the Johnson & Johnson vaccine just in development, you know, kind of the first to get the studies out, the first to get an emergency use authorization, the first to get FDA approval. And I think it just takes time for the FDA to kind of process the data, But I know that Moderna has submitted information on their boosters. And we also recently saw some information on the second dose of the Johnson & Johnson vaccine. So I think this will happen. My prediction is weeks to a month or two at the greatest. I think there’s a lot of pressure to get advice out about boosters for all of the individuals that got the Moderna and Johnson & Johnson vaccines.

[00:06:53] Bill Walsh: One more follow-up question for you, Dr. Johnson. CDC model suggests that COVID hospital admissions will decrease in the next month for the first time since June 23rd. Has the delta variant run its course, and how concerned are you about the new mu variant?

[00:07:12] Steven Johnson: So I think there are some signs kind of nationally that the number of cases is declining due to delta. Incidentally, virtually all infections in the United States right now are due to delta as the predominant variant. In saying that though, you know, different states or regions have seen the surges occur at different times. So what may happen on kind of a national scale, you may not see that in regional areas. And so, one prediction might be that the delta variant infections go down in the South, but they may surge in kind of northern areas where indoor activities start to predominate and so on. I don’t know much about the mu variant. It is a variant of interest, and we’ll have to see. It’s not a significant cause of infections right now, but of course we’ve, over the last year and a half, we’ve had alpha and beta and gamma and all of these different variants. So I think there’s a really kind of elegant approach to kind of track these variants. And we’ll just have to see over the next couple of months whether new variants, including mu, are significant.

[00:08:36] Bill Walsh: Well, and it’s going to be interesting to see how effective the vaccines are against it as well.

[00:08:41] Steven Johnson: I mean, so far, the three vaccines seem to do well with the delta variant — some decline in activity, but still effective, especially against severe disease. And we think actually boosters of the original vaccines will be helpful to further control the delta outbreak.

[00:09:05] Bill Walsh: Thanks for that, Dr. Johnson. Dr. Strommen, let’s turn to you. We’re still seeing many Americans refusing to get vaccinated against COVID-19. You know, it’s an issue that’s divided the country and, in some families as well. How do we talk with family members who have declined the vaccine? Are there strategies you think are effective at convincing somebody to get vaccinated?

[00:09:28] Jane Strommen: I do think there are a number of strategies that we can use. And the first one I would just say is start by listening. There might be many reasons why people might be hesitant to get the COVID-19 vaccines, but one of the reasons often cited is that the vaccines were developed very quickly. So it’s important to acknowledge their concern and be empathetic, and ask if they’re willing to talk about their hesitancy and any ways that you could help. So that would be one way. And telling them that even though the vaccines were developed in record time, the vaccines available for use have gone through the same steps and requirements as other vaccines, so they’re meeting the safety standards. So that would be the first thing. And another useful strategy might be to cite history. Some people might not understand that the fastest and, in some cases, the only way to eliminate the threat of virus such as COVID-19 is through vaccination. And so it might be very helpful to share successful accounts about how vaccines have improved society in the past. Many older adults remember receiving the polio vaccine, and they’d seen how the rates of polio declined profoundly after, as a result of the vaccine. So it might be helpful to discuss that. Another strategy would be to address misconceptions. You know, some people might be scared about the possible side effects from the vaccine. So it’s important that people understand the expected reactions to a vaccine, such as maybe pain near injection site, or a fever or headache, and that these reactions are temporary, and it doesn’t mean that the vaccines have given the person the disease. So it’s important to really focus on myth versus facts. And then the last strategy would really to encourage them to talk to their doctor to learn more. This is where they’re going to get credible information that’s accurate and reliable, and somebody that can talk to them about their personal situation.

[00:11:38] Bill Walsh: ... whether you’re optimistic that we’re going to see a significant increase in the vaccination rates. I mean the vaccines have been out there now for a while. We’ve had what, 170 million, probably more, Americans take them. Maybe it’s the largest clinical trial in the history of the world. I just wonder at some point how much more evidence people need to see.

[00:11:59] Jane Strommen: Well, I feel like that people who are hesitant, their questions are, are the vaccines necessary? Do they work? And are they safe? And I think as we get more research data and that we can see that they are working, they are effective, they are helping people reduce those severe illnesses and hospitalizations and deaths, that hopefully over time, we’ll see more people come on board and understand that they are working.

[00:12:27] Bill Walsh: OK, Dr. Strommen, thanks so much for that. And as a reminder to our listeners, to ask your question, please press *3 on your telephone keypad. And we’re going to get to those live questions shortly. But before we do, I want to bring in Nancy LeaMond. Nancy is the executive vice president and chief advocacy and engagement officer here at AARP. Welcome, Nancy.

[00:12:49] Nancy LeaMond: Delighted to be here, Bill.

[00:12:50] Bill Walsh: You know, in addition to sharing the most current coronavirus information, we’d like to take a few minutes to update our listeners on important issues facing Congress, and how AARP is fighting for them. It’s been a busy time in Congress, as I know you know better than anybody, Nancy. Can you share a little bit about that?

[00:13:09] Nancy LeaMond: Happy to, Bill. Last week, congressional committees advanced legislation that includes a number of AARP priorities. And if enacted, these provisions would have a tremendous positive impact on Americans, age 50 and older. Specifically, we’re fighting to lower prescription drug prices, create a tax credit for family caregivers, and expand Medicare to include dental, vision and hearing, among other priorities.

[00:13:38] Bill Walsh: These issues have been discussed for a long time, but the fact that they’re finally gaining traction is great news for older Americans. Is that right?

[00:13:46] Nancy LeaMond: It is. It’s a good first step, but we have a long way to go, especially with the issue of out-of-control drug prices. We have a once in a generation opportunity to pass prescription drug reform, and it’s going to take all of us working hard to make that happen. Americans pay three times more for brand-name drugs than people do in other countries. And many of these drugs were developed using American tax dollars. Yet Medicare is barred from negotiating the cost of prescription drugs. Americans want fair prices for their medicines, the medicines that keep us healthy, and to do that, Medicare needs to be able to negotiate. I urge you, anybody on this call, to contact your representatives and ask them to let Medicare negotiate lower drug prices.

[00:14:38] Bill Walsh: Nancy, we’re now a year and a half into the coronavirus pandemic, and one in 500 Americans have died from COVID. For those ages 65 and over and for communities of color, particularly African American, Hispanic, Latino, and Native American populations, those numbers are far worse. As the United States climbs toward a tragic milestone of almost 700,000 COVID deaths, especially among older Americans, what have we lost?

[00:15:08] Nancy LeaMond: Well, as you said, Bill, the COVID death toll is just overwhelming. The numbers are so big, and it’s hard to wrap our minds around what’s happened. Families have lost loved ones, and our communities have lost their future contributors. It’s absolutely heartbreaking. These were parents and grandparents, sons and daughters, friends, neighbors, leaders, and mentors.

[00:15:35] Bill Walsh: All right, Nancy. Thank you so much for sharing those updates. Do you have any parting thoughts for us?

[00:15:41] Nancy LeaMond: Well, for years, AARP has fought to improve access to health care, to protect vulnerable seniors in nursing homes, and to support family caregivers. The pandemic has put a spotlight on how important this work is. We’re all deeply affected, and we need to do everything we can to prevent more harm. I know we spend a lot of time talking about vaccines, and today, most COVID deaths are occurring among the unvaccinated. So please, if you haven’t already done so, get vaccinated. We need you here. Your loved ones need you here, and take care of yourselves so that we can all take care of one another. And thanks to you, Bill, and to our guests tonight for helping us talk about this important issue.

[00:16:23] Bill Walsh: All right. Thank you, Nancy, for being here, we really appreciate it. Now it’s time to address your questions about the coronavirus with Dr. Steven Johnson and Dr. Jane Strommen. Please press *3 at any time on your telephone keypad, to be connected with an AARP staff member to ask your question, and if you’d like to listen in Spanish, press *0 on your telephone keypad now.

[00:16:47] [Española]

[00:16:53] Now, I’d like to bring in my AARP colleague Kevin Craiglow to help facilitate your calls today. Welcome, Kevin.

[00:17:01] Kevin Craiglow: Thanks, Bill. Happy to be here for this important conversation.

[00:17:04] Bill Walsh: Happy to have you. Let’s take our first question.

[00:17:07] Kevin Craiglow: Our first question comes from Sally in Florida.

[00:17:11] Bill Walsh: Hey, Sally. Welcome to the program. Go ahead with your question.

[00:17:15] Sally: Yes, thank you for these wonderful town hall meetings. They’re wonderful. I’d like to say that, first, because I’ve been on quite a few of them. But my question tonight is in relationship to the Johnson & Johnson booster. So I had the Johnson & Johnson in March, early March, when it first came out down here in Miami. And my question is since six months and eight months is really coming quickly, and since supposedly quote-unquote, all these vaccines are safe, I want to know are the boosters the same shot as what we had before, and if they are, why can’t we just go get them? Why do we have to wait for anybody to tell us?

[00:17:58] Bill Walsh: Yeah, thanks for that question, Sally. Dr. Johnson, can you help Sally and other listeners who might have the same question?

[00:18:06] Steven Johnson: Yeah, I think one of the issues that we mentioned earlier in the call is that we’re still waiting for some advice on booster doses, you know the third dose for the Moderna vaccine and the second dose for the Johnson & Johnson vaccine. We just saw some data released by the company that makes the Johnson & Johnson vaccine. The second dose of the Johnson & Johnson vaccine really does boost the immunity against COVID-19, so that’s very exciting. And we’re actually waiting for the FDA and the CDC to kind of come out with specific guidance. And I think it’s in, it’s in the near future. There have been some jurisdictions that have taken matters into their own hands and have offered additional doses of these vaccines, people that received a Moderna and Johnson & Johnson. But that approach currently isn’t authorized. I would talk with your own physician to get some sense about the urgency of getting an additional dose, but I really expect over the next month or two, that you’ll have, you and your doctor will have the advice that they need regarding additional doses.

[00:19:32] Bill Walsh: Go ahead, Dr. Johnson.

[00:19:33] Steven Johnson: No, I’m just saying this seems to be at times a little frustratingly slow. And we’ve just heard more about the Pfizer, just because it’s been out a little bit longer.

[00:19:47] Bill Walsh: Yeah, and I think one thing Sally was getting at is the interchangeability of these vaccines and their boosters. So I know Pfizer and Moderna use the same technology in their vaccine. If somebody got a Moderna vaccine, could they, would go get a Pfizer booster? If they got the J&J vaccine, could they get a Moderna booster? Does it work that way?

[00:20:10] Steven Johnson: Well, this is actually happening. And one of our local community health centers here is giving one of the messenger RNA vaccines, that’s either Moderna or Pfizer, to people who had received the Johnson & Johnson vaccine. But this kind of mix and match approach has not been as well studied, and so it has not been kind of officially sanctioned at the federal level. Again, I think we’re going to have some clarity in the relatively near future, and so my advice is to wait a little bit to hear, rather than going out and getting kind of the other brand of vaccine. We just know a little bit less about the safety of that approach.

[00:21:00] Bill Walsh: Yeah, thank you for that. Kevin, let’s take another question.

[00:21:14] Kevin Craiglow: Our next caller is also Bill from Massachusetts.

[00:21:19] Bill Walsh: Hey, Bill, welcome to the program. Go ahead with your question.

[00:21:22] Bill: Very quickly. I’m in my late 70s, I am not immunocompromised. I had my second Pfizer injection in March, which was about six months before mid-September. And I have two simple questions. I’ve been advised that I should wait 30 days between my annual multivalent flu shot and my Pfizer poster. Is that 30 days delta required, that’s question one; and number two, should I get the flu shot first or the Pfizer booster first? Thank you.

[00:21:55] Bill Walsh: Dr. Johnson, can you answer Bill’s question?

[00:21:58] Steven Johnson: Yes, I think there’s a pretty straightforward answer. You can certainly get the flu shot and your Pfizer booster at the same time. Earlier on in the vaccine rollout, there was a recommendation from the CDC’s Advisory Committee to space the COVID vaccines two weeks apart from any other vaccines. That wasn’t really based on science, and it was just out of caution. They have removed that proviso, and so you can certainly get them both. In terms of the flu shot, you know, the CDC recommends getting the flu shot in either September or October. So we’re already there. And in terms of the booster, the recommendation is going to be six months, which you’re at. So what I would do is I would get both vaccines in the relatively near future. If you get them on a same day, there’s a recommendation that you might get them in opposite arms. But apart from that, you can get them simultaneously. And in fact, in the future, there may be work on combined vaccines that have both flu and the SARS-CoV-2 virus in the same vaccine.

