AARP Coronavirus Tele-Town Halls

Boosters, Flu Vaccines & Wellness Visits

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 star zero on your telephone keypad now.

 [Español]

Bill Walsh: 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. Last week, the United States recorded the 700,000th death from COVID-19.

It was a milestone few dared imagine at the beginning of the pandemic, nearly 20 years ago. Yet as misinformation about the vaccines proliferates, tens of millions of Americans continue to refuse to take one. It has enabled COVID variants to easily spread through the population and clogged hospital emergency rooms.

Meanwhile, some of those who have been vaccinated have begun getting booster shots for extra protection, and promising new treatments for COVID appear to be on the horizon. As a nation wrestles with the pandemic, Congress is debating one of the most significant packages of legislation for older adults in a generation.

There are bills to lower prescription drug prices, add benefits to Medicare and create a tax credit for family caregivers. AARP is in the thick of the fight to get it all enacted. Today we'll hear from an impressive panel of experts about these issues, and if you've participated one of our tele-town halls before, you know this is similar to a radio talk show, and you have the opportunity to ask your questions live.

For those of you joining us on the phone, if you'd like to ask a question about the coronavirus pandemic, press star three on your telephone to be connected with an AARP staff member, who will note your name and question and place you in a queue to ask that question live. If you're joining on Facebook or YouTube, you can pose your question in the comment section.

Hello. If you're just joining I'm Bill Walsh with AARP, and I want to welcome you to this important discussion about the global coronavirus pandemic. We're talking with leading experts and taking your questions live. To ask your question, please press star three, and if you're joining on Facebook or YouTube, you can post your questions in the comments.

We have some outstanding guests joining us today, including a medical expert and one on immunizations. We also be joined by my AARP colleague Jesse Salinas, who will help facilitate your calls today. This event is being recorded, and you can access the recording at AARP.org/coronavirus 24 hours after we wrap up.

Again, to ask your question, please press star three at any time on your telephone keypad to be connected with an AARP staff member. Or if you're joining us on Facebook or YouTube, place your question in the comments. Now I'd like to welcome our guests. Tom Talbot is an M.D. and master of public health.

He is a professor of medicine at the Vanderbilt University School of Medicine. He is also the chief hospital epidemiologist at Vanderbilt University Medical Center. Welcome to the program, Dr. Talbot.

Tom Talbot: Thank you for having me, I’m really glad to be here.

Bill Walsh: All right, we're glad to have you. I'd also like to welcome L.J. Tan, a master of science and a Ph.D. Dr. Tan is the chief policy and partnerships officer with the Immunization Action Coalition. He is also the cochair of the National Adult and Influenza Immunization Summit. Welcome, Dr. Tan.

Litjen Tan: Thank you very much, Bill. Pleasure to be here.

Bill Walsh: All right, we're delighted to have you. Let's go ahead and get started with the discussion.

Now, just a reminder to our listeners: To ask your question, go ahead and press star three on your telephone keypad or drop it in the comments section on Facebook or YouTube. Dr Talbot, let's start with you. With FDA approval of a Pfizer COVID vaccine booster, there are some important questions. Let's address several of them briefly The first is, how beneficial is a COVID-19 booster?

Tom Talbot: Yeah. Thanks Bill. Really good question. We've heard about boosters the last month or so. And that's based on some data that we're seeing, particularly with the Pfizer vaccine, that while it still remains very protective against severe infection from COVID, we are starting to see a waning of the protection, usually around about six months out from your last shot.

And so people are getting infected again who have been vaccinated. You hear about the breakthrough cases of infection. Fortunately, many of those individuals have mild infections, but it's still a problem, particularly as we're facing this wave of delta variant across the country. And so, we really do need to kind of do the things to prevent that spread.

So getting a booster will amplify your immune response and gonna basically boost the immune protection against getting infected again. And we've seen some data from other countries that getting that booster does reduce the chance of getting any infection from COVID, which is so important right now, as we're trying to really break the wave of delta, so to speak.

Bill Walsh: Let me throw a few other questions at you about boosters. Who is eligible for booster shots right now?

Tom Talbot: Yeah, and you may recall there was a little bit of confusion when this happened, but let me hopefully distill it down. So if are 65 years of age and older, you're eligible for a booster. Actually, let me step back. Only right now if you've got a Pfizer vaccine as your first doses of COVID vaccination. So I'm talking right now about Pfizer. If you've got Moderna or J&J let's hold that for a little later. If you're 65 and up, you should get a booster. If you're younger than 65, 18 and up, and have underlying medical conditions that may increase you of having higher risk for COVID complications.

And those could be things like cancer, diabetes, obesity, a pretty wide range of conditions. If you're 50 and up, the CDC said they really strongly recommend getting a booster. If you're under 50, an adult, really, they recommend the booster, but assess that based on your own kind of situation and your risk of exposures. But really it's very broad if you should get a booster.

And then the last group are those that may not have a high risk condition, but they may be in a situation where they have a high risk of exposure particularly through where they work. And so in that bucket are groups like our health care workers, our teachers. And part of the rationale for those is that, even a mild infection amongst those groups, you heard a lot about our health care system being really strained with the delta wave.

If we lose any health care worker, even if they have a mild cold, they can't come to work. And that is a very serious strain on the health care system and really has a massive impact. If we lose teachers, we lose the ability to teach the kids. So preventing even a mild infection in these groups is really important right now as we face the delta variation.

Bill Walsh: Okay. Very good. Now for those who are eligible for booster shots, how much time is required between completion of a full dose and a booster?

Tom Talbot: Sure. So you need to have had your two doses of vaccine, and your second dose should have been six months ago. So if you just got your series, maybe back in June, you're fine.

The one thing we should clarify too, and I think there's a little confusion is the difference between a booster dose and a third dose. Some populations, some folks that are very immunocompromised have needed to get a third dose as part of their regular series. So their real series of vaccinations would be, one dose followed several weeks later by dose two followed four weeks later by dose three. So there's a little bit of confusion there, but the booster is six months after that last dose.

Bill Walsh: Okay. Now of course, we're talking about a Pfizer vaccine booster shot. What about those who completed a vaccine cycle with Moderna or J&J. Can they get the Pfizer booster?

Tom Talbot: So right now that's not recommended, but at the end of next week, the FDA advisory committee will be meeting on exactly those questions for the Moderna and the J&J vaccine about whether they need boosters. Now, there are some data with Moderna in particular, Moderna is a little bit of a higher dose of a vaccine and had a little bit more spacing out between dose one and two.

And we're not seeing that waning of immunity like we've seen with Pfizer. So it'll be interesting to see what the FDA decides next week. But we know those are really important questions to our patients. We face them here at Vanderbilt and we're hoping to get some clarity probably in the next two weeks from those meetings and discussions about answers for those individuals and boosters.

Bill Walsh: Okay. Now, final question. Will booster shots become available for those folks who aren't eligible today? And when do you think that might happen?

Tom Talbot: Yeah, that's a great question. Because right now, as I mentioned it in the middle of the delta wave, our threshold to really kind of break the wave is, we've got to really push that.

But the question is, in a healthy 20, 25 year old, will they need a booster at all? Or is it just a function of, you know, there's other groups, cause we're in the delta wave. And we don't know that yet. There's also some postulation — and don't hold me to this — but once all the dust settles and we get through our COVID and get all the data and the scientists look at this, potentially down the road, we might find that actually everybody should get three shots as their COVID vaccine series, kind of like we do with hepatitis. But we don't know that yet.

So I don't know necessarily if you're not eligible, you may not necessarily need a booster right now. But that's time will tell. So I kept that as vague as I could, because I don't know the right answer at this point, but.

Bill Walsh: Well, we're figuring out a lot of things, in real time. That's one of the markers of this pandemic. Hasn't it been? All right. Well, Dr. Talbot, thank you very much for that. Dr. Tan, let's turn to you. Why is it important to have a traditional flu vaccine, even if you're fully vaccinated for COVID?

Litjen Tan: Oh, thank you Bill for that. And Tom, that was a fantastic discussion on the boosters. And I think the point here is obviously, COVID is one disease and influenza is another disease, and both are serious life-threatening illnesses.

So even if someone's fully vaccinated for COVID, that does not give them protection against influenza or the flu. And so getting the flu vaccine right now is essential so that people are protected against both. We do not want people having flu and thinking that they're not getting back in for COVID, and we don't want people getting COVID and thinking they don't need to get back to you for flu.

You gotta get both, both due to separate illnesses, and they're both life-threatening illnesses.

Bill Walsh: Okay. Well, let me follow up on that. Is it advisable to get a flu shot and a booster at the same time? Are there interaction concerns for the COVID booster and things like shingles and pneumococcal or whooping cough vaccines?

Litjen Tan: Absolutely. It is advisable and in fact it is even recommended that if you're going in and getting a COVID-19 booster, please consider getting at that same visit the flu vaccine, if you haven't got it already. And the other vaccines that you've mentioned, including obviously a pneumococcal vaccine. So I think, absolutely the CDC has said that the COVID-19 vaccine can be what we call co-administered. That means given at the same time, at the same clinical visit, with other vaccines, such as the flu vaccine or the pneumococcal vaccine.

Bill Walsh: All right. Well, that's great news. Thanks very much, Dr. Tan. And as a reminder to our listeners, to ask your question, please press star three on your telephone key pad. We're going to get to your questions shortly, but before we do, I wanted to bring in Megan O'Reilly. She's an AARP vice president for health and family government affairs. Welcome, Megan.

Megan O'Reilly: Hi Bill, it's good to be with you.

Bill Walsh: Great to have you. 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 I know they've got their hands full these days. So Megan, thanks for joining us today. Is there any progress being made on legislation that can help Americans 50 and older?

Megan O'Reilly: Yes. The good news is we're making headway in our fight to lower prescription drug prices. AARP has been hard at work supporting legislation that will lower the price of medication by allowing Medicare to negotiate with drug companies. Prescription drug prices have long been out of control. So for Congress to take this action and allow Medicare to finally use its bargaining power to lower prices would be a huge victory for older Americans.

Bill Walsh: Okay. AARP members have been an important part of this fight as well. Haven't they been?

Megan O'Reilly: Oh, absolutely. AARP members have been leading the way. Just using the telephone and the internet, anyone can raise their voice and urge Congress to support important matters, like high prescription drug prices, as well as issues like Social Security and Medicare.

And we know many of you have. Most recently, AARP activists have sent 675,000 emails and made more than 200,000 phone calls, urging members of Congress to let Medicare negotiate drug prices. Our Show Your Receipts docial media campaign highlighted 24,000 real life prescription drug receipts totalling over $12 million.

It's hard to deny that drug prices are too high. When you see what many older adults are having to pay. Our members are also doing a great job. Writing letters, calling your representatives and meeting with legislators.

Bill Walsh: Well, that's fantastic. Now caregiving is another priority that AARP is working to gain more support for, isn't that right?

Megan O'Reilly: Absolutely. AARP is leading efforts on several fronts that are urging the government to recognize and support family caregivers. Right now we're asking Congress to enact a federal law that supports paid leave for caregivers. And we're also fighting for passage of a family caregiver tax credit. You should not be at risk for losing your job if you drive your parents to a doctor's appointment. You can also take action to help offset some of the financial costs of caregiving. These are practical, common-sense steps that the government can take to lessen the challenges facing families who are caring for their loved ones.

Bill Walsh: Alright, anything else AARP is fighting for at this time that our listener should know about?

Megan O'Reilly: Yeah. There are several other items for supporting and reconciliation, including dental, hearing and vision benefits to Medicare. In addition to our health care work, AARP is actively supporting the Protecting Older Job Applicants Act. Just last week, we sent a letter to Congress expressing our support for this bill that extends protections for job applicants, fighting age discrimination and employment.

Unfortunately, ageism exists in the workplace. Even workers over the age of 50 contribute valuable skills experience. AARP fights age discrimination in all forms, including workplace discrimination. Supporting this act is important because everybody deserves equal opportunity when applying for a job.

Bill Walsh: All right. That's a lot of promising news. Thanks so much for being here, Megan. We really appreciate it.

Megan O'Reilly: Thank you.

Bill Walsh: All right, it's now time to address your questions about the coronavirus pandemic with Dr. Tom Talbot and Dr. L.J. Tan. Please press star three at any time on your telephone keypad to be connected with an AARP staff member to share your question live. If you'd like to listen in Spanish, please press star zero on your telephone keypad now.

I'd like to now bring in my AARP colleague Jesse Salinas to help facilitate your calls today. Welcome Jesse.

Jesse Salinas: Thanks, Bill. Glad to be here for this important conversation.

Bill Walsh: All right, let's go ahead and take our first question.

Jesse Salinas: Yeah, first off is going to be from Linda in Virginia.

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

Linda: Hello?

Bill Walsh: Hey, Linda, how are you? Go ahead with your question.

Linda: I am well, thank you.

Bill Walsh: Go ahead with your question. Yup.

Linda: I'm calling for clarification of what Dr. Tan said about the booster and the flu shot. I wasn't sure if there is a time frame between both or if one can get the booster and the flu shot at the same time.

Bill Walsh: Well Dr. Tan, can you elaborate?

Litjen Tan: Absolutely. Can you hear me?

Bill Walsh: Yep. Go ahead.

Litjen Tan: Oh, perfect. There is no timeframe between the two that you have to wait. Linda, you can go ahead. You can get the flu vaccine in one arm and you can get the COVID-19 booster in the other arm. So, at the same time. So you're perfectly good there.

Bill Walsh: Okay. Thanks for that, Dr. Tan. Jesse, who's our next caller?

Jesse Salinas: Our next caller is going to be from Julia in Alabama.

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

Julia: I'm calling to see if there is any way to be.

Bill Walsh: Julia, still with us?

Jesse Salinas: Hey Bill. I think we lost Julia with some technical issues, so let's try Sarah in New York.

Bill Walsh: All right, Sarah. Welcome to the program. Go ahead with your question.

Sarah: Hi. I'm almost 65 and I got the Moderna second shot and I'm about seven months into, you know, I need a booster. Now, I wanted, my question is, well, I wanted to know if I could get the Pfizer and then I heard that it's not acceptable, it's not recommended right now. But my question is also, what did Moderna never gets FDA approved? What happens to all of us that got that one?

Bill Walsh: Well, Dr. Talbot, there are a couple of questions in there. Can you clarify for Sarah and our listeners?

Tom Talbot: Yeah. Sarah, it's a really great question. So, we'll learn more about folks like you that got the Moderna two shots next week at the FDA.

As I mentioned, the data on Moderna do show that that kind of loss of some protection that we saw with Pfizer, we don't see as much with Moderna. So there may be some still encouraging information about the Moderna protection. I think the question that you have is a really good one. And actually, I had just forgotten it's still on EUA since you asked that. And I think the reason being is, I have to kind of elevate our folks at the FDA and CDC who had been working furiously during this pandemic to try and get through all this. And I can only imagine just going through everything.

I know Moderna has submitted their paperwork several months ago for full approval FDA takes a really good thorough time to really make sure that, hey, they look at all the data, but also make sure that all the plants can manufacture the vaccine safely and do all that diligence. And so that's still ongoing. We haven't heard much of that timeline because of things like the booster questions that they've been helping us with. And then I'm sure folks out there have the questions about young children and that vaccine. So I think the FDA's plate is very full and they're working as they can both measured and safe and do all cross all the T's dot all the I's. But I imagine we'll get full approval of Moderna hopefully in the next few months, as I know stuff has been submitted for that.

Bill Walsh: All right, Dr. Talbot, thanks very much for that. Let's go back to the lines. Jesse, who do we have net?

Jesse Salinas: Our next caller is going to be Brenda from Georgia.

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

Brenda: I was, I wanted to ask about if you've already had the COVID and you have tested positive for antibodies, what is the push for us to be vaccinated?

Bill Walsh: Dr. Talbot can you help Brenda with that question?

Tom Talbot: Yeah, that is a great question, Brenda. I get asked that a lot. In fact, I just responded in the last hour to an email on that. And I'll kind of try and walk through quickly kind of the reason being. We know after COVID infection, you do have some immune proteins. We know that the problem is that not everybody has the same level of protection. And before we face this delta variant that we're seeing now, we saw that people with natural infection, the level of really important antibodies that they need to kind of stick on that virus when it tries to infect us, that level of antibodies in naturally infected folks is much lower than in vaccine protected folks.

And so people who had a natural immunity would lose detection of the antibodies. So, one. The other thing we see is that there's a really important part of the virus — you've probably seen all the cartoons with the spikes that stick out of the virus. And on the end of that spike is a really important part of that, that the virus uses to stick to our airway cells and cause infection.

And that part is what the variants changed to make them kind of evade things. And so what we see with natural infection is, they make a couple of types of antibodies to that key part, and they make antibodies to alot of other parts of the virus. But with the vaccine, they make a lot of other flavors. So it's kind of like natural infection makes chocolate and vanilla, but the vaccine makes rocky road and other types, so that if you get these variants that come out, you're more protected from the antibodies from the vaccine.

There's interesting data now that say, if you've had a COVID infection, your risk of getting another infection is over two times higher if you're not vaccinated than if you're vaccinated. And part of the challenge too, my last one is you kind of mentioned the detectable antibodies and that's the big challenge is, the antibodies may be detectable, but they may not be protective against the delta variant. So you may think, oh, I've got some antibodies and I'm okay when you're really still vulnerable to this variant. And so that's part of why we recommend getting vaccinated, even if you've had COVID infection. It is confusing, though.

And I think it's, like I said, a very common question that I've been getting lately.

Bill Walsh: All right, Dr. Talbot. Well, thanks for clearing that up. Good explanation. Alright, Jesse, who do we have next?

Jesse Salinas: Our next question, Bill, comes from YouTube. This is Frances and she asks, can the shingles vaccine be taken at the same time as the COVID vaccine?

Bill Walsh: Dr. Tan, I think answered that, but Dr. Tan, do you want to elaborate on that question?

Litjen Tan: Yes. So the advice from the CDC is that you can co-administer the COVID-19 vaccine with any other vaccine. There are a couple of exceptions and the shingles vaccine is not on the exception list. So, yes.

Bill Walsh: Okay. Very good. Jessie, let's take another caller.

Jesse Salinas: Our next caller is Zani from Florida.

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

Zani: My name is Zani. I have a question about a person with lupus. I asked this question last set. And the doctor answered just basic question and it was very short. I am, I have had attacks, my immune system is shot and I've been hospitalized for just taking some medication. I took a tetanus shot and ended up in the hospital.

I I've had several reactions to just what would be normal for other people. It's not normal for me. And they don't talk about people with lupus. I know lots of people with lupus, and we are afraid because you're putting a live vaccine into our bodies. And that means that we are going to be exposed to it immediately.

Bill Walsh: Right. Zani, I remember you calling in two weeks ago. Let's see if we can get your question answered. Dr. Talbot, can you address Zani’s question?

Tom Talbot: Yes, Zani. Thanks for asking that. I think it's a common question. So, as far as folks with lupus, there's a couple of things that we are concerned about, not with necessarily the vaccine, but with COVID infection.

We know that folks with kind of underlying illness like lupus have a much greater risk if they get infected to get really serious infections. That may be due to the lupus itself or due to a lot of medicines we have our patients with lupus take that effect their immune system. And so the risk of having a really bad outcome if you get COVID is really high. What we're not seeing in the millions of people that have gotten it, some of those have lupus, is we're not seeing signals of flares of those types of diseases. Like the autoimmune diseases, like lupus or rheumatoid arthritis. We're not seeing that happen after vaccination, which is reassuring as well.

