AARP Coronavirus Tele-Town Hall From October 21

Bill Walsh: Hello, I am AARP Vice President Bill Walsh, and I want to welcome you to this important discussion about the coronavirus. Before we begin, if you'd like to hear this telephone town hall in Spanish, press *0 on your telephone keypad now.

(Instructions in Spanish)

Bill Walsh: AARP, a nonprofit, nonpartisan, membership organization has been working to promote the health and well-being of older Americans for more than 60 years. In the face of the global coronavirus pandemic, AARP is providing information and resources to help older adults and those caring for them. Cold and flu season is upon us, and it could be a particularly challenging time for older adults. COVID booster vaccination rates have dipped, and according to one survey, less than half of adults plan to get a flu vaccine. As we enter our third pandemic winter, many experts worry that vaccine fatigue may have serious consequences for people's health. The good news is that as we prepare for seasonal travels and gatherings with friends and family, there are some simple steps you can take to ensure the safety and protection of yourself and loved ones.

Today we'll hear from the White House COVID response coordinator about these issues and more. We'll also get an update from Capitol Hill on legislation affecting older Americans. If you've participated in one of our tele-town halls in the past, you know this is similar to a radio talk show, and you have the opportunity to ask your question live. For those of you joining us on the phone, if you'd like to ask a question, press *3 on your telephone keypad to be connected with an AARP staff member who will note your name and question and place you in a queue to ask that question live. And if you're joining on Facebook or YouTube, you can post your question in the comments.

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 *3 on your telephone keypad, and if you're joining on Facebook or YouTube, you can post your question in the comments section. Today we have Dr. Ashish Jha, one of the leading public health experts in America, and the White House COVID-19 response coordinator. We'll also be joined by my AARP colleague Gil Cabrera, who will help facilitate your calls today. This event is being recorded, and you can access the recording at AARP.org/coronavirus 24 hours after we wrap up. Again, to ask your question, please press *3 at any time on your telephone keypad to be connected with an AARP staff member, or if you're joining on Facebook or YouTube, drop your question into the comments section.

Now I'd like to welcome our special expert guest. Dr. Ashish Jha is the former dean of the Brown University School of Public Health, and he serves as the White House COVID-19 response coordinator. Welcome back to the program, Dr. Jha.

Ashish Jha: Hey, Bill, thank you so much for having me back.

Bill Walsh: All right, we're delighted to have you. And as a reminder to our listeners, to ask your question, press *3 in your telephone keypad or drop it in the comments on Facebook or YouTube. Well, let's get right to it, Dr. Jha. There have been some important developments recently in COVID vaccines. Let's begin, if you would, with a review of the vaccines and treatments that are available today, how they differ and why they matter. What do older adults need to know?

Ashish Jha: Bill, that's a great place to start. So, the good news is that we have made an important update to the COVID vaccine for the following reason. You know, the original vaccine, which was very good, was developed an early 2020, and it targeted the virus that was circulating at the time. Well, the virus has evolved a lot in the last two and a half years — new variants, new subvariants. So, over the summer, the Food and Drug administration made a decision to make a substantial upgrade to the vaccine so it could target the virus that's circulating today. And that's what we have. And all of the evidence so far suggests it's going to do a much, much better job at protecting people against infection, against serious illness or worse. So, that's number one. And the other part of the good news here is that for most people, this is now a once-a-year shot. I do think for some vulnerable older adults, they may need shots more than once a year. But I think for a majority of Americans, it's a once-a-year shot. So, that's probably the single most important thing, and if you've not gone out and gotten this new, what we call the bivalent vaccine, this new COVID vaccine, it's really, really critical that people do so. The other thing is we also have a tremendous number of treatments that are incredibly effective at preventing serious illness and death. And so, thinking about medications like Paxlovid, we'll probably end up talking more about that in the Q&A, but it is very, very effective at preventing serious illness. I'll put it this way, Bill. We are now at a point in this pandemic where if people are up to date on their vaccines, and if they get treated if they get a breakthrough infection, no one needs to die of COVID anymore. We can prevent nearly every single death, and that is the priority of the administration, and it's certainly my personal priority.

Bill Walsh: It's really remarkable. Well, let me follow up to that, given the efficacy, particularly of the new bivalent vaccine. Because we know about 80 percent of the U.S. population by now has received one dose of the COVID vaccine, but just 50 percent of vaccinated people have received a booster, and fewer still of this latest bivalent vaccine you just described. If someone hasn't had an additional vaccine since the initial cycle, what sort of protection do they have against the COVID virus today?

Ashish Jha: Yeah, so as I said earlier, Bill, the virus has evolved so much. I mean, this is a very challenging virus, obviously novel, new to the human species just as of a few years ago. It has evolved so much in the last two years, even in the last year, that if you got your last vaccine a year ago, a year and a half ago, even six months ago, you're really not all that well protected. And if you got your last vaccine a year ago, you have very little protection against infection and only modest protection against serious illness. This is why we made the major update that we did over the summer, because we found that the new vaccine would provide much better protection. And the good news is not only is it much more effective, it is widely available across America. So, it's pretty easy to get, and I, at this point, just would not rely on any vaccine or infection prevention ... protection you have from, let's say, an infection you might have had nine months ago or a vaccine a year ago. It's just not going to provide the level of protection you need anymore.

Bill Walsh: Yeah. Well, given the broad access and the effectiveness of the new vaccine, how do you explain the hesitancy, particularly as we're heading into fall and winter, when traditionally we've seen COVID rates, surge back up?

Ashish Jha: Yeah, I don't know that I see it as hesitancy. I see people learning about the new vaccine, trying to understand the importance of these new vaccines. You know, it's just, I think it's important for us in the public health world to remind people that COVID is still here. And just as we go out and get a flu shot every year because we know that flu becomes much more of a problem in the fall and winter, it's really important for people to go out and get their COVID shot. You know, I think part of that hesitancy is the fact that COVID is no longer front of mind for everyone. I actually think that's good news. We don't need to be in that same kind of emergency “thinking about COVID all the time” phase. And if people continue to protect themselves with vaccines and treatments, we really can put COVID behind us.

Bill Walsh: Yeah. Well, let's talk about those treatments. And as a reminder to our listeners, if you'd like to pose a question to White House COVID response coordinator Dr. Ashish Jha, press *3 on your telephone keypad, or drop your question into the comments on Facebook or YouTube. Now, according to a recent study by Epic Research, infected patients treated with Paxlovid are about two times less likely to be hospitalized and about four times less likely to die. Antivirals were held as a game changer, but few people are taking them. Why do you suppose that is?

Ashish Jha: Yeah, so it's a great question. The data on antivirals like Paxlovid is actually overwhelmingly clear, and it is very good data; it's very compelling data. I think we know this with medicines in general, that whenever new medicines are introduced, it takes doctors a while to start using them and getting comfortable with them. Obviously, this is a new pandemic and a new virus, and these treatments are about now they've been available for about 10 months and doctors are still getting comfortable using them. But I will tell you, my elderly parents were in their 80s, got COVID over the summer, and they both called me. They got it at the same time. They called me and the first thing we did was put them on Paxlovid because the data on this is not subtle, Bill. It's not a close call. What we know is that it's so clear that if you get on Paxlovid, you will not end up in the hospital or your risk of ending up in the hospital goes way down, and your risk of ICUs or death just dramatically plummet. Really, really effective.

Bill Walsh: Well, it sounds like your parents took your advice. What would you say to other older Americans, particularly those over 65 who have COVID, about whether to get Paxlovid, and what should they consider as they're thinking that through?

Ashish Jha: Yeah, and as you might imagine, Bill, my parents don't always take my advice, but I'll ...

Bill Walsh: Well, and you didn't always take their advice, I imagine, either so …

Ashish Jha: That is also true. What comes around goes around on these things. No, but here's my advice to people over 65. First of all, I think everyone over 65 should get treated. But if Paxlovid is not the right drug, there are other options as well. Paxlovid is first line, but there are other options as well. There are other oral antivirals, like one called Lagevrio, this monoclonal antibodies, so there are other choices as well. The second thing I would say is you got to talk to somebody, and you got to talk to somebody early. So, what happens often is you're 65, 70 years old, you get COVID, you don't feel great for a day or two, but the first couple of days are not so bad and maybe it's just a mild cold. You don't call anybody; you don't call your doctor. By the time the symptoms get really bad, it might be day five or six, and if you're calling your doctor at that point, you might be getting out of the window where Paxlovid is really useful. So, what I recommend, and what I did with my parents, is even if the symptoms are mild — because what we know is that symptoms can get worse later and you may miss the window for treatment — treatment is best when it's early. If you, the moment you get infected, I believe that if you're over 65, you've got to get it. So, what do you do? Call your doctor. OK, so what if you're having a hard time reaching your doctor, or you may not have a primary care physician, or you may not have somebody you can reach? There are other options. You can go to COVID.gov. We have lists of literally thousands of test-to-treat sites. Every state has them. You can go to these test-to-treat sites. They verify you're positive, and they can give you treatment right away. There are clinics like CVS and Walmart and Walgreens that have them. So, there are multiple options. The key is, be persistent, and if you are over 65, I really believe at this point the standard of care is you need to be getting treated If you get COVID.

Bill Walsh: OK. Now one other question I had on Paxlovid is, despite its effectiveness, recent reports suggest that it could have interactions with some common heart medications, including blood thinners and statins. Is this a concern? And when seeking treatment, what would your advice be to someone who gets COVID and is on heart medication?

Ashish Jha: Yeah, this is why it's really important to talk to your doctor or talk to a pharmacist, by the way. Pharmacists are terrific at understanding these issues. Here's how I would think about it. There's a series of heart medicines that are not a big deal to stop for five days. So, the way you handle some things is — and we do this all the time by the way, when an older American, let's say, gets admitted to the hospital and they need a procedure, we stop certain medicines for five days. Not a big deal. But other medicines, stopping it for five days can be more of an issue. So, this is why that conversation with the physician is so important. I think the vast majority of the times, 90-plus percent of the time, you can find a way to take Paxlovid safely and not be a big deal. If you find yourself in that rare circumstance where your physician feels like you just, let's say you're on a blood thinner and they just don't think you can stop that blood thinner for five days, then you have those alternatives, Legavrio, the monoclonal antibodies. So, everybody should get treated with something. If you're in that rare circumstance where you really just cannot take Paxlovid, then there are other options for you as well.

Bill Walsh: OK. Very good. Well, I've asked enough questions for now. Let's go to our phones and take some questions from our listeners. It is now time to address all of your questions or as many as possible about the coronavirus with the White House COVID response coordinator, Dr. Ashish Jha. As a reminder, press *3 at any time on your telephone keypad to be connected with an AARP staff member to get in the queue to ask your question live. And if you'd like to listen to this program in Spanish, press *0 on your telephone keypad now.

(Instructions in Spanish)

Bill Walsh: And now I'd like to bring in my AARP colleague Gil Cabrera to help facilitate your calls today. Welcome, Gil.

Gil Cabrera: Bill, thank you very much. I'm thrilled to be here for this important conversation, indeed.

Bill Walsh: All right. Who is our first caller?

Gil Cabrera: Well, our first caller is Steve, who's calling from New Jersey, Bill.

Bill Walsh: All right, Steve. Welcome to our program. Go ahead with your question.

Steve: Thanks and thanks for taking my question. I'm 68 years old. I had the two Moderna original vaccines and the two boosters. I still got COVID late this past August … and I took Paxlovid, too, and my symptoms were mild. My question is, a lot of what I've read says if you had COVID with this new bivalent booster, you should wait three months to get that booster. So, my question is, your thoughts on that, waiting the three months?

Bill Walsh: Yeah, Dr. Jha.

Ashish Jha: Great question, Steve. First of all, thank you for doing everything you can to keep yourself protected and healthy. Look, it's a very tough virus, and the truth is, even with keeping up with your vaccines, you can get breakthrough infections. But the good news is, because of the fact that you are up to date on your vaccines and took Paxlovid, it sounds like you had a mild course, and that's what we want for everybody. Now, to your question, how long to wait after infection? I think three months is perfect. FDA has said that you need to wait at least two months. I think that's right. But my general recommendation to my friends and family has been, wait three months. If you got either your last vaccine or your last infection, wait three months. Why? What you're doing is you're letting your immune system mature. Your immune system is still quite revved up from that prior infection, and giving it a little bit of time actually will make the vaccine more effective. So, I believe three months is exactly the right time to do it. And if you got it in August, you'll be able to get it sometime in late November. And that means that by the time holidays roll around, you'll really be getting the benefit, the maximum benefits, of that vaccine.

Bill Walsh: Great. Thanks so much for that. And look, I know it's still early days on this new bivalent vaccine, but do we have a sense of how long the immunity lasts?

Ashish Jha: We don't know, and this is part of the challenge of new … of the virus evolving and vaccines coming on is we don't … the longer-term stuff will take a little longer. What I suspect is, when you saw with prior vaccinations, you did see that waning of immunity, and part of it was because the virus had evolved so far away from the vaccine. And that, from a biological point of view, means, given these new vaccines so tightly target the virus that's out there, that we should see more durable protection. It should last meaningfully longer both against infection and serious illness. We just don't know how much longer. We don't know exactly how much more durable, but all of the evidence so far suggests it really should do that.

Bill Walsh: OK. Very good. Gil, let's take another caller.

Gil Cabrera: Sure. Bill, we have Sophia via Facebook. She is asking, "Do we have to specifically ask for the new vaccine when we schedule an appointment for a booster?"

Ashish Jha: You should not have to, because when FDA made this change and authorized the new bivalent vaccine, it de-authorized, or got rid of, the prior vaccine as a booster. So, at this point, there's only one booster option for older Americans, for actually, for basically, all adults. And so if you go and make an appointment and say, “I'm here for my additional shot, my booster shot, my annual COVID shot,” you should get the bivalent vaccine.

Bill Walsh: OK. And Dr., I wonder if we've heard anything about side effects for the bivalent vaccine.

Ashish Jha: Well, so far, and I'll start with my own personal experience, you know, I got both the flu shot and the COVID shot, and at the same time, same arm. My arm was a little sore for about 24 hours, but other than that, I felt fine. I think the evidence so far suggests that the side effects are really quite mild. You know, people know them. Some people do end up having a difficult 24 hours where they may feel some aches and chills, but a vast majority of people have very mild things, a little redness at the site sometimes. A sore arm is very common, usually lasts about 24 hours.

Bill Walsh: Got it. All right. Gil, let's take another call.

Gil Cabrera: Sure thing. Bill. We have Patricia from Illinois.

Bill Walsh: Hey, Patricia. Welcome to our program. Go ahead with your question.

Patricia: My question was, I am 76 years old. I have not eaten in a restaurant since the beginning of COVID, and my husband is asking me if I want to go to a restaurant today for lunch. And I'm wondering how much risk it still is to go to a restaurant to eat. I have several immune compromising things. I'm on a CPAP, and I have third-stage liver disease, no cancer, and am hemolytic anemia, so forth. Oh, I'm diabetic. I'm wondering how risky it is to go to a restaurant to eat at this point.

Bill Walsh: Dr. Jha, very timely question for Patricia, but I think it, it speaks to a question on a lot of people's minds, how freely should they feel to get back out in public, and if they do, what steps should they take?

Ashish Jha: Yeah, it is a very good question. So, I'll start off by talking about both myself and my elderly parents. I didn't really eat much in a, certainly not indoors in a restaurant for most of, I'd say all of 20, and much of 20, or early part of 2021. But certainly this year I have started doing it again, and I actually had dinner with my elderly parents inside a restaurant. Two things. First of all, it is a little bit of more risk. Look, it is very hard to get to zero risk with this virus. It's everywhere. So, definitely is a bit more of, and the reason is because obviously in the restaurant, people are eating, drinking, no one's wearing a mask. But the bottom line is, I think the risk of, especially if you're up to date on your vaccines, the risk of getting COVID is relatively low and then the bottom line is that even if you end up getting infected —and again, one dinner is unlikely to get, or lunch is unlikely to cause that — but if you do, you do have a lot of very good treatments available. So, I believe that at this point, for most people … Now I do want to caution, Patricia, you mentioned that you have some specific health issues and obviously, I'm not your personal physician, so it's hard for me to assess for you how significant those are. It's worth having that conversation with your doctor, but I do think for most people, including people who have health problems, we're at a point where eating at a restaurant is reasonably safe. There is a small risk of getting infected, as there's always been, by the way. There's been a small risk of getting infected with flu in the past. But the good news is, if you're up to date in your vaccine, your risk of getting serious is very low, and then you throw in treatments on top of that, and boy, it just, the chances you'll end up having a bad outcome from it is extremely, extremely low.

Bill Walsh: Right. OK. Thanks for that, Dr. Jha. Gil, who is our next caller?

Gil Cabrera: Well, we have via YouTube Lon asking the following question, Bill. "How far ahead of a trip should I get a booster shot?"

Ashish Jha: Ah, great question Lon, and I would say that what we know is that about two weeks after you've gotten your shot is when your antibodies have really sort of kicked up. So, you need, I mean, and again, that starts increasing after seven to 10 days. You start getting some benefits for probably two weeks, is kind of the maximal time, and then it stays up for a while and then it will slowly decline. So, this is why, for instance, I have said to people that if you have not gotten your new COVID vaccine, your bivalent vaccine, Halloween is a really good target time to by which to get it, because if you get it by Halloween, which is only about 10 days away, you'll be in really good shape for Thanksgiving. And you should be in very good shape for the holidays and the time that follows. So, it's hard to time these things perfectly, but I would say you want to give your immune system at least a couple of weeks to sort of maximize that protection.

Bill Walsh: Yeah. Thanks for that, doctor. You mentioned earlier that these vaccines continue to be free. Will they be free even in the new year?