[00:23:14] Bill Walsh: Thank you very much, Dr. Johnson. Kevin, let’s take another question.

[00:23:18] Kevin Craiglow: Our next question actually comes from social media. A YouTube user wants to know, “My elderly parents live far from me and are very isolated. What can I do to ensure they’re safe and taking care of themselves?”

[00:23:31] Bill Walsh: Dr. Strommen, can you address that one?

[00:23:35] Jane Strommen: Well, that’s been a big concern for people over the course of this pandemic … people who are isolated, meaning that they are maybe concerned, maybe the health concerns, or maybe ages limiting them to get out and about in the community. It’s difficult when we have long-distance family members or caregivers. So I guess just to start with, not knowing much about the situation, is that it’s important for older adults to be as connected as possible and have a social network, even if they’re in their house. And we saw a lot of technology being used early on in the pandemic, whether it was trying Skype or Zoom or some kind of videoconference for the first time with, you know, parents and grandparents connecting the old-fashioned way by phone. But I really feel like whoever, you know, if this adult child lives far away, who is in that area? Are there other relatives or other neighbors, friends? Who can she turn to to create kind of a social network for her parents so that they don’t feel isolated? If they need care, that’s a whole other topic and things like that, but there are organizations. There’s an aging and disability resource center in each state. You could contact them and find out what kind of maybe support services there might be in that area as well.

[00:25:19] Bill Walsh: OK, Dr. Strommen, thanks very much for that. Kevin, let’s take another call.

[00:25:24] Kevin Craiglow: Absolutely. We have Gail from Connecticut next.

[00:25:27] Bill Walsh: Hey, Gail. Welcome to the program. Go ahead with your question.

[00:25:30] Gail: Thank you for taking my call. My call is concerning the breakthrough delta variant. My daughter, who’s 42 and completely healthy, and had all her vaccinations, came down with the delta and it’s long haul after two and a half months. She’s still sleeping 16 hours a day, getting up, showering, and going back for another 16 hours. She has brain fog, no energy, lethargic. Is there anything you can recommend? There’s nothing in the news to, you know, about the breakthrough and long haul.

[00:26:11] Bill Walsh: Gail, let me ask you. Have you been vaccinated?

[00:26:14] Gail: Oh, yes, of course.

[00:26:17] Bill Walsh: Dr. Johnson, can you address this? This is something we hear about increasingly about these long haul symptoms. Is there anything that people can do?

[00:26:27] Steven Johnson: Well, let’s talk about, first, breakthrough infections. We are seeing breakthrough infections, of course. And on average, they are milder than individuals who have not been vaccinated, by a great measure. And so, for example, at our hospital here, some of our hospitalized patients have been vaccinated, but very few, if any, are in the intensive care unit. So the infections on average are milder in those that have been vaccinated. And what we’ve learned about boosters, at least with the Pfizer vaccine, is that infections are less common after boosting compared to people that just got the primary series. In terms of what this means in terms of the long COVID syndrome, I think we’re still trying to sort that out. As this caller’s situation illustrates, you know, there are people who have been vaccinated that get ill. Some develop severe disease, some develop long COVID. And so it, it isn’t absolute that it’s protected, that the vaccines protect you from this condition. I think it would be important if it’s not happened already, that your daughter be under medical care with somebody who’s knowledgeable about COVID-19 and its complications just to make sure that there’s not a specific complication for which there might be a specific treatment. This long COVID syndrome is an area of very heavy study. I think we’re still learning kind of what types of interventions may be helpful here. There actually have been some anecdotal reports that people that had long COVID and then got vaccinated noted improvements in their symptoms, but I don’t think that’s really been demonstrated in large enough trials to be sure. So, you know, I think we have to stay tuned for the research, but in the meantime, I wouldn’t just make sure that your daughter is in the hands of a very good physician. My particular specialty, infectious disease, will sometimes see these individuals in consultation just to make sure that we’re not missing some discrete complication that might require a specific treatment.

[00:29:03] Bill Walsh: All right, Dr. Johnson, thank you very much. Kevin, who’s next on the line?

[00:29:23] Kevin Craiglow: Bill, lots of questions online as well, and that’s where our next one comes from. Lisa asks, “What are some self-care activities I should continue to maintain, for example, should I keep doctor’s appointments? Should I continue to see my therapist?”

[00:29:37] Bill Walsh: Interesting question. We hear this one a lot. Dr. Strommen, can you address that for Lisa and others?

[00:29:43] Jane Strommen: Yes, I sure can. I tell you that, you know, we all thought we were coming out of the pandemic with the vaccinations and then infection rates going down, and we were gathering in large groups and then the delta variant was identified, and warnings were growing. So, the delta variant really has amplified our anxiety about our life activities and decisions about our well-being, masks and vaccines, they’re all back in our thoughts. And so we really long for that definitive answer; when is this all going to be over, and we’re not getting it. So we’re really calling this that we’re in a flux, we’re in a pandemic flux. So we kind of find ourselves in a feeling of a need to escape from a threat that we can’t control. But this is really kind of a shared humanitarian crisis that’s going along across the globe, and it’s normal for us to feel this way. So I’d say the first thing is that we need to be gentle with ourselves and allow ourselves to feel the emotions as normal in this collective experience that we have. You know, I always say, let’s take what we’ve learned from this first shutdown and apply it now. What worked well? What did not? What should we not be doing? And kind of reassess along the way. We really do need to create a kind of a feeling of control as well as support. So, one of the things that I’d say for some other strategies, you know, the caller mentioned keeping regular routines and schedules as much as possible, keeping those doctor appointments, getting those screenings, staying physically active. There’s so many benefits from that that keeps us strong, gives us more energy. We have more, a better balance that delays or prevents some of our chronic diseases, and really important, it perks up our mood and reduces depression. So I’d say those are really important things to be doing.

[00:31:51] Bill Walsh: I don’t know if this was on Lisa’s mind, but I know a lot of folks were worried about upcoming doctor visits or dentist visits, simply because you’re going into a place where there are sick people, right, and we don’t want to put ourselves at risk. What should people do with their preventative health care, regular checkups, if they’ve got chronic illnesses, should they keep those appointments? How do they ensure that they’re getting the health care they need in the safest way possible?

[00:32:22] Jane Strommen: Well, I can talk to some of that. And maybe Dr. Johnson has some better advice as well, but every person’s situation is different, and I think they need to assess the risks. If it’s important that they continue with the health care that they’re getting, or the preventative visits, and the precautions are in place at those health care facilities. And we were doing this during the earlier part of the pandemic, then it probably makes sense based on their risk assessment. So I think those are important individual choices that people need to make, based on their age, their health, who’s living in their household, all of those types of things.

[00:33:13] Bill Walsh: Right. OK, Dr. Strommen. Thanks very much. Kevin, let’s go back to the lines. Who do we have next?

[00:33:19] Kevin Craiglow: Absolutely, we have Carolyn from Oregon.

[00:33:22] Bill Walsh: Hey, Carolyn. Welcome to the program. Go ahead with your question.

[00:33:26] Carolyn: Hi there. I have two questions. Is the Moderna vaccine more effective and if so, if your first two shots were Pfizer, since they’re both mRNA, what are the risks of switching to Moderna for the third shot?

[00:33:45] Bill Walsh: OK, and you had a second question?

[00:33:48] Carolyn: Yeah, are they modifying any of the vaccines more towards the delta and mu variant?

[00:33:55] Bill Walsh: Dr. Johnson, can you weigh in on that? Carolyn seems to be asking about the issue we talked a little bit about before, which is kind of switching out the various of vaccines and also what kind of modifications are being made to the vaccines to keep up with the various variants?

[00:34:12] Steven Johnson: Well, I think the, thank you, I think the first part of the question too was comparing the efficacy of these different vaccines. And there have been some recent data, studies looking at the immune response, but then also large studies looking at the effect of vaccines that seem to suggest that the Moderna vaccine might be a little bit more effective than the Pfizer vaccine. We don’t know whether the strategy of boosting now will remove that difference or magnify that difference. And it also depends on what you’re looking at because all three vaccines really do a very good job of preventing severe disease. Because the Moderna vaccine has had some recent studies that suggest it might be a little bit more powerful, there has been an interest in looking at this kind of mix and match approach. Again, I don’t think we know enough about the safety of this approach. I know anecdotally some of the people that I take care of have elected to get a Moderna dose after the Pfizer series. But if they ask me for my advice, I stuck with the advice from the FDA and the CDC recommending that if you get a third dose, for example, if your immune system is weakened, or now get a booster dose with the Pfizer vaccine, that you use the same vaccine. We’ll see in subsequent studies about the safety of using more than one vaccine type. It may turn out that is an important strategy. We do that with some other diseases; we have two types of pneumonia vaccines, and so on. In terms of whether vaccines with new strains and then are being developed, the answer is yes. And I think the companies are looking at some of the new variants and using them as the backbone for newer vaccines. But I would say, you know, that we still feel that our current vaccines that were initially developed, especially now with plans for boosting, are still very effective against the delta variant.

[00:36:35] Bill Walsh: Thank you, Dr. Johnson, and thanks to our listeners for all those questions. We’re going to take more questions shortly. …

[00:37:05] Now let’s turn back to our experts. Dr. Johnson, we talked about the FDA recommendations about the Pfizer vaccine. What does this mean for those at high risk or over 65 who received Moderna and J&J vaccines? We’ve talked a little bit about this already. I guess we’re waiting on more advice about whether they should get the Pfizer vaccine or they should wait. But if these folks who are at high risk, what would you advise them to do?

[00:37:33] Steven Johnson: I think there’s always room to work with your primary care physician who’s well aware of your underlying medical conditions and how at risk you are. But I do think, you know, if we’re looking at kind of the advice from the CDC and advice from the FDA, that the only real advice we have now for boosters is from Pfizer. Remember though, that we have an earlier advice from the FDA and the CDC about third doses in individuals whose immune system is weakened. And those recommendations are both for Pfizer and Moderna recipients. So if you have like an underlying transplant or are on cancer treatment and so on, and have gotten two doses of either Pfizer or Moderna, you can actually get an additional dose now under the previous authorization. We consider these third doses in immunocompromised people, as opposed to booster doses. That still leaves the group that have gotten the J&J vaccine without any official advice. And as I mentioned before, I know of some jurisdictions that are offering second doses of other vaccines to J& J recipients, but they’re doing so without really any kind of federal authorization. It’s interesting how a lot of local and state programs have kind of instituted some of these policies ahead of actually them being sanctioned at the federal level.

[00:39:23] Bill Walsh: Yeah, all right. Thanks for that, Dr. Johnson. Let me follow up quickly. You know, while the COVID vaccines are in the headlines, of course, they aren’t the only vaccine. Why is it important for folks to have the traditional flu vaccine even if you’re fully vaccinated for COVID?

[00:39:41] Steven Johnson: Yeah, we kind of forget that prior to COVID-19, influenza was the illness that we feared each season. And influenza has been associated with 20,000 to 60,000 deaths in the U.S. each flu season. So again, prior to COVID-19, this was the illness to fear. And, of course, this can especially attack the same types of individuals that COVID-19 is severe in. So people who are older, people with underlying comorbidities like obesity, hypertension, lung disease, heart disease, and so on, and then people with a weakened immune system. The other issue is that because of the social distancing and masking and other measures last year, it was actually a very mild flu season, which on the surface is a good thing, but one of the things about flu is that we give annual flu shots to kind of build up immunity. And part of that immunity is probably also triggered by being exposed to the flu virus. So there’s some concern that this year could actually be a worse flu season because people have lost some of that partial immunity, and, of course, I think people are also have, some have grown tired of the measures such as masking and social distancing. The other issue is, as a health care provider, we would like individuals vaccinated against influenza because we’d like to avoid kind of the confusion between these two respiratory diseases. They have signs and symptoms that overlap significantly. So for all of those reasons, that you should get your flu shot this month and next month, and I actually, for people over 65, I actually recommend the high dose influenza vaccine.

[00:41:45] Bill Walsh: OK, thank you for that, Dr. Johnson. Dr. Strommen, let’s turn to you. According to the National Law Enforcement Officers Memorial Fund, COVID-19 is the leading cause of death for police officers through June 30th for the prior 18 months, more than firearm- and traffic-related incidents combined. How substantial is COVID’s toll on our frontline workers, and is our safety and quality of care compromised as a result?