And so as I talk to my patients that have similar kinds of conditions, lupus or other things, I kind of phrase it like this — we really have two pathways to walk on. And I wish there was a third where we didn't have to get vaccinated or have COVID. But those are our pathways. Take the vaccine and while it's very, very safe, it's not a hundred percent. Just like if you go get a medicine at Target, you may have a reaction to that. Very, very rare. But the safety profiles of the vaccines are very, very, very reassuring. Or you risk getting exposed to COVID and having really serious harms from COVID infection.

And we know folks with autoimmune disease and lupus in particular have that risk. And so different societies have said that support kind of patients with diseases like lupus have said, look, we really, you should get vaccinated because of that risk of really severe infection.

I do want to clarify one thing, cause it's a really common confusion. Like you mentioned with the COVID vaccine is, it is not a live vaccine, so this is not, they don't have a live virus. You absolutely cannot catch COVID from the COVID vaccine. It only has the instructions to make a single piece of that virus, not the rest of it. So that often gets folks worried that are, have a weaker immune system that they'd be exposed.

And we do have some vaccines like chicken pox vaccine, that we don't necessarily give to those folks because it's a little bit more of a risk with a live virus type of situation. But COVID vaccines are not like that.

Bill Walsh: Okay. Dr. Talbot, thanks for that explanation. And Zani, I hope you get the answer you're looking for there. Jesse, let's take another call.

Jesse Salinas: Our next caller is going to be Laura from Vermont.

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

Laura: My question, I already gave it. And you said you wanted it on air. So I had to wait, but I'd like to add to that. My question was, may I take the booster when I'm a little bit sick?

The second question is the shingles vaccine. I've had shingles, but I've never had the vaccine. And I need to address that. I had shingles about eight years ago. So I don't know if one affects the other or if I could have a shingles vaccine at the same time.

Bill Walsh: Well, let's start with the shingles vaccine. Right. So Dr. Tan, Laura had shingles eight years ago. She's wondering if she should get vaccinated for that. And I think she also asked whether she can get a booster if she's been a little bit sick.

Litjen Tan: Hi, Laura, thank you for that. I, and I hope you've recovered fully from shingles. That's a painful condition. So yes, absolutely. You can definitely get the shingles vaccine now, eight years down from the last attack of shingles. absolutely highly recommended. Please get the shingles vaccine.

And as a reminder, that is the two doses of the vaccine, about six months apart. So please, please do seek out the vaccine. And again, you can have, you can absolutely get that vaccine, the shingles vaccine at the same time as you get your COVID-19 booster. The one recommendation is that, because both those actions tend to be a little bit more reactive, to place them both in different arms.

That's about the only recommendation from CDC about co-administering the two vaccines. I'm going to punt the actual clinical question about being sick. I do have an answer, but I want to give Tom maybe a chance to answer that first.

Bill Walsh: Sure. Dr. Talbot, do you want to take a crack at that? Laura was concerned because she's been a little bit sick. And she's wondering about getting a booster at this time.

Litjen Tan: The COVID-19 booster.

Tom Talbot: Yeah. Yeah. That's a good question. So I think if I had kind of a cold and sniffle to make sure, hey, it wasn't COVID, but if it's not, and I just felt a little punky, I probably would wait a couple of days before getting into booster.

Because remember, the way these vaccines work is, they rev up your immune system. They kind of build those antibodies. And so just like when you have a cold, sometimes the way, the reason you feel cruddy is the immune system's revved up, so putting that on top of already feeling sick. but I wouldn't, I wouldn't delay too long.

So if it's something that, like I just feel kind of run down, I've been that way for several weeks, but I probably would go ahead and get that just to make it. Don't forget to get that booster or have that risk of getting exposed to COVID. That'd be my recommendation.

Bill Walsh: Okay, Dr. Talbot and Dr. Tan. Go ahead, Dr. Tan.

Litjen Tan: I was just going to jump in Bill and say that some tests, some people get confused because they hear that, oh, if you've got symptoms, you're not supposed to come in to get your vaccine. A lot of that also has to do with the fact that they just want to make sure you don't have COVID, right. That's what Tom kind of suggested. So you don’t want to be bringing it into the health care facility, in other words.

Bill Walsh: Okay. Thank you both for that. Jesse, let's take another call.

Jesse Salinas: Yeah. Our next call is going to be from Bill in Ohio.

Bill Walsh: Hey Bill. Welcome to the program. Go ahead with your call.

Bill: I'm an 85-year-old male.

I've had my both Pfizer shots about a year ago and I've been okay. Except the last couple of weeks I came down with the COVID. I tested positive here a week ago. I'm starting to feel a little better now, but my question is, how long should I wait before getting a booster shot, or the flu shot. Should I be testing negative first before I get shots?

Bill Walsh: That's a good question, Bill. Let’s ask Dr. Talbot about that. Dr. Talbot?

Tom Talbot: Yeah, Bill. I hope you're feeling better. I know, getting COVID can be really serious. I hope it sounds like you're on the mend. So that's the first point. The general guidance is that we want to make sure first that you're no longer infectious.

So usually that's about 10 days after the infection starts. So we definitely wouldn't want you to come in right now. And that's just, we don't want to expose other folks to COVID. And then after that, our recommendation is that you can go ahead and get the booster, although you still really, you've probably boosted your immune system a little bit with your COVID infection and you may be able to wait a little bit.

The problem is we don't want you forgetting it in about two months or three months. Oh, I needed to go get that booster. So we've been recommending, once you're cleared from being infectious, go ahead and come on in and get the booster. You may have a pretty nice response to that vaccine that, you know, to kind of feel a little cruddy the day after, but that's okay.

But that's been what we've been guiding in this kind of situation, you don't need to get a negative test before you come in. You just need to be cleared from isolation, from your doctor, your health authority.

Bill Walsh: Okay. Very good. Thanks for that, Dr. Talbot. And thanks for all those questions. We're going to — oh, go ahead, Dr. Tan. I'm sorry.

Litjen Tan: Oh, I just want to address the part about the flu vaccine. And I think that's what Dr. Talbot says when he's in there, he should definitely also get his flu vaccine.

Bill Walsh: Right, right. Yep. Absolutely. All right.

Well, Bill in Ohio, thank you for that question. Thanks to all those questions. We're going to take more of your calls soon. As a reminder, if you'd like to ask a question, press star three on your telephone key pad, or drop your question in the comments section on Facebook or YouTube. And if you'd like to listen to this program in Spanish, press star zero on your telephone keypad now.

All right now, let's turn back to our experts. Dr. Talbot, the drug company, Merck and Pfizer expected to seek FDA approval for a short-term regimen of daily pills to fight the virus. And another drug company, AstraZeneca announced their vaccine is 74% effective, even higher in adults who are 65 or older.

Can you briefly review these emerging efforts and how will prevention and treatment differ, and how quickly can we expect to see some changes?

Tom Talbot: Yeah, thanks Bill. So I think one thing as an infectious disease physician, as a scientist, that's been really exciting to see — if they call the pandemic exciting — is just the advancement of science and scientists really going to hard at work to really help answer a lot of questions.

And so the things we didn't have, or didn't know about this virus just as little as a year and a half ago, and so some of that is we're really learning about how best to both prevent, but also treat individuals with COVID infection. So right now, if you come in with COVID infection, you could get a monoclonal antibody.

If you have mild infection, if you come in the hospital, you'll get an antivirus medicine and some steroids, and you may need even some more severe kind of immune suppressing medication. The challenge is, we don't really have an antivirus medicine that you can go to your doctor in the clinic to get.

So folks may be most familiar with a drug called Tamiflu. So thinking of influenza infection, sometimes we'll give that to individuals to help reduce symptoms. And so we haven't had that with regards to COVID, but now with Merck and they announced their [inaudible] data as well. And so it's very exciting. I think we'll be getting more information about the effectiveness of the trial they released was really encouraging about preventing the need to go in the hospital if you've got COVID.

So that's great to have that in our pocket to use. Other vaccines like AstraZeneca. I think one thing that's been phenomenal due to the funding support and the science is all the new vaccines that are emerging across the world to COVID because we really supported those. And I don't know where AstraZeneca will fall in the United States.

We have three vaccines now. And as I mentioned earlier, the FDA has been really focused on a lot of important questions like boosters and full approval and kids. And so I don't know when in the line their vaccine will come in if they will in the U.S. but it's great to have that available throughout the world because we can't forget the world and protecting them. So I think as we learn more and more, it's really going to be, I think we're even six months from now, we'll have a much greater clarity of if someone has COVID, how to manage them, how to prevent COVID, how to prevent spreading from people if you don't know that you're sick.

I think that's just kind of, these are all examples of just really hard-at-work scientists, some really exciting discoveries around this virus.

Bill Walsh: Well, and more or tools in our toolkit to fight the spread of the pandemic. Dr. Talbot, I wonder what you think is the likelihood the U.S. will see another surge in cases later this fall or this winter.

And I'm curious, you mentioned outbreaks in other parts of the world. How do surges elsewhere impact us here in the United States?

Tom Talbot: Yeah. So I think if I had a crystal ball and could tell you the right answer to that, I would have bought the Powerball lottery this week, but I didn't and didn't win.

So I don't know. And honestly, I will tell you. While we had the delta variant in June, I was very optimistic and excited to have my mask off and went through the stages of grief when this wave hit, which the delta wave has been the most severe for us in Tennessee than any part of the pandemic.

So I don't really know what to see in the winter. I think we've got to be worried about flu coming back and what that will mean. But the biggest issue is as long as this virus is able to actively spread throughout the world, there's a chance that a new variant could emerge, because the viruses want to continue to survive.

And as they continue to divide, divide, divide, sometimes small changes happen. And most of those changes don't cause trouble. But sometimes they give the virus an advantage, like with delta, where it was just more infectious, more transmissible and more riskier strain of that. And so the worry is, as more people are susceptible and can get infected, will there be another variant that maybe the next one isn't as protective from the vaccines or maybe more fatal?

And that really is the scary aspect. So the priority continues to need to be, to get as many people around the world vaccinated as possible. That's going to be the way to absolutely end the pandemic. And how well we do that will help determine whether we have another surge. I will say I'm hopeful that another surge in the U.S. won't be as precipitously big as this one, but I get nervous saying that, cause I want to knock on wood because as I said, COVID is keeping us on our toes.

Bill Walsh: Right. Well, Dr. Talbot let me follow up on that. You talked about variants just a moment ago, and I've been amazed how well the existing vaccines have done against the delta variant and others that we've seen. What is the risk that we'll see a vaccine-resistant variant, and how can we avoid that.

Tom Talbot: Yeah, I don't have a number. I can't give you like, oh, it's a 10% chance or X% chance, but it's there. And it's a very real concern. The way to prevent it is, we gotta give this virus, we need to remove the chance of this virus from infecting airways that are susceptible.

Basically, we’ve got to vaccinate people. Cause if the virus can't spread, it can't mutate. It can't change. And can't create that variant.

Bill Walsh: Okay, succinctly put, thank you very much. Dr. Tan, let me turn to you. Since really, since the start of the pandemic, there have been concerning rumors that have circulated about COVID and COVID vaccines, and I was hoping you could help us fact check some of them.

I'd like to throw a few of them your way, and maybe you can take them one by one. All right. Great. Well, the first one was, so do COVID vaccines change your blood color to a darker hue?

Litjen Tan: Oh, thank you, Bill. As I go down inside, just a couple of quick things I always remind everybody, and I want to reassure all the listeners is that the United States has the best vaccine safety surveillance system in the world.

We catch any potential, what we call bad event or adverse event from a vaccine really, really quickly. And so to reassure everybody we've been looking with COVID-19 vaccines really hard for potential, what we call, side effects or adverse events. And that's why we can find them when they pop up.

Just so it'd be reassuring everyone of that. And then the second thing I always do when I look at these rumors is to, for me, at least, your listeners should know this, that the scientists and the physicians like Dr. Talbot here, a lot of our opinions that are expert opinions are based on what we call biological plausibility.

Can it actually happen? Does the biology allow it to happen? And if it can't then  it's just a rumor. So the first one, blood color change, I think this came from some internet posts about showing two different bags of blood of different color. So the answer is no, it cannot, it does not. What changes blood color is the level of oxygen that is in the blood.

And so it does not change blood color.

Bill Walsh: Okay. Well, let me throw another rumor at you and see if you can address this one. Are COVID vaccines fueling a dramatic increase in uterine cancer?

Litjen Tan: Bill, the answer is no, it is not. In fact, there's a very good cancer surveillance systems in the United States as well.

And we are not seeing spikes in uterine cancer, reporting of cases, following COVID-19 vaccinations. So the answer is no.

Bill Walsh: Okay. Thanks for that. Another rumor is that COVID vaccines are reducing fertility or sexual function in men and women. Is that true

Litjen Tan: Again, the answer for that. And like, this is the one that has biological plausibility, arguments that we look into as well. As Dr. Talbot has already told you, the mechanism by which this vaccine works. It is not biologically possible that this vaccine, which has this single protein called the spike protein, will impact male or female fertility.

So the answer is no, but interestingly enough, there is actually a publication that has now come out that shows that the COVID 19 virus, the entire virus itself, actually can be found in the testicles of males. That's just the first finding. Now whether or not that impacts fertility is something else. But that is the actual disease itself.

S I think it's more important now, as Tom has already specified, the vaccine has so many benefits.

Bill Walsh: Okay. Well, let me throw another one at you. Of course, the technology behind the Pfizer and Moderna vaccines is called mRNA. Our scientists manipulating lettuce and spinach with mRNA to vaccinate people without pills?

Litjen Tan: So that's a great question, Bill. And you know what, research way before COVID has been looking at ways to make what we call oral vaccines, including using the mRNA technology that we have, that's been used for the COVID-19 vaccine. So this is down the road. It's something for the future. It is not something that's happening now with specific to COVID-19, but it has been something that we've been looking at for a broad panel of vaccines, to kind of what we created, what we call oral vaccines.

So yes, we are doing that, but not specific to COVID 19, and it's something that's happened before the pandemic and it's research that continues to go forward. And sometime in the, perhaps we will have an oral vaccine that we can use by eating lettuce or eating spinach.

Bill Walsh: Okay. Very good. Here's another one, another rumor that we've heard out there. Does donating blood reduce the COVID vaccine’s effectiveness in your body?

Litjen Tan: No, it does not. And in fact, with the demand for blood and plasma products, please, you need to know, and the American Red Cross has said this, you can indeed donate blood after getting the COVID 19 vaccination. So the answer is no, donating blood does not reduce the vaccine’s effectiveness in your body. We can go into all the biological reasons for that, but I'm just going to stop there and say, no, it does not.

Bill Walsh: All right, Dr. Tan, thanks for that. Are there any other rumors that you've heard out there that you'd like to address?

Litjen Tan: I think we've addressed a bunch of the questions and answers. I think the best way to go ahead and get these questions and let us let that happen again.

Bill Walsh: Oh, right. Well, thanks for setting the record straight, Dr. Tan. We very much appreciate it. Now it's time to address more of your questions with Dr. Tom Talbot and Dr. L.J. tan, please press star three at any time on your telephone keypad, to be connected with an AARP staff member to ask your question live. Jesse, who do we have next on the line?

Jesse Salinas: Yeah, our next caller is going to be actually from YouTube. And Mike asks, how many days after getting the booster shot does it become fully effective?

Bill Walsh: Okay. Dr. Talbot, can you answer that question from Mike?

Tom Talbot: Yeah, thanks Mike. So, data shows it's about two weeks. So just like with the other doses, it's about two weeks before you get kind of full impact of the booster.

Bill Walsh: And I'm just curious, do we know the effectiveness of the booster, that is to say, does it wane over time?

How long does the — I mean, it offers a high level of protection, but how long does the high level itself last?

Tom Talbot: Yeah. So we don't know that yet. Cause it's, we're a little early. Probably the area that has the most data on that is Israel. And they've only been boosting, I think about six weeks. But they have definitely shown the protective impact of boosting, but it'll be awhile before we know how long there's a protection and if there needs to be any further booster doses, or what's happening with the delta wave and other things. So right now we don't know.

Bill Walsh: Okay. Very good. Let's take another call. Hey, Jesse, let's go back to the phone.

Jesse Salinas: So here's your next caller, Margaret in Mississippi.

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

Jesse Salinas: I think we may have lost her.

Bill Walsh: Oh, hang on. Is Margaret there?

Jesse Salinas: I think we lost her. Okay. Let's try Kathy in Georgia, Bill. My apologies.

Bill Walsh: Right. Hey, Kathy. Welcome to the show. Go ahead with your question.

Kathy: Yes, good afternoon, everyone. My question concerns NY the relationship with a negative or positive between the booster shot, getting the booster shot and a pneumonia shot, because I recently got the pneumonia shot, and I should qualify for the booster in early November.

Bill Walsh: And so your question is, should you go ahead and get that booster shot? All right. Well, Dr. Tan, can you address that? Please for Kathy?

Litjen Tan: Yeah, absolutely, and Kathy, thank you for getting your pneumonia shot. That's a really important vaccine. So, congrats for getting that. And yes, you can. If you're due in November, which I assume would be six months from your second dose of the Pfizer vaccine, you are absolutely eligible to get the booster.

Bill Walsh: Okay, Jesse, who's up next?

Jesse Salinas: Our next question is from Carol in Texas.

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

Carol: My question’s this, I have had both doses of the Pfizer. I have had my booster shot. My question is, regarding if there were to be a breakthrough infection, what is the possibility of like the, a long COVID, long haul COVID, and does vaccination give you a considerable protection against the possibility of getting long haul COVID if you got a breakthrough?

Bill Walsh: That's a great question. Dr. Talbot, can you help Carol with that?

Tom Talbot: Yeah, Carol. Really good question. And there actually has been some data, not just simply from folks that got the booster, but folks that got two doses of an mRNA vaccine. So that study was out in the New England Journal several weeks ago, that found that compared to non-vaccinated folks that got infected and folks that just got one dose of a Pfizer/Moderna vaccine, if you got two doses of Pfizer or Moderna, your risk of having those kind of long COVID symptoms a month out was significantly lower. And so we are seeing, that's a really interesting, I don't, I don't quite know the, the, the reason behind that, but it's very interesting as we learn more about this disease.

So there, there is some signals that getting back to that will reduce that chance, if you do get COVID, of having the long COVID symptoms that are, that it can be pretty scary.

Bill Walsh: Yeah. Talk about some of those long haul COVID symptoms, if you would, Dr. Talbot.

Tom Talbot: Yeah. What we're seeing in individuals, and it doesn't necessarily relate to how bad your first COVID infection was, is that some individuals will have lingering symptoms some for months, and they could be things like neurologic, like just, described as like brain fog, trouble thinking, difficulty thinking, fatigue. Some folks have some vascular challenges, some cardiovascular issues, kind of a wide array of issues and challenges that are there.

And even when one recent report quoted about 25% of individuals with COVID were seeing some degree of symptoms, several weeks to months out from their infection. And so we don't understand exactly the reason why, it's probably immunologic, but we're not certain with that. But it is striking and can be pretty debilitating.

In fact, we at Vanderbilt now have a post-acute COVID clinic for these patients to help manage their symptoms and treat them. So, that is a thing that's a little bit unique to this virus that we're learning about and seeing throughout the pandemic.

Bill Walsh: Okay. Very good. Thanks so much for that. Dr. Talbot. Jesse, let's go back to the lines.

Jesse Salinas: Yeah, we're going to bring our next caller, Lance from Illinois.

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

Lance: Okay. Thank you. My question is, if you had COVID and now you test negative and you went and got the Johnson and Johnson one-shot vaccine, can you then also get the Pfizer booster?

Bill Walsh: Okay. Dr. Talbot, I think you talked a little bit about this before. Can you address Lance's question?

Tom Talbot: Yeah, right now, the recommendations for boosters are only if you've gotten the two doses of Pfizer. And now the Johnson and Johnson question will be discussed next week at the FDA. And so we may get some more information there.