Ashish Jha: Yeah. So, in the beginning of the new year, they will be. Well, the U.S. government, we bought a good number of doses ’cause we thought it was very, very important for Americans to have, continue to have free access. Congress has stopped funding the COVID response now, as of about six, seven months ago. So, we've been pulling resources out of many other programs to try to make sure we have enough vaccines and treatments. Next year, we will move to commercialization because we are out of resources, and that means it'll start going through your health plan. Vaccines should remain free because the Affordable Care Act, Obamacare from many years ago, one of its stipulations was that preventive things like vaccines should be free. So, vaccines should remain free. What we're trying to do is figure out how do we make sure there are not cost barriers to treatments. But that's all next year and probably later part of next year. Right now these vaccines are free, and I think in early part of '23 you're going to see it continue to get, be free.

Bill Walsh: OK. Very good. Gil, let's take another call.

Gil Cabrera: Of course, Bill. We have Maria from Michigan.

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

Maria: Hi. My 57-year-old husband was vaccinated and boosted on schedule. He was also religious about COVID protocols. He wore a mask all day at work and anytime he left the house. He was obsessive about washing his hands, and yet he got COVID in mid-August, and then again in early October. And the only possibility we can find in looking at the calendar is that this last infection, three or four days before the very first symptoms, he picked up groceries from Walmart. You know, it could have been anywhere, but from a grocery pickup service. Have we learned anything new about how the virus is transmitted, and should we still be wiping off our groceries?

Bill Walsh: That's a great question. Dr. Jha, can you address that from Maria and others who might have the same concern?

Ashish Jha: Absolutely. I'm happy to Maria, and I'm, first of all, I'm sorry that your husband got infected, especially twice. I hope he's doing OK. Here's what we know. We've actually learned a lot. In general, you can't, or you don't get this virus from surfaces, and therefore, you don't need to be wiping down groceries. And handwashing is a good public health measure all around, but it's not particularly different for COVID. What I think is most important is to understand that COVID is spread through the air, it's an airborne illness, and therefore where COVID spreads is in indoor spaces where lots of people are gathered, especially if it's poorly ventilated spaces. That's where we tend to get most of the spread. We get very little spread outdoors. And again, so what I have recommended now for a year-plus is you don't need to wipe down groceries; you don't need to wipe down anything. Washing hands is always a good idea. It just keeps lots of other bugs out of your system, so that's good. But the key here is, good ventilation, being outdoors, always healthier and safer. If you're going to be indoors, if it's super packed, if it has lots of people, wearing that mask can make a big difference. So, again, I'm not sure where your husband specifically got it. I doubt he got it from the groceries. It really just doesn't spread by surface.

Bill Walsh: Hmm. I wonder if Maria's husband's experience might speak to how the virus changes over time. I mean, we know even as we speak, it's changing. And do you think it's possible that he got a new strain that wasn't … the vaccine wasn't as protective at preventing spread?

Ashish Jha: Yeah, absolutely, Bill, and I actually thank you for raising that, because I think that is likely what happened. What we know, again, remember the original vaccine was built against that Wuhan strain from 2020, and by the time we got to August — and, again, I don't know the specifics of Maria's husband — but he probably got infected with a BA.5 strain. And BA.5 strain is very immune evasive, and the old vaccines, while continuing to be good at preventing serious illness, just weren't that effective, weren't as effective at preventing infection. Clearly, there had been a diminishing of that protection. This is why we updated to a bivalent vaccine to make it specifically protective against BA.5. It's a reminder the virus continues to evolve. It's continuing to always look for ways around the wall of immunity that we have built up through vaccinations. But I always say the virus is wily and tricky and it does its thing, but humans have a lot of ingenuity, too, and we can counterattack. And so when the virus changes, well, we can update our vaccines to make them more effective. And that's what we've done with the current vaccine.

Bill Walsh: All right. Very good. Gil, let's take another question.

Gil Cabrera: Sure. Bill, we have Lisa coming to us from New York.

Bill Walsh: Hey, Lisa, welcome to our program today. What's your question?

Lisa: Yes, hi. With Thanksgiving around the corner, my husband and I have been both vaccinated, boosted. We're 70 years old and we were invited to Thanksgiving dinner. There will be about 12 people there, and we're just wondering how safe it is to attend. Should we request that the other guests be tested before they come? Or do you feel it's safe enough to go, and of course, it's going to be indoors.

Bill Walsh: Very timely question.

Ashish Jha: Very timely question, Lisa, and a very good question. So, here's how I think about it. There's no, there are no guarantees, right? If three years ago you had gone to that Thanksgiving dinner you could have picked up the flu or RSV, so that's always out there and a possibility. The key in my mind is, you want to make sure that that Thanksgiving event is as safe as possible without causing a lot of disruption. And the most important thing is, obviously, for you and your husband, to make sure that you are updated on your vaccines with this bivalent vaccine. I think that's sort of critical step number one. Number two is, I think testing can be helpful. We actually know very good data that before gatherings, if people test, this dramatically reduces the risk of infection. These tests are widely available, actually free if you are on Medicare or on private insurance. You can go to a CVS or a Walgreens and say, “I would like my eight free tests per month.” That's something that the government has pushed the insurance companies to make available, so they are easily available. And I'll tell you, is it necessary? Well, it just reduces the risk. So, even if the risk wasn't high, I think it just adds one more layer of protection. Not critical, but I'll tell you, in my family, we're getting together for Thanksgiving — my brother and his family, my wife and I, and our kids with my elderly parents. There'll be about 12 of us. And my plan is, we'll just get everybody a test that first morning just to make sure nobody's got the infection. It's just adds one more layer of protection.

Bill Walsh: All right. Thanks for that. And thank you to for all your questions. We're going to take more of our listener questions shortly. But before we do, let's get an update from Capitol Hill on important legislation that's affecting older adults. You know, in addition to sharing information and resources, AARP advocates for issues that affect you the most. To give a quick update on how AARP is fighting for you, I want to bring in AARP executive vice president and chief advocacy and engagement officer, Nancy LeaMond. Welcome to the program, Nancy.

Nancy LeaMond: Well thanks, Bill. Happy to be here.

Bill Walsh: I want to ask about a few important issues, but let's start with some good news. Of course, this past August, historic prescription drug reforms were passed in the House and Senate and signed into law. Can you discuss what it means for people?

Nancy LeaMond: Sure. Prescription drug pricing reform is a huge victory for older Americans. After decades of calling on Congress to make prescription drugs more affordable, AARP won the fight to let Medicare negotiate lower drug prices and for other policies that will save seniors money on their medications. So, for example, the new law caps the cost of Medicare-covered insulin at $35 a month, and eliminates out-of-pocket costs for most vaccines under Medicare, such as the shingles vaccine. There also is going to be an annual $2,000 limit on how much Medicare Part D beneficiaries pay out of pocket for their prescriptions, and drugmakers that increase prices faster than the rate of inflation will be penalized. These are huge wins for us, and we know how important the cost of drugs has been to seniors.

Bill Walsh: That sure is. That's terrific news. Now, in addition to Medicare, Social Security is another top priority for AARP, and there's also good news there, isn't there?

Nancy LeaMond: Yes. Social Security recently announced an 8.7 percent cost of living adjustment, the largest COLA increase in 41 years. AARP has fought long and hard to protect Social Security COLAs so seniors can keep up with rising prices. This increase will provide much-needed relief to millions of Americans struggling with higher food, health care and, of course, other costs. We're also urging Congress to work together in a bipartisan way to protect and strengthen Social Security for the long term.

Bill Walsh: OK. Thanks so much. Now, of course, we're in the middle of an election season right now. What is AARP's focus heading into the November election.

Nancy LeaMond: Well, first, I want to remind folks that AARP is, and always has been, strictly nonpartisan. We don't endorse or give money to political candidates, parties or campaigns. During election years we focus on making sure that candidates pay attention to older Americans and address the issues that are important to them. And in all recent elections, we fully expect age 50+ voters to make up the majority of the electorate in November. We're also making sure our members and broader constituency know how, where and when to vote. Listeners can visit AARP.org/vote to find details about how to vote in their state.

Bill Walsh: OK. Very good. Now, before I let you go, I want to talk to you about the current state of COVID in America's nursing homes. For those living and working in skilled nursing facilities, this pandemic is far from over, isn't it?

Nancy LeaMond: Well, sadly, that's correct. AARP's Nursing Home COVID Dashboard shows us that transmission in nursing homes remains significantly elevated compared to the rest of the population. One of the most important things people can do is make sure their loved ones are vaccinated and have gotten the recommended boosters. Nearly half of residents and more than half of staff are not up to date with their shots, and this could have deadly consequences as we head into the cold and flu season. Please don't take for granted that your family member has received theirs. Follow up with their care provider and make a plan.

Bill Walsh: All right. That sounds like good advice. Thanks so much for being here today, Nancy. And if our listeners want to stay on top of a AARP'S advocacy news, how can they find out the latest?

Nancy LeaMond: Well, we encourage everyone to go online and search AARP Fighting for You. That will lead you to a daily roundup of all the latest advocacy news on our work with Congress and across the country.

Bill Walsh: Very good. AARP Fighting for You. Thanks so much, Nancy. Have a great day.

Nancy LeaMond: Thanks, Bill.

Bill Walsh: All right. Now let's turn back to our expert guest, Dr. Ashish Jha, the White House COVID 19 response coordinator. Dr. Jha, we were talking about variants earlier, and each subsequent variant of COVID-19 has seemingly been less severe than the earlier ones. Why is that, and could it change?

Ashish Jha: That is a very good question, Bill, and the answer is, it could change. So far there are two reasons why the current variants seem to be less severe. One is there is so much immunity out there that a lot of the infections that are now happening, most of the infections are happening, in people who have immunity. Either they've been previously infected, or they've been vaccinated. And so if you're vaccinated, you're going to have a milder course. And since a lot of people are vaccinated, it appears that this version of the virus is milder. The second is that there is laboratory evidence that this virus, this version of the virus, the omicron version, is milder. We don’t know how much milder — maybe 20 or 30 percent, not dramatically milder — but it is, and that’s also good news. So, inherently milder and the underlying immunity. The problem is that if you think about viruses over the long run, there's a belief out there that viruses always become milder over time. Unfortunately, that's just not true, as much as we wish it were the case. We've seen this with lots of viruses. The Ebola virus that's circulating today is no milder than the one that was there 30 years ago. Influenza, some seasons it's very severe; other seasons, it's mild. So, we don't know if the next variant of COVID will end up being milder, the same or even worse. And so we always are thinking about it and preparing for all of those potential outcomes.

Bill Walsh: OK, well, let's talk about the effects of a COVID infection. You know, the possibility of stroke, heart attack, type 2 diabetes and more issues are elevated after a COVID-19 infection, even in mild cases. I wonder if you think whether older adults fully understand the complete risks of a COVID infection.

Ashish Jha: Yeah, this is a really important issue because often we talk about the bad outcome being death, which of course is the worst outcome of all. So, very, very important that we track that. But what we have seen is a lot of people who end up, after a COVID infection, they recover, but you look out to the next six months, clearly elevated risk of stroke, heart attack, a lot of the things that you mentioned. Partly because the virus actually damages the vascular system and therefore really triggers the kind of risk of those strokes and heart attacks. A lot of people end up having significant pulmonary symptoms afterward because even if the initial infection looked mild, it still caused damage in the lung. So, we have to take it seriously, and this is why we think it's really important to stay up to date on your vaccines ’cause one of the things we have seen is, if you're vaccinated, you're much less likely, if you get infection, you're much less likely to have long COVID. And even if you have long COVID, it's to be quite mild, relatively speaking. So, vaccines don't just prevent serious illness and death. They prevent a lot of those long-term complications as well.

Bill Walsh: Hmm, great point. Now, as you said, I mean, we know from hundreds of millions of COVID vaccines administered that they have a remarkable track record of effectiveness. What can you tell us about the effectiveness of the flu vaccine this year? Of course, it changes every year. And what can you also tell us about the high-dose flu vaccine that we've heard about?

Ashish Jha: Yep. Two good questions. So, the flu vaccine does change every year because flu changes every year. And you know what, I do think by the way, we're kind of heading toward the same thing with COVID, where you're just going to have an annual shot for most people. With the flu vaccine, actually, it's tougher to make those guesses about exactly what strain will be circulating. And a group of scientists make that prediction late in the spring, and then some years they get it really right, and some years it's off. Early, early data, Bill, and I don't want to overstate it because we don't know for sure, but early data suggests this year's flu vaccine may be actually quite good, may be quite on target with the version that's circulating. So, I'm cautiously optimistic that that's where the data will come in, that the vaccine effectiveness against infection will be quite high. Now, in terms of the specific vaccine that is recommended for older Americans, for people over 65, there's something called Fluzone, it's the high dose of the [inaudible]. It's a quadrivalent vaccine. It sounds complicated. But basically what it is, is it's got four times the antigen— that's the thing that your immune system recognizes. And it's just much more effective, especially for older Americans. So, the strong recommendation, my personal recommendation to my family and friends, has been if you're over 65, what I tell them is get the high-dose quadrivalent vaccine. If for some reason you can't access it — and most places have it, but not all — the regular flu vaccine is still way better than not getting vaccinated at all. But if you can get that high-dose quadrivalent vaccine, it's called Fluzone, it is really worth doing.

Bill Walsh: OK, well, just 49 percent of U.S. adults plan to get a flu vaccine this fall, according to a survey commissioned by the National Foundation for Infectious Diseases. Why do you suppose that is, and what is the risk of skipping the flu vaccine?

Ashish Jha: Yeah, so I think there's a little bit of misinformation out there. There's some people who think, Well, maybe I'll get the flu from the flu vaccine. You can't get the flu from flu vaccine any more than you can get COVID from the COVID vaccine. That's just not how it works. They're not, you know, the virus can't, in the flu vaccine case, the vaccine just can't give it to you. And there's no virus in the COVID vaccine. So, that's point number one. You can't get the flu from the flu vaccine. OK. Second point is a lot of people say, “Well I haven't had it, or I had it and it was fine. It was mild.” You know, my take is, sure, it's entirely possible that you had it and it was mild in the past. There is no reason to assume that your next one will not be more severe. And, in terms of the consequences of not getting it, I will put it this way. I have been a practicing physician for 20 years, and every winter I'm in the hospital, December or January, taking care of hospitalized patients; hospitals are just full. I find people having to wait in the emergency room for three days before they can get a hospital bed, and all of it, a large chunk of it, is triggered by influenza. People don't get vaccinated. They get the flu. They end up having a severe case that they weren't expecting. Then they end up having all sorts of problems with their heart, their kidneys, other things. So, such an easy intervention. You can walk into any pharmacy today and get it. It's free again, because as you heard from Nancy LeaMond, the great work of AARP and others, we really do believe that these things should be free, and certainly the administration's been very focused on that. So, it's free, it's widely available. And my gosh, if it prevents you from getting hospitalized or worse, this feels to me like people need to do this.

Bill Walsh: All right. Now I believe you mentioned earlier that you got your flu vaccine at the same time that you got that bivalent vaccine. So, I assume that's recommended protocol for all Americans. I wonder, what about other vaccines, such as the ones for shingles? Should people go in and be asking for multiple vaccines at the same time?

Ashish Jha: Yeah, it's, I'll tell you, I think the answer is yes, and I'll explain why. First of all, totally safe and just as effective. Like, there's no problems with it from a safety or effectiveness point of view. And the reason is, your immune system is remarkable. Its ability to recognize multiple different vaccines and mount a really good response against all of them is quite, quite good. We see this in kids where — I remember when my kids were young, we take them to the pediatrician's office and they get four shots and they're in one visit. And the kids didn't love it, but we loved it because it was convenient. You just get all those shots done in one visit. That's the main reason I recommend it is, I went one day on, I think it was a Friday, and I got both shots in the same arm and then I was just done. I was done. I don't have to go back and do a second visit. So, again, safe, easy and so convenient. So, I generally recommend, there's no problem with getting multiple shots at once.

Bill Walsh: OK. Now, let me shift gears. I want to talk about an issue that's really top of mind for a lot of our members, and that's hearing aids. We know the cost of hearing aids is substantial, but, of course, the FDA recently approved the sale of over-the-counter hearing aids. How big a deal is this, and what should people know about it?

Ashish Jha: Yeah, I have to tell you, I am very excited about this. And again, I know I keep bringing back my elderly parents, but you'll let me do it one more time, if you don't mind, Bill. You know, my parents, my dad spent thousands and thousands of dollars on hearing aids over the years, and they're just, they were so expensive, and it just didn't make any sense to me that they were as expensive as they were. And what happened was in 2017, Congress passed bipartisan legislation, but nothing really happened, saying that basically that hearing aids could move to over the counter. Not much happened in the few years that followed, but when President Biden came in, he made this a priority and basically said to the FDA, “Let's get this done. Let's get it done.” And so just this past week, we saw all of the major retailers bring hearing aids onto their shelves. So, Walgreens, Walmart, Sam's Club, Best Buy, so many more. And these hearing aids, as I said with my dad's experience, they cost thousands and thousands of dollars. Right now we're seeing hearing aids in these places for $200, $300. And the other thing I'll tell you, which excites me, is it's not just going to be cheaper. Some of the major audio companies, Bose and others, are saying they're going to get into this business. So … I think what's going to happen is we're going to see hearing aids, the prices continue to come down. We're going to see quality continue to go up. I think this is really important, and it's a long time coming, and I was so grateful for the president ’cause he — again, the legislation had been passed. He really said to the FDA and to his administration, “Enough is enough. Let's get this done, and this now is going to be out there.”

Bill Walsh: OK, very good. Great news for consumers. Let's take some more calls from our listeners. As a reminder, press *3 at any time on your telephone keypad to be connected with an AARP staff member and get into the line to ask your question live. Gil, who do we have in line now?

Gil Cabrera: Bill, we have Susan coming to us from Alabama.