[00:42:18] Jane Strommen: You know, going to work during the COVID pandemic has really placed our frontline workers under immense and just really unprecedented pressure. It puts them at more physical, mental and social well-being risk. So exposure to excessive stress for prolonged periods can really have many harmful consequences on people’s emotional, mental well-being, and especially for our frontline workers. It can lead to burnout, the onset of mental disorders, such as depression and anxiety and trauma, and all these things can result in … unhealthy behaviors like using tobacco and alcohol, other substances, perhaps frequent absences from work, reduced productivity while at work, increasing the risk of suicide among frontline workers, especially health care workers. So to answer your question in the context of COVID-19, and especially in our health care settings, this may mean compromised in quality and safety of care, maybe a breach of protocols and guidelines, increased risk of infections, just a compromised capacity for the health system and our emergency response system. So it’s a serious problem. Our frontline workers have been under extraordinary stress for a prolonged period of time, and it is a concern.

[00:43:57] Bill Walsh: The effects of COVID-19 continue to ripple across the country. Thank you for that, Dr. Strommen. Now it’s time to address more of your questions with Dr. Steven Johnson and Dr. Jane Strommen. Kevin, who do we have next on the line?

[00:44:19] Kevin Craiglow: Bill, we’re going next to Joanne from Minnesota.

[00:44:22] Bill Walsh: Hey, Joanne. Welcome to the program. Go ahead with your question.

[00:44:26] Joanne: Yes, thank you. I’m calling; I have two grandsons, one is 13. And he has asthma and gets croup every year and is on a NEB machine. But his mother is afraid to have him get the vaccine because she’s heard that young men in that age group have gotten that peritonitis or carditis around the heart. Her other one, who is 12, was born under 2 pounds. He doesn’t seem to have health problems, but should they receive the vaccine or should they not? And one other quick one I’d like to stick in, I’m due for a shingles shot. How close can I have my third COVID shot, and how long would I have to wait to have the shingles shot? Thank you.

[00:45:23] Bill Walsh: All right. Thank you, Joanne. Dr. Johnson, do you want to address that? Maybe you can address the shingles shot question first, and then we can get into whether vaccines would be appropriate for these youngsters.

[00:45:36] Steven Johnson: Yeah, so in terms of the shingles shot, it can be given at the same time as the COVID-19 vaccine. As we had talked about earlier, the recommendation to space COVID 19 vaccines at least two weeks apart from other vaccines has been removed. I would say that that the shingles vaccine can cause significant side effects. It’s a very powerful vaccine, as I like to tell people it’s really, if you’re feeling poorly after it, it’s really a sign that it’s really making your immune system attack the shingles virus and develop immunity. And, of course, some of our COVID-19 vaccines also have reactions that include fever and so on. So, it’s certainly fine to space out the two by a couple of days and so on, just so you’re not dealing with the symptoms of both at the same time, but on the other hand, it’s certainly not wrong to get them on the same day. And we’ve certainly done that in our practice. In terms of the questions about vaccines for the 12- and 13-year-old, for specific situations like this that involve specific people, I always encourage you to talk with their pediatrician just because they would have a clear background of the medical history, and so on. But I would say that why we recommend vaccines in people, in adolescents of this age, is that we feel that the benefits outweigh the risks. And, of course, anything in medicine, there’s always a risk benefit analysis. And so, individuals that have asthma, that’s a potential risk factor for difficulties with COVID-19, so as an across the board statement, it sounds like you should get the vaccines, but for your specific grandchildren, I would want you to have them talk directly with their pediatrician.

[00:47:47] Bill Walsh: Dr. Strommen, I wonder if you could weigh in on this as well. I mean, Joanne’s the grandmother here and obviously wants to protect her grandkids as much as possible. Clearly their mother has some concerns about the vaccination. What advice would you give to Joanne about how to deal with this? I mean she could be in a situation where she feels her grandkids need a vaccination, but the mother of the children really resists that.

[00:48:18] Jane Strommen: I think it’s going back to really understanding why she is really hesitant to get the vaccine for her sons. And is it because of the potential side effects or does it go beyond that? Are there other concerns that she has, and really, I think, as Dr. Johnson said, really encouraging her daughter to visit with the pediatrician, because that is a trusted source of information that they can listen to. I think sometimes there’s too much information out on social media and every place, that people really don’t know what to know is truth versus a misconception, or a myth. So, I would really encourage her to visit with her daughter, visit with the pediatrician, to get the full information and maybe address some of her concerns.

[00:49:22] Bill Walsh: OK, very good. Thank you both, Dr. Johnson and Dr. Strommen. And if you’re looking for facts on the vaccines or COVID writ large, you can also check out aarp.org/coronavirus. We monitor the latest news from the FDA and the CDC. We provide tips on how to talk to your doctor, questions to ask in how to keep yourself and your family safe. Kevin, let’s take another question.

[00:49:52] Kevin Craiglow: Absolutely, Bill. I’m going to apologize in advance for pronunciation, but I think it’s Zani from Florida.

[00:50:00] Bill Walsh: Hey, Zani, welcome to the program. Go ahead with your question.

[00:50:03] Zani: Hi, thank you. I’ve waited so long to ask this question. I have a question about lupus, people with lupus. I’m surprised no one has ever discussed this on this program. What are your opinion about that, the vaccines for people who have lupus?

[00:50:20] Bill Walsh: Have you been vaccinated Zani?

[00:50:23] Zani: Now, you’re not supposed to ask me a question, you’re supposed to answer my question.

[00:50:26] Bill Walsh: [laugh] Well, we’re just trying to get the context.

[00:50:30] Zani: No, I have not.

[00:50:31] Bill Walsh: You have not, and probably because you’re concerned, you’re not sure, right, about the interactions.

[00:50:35] Zani: Yes.

[00:50:36] Bill Walsh: OK. Can I ask how old are you?

[00:50:38] Zani: 77.

[00:50:39] Bill Walsh: I know that’s an, that’s an impolite question, but just ballpark.

[00:50:43] Zani: You should never ask a lady those questions.

[00:50:45] Bill Walsh: [chuckles] OK, Dr. Johnson. I wonder if you can help Zani and others out there who might have questions like this. She’s got lupus, wondering about taking the vaccination.

[00:50:56] Steven Johnson: Yeah, I think her situation as a high priority to get the vaccine. So individuals with underlying medical conditions like lupus are often treated with different medications, some of which weaken the immune system. So that is actually an indication for the vaccines, and it’s actually going to be an indicator for a third dose or a booster dose. So I definitely think that a person with lupus should get vaccinated. The other thing about all three vaccines, of course, is that they’re not live vaccines. They don’t have a specific danger for people whose immune system is weakened. The one concern might be that if you were on medications that weaken your immune system to control lupus, it may prevent or blunt your response to vaccines. It would be important to work with your personal physician, perhaps a rheumatologist that’s helping you to take a take care of your lupus. What we’ve done with some individuals that are on medications that weaken the immune system is that we may actually give the vaccine during a holiday from those medications, like the steroids are stopped for a period of time or something like that to maybe give the immune system a better chance to develop a response to the vaccine. So in short, I would definitely recommend the vaccine for you, and I would talk with your personal physician about the timing of it.

[00:52:29] Bill Walsh: OK, thank you very much, Dr. Johnson. Kevin, let’s take another question.

[00:52:34] Kevin Craiglow: Absolutely. Bill, we’re going to go to social media for this one. Sharon on YouTube asks, “What’s the treatment if you do contract COVID? You’re told to quarantine, but not given any advice on what to do to lessen the effects or prevent progression of COVID to its critical form.”

[00:52:51] Bill Walsh: Hmm. Dr. Johnson, do you want to weigh in on that one?

[00:52:53] Steven Johnson: Yes, I’d be happy to. In the outpatient setting, there’s really only one intervention right now apart from just managing symptoms, staying well-hydrated, and perhaps taking medications to alleviate symptoms and fever. The one intervention in the outpatient setting are these monoclonal antibody infusions. And these are intravenous infusions, sometimes they can be given under the skin, that combat the virus, and they’re specifically indicated in individuals who are at risk for progression to more severe disease to be hospitalized, and so on. And there is a list that the FDA and the CDC have about those conditions. If you don’t have those conditions, then the outpatient management is really just monitoring for symptoms and having a low threshold to be seen if you’re feeling worse. On the inpatient side, there are more treatments. There is an antiviral medication called Remdesivir. There are several drugs that combat the inflammatory response that sometimes overwhelms individuals, so steroid medications and other types of medications. And, of course, there is work in both the outpatient/inpatient setting, clinical trials, trying to find additional strategies to kind of manage COVID-19 and try to prevent the severe complications.

[00:54:36] Bill Walsh: You know, Dr. Johnson, I’ve read a lot recently about folks who don’t take the vaccine, who develop COVID, and … get the antibody treatment. Do you, I assume you don’t recommend that as a course to follow. What are the concerns you might have about that?

[00:54:59] Steven Johnson: Well, I think because individuals have not been vaccinated, who have not been vaccinated, are at risk for more severe disease than those individuals who have been vaccinated, the monoclonal antibodies take on a special importance in that group because they do, they can prevent progression of disease, prevent hospitalization, and so on. I think it is an intervention in that setting. And it’s also an important intervention in those individuals that have been vaccinated but may not respond to the vaccine because their immune system is weak. One of the recommendations for people that receive the monoclonal antibodies is they actually wait 90 days after the monoclonal antibodies to get vaccinated. And that’s so that the antibody preparation in the bloodstream doesn’t interfere with the vaccine response. That is a policy that may be revisited at one point. But if you’re unvaccinated and you have risks for developing severe COVID-19, then I would really recommend the monoclonal antibodies, and then once you get about three months out, then maybe a rethinking and getting the vaccine. One of the things that we know is if you get a vaccine after having the infection, it’s a very strong boost to the immune system.

[00:56:25] Bill Walsh: But just to be clear, you’re not recommending the monoclonal antibodies as a first line of defense. You’re recommending people get the vaccine if they’re able to.

[00:56:34] Steven Johnson: The vaccine is definitely the primary intervention, but if individuals have not been vaccinated and get ill, then the monoclonals are there, but I would not rely on that approach. I would say as a strategy, the vaccine series is more effective in saving your life than the monoclonal antibodies.

[00:56:55] Bill Walsh: Yeah. OK, Kevin, let’s take another question.

[00:57:04] Kevin Craiglow: Absolutely, our next question comes from Lynette in Massachusetts.

[00:57:08] Bill Walsh: Hey, Lynette, welcome to the program. Go ahead with your question. ... Lynette, are you with us? Go ahead with your question. ... It seems like we may have ...

[00:57:27] Lynette: Can you hear me?

[00:57:27] Bill Walsh: Oh, I got you now. Hey, Lynette, how are you? Go ahead with your question.

[00:57:27] Lynette: Hi, I’m fine. Thank you. I’m an individual who has remitting-relapsing MS. I’ve gotten my Pfizer shots. I’ve gotten my booster shot, and I’ll be taking my flu vaccine this coming month in October. My concern is, I don’t know, the lack of education or the push by the CDC and others, and attending to the lackadaisical attitude of people; one, we have tours going on here like in Salem, Massachusetts, that start today, and it was about 40 or 50 people. No one had a mask on. I know when I limit, I limit myself to the restaurant, there was a gentleman who asked me, “You brought your own utensils?” I said, “Yeah.” And I said, “And I have my Lysol spray can, and my Lysol wipes to wipe the table.” He says, “Well, why do you do that?” I said, “Because I’m not inviting delta or COVID into my body.” Now that’s just me, but what I’m saying is that overall there is a lackadaisical attitude, and it’s just concerning to me. And what [does] the medical community have to say about that?

[00:58:47] Bill Walsh: You know, Lynette, I had the exact same thought. I’m a huge college football fan, and when I tune in to see 100,000 people packed into stadiums, none of them with masks on, I have the exact same thought. Dr. Johnson, I wonder what, let’s answer Lynette’s question. What does the medical community have to say about that?

[00:59:06] Steven Johnson: Well, I think that the vast majority of the medical community, of course, feels like our vaccination rates need to be higher, first of all. I actually attended a presentation last night and was told that the United States is on the list of most vaccinated countries, is now 45th. So there’s 44 other countries that have higher rates of vaccination. So we definitely need to improve our vaccination rates above what they are. That’s a big strategy. And I think, like it or not, these other types of strategies that we used earlier in the epidemic, such as social distancing and masking and not going places if you’re sick, and things like that, those are strategies that are also important in the delta era. So, I think it’s frustrating sometimes, and it’s sometimes it’s more than frustrating, it’s sad actually to see, you know, somebody who’s unvaccinated or is infected by somebody who was unvaccinated and now is in the hospital on a ventilator. There’s a lot of really sad stories about these illnesses, including illnesses that we feel should be preventable.

[01:00:22] Bill Walsh: Yep. All right, let’s take another question. Kevin.

[01:00:26] Kevin Craiglow: Absolutely. Our final question comes from Pat in Tennessee.

[01:00:31] Bill Walsh: Hey, Pat, you’re on the program. Go ahead with your question.