J&J did release some data in the last week about what happens with antibody levels with a second dose — so their booster would be dose two, so to speak —and showed a really promising impact on antibody levels with a second dose. So what I’ll say is, hang on for about a week, a week and a half.

And I think we'll hear more about how to deal with our patients who got Johnson and Johnson and whether they need a booster or dose number two.

Bill Walsh: Okay. Thanks for that, Dr. Talbot. Let's go back to the lines. Who do we have next?

Jesse Salinas: Our next caller is Edith from Maryland.

Bill Walsh: Hey, Edith. Welcome to the program. Hey, how are you? Go ahead with your question.

Edith: Hi, I think you already asked, someone asked my question, but I'll rephrase it and see whether or not you feel it has been answered. I had a two part question. Now I have the booster shot, and I was wondering, what is the level of effort, efficacy or effectiveness at this point? And also now that I've had the booster on Sunday, it will be my two-week period. So when I'm around my grandkids who are under the age of 11, should I wear my mask around them inside as well as outside?

Bill Walsh: Oh, good questions. So, Dr. Talbott do you want to address that? And Dr. Tan, if you'd like to get in on that too, go ahead.

Tom Talbot: Yeah, Edith really good. So first question about what's the effectiveness now with the booster. Really the data we have so far predominantly from Israel, it does look like that you get effectiveness back into those kind of mid 90% levels that we saw from the clinical trials with two doses. So it does seem to kind of boost you back up to where we were with dose two.

The question you asked, so now on Sunday, you'll be fully, fully vaccinated plus boosted, and whether you need to wear a mask with your younger kids. Your chance of getting a breakthrough infection is much lower now. And so I think my general advice is outdoors, I actually think it's safe to not wear a mask. Indoors probably you're okay to not wear a mask, it kind of depends on how things are circulating in your community. If things are really heavy in COVID, you could wear one just to be extra careful. But I think it's a really good question we're going to be faced with is, are boosted folks, are they kind of at a different level of immunity that maybe they, they unmask and, right now in Nashville, we have such activity of COVID that we'd say hold off, but it may be that things are declining, you'll be able to kind of remove that mask and your grandchild will see your face and that'd be great.

Bill Walsh: All right. And maybe that grandchild will be able to get a vaccine soon as well. Dr. Tan, did you want to add anything to that?

Litjen Tan: Yeah, nothing to that second question, that I think the community risk level is the thing that you have to look for. I agree that she's going to be really well protected. The other thing, just to put out there for all your listeners and as an answer to the question, is that the effectiveness of that booster is not just about that 95% protection against infection, it also is incredible protection against becoming really sick, right? The long haul as was discussed earlier, but also hospitalizations and medically attended visits. They go down dramatically as a result of the booster as well. So that's the data from Israel.

Bill Walsh: Yeah, that's a great point. Thanks Dr. Tan. All right, Jesse, let's take another.

Jesse Salinas: Yeah, this next caller is Linda from Virginia.

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

Linda: Thank you. I'm scheduled for a mammogram and I'm also waiting for the booster for the Moderna. Is it safe for me to have a mammogram and then I can get the booster for the Moderna, or is there a timeframe between that?

Bill Walsh: Dr. Talbot, can you address that?

Tom Talbot: Yeah, Linda. Thanks. So, one thing that we do see, in folks that get vaccinated, in some folks, because you're prompting the immune system to kind of react, and part of that immune system are lymph nodes, like under your arm, is there were reports of women that would go for their routine mammogram and be noted to have a swollen lymph node on the mammogram.

And so that's raised some questions of, do I defer my mammogram or do I defer my shot. And the general consensus now is that you don't defer either. But when you go to get your mammogram, make sure you tell the folks that you've had a booster recently, because then that way the radiologist reading it will know, oh, there's a little bit of a lymph node there, but they had their booster and that's what's there, and they can use that information to help read that. But it wouldn't be something we don't want folks who need that mammogram to miss that mammogram or delay that mammogram. And we also don't want you to miss the booster when it's time too.

Tom Talbot: Okay. Thanks for that, Dr. Talbot. Let's take another quick question.

Jesse Salinas: Our last question I think is going to be from Facebook. It's from Lisa and she wants to know, should I postpone my yearly doctor visits or my annual wellness visits due to the COVID delta virus?

Bill Walsh: Well, Dr. Talbot was talking about that issue just a moment ago, Dr. Talbot, do you wanna elaborate?

Tom Talbot: Yeah, I would say absolutely no, one thing we learned last year when we all locked down and a lot of people didn't get their regular medical care. As we saw folks here and across the country that had kind of worsening of the underlying conditions and illnesses, and we saw people not get routine immunizations.

And so we definitely recommend to maintain checkups and everything. The good thing is that all the clinics and hospitals,  and this is what I do at Vanderbilt, we have infection prevention practices to prevent the risk of spread to each other and our patients. So masking and other things, you may on entry be asked about symptoms.

Obviously don't come if you’re feeling sick, but there's a lot of protections there to protect you from catching COVID there. So definitely want to make sure you go get that visit, get your checkup, maintain your health care, because we don't want you getting sick from something else, too. And we'll protect you from COVID.

Bill Walsh: All right. Thanks to both of our experts for answering our questions. This has been a really informative discussion today, and thank you, our AARP members, volunteers and listeners for participating in the discussion today. AARP, a nonprofit nonpartisan membership organization, has been working to promote the health and well-being of older Americans for more than 60 years.

And 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 the spread to others, while taking care of themselves. All of the resources referenced today, including a full recording of today's Q&A event can be found at AARP.org/coronavirus on October 8. There, you can see a full transcript of the program. Again, that address is AARP.org/coronavirus. Go there if your question was not addressed, and you'll find the latest updates as well as information created specifically for older adults and family caregivers. We hope you learned something today that can help keep you and your loved ones healthy.

Please join us on October 21 at 1 p.m. Eastern time for another live event, answering your questions about the coronavirus. We hope you can join us. Thank you and have a good day. This concludes our call.

Boosters, Flu Vaccines & Wellness Visits 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 star zero on your telephone keypad now.

[00:00:15] [Español]

[00:00:23] 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. Last week, the United States recorded the 700,000th death from COVID-19.

[00:00:49] It was a milestone few dared imagine at the beginning of the pandemic, nearly 20 years ago. Yet as misinformation about the vaccines proliferates, tens of millions of Americans continue to refuse to take one. It has enabled COVID variants to easily spread through the population and clogged hospital emergency rooms.

[00:01:12] Meanwhile, some of those who have been vaccinated have begun getting booster shots for extra protection, and promising new treatments for COVID appear to be on the horizon. As a nation wrestles with the pandemic, Congress is debating one of the most significant packages of legislation for older adults in a generation.

[00:01:32] There are bills to lower prescription drug prices, add benefits to Medicare and create a tax credit for family caregivers. AARP is in the thick of the fight to get it all enacted. Today we'll hear from an impressive panel of experts about these issues, and if you've participated one of our tele-town halls before, you know this is similar to a radio talk show, and you have the opportunity to ask your questions live.

[00:01:58] For those of you joining us on the phone, if you'd like to ask a question about the coronavirus pandemic, press star three on your telephone to be connected with an AARP staff member, who will note your name and question and place you in a queue to ask that question live. If you're joining on Facebook or YouTube, you can pose your question in the comment section.

[00:02:21] Hello. If you're just joining I'm Bill Walsh with AARP, and I want to welcome you to this important discussion about the global coronavirus pandemic. We're talking with leading experts and taking your questions live. To ask your question, please press star three, and if you're joining on Facebook or YouTube, you can post your questions in the comments.

[00:02:41] We have some outstanding guests joining us today, including a medical expert and one on immunizations. We also be joined by my AARP colleague Jesse Salinas, 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.

[00:03:05] Again, to ask your question, please press star three at any time on your telephone keypad to be connected with an AARP staff member. Or if you're joining us on Facebook or YouTube, place your question in the comments. Now I'd like to welcome our guests. Tom Talbot is an M.D. and master of public health.

[00:03:25] He is a professor of medicine at the Vanderbilt University School of Medicine. He is also the chief hospital epidemiologist at Vanderbilt University Medical Center. Welcome to the program, Dr. Talbot.

[00:03:37] Tom Talbot: Thank you for having me, I’m really glad to be here.

[00:03:39] Bill Walsh: All right, we're glad to have you. I'd also like to welcome L.J. Tan, a master of science and a Ph.D. Dr. Tan is the chief policy and partnerships officer with the Immunization Action Coalition. He is also the cochair of the National Adult and Influenza Immunization Summit. Welcome, Dr. Tan.

[00:04:03] Litjen Tan: Thank you very much, Bill. Pleasure to be here.

[00:04:05] Bill Walsh: All right, we're delighted to have you. Let's go ahead and get started with the discussion.

[00:04:09] Now, just a reminder to our listeners: To ask your question, go ahead and press star three on your telephone keypad or drop it in the comments section on Facebook or YouTube. Dr Talbot, let's start with you. With FDA approval of a Pfizer COVID vaccine booster, there are some important questions. Let's address several of them briefly The first is, how beneficial is a COVID-19 booster?

[00:04:37] Tom Talbot: Yeah. Thanks Bill. Really good question. We've heard about boosters the last month or so. And that's based on some data that we're seeing, particularly with the Pfizer vaccine, that while it still remains very protective against severe infection from COVID, we are starting to see a waning of the protection, usually around about six months out from your last shot.

[00:04:57] And so people are getting infected again who have been vaccinated. You hear about the breakthrough cases of infection. Fortunately, many of those individuals have mild infections, but it's still a problem, particularly as we're facing this wave of delta variant across the country. And so, we really do need to kind of do the things to prevent that spread.

[00:05:16] So getting a booster will amplify your immune response and gonna basically boost the immune protection against getting infected again. And we've seen some data from other countries that getting that booster does reduce the chance of getting any infection from COVID, which is so important right now, as we're trying to really break the wave of delta, so to speak.

[00:05:36] Bill Walsh: Let me throw a few other questions at you about boosters. Who is eligible for booster shots right now?

[00:05:43] Tom Talbot: Yeah, and you may recall there was a little bit of confusion when this happened, but let me hopefully distill it down. So if are 65 years of age and older, you're eligible for a booster. Actually, let me step back. Only right now if you've got a Pfizer vaccine as your first doses of COVID vaccination. So I'm talking right now about Pfizer. If you've got Moderna or J&J let's hold that for a little later. If you're 65 and up, you should get a booster. If you're younger than 65, 18 and up, and have underlying medical conditions that may increase you of having higher risk for COVID complications.

[00:06:16] And those could be things like cancer, diabetes, obesity, a pretty wide range of conditions. If you're 50 and up, the CDC said they really strongly recommend getting a booster. If you're under 50, an adult, really, they recommend the booster, but assess that based on your own kind of situation and your risk of exposures. But really it's very broad if you should get a booster.

[00:06:37] And then the last group are those that may not have a high risk condition, but they may be in a situation where they have a high risk of exposure particularly through where they work. And so in that bucket are groups like our health care workers, our teachers. And part of the rationale for those is that, even a mild infection amongst those groups, you heard a lot about our health care system being really strained with the delta wave.

[00:06:59] If we lose any health care worker, even if they have a mild cold, they can't come to work. And that is a very serious strain on the health care system and really has a massive impact. If we lose teachers, we lose the ability to teach the kids. So preventing even a mild infection in these groups is really important right now as we face the delta variation.

[00:07:15] Bill Walsh: Okay. Very good. Now for those who are eligible for booster shots, how much time is required between completion of a full dose and a booster?

[00:07:25] Tom Talbot: Sure. So you need to have had your two doses of vaccine, and your second dose should have been six months ago. So if you just got your series, maybe back in June, you're fine.

[00:07:36] The one thing we should clarify too, and I think there's a little confusion is the difference between a booster dose and a third dose. Some populations, some folks that are very immunocompromised have needed to get a third dose as part of their regular series. So their real series of vaccinations would be, one dose followed several weeks later by dose two followed four weeks later by dose three. So there's a little bit of confusion there, but the booster is six months after that last dose.

[00:08:03] Bill Walsh: Okay. Now of course, we're talking about a Pfizer vaccine booster shot. What about those who completed a vaccine cycle with Moderna or J&J. Can they get the Pfizer booster?

[00:08:16] Tom Talbot: So right now that's not recommended, but at the end of next week, the FDA advisory committee will be meeting on exactly those questions for the Moderna and the J&J vaccine about whether they need boosters. Now, there are some data with Moderna in particular, Moderna is a little bit of a higher dose of a vaccine and had a little bit more spacing out between dose one and two.

[00:08:36] And we're not seeing that waning of immunity like we've seen with Pfizer. So it'll be interesting to see what the FDA decides next week. But we know those are really important questions to our patients. We face them here at Vanderbilt and we're hoping to get some clarity probably in the next two weeks from those meetings and discussions about answers for those individuals and boosters.

[00:08:53] Bill Walsh: Okay. Now, final question. Will booster shots become available for those folks who aren't eligible today? And when do you think that might happen?

[00:09:01] Tom Talbot: Yeah, that's a great question. Because right now, as I mentioned it in the middle of the delta wave, our threshold to really kind of break the wave is, we've got to really push that.

[00:09:09] But the question is, in a healthy 20, 25 year old, will they need a booster at all? Or is it just a function of, you know, there's other groups, cause we're in the delta wave. And we don't know that yet. There's also some postulation — and don't hold me to this — but once all the dust settles and we get through our COVID and get all the data and the scientists look at this, potentially down the road, we might find that actually everybody should get three shots as their COVID vaccine series, kind of like we do with hepatitis. But we don't know that yet.

[00:09:35] So I don't know necessarily if you're not eligible, you may not necessarily need a booster right now. But that's time will tell. So I kept that as vague as I could, because I don't know the right answer at this point, but.

[00:09:46] Bill Walsh: Well, we're figuring out a lot of things, in real time. That's one of the markers of this pandemic. Hasn't it been? All right. Well, Dr. Talbot, thank you very much for that. Dr. Tan, let's turn to you. Why is it important to have a traditional flu vaccine, even if you're fully vaccinated for COVID?

[00:10:07] Litjen Tan: Oh, thank you Bill for that. And Tom, that was a fantastic discussion on the boosters. And I think the point here is obviously, COVID is one disease and influenza is another disease, and both are serious life-threatening illnesses.

[00:10:19] So even if someone's fully vaccinated for COVID, that does not give them protection against influenza or the flu. And so getting the flu vaccine right now is essential so that people are protected against both. We do not want people having flu and thinking that they're not getting back in for COVID, and we don't want people getting COVID and thinking they don't need to get back to you for flu.

[00:10:40] You gotta get both, both due to separate illnesses, and they're both life-threatening illnesses.

[00:10:45] Bill Walsh: Okay. Well, let me follow up on that. Is it advisable to get a flu shot and a booster at the same time? Are there interaction concerns for the COVID booster and things like shingles and pneumococcal or whooping cough vaccines?

[00:11:01] Litjen Tan: Absolutely. It is advisable and in fact it is even recommended that if you're going in and getting a COVID-19 booster, please consider getting at that same visit the flu vaccine, if you haven't got it already. And the other vaccines that you've mentioned, including obviously a pneumococcal vaccine. So I think, absolutely the CDC has said that the COVID-19 vaccine can be what we call co-administered. That means given at the same time, at the same clinical visit, with other vaccines, such as the flu vaccine or the pneumococcal vaccine.

[00:11:34] Bill Walsh: All right. Well, that's great news. Thanks very much, Dr. Tan. And as a reminder to our listeners, to ask your question, please press star three on your telephone key pad. We're going to get to your questions shortly, but before we do, I wanted to bring in Megan O'Reilly. She's an AARP vice president for health and family government affairs. Welcome, Megan.

[00:11:58] Megan O'Reilly: Hi Bill, it's good to be with you.

[00:11:59] Bill Walsh: Great to have you. 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 I know they've got their hands full these days. So Megan, thanks for joining us today. Is there any progress being made on legislation that can help Americans 50 and older?

[00:12:23] Megan O'Reilly: Yes. The good news is we're making headway in our fight to lower prescription drug prices. AARP has been hard at work supporting legislation that will lower the price of medication by allowing Medicare to negotiate with drug companies. Prescription drug prices have long been out of control. So for Congress to take this action and allow Medicare to finally use its bargaining power to lower prices would be a huge victory for older Americans.

[00:12:49] Bill Walsh: Okay. AARP members have been an important part of this fight as well. Haven't they been?

[00:12:58] Megan O'Reilly: Oh, absolutely. AARP members have been leading the way. Just using the telephone and the internet, anyone can raise their voice and urge Congress to support important matters, like high prescription drug prices, as well as issues like Social Security and Medicare.

[00:13:14] And we know many of you have. Most recently, AARP activists have sent 675,000 emails and made more than 200,000 phone calls, urging members of Congress to let Medicare negotiate drug prices. Our Show Your Receipts docial media campaign highlighted 24,000 real life prescription drug receipts totalling over $12 million.

[00:13:38] It's hard to deny that drug prices are too high. When you see what many older adults are having to pay. Our members are also doing a great job. Writing letters, calling your representatives and meeting with legislators.

[00:13:51] Bill Walsh: Well, that's fantastic. Now caregiving is another priority that AARP is working to gain more support for, isn't that right?

[00:14:00] Megan O'Reilly: Absolutely. AARP is leading efforts on several fronts that are urging the government to recognize and support family caregivers. Right now we're asking Congress to enact a federal law that supports paid leave for caregivers. And we're also fighting for passage of a family caregiver tax credit. You should not be at risk for losing your job if you drive your parents to a doctor's appointment. You can also take action to help offset some of the financial costs of caregiving. These are practical, common-sense steps that the government can take to lessen the challenges facing families who are caring for their loved ones.

[00:14:34] Bill Walsh: Alright, anything else AARP is fighting for at this time that our listener should know about?

[00:14:41] Megan O'Reilly: Yeah. There are several other items for supporting and reconciliation, including dental, hearing and vision benefits to Medicare. In addition to our health care work, AARP is actively supporting the Protecting Older Job Applicants Act. Just last week, we sent a letter to Congress expressing our support for this bill that extends protections for job applicants, fighting age discrimination and employment.

[00:15:04] Unfortunately, ageism exists in the workplace. Even workers over the age of 50 contribute valuable skills experience. AARP fights age discrimination in all forms, including workplace discrimination. Supporting this act is important because everybody deserves equal opportunity when applying for a job.

[00:15:24] Bill Walsh: All right. That's a lot of promising news. Thanks so much for being here, Megan. We really appreciate it.

[00:15:30] Megan O'Reilly: Thank you.

[00:15:31] Bill Walsh: All right, it's now time to address your questions about the coronavirus pandemic with Dr. Tom Talbot and Dr. L.J. Tan. Please press star three at any time on your telephone keypad to be connected with an AARP staff member to share your question live. If you'd like to listen in Spanish, please press star zero on your telephone keypad now.

[00:15:58] I'd like to now bring in my AARP colleague Jesse Salinas to help facilitate your calls today. Welcome Jesse.

[00:16:10] Jesse Salinas: Thanks, Bill. Glad to be here for this important conversation.

[00:16:13] Bill Walsh: All right, let's go ahead and take our first question.

[00:16:17] Jesse Salinas: Yeah, first off is going to be from Linda in Virginia.

[00:16:21] Bill Walsh: . Hey, Linda. Welcome to the program. Go ahead with your question.

[00:16:30] Linda: Hello?

[00:16:31] Bill Walsh: Hey, Linda, how are you? Go ahead with your question.

[00:16:38] Linda: I am well, thank you.

[00:16:40] Bill Walsh: Go ahead with your question. Yup.

[00:16:44] Linda: I'm calling for clarification of what Dr. Tan said about the booster and the flu shot. I wasn't sure if there is a time frame between both or if one can get the booster and the flu shot at the same time.