Bill Walsh: Hey, Susan, welcome to our program. Go ahead with your question. Susan, go ahead with your question.

Susan: My question is, if you haven't had any vaccines, where do you start?

Bill Walsh: Hmm. Dr. Jha.

Ashish Jha: Good question, Susan, and the answer is, you just go ahead and get started. I think you can, basically, I appreciate the question. I think there are obviously still about 10 to 15 percent of Americans, adults who have not gotten vaccinated at all. And when I talk to them, and when they're ready to get vaccinated, which I'm always grateful when they are, I say, you just, you get started. You've got to get that primary series, that first of the first two shots, and the reason that's really important is that sort of creates the base of your immune system against this virus. So, still widely available. You just call up CVS, Walgreens, the, Highmark, whatever's near, Albertson's. Almost all of them still have it. Call them up, say, “I'm ready to get my primary series going,” and then you get vaccinated.

Bill Walsh: OK. So, that's a very interesting point. So, she shouldn't ask for the new bivalent vaccine. She should ask for the original dose of the vaccine.

Ashish Jha: Yeah, the original primary series is still what FDA's recommending for people who are[n’t] vaccinated. And the reason, Bill, is that that original series really created this broad base of immunity that's going to be very, very important for people. So, that's what's still recommended. Down the pike, we may see changes on that, but right now, that's what's still recommended and that's what I still recommend for people.

Bill Walsh: OK. Thanks for that. Gil, who do we have up next?

Gil Cabrera: Well, via our YouTube channel, Bill, we have Evelyna. She is asking a two-pronged question, which is, "What is causing the variant, and is it true that those who are not vaccinated are the ones that are creating the new variants?"

Bill Walsh: Hmm. Dr. Jha?

Ashish Jha: Those are very good questions. So, what is causing the variant is essentially its evolution of a virus that, as I said, has turned out to be a very, very formidable foe. You know, as we've gotten people vaccinated, as people have gotten infected and have started building up that population immunity, it creates this pressure on the virus to evolve because by evolving, it can try to get around that immunity. And there's no question about it that a lot of the infections that are leading to variants are happening in people who are not fully protected, whose immunologic status is not fully up to date. They may be immunocompromised, they may not have gotten their vaccines, and they often are the source of a lot of the variants. So, it's a complicated picture. You know, one of the things that's really important is that if everybody kind of got up to date on their vaccines, it would definitely dramatically reduce infections. It would keep the number of variants down. But it's … the problem, always remember, is it's not just what's happening in the United States that matters. This is a global pandemic, and so we can even do great work here in improving our vaccinations, and we're continuing to work on that. If there are large pockets of the world where people are under-vaccinated, they can become sources of variants too.

Bill Walsh: OK, Gil, let's take another call.

Gil Cabrera: Sure, Bill, we have Kim from Maryland.

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

Kim: Yes, I've been double-vaccinated and double-boosted and all with Moderna, but this bivalent is, I don't know by who. And I tend to have allergic reactions to medications, so I haven't had any, so far, and I'm wondering what it'll do to mix it, because I've been getting numerous phone calls from, reminder calls to come and get this fifth shot.

Bill Walsh: Hmm. Thanks for that question, Kim. Dr. Jha, can you address that. We haven't really talked about folks who have had allergic reactions or who makes the bivalent vaccine.

Ashish Jha: Yeah, thank you. Thank you, Kim, for that fantastic question. So, two things. Two companies make them; they're the same two companies that were making the vaccines that most of us got, Moderna and Pfizer. The risk of allergic reaction was something we worried about for that initial shot, that first shot. What we have found is, a tiny portion of people have that allergic reaction to that first. If you didn't have it to the first, there was little to no chance you were going to have it to the second, third or fourth. It's also very safe to mix it up, meaning again, Moderna before, get Pfizer now. You know, what I would say to you, Kim, is I'd be pretty comfortable that the Pfizer, if you had a Pfizer bivalent, that would be fine. But if you said, “Look, I've gotten four Moderna shots and I'd like to get another Moderna,” that's more than reasonable. And they're both widely available now. So, some pharmacies carry one, others carry others. So, you may have to just do a little bit of sleuthing around and looking around to see who's got the Moderna one. But they're definitely out there and in lots and lots of places.

Bill Walsh: But it sounds like it doesn't really matter, right, which version of the bivalent vaccine Kim or others got. They don't have to … they could mix and match, is what I'm saying.

Ashish Jha: Absolutely. And so much so that the day I got my bivalent vaccine, I didn't even know which one I was going to get, and when I was sitting there in the chair and the nurse was about to give me the injection, I asked her which one I was getting, and she told me it was Moderna. And I said, OK. But clearly, it didn't make any difference to me. I only found out about it about 10 seconds before the injection went in.

Bill Walsh: Now, did they keep you there after you got the shot? I know originally when we got the vaccines, they wanted to monitor you for 15, 20 minutes to see if there was an allergic reaction. Are they still doing that?

Ashish Jha: You know, some places are still doing that. They didn't. I got mine at a health clinic in Washington, D.C. They didn't for me. I think a lot of places still ask people to just be there. I mean, I've been to CVS where, or I think Walgreens, where they say to people, “Hey, just stay in the store. Don't go out,” because they just want to make sure. But these things are so rare now. If you didn't have an allergic reaction initially, the chances you're going to have one now are just so exceedingly low.

Bill Walsh: OK. Gil, let's take another question.

Gil Cabrera: Sure, Bill. We have Natasha with us from Tennessee.

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

Natasha: Yes, hi. Thank you for taking my question which is, I'm getting ready to go for my Moderna booster. I've done all the series up till now and in about an hour, and I am using the local CVS, and they've really are perfecting their app. So just to mention that, so you can make an appointment, and then now I just got an alert saying, “Please let us know when you're in the store” so they can prepare for me.

Bill Walsh: Wow.

Natasha: So, the question is, and I was just looking about nutrition. What should I eat or drink before a booster, or can you recommend for that would be best to go there on an empty stomach, not on an empty stomach? Any advice on that level would be helpful.

Ashish Jha: Absolutely. So, what I recommend basically before any blood draw, before any infection, there's some people who are more likely to get lightheaded or dizzy, and most people don't. So, I generally recommend that, make sure you've eaten or drank water or drank juice or whatever you like to drink. Obviously not alcohol, but basically, I think in general, you should not go on an empty stomach. You should not go particularly hungry because you just don't want to then get lightheaded afterward and feel lousy. But other than that, I just think people should eat and drink normally and go, and as long as you do that, you should be just fine.

Bill Walsh: OK. Thanks very much. Gil, let's take another caller.

Gil Cabrera: Sure, Bill. We have Charlotte from Texas.

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

Charlotte: OK, yes. I had the two first COVID vaccines, but I didn't have the third one and I didn't know anything about the fourth one. So, what should I do at this point?

Ashish Jha: Yeah, Charlotte. It's a great, great, great question and the answer is simple. You just need one shot right now, which is you need to go out and get that new bivalent vaccine. You don't need to catch up; you don't need to get ones that are from prior. None of that at this point. This new bivalent vaccine that's out there, free, it's going to make a big difference for you. It's going to substantially increase your protection ’cause if you only got those initial two shots, you don't have the level of protection you really need in this fall and winter. So, I'm grateful for your calling in. And the answer is simple: You just need that new shot.

Bill Walsh: And I think you said earlier in the program, Dr. Jha, that people don't have to request it specifically, that it is the shot they will get if they sign up for a vaccine.

Ashish Jha: Yeah. If you just sign, you're signing up for a booster shot, for that additional shot, you will get the bivalent vaccine.

Bill Walsh: Got it. All right, Gil. Let's take another caller.

Gil Cabrera: Sure. Thank you, Bill. We have Frances from Kansas.

Bill Walsh: Hey, Frances. Welcome to our program. Go ahead with your question.

Frances: Hi. When I received my third shot, I had a severe reaction to it, not immediately. It wasn't until the next day, and it took about 10 days to get over it. I am very reluctant to get another shot.

Bill Walsh: What kind of reaction did you have, Frances?

Frances: Extreme pain. I couldn't, couldn't hardly move. I didn't eat for three days.

Bill Walsh: Mmm.

Ashish Jha: Hmm.

Bill Walsh: Dr. Jha, what would you … Go ahead. Go ahead, Frances.

Frances: I was just miserable.

Bill Walsh: Yeah, it sounds like it.

Frances: I was just miserable.

Bill Walsh: Yeah, it sounds like it, I'm so sorry about that. Dr. Jha, what would you say to Frances and other people who have had bad experiences like that?

Ashish Jha: Yeah. So, first of all, I'm sorry to hear it, Frances. It sounds like it was just an awful experience. I would have a conversation with your physician about this. Here's a couple of thoughts. I mean, first is, there are times when you can sort of pre-, depending a bit on the reaction, if we think there's an allergic component, you could sometimes, what we call pre-medicate people with anti-allergy medicines that can make a difference. It really can make a difference if it's allergic in nature. Obviously, given how much COVID is still out there, it is really important for people to be up to date on their vaccines. If you really … if you and your doctor just together decide you really just can't get a vaccine, then I think you should think about, there are some longer-acting what are called monoclonal antibodies. These are other ways of building up your protection. So, it's a tricky situation. I would explore this a bit more with your physician. Think about whether pre-medication with any medicines can make a difference and have that discussion. And if at the end of it you decide not to do it again, then I would make absolutely make sure that you have a good plan for how you're going to get treated if you end up having an infection in terms of Paxlovid or something else.

Bill Walsh: OK, very good. Gil, let's take another question.

Gil Cabrera: Sure thing, Bill. We have Bill out of New Jersey for us.

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

Bill: Hi, Dr. Jha. Thank you for doing this. I'm wondering if you would recommend a website that's authoritative to which things such as frequently asked questions format might be used, or some other format that allows people to use hypertext to follow into authoritative responses to reasonable questions about this, a service that you can recommend?

Ashish Jha: Yeah. I do think CDC has done a very good job of updating a lot of their frequently asked questions from consumers, from patients around vaccines and treatments. So, that's where I send people; that's where I send my family. I still think it's out there. You know, there are other good outside sources as well. A lot of like Infectious Disease Society and other clinical groups. But I really would suggest that you start at CDC and cdc.gov and look at their coronavirus information, 'cause it is still the best information out there.

Bill Walsh: Yep, cdc.gov is good, and Bill, I'd also suggest, and maybe for all our listeners, checking out AARP.org/coronavirus. We have the latest updates on vaccines, treatments and the trajectory of the virus itself. And we also have an ongoing FAQ that you can check out as well, and usually we pull our information from CDC and experts like Dr. Jha. So, I think it's pretty informative.

This has been a really informative discussion today. I want to thank Dr. Jha for all of your information insights. It's been really helpful. And I want to thank you, our AARP members, volunteers and listeners for participating 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. In the face of this crisis, we're providing information and resources to help older adults and those caring for them protect themselves from the virus, prevent its spread to others while taking care of themselves. Now, all of the resources we referenced today, including a recording of the Q&A event, can be found at AARP.org/coronavirus beginning on October 24th. Go there if your question was not addressed, and you will find the latest updates as well as information created specifically for older adults and family caregivers. We hope you learned something that can help keep you and your loved ones healthy. Please join us again November 10th for another tele-town hall on COVID-19. Until then, thank you and have a great day. This concludes our call.

[00:00:00] Bill Walsh: Hello, I am AARP Vice President Bill Walsh, and I want to welcome you to this important discussion about the coronavirus. Before we begin, if you'd like to hear this telephone town hall in Spanish, press *0 on your telephone keypad now.

[00:00:21] [Instructions in Spanish]

[00:00:21] AARP, a nonprofit, nonpartisan, membership organization has been working to promote the health and well-being of older Americans for more than 60 years. In the face of the global coronavirus pandemic, AARP is providing information and resources to help older adults and those caring for them. Cold and flu season is upon us, and it could be a particularly challenging time for older adults. COVID booster vaccination rates have dipped, and according to one survey, less than half of adults plan to get a flu vaccine. As we enter our third pandemic winter, many experts worry that vaccine fatigue may have serious consequences for people's health. The good news is that as we prepare for seasonal travels and gatherings with friends and family, there are some simple steps you can take to ensure the safety and protection of yourself and loved ones.

[00:01:15] Today we'll hear from the White House COVID response coordinator about these issues and more. We'll also get an update from Capitol Hill on legislation affecting older Americans. If you've participated in one of our tele-town halls in the past, you know this is similar to a radio talk show, and you have the opportunity to ask your question live. For those of you joining us on the phone, if you'd like to ask a question, press *3 on your telephone keypad to be connected with an AARP staff member who will note your name and question and place you in a queue to ask that question live. And if you're joining on Facebook or YouTube, you can post your question in the comments.

[00:01:55] 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 *3 on your telephone keypad, and if you're joining on Facebook or YouTube, you can post your question in the comments section. Today we have Dr. Ashish Jha, one of the leading public health experts in America, and the White House COVID-19 response coordinator. We'll also be joined by my AARP colleague Gil Cabrera, who will help facilitate your calls today. This event is being recorded, and you can access the recording at AARP.org/coronavirus 24 hours after we wrap up. Again, to ask your question, please press *3 at any time on your telephone keypad to be connected with an AARP staff member, or if you're joining on Facebook or YouTube, drop your question into the comments section.

[00:02:58] Now I'd like to welcome our special expert guest. Dr. Ashish Jha is the former dean of the Brown University School of Public Health, and he serves as the White House COVID-19 response coordinator. Welcome back to the program, Dr. Jha.

[00:03:13] Ashish Jha: Hey, Bill, thank you so much for having me back.

[00:03:15] Bill Walsh: All right, we're delighted to have you. And as a reminder to our listeners, to ask your question, press *3 in your telephone keypad or drop it in the comments on Facebook or YouTube. Well, let's get right to it, Dr. Jha. There have been some important developments recently in COVID vaccines. Let's begin, if you would, with a review of the vaccines and treatments that are available today, how they differ and why they matter. What do older adults need to know?

[00:03:43] Ashish Jha: Bill, that's a great place to start. So, the good news is that we have made an important update to the COVID vaccine for the following reason. You know, the original vaccine, which was very good, was developed an early 2020, and it targeted the virus that was circulating at the time. Well, the virus has evolved a lot in the last two and a half years — new variants, new subvariants. So, over the summer, the Food and Drug administration made a decision to make a substantial upgrade to the vaccine so it could target the virus that's circulating today. And that's what we have. And all of the evidence so far suggests it's going to do a much, much better job at protecting people against infection, against serious illness or worse. So, that's number one. And the other part of the good news here is that for most people, this is now a once-a-year shot. I do think for some vulnerable older adults, they may need shots more than once a year. But I think for a majority of Americans, it's a once-a-year shot. So, that's probably the single most important thing, and if you've not gone out and gotten this new, what we call the bivalent vaccine, this new COVID vaccine, it's really, really critical that people do so. The other thing is we also have a tremendous number of treatments that are incredibly effective at preventing serious illness and death. And so, thinking about medications like Paxlovid, we'll probably end up talking more about that in the Q&A, but it is very, very effective at preventing serious illness. I'll put it this way, Bill. We are now at a point in this pandemic where if people are up to date on their vaccines, and if they get treated if they get a breakthrough infection, no one needs to die of COVID anymore. We can prevent nearly every single death, and that is the priority of the administration, and it's certainly my personal priority.

[00:05:34] Bill Walsh: It's really remarkable. Well, let me follow up to that, given the efficacy, particularly of the new bivalent vaccine. Because we know about 80 percent of the U.S. population by now has received one dose of the COVID vaccine, but just 50 percent of vaccinated people have received a booster, and fewer still of this latest bivalent vaccine you just described. If someone hasn't had an additional vaccine since the initial cycle, what sort of protection do they have against the COVID virus today?

[00:06:06] Ashish Jha: Yeah, so as I said earlier, Bill, the virus has evolved so much. I mean, this is a very challenging virus, obviously novel, new to the human species just as of a few years ago. It has evolved so much in the last two years, even in the last year, that if you got your last vaccine a year ago, a year and a half ago, even six months ago, you're really not all that well protected. And if you got your last vaccine a year ago, you have very little protection against infection and only modest protection against serious illness. This is why we made the major update that we did over the summer, because we found that the new vaccine would provide much better protection. And the good news is not only is it much more effective, it is widely available across America. So, it's pretty easy to get, and I, at this point, just would not rely on any vaccine or infection prevention ... protection you have from, let's say, an infection you might have had nine months ago or a vaccine a year ago. It's just not going to provide the level of protection you need anymore.

[00:07:09] Bill Walsh: Yeah. Well, given the broad access and the effectiveness of the new vaccine, how do you explain the hesitancy, particularly as we're heading into fall and winter, when traditionally we've seen COVID rates, surge back up?

[00:07:25] Ashish Jha: Yeah, I don't know that I see it as hesitancy. I see people learning about the new vaccine, trying to understand the importance of these new vaccines. You know, it's just, I think it's important for us in the public health world to remind people that COVID is still here. And just as we go out and get a flu shot every year because we know that flu becomes much more of a problem in the fall and winter, it's really important for people to go out and get their COVID shot. You know, I think part of that hesitancy is the fact that COVID is no longer front of mind for everyone. I actually think that's good news. We don't need to be in that same kind of emergency “thinking about COVID all the time” phase. And if people continue to protect themselves with vaccines and treatments, we really can put COVID behind us.

[00:08:13] Bill Walsh: Yeah. Well, let's talk about those treatments. And as a reminder to our listeners, if you'd like to pose a question to White House COVID response coordinator Dr. Ashish Jha, press *3 on your telephone keypad, or drop your question into the comments on Facebook or YouTube. Now, according to a recent study by Epic Research, infected patients treated with Paxlovid are about two times less likely to be hospitalized and about four times less likely to die. Antivirals were held as a game changer, but few people are taking them. Why do you suppose that is?