[01:00:34] Pat: Thank you for taking my call. What I need to know is, my husband and I are fully vaccinated as far as the … all vaxed up. That was close to seven months ago now, we went and had the first part of the Moderna, we went back March the 1st and had the rest of that done. And that’s been about seven months. So, that’s out a ways six months, and we’re told now it’s going to be eight months before the booster. We’ve been told about the third shot, which would be Moderna for us. Is it OK to have that now and wait for the booster, because we don’t know when the booster’s going to come. It seems they keep changing. You know, they have the [inaudible], they change, and they change back, but I guess they’re trying to get this taken care of and figure out something, but what do we do about that? We’re waiting to get the booster, and then we need to, I was told by my primary care doctor to wait two weeks after the booster to get my flu shot.

[01:01:49] Bill Walsh: So, we’ve had a lot of questions on boosters and the interchangeability. Pat, can I ask how old you are? You and your husband, are you over 65?

[01:01:59] Kevin Craiglow: OK, Bill, I’m sorry, we accidentally lost Pat.

[01:02:02] Bill Walsh: Got it, no worries, no worries. Dr. Johnson, I wonder if you can address Pat’s question. Obviously, this is top of mind for a lot of people.

[01:02:11] Steven Johnson: Well, one of the questions I wanted to ask, is whether either her or her husband had a medical condition for which they might qualify for those third doses. In other words, there’s a separate initiative from the booster initiative for people with weakened immune systems. And in that setting, you don’t wait a specific amount of time. You have to wait actually 28 days after the second dose, but you can go ahead and get a third dose. If they don’t fall into that category, then they have two choices. They can either find a pharmacy or a clinic or so on that will kind of give them a third dose, kind of off-line or kind of without federal guidance, and some people have done that. But I think probably what we’re all waiting for that we’ve talked about on some of these other calls, is advice on the Moderna boosters, which again, I think will be here next month, the following month, that kind of thing. … And I think there’s room for people to talk with their personal physicians. We have some people who are profoundly, have a profoundly weakened immune system, and have really gone out and sought third doses before the federal government has made up their mind how to put this together. It seems like a lot of local pharmacies and clinics are kind of willing to give additional doses out of sequence.

[01:03:45] Bill Walsh: OK. Well, thanks for that, Dr. Johnson, and thank you also Dr. Strommen. And thank you, our AARP members, volunteers and listeners for participating in this discussion. AARP, a nonprofit, nonpartisan membership 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 Sept. 24. 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 today. Please join us again on Oct. 7 at 1 p.m. Eastern Time for another live event answering your questions about the coronavirus. We hope you can join us then. Thank you and have a good day. This concludes our call.

Teleasamblea sobre el coronavirus:

variante delta, dosis de refuerzo y autocuidado

 

Participan:

 

Jane Strommen, Ph.D.: especialista en Gerontología North Dakota State University Extension

 

Steven C. Johnson, M.D.: profesor de Medicina, División de Enfermedades Infecciosas Facultad de Medicina de University of Colorado y Anschutz Medical Campus

 

Nancy LeaMond: Invitada especial, vicepresidenta ejecutiva, directora

de promoción y participación, AARP

Kevin Craiglow: organizador, director, AARP

 

Bill Walsh: moderador, vicepresidente, AARP

 

 

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 desean escuchar esta teleasamblea en español, presionen * 0 en el teclado de su teléfono ahora.

 

[En español]

 

Bill Walsh: AARP, una organización con 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 proporciona información y recursos para ayudar a los adultos mayores y a quienes los cuidan.

 

Dieciocho meses después de la pandemia de COVID-19, la variante delta continúa ocasionando miedo e incertidumbre en todo el país. Las muertes relacionadas con COVID-19 vuelven a tener una tendencia al alza a medida que las personas continúan discutiendo sobre la gravedad de la amenaza y cómo abordarla.

 

Mientras tanto, una nueva variante de COVID-19 está en el horizonte y la nación se dirige a la temporada de gripe. En este contexto, esta semana la Administración de Alimentos y Medicamentos recomendó una vacuna de refuerzo para las personas de 65 años o más. Pero el anuncio tan esperado de la FDA pareció suscitar tantas preguntas como respuestas.

 

Hoy, escucharemos a un impresionante panel de expertos hablar sobre estos temas y otros. Si ya han participado en alguna de nuestras teleasambleas, saben que esto es similar a un programa de entrevistas de radio y tienen la oportunidad de hacer sus preguntas en vivo.

 

Para aquellos de ustedes que nos acompañan por teléfono, si desean hacer una pregunta sobre la pandemia de coronavirus, presionen * 3 en el teclado de su teléfono para comunicarse con un miembro del personal de AARP que anotará su nombre y su pregunta y los colocará en una cola para hacer esa pregunta en vivo. Si se unen a través de Facebook o YouTube, pueden publicar su pregunta en los comentarios.

 

Hola, si acaban de unirse, soy Bill Walsh de AARP y quiero darles la bienvenida a esta importante discusión sobre la pandemia mundial de coronavirus. Estaremos hablando con expertos líderes y respondiendo sus preguntas en vivo. Para hacer una pregunta, presionen * 3. Y si se unen a través de Facebook o YouTube, pueden publicar su pregunta en la sección de comentarios.

 

Hoy nos acompaña un panel de invitados excepcionales, incluido un experto en enfermedades infecciosas y una experta en bienestar y envejecimiento saludable. También nos acompañará mi colega de AARP Kevin Craiglow, quien ayudará a facilitar sus llamadas.

 

Este evento está siendo grabado y se podrá acceder a la grabación en aarp.org/coronavirus, 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 través de Facebook o YouTube, pueden colocar su pregunta en la sección de comentarios.

 

Ahora me gustaría dar la bienvenida a nuestros invitados. Primero tenemos al Dr. Steven C. Johnson, profesor de Medicina en la División de Enfermedades Infecciosas de la Facultad de Medicina de University of Colorado y el Centro Multidisciplinario sobre el Envejecimiento del Campus Médico Anschutz. Bienvenido de nuevo al programa, Dr. Johnson.

 

Steven C. Johnson: Sí. Gracias por invitarme.

 

Bill Walsh: Muy bien, estamos encantados de tenerlo con nosotros. También nos acompaña la Dra. Jane Strommen, especialista en gerontología de North Dakota State University Extension. Bienvenida de nuevo al programa, Dra. Strommen.

 

Jane Strommen: Gracias. Encantada de estar aquí.

 

Bill Walsh: Muy bien, nos alegra tenerla. Sigamos adelante y comencemos con la discusión. Y solo como recordatorio para nuestros oyentes, para hacer una pregunta, por favor presionen * 3 en el teclado de su teléfono o déjenla en la sección de comentarios en Facebook o YouTube. Empecemos.

 

Dr. Johnson, la semana pasada, la Administración de Alimentos y Medicamentos recomendó la autorización de uso de emergencia para una dosis de refuerzo de la vacuna Pfizer para personas de alto riesgo o mayores de 65 años. Ahora se anticipó que el refuerzo se aprobaría para una disponibilidad más generalizada. ¿Cómo llegaron a esta decisión?

 

Steven C. Johnson: Sí, es una buena pregunta. Creo que la pregunta inicial que abordó la FDA es si autorizar un refuerzo para todas las personas mayores de 16 años, pero creo que la preocupación es que no tenemos un conjunto completo de datos, especialmente para las personas sanas más jóvenes.

 

Entonces optaron por una recomendación más conservadora que incluía a personas de 65 años o más, y luego a personas más jóvenes que tienen riesgos de COVID-19 grave, y la FDA también recomendó que las personas que tienen exposición institucional u ocupacional también reciban una vacuna de refuerzo, aunque el Comité Asesor de los CDC que se reunió hoy ha dado recomendaciones algo diferentes.

 

Bill Walsh: Entonces, con estas diferentes recomendaciones, ¿dónde nos deja eso?

 

Steven C. Johnson: Bueno, creo que... Lo que sucedió hoy es que el Comité Asesor de los CDC se reunió y estuvieron de acuerdo con dos de las recomendaciones de la FDA, los mayores de 65 años y los de 18 a 64 años con problemas médicos subyacentes. Y la única área de diferencia fue si las personas que tienen una mayor exposición basada en la ocupación, como los trabajadores de la salud, serían candidatos.

 

Será interesante porque, ya sabe, la FDA es la que proporciona la autorización. Y luego el Comité Asesor es una especie de guía, así que no puedo predecir cómo se resolverá esto.

 

Bill Walsh: Está bien.

 

Steven C. Johnson: Y tendremos que ver en los próximos días cómo se resuelve esto y quién gana.

 

Bill Walsh: Está bien. Me pregunto si los refuerzos para otras vacunas contra la COVID-19 estarán más disponibles en algún momento, y ¿cuándo se espera que suceda?

 

Steven C. Johnson: Bueno, creo que eso sucederá entre las próximas semanas a uno o dos meses, ya sabe, la vacuna Pfizer ha estado por delante de la Moderna y la vacuna Johnson & Johnson recién en desarrollo, al ser los primeros en publicar los estudios, los primeros en obtener una autorización de emergencia, los primeros en obtener la aprobación de la FDA.

 

Y creo que solo se necesita tiempo para que la FDA procese los datos, pero sé que Moderna ha enviado información sobre sus refuerzos. Y también vimos recientemente información sobre la segunda dosis de la vacuna Johnson & Johnson. Entonces creo que esto sucederá, mi predicción es en semanas a un mes o dos como máximo, creo que hay mucha presión para obtener consejos sobre refuerzos para todas las personas que recibieron las vacunas Moderna y Johnson & Johnson.

 

Steven C. Johnson: Bien, una pregunta de seguimiento más para usted, Dr. Johnson. El modelo de los CDC sugiere que las admisiones hospitalarias de COVID-19 disminuirán en el próximo mes por primera vez desde el 23 de junio. ¿Ha seguido su curso la variante delta? ¿Y qué tan preocupado está por la nueva variante mu?

 

Steven C. Johnson: Creo que hay algunas señales a nivel nacional de que el número de casos causados por delta está disminuyendo, por cierto, prácticamente todas las infecciones en Estados Unidos en este momento se deben a delta como la variante predominante. Sin embargo, dicho eso, ya sabe, diferentes estados o regiones han visto que los aumentos repentinos ocurren en diferentes momentos.

 

Entonces, lo que puede suceder en una especie de escala nacional, es posible que no se vea en las áreas regionales. Entonces, una predicción podría ser que las infecciones de la variante delta disminuyan en el sur, pero pueden subir en las áreas del norte donde las actividades en el interior comienzan a predominar, etc. No sé mucho sobre la variante mu, es una variante de interés.

 

Y lo único que tendremos que ver es que no es una causa importante de infecciones en este momento, pero, por supuesto, durante el último año y medio, hemos tenido alfa, beta y gamma, y todas estas diferentes variantes. Así que creo que hay un enfoque realmente elegante para rastrear estas variantes. Y solo tendremos que ver en los próximos meses, si las nuevas variantes, incluida mu, son significativas.

 

Bill Walsh: Bueno, también será interesante ver qué tan efectivas son las vacunas contra ella.

 

Steven C. Johnson: Sí, bueno, hasta ahora, las tres vacunas parecen funcionar bien contra la variante delta, algo de disminución en la actividad, pero aún eficaz, especialmente contra enfermedades graves. Y creemos que, de hecho, los refuerzos de las vacunas originales serán útiles para controlar aún más el brote de delta.

 

Bill Walsh: Está bien. Gracias, Dr. Johnson. Dra. Strommen, volvamos a usted. Seguimos viendo a muchas personas en este país que se niegan a vacunarse contra la COVID-19, un problema que ha dividido al país y también a algunas familias. ¿Cómo hablamos con los miembros de la familia que han rechazado la vacuna? ¿Hay estrategias que usted crea que son efectivas para convencer a alguien de que se vacune?

 

Jane Strommen: Creo que hay varias estrategias que podemos utilizar. Y la primera que mencionaría es empezar por escuchar. Puede haber muchas razones por las que las personas dudan en recibir las vacunas contra la COVID-19, pero una de las razones que se mencionan a menudo es que las vacunas se desarrollaron muy rápidamente.

 

Por lo tanto, es importante reconocer su preocupación y ser empático y preguntar si están dispuestos a hablar sobre su vacilación y alguna forma en que uno pueda ayudar, así que esa sería una manera. Y decirles que a pesar de que las vacunas se desarrollaron en un tiempo récord, las vacunas disponibles para su uso han pasado por los mismos procesos y requisitos que otras vacunas, por lo que cumplen con los estándares de seguridad, entonces eso sería lo primero. Y otra estrategia útil podría ser citar la historia.