[00:17:06] Bill Walsh: Well Dr. Tan, can you elaborate?

[00:17:10] Litjen Tan: Absolutely. Can you hear me?

[00:17:12] Bill Walsh: Yep. Go ahead.

[00:17:15] Litjen Tan: Oh, perfect. There is no timeframe between the two that you have to wait. Linda, you can go ahead. You can get the flu vaccine in one arm and you can get the COVID-19 booster in the other arm. So, at the same time. So you're perfectly good there.

[00:17:29] Bill Walsh: Okay. Thanks for that, Dr. Tan. Jesse, who's our next caller?

[00:17:35] Jesse Salinas: Our next caller is going to be from Julia in Alabama.

[00:17:40] Bill Walsh: Hey, Julia, welcome to the program. Go ahead with your question.

[00:17:46] Julia: I'm calling to see if there is any way to be.

[00:17:53] Bill Walsh: Julia, still with us?

[00:17:56] Jesse Salinas: Hey Bill. I think we lost Julia with some technical issues, so let's try Sarah in New York.

[00:18:02] Bill Walsh: All right, Sarah. Welcome to the program. Go ahead with your question.

[00:18:07] Sarah: Hi. I'm almost 65 and I got the Moderna second shot and I'm about seven months into, you know, I need a booster. Now, I wanted, my question is, well, I wanted to know if I could get the Pfizer and then I heard that it's not acceptable, it's not recommended right now. But my question is also, what did Moderna never gets FDA approved? What happens to all of us that got that one?

[00:18:40] Bill Walsh: Well, Dr. Talbot, there are a couple of questions in there. Can you clarify for Sarah and our listeners?

[00:18:49] Tom Talbot: Yeah. Sarah, it's a really great question. So, we'll learn more about folks like you that got the Moderna two shots next week at the FDA.

[00:18:58] As I mentioned, the data on Moderna do show that that kind of loss of some protection that we saw with Pfizer, we don't see as much with Moderna. So there may be some still encouraging information about the Moderna protection. I think the question that you have is a really good one. And actually, I had just forgotten it's still on EUA since you asked that. And I think the reason being is, I have to kind of elevate our folks at the FDA and CDC who had been working furiously during this pandemic to try and get through all this. And I can only imagine just going through everything.

[00:19:30] I know Moderna has submitted their paperwork several months ago for full approval FDA takes a really good thorough time to really make sure that, hey, they look at all the data, but also make sure that all the plants can manufacture the vaccine safely and do all that diligence. And so that's still ongoing. We haven't heard much of that timeline because of things like the booster questions that they've been helping us with. And then I'm sure folks out there have the questions about young children and that vaccine. So I think the FDA's plate is very full and they're working as they can both measured and safe and do all cross all the T's dot all the I's. But I imagine we'll get full approval of Moderna hopefully in the next few months, as I know stuff has been submitted for that.

[00:20:11] Bill Walsh: All right, Dr. Talbot, thanks very much for that. Let's go back to the lines. Jesse, who do we have net?

[00:20:19] Jesse Salinas: Our next caller is going to be Brenda from Georgia.

[00:20:23] Bill Walsh: Hey, Brenda, welcome to the program. Go ahead with your question.

[00:20:30] Brenda: I was, I wanted to ask about if you've already had the COVID and you have tested positive for antibodies, what is the push for us to be vaccinated?

[00:20:41] Bill Walsh: Dr. Talbot can you help Brenda with that question?

[00:20:46] Tom Talbot: Yeah, that is a great question, Brenda. I get asked that a lot. In fact, I just responded in the last hour to an email on that. And I'll kind of try and walk through quickly kind of the reason being. We know after COVID infection, you do have some immune proteins. We know that the problem is that not everybody has the same level of protection. And before we face this delta variant that we're seeing now, we saw that people with natural infection, the level of really important antibodies that they need to kind of stick on that virus when it tries to infect us, that level of antibodies in naturally infected folks is much lower than in vaccine protected folks.

[00:21:24] And so people who had a natural immunity would lose detection of the antibodies. So, one. The other thing we see is that there's a really important part of the virus — you've probably seen all the cartoons with the spikes that stick out of the virus. And on the end of that spike is a really important part of that, that the virus uses to stick to our airway cells and cause infection.

[00:21:45] And that part is what the variants changed to make them kind of evade things. And so what we see with natural infection is, they make a couple of types of antibodies to that key part, and they make antibodies to alot of other parts of the virus. But with the vaccine, they make a lot of other flavors. So it's kind of like natural infection makes chocolate and vanilla, but the vaccine makes rocky road and other types, so that if you get these variants that come out, you're more protected from the antibodies from the vaccine.

[00:22:12] There's interesting data now that say, if you've had a COVID infection, your risk of getting another infection is over two times higher if you're not vaccinated than if you're vaccinated. And part of the challenge too, my last one is you kind of mentioned the detectable antibodies and that's the big challenge is, the antibodies may be detectable, but they may not be protective against the delta variant. So you may think, oh, I've got some antibodies and I'm okay when you're really still vulnerable to this variant. And so that's part of why we recommend getting vaccinated, even if you've had COVID infection. It is confusing, though.

[00:22:46] And I think it's, like I said, a very common question that I've been getting lately.

[00:22:49] Bill Walsh: All right, Dr. Talbot. Well, thanks for clearing that up. Good explanation. Alright, Jesse, who do we have next?

[00:22:57] Jesse Salinas: Our next question, Bill, comes from YouTube. This is Frances and she asks, can the shingles vaccine be taken at the same time as the COVID vaccine?

[00:23:07] Bill Walsh: Dr. Tan, I think answered that, but Dr. Tan, do you want to elaborate on that question?

[00:23:13] Litjen Tan: Yes. So the advice from the CDC is that you can co-administer the COVID-19 vaccine with any other vaccine. There are a couple of exceptions and the shingles vaccine is not on the exception list. So, yes.

[00:23:28] Bill Walsh: Okay. Very good. Jessie, let's take another caller.

[00:23:33] Jesse Salinas: Our next caller is Zani from Florida.

[00:23:36] Bill Walsh: Hey, welcome to the program. Go ahead with your question.

[00:23:40] Zani: My name is Zani. I have a question about a person with lupus. I asked this question last set. And the doctor answered just basic question and it was very short. I am, I have had attacks, my immune system is shot and I've been hospitalized for just taking some medication. I took a tetanus shot and ended up in the hospital.

[00:24:07] I I've had several reactions to just what would be normal for other people. It's not normal for me. And they don't talk about people with lupus. I know lots of people with lupus, and we are afraid because you're putting a live vaccine into our bodies. And that means that we are going to be exposed to it immediately.

[00:24:27] Bill Walsh: Right. Zani, I remember you calling in two weeks ago. Let's see if we can get your question answered. Dr. Talbot, can you address Zani’s question?

[00:24:37] Tom Talbot: Yes, Zani. Thanks for asking that. I think it's a common question. So, as far as folks with lupus, there's a couple of things that we are concerned about, not with necessarily the vaccine, but with COVID infection.

[00:24:48] We know that folks with kind of underlying illness like lupus have a much greater risk if they get infected to get really serious infections. That may be due to the lupus itself or due to a lot of medicines we have our patients with lupus take that effect their immune system. And so the risk of having a really bad outcome if you get COVID is really high. What we're not seeing in the millions of people that have gotten it, some of those have lupus, is we're not seeing signals of flares of those types of diseases. Like the autoimmune diseases, like lupus or rheumatoid arthritis. We're not seeing that happen after vaccination, which is reassuring as well.

[00:25:26] And so as I talk to my patients that have similar kinds of conditions, lupus or other things, I kind of phrase it like this — we really have two pathways to walk on. And I wish there was a third where we didn't have to get vaccinated or have COVID. But those are our pathways. Take the vaccine and while it's very, very safe, it's not a hundred percent. Just like if you go get a medicine at Target, you may have a reaction to that. Very, very rare. But the safety profiles of the vaccines are very, very, very reassuring. Or you risk getting exposed to COVID and having really serious harms from COVID infection.

[00:25:59] And we know folks with autoimmune disease and lupus in particular have that risk. And so different societies have said that support kind of patients with diseases like lupus have said, look, we really, you should get vaccinated because of that risk of really severe infection.

[00:26:13] I do want to clarify one thing, cause it's a really common confusion. Like you mentioned with the COVID vaccine is, it is not a live vaccine, so this is not, they don't have a live virus. You absolutely cannot catch COVID from the COVID vaccine. It only has the instructions to make a single piece of that virus, not the rest of it. So that often gets folks worried that are, have a weaker immune system that they'd be exposed.

[00:26:37] And we do have some vaccines like chicken pox vaccine, that we don't necessarily give to those folks because it's a little bit more of a risk with a live virus type of situation. But COVID vaccines are not like that.

[00:26:48] Bill Walsh: Okay. Dr. Talbot, thanks for that explanation. And Zani, I hope you get the answer you're looking for there. Jesse, let's take another call.

[00:26:58] Jesse Salinas: Our next caller is going to be Laura from Vermont.

[00:27:01] Bill Walsh: Hey Laura. Welcome to the program. Go ahead with your question.

[00:27:05] Laura: My question, I already gave it. And you said you wanted it on air. So I had to wait, but I'd like to add to that. My question was, may I take the booster when I'm a little bit sick?

[00:27:21] The second question is the shingles vaccine. I've had shingles, but I've never had the vaccine. And I need to address that. I had shingles about eight years ago. So I don't know if one affects the other or if I could have a shingles vaccine at the same time.

[00:27:44] Bill Walsh: Well, let's start with the shingles vaccine. Right. So Dr. Tan, Laura had shingles eight years ago. She's wondering if she should get vaccinated for that. And I think she also asked whether she can get a booster if she's been a little bit sick.

[00:28:05] Litjen Tan: Hi, Laura, thank you for that. I, and I hope you've recovered fully from shingles. That's a painful condition. So yes, absolutely. You can definitely get the shingles vaccine now, eight years down from the last attack of shingles. absolutely highly recommended. Please get the shingles vaccine.

[00:28:24] And as a reminder, that is the two doses of the vaccine, about six months apart. So please, please do seek out the vaccine. And again, you can have, you can absolutely get that vaccine, the shingles vaccine at the same time as you get your COVID-19 booster. The one recommendation is that, because both those actions tend to be a little bit more reactive, to place them both in different arms.

[00:28:46] That's about the only recommendation from CDC about co-administering the two vaccines. I'm going to punt the actual clinical question about being sick. I do have an answer, but I want to give Tom maybe a chance to answer that first.

[00:29:01] Bill Walsh: Sure. Dr. Talbot, do you want to take a crack at that? Laura was concerned because she's been a little bit sick. And she's wondering about getting a booster at this time.

[00:29:12] Litjen Tan: The COVID-19 booster.

[00:29:14] Tom Talbot: Yeah. Yeah. That's a good question. So I think if I had kind of a cold and sniffle to make sure, hey, it wasn't COVID, but if it's not, and I just felt a little punky, I probably would wait a couple of days before getting into booster.

[00:29:26] Because remember, the way these vaccines work is, they rev up your immune system. They kind of build those antibodies. And so just like when you have a cold, sometimes the way, the reason you feel cruddy is the immune system's revved up, so putting that on top of already feeling sick. but I wouldn't, I wouldn't delay too long.

[00:29:42] So if it's something that, like I just feel kind of run down, I've been that way for several weeks, but I probably would go ahead and get that just to make it. Don't forget to get that booster or have that risk of getting exposed to COVID. That'd be my recommendation.

[00:29:54] Bill Walsh: Okay, Dr. Talbot and Dr. Tan. Go ahead, Dr. Tan.

[00:29:59] Litjen Tan: I was just going to jump in Bill and say that some tests, some people get confused because they hear that, oh, if you've got symptoms, you're not supposed to come in to get your vaccine. A lot of that also has to do with the fact that they just want to make sure you don't have COVID, right. That's what Tom kind of suggested. So you don’t want to be bringing it into the health care facility, in other words.

[00:30:16] Bill Walsh: Okay. Thank you both for that. Jesse, let's take another call.

[00:30:21] Jesse Salinas: Yeah. Our next call is going to be from Bill in Ohio.

[00:30:25] Bill Walsh: Hey Bill. Welcome to the program. Go ahead with your call.

[00:30:28] Bill: I'm an 85-year-old male.

[00:30:33] I've had my both Pfizer shots about a year ago and I've been okay. Except the last couple of weeks I came down with the COVID. I tested positive here a week ago. I'm starting to feel a little better now, but my question is, how long should I wait before getting a booster shot, or the flu shot. Should I be testing negative first before I get shots?

[00:31:04] Bill Walsh: That's a good question, Bill. Let’s ask Dr. Talbot about that. Dr. Talbot?

[00:31:08] Tom Talbot: Yeah, Bill. I hope you're feeling better. I know, getting COVID can be really serious. I hope it sounds like you're on the mend. So that's the first point. The general guidance is that we want to make sure first that you're no longer infectious.

[00:31:22] So usually that's about 10 days after the infection starts. So we definitely wouldn't want you to come in right now. And that's just, we don't want to expose other folks to COVID. And then after that, our recommendation is that you can go ahead and get the booster, although you still really, you've probably boosted your immune system a little bit with your COVID infection and you may be able to wait a little bit.

[00:31:42] The problem is we don't want you forgetting it in about two months or three months. Oh, I needed to go get that booster. So we've been recommending, once you're cleared from being infectious, go ahead and come on in and get the booster. You may have a pretty nice response to that vaccine that, you know, to kind of feel a little cruddy the day after, but that's okay.

[00:31:58] But that's been what we've been guiding in this kind of situation, you don't need to get a negative test before you come in. You just need to be cleared from isolation, from your doctor, your health authority.

[00:32:09] Bill Walsh: Okay. Very good. Thanks for that, Dr. Talbot. And thanks for all those questions. We're going to — oh, go ahead, Dr. Tan. I'm sorry.

[00:32:17] Litjen Tan: Oh, I just want to address the part about the flu vaccine. And I think that's what Dr. Talbot says when he's in there, he should definitely also get his flu vaccine.

[00:32:25] Bill Walsh: Right, right. Yep. Absolutely. All right.

[00:32:29] Well, Bill in Ohio, thank you for that question. Thanks to all those questions. We're going to take more of your calls soon. As a reminder, if you'd like to ask a question, press star three on your telephone key pad, or drop your question in the comments section on Facebook or YouTube. And if you'd like to listen to this program in Spanish, press star zero on your telephone keypad now.

[00:32:59] All right now, let's turn back to our experts. Dr. Talbot, the drug company, Merck and Pfizer expected to seek FDA approval for a short-term regimen of daily pills to fight the virus. And another drug company, AstraZeneca announced their vaccine is 74% effective, even higher in adults who are 65 or older.

[00:33:22] Can you briefly review these emerging efforts and how will prevention and treatment differ, and how quickly can we expect to see some changes?

[00:33:34] Tom Talbot: Yeah, thanks Bill. So I think one thing as an infectious disease physician, as a scientist, that's been really exciting to see — if they call the pandemic exciting — is just the advancement of science and scientists really going to hard at work to really help answer a lot of questions.

[00:33:50] And so the things we didn't have, or didn't know about this virus just as little as a year and a half ago, and so some of that is we're really learning about how best to both prevent, but also treat individuals with COVID infection. So right now, if you come in with COVID infection, you could get a monoclonal antibody.

[00:34:07] If you have mild infection, if you come in the hospital, you'll get an antivirus medicine and some steroids, and you may need even some more severe kind of immune suppressing medication. The challenge is, we don't really have an antivirus medicine that you can go to your doctor in the clinic to get.

[00:34:22] So folks may be most familiar with a drug called Tamiflu. So thinking of influenza infection, sometimes we'll give that to individuals to help reduce symptoms. And so we haven't had that with regards to COVID, but now with Merck and they announced their [inaudible] data as well. And so it's very exciting. I think we'll be getting more information about the effectiveness of the trial they released was really encouraging about preventing the need to go in the hospital if you've got COVID.

[00:34:48] So that's great to have that in our pocket to use. Other vaccines like AstraZeneca. I think one thing that's been phenomenal due to the funding support and the science is all the new vaccines that are emerging across the world to COVID because we really supported those. And I don't know where AstraZeneca will fall in the United States.

[00:35:07] We have three vaccines now. And as I mentioned earlier, the FDA has been really focused on a lot of important questions like boosters and full approval and kids. And so I don't know when in the line their vaccine will come in if they will in the U.S. but it's great to have that available throughout the world because we can't forget the world and protecting them. So I think as we learn more and more, it's really going to be, I think we're even six months from now, we'll have a much greater clarity of if someone has COVID, how to manage them, how to prevent COVID, how to prevent spreading from people if you don't know that you're sick.

[00:35:39] I think that's just kind of, these are all examples of just really hard-at-work scientists, some really exciting discoveries around this virus.

[00:35:46] Bill Walsh: Well, and more or tools in our toolkit to fight the spread of the pandemic. Dr. Talbot, I wonder what you think is the likelihood the U.S. will see another surge in cases later this fall or this winter.

[00:36:01] And I'm curious, you mentioned outbreaks in other parts of the world. How do surges elsewhere impact us here in the United States?

[00:36:12] Tom Talbot: Yeah. So I think if I had a crystal ball and could tell you the right answer to that, I would have bought the Powerball lottery this week, but I didn't and didn't win.

[00:36:19] So I don't know. And honestly, I will tell you. While we had the delta variant in June, I was very optimistic and excited to have my mask off and went through the stages of grief when this wave hit, which the delta wave has been the most severe for us in Tennessee than any part of the pandemic.

[00:36:37] So I don't really know what to see in the winter. I think we've got to be worried about flu coming back and what that will mean. But the biggest issue is as long as this virus is able to actively spread throughout the world, there's a chance that a new variant could emerge, because the viruses want to continue to survive.

[00:36:55] And as they continue to divide, divide, divide, sometimes small changes happen. And most of those changes don't cause trouble. But sometimes they give the virus an advantage, like with delta, where it was just more infectious, more transmissible and more riskier strain of that. And so the worry is, as more people are susceptible and can get infected, will there be another variant that maybe the next one isn't as protective from the vaccines or maybe more fatal?

[00:37:23] And that really is the scary aspect. So the priority continues to need to be, to get as many people around the world vaccinated as possible. That's going to be the way to absolutely end the pandemic. And how well we do that will help determine whether we have another surge. I will say I'm hopeful that another surge in the U.S. won't be as precipitously big as this one, but I get nervous saying that, cause I want to knock on wood because as I said, COVID is keeping us on our toes.

[00:37:54] Bill Walsh: Right. Well, Dr. Talbot let me follow up on that. You talked about variants just a moment ago, and I've been amazed how well the existing vaccines have done against the delta variant and others that we've seen. What is the risk that we'll see a vaccine-resistant variant, and how can we avoid that.

[00:38:21] Tom Talbot: Yeah, I don't have a number. I can't give you like, oh, it's a 10% chance or X% chance, but it's there. And it's a very real concern. The way to prevent it is, we gotta give this virus, we need to remove the chance of this virus from infecting airways that are susceptible.

[00:38:37] Basically, we’ve got to vaccinate people. Cause if the virus can't spread, it can't mutate. It can't change. And can't create that variant.

[00:38:45] Bill Walsh: Okay, succinctly put, thank you very much. Dr. Tan, let me turn to you. Since really, since the start of the pandemic, there have been concerning rumors that have circulated about COVID and COVID vaccines, and I was hoping you could help us fact check some of them.

[00:39:03] I'd like to throw a few of them your way, and maybe you can take them one by one. All right. Great. Well, the first one was, so do COVID vaccines change your blood color to a darker hue?