[00:08:46] Ashish Jha: Yeah, so it's a great question. The data on antivirals like Paxlovid is actually overwhelmingly clear, and it is very good data; it's very compelling data. I think we know this with medicines in general, that whenever new medicines are introduced, it takes doctors a while to start using them and getting comfortable with them. Obviously, this is a new pandemic and a new virus, and these treatments are about now they've been available for about 10 months and doctors are still getting comfortable using them. But I will tell you, my elderly parents were in their 80s, got COVID over the summer, and they both called me. They got it at the same time. They called me and the first thing we did was put them on Paxlovid because the data on this is not subtle, Bill. It's not a close call. What we know is that it's so clear that if you get on Paxlovid, you will not end up in the hospital or your risk of ending up in the hospital goes way down, and your risk of ICUs or death just dramatically plummet. Really, really effective.

[00:09:49] Bill Walsh: Well, it sounds like your parents took your advice. What would you say to other older Americans, particularly those over 65 who have COVID, about whether to get Paxlovid, and what should they consider as they're thinking that through?

[00:10:03] Ashish Jha: Yeah, and as you might imagine, Bill, my parents don't always take my advice, but I'll ...

[00:10:09] Bill Walsh: Well, and you didn't always take their advice, I imagine, either so …

[00:10:11] Ashish Jha: That is also true. What comes around goes around on these things. No, but here's my advice to people over 65. First of all, I think everyone over 65 should get treated. But if Paxlovid is not the right drug, there are other options as well. Paxlovid is first line, but there are other options as well. There are other oral antivirals, like one called Lagevrio, this monoclonal antibodies, so there are other choices as well. The second thing I would say is you got to talk to somebody, and you got to talk to somebody early. So, what happens often is you're 65, 70 years old, you get COVID, you don't feel great for a day or two, but the first couple of days are not so bad and maybe it's just a mild cold. You don't call anybody; you don't call your doctor. By the time the symptoms get really bad, it might be day five or six, and if you're calling your doctor at that point, you might be getting out of the window where Paxlovid is really useful. So, what I recommend, and what I did with my parents, is even if the symptoms are mild — because what we know is that symptoms can get worse later and you may miss the window for treatment — treatment is best when it's early. If you, the moment you get infected, I believe that if you're over 65, you've got to get it. So, what do you do? Call your doctor. OK, so what if you're having a hard time reaching your doctor, or you may not have a primary care physician, or you may not have somebody you can reach? There are other options. You can go to COVID.gov. We have lists of literally thousands of test-to-treat sites. Every state has them. You can go to these test-to-treat sites. They verify you're positive, and they can give you treatment right away. There are clinics like CVS and Walmart and Walgreens that have them. So, there are multiple options. The key is, be persistent, and if you are over 65, I really believe at this point the standard of care is you need to be getting treated If you get COVID.

[00:12:08] Bill Walsh: OK. Now one other question I had on Paxlovid is, despite its effectiveness, recent reports suggest that it could have interactions with some common heart medications, including blood thinners and statins. Is this a concern? And when seeking treatment, what would your advice be to someone who gets COVID and is on heart medication?

[00:12:28] Ashish Jha: Yeah, this is why it's really important to talk to your doctor or talk to a pharmacist, by the way. Pharmacists are terrific at understanding these issues. Here's how I would think about it. There's a series of heart medicines that are not a big deal to stop for five days. So, the way you handle some things is — and we do this all the time by the way, when an older American, let's say, gets admitted to the hospital and they need a procedure, we stop certain medicines for five days. Not a big deal. But other medicines, stopping it for five days can be more of an issue. So, this is why that conversation with the physician is so important. I think the vast majority of the times, 90-plus percent of the time, you can find a way to take Paxlovid safely and not be a big deal. If you find yourself in that rare circumstance where your physician feels like you just, let's say you're on a blood thinner and they just don't think you can stop that blood thinner for five days, then you have those alternatives, Legavrio, the monoclonal antibodies. So, everybody should get treated with something. If you're in that rare circumstance where you really just cannot take Paxlovid, then there are other options for you as well.

[00:13:30] Bill Walsh: OK. Very good. Well, I've asked enough questions for now. Let's go to our phones and take some questions from our listeners. It is now time to address all of your questions or as many as possible about the coronavirus with the White House COVID response coordinator, Dr. Ashish Jha. As a reminder, press *3 at any time on your telephone keypad to be connected with an AARP staff member to get in the queue to ask your question live. And if you'd like to listen to this program in Spanish, press *0 on your telephone keypad now.

[00:14:04] [Instructions in Spanish]

[00:14:09] And now I'd like to bring in my AARP colleague Gil Cabrera to help facilitate your calls today. Welcome, Gil.

[00:14:17] Gil Cabrera: Bill, thank you very much. I'm thrilled to be here for this important conversation, indeed.

[00:14:22] Bill Walsh: All right. Who is our first caller?

[00:14:25] Gil Cabrera: Well, our first caller is Steve, who's calling from New Jersey, Bill.

[00:14:29] Bill Walsh: All right, Steve. Welcome to our program. Go ahead with your question.

[00:14:33] Steve: Thanks and thanks for taking my question. I'm 68 years old. I had the two Moderna original vaccines and the two boosters. I still got COVID late this past August … and I took Paxlovid, too, and my symptoms were mild. My question is, a lot of what I've read says if you had COVID with this new bivalent booster, you should wait three months to get that booster. So, my question is, your thoughts on that, waiting the three months?

[00:15:07] Bill Walsh: Yeah, Dr. Jha.

[00:15:09] Ashish Jha: Great question, Steve. First of all, thank you for doing everything you can to keep yourself protected and healthy. Look, it's a very tough virus, and the truth is, even with keeping up with your vaccines, you can get breakthrough infections. But the good news is, because of the fact that you are up to date on your vaccines and took Paxlovid, it sounds like you had a mild course, and that's what we want for everybody. Now, to your question, how long to wait after infection? I think three months is perfect. FDA has said that you need to wait at least two months. I think that's right. But my general recommendation to my friends and family has been, wait three months. If you got either your last vaccine or your last infection, wait three months. Why? What you're doing is you're letting your immune system mature. Your immune system is still quite revved up from that prior infection, and giving it a little bit of time actually will make the vaccine more effective. So, I believe three months is exactly the right time to do it. And if you got it in August, you'll be able to get it sometime in late November. And that means that by the time holidays roll around, you'll really be getting the benefit, the maximum benefits, of that vaccine.

[00:16:18] Bill Walsh: Great. Thanks so much for that. And look, I know it's still early days on this new bivalent vaccine, but do we have a sense of how long the immunity lasts?

[00:16:29] Ashish Jha: We don't know, and this is part of the challenge of new … of the virus evolving and vaccines coming on is we don't … the longer-term stuff will take a little longer. What I suspect is, when you saw with prior vaccinations, you did see that waning of immunity, and part of it was because the virus had evolved so far away from the vaccine. And that, from a biological point of view, means, given these new vaccines so tightly target the virus that's out there, that we should see more durable protection. It should last meaningfully longer both against infection and serious illness. We just don't know how much longer. We don't know exactly how much more durable, but all of the evidence so far suggests it really should do that.

[00:17:17] Bill Walsh: OK. Very good. Gil, let's take another caller.

[00:17:22] Gil Cabrera: Sure. Bill, we have Sophia via Facebook. She is asking, "Do we have to specifically ask for the new vaccine when we schedule an appointment for a booster?"

[00:17:32] Ashish Jha: You should not have to, because when FDA made this change and authorized the new bivalent vaccine, it de-authorized, or got rid of, the prior vaccine as a booster. So, at this point, there's only one booster option for older Americans, for actually, for basically, all adults. And so if you go and make an appointment and say, “I'm here for my additional shot, my booster shot, my annual COVID shot,” you should get the bivalent vaccine.

[00:18:02] Bill Walsh: OK. And Dr., I wonder if we've heard anything about side effects for the bivalent vaccine.

[00:18:08] Ashish Jha: Well, so far, and I'll start with my own personal experience, you know, I got both the flu shot and the COVID shot, and at the same time, same arm. My arm was a little sore for about 24 hours, but other than that, I felt fine. I think the evidence so far suggests that the side effects are really quite mild. You know, people know them. Some people do end up having a difficult 24 hours where they may feel some aches and chills, but a vast majority of people have very mild things, a little redness at the site sometimes. A sore arm is very common, usually lasts about 24 hours.

[00:18:43] Bill Walsh: Got it. All right. Gil, let's take another call.

[00:18:48] Gil Cabrera: Sure thing. Bill. We have Patricia from Illinois.

[00:18:51] Bill Walsh: Hey, Patricia. Welcome to our program. Go ahead with your question.

[00:18:56] Patricia: My question was, I am 76 years old. I have not eaten in a restaurant since the beginning of COVID, and my husband is asking me if I want to go to a restaurant today for lunch. And I'm wondering how much risk it still is to go to a restaurant to eat. I have several immune compromising things. I'm on a CPAP, and I have third-stage liver disease, no cancer, and am hemolytic anemia, so forth. Oh, I'm diabetic. I'm wondering how risky it is to go to a restaurant to eat at this point.

[00:19:39] Bill Walsh: Dr. Jha, very timely question for Patricia, but I think it, it speaks to a question on a lot of people's minds, how freely should they feel to get back out in public, and if they do, what steps should they take?

[00:19:50] Ashish Jha: Yeah, it is a very good question. So, I'll start off by talking about both myself and my elderly parents. I didn't really eat much in a, certainly not indoors in a restaurant for most of, I'd say all of 20, and much of 20, or early part of 2021. But certainly this year I have started doing it again, and I actually had dinner with my elderly parents inside a restaurant. Two things. First of all, it is a little bit of more risk. Look, it is very hard to get to zero risk with this virus. It's everywhere. So, definitely is a bit more of, and the reason is because obviously in the restaurant, people are eating, drinking, no one's wearing a mask. But the bottom line is, I think the risk of, especially if you're up to date on your vaccines, the risk of getting COVID is relatively low and then the bottom line is that even if you end up getting infected —and again, one dinner is unlikely to get, or lunch is unlikely to cause that — but if you do, you do have a lot of very good treatments available. So, I believe that at this point, for most people … Now I do want to caution, Patricia, you mentioned that you have some specific health issues and obviously, I'm not your personal physician, so it's hard for me to assess for you how significant those are. It's worth having that conversation with your doctor, but I do think for most people, including people who have health problems, we're at a point where eating at a restaurant is reasonably safe. There is a small risk of getting infected, as there's always been, by the way. There's been a small risk of getting infected with flu in the past. But the good news is, if you're up to date in your vaccine, your risk of getting serious is very low, and then you throw in treatments on top of that, and boy, it just, the chances you'll end up having a bad outcome from it is extremely, extremely low.

[00:21:34] Bill Walsh: Right. OK. Thanks for that, Dr. Jha. Gil, who is our next caller?

[00:21:40] Gil Cabrera: Well, we have via YouTube Lon asking the following question, Bill. "How far ahead of a trip should I get a booster shot?"

[00:21:50] Ashish Jha: Ah, great question Lon, and I would say that what we know is that about two weeks after you've gotten your shot is when your antibodies have really sort of kicked up. So, you need, I mean, and again, that starts increasing after seven to 10 days. You start getting some benefits for probably two weeks, is kind of the maximal time, and then it stays up for a while and then it will slowly decline. So, this is why, for instance, I have said to people that if you have not gotten your new COVID vaccine, your bivalent vaccine, Halloween is a really good target time to by which to get it, because if you get it by Halloween, which is only about 10 days away, you'll be in really good shape for Thanksgiving. And you should be in very good shape for the holidays and the time that follows. So, it's hard to time these things perfectly, but I would say you want to give your immune system at least a couple of weeks to sort of maximize that protection.

[00:22:47] Bill Walsh: Yeah. Thanks for that, doctor. You mentioned earlier that these vaccines continue to be free. Will they be free even in the new year?

[00:22:56] Ashish Jha: Yeah. So, in the beginning of the new year, they will be. Well, the U.S. government, we bought a good number of doses ’cause we thought it was very, very important for Americans to have, continue to have free access. Congress has stopped funding the COVID response now, as of about six, seven months ago. So, we've been pulling resources out of many other programs to try to make sure we have enough vaccines and treatments. Next year, we will move to commercialization because we are out of resources, and that means it'll start going through your health plan. Vaccines should remain free because the Affordable Care Act, Obamacare from many years ago, one of its stipulations was that preventive things like vaccines should be free. So, vaccines should remain free. What we're trying to do is figure out how do we make sure there are not cost barriers to treatments. But that's all next year and probably later part of next year. Right now these vaccines are free, and I think in early part of '23 you're going to see it continue to get, be free.

[00:23:58] Bill Walsh: OK. Very good. Gil, let's take another call.

[00:24:02] Gil Cabrera: Of course, Bill. We have Maria from Michigan.

[00:24:05] Bill Walsh: Hey, Maria, welcome to our program. Go ahead with your question.

[00:24:08] Maria: Hi. My 57-year-old husband was vaccinated and boosted on schedule. He was also religious about COVID protocols. He wore a mask all day at work and anytime he left the house. He was obsessive about washing his hands, and yet he got COVID in mid-August, and then again in early October. And the only possibility we can find in looking at the calendar is that this last infection, three or four days before the very first symptoms, he picked up groceries from Walmart. You know, it could have been anywhere, but from a grocery pickup service. Have we learned anything new about how the virus is transmitted, and should we still be wiping off our groceries?

[00:25:07] Bill Walsh: That's a great question. Dr. Jha, can you address that from Maria and others who might have the same concern?

[00:25:11] Ashish Jha: Absolutely. I'm happy to Maria, and I'm, first of all, I'm sorry that your husband got infected, especially twice. I hope he's doing OK. Here's what we know. We've actually learned a lot. In general, you can't, or you don't get this virus from surfaces, and therefore, you don't need to be wiping down groceries. And handwashing is a good public health measure all around, but it's not particularly different for COVID. What I think is most important is to understand that COVID is spread through the air, it's an airborne illness, and therefore where COVID spreads is in indoor spaces where lots of people are gathered, especially if it's poorly ventilated spaces. That's where we tend to get most of the spread. We get very little spread outdoors. And again, so what I have recommended now for a year-plus is you don't need to wipe down groceries; you don't need to wipe down anything. Washing hands is always a good idea. It just keeps lots of other bugs out of your system, so that's good. But the key here is, good ventilation, being outdoors, always healthier and safer. If you're going to be indoors, if it's super packed, if it has lots of people, wearing that mask can make a big difference. So, again, I'm not sure where your husband specifically got it. I doubt he got it from the groceries. It really just doesn't spread by surface.

[00:26:31] Bill Walsh: Hmm. I wonder if Maria's husband's experience might speak to how the virus changes over time. I mean, we know even as we speak, it's changing. And do you think it's possible that he got a new strain that wasn't … the vaccine wasn't as protective at preventing spread?

[00:26:53] Ashish Jha: Yeah, absolutely, Bill, and I actually thank you for raising that, because I think that is likely what happened. What we know, again, remember the original vaccine was built against that Wuhan strain from 2020, and by the time we got to August — and, again, I don't know the specifics of Maria's husband — but he probably got infected with a BA.5 strain. And BA.5 strain is very immune evasive, and the old vaccines, while continuing to be good at preventing serious illness, just weren't that effective, weren't as effective at preventing infection. Clearly, there had been a diminishing of that protection. This is why we updated to a bivalent vaccine to make it specifically protective against BA.5. It's a reminder the virus continues to evolve. It's continuing to always look for ways around the wall of immunity that we have built up through vaccinations. But I always say the virus is wily and tricky and it does its thing, but humans have a lot of ingenuity, too, and we can counterattack. And so when the virus changes, well, we can update our vaccines to make them more effective. And that's what we've done with the current vaccine.

[00:28:05] Bill Walsh: All right. Very good. Gil, let's take another question.

[00:28:10] Gil Cabrera: Sure. Bill, we have Lisa coming to us from New York.

[00:28:14] Bill Walsh: Hey, Lisa, welcome to our program today. What's your question?

[00:28:18] Lisa: Yes, hi. With Thanksgiving around the corner, my husband and I have been both vaccinated, boosted. We're 70 years old and we were invited to Thanksgiving dinner. There will be about 12 people there, and we're just wondering how safe it is to attend. Should we request that the other guests be tested before they come? Or do you feel it's safe enough to go, and of course, it's going to be indoors.

[00:28:51] Bill Walsh: Very timely question.

[00:28:52] Ashish Jha: Very timely question, Lisa, and a very good question. So, here's how I think about it. There's no, there are no guarantees, right? If three years ago you had gone to that Thanksgiving dinner you could have picked up the flu or RSV, so that's always out there and a possibility. The key in my mind is, you want to make sure that that Thanksgiving event is as safe as possible without causing a lot of disruption. And the most important thing is, obviously, for you and your husband, to make sure that you are updated on your vaccines with this bivalent vaccine. I think that's sort of critical step number one. Number two is, I think testing can be helpful. We actually know very good data that before gatherings, if people test, this dramatically reduces the risk of infection. These tests are widely available, actually free if you are on Medicare or on private insurance. You can go to a CVS or a Walgreens and say, “I would like my eight free tests per month.” That's something that the government has pushed the insurance companies to make available, so they are easily available. And I'll tell you, is it necessary? Well, it just reduces the risk. So, even if the risk wasn't high, I think it just adds one more layer of protection. Not critical, but I'll tell you, in my family, we're getting together for Thanksgiving — my brother and his family, my wife and I, and our kids with my elderly parents. There'll be about 12 of us. And my plan is, we'll just get everybody a test that first morning just to make sure nobody's got the infection. It's just adds one more layer of protection.