 

Es posible que algunas personas no comprendan que la forma más rápida y, en algunos casos, la única forma de eliminar la amenaza de un virus como la COVID-19 es mediante la vacunación. Por lo tanto, podría ser muy útil compartir relatos exitosos sobre cómo las vacunas han mejorado la sociedad en el pasado.

 

Muchos adultos mayores recuerdan haber recibido la polio… la vacuna contra la polio, y han visto cómo las tasas de polio disminuyeron considerablemente después como resultado de la vacuna. Así que podría ser útil discutir eso. Otra estrategia sería abordar los conceptos erróneos.

 

Algunas personas pueden tener miedo de los posibles efectos secundarios de la vacuna. Por lo tanto, es importante que las personas comprendan las reacciones esperadas a una vacuna, como tal vez dolor cerca del lugar de la inyección o fiebre o dolor de cabeza. Y que estas reacciones son temporales. Y no significa que las vacunas le hayan dado la enfermedad a la persona.

 

Por eso es importante centrarse realmente en los mitos frente a los hechos. Y luego, la última estrategia sería realmente animarlos a hablar con su médico para obtener más información. Aquí es donde obtendrán información creíble que sea precisa y confiable, y alguien que pueda hablar con ellos sobre su situación personal.

 

Bill Walsh: Bueno, somos optimistas de que veremos un aumento significativo en las tasas de vacunación. Quiero decir, las vacunas existen hace un tiempo, y las han recibido unos 170 millones, o probablemente más personas. Tal vez sea el ensayo clínico más grande de la historia. Me pregunto en algún momento, cuánta más evidencia necesita ver la gente.

 

Jane Strommen: Sí. Pero siento que las personas que dudan, ya sabe, sus preguntas son, ¿son necesarias las vacunas? ¿Son eficaces? ¿Son seguras? Y creo que a medida que obtengamos más datos de investigación y podamos ver que dan resultado, que son efectivas, que están ayudando a las personas a reducir esas enfermedades graves y las hospitalizaciones y muertes que, con suerte, con el tiempo, veremos que más personas se unen y comprenden que están funcionando.

 

Bill Walsh: Está bien, Dra. Strommen, muchas gracias. Y como recordatorio para nuestros oyentes, para hacer una pregunta, por favor presionen * 3 en el teclado de su teléfono. Y vamos a llegar a esas preguntas en vivo en breve, pero antes de hacerlo, quiero traer a Nancy LeaMond. Nancy es la vicepresidenta ejecutiva y directora de Promoción y Participación aquí en AARP. Bienvenida, Nancy.

 

Nancy LeaMond: Encantada de estar aquí, Bill.

 

Bill Walsh: Saben, además de compartir la información más actualizada sobre el coronavirus, nos gustaría tomarnos unos minutos para actualizar a nuestros oyentes sobre temas importantes que enfrenta el Congreso y cómo AARP está luchando por ellos. Han estado muy ocupados en el Congreso, como usted lo sabe mejor que nadie, Nancy, ¿puede compartir un poco sobre eso?

 

Nancy LeaMond: Con gusto, Bill. La semana pasada, los comités del Congreso impulsaron una legislación que incluye una serie de prioridades de AARP. Y si se promulgan, estas disposiciones tendrían un tremendo impacto positivo en los adultos de 50 años o más. Específicamente, estamos luchando para reducir los precios de los medicamentos recetados, crear un crédito fiscal para los cuidadores familiares y expandir Medicare para incluir servicios dentales, de la vista y audición, entre otras prioridades.

 

Bill Walsh: Estos temas se han debatido durante mucho tiempo, pero el hecho de que finalmente estén ganando terreno es una gran noticia para los adultos mayores. ¿No es así?

 

Nancy LeaMond: Así es. Es un buen primer paso, pero tenemos un largo camino por recorrer, especialmente con el tema de los precios descontrolados de los medicamentos. Tenemos una oportunidad única en una generación de aprobar la reforma de los medicamentos recetados y todos vamos a trabajar duro para que eso suceda.

 

Las personas pagaron tres veces más por medicamentos de marca que en otros países. Y muchos de estos medicamentos se desarrollaron utilizando dólares de impuestos estadounidenses. Sin embargo, Medicare tiene prohibido negociar el costo de los medicamentos recetados. Las personas quieren precios justos para sus medicamentos, los medicamentos que nos mantienen saludables.

 

Y para hacer eso, Medicare necesita poder negociar. Les pido a todos los que estén en la llamada que se comuniquen con sus representantes y les pidan que permitan que Medicare negocie precios más bajos para los medicamentos.

 

Bill Walsh: Nancy, ahora llevamos un año y medio en la pandemia del coronavirus y 1 de cada 500 personas ha muerto por COVID-19. Entre las personas de 65 años o más y las comunidades de color, particularmente afroamericanos, hispanos, latinos y poblaciones nativas americanas, esos números son mucho peores. A medida que Estados Unidos avanza hacia un trágico hito de casi 700,000 muertes por COVID-19, especialmente entre los adultos mayores. ¿Qué hemos perdido?

 

Nancy LeaMond: Bueno, como dijo, Bill, el número de muertos por COVID-19 es simplemente abrumador. Los números son tan altos y es difícil pensar en lo que sucedió. Las familias han perdido a sus seres queridos y nuestras comunidades han perdido a sus futuros contribuyentes. Es absolutamente desgarrador. Estos son padres y abuelos, hijos e hijas, amigos, vecinos, líderes y mentores.

 

Bill Walsh: Muy bien, Nancy, muchas gracias por compartir esas actualizaciones. ¿Tiene algún pensamiento de despedida para nosotros?

 

Nancy LeaMond: Bueno, durante años, AARP ha luchado para mejorar el acceso a la atención médica para proteger a las personas mayores vulnerables en hogares de ancianos y para apoyar a los cuidadores familiares. La pandemia ha sacado a la luz la importancia de este trabajo. Todos estamos profundamente afectados y debemos hacer todo lo posible para evitar más daño.

 

Sé que pasamos mucho tiempo hablando de vacunas y, hoy en día, la mayoría de las muertes por COVID-19 ocurren entre los no vacunados. Así que, por favor, si aún no lo han hecho, vacúnense. Los necesitamos aquí. Sus seres queridos los necesitan aquí. Y cuídense para cuidarnos a todos. Y gracias a usted, Bill, y a nuestros invitados esta noche por ayudarnos a hablar sobre este importante tema.

 

Bill Walsh: Está bien. Gracias, Nancy, por estar aquí. Realmente lo apreciamos. Ahora es el momento de abordar sus preguntas sobre el coronavirus con el Dr. Steven Johnson y la Dra. Jane Strommen. Presionen * 3 en cualquier momento en el teclado de su teléfono para comunicarse con un miembro del personal de AARP y hacer su pregunta. Y si desean escuchar en español, presionen * 0 en el teclado de su teléfono ahora.

 

[En español]

 

Bill Walsh: Ahora me gustaría traer a mi colega de AARP Kevin Craiglow para ayudar a facilitar sus llamadas de hoy. Bienvenido, Kevin.

 

Kevin Craiglow: Gracias, Bill. Feliz de estar aquí para esta importante conversación.

 

Bill Walsh: Está bien. Feliz de tenerlo. ¿Quién es nuestro...? Tomemos nuestra primera pregunta.

 

Kevin Craiglow: Nuestra primera pregunta proviene de Sally en Florida.

 

Bill Walsh: Hola, Sally, bienvenida al programa. Continúe con su pregunta.

 

Sally: Sí, gracias por estas maravillosas teleasambleas. Son maravillosos. Me gustaría decir eso primero. He estado en varias de ellas, pero mi pregunta de esta noche está relacionada con el refuerzo de Johnson & Johnson. Recibí la Johnson & Johnson en marzo, principios de marzo cuando salió por primera vez aquí en Miami. Y mi pregunta es, ya que estamos llegando a los seis u ocho meses realmente rápido, y dado que supuestamente, "todas estas vacunas son seguras", quiero saber, ¿los refuerzos son la misma inyección que recibimos antes? Y si lo son, ¿por qué no podemos ir a recibirla? ¿Por qué tenemos que esperar a que alguien nos lo indique?

 

Bill Walsh: Sí. Gracias por esa pregunta, Sally. Dr. Johnson, ¿puede ayudar a Sally y a otros oyentes que puedan tener la misma pregunta?

 

Steven C. Johnson: Sí, creo que uno de los problemas que mencionamos anteriormente en la llamada es que todavía estamos esperando algunos consejos sobre las dosis de refuerzo, de la tercera dosis de la vacuna Moderna y la segunda dosis de la vacuna Johnson & Johnson.

 

Acabamos de ver algunos datos publicados por la compañía que fabrica la vacuna Johnson & Johnson, la segunda dosis de la vacuna Johnson & Johnson realmente aumenta la inmunidad contra COVID-19, así que eso es muy emocionante. Y en realidad estamos esperando a que la FDA y los CDC propongan una guía específica. Y creo que será en un futuro cercano.

 

Ha habido algunas jurisdicciones que han tomado el asunto en sus propias manos y han ofrecido dosis adicionales de estas vacunas a personas que recibieron Moderna y Johnson & Johnson, pero si ese enfoque no está autorizado actualmente, hablaría con su propio médico para obtener alguna idea sobre la urgencia de recibir una dosis adicional, pero realmente espero que durante el próximo mes o dos usted y su médico tengan el consejo que necesitan con respecto a las dosis adicionales.

 

Bill Walsh: Adelante, Dr. Johnson.

 

Steven C. Johnson: No, solo digo que a veces parece ser un poco frustrantemente lento. Y acabamos de escuchar más sobre Pfizer solo porque ha estado en circulación un poco más tiempo.

 

Bill Walsh: Sí. Y creo que a una cosa a la que se refería Sally es a la posibilidad de intercambiar estas vacunas y sus refuerzos, así que sé que Pfizer y Moderna usan la misma tecnología en su vacuna. Si alguien recibe una vacuna Moderna, ¿podría recibir un refuerzo de Pfizer? Si recibieron la vacuna J&J, ¿podrían recibir un refuerzo de Moderna? ¿Eso funciona de esa manera?

 

Steven C. Johnson: Bueno, esto de hecho está sucediendo. Y uno de nuestros centros de salud comunitarios locales aquí está administrando una de las vacunas de ARN mensajero, que es Moderna o Pfizer, a personas que habían recibido la vacuna Johnson & Johnson, pero esta especie de enfoque de combinación no ha sido tan estudiado.

 

Y entonces no ha sido, digamos, oficialmente, sancionado a nivel federal. Nuevamente, creo que vamos a tener algo de claridad en un futuro relativamente cercano. Entonces, mi consejo es esperar un poco y escuchar en lugar de ir y recibir otra marca de vacuna. Solo sabemos un poco menos sobre la seguridad de ese enfoque.

 

Bill Walsh: Sí. Bueno. Gracias. Como recordatorio para nuestros oyentes, para hacer una pregunta, presionen * 3 en el teclado de su teléfono o escriban en la sección de comentarios en YouTube o Facebook. Kevin, tomemos otra pregunta.

 

Kevin Craiglow: Nuestro próximo oyente también es Bill, Bill de Massachusetts.

 

Bill Walsh: Hola, Bill, bienvenido al programa. Continúe con su pregunta.

 

Bill: Bien rápido, estoy cerca de los 70, no estoy inmunodeprimido. Recibí mi segunda inyección de Pfizer en marzo, que es aproximadamente seis meses antes de mediados de septiembre. Y tengo dos preguntas sencillas. Me han informado que debo esperar 30 días entre mi vacuna antigripal multivalente anual y mi refuerzo de Pfizer. ¿Se requieren 30 días por la delta? Esa es la primera pregunta. Y número dos, ¿debería ponerme la vacuna contra la gripe primero o el refuerzo de Pfizer primero? Gracias.

 

Bill Walsh: Dr. Johnson, ¿puede responder la pregunta de Bill?

 

Steven C. Johnson: Sí. Creo que hay una respuesta bastante sencilla. Sin duda, puede recibir la vacuna contra la gripe y el refuerzo de Pfizer al mismo tiempo. Anteriormente, en el lanzamiento de la vacuna, el Comité Asesor de los CDC recomendó espaciar las vacunas contra la COVID-19 con dos semanas de diferencia de cualquier otra vacuna, y eso no se basaba realmente en la ciencia sino que fue solo por precaución.

 

Han eliminado esa condición. Y entonces, ciertamente puede recibir ambas. En cuanto a la vacuna contra la gripe, los CDC recomiendan recibirla en septiembre u octubre. Es decir, en esta época. Y en términos del refuerzo, la recomendación será seis meses, que es donde está.