[00:39:19] Litjen Tan: Oh, thank you, Bill. As I go down inside, just a couple of quick things I always remind everybody, and I want to reassure all the listeners is that the United States has the best vaccine safety surveillance system in the world.

[00:39:30] We catch any potential, what we call bad event or adverse event from a vaccine really, really quickly. And so to reassure everybody we've been looking with COVID-19 vaccines really hard for potential, what we call, side effects or adverse events. And that's why we can find them when they pop up.

[00:39:51] Just so it'd be reassuring everyone of that. And then the second thing I always do when I look at these rumors is to, for me, at least, your listeners should know this, that the scientists and the physicians like Dr. Talbot here, a lot of our opinions that are expert opinions are based on what we call biological plausibility.

[00:40:08] Can it actually happen? Does the biology allow it to happen? And if it can't then it's just a rumor. So the first one, blood color change, I think this came from some internet posts about showing two different bags of blood of different color. So the answer is no, it cannot, it does not. What changes blood color is the level of oxygen that is in the blood.

[00:40:29] And so it does not change blood color.

[00:40:31] Bill Walsh: Okay. Well, let me throw another rumor at you and see if you can address this one. Are COVID vaccines fueling a dramatic increase in uterine cancer?

[00:40:42] Litjen Tan: Bill, the answer is no, it is not. In fact, there's a very good cancer surveillance systems in the United States as well.

[00:40:49] And we are not seeing spikes in uterine cancer, reporting of cases, following COVID-19 vaccinations. So the answer is no.

[00:40:57] Bill Walsh: Okay. Thanks for that. Another rumor is that COVID vaccines are reducing fertility or sexual function in men and women. Is that true

[00:41:08] Litjen Tan: Again, the answer for that. And like, this is the one that has biological plausibility, arguments that we look into as well. As Dr. Talbot has already told you, the mechanism by which this vaccine works. It is not biologically possible that this vaccine, which has this single protein called the spike protein, will impact male or female fertility.

[00:41:28] So the answer is no, but interestingly enough, there is actually a publication that has now come out that shows that the COVID 19 virus, the entire virus itself, actually can be found in the testicles of males. That's just the first finding. Now whether or not that impacts fertility is something else. But that is the actual disease itself.

[00:41:50] S I think it's more important now, as Tom has already specified, the vaccine has so many benefits.

[00:42:00] Bill Walsh: Okay. Well, let me throw another one at you. Of course, the technology behind the Pfizer and Moderna vaccines is called mRNA. Our scientists manipulating lettuce and spinach with mRNA to vaccinate people without pills?

[00:42:18] Litjen Tan: So that's a great question, Bill. And you know what, research way before COVID has been looking at ways to make what we call oral vaccines, including using the mRNA technology that we have, that's been used for the COVID-19 vaccine. So this is down the road. It's something for the future. It is not something that's happening now with specific to COVID-19, but it has been something that we've been looking at for a broad panel of vaccines, to kind of what we created, what we call oral vaccines.

[00:42:47] So yes, we are doing that, but not specific to COVID 19, and it's something that's happened before the pandemic and it's research that continues to go forward. And sometime in the, perhaps we will have an oral vaccine that we can use by eating lettuce or eating spinach.

[00:43:05] Bill Walsh: Okay. Very good. Here's another one, another rumor that we've heard out there. Does donating blood reduce the COVID vaccine’s effectiveness in your body?

[00:43:17] Litjen Tan: No, it does not. And in fact, with the demand for blood and plasma products, please, you need to know, and the American Red Cross has said this, you can indeed donate blood after getting the COVID 19 vaccination. So the answer is no, donating blood does not reduce the vaccine’s effectiveness in your body. We can go into all the biological reasons for that, but I'm just going to stop there and say, no, it does not.

[00:43:39] Bill Walsh: All right, Dr. Tan, thanks for that. Are there any other rumors that you've heard out there that you'd like to address?

[00:43:48] Litjen Tan: I think we've addressed a bunch of the questions and answers. I think the best way to go ahead and get these questions and let us let that happen again.

[00:43:56] Bill Walsh: Oh, right. Well, thanks for setting the record straight, Dr. Tan. We very much appreciate it. Now it's time to address more of your questions with Dr. Tom Talbot and Dr. L.J. tan, please press star three at any time on your telephone keypad, to be connected with an AARP staff member to ask your question live. Jesse, who do we have next on the line?

[00:44:20] Jesse Salinas: Yeah, our next caller is going to be actually from YouTube. And Mike asks, how many days after getting the booster shot does it become fully effective?

[00:44:28] Bill Walsh: Okay. Dr. Talbot, can you answer that question from Mike?

[00:44:32] Tom Talbot: Yeah, thanks Mike. So, data shows it's about two weeks. So just like with the other doses, it's about two weeks before you get kind of full impact of the booster.

[00:44:40] Bill Walsh: And I'm just curious, do we know the effectiveness of the booster, that is to say, does it wane over time?

[00:44:47] How long does the — I mean, it offers a high level of protection, but how long does the high level itself last?

[00:44:56] Tom Talbot: Yeah. So we don't know that yet. Cause it's, we're a little early. Probably the area that has the most data on that is Israel. And they've only been boosting, I think about six weeks. But they have definitely shown the protective impact of boosting, but it'll be awhile before we know how long there's a protection and if there needs to be any further booster doses, or what's happening with the delta wave and other things. So right now we don't know.

[00:45:19] Bill Walsh: Okay. Very good. Let's take another call. Hey, Jesse, let's go back to the phone.

[00:45:31] Jesse Salinas: So here's your next caller, Margaret in Mississippi.

[00:45:34] Bill Walsh: Hey, Margaret. Welcome to the program. Go ahead with your question. Hi Margaret. Go ahead with your question.

[00:45:48] Jesse Salinas: I think we may have lost her.

[00:45:51] Bill Walsh: Oh, hang on. Is Margaret there?

[00:45:54] Jesse Salinas: I think we lost her. Okay. Let's try Kathy in Georgia, Bill. My apologies.

[00:45:58] Bill Walsh: Right. Hey, Kathy. Welcome to the show. Go ahead with your question.

[00:46:04] Kathy: Yes, good afternoon, everyone. My question concerns NY the relationship with a negative or positive between the booster shot, getting the booster shot and a pneumonia shot, because I recently got the pneumonia shot, and I should qualify for the booster in early November.

[00:46:24] Bill Walsh: And so your question is, should you go ahead and get that booster shot? All right. Well, Dr. Tan, can you address that? Please for Kathy?

[00:46:36] Litjen Tan: Yeah, absolutely, and Kathy, thank you for getting your pneumonia shot. That's a really important vaccine. So, congrats for getting that. And yes, you can. If you're due in November, which I assume would be six months from your second dose of the Pfizer vaccine, you are absolutely eligible to get the booster.

[00:46:54] Bill Walsh: Okay, Jesse, who's up next?

[00:46:58] Jesse Salinas: Our next question is from Carol in Texas.

[00:47:03] Bill Walsh: Hey Carol. Welcome to the program. Go ahead with your question.

[00:47:08] Carol: My question’s this, I have had both doses of the Pfizer. I have had my booster shot. My question is, regarding if there were to be a breakthrough infection, what is the possibility of like the, a long COVID, long haul COVID, and does vaccination give you a considerable protection against the possibility of getting long haul COVID if you got a breakthrough?

[00:47:38] Bill Walsh: That's a great question. Dr. Talbot, can you help Carol with that?

[00:47:42] Tom Talbot: Yeah, Carol. Really good question. And there actually has been some data, not just simply from folks that got the booster, but folks that got two doses of an mRNA vaccine. So that study was out in the New England Journal several weeks ago, that found that compared to non-vaccinated folks that got infected and folks that just got one dose of a Pfizer/Moderna vaccine, if you got two doses of Pfizer or Moderna, your risk of having those kind of long COVID symptoms a month out was significantly lower. And so we are seeing, that's a really interesting, I don't, I don't quite know the, the, the reason behind that, but it's very interesting as we learn more about this disease.

[00:48:20] So there, there is some signals that getting back to that will reduce that chance, if you do get COVID, of having the long COVID symptoms that are, that it can be pretty scary.

[00:48:29] Bill Walsh: Yeah. Talk about some of those long haul COVID symptoms, if you would, Dr. Talbot.

[00:48:35] Tom Talbot: Yeah. What we're seeing in individuals, and it doesn't necessarily relate to how bad your first COVID infection was, is that some individuals will have lingering symptoms some for months, and they could be things like neurologic, like just, described as like brain fog, trouble thinking, difficulty thinking, fatigue. Some folks have some vascular challenges, some cardiovascular issues, kind of a wide array of issues and challenges that are there.

[00:49:05] And even when one recent report quoted about 25% of individuals with COVID were seeing some degree of symptoms, several weeks to months out from their infection. And so we don't understand exactly the reason why, it's probably immunologic, but we're not certain with that. But it is striking and can be pretty debilitating.

[00:49:19] In fact, we at Vanderbilt now have a post-acute COVID clinic for these patients to help manage their symptoms and treat them. So, that is a thing that's a little bit unique to this virus that we're learning about and seeing throughout the pandemic.

[00:49:35] Bill Walsh: Okay. Very good. Thanks so much for that. Dr. Talbot. Jesse, let's go back to the lines.

[00:49:41] Jesse Salinas: Yeah, we're going to bring our next caller, Lance from Illinois.

[00:49:45] Bill Walsh: Hey Lance. Welcome to the program. Go ahead with your question.

[00:49:50] Lance: Okay. Thank you. My question is, if you had COVID and now you test negative and you went and got the Johnson and Johnson one-shot vaccine, can you then also get the Pfizer booster?

[00:50:13] Bill Walsh: Okay. Dr. Talbot, I think you talked a little bit about this before. Can you address Lance's question?

[00:50:20] Tom Talbot: Yeah, right now, the recommendations for boosters are only if you've gotten the two doses of Pfizer. And now the Johnson and Johnson question will be discussed next week at the FDA. And so we may get some more information there.

[00:50:33] J&J did release some data in the last week about what happens with antibody levels with a second dose — so their booster would be dose two, so to speak —and showed a really promising impact on antibody levels with a second dose. So what I’ll say is, hang on for about a week, a week and a half.

[00:50:51] And I think we'll hear more about how to deal with our patients who got Johnson and Johnson and whether they need a booster or dose number two.

[00:50:58] Bill Walsh: Okay. Thanks for that, Dr. Talbot. Let's go back to the lines. Who do we have next?

[00:51:02] Jesse Salinas: Our next caller is Edith from Maryland.

[00:51:08] Bill Walsh: Hey, Edith. Welcome to the program. Hey, how are you? Go ahead with your question.

[00:51:13] Edith: Hi, I think you already asked, someone asked my question, but I'll rephrase it and see whether or not you feel it has been answered. I had a two part question. Now I have the booster shot, and I was wondering, what is the level of effort, efficacy or effectiveness at this point? And also now that I've had the booster on Sunday, it will be my two-week period. So when I'm around my grandkids who are under the age of 11, should I wear my mask around them inside as well as outside?

[00:51:53] Bill Walsh: Oh, good questions. So, Dr. Talbott do you want to address that? And Dr. Tan, if you'd like to get in on that too, go ahead.

[00:52:00] Tom Talbot: Yeah, Edith really good. So first question about what's the effectiveness now with the booster. Really the data we have so far predominantly from Israel, it does look like that you get effectiveness back into those kind of mid 90% levels that we saw from the clinical trials with two doses. So it does seem to kind of boost you back up to where we were with dose two.

[00:52:22] The question you asked, so now on Sunday, you'll be fully, fully vaccinated plus boosted, and whether you need to wear a mask with your younger kids. Your chance of getting a breakthrough infection is much lower now. And so I think my general advice is outdoors, I actually think it's safe to not wear a mask. Indoors probably you're okay to not wear a mask, it kind of depends on how things are circulating in your community. If things are really heavy in COVID, you could wear one just to be extra careful. But I think it's a really good question we're going to be faced with is, are boosted folks, are they kind of at a different level of immunity that maybe they, they unmask and, right now in Nashville, we have such activity of COVID that we'd say hold off, but it may be that things are declining, you'll be able to kind of remove that mask and your grandchild will see your face and that'd be great.

[00:53:12] Bill Walsh: All right. And maybe that grandchild will be able to get a vaccine soon as well. Dr. Tan, did you want to add anything to that?

[00:53:21] Litjen Tan: Yeah, nothing to that second question, that I think the community risk level is the thing that you have to look for. I agree that she's going to be really well protected. The other thing, just to put out there for all your listeners and as an answer to the question, is that the effectiveness of that booster is not just about that 95% protection against infection, it also is incredible protection against becoming really sick, right? The long haul as was discussed earlier, but also hospitalizations and medically attended visits. They go down dramatically as a result of the booster as well. So that's the data from Israel.

[00:53:55] Bill Walsh: Yeah, that's a great point. Thanks Dr. Tan. All right, Jesse, let's take another.

[00:54:01] Jesse Salinas: Yeah, this next caller is Linda from Virginia.

[00:54:04] Bill Walsh: Hey Linda. Welcome to the program. Go ahead with your question.

[00:54:09] Linda: Thank you. I'm scheduled for a mammogram and I'm also waiting for the booster for the Moderna. Is it safe for me to have a mammogram and then I can get the booster for the Moderna, or is there a timeframe between that?

[00:54:30] Bill Walsh: Dr. Talbot, can you address that?

[00:54:34] Tom Talbot: Yeah, Linda. Thanks. So, one thing that we do see, in folks that get vaccinated, in some folks, because you're prompting the immune system to kind of react, and part of that immune system are lymph nodes, like under your arm, is there were reports of women that would go for their routine mammogram and be noted to have a swollen lymph node on the mammogram.

[00:54:51] And so that's raised some questions of, do I defer my mammogram or do I defer my shot. And the general consensus now is that you don't defer either. But when you go to get your mammogram, make sure you tell the folks that you've had a booster recently, because then that way the radiologist reading it will know, oh, there's a little bit of a lymph node there, but they had their booster and that's what's there, and they can use that information to help read that. But it wouldn't be something we don't want folks who need that mammogram to miss that mammogram or delay that mammogram. And we also don't want you to miss the booster when it's time too.

[00:55:22] Okay. Thanks for that, Dr. Talbot. Let's take another quick question.

[00:55:27] Jesse Salinas: Our last question I think is going to be from Facebook. It's from Lisa and she wants to know, should I postpone my yearly doctor visits or my annual wellness visits due to the COVID delta virus?

[00:55:38] Bill Walsh: Well, Dr. Talbot was talking about that issue just a moment ago, Dr. Talbot, do you wanna elaborate?

[00:55:44] Tom Talbot: Yeah, I would say absolutely no, one thing we learned last year when we all locked down and a lot of people didn't get their regular medical care. As we saw folks here and across the country that had kind of worsening of the underlying conditions and illnesses, and we saw people not get routine immunizations.

[00:56:00] And so we definitely recommend to maintain checkups and everything. The good thing is that all the clinics and hospitals, and this is what I do at Vanderbilt, we have infection prevention practices to prevent the risk of spread to each other and our patients. So masking and other things, you may on entry be asked about symptoms.

[00:56:18] Obviously don't come if you’re feeling sick, but there's a lot of protections there to protect you from catching COVID there. So definitely want to make sure you go get that visit, get your checkup, maintain your health care, because we don't want you getting sick from something else, too. And we'll protect you from COVID.

[00:56:32] Bill Walsh: All right. Thanks to both of our experts for answering our questions. This has been a really informative discussion today, and thank you, our AARP members, volunteers and listeners for participating in the discussion today. AARP, a nonprofit nonpartisan membership organization, has been working to promote the health and well-being of older Americans for more than 60 years.

[00:56:55] And 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 the spread to others, while taking care of themselves. All of the resources referenced today, including a full recording of today's Q&A event can be found at AARP.org/coronavirus on October 8. There, you can see a full transcript of the program. Again, that address is AARP.org/coronavirus. Go there if your question was not addressed, and you'll find the latest updates as well as information created specifically for older adults and family caregivers. We hope you learned something today that can help keep you and your loved ones healthy.

[00:57:45] Please join us on October 21 at 1 p.m. Eastern time for another live event, answering your questions about the coronavirus. We hope you can join us. Thank you and have a good day. This concludes our call.

Teleasamblea de AARP - Coronavirus: refuerzos, vacunas contra la influenza y visitas de bienestar

 

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.

 

La semana pasada, Estados Unidos registró la muerte número 700,000 por COVID-19. Fue un hito, pocos se atreven a imaginar el inicio de la pandemia hace casi 20 años. Sin embargo, ha proliferado la información errónea sobre las vacunas y decenas de millones de personas en el país continúan negándose a vacunarse.

 

Eso ha permitido que las variantes de COVID-19 se propaguen fácilmente por la población y llenen las salas de emergencia de los hospitales. Mientras tanto, algunos de los que han sido vacunados han comenzado a recibir dosis de refuerzo para tener una protección adicional, y aparecen nuevos tratamientos prometedores para la COVID-19.

 

Mientras la nación lucha contra la pandemia, el Congreso está debatiendo uno de los paquetes de legislación más importantes para los adultos mayores en una generación. Hay proyectos de ley para reducir los precios de los medicamentos recetados, agregar beneficios a Medicare y crear un crédito fiscal para los cuidadores familiares.

 

AARP está en el centro de la lucha para que todo se lleve a cabo. Hoy escucharemos a un impresionante panel de expertos hablar sobre estos temas y otros. Si ya han participado en alguna de nuestras teleasambleas, ya 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 su teléfono para comunicarse con un miembro del personal de AARP, quien anotará su nombre y pregunta y los ubicará en una cola para hacer esa pregunta en vivo. Si se unen a través de Facebook o YouTube, pueden publicar su pregunta en la sección de 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 sus preguntas en los comentarios.

 

Hoy nos acompañan invitados sobresalientes, incluido un experto médico y uno en inmunizaciones. También nos acompañará mi colega de AARP, Jesse Salinas, quien ayudará a facilitar sus llamadas hoy.

 

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

 

Ahora me gustaría dar la bienvenida a nuestros invitados. Tom Talbot es médico y conoce mucho sobre salud pública. Es profesor de Medicina en la Facultad de Medicina de Vanderbilt University. También es el epidemiólogo jefe del hospital en el Centro Médico de Vanderbilt University. Bienvenido al programa, Dr. Talbot.

 

Tom Talbot: Bill, gracias por recibirme, me alegro mucho de estar aquí.

 

Bill Walsh: Está bien, nos alegra tenerlo. También me gustaría dar la bienvenida a L.J Tan, Master of Science y PhD. El Dr. Tan es el director de políticas y asociaciones de la Coalición de Acción de Inmunización. También es copresidente de la Cumbre Nacional de Inmunización de Adultos e Influenza. Bienvenido, Dr. Tan.

 

Litjen (L.J.) Tan: Oh, muchas gracias, Bill. Es un placer estar aquí.

 

Bill Walsh: Muy bien, estamos encantados de tenerlo. Sigamos adelante y comencemos con la discusión. Solo 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 Facebook o YouTube.

 

Dr. Talbot, comencemos por usted. Con la aprobación de la FDA de un refuerzo de la vacuna Pfizer contra la COVID-19, hay algunas preguntas importantes. Abordemos algunas brevemente. La primera es ¿qué tan beneficioso es un refuerzo de la vacuna contra la COVID-19?

 

Tom Talbot: Sí. Gracias, Bill. Muy buena pregunta. Hemos escuchado mucho sobre las dosis de refuerzo durante el último mes. Y se basa en algunos datos que estamos viendo, particularmente con las vacunas de Pfizer que... Si bien aún sigue siendo muy protectora contra la infección grave por COVID-19, estamos comenzando a ver una disminución de la protección, generalmente alrededor de seis meses después de la última inyección.