[00:30:28] Bill Walsh: All right. Thanks for that. And thank you to for all your questions. We're going to take more of our listener questions shortly. But before we do, let's get an update from Capitol Hill on important legislation that's affecting older adults. You know, in addition to sharing information and resources, AARP advocates for issues that affect you the most. To give a quick update on how AARP is fighting for you, I want to bring in AARP executive vice president and chief advocacy and engagement officer, Nancy LeaMond. Welcome to the program, Nancy.

[00:31:00] Nancy LeaMond: Well thanks, Bill. Happy to be here.

[00:31:01] Bill Walsh: I want to ask about a few important issues, but let's start with some good news. Of course, this past August, historic prescription drug reforms were passed in the House and Senate and signed into law. Can you discuss what it means for people?

[00:31:15] Nancy LeaMond: Sure. Prescription drug pricing reform is a huge victory for older Americans. After decades of calling on Congress to make prescription drugs more affordable, AARP won the fight to let Medicare negotiate lower drug prices and for other policies that will save seniors money on their medications. So, for example, the new law caps the cost of Medicare-covered insulin at $35 a month, and eliminates out-of-pocket costs for most vaccines under Medicare, such as the shingles vaccine. There also is going to be an annual $2,000 limit on how much Medicare Part D beneficiaries pay out of pocket for their prescriptions, and drugmakers that increase prices faster than the rate of inflation will be penalized. These are huge wins for us, and we know how important the cost of drugs has been to seniors.

[00:32:10] Bill Walsh: That sure is. That's terrific news. Now, in addition to Medicare, Social Security is another top priority for AARP, and there's also good news there, isn't there?

[00:32:22] Nancy LeaMond: Yes. Social Security recently announced an 8.7 percent cost of living adjustment, the largest COLA increase in 41 years. AARP has fought long and hard to protect Social Security COLAs so seniors can keep up with rising prices. This increase will provide much-needed relief to millions of Americans struggling with higher food, health care and, of course, other costs. We're also urging Congress to work together in a bipartisan way to protect and strengthen Social Security for the long term.

[00:32:58] Bill Walsh: OK. Thanks so much. Now, of course, we're in the middle of an election season right now. What is AARP's focus heading into the November election.

[00:33:08] Nancy LeaMond: Well, first, I want to remind folks that AARP is, and always has been, strictly nonpartisan. We don't endorse or give money to political candidates, parties or campaigns. During election years we focus on making sure that candidates pay attention to older Americans and address the issues that are important to them. And in all recent elections, we fully expect age 50+ voters to make up the majority of the electorate in November. We're also making sure our members and broader constituency know how, where and when to vote. Listeners can visit AARP.org/vote to find details about how to vote in their state.

[00:33:50] Bill Walsh: OK. Very good. Now, before I let you go, I want to talk to you about the current state of COVID in America's nursing homes. For those living and working in skilled nursing facilities, this pandemic is far from over, isn't it?

[00:34:04] Nancy LeaMond: Well, sadly, that's correct. AARP's Nursing Home COVID Dashboard shows us that transmission in nursing homes remains significantly elevated compared to the rest of the population. One of the most important things people can do is make sure their loved ones are vaccinated and have gotten the recommended boosters. Nearly half of residents and more than half of staff are not up to date with their shots, and this could have deadly consequences as we head into the cold and flu season. Please don't take for granted that your family member has received theirs. Follow up with their care provider and make a plan.

[00:34:45] Bill Walsh: All right. That sounds like good advice. Thanks so much for being here today, Nancy. And if our listeners want to stay on top of a AARP'S advocacy news, how can they find out the latest?

[00:34:56] Nancy LeaMond: Well, we encourage everyone to go online and search AARP Fighting for You. That will lead you to a daily roundup of all the latest advocacy news on our work with Congress and across the country.

[00:35:08] Bill Walsh: Very good. AARP Fighting for You. Thanks so much, Nancy. Have a great day.

[00:35:13] Nancy LeaMond: Thanks, Bill.

[00:35:14] Bill Walsh: All right. Now let's turn back to our expert guest, Dr. Ashish Jha, the White House COVID 19 response coordinator. Dr. Jha, we were talking about variants earlier, and each subsequent variant of COVID-19 has seemingly been less severe than the earlier ones. Why is that, and could it change?

[00:35:34] Ashish Jha: That is a very good question, Bill, and the answer is, it could change. So far there are two reasons why the current variants seem to be less severe. One is there is so much immunity out there that a lot of the infections that are now happening, most of the infections are happening, in people who have immunity. Either they've been previously infected, or they've been vaccinated. And so if you're vaccinated, you're going to have a milder course. And since a lot of people are vaccinated, it appears that this version of the virus is milder. The second is that there is laboratory evidence that this virus, this version of the virus, the omicron version, is milder. We don’t know how much milder — maybe 20 or 30 percent, not dramatically milder — but it is, and that’s also good news. So, inherently milder and the underlying immunity. The problem is that if you think about viruses over the long run, there's a belief out there that viruses always become milder over time. Unfortunately, that's just not true, as much as we wish it were the case. We've seen this with lots of viruses. The Ebola virus that's circulating today is no milder than the one that was there 30 years ago. Influenza, some seasons it's very severe; other seasons, it's mild. So, we don't know if the next variant of COVID will end up being milder, the same or even worse. And so we always are thinking about it and preparing for all of those potential outcomes.

[00:37:00] Bill Walsh: OK, well, let's talk about the effects of a COVID infection. You know, the possibility of stroke, heart attack, type 2 diabetes and more issues are elevated after a COVID-19 infection, even in mild cases. I wonder if you think whether older adults fully understand the complete risks of a COVID infection.

[00:37:22] Ashish Jha: Yeah, this is a really important issue because often we talk about the bad outcome being death, which of course is the worst outcome of all. So, very, very important that we track that. But what we have seen is a lot of people who end up, after a COVID infection, they recover, but you look out to the next six months, clearly elevated risk of stroke, heart attack, a lot of the things that you mentioned. Partly because the virus actually damages the vascular system and therefore really triggers the kind of risk of those strokes and heart attacks. A lot of people end up having significant pulmonary symptoms afterward because even if the initial infection looked mild, it still caused damage in the lung. So, we have to take it seriously, and this is why we think it's really important to stay up to date on your vaccines ’cause one of the things we have seen is, if you're vaccinated, you're much less likely, if you get infection, you're much less likely to have long COVID. And even if you have long COVID, it's to be quite mild, relatively speaking. So, vaccines don't just prevent serious illness and death. They prevent a lot of those long-term complications as well.

[00:38:37] Bill Walsh: Hmm, great point. Now, as you said, I mean, we know from hundreds of millions of COVID vaccines administered that they have a remarkable track record of effectiveness. What can you tell us about the effectiveness of the flu vaccine this year? Of course, it changes every year. And what can you also tell us about the high-dose flu vaccine that we've heard about?

[00:38:57] Ashish Jha: Yep. Two good questions. So, the flu vaccine does change every year because flu changes every year. And you know what, I do think by the way, we're kind of heading toward the same thing with COVID, where you're just going to have an annual shot for most people. With the flu vaccine, actually, it's tougher to make those guesses about exactly what strain will be circulating. And a group of scientists make that prediction late in the spring, and then some years they get it really right, and some years it's off. Early, early data, Bill, and I don't want to overstate it because we don't know for sure, but early data suggests this year's flu vaccine may be actually quite good, may be quite on target with the version that's circulating. So, I'm cautiously optimistic that that's where the data will come in, that the vaccine effectiveness against infection will be quite high. Now, in terms of the specific vaccine that is recommended for older Americans, for people over 65, there's something called Fluzone, it's the high dose of the [inaudible] . It's a quadrivalent vaccine. It sounds complicated. But basically what it is, is it's got four times the antigen— that's the thing that your immune system recognizes. And it's just much more effective, especially for older Americans. So, the strong recommendation, my personal recommendation to my family and friends, has been if you're over 65, what I tell them is get the high-dose quadrivalent vaccine. If for some reason you can't access it — and most places have it, but not all — the regular flu vaccine is still way better than not getting vaccinated at all. But if you can get that high-dose quadrivalent vaccine, it's called Fluzone, it is really worth doing.

[00:40:43] Bill Walsh: OK, well, just 49 percent of U.S. adults plan to get a flu vaccine this fall, according to a survey commissioned by the National Foundation for Infectious Diseases. Why do you suppose that is, and what is the risk of skipping the flu vaccine?

[00:40:59] Ashish Jha: Yeah, so I think there's a little bit of misinformation out there. There's some people who think, Well, maybe I'll get the flu from the flu vaccine. You can't get the flu from flu vaccine any more than you can get COVID from the COVID vaccine. That's just not how it works. They're not, you know, the virus can't, in the flu vaccine case, the vaccine just can't give it to you. And there's no virus in the COVID vaccine. So, that's point number one. You can't get the flu from the flu vaccine. OK. Second point is a lot of people say, “Well I haven't had it, or I had it and it was fine. It was mild.” You know, my take is, sure, it's entirely possible that you had it and it was mild in the past. There is no reason to assume that your next one will not be more severe. And, in terms of the consequences of not getting it, I will put it this way. I have been a practicing physician for 20 years, and every winter I'm in the hospital, December or January, taking care of hospitalized patients; hospitals are just full. I find people having to wait in the emergency room for three days before they can get a hospital bed, and all of it, a large chunk of it, is triggered by influenza. People don't get vaccinated. They get the flu. They end up having a severe case that they weren't expecting. Then they end up having all sorts of problems with their heart, their kidneys, other things. So, such an easy intervention. You can walk into any pharmacy today and get it. It's free again, because as you heard from Nancy LeaMond, the great work of AARP and others, we really do believe that these things should be free, and certainly the administration's been very focused on that. So, it's free, it's widely available. And my gosh, if it prevents you from getting hospitalized or worse, this feels to me like people need to do this.

[00:42:48] Bill Walsh: All right. Now I believe you mentioned earlier that you got your flu vaccine at the same time that you got that bivalent vaccine. So, I assume that's recommended protocol for all Americans. I wonder, what about other vaccines, such as the ones for shingles? Should people go in and be asking for multiple vaccines at the same time?

[00:43:08] Ashish Jha: Yeah, it's, I'll tell you, I think the answer is yes, and I'll explain why. First of all, totally safe and just as effective. Like, there's no problems with it from a safety or effectiveness point of view. And the reason is, your immune system is remarkable. Its ability to recognize multiple different vaccines and mount a really good response against all of them is quite, quite good. We see this in kids where — I remember when my kids were young, we take them to the pediatrician's office and they get four shots and they're in one visit. And the kids didn't love it, but we loved it because it was convenient. You just get all those shots done in one visit. That's the main reason I recommend it is, I went one day on, I think it was a Friday, and I got both shots in the same arm and then I was just done. I was done. I don't have to go back and do a second visit. So, again, safe, easy and so convenient. So, I generally recommend, there's no problem with getting multiple shots at once.

[00:44:06] Bill Walsh: OK. Now, let me shift gears. I want to talk about an issue that's really top of mind for a lot of our members, and that's hearing aids. We know the cost of hearing aids is substantial, but, of course, the FDA recently approved the sale of over-the-counter hearing aids. How big a deal is this, and what should people know about it?

[00:44:28] Ashish Jha: Yeah, I have to tell you, I am very excited about this. And again, I know I keep bringing back my elderly parents, but you'll let me do it one more time, if you don't mind, Bill. You know, my parents, my dad spent thousands and thousands of dollars on hearing aids over the years, and they're just, they were so expensive, and it just didn't make any sense to me that they were as expensive as they were. And what happened was in 2017, Congress passed bipartisan legislation, but nothing really happened, saying that basically that hearing aids could move to over the counter. Not much happened in the few years that followed, but when President Biden came in, he made this a priority and basically said to the FDA, “Let's get this done. Let's get it done.” And so just this past week, we saw all of the major retailers bring hearing aids onto their shelves. So, Walgreens, Walmart, Sam's Club, Best Buy, so many more. And these hearing aids, as I said with my dad's experience, they cost thousands and thousands of dollars. Right now we're seeing hearing aids in these places for $200, $300. And the other thing I'll tell you, which excites me, is it's not just going to be cheaper. Some of the major audio companies, Bose and others, are saying they're going to get into this business. So … I think what's going to happen is we're going to see hearing aids, the prices continue to come down. We're going to see quality continue to go up. I think this is really important, and it's a long time coming, and I was so grateful for the president ’cause he — again, the legislation had been passed. He really said to the FDA and to his administration, “Enough is enough. Let's get this done, and this now is going to be out there.”

[00:46:11] Bill Walsh: OK, very good. Great news for consumers. Let's take some more calls from our listeners. As a reminder, press *3 at any time on your telephone keypad to be connected with an AARP staff member and get into the line to ask your question live. Gil, who do we have in line now?

[00:46:30] Gil Cabrera: Bill, we have Susan coming to us from Alabama.

[00:46:34] Bill Walsh: Hey, Susan, welcome to our program. Go ahead with your question. Susan, go ahead with your question.

[00:46:43] Susan: My question is, if you haven't had any vaccines, where do you start?

[00:46:49] Bill Walsh: Hmm. Dr. Jha.

[00:46:50] Ashish Jha: Good question, Susan, and the answer is, you just go ahead and get started. I think you can, basically, I appreciate the question. I think there are obviously still about 10 to 15 percent of Americans, adults who have not gotten vaccinated at all. And when I talk to them, and when they're ready to get vaccinated, which I'm always grateful when they are, I say, you just, you get started. You've got to get that primary series, that first of the first two shots, and the reason that's really important is that sort of creates the base of your immune system against this virus. So, still widely available. You just call up CVS, Walgreens, the, Highmark, whatever's near, Albertson's. Almost all of them still have it. Call them up, say, “I'm ready to get my primary series going,” and then you get vaccinated.

[00:47:41] Bill Walsh: OK. So, that's a very interesting point. So, she shouldn't ask for the new bivalent vaccine. She should ask for the original dose of the vaccine.

[00:47:52] Ashish Jha: Yeah, the original primary series is still what FDA's recommending for people who are [n’t] vaccinated. And the reason, Bill, is that that original series really created this broad base of immunity that's going to be very, very important for people. So, that's what's still recommended. Down the pike, we may see changes on that, but right now, that's what's still recommended and that's what I still recommend for people.

[00:48:15] Bill Walsh: OK. Thanks for that. Gil, who do we have up next?

[00:48:20] Gil Cabrera: Well, via our YouTube channel, Bill, we have Evelyna. She is asking a two-pronged question, which is, "What is causing the variant, and is it true that those who are not vaccinated are the ones that are creating the new variants?"

[00:48:36] Bill Walsh: Hmm. Dr. Jha?

[00:48:39] Ashish Jha: Those are very good questions. So, what is causing the variant is essentially its evolution of a virus that, as I said, has turned out to be a very, very formidable foe. You know, as we've gotten people vaccinated, as people have gotten infected and have started building up that population immunity, it creates this pressure on the virus to evolve because by evolving, it can try to get around that immunity. And there's no question about it that a lot of the infections that are leading to variants are happening in people who are not fully protected, whose immunologic status is not fully up to date. They may be immunocompromised, they may not have gotten their vaccines, and they often are the source of a lot of the variants. So, it's a complicated picture. You know, one of the things that's really important is that if everybody kind of got up to date on their vaccines, it would definitely dramatically reduce infections. It would keep the number of variants down. But it's … the problem, always remember, is it's not just what's happening in the United States that matters. This is a global pandemic, and so we can even do great work here in improving our vaccinations, and we're continuing to work on that. If there are large pockets of the world where people are under-vaccinated, they can become sources of variants too.

[00:49:59] Bill Walsh: OK, Gil, let's take another call.

[00:50:03] Gil Cabrera: Sure, Bill, we have Kim from Maryland.

[00:50:05] Bill Walsh: Hey, Kim, welcome to our program. Go ahead with your question.

[00:50:09] Kim: Yes, I've been double-vaccinated and double-boosted and all with Moderna, but this bivalent is, I don't know by who. And I tend to have allergic reactions to medications, so I haven't had any, so far, and I'm wondering what it'll do to mix it, because I've been getting numerous phone calls from, reminder calls to come and get this fifth shot.

[00:50:40] Bill Walsh: Hmm. Thanks for that question, Kim. Dr. Jha, can you address that. We haven't really talked about folks who have had allergic reactions or who makes the bivalent vaccine.

[00:50:50] Ashish Jha: Yeah, thank you. Thank you, Kim, for that fantastic question. So, two things. Two companies make them; they're the same two companies that were making the vaccines that most of us got, Moderna and Pfizer. The risk of allergic reaction was something we worried about for that initial shot, that first shot. What we have found is, a tiny portion of people have that allergic reaction to that first. If you didn't have it to the first, there was little to no chance you were going to have it to the second, third or fourth. It's also very safe to mix it up, meaning again, Moderna before, get Pfizer now. You know, what I would say to you, Kim, is I'd be pretty comfortable that the Pfizer, if you had a Pfizer bivalent, that would be fine. But if you said, “Look, I've gotten four Moderna shots and I'd like to get another Moderna,” that's more than reasonable. And they're both widely available now. So, some pharmacies carry one, others carry others. So, you may have to just do a little bit of sleuthing around and looking around to see who's got the Moderna one. But they're definitely out there and in lots and lots of places.

[00:51:52] Bill Walsh: But it sounds like it doesn't really matter, right, which version of the bivalent vaccine Kim or others got. They don't have to … they could mix and match, is what I'm saying.

[00:52:02] Ashish Jha: Absolutely. And so much so that the day I got my bivalent vaccine, I didn't even know which one I was going to get, and when I was sitting there in the chair and the nurse was about to give me the injection, I asked her which one I was getting, and she told me it was Moderna. And I said, OK. But clearly, it didn't make any difference to me. I only found out about it about 10 seconds before the injection went in.

[00:52:24] Bill Walsh: Now, did they keep you there after you got the shot? I know originally when we got the vaccines, they wanted to monitor you for 15, 20 minutes to see if there was an allergic reaction. Are they still doing that?