 

Entonces, lo que haría es recibir ambas vacunas en un futuro relativamente cercano. Si las recibe el mismo día, hay una recomendación de que se las coloque en brazos opuestos, pero fuera de eso, puede recibirlas simultáneamente. Y de hecho, es posible que en el futuro se trabaje en la combinación de vacunas que tienen tanto la gripe como el virus SARS-CoV-2 en la misma vacuna.

 

Bill Walsh: Muchas gracias, Dr. Johnson. Kevin, tomemos otra pregunta.

 

Kevin Craiglow: Nuestra siguiente pregunta en realidad proviene de las redes sociales. Un usuario de YouTube quiere saber: "Mis padres ancianos viven lejos de mí y están muy aislados. ¿Qué puedo hacer para asegurarme de que estén seguros y se cuiden?"

 

Bill Walsh: Dra. Strommen, ¿puede abordar esa pregunta?

 

Jane Strommen: Bueno, sí, esa ha sido una gran preocupación durante el transcurso de esta pandemia: las personas que están aisladas. Lo que significa que tal vez estén preocupadas, tal vez por problemas de salud, o tal vez la edad las limita para salir de casa hacia la comunidad.

 

Es difícil cuando tenemos familiares o cuidadores a larga distancia. Así que supongo que para empezar, sin saber mucho sobre la situación, es importante que los adultos mayores estén lo más conectados posible y tengan una red social, incluso si están en su casa. Y vimos que se usaba mucha tecnología al principio de la pandemia, ya sea probando Skype o Zoom o algún tipo de videoconferencia por primera vez, con padres y abuelos que se conectaban a la vieja usanza por teléfono.

 

Pero realmente siento que si este hijo adulto vive lejos, ¿quién está en esa zona? ¿Hay otros parientes u otros vecinos, amigos a quienes pueda acudir para crear una especie de red social para sus padres para que no se sientan aislados? Si necesitan atención, ese es otro tema y para cosas así, hay organizaciones.

 

Hay un Centro de Recursos para Personas Mayores y Discapacitados en cada estado, puede comunicarse con ellos y averiguar qué tipo de servicios de apoyo podría haber en esa área también.

 

Bill Walsh: Está bien, Dra. Strommen, muchas gracias. Kevin, tomemos otra llamada.

 

Kevin Craiglow: Por supuesto. A continuación tenemos a Gail de Connecticut.

 

Bill Walsh: Hola, Gail, bienvenida al programa. Continúe con su pregunta.

 

Gail: Gracias por atender mi llamada. Mi pregunta está relacionada con la innovadora variante delta. Mi hija, que tiene 42 años, está completamente sana y recibió todas sus vacunas, pero se contagió de la delta. Y han sido unos largos dos meses y medio. Ella todavía duerme 16 horas al día, se levanta para ducharse y regresa por otras 16 horas. Tiene confusiones mentales, no tiene energía, está letárgica. ¿Hay algo que puedan recomendar? Ya sabe, no hay nada en las noticias sobre la infección posvacunación y a largo plazo.

 

Bill Walsh: Gail, déjeme preguntarle, ¿lo han vacunado?

 

Gail: Oh, sí, por supuesto.

 

Bill Walsh: Está bien. Bueno. Dr. Johnson, ¿puede abordar esto? Esto es algo de lo que escuchamos cada vez más, sobre estos síntomas de larga duración. ¿Hay algo que la gente pueda hacer?

 

Steven C. Johnson: Bueno, hablemos primero de las infecciones posvacunación, estamos viendo infecciones posvacunación por supuesto, y en promedio, son más leves que en las personas que han sido vacunadas en gran medida. Y así, por ejemplo, en nuestro hospital aquí, algunos de nuestros pacientes hospitalizados han sido vacunados, pero muy pocos, si es que hay alguno, están en la unidad de cuidados intensivos.

 

Entonces las infecciones, en promedio, son más leves en aquellos que han sido vacunados. Y lo que hemos aprendido sobre los refuerzos, al menos con la vacuna Pfizer, es que las infecciones son menos comunes después del refuerzo en comparación con las personas que acaban de recibir la serie primaria. En términos de lo que esto significa, en términos del síndrome de COVID-19 prolongada, creo que todavía estamos tratando de resolverlo, como muestra la situación de este oyente, hay personas que han sido vacunadas que se enferman, algunas desarrollan una enfermedad grave, algunas desarrollan una COVID-19 prolongada.

 

Y nosotros... Las vacunas no aseguran una protección absoluta ante esta afección. Creo que sería importante, si no ha sucedido ya, que su hija esté bajo atención médica con alguien que conozca sobre COVID-19 y sus complicaciones, solo para asegurarse de que no haya una complicación específica para la cual podría haber un tratamiento específico.

 

Este síndrome de COVID-19 prolongada es un área de mucho estudio, creo que todavía estamos aprendiendo qué tipos de intervenciones pueden ser útiles para eso. De hecho, ha habido algunos informes anecdóticos de que las personas que tuvieron COVID-19 durante mucho tiempo y luego se vacunaron, notaron mejoras en sus síntomas, pero no creo que eso se haya demostrado realmente en ensayos lo suficientemente grandes como para estar seguros.

 

Entonces, ya sabe, creo que tenemos que estar atentos a la investigación, pero mientras tanto, me aseguraría de que su hija esté en manos de un muy buen médico. En mi especialidad en particular, enfermedades infecciosas, a veces veremos a estas personas en consulta, solo para asegurarnos de que no nos estamos perdiendo alguna complicación discreta que pueda requerir un tratamiento específico.

 

Bill Walsh: Muy bien, Dr. Johnson, muchas gracias. Y para nuestros oyentes, para hacer una pregunta al Dr. Steven Johnson o la Dra. Jane Strommen, presionen * 3 en el teclado de su teléfono para conectarse con un miembro del personal de AARP que lo colocará en la cola para hacer esa pregunta en vivo. Kevin, ¿quién es el próximo en la cola?

 

Kevin Craiglow: Bill, hay muchas preguntas en línea también. Y de ahí viene la siguiente. Lisa preguntó: "¿Cuáles son algunas de las actividades de cuidado personal que debo seguir manteniendo? Por ejemplo, ¿debo acudir a la cita con el médico? ¿Debo seguir viendo a mi terapeuta?"

 

Bill Walsh: Pregunta interesante. La escuchamos mucho. Dra. Strommen, ¿puede abordar la pregunta para Lisa y los demás?

 

Jane Strommen: Sí. Claro que puedo. Les diré que todos pensamos que salíamos de la pandemia con las vacunas, y las tasas de infección que bajaban y nos reuníamos en grupos grandes, y luego se identificó la variante delta y ahora las advertencias están creciendo. Entonces, la variante delta realmente ha amplificado nuestra ansiedad sobre nuestras actividades de vida y decisiones sobre nuestro bienestar, mascarillas y vacunas.

 

Otra vez pensamos en eso. Y entonces realmente anhelamos esa respuesta definitiva, ¿cuándo se va a terminar todo esto? Y no tenemos la respuesta. Así que realmente estamos llamando a esto, estamos en un flujo, estamos en un flujo pandémico. Así que nos encontramos con un sentimiento de necesidad de escapar de una amenaza que no podemos controlar.

 

Pero esta es realmente una especie de crisis humanitaria compartida que está ocurriendo en todo el mundo. Y es normal que nos sintamos así. Entonces, yo diría que lo primero es que debemos ser amables con nosotros mismos y permitirnos sentir las emociones como algo normal en esta experiencia colectiva que estamos viviendo.

 

Siempre digo que veamos lo que aprendimos del primer encierro y apliquémoslo ahora. ¿Qué dio resultado? ¿Qué no deberíamos estar haciendo y reevaluar en el camino? Realmente necesitamos crear una especie de sensación de control y apoyo.

 

Entonces, mencionaría algunas otras estrategias, que mencionó la persona que llamó, mantener rutinas y horarios regulares tanto como sea posible, asistir a las citas con el médico, realizarse exámenes, mantenerse físicamente activos, sabemos que eso brinda muchos beneficios. Nos mantiene fuertes, nos da más energía, tenemos un mejor equilibrio, o retrasa o previene algunas de nuestras enfermedades crónicas, y algo muy importante, nos anima y reduce la depresión. Entonces yo diría que esas son cosas realmente importantes que hacer.

 

Bill Walsh: No sé si esto estaba en la mente de Lisa, pero sé que mucha gente está preocupada por sus próximas visitas al médico o al dentista, simplemente porque son lugares donde hay enfermos, ¿verdad? Y no queremos ponernos en riesgo. ¿Qué deben hacer las personas con su atención médica preventiva o chequeos regulares si tienen enfermedades crónicas? ¿Deberían acudir a esas citas? ¿Cómo se aseguran de recibir la atención médica que necesitan de la manera más segura posible?

 

Jane Strommen: Bueno, no puedo hablar sobre todo eso, y tal vez el Dr. Johnson también tenga un mejor consejo. Pero la situación de cada persona es diferente. Y creo que necesitan evaluar los riesgos. Si es importante que continúen con la atención médica que están recibiendo o con las visitas preventivas, y si hay precauciones establecidas en esos centros de atención médica.

 

Y antes hacíamos esto, durante la primera parte de la pandemia, entonces probablemente tenga sentido, según la evaluación de riesgo de cada uno, así que creo que esas son decisiones individuales importantes que las personas deben tomar, según su edad, su estado de salud, ya sabe, quién vive en su casa, todo ese tipo de cosas.

 

Bill Walsh: Está bien. De acuerdo, Dra. Strommen. Muchas gracias. Kevin, volvamos a las líneas. ¿A quién tenemos ahora?

 

Kevin Craiglow: Por supuesto. Tenemos a Carolyn de Oregón.

 

Bill Walsh: Hola, Carolyn, bienvenida al programa. Continúe con su pregunta.

 

Carolyn: Hola. Tengo dos preguntas. ¿La vacuna Moderna es más eficaz? Y si es así, si uno recibió las dos primeras inyecciones de Pfizer, ya que ambas son ARNm, ¿cuáles son los riesgos de cambiar a Moderna para la tercera inyección?

 

Bill Walsh: Bien, ¿y tenías una segunda pregunta?

 

Carolyn: Sí. ¿Están modificando alguna de las vacunas más hacia la barrera de inmunidad ante la delta?

 

Bill Walsh: Bien, Dr. Johnson, ¿puede opinar sobre eso? Carolyn parece estar preguntando sobre el tema del que hablamos un poco antes, sobre combinar las diversas vacunas, y también, ¿qué tipo de modificaciones se están realizando en las vacunas para mantenerse al día con las diversas variantes?

 

Steven C. Johnson: Bueno, Gracias. Creo que la primera parte de la pregunta también fue comparar la eficacia de estas diferentes vacunas. Y ha habido algunos datos recientes de estudios que analizan la respuesta inmunitaria, pero también grandes estudios que analizan el efecto de las vacunas que parecen sugerir que la vacuna Moderna podría ser un poco más efectiva que la vacuna Pfizer.

 

No sabemos si la estrategia del refuerzo ahora eliminará esa diferencia o la magnificará. Y también depende del enfoque porque las tres vacunas realmente son muy eficaces en la prevención de enfermedades graves, porque la vacuna Moderna ha tenido algunos estudios recientes que sugieren que podría ser un poco más poderosa.

 

Ha habido interés en observar este tipo de enfoque de combinación. Nuevamente, no creo que sepamos lo suficiente sobre la seguridad de este enfoque. Conozco anecdóticamente que algunas de las personas a las que atiendo han optado por recibir una dosis de Moderna después de la serie de Pfizer, pero si me pidieran mi consejo, recomendaría seguir los consejos de la FDA y los CDC, que recomiendan una tercera dosis, por ejemplo, si su sistema inmunitario está debilitado, o si ahora reciben una dosis de refuerzo con la vacuna Pfizer, que usen la misma vacuna.

 

Veremos en estudios posteriores sobre la seguridad de usar más de un tipo de vacuna, que puede resultar siendo una estrategia importante. Hacemos eso con algunas otras enfermedades. Tenemos dos tipos de vacunas contra la neumonía y así sucesivamente. En cuanto a si se están desarrollando vacunas teniendo en cuenta las nuevas cepas, la respuesta es sí.

 

Y creo que las empresas están analizando algunas de las nuevas variantes y utilizándolas como base para crear vacunas más nuevas, pero yo diría que todavía sentimos que nuestras vacunas actuales que se desarrollaron inicialmente, especialmente ahora con planes para refuerzos, siguen siendo muy eficaces contra la variante delta.

 

Bill Walsh: Bien, gracias, Dr. Johnson, y gracias a nuestros oyentes por esas preguntas. Responderemos algunas preguntas más en breve. Recuerden, si desean hacer una pregunta, presionen * 3 en el teclado de su teléfono. O si están en YouTube o Facebook, colóquenla en la sección de comentarios. Si desean escuchar esta teleasamblea en español, presionen * 0 en el teclado de su teléfono ahora.