 

Entonces, las personas se están infectando nuevamente, y quienes han sido vacunadas, se escuchan casos de infección posvacunación. Afortunadamente, muchas de esas personas tienen infecciones leves. Pero sigue siendo un problema, especialmente porque nos enfrentamos a esta ola de la variante delta en todo el país. Y entonces realmente necesitamos hacer algo para prevenir esa propagación.

 

Por lo tanto, recibir un refuerzo amplificará la respuesta inmunitaria y, básicamente, aumentará la protección inmunitaria contra la infección. Y hemos visto algunos datos de otros países, y recibir ese refuerzo reduce la posibilidad de contraer cualquier infección por COVID-19, que es muy importante en este momento porque estamos tratando de romper realmente la ola delta, por así decirlo.

 

Bill Walsh: Bueno, déjeme hacerle otras preguntas sobre las vacunas de refuerzo. ¿Quién es apto para dosis de refuerzo en este momento?

 

Tom Talbot: Sí. Y tal vez recuerden, con un poco de confusión cuando esto sucedió, pero permítanme, con suerte, resumirlo. Si tiene 65 años o más, califica para recibir la dosis de refuerzo. De hecho, déjeme dar un paso atrás. Solo si tiene la vacuna Pfizer como primera dosis de la vacuna contra COVID-19. Así que ahora estoy hablando de Pfizer.

 

Si tiene Moderna o J&J, dejémoslo para un poco más adelante. Si tiene 65 años o más, debería recibir un refuerzo. Si tiene menos de 65, 18 años o más y tienes enfermedades subyacentes que pueden aumentar el riesgo de complicaciones por COVID-19, y esas podrían ser cosas como cáncer, diabetes, obesidad y un amplio rango de trastornos.

 

Si tiene 50 años o más, dijeron los CDC, realmente recomiendan recibir una dosis de refuerzo. Si tiene menos de 50 años, es un adulto, realmente recomiendan el refuerzo, pero evalúelo en función de su propia situación y su riesgo de exposición. Pero en realidad, es muy amplio el criterio para establecer quién debería recibir un refuerzo.

 

Y luego, el último grupo son aquellos que pueden no tener una condición de alto riesgo, pero pueden estar en una situación en la que tienen un alto riesgo de exposición, particularmente en el lugar donde trabajan. Por ejemplo nuestros trabajadores de la salud, nuestros maestros. Y parte de la justificación de esto es que incluso una infección leve entre esos grupos...

 

Se escuchó mucho acerca de que nuestro sistema de salud está realmente afectado por la ola delta. Si perdemos a algún trabajador de la salud, incluso si tiene un resfriado leve, no puede venir a trabajar. Y esa es una variante muy seria en el sistema de salud y realmente tiene un impacto masivo. Si perdemos maestros, perdemos la capacidad de enseñar a los niños. Por lo tanto, prevenir incluso una infección leve en estos grupos es realmente importante en este momento, mientras nos enfrentamos a la ola delta.

 

Bill Walsh: De acuerdo, muy bien. Ahora, para aquellos que califican para recibir las dosis de refuerzo, ¿cuánto tiempo se requiere entre la finalización de una dosis completa y una dosis de refuerzo?

 

Tom Talbot: Claro. Bueno, debe haber recibido sus dos dosis de vacuna y su segunda dosis debería haber sido hace seis meses. Entonces, si recibió la segunda en junio, está bien. Lo que creo que deberíamos aclarar también, y creo que hay un poco de confusión al respecto, es la diferencia entre una dosis de refuerzo y una tercera dosis.

 

Una parte de la población, algunas personas que están muy inmunodeprimidas, han necesitado recibir una tercera dosis como parte de su serie regular. Entonces, su serie real de vacunación sería una dosis, seguida varias semanas después por la dosis dos, seguida cuatro semanas después por la dosis tres. Así que hay un poco de confusión, pero el refuerzo es seis meses después de la última dosis.

 

Bill Walsh: Está bien. Ahora, por supuesto, estamos hablando de una vacuna de refuerzo de Pfizer. ¿Qué pasa con aquellos que completaron un ciclo de vacunas con Moderna o J&J? ¿Pueden recibir el refuerzo de Pfizer?

 

Tom Talbot: Por ahora, eso no es recomendable. Pero a fines de la próxima semana, el Comité Asesor de la FDA se reunirá para tratar exactamente esas preguntas: si los vacunados con Moderna y J&J necesitan refuerzos. Ahora, hay algunos datos, con Moderna en particular. Moderna tiene una dosis un poco más alta de una vacuna y tuvo un poco más de espacio entre la dosis uno y dos.

 

Y no estamos viendo esa disminución de la inmunidad como hemos visto con Pfizer. Así que será interesante ver qué decide la FDA la próxima semana. Pero sabemos que esas son preguntas realmente importantes para nuestros pacientes. Las enfrentamos aquí en Vanderbilt y esperamos obtener algo de claridad probablemente en las próximas dos semanas, a partir de esas reuniones y discusiones sobre las respuestas para esas personas y los refuerzos.

 

Bill Walsh: Está bien. Ahora la pregunta final, ¿estarán disponibles las vacunas de refuerzo para aquellas personas que no califican hoy? ¿Y cuándo cree que podría suceder eso?

 

Tom Talbot: Sí, esa es una buena pregunta, porque en este momento, como mencioné, en medio de la ola delta, para romper con la ola realmente tenemos que impulsar eso. Pero la pregunta es: un joven sano de 20 o 25 años, ¿necesitará un refuerzo? ¿O es solo cuestión de proteger a los otros grupos? Porque estamos en la ola delta y no lo sabemos todavía.

 

También se dice, y no me tomen la palabra, pero una vez que todo se asiente, atravesemos la COVID-19 y obtengamos todos los datos y la ciencia, potencialmente en el futuro, podría ser que en realidad, todos deban recibir tres inyecciones como su serie de vacunas contra la COVID-19, algo así como hacemos con la hepatitis, pero aún no lo sabemos. Entonces no sé necesariamente si no califica. Es posible que no necesite necesariamente un refuerzo en este momento, pero el tiempo lo dirá. Respondí como pude, porque no sé la respuesta correcta en este momento, pero...

 

Bill Walsh: Claro. Bueno, estamos averiguando muchas cosas en tiempo real. Ese es uno de los marcadores de esta pandemia, ¿no es así?

 

Tom Talbot: Por supuesto.

 

Bill Walsh: Está bien. Bueno, Dr. Talbot, muchas gracias. Dr. Tan, pasemos a usted. ¿Por qué es importante tener una vacuna contra la gripe tradicional incluso si uno está completamente vacunado contra la COVID-19?

 

Litjen (L.J.) Tan: Oh. Gracias, Bill. Y, Tom, esa fue una discusión fantástica sobre los refuerzos. Y creo que el punto aquí es, obviamente, la COVID-19 es una enfermedad y la influenza es otra enfermedad, y ambas son enfermedades graves que amenazan la vida. Entonces, incluso si alguien está completamente vacunado contra la COVID-19, eso no le brinda protección contra la influenza o la gripe.

 

Entonces, vacunarse contra la gripe ahora mismo es esencial para que las personas estén protegidas contra ambas. No queremos que las personas tengan gripe y piensen que... Si no se vacunan contra la COVID-19, no queremos que las personas se contagien de COVID-19 y piensen que no es necesario vacunarse contra la gripe. Tienen que recibir ambas, ambas son ... Estas son enfermedades diferentes y ambas son enfermedades potencialmente mortales.

 

Bill Walsh: Está bien. Bueno, déjeme seguir con eso. ¿Es aconsejable vacunarse contra la gripe y recibir una dosis de refuerzo al mismo tiempo? ¿Existen preocupaciones de interacción para la vacuna de refuerzo contra COVID-19 y cosas como la culebrilla y las vacunas antineumocócicas o contra la tos ferina?

 

Litjen (L.J.) Tan: Bueno, Bill, absolutamente, se recomienda que si uno va a recibir un refuerzo de la vacuna contra la COVID-19, considere recibir en esa misma visita la vacuna contra la gripe, si aún no la ha recibido y las otras vacunas que ha mencionado, ya sabe, incluida, la vacuna antineumocócica. Creo que los CDC han dicho que la vacuna contra la COVID-19 puede ser, lo que llamamos, coadministrada. Eso significa administrarse al mismo tiempo, en las mismas visitas clínicas, con otras vacunas, como la vacuna contra la gripe o la vacuna antineumocócica.

 

Bill Walsh: Está bien. Bueno, eso es una buena noticia. Muchas gracias, Dr. Tan. Y como recordatorio para nuestros oyentes, para hacer una pregunta, por favor presionen * 3 en el teclado de su teléfono. Vamos a llegar a las preguntas en breve. Pero antes de hacerlo, quería traer a Megan O'Reilly. Es vicepresidenta de Salud y Familia, Asuntos Gubernamentales de AARP. Bienvenida, Megan.

 

Megan O’Reilly: Hola. Es bueno estar aquí.

 

Bill Walsh: Es bueno tenerla aquí. Sabe, además de compartir la información más actualizada sobre el coronavirus, nos gusta tomarnos unos minutos para actualizar a nuestros oyentes sobre los temas importantes que enfrenta el Congreso. Y sé que tienen las manos ocupadas estos días. Entonces, Megan, gracias por acompañarnos hoy. ¿Se está logrando algún progreso en la legislación que pueda ayudar a los adultos de 50 años o más?

 

Megan O’Reilly: Sí. La buena noticia es que estamos avanzando en nuestra lucha para reducir los precios de los medicamentos recetados. AARP ha trabajado arduamente para respaldar la legislación que reducirá el precio de los medicamentos al permitir que Medicare negocie con las compañías farmacéuticas.

 

Los precios de los medicamentos recetados han estado fuera de control durante mucho tiempo. Entonces, que el Congreso tome esta acción y permita que Medicare finalmente use su poder de negociación para bajar los precios sería una gran victoria para los adultos mayores.

 

Bill Walsh: Bien, los socios de AARP también han sido una parte importante de esta lucha, ¿no es así?

 

Megan O’Reilly: Oh, absolutamente. Los socios de AARP han estado liderando el camino, con solo usar el teléfono e internet, cualquiera puede alzar la voz e instar al Congreso a apoyar asuntos importantes, como los altos precios de los medicamentos recetados, así como asuntos como el Seguro Social y Medicare. Sabemos que muchos de ustedes lo han hecho.

 

Más recientemente, los activistas de AARP han enviado 675,000 correos electrónicos y realizado más de 200,000 llamadas telefónicas para instar a los miembros del Congreso a permitir que Medicare negocie los precios de los medicamentos. Nuestra campaña de redes sociales ShowYourReceipts destacó 24,000 recibos de medicamentos recetados en la vida real por un total de más de $12 millones.

 

Es difícil negar que los precios de los medicamentos son demasiado altos cuando se ve lo que tienen que pagar muchos adultos mayores. Nuestros socios también están haciendo un gran trabajo escribiendo cartas, llamando a sus representantes y reuniéndose con legisladores.

 

Bill Walsh: Bueno, eso es fantástico. Ahora, la prestación de cuidados es otra prioridad para la que AARP está trabajando para obtener más apoyo, ¿no es así?

 

Megan O’Reilly: Por supuesto. AARP está liderando iniciativas en varios frentes que instan al Gobierno a reconocer y apoyar a los cuidadores familiares. En este momento, le estamos pidiendo al Congreso que promulgue una ley federal que respalde el pago de los cuidadores, y también estamos luchando por la aprobación de un crédito fiscal para cuidadores familiares. No debería uno correr riesgo de perder su trabajo por llevar a sus padres a una cita con el médico.

 

También podemos tomar medidas para ayudar a compensar algunos de los costos financieros del cuidado. Estas son medidas prácticas y de sentido común que el Gobierno puede tomar para disminuir los desafíos que enfrentan las familias que cuidan a sus seres queridos.

 

Bill Walsh: Está bien. ¿Algo más por lo que AARP esté luchando en este momento que nuestros oyentes deban saber?

 

Megan O’Reilly: Ahora hay varios otros elementos que apoyamos en la reconciliación, incluidos los beneficios dentales, de visión y audición para Medicare. Además de nuestro trabajo con la atención médica, AARP está apoyando activamente a los solicitantes de empleo mayores.

 

Apenas la semana pasada, enviamos una carta al Congreso para expresar nuestro apoyo a este proyecto de ley que extiende las protecciones para los solicitantes de empleo que luchan contra la discriminación por edad y el empleo. Desafortunadamente, existe discriminación por edad en el lugar de trabajo. Aunque los trabajadores mayores de 50 años aportan valiosas habilidades, experiencia y sabiduría, AARP lucha contra la discriminación por edad en todas sus formas, incluida la discriminación en el lugar de trabajo. Denunciar este hecho es importante porque todos merecen las mismas oportunidades al solicitar un trabajo.

 

Bill Walsh: Muy bien, son muchas noticias prometedoras. Muchas gracias por estar aquí, Megan. Realmente lo apreciamos.

 

Megan O’Reilly: Gracias.

 

Bill Walsh: De acuerdo. Ahora es el momento de abordar sus preguntas sobre la pandemia de coronavirus con el Dr. Tom Talbot y el Dr. L.J. Tan. Presionen * 3 en cualquier momento en el teclado de su teléfono para conectarse con un miembro del personal de AARP y compartir su pregunta en vivo. Si desean escuchar en español, presionen * 0 en el teclado de su teléfono ahora.

 

[En español]

 

Bill Walsh: Me gustaría traer a mi colega de AARP, Jesse Salinas para ayudar a facilitar sus llamadas hoy. Bienvenido, Jesse.

 

Jesse Salinas: Gracias, Bill. Muy contento de estar aquí para esta importante conversación.

 

Bill Walsh: Muy bien, continuemos y respondamos nuestra primera pregunta.

 

Jesse Salinas: Sí. La primera persona que llama es Linda en Virginia.

 

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

 

Linda: ¿Hola?

 

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

 

Linda: Estoy bien, gracias.

 

Bill Walsh: Está bien. Continúe con su pregunta. Sí.

 

Linda: Llamo para pedir una aclaración de lo que dijo el Dr. Tan sobre el refuerzo y la vacuna contra la gripe. Quiero asegurarme de si hay un período entre ambas o si uno puede recibir el refuerzo y la vacuna contra la gripe al mismo tiempo.

 

Bill Walsh: Está bien. Bueno, Dr. Tan, ¿puede darnos más detalles?

 

Litjen (L.J.) Tan: Por supuesto. ¿Puede oírme?

 

Bill Walsh: Sí, adelante.

 

Litjen (L.J.) Tan: Oh, perfecto. No hay un período entre las dos que tenga que esperar, Linda. Puede hacerlo. Puede recibir la vacuna contra la gripe en un brazo y recibir el refuerzo contra la COVID-19 en el otro brazo al mismo tiempo. No hay problema.

 

Bill Walsh: Está bien. Gracias por eso, Dr. Tan. Jesse, ¿de quién es nuestra próxima llamada?

 

Jesse Salinas: Nuestra próxima llamada es de Julia en Alabama.

 

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

 

Julia: Llamo para ver si hay alguna forma de ser...

 

Bill Walsh: ¿Julia, todavía está con nosotros?

 

Jesse Salinas: Hola, Bill, creo que perdimos a Julia por algunos problemas técnicos.

 

Bill Walsh: Está bien.

 

Jesse Salinas: Probemos con Sarah en Nueva York.

 

Bill Walsh: Muy bien, Sarah, bienvenida al programa. Continúe con su pregunta.

 

Sarah: Hola. Tengo 65 años y recibí la segunda inyección de Moderna hace unos 7 meses. Necesito un refuerzo ahora. Quiero... Mi pregunta es, bueno, quería saber si podía recibir la Pfizer. Y luego escuché que no es aceptable, que no se recomienda en este momento. Pero mi pregunta también es ¿por qué Moderna nunca obtiene la aprobación de la FDA? ¿Qué pasa con todos los que recibimos esa?

 

Bill Walsh: Bueno, Dr. Talbot, hay un par de preguntas ahí, ¿puede aclararlas para Sarah y nuestros oyentes?

 

Tom Talbot: Sí. Es una buena pregunta. Tendremos más información sobre las personas como usted que recibieron dos inyecciones de Moderna la próxima semana en la FDA. Como mencioné, los datos de Moderna muestran ese tipo de pérdida de protección que vimos con Pfizer. No vemos tanto con Moderna. Por lo tanto, es posible que todavía haya información alentadora sobre la protección de Moderna.

 

Creo que la pregunta que hizo es muy buena. Y de hecho, había olvidado que todavía está en EUA, ya que preguntó eso. Y creo que la razón es que tengo que elevar a nuestra gente en la FDA y los CDC que habían estado trabajando arduamente durante esta pandemia para tratar de superar todo esto. Y ni me imagino pasar por eso.

 

Sé que Moderna ha presentado su documentación hace varios meses para su aprobación total. La FDA se toma un buen tiempo para asegurarse de que, primero, se examinen todos los datos, pero también de que todas las plantas puedan fabricar la vacuna de manera segura y hagan toda esa diligencia. Y eso todavía está en curso.

 

No hemos escuchado mucho sobre su cronología debido a cosas como las preguntas sobre refuerzos con las que nos han estado ayudando. Y estoy seguro de que la gente tiene preguntas sobre los niños pequeños y esa vacuna. Creo que la FDA tiene sus manos muy ocupadas y está trabajando como puede, medidos y seguros, para asegurarse de que todo sea correcto, pero imagino que obtendremos la aprobación completa de Moderna, con suerte, en los próximos meses, ya que sé que se han enviado cosas para eso.

 

Bill Walsh: Muy bien, Dr. Talbot, muchas gracias por eso. Volvamos a la línea. Entonces, Jesse, ¿a quién tenemos ahora?

 

Jesse Salinas: Sí, nuestra próxima llamada será de Brenda de Georgia.

 

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

 

Brenda: Quería preguntarles, si uno ya ha tenido COVID-19 y ha dado positivo en la prueba de anticuerpos, ¿por qué se les empuja a que se vacunen?

 

Bill Walsh: Dr. Talbot, ¿puede ayudar a Brenda con esa pregunta?

 

Tom Talbot: Sí. Esa es una buena pregunta, Brenda, me la preguntan mucho. De hecho, acabo de responder en la última hora a un correo electrónico sobre eso e intentaré explicar rápidamente la razón. Sabemos que después de la infección por COVID-19 tiene algo de protección inmunitaria, lo sabemos. El problema es que no todo el mundo tiene el mismo nivel de protección.

 

Y antes de enfrentarnos a esta variante delta que estamos viendo ahora, vimos que en las personas con infección natural, el nivel de anticuerpos realmente importante que necesitan para adherirse a ese virus cuando intenta infectarnos, ese nivel de anticuerpos en las personas infectadas naturalmente es mucho menor que en las personas protegidas por la vacuna.

 

Y entonces las personas que tuvieran una inmunidad natural perderían la detección del anticuerpo, primero. La otra cosa que vemos es que hay una parte realmente importante del virus que probablemente haya visto en todos los dibujos animados con los picos que sobresalen del virus. Y al final de ese pico hay una parte realmente importante que el virus usa para adherirse a las células de nuestras vías respiratorias y causar una infección. Y esa parte es lo que cambia en las variantes.

 

Entonces, lo que vemos con la infección natural es que se producen un par de tipos de anticuerpos y se producen anticuerpos para muchas otras partes del virus. Pero con la vacuna, se hacen como de muchos otros sabores. Es como que una infección natural produce chocolate y vainilla, pero la vacuna produce otros tipos más sabrosos.

 

De modo que si está en contacto con estas variantes que salen, estará más protegido con los anticuerpos de la vacuna. Ahora hay datos interesantes que dicen que si ha tenido una infección por COVID-19, su riesgo de contraer otra infección es dos veces mayor si no está vacunado que si está vacunado. Y es parte del desafío para usted, lo último es que mencionó, sobre los anticuerpos detectables.