[00:52:35] Ashish Jha: You know, some places are still doing that. They didn't. I got mine at a health clinic in Washington, D.C. They didn't for me. I think a lot of places still ask people to just be there. I mean, I've been to CVS where, or I think Walgreens, where they say to people, “Hey, just stay in the store. Don't go out,” because they just want to make sure. But these things are so rare now. If you didn't have an allergic reaction initially, the chances you're going to have one now are just so exceedingly low.

[00:53:05] Bill Walsh: OK. Gil, let's take another question.

[00:53:09] Gil Cabrera: Sure, Bill. We have Natasha with us from Tennessee.

[00:53:12] Bill Walsh: Hey, Natasha, welcome to our program. Go ahead with your question.

[00:53:16] Natasha: Yes, hi. Thank you for taking my question which is, I'm getting ready to go for my Moderna booster. I've done all the series up till now and in about an hour, and I am using the local CVS, and they've really are perfecting their app. So just to mention that, so you can make an appointment, and then now I just got an alert saying, “Please let us know when you're in the store” so they can prepare for me.

[00:53:45] Bill Walsh: Wow.

[00:53:46] Natasha: So, the question is, and I was just looking about nutrition. What should I eat or drink before a booster, or can you recommend for that would be best to go there on an empty stomach, not on an empty stomach? Any advice on that level would be helpful.

[00:54:06] Ashish Jha: Absolutely. So, what I recommend basically before any blood draw, before any infection, there's some people who are more likely to get lightheaded or dizzy, and most people don't. So, I generally recommend that, make sure you've eaten or drank water or drank juice or whatever you like to drink. Obviously not alcohol, but basically, I think in general, you should not go on an empty stomach. You should not go particularly hungry because you just don't want to then get lightheaded afterward and feel lousy. But other than that, I just think people should eat and drink normally and go, and as long as you do that, you should be just fine.

[00:54:47] Bill Walsh: OK. Thanks very much. Gil, let's take another caller.

[00:54:51] Gil Cabrera: Sure, Bill. We have Charlotte from Texas.

[00:54:54] Bill Walsh: Hey, Charlotte, welcome to our program. Go ahead with your question.

[00:54:58] Charlotte: OK, yes. I had the two first COVID vaccines, but I didn't have the third one and I didn't know anything about the fourth one. So, what should I do at this point?

[00:55:14] Ashish Jha: Yeah, Charlotte. It's a great, great, great question and the answer is simple. You just need one shot right now, which is you need to go out and get that new bivalent vaccine. You don't need to catch up; you don't need to get ones that are from prior. None of that at this point. This new bivalent vaccine that's out there, free, it's going to make a big difference for you. It's going to substantially increase your protection ’cause if you only got those initial two shots, you don't have the level of protection you really need in this fall and winter. So, I'm grateful for your calling in. And the answer is simple: You just need that new shot.

[00:55:48] Bill Walsh: And I think you said earlier in the program, Dr. Jha, that people don't have to request it specifically, that it is the shot they will get if they sign up for a vaccine.

[00:55:58] Ashish Jha: Yeah. If you just sign, you're signing up for a booster shot, for that additional shot, you will get the bivalent vaccine.

[00:56:06] Bill Walsh: Got it. All right, Gil. Let's take another caller.

[00:56:10] Gil Cabrera: Sure. Thank you, Bill. We have Frances from Kansas.

[00:56:13] Bill Walsh: Hey, Frances. Welcome to our program. Go ahead with your question.

[00:56:17] Frances: Hi. When I received my third shot, I had a severe reaction to it, not immediately. It wasn't until the next day, and it took about 10 days to get over it. I am very reluctant to get another shot.

[00:56:34] Bill Walsh: What kind of reaction did you have, Frances?

[00:56:39] Frances: Extreme pain. I couldn't, couldn't hardly move. I didn't eat for three days.

[00:56:47] Bill Walsh: Mmm.

[00:56:47] Ashish Jha: Hmm.

[00:56:50] Bill Walsh: Dr. Jha, what would you … Go ahead. Go ahead, Frances.

[00:56:53] Frances: I was just miserable.

[00:56:55] Bill Walsh: Yeah, it sounds like it.

[00:56:56] Frances: I was just miserable.

[00:56:56] Bill Walsh: Yeah, it sounds like it, I'm so sorry about that. Dr. Jha, what would you say to Frances and other people who have had bad experiences like that?

[00:57:01] Ashish Jha: Yeah. So, first of all, I'm sorry to hear it, Frances. It sounds like it was just an awful experience. I would have a conversation with your physician about this. Here's a couple of thoughts. I mean, first is, there are times when you can sort of pre-, depending a bit on the reaction, if we think there's an allergic component, you could sometimes, what we call pre-medicate people with anti-allergy medicines that can make a difference. It really can make a difference if it's allergic in nature. Obviously, given how much COVID is still out there, it is really important for people to be up to date on their vaccines. If you really … if you and your doctor just together decide you really just can't get a vaccine, then I think you should think about, there are some longer-acting what are called monoclonal antibodies. These are other ways of building up your protection. So, it's a tricky situation. I would explore this a bit more with your physician. Think about whether pre-medication with any medicines can make a difference and have that discussion. And if at the end of it you decide not to do it again, then I would make absolutely make sure that you have a good plan for how you're going to get treated if you end up having an infection in terms of Paxlovid or something else.

[00:58:16] Bill Walsh: OK, very good. Gil, let's take another question.

[00:58:21] Gil Cabrera: Sure thing, Bill. We have Bill out of New Jersey for us.

[00:58:25] Bill Walsh: Hey, Bill. Welcome to our program. Go ahead with your question.

[00:58:28] Bill: Hi, Dr. Jha. Thank you for doing this. I'm wondering if you would recommend a website that's authoritative to which things such as frequently asked questions format might be used, or some other format that allows people to use hypertext to follow into authoritative responses to reasonable questions about this, a service that you can recommend?

[00:58:55] Ashish Jha: Yeah. I do think CDC has done a very good job of updating a lot of their frequently asked questions from consumers, from patients around vaccines and treatments. So, that's where I send people; that's where I send my family. I still think it's out there. You know, there are other good outside sources as well. A lot of like Infectious Disease Society and other clinical groups. But I really would suggest that you start at CDC and cdc.gov and look at their coronavirus information, 'cause it is still the best information out there.

[00:59:29] Bill Walsh: Yep, cdc.gov is good, and Bill, I'd also suggest, and maybe for all our listeners, checking out AARP.org/coronavirus. We have the latest updates on vaccines, treatments and the trajectory of the virus itself. And we also have an ongoing FAQ that you can check out as well, and usually we pull our information from CDC and experts like Dr. Jha. So, I think it's pretty informative.

[00:59:59] This has been a really informative discussion today. I want to thank Dr. Jha for all of your information insights. It's been really helpful. And I want to thank you, our AARP members, volunteers and listeners for participating 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. In the face of this crisis, we're providing information and resources to help older adults and those caring for them protect themselves from the virus, prevent its spread to others while taking care of themselves. Now, all of the resources we referenced today, including a recording of the Q&A event, can be found at AARP.org/coronavirus beginning on October 24th. Go there if your question was not addressed, and you will find the latest updates as well as information created specifically for older adults and family caregivers. We hope you learned something that can help keep you and your loved ones healthy. Please join us again November 10th for another tele-town hall on COVID-19. Until then, thank you and have a great day. This concludes our call.

Teleasamblea de AARP sobre el coronavirus:

Vacunas y tratamientos contra la COVID-19 y temporada de gripe

 

 

Bill Walsh: Hola, soy Bill Walsh, vicepresidente de AARP, 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. 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 del país durante más de 60 años. Ante la pandemia mundial del coronavirus, AARP brinda información y recursos para ayudar a los adultos mayores y a quienes los cuidan.

 

La temporada de resfriados y gripe se está acercando, y podría significar un momento particularmente desafiante para los adultos mayores. Las tasas de vacunación de refuerzo de COVID-19 han disminuido y, según una encuesta, menos de la mitad de los adultos planean vacunarse contra la gripe. A medida que entramos en nuestro tercer invierno pandémico, a muchos expertos les preocupa que la fatiga ante las vacunas pueda tener graves consecuencias para la salud de las personas. La buena noticia es que mientras nos preparamos para los viajes de temporada y las reuniones con amigos y familiares, hay algunos pasos simples que se pueden seguir para garantizar su seguridad y protección y la de sus seres queridos.

 

Hoy escucharemos al coordinador de respuesta contra la COVID-19 de la Casa Blanca hablar sobre estos temas y otros. También recibiremos una actualización del Capitolio sobre la legislación que afecta a los adultos mayores. Si ya han participado en alguna de nuestras teleasambleas, saben que es similar a un programa de entrevistas de radio y tienen la oportunidad de hacer su pregunta en vivo. Para aquellos de ustedes que nos acompañan por teléfono, si desean hacer una pregunta, presionen * 3 en el teclado de su teléfono para conectarse con un miembro del personal de AARP que anotará su nombre y su pregunta y los colocará en una lista para hacer su pregunta en vivo. Y si nos acompañan por Facebook o YouTube, pueden publicar su pregunta en los comentarios.

 

Hola, si recién se unen, soy Bill Walsh, de AARP, y quiero darles la bienvenida a esta importante discusión sobre la pandemia mundial del coronavirus. Estaremos hablando con principales expertos y respondiendo sus preguntas en vivo. Para hacer una pregunta, presionen * 3 en el teclado de su teléfono. Y si participan por Facebook o YouTube, pueden publicar su pregunta en la sección de comentarios. Hoy contamos con el Dr. Ashish Jha, uno de los principales expertos en salud pública de Estados Unidos y Coordinador de Respuesta contra la COVID-19 de la Casa Blanca. También nos acompañará mi colega de AARP, Gil Cabrera, quien ayudará a facilitar sus llamadas. Este evento está siendo grabado y podrán acceder a la grabación en aarp.org/coronavirus, 24 horas después de que terminemos. Nuevamente, para hacer una pregunta, presionen * 3 en cualquier momento en el teclado de su teléfono para conectarse con un miembro del personal de AARP. O si participan por Facebook o YouTube, dejen su pregunta en la sección de comentarios.

 

Ahora, me gustaría dar la bienvenida a nuestro invitado experto especial. El Dr. Ashish Jha es el exdecano de la Escuela de Salud Pública de Brown University y se desempeña como Coordinador de Respuesta contra la COVID-19 de la Casa Blanca. Bienvenido de nuevo al programa, Dr. Jha.

 

Ashish Jha: Hola, Bill, muchas gracias por recibirme.

 

Bill Walsh: Muy bien, estamos encantados de tenerlo. Y como recordatorio para nuestros oyentes, para hacer una pregunta, presionen * 3 en el teclado de su teléfono o déjenla en los comentarios en Facebook o YouTube. Bueno, vayamos directo al grano, Dr. Jha. Ha habido algunos desarrollos importantes recientemente en las vacunas contra la COVID-19. Comencemos, por así decirlo, con una revisión de las vacunas y los tratamientos que están disponibles en la actualidad, en qué se diferencian y por qué son importantes. ¿Qué deben saber los adultos mayores?

 

Ashish Jha: Sí, Bill, ese es un buen lugar para comenzar. La buena noticia es que hemos realizado una importante actualización de la vacuna contra la COVID-19 por el siguiente motivo. La vacuna original, que era muy buena, se desarrolló a principios del 2020 y estaba dirigida al virus que circulaba en ese momento. Pero el virus ha evolucionado mucho en los últimos dos años y medio. Nuevas variantes, nuevas subvariantes. Durante el verano, la Administración de Drogas y Alimentos tomó la decisión de realizar una actualización sustancial de la vacuna, para que pudiera atacar el virus que circula hoy. Y eso es lo que tenemos. Y toda la evidencia hasta el momento sugiere que hará un trabajo mucho, mucho mejor en la protección de las personas contra infecciones, contra enfermedades graves o algo peor. Así que eso primero. Y la otra parte de las buenas noticias, es que para la mayoría de las personas, ahora es una vacuna anual. Creo que algunos adultos mayores vulnerables pueden necesitar inyecciones más de una vez al año. Pero creo que para la mayoría de las personas en el país, es una dosis al año. Así que eso es probablemente lo más importante. Y si no han ido a obtener esta nueva, lo que llamamos vacuna bivalente, esta nueva vacuna contra la COVID-19, es muy, muy importante que o hagan. La otra cosa es que también tenemos una gran cantidad de tratamientos que son increíblemente eficaces para prevenir enfermedades graves y la muerte. Entonces, pensando en medicamentos como Paxlovid, probablemente terminaremos hablando más sobre eso en las preguntas y respuestas. Pero es muy, muy eficaz para prevenir enfermedades graves. Lo diré de esta manera, Bill, ahora estamos en un punto de esta pandemia en el que si las personas están al día con sus vacunas y reciben tratamiento, si contraen una infección avanzada, ya nadie debe morir de COVID-19. Si podemos prevenir casi todas las muertes, y esa es la prioridad de la Administración, ciertamente es mi prioridad personal.

 

Bill Walsh: Verdaderamente increíble. Bueno, permítanme seguir con eso, dada la eficacia, particularmente de la nueva vacuna bivalente porque sabemos que aproximadamente el 80% de la población de Estados Unidos ya ha recibido una dosis de la vacuna contra la COVID-19, pero solo el 50% de las personas vacunadas han recibido un refuerzo y menos aún de esta última vacuna bivalente que acaba de describir. Si alguien no ha recibido una vacuna adicional desde el ciclo inicial, ¿qué tipo de protección tiene contra el virus de la COVID-19 hoy?

 

Ashish Jha: Sí, como dije antes, Bill, el virus ha evolucionado mucho. Quiero decir, este es un virus muy desafiante, obviamente nuevo para la especie humana desde hace unos años. Ha evolucionado mucho en los últimos dos años, y ahora incluso en el último año. Pero si alguien recibió su última vacuna hace un año, año y medio, incluso hace seis meses, realmente no está tan bien protegido. Y si alguien recibió su última vacuna hace un año, tiene muy poca protección contra infecciones y solo una modesta protección contra enfermedades graves. Es por eso que hicimos la actualización principal que hicimos durante el verano porque descubrimos que la nueva vacuna brindaría una protección mucho mejor. Y la buena noticia es que no solo es mucho más eficaz, sino que está ampliamente disponible de forma gratuita en todo Estados Unidos. Por lo tanto, es bastante fácil de conseguir, y en este momento simplemente no confiaría en ninguna vacuna o prevención de infecciones o protección que tenga contra, digamos, una infección que podría haber tenido hace nueve meses o una vacuna hace un año, simplemente no va a proporcionar el nivel de protección que uno necesita ya.

 

Bill Walsh: Sí. Bueno, dado el amplio acceso y la eficacia de la nueva vacuna, ¿cómo se explica la vacilación, particularmente cuando nos dirigimos al otoño y al invierno, cuando tradicionalmente hemos visto aumentar las tasas de COVID-19?

 

Ashish Jha: Sí, no sé si lo veo como vacilación. Veo personas que se informan sobre la nueva vacuna, que tratan de comprender la importancia de estas nuevas vacunas. Creo que es importante para nosotros, en el mundo de la salud pública, recordarle a la gente que la COVID-19 todavía está aquí. Y así como salimos y nos vacunamos contra la gripe todos los años porque sabemos que la gripe se vuelve un problema mucho mayor en el otoño y el invierno, es realmente importante que las personas salgan y se vacunen contra la COVID-19. Creo que parte de esa vacilación es el hecho de que la COVID-19 ya no es una prioridad para todos. De hecho, creo que son buenas noticias. No necesitamos vivir ese mismo tipo de emergencia pensando en la COVID-19 todo el tiempo. Y si las personas continúan protegiéndose con vacunas y tratamientos, realmente podemos dejar atrás la COVID-19.

 

Bill Walsh: Sí, bueno, hablemos de esos tratamientos. Y como recordatorio para nuestros oyentes, si desean hacer una pregunta al coordinador de respuesta contra la COVID-19 de la Casa Blanca, el Dr. Ashish Jha, presionen * 3 en el teclado de su teléfono o escriban su pregunta en los comentarios en Facebook o YouTube. Ahora, según un estudio reciente de Epic Research, los pacientes infectados tratados con Paxlovid tienen aproximadamente dos veces menos probabilidades de ser hospitalizados y aproximadamente cuatro veces menos probabilidades de morir. Los antivirales significaron como un cambio de juego, pero pocas personas los toman. ¿Por qué supone que es eso?

 

Ashish Jha: Sí, es una buena pregunta. Los datos sobre antivirales, como Paxlovid, son abrumadoramente claros y son muy buenos datos. Son datos muy convincentes. Creo que sabemos esto con los medicamentos en general, que cada vez que se introducen nuevos medicamentos, los médicos tardan un tiempo en comenzar a usarlos y sentirse cómodos con ellos. Obviamente, esta es una nueva pandemia y un nuevo virus, y estos tratamientos, ahora han estado disponibles durante aproximadamente 10 meses y los médicos todavía se sienten cómodos usándolos. Pero les diré, mis padres ancianos que tenían 80 años contrajeron COVID-19 durante el verano y ambos me llamaron, fue al mismo tiempo y me llamaron, y lo primero que hicimos fue darles Paxlovid porque la fecha en este caso no es sutil, no hay mucho margen. Lo que sabemos es que está muy claro que si uno toma Paxlovid, no terminará en el hospital, o su riesgo de terminar en el hospital disminuirá considerablemente, y su riesgo de estar en la UCI o muerte simplemente se desplomará drásticamente. Es realmente, realmente eficaz.

 

Bill Walsh: Bueno, parece que sus padres siguieron su consejo. ¿Qué les diría a otros adultos mayores, particularmente a los mayores de 65 años que tienen COVID-19, sobre si deben tomar Paxlovid y qué deberían considerar mientras lo piensan?