 

[En español]

 

Bill Walsh: Ahora volvamos a nuestros expertos. Entonces, Dr. Johnson, hablamos sobre las recomendaciones de la FDA sobre la vacuna Pfizer. ¿Qué significa esto para las personas con alto riesgo o mayores de 65 años que recibieron las vacunas Moderna y J&J? Ya hemos hablado un poco de esto. Supongo que estamos esperando más consejos sobre si deberían recibir la vacuna Pfizer o deberían esperar, pero si estas personas tienen un alto riesgo, ¿qué les aconsejaría que hicieran?

 

Steven C. Johnson: Bueno, creo que siempre hay lugar para trabajar con su médico de atención primaria, que conoce bien sus problemas médicos subyacentes y el riesgo que corren... Pero creo que si estamos analizando el tipo de consejo de los CDC y el consejo de la FDA, el único consejo real que tenemos ahora para los refuerzos es de Pfizer.

 

Sin embargo, recuerden que tenemos un consejo anterior de la FDA y los CDC sobre terceras dosis en personas cuyo sistema inmunitario está debilitado. Y esas recomendaciones son para los que recibieron Pfizer y Moderna. Entonces, si tienen un trasplante subyacente o están en tratamiento contra el cáncer, etc., y han recibido dos dosis de Pfizer o Moderna, en realidad pueden recibir una dosis adicional ahora con la autorización previa.

 

Consideramos estas terceras dosis en personas inmunodeprimidas en lugar de dos dosis de refuerzo, que aún dejan al grupo que recibió la vacuna J&J sin ningún consejo oficial. Y como mencioné antes, conozco algunas jurisdicciones que están ofreciendo segundas dosis de otras vacunas a los receptores de J&J, pero lo están haciendo realmente sin ningún tipo de autorización federal.

 

Es interesante cómo muchos tipos de programas locales y estatales han instituido algunas de estas políticas antes de que realmente sean sancionadas a nivel federal.

 

Bill Walsh: Sí. Está bien. Gracias, Dr. Johnson. Déjeme hacer un seguimiento rápido. Mientras que las vacunas contra la COVID-19 están en los titulares, por supuesto, no son la única vacuna. ¿Por qué es importante que las personas se pongan la vacuna tradicional contra la gripe incluso si están completamente vacunados contra la COVID-19?

 

Steven C. Johnson: Sí, ya sabe, nos olvidamos de que antes de la COVID-19, la influenza era la enfermedad que temíamos cada temporada. Y la influenza se ha asociado con 20,000 a 60,000 muertes en EE.UU. en cada temporada de influenza. Entonces, nuevamente, antes de la COVID-19, esta era la enfermedad a la que temer.

 

Y, por supuesto, puede atacar especialmente a los mismos tipos de personas que contraen COVID-19 grave. Entonces, personas mayores, personas con comorbilidades subyacentes como obesidad, hipertensión, enfermedad pulmonar, enfermedad cardíaca, etc., y luego personas con un sistema inmunitario debilitado.

 

El otro problema es que debido al distanciamiento social y el uso de mascarillas y otras medidas el año pasado, fue una temporada de gripe muy leve, lo que en la superficie es algo bueno, pero una de las cosas acerca de la gripe es que administramos vacunas anuales contra la gripe para crear una especie de inmunidad. Y es probable que parte de esa inmunidad también se active al estar expuesto al virus de la gripe.

 

Por lo tanto, existe cierta preocupación de que este año podría ser la peor temporada de gripe porque las personas han perdido parte de esa inmunidad parcial. Y claro, creo que la gente también se ha cansado de las medidas como el uso de mascarillas y el distanciamiento social. El otro problema es que, como proveedores de atención médica, nos gustaría que las personas se vacunaran contra la influenza porque quisiéramos evitar un poco la confusión entre estas dos enfermedades respiratorias.

 

Tienen signos y síntomas que se superponen significativamente. Entonces, por todas esas razones, debe vacunarse contra la influenza este mes y el mes que viene, y para las personas mayores de 65 años, en realidad, recomiendan la vacuna contra la influenza en dosis altas.

 

Bill Walsh: Bien, gracias por eso, Dr. Johnson. Dra. Strommen, volvamos a usted. Según el Fondo Conmemorativo Nacional para Oficiales de la Aplicación de la Ley, la COVID-19 fue la principal causa de muerte de agentes de policía hasta el 30 de junio durante los 18 meses anteriores, más que los incidentes relacionados con armas de fuego y tráfico combinados. ¿Qué tan alto es el costo de la COVID-19 para nuestros trabajadores de primera línea? Y como resultado, ¿nuestra seguridad y calidad de atención se ven comprometidas?

 

Jane Strommen: Sabe, ir a trabajar durante la pandemia de COVID-19 realmente ha puesto a nuestros trabajadores de primera línea bajo una presión inmensa y sin precedentes, y los pone en mayor riesgo en cuanto al bienestar físico, mental y social. Por lo tanto, la exposición a un estrés excesivo durante períodos prolongados puede tener muchas consecuencias perjudiciales para el bienestar emocional y mental de las personas y, especialmente, para nuestros trabajadores de primera línea.

 

Ya sabe, puede provocar agotamiento, la aparición de trastornos mentales como depresión, ansiedad y trauma. Y estas cosas pueden resultar en comportamientos poco saludables como el uso de tabaco y alcohol u otras sustancias, tal vez ausencias frecuentes al trabajo, reducción de la productividad laboral y aumento del riesgo de suicidio entre los trabajadores de primera línea, especialmente los trabajadores de la salud.

 

Entonces, para responder a su pregunta en el contexto de COVID-19, especialmente en nuestro entorno de atención médica, esto puede resultar en una calidad y seguridad de la atención comprometida, tal vez una violación de los protocolos y pautas, un mayor riesgo de infecciones, solo una capacidad comprometida para el sistema de salud y nuestro sistema de respuesta a emergencias. Entonces es un problema serio. Nuestros trabajadores de primera línea han estado sometidos a un estrés extraordinario durante un período prolongado y es preocupante.

 

Bill Walsh: Los efectos de la COVID-19 continúan propagándose por todo el país. Gracias, Dra. Strommen. Ahora es el momento de abordar más preguntas con el Dr. Steven Johnson y la Dra. Jane Strommen. Y como recordatorio, presionen * 3 en cualquier momento en el teclado de su teléfono para conectarse con un miembro del personal de AARP. Kevin, ¿a quién tenemos ahora en la línea?

 

Kevin Craiglow: Bill, vamos ahora con Joanne de Minnesota.

 

Bill Walsh: Hola, Joanne, bienvenida al programa. Continúe con su pregunta.

 

Joanne: Sí, gracias. Llamo porque tengo dos nietos, uno tiene 13 años, tiene asma y le da tos ferina todos los años y está conectado a un nebulizador, pero su madre tiene miedo de que le pongan la vacuna porque ha escuchado que un joven de ese grupo de edad ha contraído peritonitis o carditis alrededor del corazón. El otro, que tiene 12 años, nació con menos de dos libras. No parece tener problemas de salud, pero ¿deberían recibir la vacuna o no? Y otra rápida en la que me gustaría agregar. Tengo pendiente colocarme una inyección. ¿Qué tan pronto puedo recibir mi tercera dosis contra la COVID-19 y cuánto tiempo tendré que esperar para recibir la inyección del herpes? Gracias.

 

Bill Walsh: Está bien. De acuerdo. Gracias, Joanne. Dr. Johnson, ¿quiere abordar tal vez primero la pregunta sobre la vacuna contra el herpes zóster? Y luego podemos analizar si las vacunas serían apropiadas para estos jóvenes.

 

Steven C. Johnson: Sí, en términos de la vacuna contra la culebrilla, se puede administrar al mismo tiempo que la vacuna contra la COVID-19. Como hemos mencionado anteriormente, se ha eliminado la recomendación de espaciar las vacunas contra la COVID-19 al menos dos semanas de otras vacunas. Yo diría que la vacuna contra el herpes zóster puede causar efectos secundarios importantes. Es una vacuna muy poderosa.

 

Como me gusta decirle a la gente, si se sienten mal después de recibirla, es realmente una señal de que está haciendo que el sistema inmunitario ataque el virus del herpes zóster y desarrolle inmunidad. Y, por supuesto, algunas de nuestras vacunas contra la COVID-19 también tienen reacciones que incluyen fiebre, etc.

 

Por lo tanto, ciertamente está bien espaciar las dos por un par de días y eso, solo para que no esté lidiando con los síntomas de ambas al mismo tiempo, pero por otro lado, ciertamente no está mal recibirlas el mismo día. Y ciertamente lo hemos hecho así en nuestra práctica.

 

En cuanto a las preguntas sobre vacunas para niños de 12 y 13 años, en situaciones específicas como esta que involucran personas específicas, siempre insisto en que hablen con su pediatra, solo porque tendría un trasfondo claro del historial médico y demás, pero yo diría que la razón por la que recomendamos las vacunas en adolescentes de esta edad es que sentimos que los beneficios superan los riesgos.

 

Y, por supuesto, cualquier cosa en medicina es siempre un análisis de riesgo y beneficio. Entonces, las personas que tienen asma, ese es un posible factor de riesgo para tener dificultades por COVID-19. Entonces, a modo de declaración generalizada, parece que deberían vacunarse, pero para sus nietos en particular, quisiera que hablen directamente con su pediatra.

 

Bill Walsh: Dra. Strommen, me pregunto si también podría opinar sobre esto. Quiero decir, Joanne es la abuela aquí y obviamente quiere proteger a sus nietos tanto como sea posible. Claramente, su madre tiene algunas preocupaciones sobre la vacunación, ¿qué consejo le daría a Joanne sobre cómo lidiar con esto? Quiero decir, ella podría estar en la situación en la que siente que sus nietos necesitan una vacuna, pero la madre de los niños realmente se resiste a eso.

 

Jane Strommen: Sabe, creo que se trata de comprender realmente por qué duda en vacunar a sus hijos. ¿Se debe a los posibles efectos secundarios o va más allá de eso? ¿Tiene otras preocupaciones? Y creo, como dijo el Dr. Johnson, que se trata realmente de alentar a su hija a visitar a un pediatra porque es una fuente confiable de información a la que pueden escuchar.

 

Creo que a veces hay demasiada información en las redes sociales y en todos lados, donde la gente realmente no sabe cómo distinguir qué es verdad y cuáles son conceptos erróneos o mitos. Así que realmente insisto en que visite a un pediatra con su hija para obtener la información completa y tal vez abordar algunas de sus inquietudes.

 

Bill Walsh: Está bien, de acuerdo. Gracias a ambos, Dr. Johnson y Dra. Strommen. Y si están buscando información sobre las vacunas o la COVID-19 en toda su magnitud, también pueden consultar aarp.org/coronavirus. Monitoreamos las últimas noticias de la FDA y los CDC. Brindamos consejos sobre cómo hablar con el médico, preguntas que deben hacer y cómo mantenerse uno y su familia a salvo. Kevin, tomemos otra pregunta.

 

Kevin Craiglow: Por supuesto. Bill, voy a disculparme de antemano por la pronunciación, pero creo que es Zany de Florida.

 

Bill Walsh: Hola, Zany, bienvenida al programa. Continúe con su pregunta.

 

Zany: Hola, gracias. He esperado tanto para hacer esta pregunta. Tengo una pregunta sobre lupus, las personas con lupus. Me sorprende que nadie haya discutido esto en este programa. ¿Cuáles son sus opiniones sobre las vacunas para las personas que tienen lupus?

 

Bill Walsh: ¿Ha sido vacunada, Zany?

 

Zany: Supuestamente no debe hacerme preguntas a mi, se supone que debe responder mi pregunta.

 

Bill Walsh: Bueno, solo estamos tratando de conseguir...

 

Zany: Oh, no lo he hecho.

 

Bill Walsh: No lo ha hecho y probablemente sea porque está preocupada, no está segura, por las interacciones.

 

Zany: Sí.

 

Bill Walsh: Está bien. ¿Puedo preguntarle cuántos años tiene?

 

Zany: Setenta y siete.

 

Bill Walsh: Pregunta descortés, pero 77.

 

Zany: Nunca le haga esas preguntas a una dama.

 

Bill Walsh: Está bien. Dr. Johnson, me pregunto si puede ayudar a Zany y a otros que puedan tener preguntas como esta. Tiene lupus y se pregunta si debe vacunarse.

 

Steven C. Johnson: Sí, bueno, creo que su situación es de alta prioridad para recibir la vacuna. Las personas con enfermedades subyacentes como el lupus a menudo son tratadas con diferentes medicamentos, algunos de los cuales debilitan el sistema inmunitario, por lo que, de hecho, es una indicación para vacunarse.