 

Y ese es el gran desafío, que los anticuerpos pueden ser detectables, pero pueden no proteger contra la variante delta. Entonces puede pensar, oh, tengo algunos anticuerpos y estoy bien, cuando aún es vulnerable a esta variante. Y esa es parte de la razón por la que recomendamos vacunarse, incluso si ha tenido una infección por COVID-19. Sin embargo, es confuso. Y creo que es como dije, una pregunta muy común que me he estado haciendo últimamente.

 

Bill Walsh: Está bien, Dr. Talbot. Bueno, gracias por aclarar eso. Buena explicación. De acuerdo, Jesse, ¿a quién tenemos ahora?

 

Jesse Salinas: Nuestra siguiente pregunta, Bill, proviene de YouTube. Es de Francis y ella preguntó: "¿Se puede administrar la vacuna contra la culebrilla al mismo tiempo que la vacuna contra la COVID-19?"

 

Bill Walsh: Creo que el Dr. Tan respondió eso. Pero, Dr. Tan, ¿quiere elaborar esa pregunta?

 

Litjen (L.J.) Tan: Sí, entonces, el consejo de los CDC es que se puede coadministrar la vacuna contra la COVID-19 con cualquier otra vacuna. Hay un par de excepciones y la vacuna contra el herpes zóster no está en la lista de excepciones. Entonces sí.

 

Bill Walsh: Está bien. Muy bien. Jesse, tomemos otra llamada.

 

Jesse Salinas: Nuestra próxima oyente es Zaini de Florida.

 

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

 

Zaini: Mi nombre es Zaini. Tengo una pregunta sobre una persona con lupus. Hice esta pregunta en la última serie y el médico respondió solo una pregunta básica. Fue muy breve. He tenido ataques... Mi sistema inmunitario está inactivo y me han hospitalizado solo por tomar algunos medicamentos. Me inyecté contra el tétanos y terminé en el hospital. He tenido varias reacciones a lo que sería normal para otras personas, no es normal para mí. Y no hablan de personas con lupus, conozco a muchas personas con lupus. Y tenemos miedo porque están poniendo una vacuna viva en nuestro cuerpo, y eso significa que vamos a estar expuestos a ella de inmediato.

 

Bill Walsh: De acuerdo. Zaini, recuerdo que llamó hace dos semanas. Veamos si podemos obtener una respuesta a su pregunta. Dr. Talbot, ¿puede abordar la pregunta de Zaini?

 

Tom Talbot: Sí, Zaini, gracias por preguntar eso. Creo que es una pregunta común. En cuanto a las personas con lupus, hay un par de cosas que nos preocupan, no necesariamente con la vacuna, sino con la infección por COVID-19. Sabemos que las personas que tienen algún tipo de enfermedad subyacente como el lupus tienen un riesgo mucho mayor si se infectan, de contraer una infección realmente grave, y eso puede deberse al lupus en sí o a muchos medicamentos que hacemos tomar a nuestros pacientes con lupus y que afectan su sistema inmunitario.

 

Entonces, el riesgo de tener un resultado realmente malo si contraes COVID-19 es realmente alto. Lo que no estamos viendo en los millones de personas que lo han contraído, y algunas de ellas tienen lupus, es que no estamos viendo señales de brotes de ese tipo de enfermedades como las enfermedades autoinmunitarias como el lupus o artritis reumatoide, no estamos viendo que eso suceda después de la vacunación, lo cual también es tranquilizador.

 

Y así, cuando hablo con mis pacientes que tienen un tipo similar de enfermedades, lupus u otros trastornos, lo que digo es que realmente tenemos dos caminos. Y desearía que hubiera un tercero, en el que no tuviéramos que vacunarnos o tener COVID-19, ya sabe, pero esos son nuestros caminos. Recibe la vacuna, y aunque es muy, muy segura, no es al 100%, al igual que si compra un medicamento en Target, es posible que tenga una reacción a ella, pero muy, muy raro.

 

Pero el perfil de seguridad de las vacunas es muy, muy, muy tranquilizador, o corre el riesgo de exponerse a COVID-19 y sufrir daños realmente graves por la infección de COVID-19 y sabemos que las personas con enfermedades autoinmunitarias y lupus, en particular, tienen ese riesgo.

 

Diferentes sociedades han dicho que apoyan que el tipo de pacientes con enfermedades como lupus deberían vacunarse debido a ese riesgo de infección realmente grave. Quiero aclarar una cosa porque es una confusión muy común, la vacuna contra la COVID-19 no es una vacuna viva. Entonces no es... No tienen virus vivo, no se puede contraer COVID-19 de la vacuna contra la COVID-19.

 

Solo tiene las instrucciones para crear una sola pieza de ese virus, no el resto. Entonces, eso a menudo preocupa a las personas que tienen un sistema inmunitario más débil y que podrían estar expuestas. Y tenemos algunas vacunas como la vacuna contra la varicela que no necesariamente les damos a esas personas, porque es un poco más riesgoso cuando se trata del virus vivo. Pero las vacunas contra la COVID-19 no son así.

 

Bill Walsh: Está bien, Dr. Talbot, gracias por esa explicación. Y, Zaini, espero que haya obtenido la respuesta que estaba buscando. Jesse, tomemos otra llamada.

 

Jesse Salinas: Sí, nuestra próxima llamada será de Laura de Vermont.

 

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

 

Laura: Mi pregunta ya la di. Y dijeron que querían que la diga al aire, así que tuve que esperar. Pero me gustaría agregar algo a eso. Mi pregunta fue, ¿puedo recibir el refuerzo cuando estoy un poco enferma? La segunda pregunta es la vacuna contra el herpes zóster, he tenido herpes zóster, pero nunca me he puesto la vacuna. Y necesito agregar que tuve herpes zóster hace unos ocho años. Así que no sé si uno afecta al otro o si podría ponerme la vacuna contra el herpes zóster al mismo tiempo.

 

Bill Walsh: De acuerdo. Bueno, comencemos ahora con la vacuna contra el herpes zóster.

 

Laura: Con el refuerzo.

 

Bill Walsh: Correcto. Dr. Tan, Laura tuvo la culebrilla hace ocho años. Se pregunta si debería vacunarse contra eso. Y creo que también preguntó si puede recibir un refuerzo si ha estado un poco enferma.

 

Litjen (L.J.) Tan: Hola, Laura, gracias por su pregunta. Espero que se haya recuperado por completo del herpes zóster. Esa es una condición dolorosa. Entonces, sí, absolutamente, definitivamente puede recibir la vacuna contra el herpes zóster ahora. Pasaron ocho años de su último ataque de herpes zóster, absolutamente muy recomendable, por favor póngase la vacuna contra el herpes zóster.

 

Y como recordatorio, hay dos dosis de la vacuna con una diferencia de seis meses. Así que, por favor, busca la vacuna. Y nuevamente, absolutamente puede recibir esa vacuna, la vacuna contra el herpes zóster, al mismo tiempo que recibe el refuerzo de la vacuna contra la COVID-19.

 

La única recomendación es que, debido a que ambas vacunas tienden a ser un poco más reactivas, colócatelas en diferentes brazos. Y esa es la única recomendación de los CDC sobre la coadministración de las dos vacunas. Voy a abordar la pregunta clínica sobre estar enfermo. Tengo una respuesta, pero quiero darle a Tom tal vez la oportunidad de responder eso primero.

 

Bill Walsh: Claro. Dr. Talbot, ¿quiere intentarlo? Laura estaba preocupada porque ha estado un poco enferma y se pregunta si podría recibir un refuerzo en este momento.

 

Litjen (L.J.) Tan: Sí, refuerzo contra la COVID-19.

 

Bill Walsh: Sí.

 

Tom Talbot: Sí, esa es una buena pregunta. Creo que si tuviera un tipo de resfrío me aseguraría primero que no sea COVID-19. Pero si no es así y me siento un poco decaído probablemente esperaría un par de días antes de recibir el refuerzo. Porque recuerde que la forma en que funcionan estas vacunas es que aceleran el sistema inmunitario. Como que construyen esos anticuerpos, así como cuando tiene un resfriado, a veces la razón por la que se siente mal es porque el sistema inmunitario está acelerado.

 

Así que añadir eso al hecho de que ya se siente mal… Pero no me demoraría demasiado. Entonces, si es algo como, "Me siento un poco agotado, he estado así durante varias semanas", pero probablemente me vacunaría solo para asegurarme de que no se olvide de conseguir el refuerzo o entre en riesgo de exponerse a COVID-19. Esa sería mi recomendación.

 

Bill Walsh: Está bien, Dr. Talbot.

 

Litjen (L.J.) Tan: Sí, es una...

 

Bill Walsh: Adelante, Dr. Tan.

 

Litjen (L.J.) Tan: Simplemente iba a intervenir, Bill, y decir que, ya sabe, a veces algunas personas se confunden porque escuchan eso, y piensan que si tienen síntomas, se supone que no deben recibir la vacuna. Mucho de eso también tiene que ver con el hecho de que solo hay que asegurarse de que no tenga COVID-19, ¿verdad? Eso es lo que sugirió Tom.

 

Bill Walsh: Está bien. Excelente.

 

Litjen (L.J.) Tan: Que no lo lleve al centro de salud y otros.

 

Bill Walsh: Bien, gracias a ambos. Jesse, tomemos otra llamada.

 

Jesse Salinas: Sí, nuestra próxima llamada será de Bill en Ohio.

 

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

 

Bill: Está bien. Soy un hombre de 85 años. He recibido mis dos inyecciones de Pfizer hace un año. Y he estado bien, excepto que en las últimas semanas, contraje la COVID-19. Di positivo aquí hace una semana. Empiezo a sentirme un poco mejor ahora. Pero mi pregunta es, ¿cuánto tiempo debo esperar para recibir una vacuna de refuerzo o la vacuna contra la gripe? ¿Debería darme un resultado negativo antes de recibir esas inyecciones?

 

Bill Walsh: Esa es una buena pregunta, Bill. Preguntémosle al Dr. Talbot sobre eso. ¿Dr. Talbot?

 

Tom Talbot: Sí, Bill, espero que se sienta mejor. Contraer COVID-19 puede ser muy serio. Así que espero que esté mejorando, ese es el primer punto, Y la guía general es que queremos asegurarnos primero de que ya no sea contagioso. Por lo general, eso sucede aproximadamente 10 días después de que comienza la infección. Así que definitivamente no queremos que vaya ahora mismo, y eso es solo porque no queremos exponer a otras personas a la COVID-19.

 

Y luego de eso [audio distorsionado] es que puede ir y recibir el refuerzo, aunque todavía... Realmente, probablemente haya fortalecido un poco su sistema inmunitario con la infección por COVID-19, y es posible que pueda esperar un poco. El problema es que no queremos que se olvide en dos o tres meses y diga "Oh, tenía que recibir el refuerzo".

 

Así que hemos estado recomendando que, una vez que uno no sea contagioso, vaya y reciba el refuerzo. Es posible que tenga una respuesta bastante agradable a esa vacuna que, se siente un poco mal al día siguiente, pero está bien. Pero eso es lo que hemos estado diciendo en este tipo de situaciones. No necesita recibir un resultado negativo de la prueba antes de ingresar, solo necesita que su médico, su autoridad de salud, le dé el alta del aislamiento.

 

Bill Walsh: Bueno, muy bien. Gracias por eso. Dr. Talbot. Y gracias por todas esas preguntas. Vamos a tomar...

 

Litjen (L.J.) Tan: Y, Bill ...

 

Bill Walsh: Oh, adelante, Dr. Tan. Lo siento.

 

Litjen (L.J.) Tan: Solo quiero aclarar la parte sobre la vacuna contra la gripe. Y creo que eso es lo que dice el Dr. Talbot. Definitivamente también debería vacunarse contra la gripe.

 

Bill Walsh: Claro, claro.

 

Tom Talbot: Sí, absolutamente. Absolutamente.

 

Bill Walsh: Está bien. Bueno, Bill en Ohio, gracias por esa pregunta. Y gracias a todas esas preguntas. Pronto aceptaremos más llamadas. Como recordatorio, si desean hacer una pregunta, presionen * 3 en el teclado de su teléfono opongan su pregunta en la sección de comentarios en Facebook o YouTube. Y si desean escuchar este programa en español, presionen * 0 en el teclado de su teléfono ahora.

 

[En español]

 

Bill Walsh: Está bien. Ahora volvamos a nuestros expertos. Dr. Talbot, se espera que la compañía farmacéutica Merck y Pfizer busquen la aprobación de la FDA para un régimen a corto plazo de píldoras diarias para combatir el virus. Y otra compañía farmacéutica, AstraZeneca, anunció que su vacuna tiene una eficacia del 74% incluso más alta en adultos de 65 años o más. ¿Puede repasar brevemente esas nuevas iniciativas? ¿Y en qué se diferenciarán la prevención y el tratamiento? ¿Y con qué rapidez podemos esperar ver algunos cambios?

 

Tom Talbot: Sí, gracias, Bill. Creo que, como médico de enfermedades infecciosas, como científico, ha sido realmente emocionante de ver. Si llamamos a la pandemia emocionante, es solo el avance de la ciencia. Los científicos realmente se esfuerzan por ayudar a responder muchas preguntas. Las cosas que no teníamos o no sabíamos sobre este virus hace tan solo un año y medio. Y realmente estamos aprendiendo sobre la mejor manera de prevenir y tratar a las personas con la infección por COVID-19.

 

Entonces, hoy en día, si uno tiene una infección por COVID-19, podría recibir un anticuerpo monoclonal, si tiene una infección leve. Si acude al hospital, recibirá un medicamento antiviral y algunos esteroides. Y es posible que necesite incluso algún tipo de medicación inmunosupresora más fuerte. El desafío es que realmente no tenemos un medicamento antiviral que uno pueda ir a su médico en la clínica y obtener.

 

Por lo tanto, es posible que la gente esté más familiarizada con un medicamento llamado Tamiflu, pensando en la infección por influenza, a veces se les dará a las personas para ayudar a reducir los síntomas. Y no hemos tenido eso con respecto a la COVID-19. Pero ahora con Merck y también anunciaron sus datos [inaudibles]. Y es muy emocionante. Creo que obtendremos más información sobre la eficacia, creo que el ensayo que publicaron fue realmente alentador para prevenir la necesidad de ir al hospital si tiene COVID-19.

 

Así que es genial tener eso en nuestro bolsillo para poder usar. Otras vacunas como AstraZeneca, creo que una cosa que ha sido fenomenal y solo a través del apoyo financiero y la ciencia, son todas las nuevas vacunas que se están fusionando en todo el mundo contra la COVID-19 porque realmente, ya sabe, apoyamos esto. Y no sé dónde caerá AstraZeneca en Estados Unidos.

 

Ahora tenemos tres vacunas. Y como mencioné anteriormente, la FDA no se enfoca realmente en muchas preguntas importantes como refuerzos, aprobación total y niños. Así que no sé cuándo entrará en la fila su vacuna, si lo hace, en EE.UU. Pero es genial tener eso disponible en todo el mundo porque no podemos olvidarnos del mundo y protegerlo.

 

Así que creo que a medida que aprendamos más y más, realmente será... Creo que, incluso dentro de seis meses, tendremos una claridad mucho mayor de si alguien tiene COVID-19, cómo manejarla, cómo prevenirla, cómo evitar contagiar a las personas si uno no sabe que está enfermo. Creo que todos estos son ejemplos de científicos realmente activos con algunos descubrimientos realmente emocionantes en torno a este virus.

 

Bill Walsh: Bueno, y más herramientas en nuestro equipo de herramientas para combatir la propagación de la pandemia. Dr. Talbot, me pregunto cuál cree usted que es la probabilidad de que Estados Unidos vea otro aumento de casos a finales de este otoño o este invierno. Y tengo curiosidad, mencionó brotes en otras partes del mundo, ¿cómo nos impactan aquí en Estados Unidos los aumentos repentinos en otras partes?

 

Tom Talbot: Sí. Creo que si tuviera una bola de cristal y pudiera decirle la respuesta correcta, habría comprado la lotería Powerball esta semana, pero no lo hice y no gané. Entonces no lo sé. Y honestamente, les diré, mientras teníamos la variante delta en junio, yo era muy optimista y estaba emocionado de haberme quitado la mascarilla y había pasado por las etapas de duelo cuando golpeó esta ola delta, y ha sido la más grave para nosotros en Tennessee que cualquier momento de la pandemia.

 

Así que realmente no sé qué veremos en invierno. Creo que debemos preocuparnos por la reaparición de la gripe y lo que eso significará. Pero el mayor problema es que, mientras este virus pueda propagarse activamente por todo el mundo, existe la posibilidad de que surja una nueva variante, porque los virus quieren seguir sobreviviendo.

 

Y a medida que continúan dividiéndose, se dividen, se dividen, a veces ocurren pequeños cambios y la mayoría de esos cambios no causan problemas. Pero a veces le dan al virus una ventaja, como con delta, que es más infecciosa, más transmisible y más peligrosa. Entonces, la preocupación es que, a medida que más personas sean vulnerables y puedan infectarse, si habrá otra variante que tal vez no responda tan bien a las vacunas o tal vez sea más fatal. Y ese es realmente el aspecto aterrador.

 

Por lo tanto, la prioridad sigue siendo vacunar a la mayor cantidad posible de personas en todo el mundo. Esa será la manera de terminar absolutamente con la pandemia. Y qué tan bien lo hagamos, ayudará a determinar si tenemos otro aumento. Diré que tengo la esperanza de que otro aumento en EE.UU. no sea tan precipitadamente grande como este. Pero me pongo nervioso al decir eso, quiero tocar madera porque, como dije, siempre nos mantiene alerta.

 

Bill Walsh: Claro. Bueno, Dr. Talbot, déjeme seguir con eso. Usted habló sobre variantes hace un momento, y me ha sorprendido lo bien que han funcionado las vacunas existentes contra la variante delta y otras que hemos visto, ya sabe, ¿cuál es el riesgo de que veamos una variante resistente a la vacuna? ¿Y cómo podemos evitarlo?

 

Tom Talbot: Sí, no tengo un número. No puedo darle un 10% de probabilidad o un X por ciento de probabilidad, pero existe, y es una preocupación muy real. Y la forma de prevenirlo es lograr que este virus... Necesitamos eliminar la posibilidad de que este virus infecte las vías respiratorias que son básicamente susceptibles. Tenemos que vacunar a la gente, porque si el virus no se puede propagar, no puede mutar, no puede cambiar y no puede crear esa variante.

 

Bill Walsh: Está bien. En pocas palabras. Muchísimas gracias. Dr. Tan, permítame dirigirme a usted. Realmente desde el comienzo de la pandemia, han circulado rumores preocupantes sobre la COVID-19 Y las vacunas contra la COVID-19, y esperaba que pudiera ayudarnos a controlar algunos de ellos. Me gustaría mencionar algunos, tal vez pueda tomarlos uno por uno. Está bien, genial. Bueno, el primero es ¿las vacunas contra la COVID-19 cambian el color de la sangre a un tono más oscuro?

 

Litjen (L.J.) Tan: Oh, gracias, Bill. A medida que respondo, quiero mencionar un par de cosas rápidamente, que siempre les recuerdo a todos. Quiero tranquilizar a todos los oyentes; Estados Unidos tiene el mejor sistema de vigilancia de seguridad de vacunas del mundo. Detectamos lo que llamamos cualquier posible evento malo o evento adverso de una vacuna muy, muy rápido.