 

Ashish Jha: Sí, y como puede imaginar, Bill, mis padres no siempre siguen mi consejo, pero creo-- [Bill y Jha se ríen]

 

Bill Walsh: Bueno, me imagino que usted tampoco siguió siempre los suyos. [Bill y Jha se ríen]

 

Ashish Jha: También se trata de "Lo que va, puede regresar", obviamente. No, pero este es mi consejo para las personas mayores de 65 años. En primer lugar, creo que todas las personas mayores de 65 años deberían recibir tratamiento. Pero si Paxlovid no es el medicamento adecuado, también hay otras opciones. Paxlovid es la primera línea, pero también hay otras opciones. Hay otros antivirales orales, como uno llamado Lagevrio, hay anticuerpos monoclonales. Así que hay otras opciones también. Lo segundo que diría es que tiene que hablar con alguien y tiene que hablar con alguien pronto. Entonces, lo que sucede a menudo es que tiene 65, 70 años, contrae COVID-19, no se siente bien durante uno o dos días, pero los primeros días no son tan malos, y tal vez solo sea un resfriado leve. No llama a nadie. No llama a su médico. En el momento en que los síntomas empeoran, podría ser el día cinco o seis, y si uno llama a su médico en ese momento, es posible que se esté saliendo de la ventana donde Paxlovid es realmente útil. Entonces, lo que recomiendo y lo que hice con mis padres es llamar incluso si los síntomas son leves, porque lo que sabemos es que los síntomas pueden empeorar más tarde y es posible que pierdan la oportunidad de recibir tratamiento. El tratamiento es mejor cuando es temprano. En el momento en que se infecta, creo que si tiene más de 65 años, debe tomarlo. Entonces, ¿Qué hace? Llama a su médico. De acuerdo, ¿qué pasa si tiene dificultades para comunicarse con su médico o si no tiene un médico de atención primaria o si no tiene a alguien a quien contactar? Hay otras opciones. Puede ir a COVID.gov. Tenemos listas de literalmente miles de sitios de prueba para tratamientos. Cada estado los tiene. Puede ir a estos sitios de prueba para tratar, verifican que es positivo y pueden brindar tratamiento de inmediato. Hay clínicas como CVS y Walmart y Walgreens que las tienen. Así que hay múltiples opciones. La clave es ser persistente. Y si uno tiene más de 65 años, realmente creo que en este momento, el estándar de atención es que debe recibir tratamiento si contrae COVID-19.

 

Bill Walsh: Bien, ahora, otra pregunta que tenía sobre Paxlovid es que, a pesar de su eficacia, los informes recientes sugieren que podría tener interacciones con algunos medicamentos comunes para el corazón, incluidos los anticoagulantes y las estatinas. ¿Es esto algo por lo que preocuparse? Y al buscar tratamiento, ¿cuál sería su consejo para alguien que contrae COVID-19 y está tomando medicamentos para el corazón?

 

Ashish Jha: Sí, por eso es muy importante hablar con su médico o, por cierto, hablar con un farmacéutico. Los farmacéuticos son excelentes para comprender estos problemas. Así es como lo pensaría. Hay una serie de medicamentos para el corazón que no es un gran problema dejar de tomar durante cinco días. Entonces, la forma en que maneja algunas cosas es, y lo hacemos todo el tiempo, por cierto, cuando los adultos mayores, digamos, ingresan en el hospital y necesitan el procedimiento, suspendemos ciertos medicamentos durante cinco días, no es gran cosa. Pero con otros medicamentos, suspenderlos durante cinco días puede ser un problema mayor. Por eso es tan importante esa conversación con el médico. Creo que la gran mayoría de las veces, más del 90% de las veces, puede encontrar una manera de tomar Paxlovid de forma segura y que no sea un gran problema. Si uno se encuentra en esa rara circunstancia en la que su médico siente que simplemente... Digamos que está tomando un anticoagulante y no cree que pueda dejar de tomarlo durante cinco días, entonces tiene esas alternativas. El Lagevrio, los anticuerpos monoclonales. Así que todo el mundo debería ser tratado con algo. Si uno se encuentra en esa rara circunstancia en la que realmente no puede tomar Paxlovid, también hay otras opciones.

 

Bill Walsh: Está bien, muy bien. Bueno, ya he hecho suficientes preguntas por ahora. Vayamos a nuestros teléfonos y tomemos algunas preguntas de nuestros oyentes. Ahora es el momento de abordar todas sus preguntas o tantas como sea posible sobre el coronavirus con el coordinador de respuesta contra la COVID-19 de la Casa Blanca, el Dr. Ashish Jha. Como recordatorio, presionen * 3 en cualquier momento en el teclado de su teléfono para conectarse con un miembro del personal de AARP y ponerse en una lista para hacer sus preguntas en vivo. Y si desean escuchar este programa en español, presionen * 0 en el teclado de su teléfono ahora. Y ahora me gustaría traer a mi colega de AARP, Gil Cabrera, para ayudar a facilitar sus llamadas. Bienvenido Gil.

 

Gil Cabrera: Bill, muchas gracias. Estoy encantado de estar aquí para esta importante conversación.

 

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

 

Gil Cabrera: Bueno, nuestra primera llamada es de Steve, que llama desde New Jersey, Bill.

 

Bill Walsh: Muy bien, Steve, bienvenido a nuestro programa. Adelante con su pregunta.

 

Steve: Gracias, y gracias por responder a mi pregunta. tengo 68 años. Tenía las dos vacunas originales de Moderna y los dos refuerzos. Aun así, tuve COVID-19 en agosto pasado. Y también tomé Paxlovid cuando mis síntomas eran leves. Mi pregunta es: mucho de lo que he leído dice que si tuve COVID-19 con este nuevo refuerzo bivalente, debo esperar tres meses para recibir ese refuerzo. Así que mi pregunta es ¿qué piensan sobre la espera de los tres meses?

 

Bill Walsh: Sí, Dr. Jha.

 

Ashish Jha: Buena pregunta, Steve. En primer lugar, gracias por hacer todo lo posible para mantenerse protegido y saludable. Mire, es un virus muy resistente, y la verdad es que, incluso si uno se mantiene al día con las vacunas, puede contraer infecciones posvacunación. Pero la buena noticia es que debido al hecho de que estaba al día con sus vacunas y recibió Paxlovid, parece que tuvo una enfermedad leve, por supuesto. Y eso es lo que queremos para todos. Ahora, a su pregunta, ¿cuánto tiempo esperar después de la infección? Creo que tres meses es perfecto. La FDA había dicho que debe esperar al menos dos meses. Creo que es correcto. Pero mi recomendación general a mis amigos y familiares ha sido que esperen tres meses, si recibieron la última vacuna o desde la última infección, que esperen tres meses. ¿Por qué? Lo que está haciendo es dejar que su sistema inmunitario madure. Su sistema inmunitario todavía está bastante acelerado por esa infección anterior y darle un poco de tiempo en realidad hará que la vacuna sea más eficaz. Así que creo que tres meses es exactamente el momento adecuado para hacerlo. Y si lo ha tenido en agosto, podrá vacunarse en algún momento a fines de noviembre. Y eso significa que para cuando lleguen las vacaciones, realmente obtendrá los máximos beneficios de esa vacuna.

 

Bill Walsh: Genial, muchas gracias. Y mire, sé que aún es pronto para esta nueva vacuna bivalente, pero ¿tenemos una idea de cuánto dura la inmunidad?

 

Ashish Jha: No lo sabemos. Y esto es parte del desafío de la evolución del virus y la llegada de las vacunas si no... Llevará un poco más de tiempo. Lo que sospecho es que con las vacunas anteriores, se vio esa disminución de la inmunidad, y en parte se debió a que el virus se había alejado mucho de la vacuna. Y eso, desde un punto de vista biológico, significa que, dado que estas nuevas vacunas se dirigen tan específicamente al virus que existe, deberíamos ver una protección más duradera. Debería durar mucho más tiempo contra infecciones y enfermedades graves. Simplemente no sabemos cuánto tiempo más. No sabemos exactamente cuánto más duradero, pero todas las pruebas hasta ahora indican que realmente debería hacerlo.

 

Bill Walsh: Está bien, muy bien. Gil, tomemos otra llamada.

 

Gil Cabrera: Claro, Bill. Tenemos a Sophia por Facebook. Ella está preguntando, ¿tenemos que pedir específicamente la nueva vacuna cuando programemos una cita para un refuerzo?

 

Ashish Jha: No debería tener que hacerlo, porque cuando la FDA hizo este cambio y autorizó una nueva vacuna bivalente, desautorizó o eliminó la vacuna anterior como refuerzo. Entonces, en este punto, solo hay una opción de refuerzo para los adultos mayores del país; en realidad, básicamente para todos los adultos. Entonces, si va y hace una cita y dice, estoy aquí para mi vacuna adicional, mi vacuna de refuerzo, mi vacuna anual contra la COVID-19, debe recibir la vacuna bivalente.

 

Bill Walsh: Bien, doctor, me pregunto si hemos escuchado algo sobre los efectos secundarios de la vacuna bivalente.

 

Ashish Jha: Bueno, hasta ahora, y comenzaré con mi propia experiencia personal. Recibí la vacuna contra la gripe y la vacuna contra la COVID-19 al mismo tiempo, en el mismo brazo. El brazo estuvo un poco adolorido durante aproximadamente 24 horas. Pero aparte de eso, me sentí bien. Creo que los datos hasta el momento sugieren que los efectos secundarios son bastante leves. La gente los conoce. Algunas personas terminan teniendo 24 horas difíciles en las que pueden sentir algunos dolores y escalofríos. Pero la gran mayoría de las personas tienen síntomas muy leves, un poco de enrojecimiento en el sitio de la inyección. A veces, el dolor en el brazo es muy común y suele durar unas 24 horas.

 

Bil Walsh: Entiendo. Está bien. Gil, tomemos otra llamada.

 

Gil Cabrera: Claro, Bill. Tenemos a Patricia, de Illinois.

 

Bill Walsh: Hola, Patricia, bienvenida a nuestro programa. Adelante con su pregunta.

 

Patricia: Mi pregunta es: tengo 76 años. No he comido en un restaurante desde el comienzo de la COVID-19, y mi esposo me pregunta si quiero ir a almorzar a un restaurante hoy. Y me pregunto cuánto riesgo sigue habiendo al ir a un restaurante a comer. Tengo varias cosas que comprometen el sistema inmunitario. Tengo un CPAP, y tengo una enfermedad hepática de tercera etapa, no tengo cáncer y anemia hemolítica, etc. Oh, soy diabética. Me pregunto qué tan arriesgado es ir a un restaurante a comer en este momento.

 

Bill Walsh: Dr. Jha, una pregunta muy oportuna la de Patricia. Pero creo que es una pregunta en la mente de muchas personas. ¿Qué tan libres deben sentirse para volver a salir en público? Y si lo hacen, ¿qué pasos deben tomar?

 

Ashish Jha: Sí, es una muy buena pregunta. Así que empezaré por hablar de mí y de mis padres ancianos. Realmente no salí a comer mucho, ciertamente no en espacios cerrados, a restaurantes durante la mayor parte, diría que todo el 2020 y gran parte de principios del 2021. Pero este año comencé a hacerlo nuevamente y de hecho cené con mis padres mayores adentro de un restaurante. Dos cosas. En primer lugar, es un poco más riesgoso. Mire, oiga, es muy difícil llegar a riesgo cero con este virus. Está en todas partes. Entonces definitivamente... y la razón es que obviamente en el restaurante, la gente come, bebe, nadie usa una mascarilla. Pero la conclusión es que creo que el riesgo, especialmente si uno está al día con sus vacunas, el riesgo de contraer COVID-19 es relativamente bajo. Y la conclusión es que incluso si uno termina infectándose, y nuevamente, es poco probable que una cena, un almuerzo, lo provoque. Pero si sucede, tiene muchos tratamientos muy buenos disponibles. Así que creo que a esta altura, para la mayoría de las personas... Ahora, quiero advertirle, Patricia, ha mencionado que tiene algunos problemas de salud específicos y, obviamente, no soy su médico personal, por lo que es difícil para mí evaluar, pero valdría la pena tener esa conversación con su médico. Pero creo que para la mayoría de las personas, incluidas las personas que tienen problemas de salud, estamos en un punto en el que comer en un restaurante es razonablemente seguro. Hay un pequeño riesgo de infectarse, como siempre lo ha habido, por cierto. Ha habido un pequeño riesgo de infectarse de gripe en el pasado. Pero la buena noticia es que si uno está al día con sus vacunas, el riesgo de enfermarse gravemente es muy bajo. Y le suma los tratamientos además de eso, y las posibilidades de que termine teniendo un mal resultado son extremadamente, extremadamente bajas.

 

Bill Walsh: Muy bien. Bien, gracias Dr. Jha. Gil, ¿de quién es nuestra próxima llamada?

 

Gil Cabrera: Bueno, tenemos vía YouTube a Juan, que le hace la siguiente pregunta a Bill. ¿Con cuánta anticipación a un viaje debo recibir una vacuna de refuerzo?

 

Ashish Jha: Ah, gran pregunta, Juan. Y yo diría que lo que sabemos es que aproximadamente dos semanas después de recibir la vacuna es cuando los anticuerpos realmente se activan. Quiero decir, y nuevamente, eso comienza a aumentar después de siete a diez días, por lo que comienza a obtener algunos beneficios. Así que probablemente dos semanas, es una especie de tiempo máximo. Y luego se mantiene por un tiempo, y luego declinará lentamente. Esta es la razón por la que, por ejemplo, le he dicho a la gente que si no ha recibido su nueva vacuna contra la COVID-19, su vacuna bivalente, Halloween es un muy buen momento para recibirla. Porque si se la pone para Halloween, que es solo dentro de 10 días, estará muy bien para el Día de Acción de Gracias. Y debería estar muy bien para las vacaciones y el tiempo que sigue. Entonces, es difícil cronometrar estas cosas a la perfección, pero diría que es bueno darle al sistema inmunitario al menos un par de semanas para maximizar esa protección.

 

Bill Walsh: Sí, gracias, doctor. Y mencionó anteriormente que estas vacunas siguen siendo gratuitas. ¿Serán gratis incluso en el nuevo año?

 

Ashish Jha: Sí, al comienzo del nuevo año, lo serán. Bueno, el Gobierno de EE.UU. compró una buena cantidad de dosis porque pensamos que era muy, muy importante que los adultos mayores siguieran teniendo acceso gratuito. El Congreso ha dejado de financiar la respuesta a la COVID-19 desde hace unos seis o siete meses. Por lo tanto, hemos estado sacando recursos de muchos otros programas para tratar de asegurarnos de tener suficientes vacunas y tratamientos. El próximo año pasaremos a la comercialización porque no tenemos recursos, y eso significa que comenzará a pasar por el plan de salud. Las vacunas deberían seguir siendo gratuitas porque una de sus estipulaciones de la Ley del Cuidado de Salud a Bajo Precio, Obamacare, desde hace muchos años, era que las medidas preventivas como las vacunas deberían ser gratuitas. Por lo tanto, las vacunas deben seguir siendo gratuitas. Lo que estamos tratando de hacer es descubrir cómo nos aseguramos de que no sean barreras de costos para los tratamientos. Pero eso es todo el próximo año y probablemente más bien a finales del próximo año. En este momento, estas vacunas son gratuitas, y creo que a principios del 23 se verá que seguirán siendo gratuitas.

 

Bill Walsh: Está bien, muy bien. Gil, tomemos otra llamada.

 

Gil Cabrera: Por supuesto, Bill. Tenemos a María, de Michigan.

 

Bill Walsh: Hola María, bienvenida a nuestro programa. Adelante con su pregunta.

 

María: Hola. Mi esposo de 57 años, fue vacunado y recibió su refuerzo a tiempo. También cumplía religiosamente con los protocolos de COVID-19. Usaba una mascarilla todo el día en el trabajo y cada vez que salía de la casa. Estaba obsesionado con lavarse las manos y, sin embargo, contrajo COVID-19 a mediados de agosto y luego nuevamente a principios de octubre. Y la única posibilidad que podemos encontrar al mirar el calendario es que esta última infección, tres o cuatro días antes de los primeros síntomas, fue al comprar comestibles de Walmart, podría haber sido en cualquier lugar, pero fue al comprar comestibles. ¿Hemos aprendido algo nuevo sobre cómo se transmite el virus y si aún debiéramos estar limpiando nuestras compras?

 

Bill Walsh: Esa es una buena pregunta. Dr. Jha, ¿puede abordar eso para María y otras personas que puedan tener la misma preocupación?

 

Ashish Jha: Absolutamente. Con gusto. María, y antes que nada, lamento que su esposo se haya infectado, especialmente dos veces. Espero que esté bien. Esto es lo que sabemos. De hecho, hemos aprendido mucho. En general, no puede, o uno no se contagia este virus de las superficies y, por lo tanto, no necesita limpiar los alimentos. Y lavarse las manos es una buena medida de salud pública en general, pero no es particularmente diferente para la COVID-19. Lo que creo que es más importante es entender que la COVID-19 se transmite por el aire, es una enfermedad transmitida por el aire y, por lo tanto, donde se propaga la COVID-19 es en espacios interiores donde se reúne mucha gente, especialmente si son espacios con poca ventilación. Ahí es donde tiende a suceder la mayor parte de la propagación. Se esparce muy poco al aire libre. Y nuevamente, lo que vengo recomendado ahora por hace más de un año es que no necesita limpiar los alimentos, no necesita limpiar nada. Lavarse las manos siempre es una buena idea, mantiene muchos otros bichos fuera del sistema, así que eso es bueno. Pero aquí la clave es que una buena ventilación, estar al aire libre, siempre es más saludable y seguro. Si va a estar adentro, si está muy lleno, que muchas personas usen la mascarilla puede marcar una gran diferencia. De nuevo, no estoy seguro de dónde se contagió específicamente su marido. Dudo que haya sido de la tienda de comestibles. La realidad es que simplemente no se propaga por la superficie.