 

Y en realidad será un indicador de una tercera dosis o una dosis de refuerzo. Así que definitivamente creo que una persona con lupus debería vacunarse. La otra cosa acerca de las tres vacunas, es que no son vacunas vivas, no presentan un peligro específico para las personas cuyo sistema inmunitario está debilitado. La única preocupación podría ser, si estuviera tomando medicamentos que debilitan el sistema inmunitario para controlar el lupus, que pudieran prevenir o entorpecer la respuesta a las vacunas. Sería importante trabajar con su médico personal, tal vez un reumatólogo que la esté atendiendo por su lupus.

 

Lo que hemos hecho con algunas personas que están tomando medicamentos que debilitan el sistema inmunitario es, de hecho, administrar la vacuna durante un período de vacaciones de esos medicamentos, como cuando los esteroides se suspenden por un período o algo así para tal vez dar al sistema inmunitario una mejor oportunidad de desarrollar una respuesta a la vacuna. En resumen, definitivamente le recomendaría la vacuna. Y hablaría con su médico personal sobre el momento oportuno.

 

Bill Walsh: Muy bien, muchas gracias, Dr. Johnson. Kevin, tomemos otra pregunta.

 

Kevin Craiglow: Por supuesto. Vamos a ir a las redes sociales para esta, Sharon en YouTube preguntó: "¿Cuál es el tratamiento si se contrae COVID-19? Le dicen que se ponga en cuarentena, pero no le dan ningún consejo sobre qué hacer para disminuir el efecto o prevenir la progresión de la COVID-19 a su forma crítica".

 

Bill Walsh: Dr. Johnson, ¿quiere opinar sobre eso?

 

Steven C. Johnson: Sí, con gusto. En el ámbito ambulatorio, en realidad solo hay una intervención en este momento, además de controlar los síntomas, mantenerse bien hidratado y quizás, tomar medicamentos para aliviar los síntomas y la fiebre. La única intervención en el ámbito ambulatorio son las infusiones de anticuerpos monoclonales. Y estas son infusiones intravenosas.

 

A veces se pueden administrar debajo de la piel para combatir el virus. Y están indicados específicamente en personas que tienen riesgo de progresión a una enfermedad más grave, de ser hospitalizadas, etc. Y hay una lista que la FDA y los CDC tienen sobre estos trastornos. Si no tiene esos trastornos, entonces el manejo ambulatorio en realidad es solo vigilar los síntomas y tener un umbral bajo para ser atendido si se siente peor.

 

Con respecto a los pacientes hospitalizados, hay más tratamientos, hay un medicamento antiviral llamado remdesivir. Hay varios medicamentos que combaten la respuesta inflamatoria que a veces abruma a las personas, es decir los esteroides y otros tipos de medicamentos. Y, por supuesto, se trabaja tanto en los ensayos clínicos ambulatorios como en entornos hospitalarios, tratando de encontrar estrategias adicionales para controlar la COVID-19 y tratar de prevenir las complicaciones graves.

 

Bill Walsh: Sabe, Dr. Johnson, he leído mucho recientemente sobre personas que no se vacunaron, contrajeron COVID-19 y reciben un tratamiento con anticuerpos. Supongo que no lo recomienda como curso a seguir. ¿Cuáles son las preocupaciones que podría tener al respecto?

 

Steven C. Johnson: Bueno, creo que, como las personas que no han sido vacunadas tienen un riesgo de enfermedad más grave que las personas que han sido vacunadas, los anticuerpos monoclonales adquieren una importancia especial en ese grupo porque pueden prevenir la progresión de la enfermedad, prevenir la hospitalización, etc. Entonces creo que es una intervención en ese escenario.

 

Y también es una intervención importante en aquellas personas que se han vacunado, pero es posible que no respondan a la vacuna porque su sistema inmunitario está débil. Una de las recomendaciones para las personas que recibieron los anticuerpos monoclonales es que en realidad esperen 90 días después de los anticuerpos monoclonales para vacunarse. Y eso es para que la preparación de anticuerpos en el torrente sanguíneo no interfiera con la respuesta a la vacuna.

 

Esa es una política que puede llegar a revisarse en algún momento. Pero si uno no está vacunado y tiene riesgos de desarrollar COVID-19 grave, realmente recomendaría los anticuerpos monoclonales. Y luego, una vez que hayan pasado unos tres meses, tal vez reconsidere y reciba la vacuna. Una de las cosas que sabemos es que si uno recibe una vacuna después de tener la infección, es un refuerzo muy fuerte para el sistema inmunitario.

 

Bill Walsh: Pero para que quede claro, no se están recomendando los anticuerpos monoclonales como primera línea de defensa. Se está recomendando que las personas se vacunen si pueden.

 

Jane Strommen: La vacuna es definitivamente la intervención primaria, pero si las personas no han sido vacunadas y se enferman, entonces los monoclonales existen, pero yo no confiaría en ese enfoque, diría, como estrategia. La serie de vacunas es más eficaz para salvar la vida que los anticuerpos monoclonales.

 

Bill Walsh: Sí. De acuerdo, Kevin, tomemos otra pregunta.

 

Kevin Craiglow: Lo siento, Bill. Por supuesto, nuestra siguiente pregunta proviene de Lynette en Massachusetts.

 

Bill Walsh: Hola, Lynette, bienvenida al programa. Continúe con su pregunta. Lynette, ¿está con nosotros? Continúe con su pregunta. Parece que podemos...

 

Lynette: ¿Puede oírme?

 

Bill Walsh: Oh, ahora sí.

 

Lynette: No, no, no, lo siento.

 

Bill Walsh: Hola, Lynette, ¿cómo está? Continúe con su pregunta.

 

Lynette: Hola. Estoy bien. Gracias. Soy una persona que tiene EM remitente recurrente. Recibí mi inyección de Pfizer. Recibí mi vacuna de refuerzo. Y me colocaré la vacuna contra la gripe el próximo mes de octubre. Mi preocupación es... No sé, la falta de educación o el impulso de los CDC y otros, y atendiendo a la actitud indiferente de la gente, hoy tenemos recorridos aquí en el resort de Salem, Massachusetts. Y eran unas 40 o 50 personas, nadie tenía puesta una mascarilla. Sé que yo me limito cuando voy al restaurante. Un señor me preguntó: "¿Ha traído sus propios utensilios?" Dije: "Sí". Y dije: "Tengo mi lata de aerosol Lysol y mis toallitas Lysol". Dijeron: "Bueno, ¿por qué hace eso?" Dije: "Porque no voy a invitar a delta o COVID-19 a mi cuerpo". Ahora, así soy yo, pero lo que estoy diciendo es que, en general, es una actitud de indiferencia. Y me preocupa.

 

Bill Walsh: Sabe...

 

Lynette: ¿Y qué tiene para decir la comunidad médica al respecto?

 

Bill Walsh: Sabe, Lynette, yo pienso exactamente igual. Soy un gran fanático del fútbol universitario. Y cuando sintonizo para ver a 100,000 personas apiñadas en los estadios, ninguna de ellas con mascarillas puestas, tengo exactamente el mismo pensamiento. Dr. Johnson, me pregunto... Respondamos la pregunta de Lynette. ¿Qué tiene para decir la comunidad médica al respecto?

 

Steven C. Johnson: Bueno, creo que la gran mayoría de la comunidad médica, por supuesto, siente que nuestras tasas de vacunación deben ser más altas, en primer lugar. De hecho, asistí a una presentación anoche y me dijeron que Estados Unidos está en la lista de países más vacunados y ahora ocupa el puesto 45. Entonces, hay otros 44 países que tienen tasas más altas de vacunación.

 

Entonces, definitivamente necesitamos mejorar nuestras tasas de vacunación por encima de lo que están. Esa es una buena estrategia. Y creo que, nos guste o no, estos otros tipos de estrategias que usamos antes en las epidemias, como el distanciamiento social y el uso de mascarillas y no ir a lugares si está enfermo y cosas así, esas son estrategias que también son importantes en la era delta.

 

Quiero decir, ya sabe, yo... creo que a veces es frustrante. Y a veces es más que frustrante. En realidad, es triste ver a alguien que no está vacunado o que se infecta por alguien que no estaba vacunado y ahora está en el hospital con un ventilador. Hay muchas historias realmente tristes sobre estas enfermedades, incluidas enfermedades que creemos que deberían poder prevenirse.

 

Bill Walsh: Sí. Muy bien, tomemos otra pregunta, Kevin.

 

Kevin Craiglow: Por supuesto. Nuestra pregunta final proviene de Pat en Tennessee.

 

Bill Walsh: Hola, Pat, está en el programa. Continúe con su pregunta.

 

Pat: Gracias por atender mi llamada. Lo que necesito saber es, mi esposo y yo estamos completamente vacunados, hace ya casi siete meses recibimos la primera de Moderna, regresamos el 1 de marzo y recibimos el resto. Y han pasado alrededor de siete meses. Se habló de seis meses, y ahora nos dicen que pasarán ocho meses antes del refuerzo.

 

Nos han dicho que la tercera inyección iba a ser Moderna para nosotros. ¿Está bien recibir esa ahora y esperar el refuerzo porque no sabemos cuándo llegará? Parece que siguen cambiando. Ya sabe, tienen una fecha, cambian y vuelven a cambiar, pero supongo que están tratando de solucionar esto y descubrir algo, pero ¿qué hacemos al respecto?

 

Estamos esperando recibir el refuerzo. Y luego tenemos que ir al médico de atención primaria el 9 de octubre para esperar 2 semanas, como el refuerzo, para recibir mi vacuna contra la gripe.

 

Bill Walsh: Hmm. Hemos tenido muchas preguntas sobre los refuerzos y la posibilidad de intercambiar las vacunas. Pat, ¿puedo preguntarle cuántos años tienen usted y su marido? ¿Tienen más de 65 años?

 

Kevin Craiglow: Bill, lo siento, la perdimos accidentalmente...

 

Bill Walsh: Entendido. Bueno. No hay problema. Dr. Johnson, me pregunto si puede responder a la pregunta de Pat. Obviamente, esto es lo más importante para muchas personas.

 

Steven C. Johnson: Bueno, una de las preguntas que quería hacer es si ella o su esposo tenían alguna condición médica por la cual podrían calificar para esas terceras dosis. En otras palabras, existe una iniciativa separada de la iniciativa del refuerzo para personas con sistema inmunitario debilitado. Y en ese entorno, no se espera una cantidad de tiempo específica, hay que esperar en realidad 28 días después de la segunda dosis, pero puede ir y obtener una tercera dosis.

 

Si no entran en esa categoría, entonces tienen dos opciones, pueden encontrar una farmacia o una clínica, o algo así, que les dé una tercera dosis como por fuera, ya sabe, sin ningún tipo de guía federal, y algunas personas lo han hecho. Pero creo que probablemente lo que todos estamos esperando y de lo que hemos hablado en algunas de estas otras llamadas es un consejo sobre los refuerzos de Moderna, que, nuevamente, creo que llegarán el próximo mes.

 

Bill Walsh: Está bien.

 

Steven C. Johnson: Un mes, algo así. Es solo que...

 

Bill Walsh: Sí.

 

Steven C. Johnson: Y, ya sabe, creo que hay espacio para que la gente hable con su médico personal, tenemos algunas personas que tienen un sistema inmunitario profundamente debilitado y realmente han salido a buscar sus dosis antes de que el Gobierno federal haya decidido cómo armar esto.

 

Bill Walsh: Claro.

 

Steven C. Johnson: Parece que muchas farmacias y clínicas locales están dispuestas a dar dosis adicionales, como algo fuera de la secuencia.

 

Bill Walsh: Está bien. Bueno, gracias, Dr. Johnson, y gracias también, Dra. Strommen. Y gracias a nuestros socios, voluntarios y oyentes de AARP por participar en esta discusión.

 

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 y evitar el contagio a otros, mientras se cuidan ellos mismos.

 

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/coronavirus a partir de mañana, 24 de septiembre. Una vez más, esa dirección web es aarp.org/coronavirus. Visítenos si no se respondió su pregunta y encontrarán las últimas actualizaciones, así como información creada específicamente para adultos mayores y cuidadores familiares.

 

Esperamos que hayan aprendido algo que pueda ayudarlos a ustedes y a sus seres queridos a mantenerse saludables hoy. Acompáñennos nuevamente el 7 de octubre a la 1:00 p.m., hora del este, para participar en otro evento en vivo que responderá sus preguntas sobre el coronavirus. Esperamos que puedan unirse. Gracias, que tengan un buen día. Con esto concluye nuestra llamada.