 

Y entonces, para tranquilizar a todos, hemos estado buscando, realmente buscando, con las vacunas contra la COVID-19, lo que llamamos posibles efectos secundarios o eventos adversos. Y es por eso que podemos encontrarlos cuando aparecen, solo para tranquilizar a todos. Y luego, lo segundo que siempre hago cuando escucho estos rumores, es que todos los oyentes deben saber esto, que los científicos y los médicos como el Dr. Talbot que está aquí, muchas de nuestras opiniones y nuestras opiniones de expertos se basan en lo que llamamos plausibilidad biológica.

 

¿Puede suceder realmente? ¿La biología permite que suceda? Y si no puede, entonces es solo un rumor, ¿verdad? Entonces, el primero, el cambio de color de sangre. Creo que esto se debe al consumo de publicaciones en internet sobre mostrar dos bolsas de sangre diferentes, de diferentes colores. La respuesta es no, no puede. No es así. Lo que cambia el color de la sangre es el nivel de oxígeno que hay en la sangre, por lo que no cambia el color de la sangre.

 

Bill Walsh: Está bien, bueno, déjeme lanzarle otro rumor y ver si puede abordar este. ¿las vacunas contra la COVID-19 están provocando un aumento dramático en el cáncer de útero?

 

Litjen (L.J.) Tan: Bill, la respuesta es no. No es así. De hecho, también son muy buenos los sistemas de vigilancia del cáncer en Estados Unidos. Y no estamos viendo un aumento en la notificación de casos de cáncer de útero después de las vacunas contra la COVID-19. Por tanto, la respuesta es no.

 

Bill Walsh: Bien, gracias. Otro rumor es que las vacunas contra la COVID-19 están reduciendo la fertilidad o la función sexual en hombres y mujeres, ¿es cierto?

 

Litjen (L.J.) Tan: Una vez más, la respuesta para eso, es la que tiene argumentos de plausibilidad biológica que también analizamos. Ahora que el Dr. Talbot ya les ha dicho el mecanismo por el cual funciona esta vacuna, no es biológicamente plausible que esta vacuna, que tiene esta proteína única llamada proteína de pico, afecte la fertilidad masculina o femenina.

 

Por tanto, la respuesta es no. Pero curiosamente, en realidad hay una publicación que ha salido a la luz que muestra que el virus que produce la COVID-19, el virus completo en sí, en realidad se puede encontrar en los testículos de los hombres. Y ese es solo el primer hallazgo ahora, ya sea que afecte o no la fertilidad y algo más, pero esa es la enfermedad en sí. Entonces creo que eso es más importante ahora, ya que Tom ya ha especificado que la vacuna tiene tantos beneficios, la enfermedad...

 

Bill Walsh: Bueno, bien, déjeme decirle otro. Por supuesto, la tecnología detrás de las vacunas Pfizer y Moderna se llama ARNm. ¿Están los científicos manipulando lechugas y espinacas con ARNm para vacunar a las personas sin pastillas?

 

Litjen (L.J.) Tan: Esa es una buena pregunta, Bill. ¿Y sabe qué? Los investigadores mucho antes de COVID-19 han estado buscando formas de hacer lo que llamamos vacunas orales, incluido el uso de la tecnología de ARNm que se ha utilizado para la vacuna contra la COVID-19. Así que esto está en el camino, es algo para el futuro.

 

No es algo que esté sucediendo ahora con algo específico de la COVID-19. Pero ha sido algo que hemos estado buscando para un amplio panel de vacunas, algo así como lo que llamamos vacunas orales. Entonces, sí, lo estamos haciendo, pero no específicamente para la COVID-19. Y es algo que sucedió antes de la pandemia, y su investigación continúa avanzando. Y en algún momento en el futuro, tal vez tengamos una vacuna oral que podamos usar al comer lechuga o espinacas.

 

Bill Walsh: Está bien, muy bien. Muy bien, aquí hay otro. Otro rumor que hemos escuchado por ahí es que el simple hecho de donar sangre reduce la eficacia de las vacunas contra la COVID-19 en el cuerpo.

 

Litjen (L.J.) Tan: No, no es así. Y, de hecho, con la demanda de productos sanguíneos y plasmáticos, por favor, necesitan saberlo y la Cruz Roja Americana lo ha dicho, se puede donar sangre después de recibir la vacuna contra la COVID-19. Entonces, la respuesta es no, la donación de sangre no reduce la eficacia de la vacuna en el cuerpo. Ahora podemos analizar todas las razones biológicas de eso, pero me detendré y diré que no, no es así.

 

Bill Walsh: Está bien. Muy bien, Dr. Tan, gracias. ¿Hay otros rumores que haya escuchado y que le gustaría abordar?

 

Litjen (L.J.) Tan: Creo que hemos abordado un montón de preguntas y respuestas. Creo que la mejor manera es recibir estas preguntas y abordarlas.

 

Bill Walsh: Está bien. Bueno, gracias por dejar las cosas claras, Dr. Tan, lo apreciamos mucho. Ahora es el momento de abordar más preguntas con el Dr. Tom Talbot y el Dr. L.J Tan. Por favor presionen * 3 en cualquier momento en el teclado de su teléfono para conectarse con un miembro del personal de AARP para hacer su pregunta en vivo. Jesse, ¿a quién tenemos ahora en la línea?

 

Jesse Salinas: Sí, nuestra próxima llamada será en realidad de YouTube. Y Mike pregunta: "¿Cuántos días después de recibir la vacuna de refuerzo se vuelve completamente efectiva?"

 

Bill Walsh: Está bien. Dr. Talbot, ¿puede responder esa pregunta de Mike?

 

Tom Talbot: Sí. Gracias, Mike. Los datos muestran que son aproximadamente dos semanas. Así que, al igual que con las otras dosis, son aproximadamente dos semanas hasta que uno reciba el impacto total del refuerzo.

 

Bill Walsh: Y tengo curiosidad, ¿conocemos la eficacia del refuerzo? Es decir, ¿disminuye con el tiempo? Ofrece un alto nivel de protección, pero ¿cuánto dura el alto nivel en sí?

 

Tom Talbot: Sí, aún no lo sabemos porque es un poco pronto. Probablemente, el área que tiene más datos sobre eso es Israel. Y solo han estado poniendo las vacunas de refuerzo creo que unas seis semanas, pero definitivamente han demostrado el impacto protector de reforzar. Pero pasará un tiempo antes de que sepamos cuánto tiempo hay de protección y si es necesario que haya más dosis de refuerzo o lo que está sucediendo con la ola delta y otras cosas. Así que ahora mismo no lo sabemos.

 

Bill Walsh: Está bien. Muy bien. Jesse, tomemos otra llamada. Oye, Jesse, volvamos a los teléfonos, ¿de quién es nuestra próxima llamada?

 

Jesse Salinas: Nuestra próxima llamada es de Margaret en Misisipi.

 

Bill Walsh: Hola, Margaret, bienvenida al programa. Continúe con su pregunta. Hola, Margaret, siga adelante con su pregunta. Creo que podemos haber perdido...

 

Jesse Salinas: Muy bien, intentemos con otro, Bill.

 

Bill Walsh: Oh, espera. ¿Margaret, está ahí?

 

Jesse Salinas: Creo que la perdimos.

 

Bill Walsh: Está bien.

 

Jesse Salinas: Probemos con Kathy en Georgia. Bill, mis disculpas.

 

Bill Walsh: Está bien. Hola, Kathy, bienvenida al programa. Continúe con su pregunta.

 

Kathy: Sí, buenas tardes a todos. Mi pregunta se refiere a una relación, ya sea negativa o positiva, entre la vacuna de refuerzo y la vacuna contra la neumonía porque recientemente recibí la vacuna contra la neumonía. Y debería calificar para el refuerzo a principios de noviembre.

 

Bill Walsh: Entonces, su pregunta es si debería recibir esa inyección de refuerzo. Está bien. Bueno, Dr. Tan, ¿puede abordar eso, por favor, para Kathy?

 

Litjen (L.J.) Tan: Sí, absolutamente. Y, Kathy, gracias por vacunarse contra la neumonía. Esa es una vacuna realmente importante. Así que felicidades por hacerlo. Y sí puede. Si lo hace en noviembre, que supongo que serían seis meses después de su segunda dosis de la vacuna Pfizer, definitivamente puede recibir el refuerzo en noviembre.

 

Bill Walsh: Está bien. Jesse, ¿quién sigue?

 

Jesse Salinas: Nuestra siguiente pregunta es de Carol en Texas.

 

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

 

Carol: Mi pregunta es esta: he recibido ambas dosis de Pfizer, he recibido mi vacuna de refuerzo. Mi pregunta es con respecto a si hubiera una infección posvacunación, ¿cuál es la posibilidad de contraer la COVID-19 prolongada? ¿Y la vacunación brinda una protección considerable contra la posibilidad de contraer COVID-19 prolongada si tienes una infección posvacunación?

 

Bill Walsh: Es una buena pregunta. Dr. Talbot, ¿puede ayudar a Carol con eso?

 

Tom Talbot: Sí, Carol, muy buena pregunta. Y en realidad ha habido algunos datos, no solo de las personas que recibieron el refuerzo, sino también de las personas que recibieron dos dosis de una vacuna de ARNm. El estudio apareció en el New England Journal hace varias semanas.

 

Al comparar las personas no vacunadas que se infectaron y las personas que solo recibieron una dosis de la vacuna Pfizer y Moderna, descubrieron que si uno recibió dos dosis de Pfizer o Moderna, el riesgo de tener ese tipo de síntomas prolongados de COVID-19 al mes fue significativamente menor.

 

Y estamos viendo... Eso es realmente interesante... No sé muy bien la razón de eso, pero es muy interesante a medida que aprendemos más sobre esta enfermedad. Por lo tanto, hay algunas señales de que vacunarse reducirá esa posibilidad, si contraes COVID-19, de tener los síntomas prolongados de COVID-19 que pueden ser bastante atemorizantes.

 

Bill Walsh: Sí, hable de algunos de esos síntomas de COVID-19 prolongada, por así decirlo, Dr. Talbot.

 

Tom Talbot: Sí, lo que estamos viendo en las personas, y no necesariamente se relaciona con la gravedad de la primera infección por COVID-19, es que algunas personas tendrán síntomas persistentes durante meses. Y pueden ser cosas neurológicas, simplemente descritas como confusión mental, problemas para pensar, fatiga, algunas personas tienen algunos problemas vasculares, cardiovasculares, una variedad de problemas y desafíos.

 

E incluso un informe reciente citó que aproximadamente el 25% de las personas con COVID-19 estaban viendo algún grado de síntomas varias semanas o meses después de la infección. Entonces, no entendemos exactamente la razón por la que probablemente sea inmunitario, pero no estamos seguros de eso.

 

Pero es sorprendente y puede ser bastante debilitante. De hecho, en Vanderbilt ahora tenemos una clínica de COVID-19 posaguda para ayudar a estos pacientes a controlar sus síntomas y tratarlos. Entonces eso es una cosa. Es un poco exclusivo de este virus del que estamos aprendiendo y viendo a lo largo de la pandemia.

 

Bill Walsh: Está bien, muy bien. Muchas gracias por eso, Dr. Talbot. Jesse, volvamos a las líneas.

 

Jesse Salinas: Sí, vamos a traer a Lance de Illinois.

 

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

 

Lance: Hola, gracias. Mi pregunta es, si uno tuvo COVID-19 y ahora da negativo en la prueba, y va y recibe la vacuna de una sola inyección de Johnson & Johnson, ¿puede recibir también la dosis de refuerzo de Pfizer?

 

Bill Walsh: Está bien. Dr. Talbot, creo que ya habló un poco de esto antes. ¿Puede abordar la pregunta de Lance?

 

Tom Talbot: Sí, en este momento las recomendaciones para los refuerzos son solo si ha recibido las dos dosis de Pfizer. Y la cuestión de Johnson & Johnson se discutirá la próxima semana en la FDA, por lo que podremos obtener más información allí. J&J dio a conocer algunos datos en la última semana sobre lo que sucede con los niveles de anticuerpos con la segunda dosis.

 

Entonces, su refuerzo sería la dosis dos, por así decirlo, y mostró un impacto realmente prometedor en los niveles de anticuerpos con una segunda dosis. Entonces, lo que diría es que esperen una semana o una semana y media. Y creo que escucharemos más sobre cómo tratar a nuestros pacientes que recibieron Johnson & Johnson y si necesitan un refuerzo o la segunda dosis.

 

Bill Walsh: Bien, gracias, Dr. Talbot. Volvamos a las líneas. ¿A quién tenemos ahora, Jesse?

 

Jesse Salinas: Nuestra próxima llamada es de Edith de Maryland.

 

Bill Walsh: Hola, Edith, bienvenida al programa. ¿Hola, qué tal? Continúe con su pregunta.

 

Edith: Hola, creo que ya Alguien hizo mi pregunta, pero la reformularé y veré si crees que ha sido respondida o no. Tenía una pregunta de dos partes. Ahora que tengo la vacuna de refuerzo y me preguntaba cuál es el nivel de eficacia o efectividad en este momento. Y también, ahora que recibí el refuerzo el domingo, será mi período de dos semanas. Entonces, cuando estoy con mis nietos menores de 11 años, ¿debo usar mi mascarilla alrededor de ellos tanto adentro como afuera?

 

Bill Walsh: Muy bien, buena pregunta. Dr. Talbot, ¿quiere abordar eso? Y, Dr. Tan, si desea participar también, adelante.

 

Tom Talbot: Sí. Es muy buena. Entonces, la primera pregunta sobre cuál es la eficacia ahora con el refuerzo. Realmente, los datos que tenemos hasta ahora, probablemente de Israel, parece que la eficacia vuelve a ese nivel medio del 90% que vimos en los ensayos clínicos con dos dosis. Así que parece que nos impulsa a volver a donde estábamos con esas dos.

 

La pregunta que hizo, que ahora el domingo estará completamente vacunada y con refuerzo, y si necesita usar una mascarilla con los niños más pequeños. Su probabilidad de contraer una infección posvacunación es mucho menor ahora. Y entonces creo que mi consejo general es al estar al aire libre, de hecho, creo que es seguro no usar mascarilla.

 

En espacios cerrados, probablemente esté bien no usar mascarilla, depende de cómo estén circulando las cosas en su comunidad. Si hay demasiados casos de COVID-19 puede usarla solo para tener mucho cuidado. Pero creo que es una muy buena pregunta. Nos enfrentaremos a esto. Nuestra gente con refuerzo tiene un nivel diferente de inmunidad que tal vez dejen de usar mascarillas.

 

En este momento en Nashville, tenemos tal actividad de COVID-19 que diríamos que espere, pero puede ser que las cosas estén disminuyendo, podrá quitarse esa mascarilla y su nieto verá su cara y eso es bueno.

 

Bill Walsh: Está bien. Y tal vez ese nieto también pueda recibir una vacuna pronto. Dr. Tan, ¿quiere agregar algo a eso?

 

Litjen (L.J.) Tan: Exactamente. Sí, nada que agregar. En la segunda pregunta que creo que el nivel de riesgo de la comunidad es lo que hay que buscar. Estoy de acuerdo en que estará muy bien protegida. La otra cosa que quiero decir a todos los oyentes, y como respuesta a la pregunta, es que la eficacia de ese refuerzo no se trata solo de que el 95% de protección contra las infecciones, también es una protección increíble contra la enfermedad grave, la prolongada que se comentó anteriormente, pero también las hospitalizaciones y las visitas médicas. Ya sabe, también disminuyen drásticamente como resultado del refuerzo, y esos son los datos de Israel.

 

Bill Walsh: Sí, ese es un buen punto. Gracias, Dr. Tan. De acuerdo, Jesse, tomemos otra llamada.

 

Jesse Salinas: Bill, la próxima persona que llama es Linda de Virginia.

 

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

 

Linda: Gracias. Tengo programada una mamografía y también estoy esperando el refuerzo de la Moderna. ¿Es seguro para mí hacerme una mamografía y luego obtener el refuerzo para Moderna, o hay un período de tiempo entre eso?

 

Bill Walsh: Dr. Talbot, ¿puede abordar la pregunta de Linda?

 

Tom Talbot: Sí, Linda, gracias. Una cosa que sí vemos en las personas que se vacunan, en algunas personas, como está provocando que el sistema inmunitario reaccione y parte de ese sistema inmunitario son los ganglios linfáticos, los de debajo del brazo, es que hubo informes de mujeres que iban a su mamografía de rutina y parecían tener un ganglio linfático inflamado en la mamografía.

 

Y eso ha planteado algunas preguntas como, ¿aplazo mi mamografía o aplazo mi vacuna? Y el consenso general ahora es que no se aplace, pero cuando vaya a hacerse la mamografía, asegúrese de decirle a la gente que ha recibido un refuerzo recientemente porque de esa manera el radiólogo que lo lea sabrá, oh, hay un pequeño ganglio linfático allí, pero se había puesto el refuerzo y eso es lo que se ve, y pueden usar esa información para ayudar a leer eso.

 

Pero no sería algo... No queremos que las personas que necesitan una mamografía se pierdan o retrasen ese examen. Y tampoco queremos que se pierda el refuerzo cuando sea el momento de recibirlo.

 

Bill Walsh: Está bien. Gracias por eso, Dr. Talbot. Tomemos otra pregunta.

 

Jesse Salinas: Nuestra última pregunta, creo que será de Facebook. Es de Lisa y ella quiere saber: "¿Debería posponer mis visitas anuales al médico o mis visitas anuales de bienestar debido al virus delta de la COVID-19?"

 

Bill Walsh: Bueno, el Dr. Talbot estaba hablando de ese tema hace un momento. Dr. Talbot, ¿quiere dar más detalles?

 

Tom Talbot: Sí, diría que no. Una cosa que aprendimos el año pasado cuando todos nos encerramos y muchas personas no recibieron su atención médica regular, vimos a personas aquí y en todo el país que habían empeorado las condiciones y enfermedades subyacentes. Y vimos que la gente no se daba las vacunas de rutina.

 

Y por eso definitivamente recomendamos hacerse sus chequeos y todo lo demás. Lo bueno es que todas las clínicas y hospitales, y esto es lo que hago en Vanderbilt, tenemos prácticas de prevención de infecciones para evitar el riesgo de contagio entre nosotros y nuestros pacientes. Entonces, el uso de mascarillas y otras medidas, es posible que al ingresar se le pregunte sobre los síntomas, y obviamente no vaya si se siente mal.

 

Por lo tanto, hay muchas protecciones para evitar contraer COVID-19 allí. Así que definitivamente quiero asegurarme de que vayan a esa visita, a hacerse un chequeo, que mantengan su atención médica porque no queremos que se enfermen por otra cosa también, y los protegeremos contra la COVID-19.

 

Bill Walsh: Muy bien, gracias a nuestros dos expertos por responder a nuestras preguntas. Esta ha sido una discusión realmente informativa. Y gracias a nuestros socios, voluntarios y oyentes de AARP por participar en el debate de hoy. AARP, una organización de membresía no partidista y sin fines de lucro, 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 que se propague a otras personas mientras se cuidan ellos mismos.

 

Todos los recursos a los que se hizo referencia hoy, incluida una grabación completa del evento de preguntas y respuestas de hoy, se podrán encontrar en aarp.org/elcoronavirus el 8 de octubre. Allí se podrá ver una transcripción completa del programa. Una vez más, esa dirección es aarp.org/elcoronavirus. Vayan allí si su pregunta no fue respondida, y encontrarán las últimas actualizaciones, así como información creada específicamente para adultos mayores y cuidadores familiares.

 

Esperamos que hayan aprendido algo hoy que pueda ayudarlos a ustedes y a sus seres queridos a mantenerse saludables. Acompáñennos el 21 de octubre a la 1:00 p.m., hora del este, para participar en otro evento en vivo donde responderemos sus preguntas sobre el coronavirus. Esperamos que puedan acompañarnos. Gracias, que tengan un buen día. Con esto concluye nuestra llamada.