 

Bill Walsh: Me pregunto si la experiencia del esposo de María podría hablar de cómo muta el virus con el tiempo. Quiero decir, sabemos que incluso mientras hablamos, está mutando. ¿Y cree que es posible que haya recibido una nueva cepa de la que la vacuna no protegiera tanto para prevenir la propagación?

 

Ashish Jha: Sí, absolutamente, Bill. Y de hecho, creo que le agradecen por plantear eso porque creo que eso es probablemente lo que sucedió. Lo que sabemos, nuevamente, recuerdo que la vacuna original se creó contra esa cepa de Wuhan del 2020. Y cuando llegamos a agosto, y nuevamente, no conozco los detalles del esposo de María, pero probablemente se infectó con una cepa BA 5. Y la cepa BA 5 es muy invasiva para el sistema inmunitario. Y la vacuna anterior, si bien seguía siendo buena para prevenir enfermedades graves, simplemente no era tan eficaz para prevenir infecciones. Es evidente que se ha producido una disminución de esa protección. Es por eso que actualizamos a una vacuna bivalente, para que sea específicamente protectora contra BA 5. Es un recordatorio, el virus continúa evolucionando, continúa buscando formas de evitar el muro de inmunidad que hemos construido con las vacunas. Pero siempre digo que el virus es astuto y engañoso, y hace lo suyo, pero los seres humanos también tenemos mucho ingenio y podemos contraatacar. Entonces, cuando el virus cambie, podemos actualizar nuestras vacunas para que sean más eficaces. Y eso es lo que hemos hecho con la vacuna actual.

 

Bill Walsh: Muy bien, muy bien. Gil, tomemos otra pregunta.

 

Gil Cabrera: Claro, Bill. Tenemos a Lisa, que se comunica desde Nueva York.

 

Bill Walsh: Hola Lisa, bienvenida a nuestro programa de hoy. ¿Cuál es su pregunta?

 

Lisa: Sí, hola. Con el Día de Acción de Gracias tan cerca, mi esposo y yo hemos sido vacunados y recibimos el refuerzo. Tenemos 70 años y nos invitaron a la cena de Acción de Gracias. Habrá alrededor de 12 personas allí, y nos preguntamos qué tan seguro es asistir. ¿Deberíamos solicitar que los otros invitados se hagan la prueba antes de que vengan, o creen que es lo suficientemente seguro para ir? Y, por supuesto, será en un espacio cerrado.

 

Bill Walsh: Pregunta muy oportuna.

 

Ashish Jha: Sí, una pregunta muy oportuna, Lisa, y una muy buena pregunta. Así que así es como lo pienso. No hay garantías, ¿verdad? Hace tres años, si hubiera ido a esa cena de Acción de Gracias, la gente podría haberse contagiado de gripe o RSV. Así que eso siempre está ahí y es una posibilidad. La clave en mi mente es que debe asegurarse de que el Día de Acción de Gracias sea lo más seguro posible sin causar muchas interrupciones. Y lo más importante obviamente es que usted y su esposo se aseguren de estar al día con sus vacunas, con esta vacuna bivalente. Creo que es una especie de paso crítico número uno. El número dos es que creo que las pruebas pueden ser útiles. De hecho, conocemos muy buenos datos de que antes de las reuniones, si las personas se hacen la prueba, se reduce drásticamente el riesgo de infección. Estas pruebas están ampliamente disponibles, en realidad, son gratuitas si tiene Medicare o un seguro privado, puede ir a CVS o Walgreens y decir, me gustaría recibir mis ocho pruebas gratuitas por mes. Eso es algo que el Gobierno ha presionado a las compañías de seguros para que estén fácilmente disponibles. Y le digo, ¿es necesario? Bueno, solo reduce el riesgo. Entonces, incluso si el riesgo no fuera alto, creo que solo agrega una capa más de protección. No es crítico, pero les diré, en mi familia, nos reuniremos para el Día de Acción de Gracias. Mi hermano y su familia, mi esposa y yo, y nuestros hijos con mis padres ancianos, seremos unos 12. Y mi plan es que les haremos una prueba a todos esa primera mañana para asegurarnos de que nadie tenga la infección. Solo agrega un nivel más de protección.

 

Bill Walsh: Muy bien, gracias por eso. Y gracias por todas sus preguntas. En breve responderemos a más preguntas de nuestros oyentes. Pero antes de hacerlo, obtengamos una actualización del Capitolio sobre legislación importante, que afecta a los adultos mayores. Además de compartir información y recursos, AARP aboga por los problemas que más los afectan. Para brindarles una actualización rápida sobre cómo AARP está luchando por ustedes, quiero traer a la vicepresidenta ejecutiva y directora de Activismo y Compromiso de AARP, Nancy LeaMond. Bienvenida al programa, Nancy.

 

Nancy LeaMond: Bueno, gracias, Bill. Feliz de estar aquí.

 

Bill Walsh: Quiero preguntar sobre algunos temas importantes, pero comencemos con algunas buenas noticias. Por supuesto, en agosto pasado, en la cámara se aprobaron históricas reformas de medicamentos recetados y se enviaron y firmaron como ley. ¿Puede discutir lo que significa para las personas?

 

Nancy LeaMond: Claro. La reforma de los precios de los medicamentos recetados es una gran victoria para los adultos mayores. Después de décadas de pedirle al Congreso que hiciera que los medicamentos recetados sean más asequibles, AARP ganó la lucha para permitir que Medicare negociara precios de medicamentos más bajos y otras políticas que ahorrarán dinero a las personas mayores en sus medicamentos. Entonces, por ejemplo, la nueva ley limita el costo de la insulina cubierta por Medicare a $35 por mes y elimina los costos de bolsillo para la mayoría de las vacunas bajo Medicare, como la vacuna contra la culebrilla. También habrá un límite anual de $2,000 sobre cuánto pagan de su bolsillo los beneficiarios de la Parte D de Medicare por sus recetas. Y los fabricantes de medicamentos que aumenten los precios más rápido que la tasa de inflación serán penalizados. Estas son grandes victorias para nosotros, y sabemos lo importante que ha sido el costo de los medicamentos para las personas mayores.

 

Bill Walsh: Seguro que lo es. Esa es una excelente noticia. Ahora, además de Medicare, el Seguro Social es otra prioridad principal para AARP y también hay buenas noticias, ¿no es así?

 

Nancy LeaMond: Sí. El seguro social anunció recientemente un ajuste del costo de vida del 8.7%, el mayor aumento de COLA en 41 años. AARP ha luchado durante mucho tiempo para proteger los COLA del seguro social para que las personas mayores puedan mantenerse al día con los precios en aumento. Este aumento brindará un alivio muy necesario a millones de adultos mayores que luchan con mayores costos de alimentos, atención médica y, por supuesto, otros costos. También instamos al Congreso a trabajar juntos de manera bipartidista para proteger y fortalecer el Seguro Social a largo plazo.

 

Bill Walsh: Bien, muchas gracias. Ahora, por supuesto, estamos en medio de una temporada de elecciones en este momento. ¿Cuál es el enfoque de AARP de cara a las elecciones de noviembre?

 

Nancy LeaMond: Bueno, primero quiero recordarles a las personas que AARP es y siempre ha sido estrictamente no partidista. No apoyamos ni damos dinero a candidatos políticos, partidos ni campañas. Durante los años electorales, nos enfocamos en asegurarnos de que los candidatos presten atención a los adultos mayores y aborden los temas que son importantes para ellos. Y en todas las elecciones recientes, esperamos que los votantes mayores de 50 años constituyan la mayoría del electorado en noviembre. También nos estamos asegurando de que nuestros socios y el electorado en general sepan cómo, dónde y cuándo votar. Los oyentes pueden visitar aarp.org/vote para encontrar detalles sobre cómo votar en su estado.

 

Bill Walsh: Está bien, muy bien. Ahora, antes de dejarla ir, quiero hablar sobre el estado actual de la COVID-19 en los hogares de ancianos de Estados Unidos. Para aquellos que viven y trabajan en centros de enfermería especializada, esta pandemia está lejos de terminar, ¿no es así?

 

Nancy LeaMond: Bueno, lamentablemente eso es correcto. El panel de control de COVID-19 de los hogares de ancianos de AARP nos muestra que la transmisión en los hogares de ancianos sigue siendo significativamente elevada en comparación con el resto de la población. Una de las cosas más importantes que la gente puede hacer es asegurarse de que sus seres queridos estén vacunados y hayan recibido los refuerzos recomendados. Casi la mitad de los residentes y más de la mitad del personal no están al día con sus vacunas. Y esto podría tener consecuencias mortales, ya que nos acercamos a la temporada de resfriados y gripe. Por favor, no den por sentado que su familiar ha recibido el suyo. Hagan un seguimiento con su proveedor de atención y elaboren un plan.

 

Bill Walsh: Muy bien, eso suena como un buen consejo. Muchas gracias por estar aquí hoy, Nancy. Y si nuestros oyentes quieren estar al tanto de las noticias de promoción de AARP, ¿cómo pueden enterarse de lo último?

 

Nancy LeaMond: Bueno, alentamos a todos a conectarse en línea y buscar AARP Fighting For You. Eso los llevará a un resumen diario de las últimas noticias de promoción sobre nuestro trabajo con el Congreso y en todo el país.

 

Bill Walsh: Muy bien. AARP Fighting For You. Muchas gracias, Nancy, que tenga un excelente día.

 

Nancy LeaMond: Gracias, Bill.

 

Bill Walsh: Muy bien. Ahora volvamos a nuestro invitado experto, el Dr. Ashish Jha, el Coordinador de Respuesta al COVID-19 de la Casa Blanca. Dr. Jha, antes hablábamos de variantes y cada variante posterior de COVID-19 aparentemente ha sido menos grave que las anteriores. ¿Por qué es eso? Y ¿podría cambiar?

 

Ashish Jha: Esa es una muy buena pregunta, Bill. Y la respuesta es que podría cambiar. Hasta ahora, hay dos razones por las que la variante actual parece ser menos grave. Una es que hay tanta inmunidad por ahí que muchas de las infecciones ahora están ocurriendo, la mayoría de las infecciones están ocurriendo en personas que tienen inmunidad. Ya sea han estado previamente infectadas o han sido vacunadas. Entonces, si uno está vacunado, tendrá síntomas más leves. Y dado que mucha gente está vacunada, parece que esta versión del virus es más leve. La segunda es que hay pruebas de laboratorio de que esta versión del virus, la versión de ómicron, es más leve. No sabemos cuánto más leve, tal vez un 20 o un 30%. No dramáticamente más leve, pero lo es, y eso también es una buena noticia. Entonces, inherentemente más leve y la inmunidad subyacente. El problema es que si piensa en los virus a largo plazo, existe la creencia de que los virus siempre se vuelven más leves con el tiempo. Desafortunadamente, eso no es tan cierto como todos deseamos. Hemos visto esto con muchos virus, el virus del ébola que circula hoy no es más leve que el que había hace 30 años. La influenza, algunas temporadas es muy grave, otras temporadas, es leve. Así que no sabemos si la próxima variante de COVID-19 terminará siendo igual de leve o incluso peor. Y por eso siempre estamos pensando en ello, preparándonos para todos esos posibles resultados.

 

Bill Walsh: Bien, bueno, hablemos de los efectos de una infección por COVID-19. La posibilidad de accidente cerebrovascular, ataque cardíaco, diabetes tipo 2 y más problemas aumenta después de una infección por COVID-19, incluso en casos leves. Me pregunto si cree que los adultos mayores comprenden completamente todos los riesgos de una infección por COVID-19.

 

Ashish Jha: Sí, este es un tema realmente importante porque a menudo hablamos de que el resultado negativo es la muerte, que por supuesto es el peor resultado de todos. Es muy, muy importante que rastreemos eso. Pero lo que hemos visto es que muchas personas que después de una infección de COVID-19 se recuperan, pero después de los próximos seis meses, el riesgo claramente elevado de accidente cerebrovascular, ataque cardíaco, muchas de las cosas que mencionó. En parte porque el virus en realidad, daña el sistema vascular y, por lo tanto, realmente desencadena el tipo de riesgo de esos accidentes cerebrovasculares y ataques cardíacos. Muchas personas terminan teniendo síntomas pulmonares significativos después porque incluso si la infección inicial parecía leve, aún causó daño en el pulmón. Así que tenemos que tomárnoslo en serio. Y es por eso que creemos que es muy importante mantenerse al día con sus vacunas. Porque una de las cosas que hemos visto es que si está vacunado, es mucho menos probable que se infecte, es mucho menos probable que tenga COVID-19 a largo plazo. E incluso si tiene COVID-19 a largo plazo, es bastante leve, en términos relativos. Por lo tanto, las vacunas no solo previenen enfermedades graves y la muerte. También previenen muchas de esas complicaciones a largo plazo.

 

Bill Walsh: Gran punto. Ahora, como usted dijo, quiero decir, sabemos por cientos de millones de vacunas contra la COVID-19 administradas, que tienen un historial notable de eficacia. ¿Qué nos puede decir sobre la eficacia de la vacuna contra la gripe este año? Por supuesto, cambia cada año. ¿Y qué nos puede decir también sobre la vacuna antigripal de dosis alta de la que hemos oído hablar?

 

Ashish Jha: Sí. Sí, dos buenas preguntas. Entonces, la vacuna contra la gripe cambia todos los años porque la gripe cambia todos los años. Y creo que, por cierto, nos dirigimos hacia lo mismo con la COVID-19, y es que la mayoría de las personas recibirán una vacuna anual. Con la vacuna contra la gripe, en realidad, es más difícil hacer esas conjeturas sobre exactamente qué cepa estará circulando. Y un grupo de científicos hizo esa predicción a fines de la primavera. Y algunos años lo hacen realmente bien, y algunos años no funciona. Los primeros datos, y no quiero exagerar porque no lo sabemos con certeza, pero los primeros datos sugieren que la vacuna contra la gripe de este año puede ser bastante buena, tal vez bastante adecuada con la versión que está circulando. Así que soy cautelosamente optimista de que ahí es donde entrarán los datos, que la eficacia de la vacuna contra la infección será bastante alta. Ahora, en términos de la vacuna específica que se recomienda para los adultos mayores, para las personas mayores de 65 años, existe algo llamado Fluzone. Es la dosis alta. Solo lo diré, es la vacuna tetravalente. Suena complicado. Pero básicamente lo que es, es que tiene cuatro veces el antígeno. Eso es lo que su sistema inmunitario reconoce. Y es mucho más eficaz, especialmente para los adultos mayores. Entonces, la recomendación, mi recomendación personal para mi familia y amigos mayores de 65 años, lo que les digo es que reciban la vacuna tetravalente de dosis alta. Si por alguna razón no puede acceder a ella, y la mayoría de los lugares las tienen, pero no todos, la vacuna regular contra la gripe sigue siendo mucho mejor que no vacunarse en absoluto. Pero si pueden obtener esa vacuna tetravalente de alta dosis, se llama Fluzone, realmente vale la pena hacerlo.

 

Bill Walsh: De acuerdo, bueno, solo el 49% de los adultos mayores en Estados Unidos planean vacunarse contra la gripe este otoño, según una encuesta encargada por la Fundación Nacional de Enfermedades Infecciosas. ¿Por qué supone que es así y cuál es el riesgo de omitir la vacuna contra la gripe?

 

Ashish Jha: Sí, creo que hay un poco de información errónea dando vueltas. Hay algunas personas que piensan, bueno, tal vez me contagie de gripe con la vacuna contra la gripe. No se puede contraer la gripe de la vacuna contra la gripe más de lo que se puede contraer COVID-19 de la vacuna contra la COVID-19. Así no es cómo funciona. En el caso de la vacuna contra la gripe, la vacuna simplemente no puede dar el virus. Y no hay virus en la vacuna contra la COVID-19. Así que ese es el punto número uno. No se puede contraer gripe por la vacuna contra la gripe. El segundo punto es que mucha gente dice, bueno, no lo he tenido, o lo tuve, y estuvo bien, fue leve. Mi opinión es que seguro, es muy posible que lo haya tenido, y fue leve en el pasado. No hay motivo para suponer que el próximo no será más grave. Y, en cuanto a las consecuencias de no contagiarse, lo expresaré de esta manera. He sido médico practicante durante 20 años, y cada invierno estoy en el hospital, diciembre o enero atendiendo a pacientes hospitalizados, los hospitales están llenos. Me encuentro con personas que tienen que esperar en la sala de emergencias durante tres días antes de que puedan obtener una cama de hospital y todo esto, en gran parte, se debe a la influenza. Las personas que no se vacunan, contraen la gripe, terminan teniendo un caso grave que no esperaban, luego terminan teniendo todo tipo de problemas con el corazón, los riñones, otras cosas. Entonces, es una intervención tan fácil. Puede ir a cualquier farmacia hoy y conseguirla, es gratis. Una vez más, como escucharon de Nancy LeaMond, el gran trabajo de AARP y otros, realmente creemos que estas cosas deberían ser gratuitas y, sin duda, la administración se ha centrado mucho en eso. Así que es gratis, está ampliamente disponible. Y Dios mío, evita que lo hospitalicen o algo peor. Me parece que la gente necesita hacer esto.

 

Bill Walsh: Muy bien. Ahora, creo que mencionó anteriormente que recibió la vacuna contra la gripe al mismo tiempo que recibió la vacuna bivalente. Así que supongo que ese es el protocolo recomendado para todas las personas en el país. Me pregunto qué pasa con otras vacunas como las de la culebrilla. ¿Debería entrar la gente y pedir múltiples vacunas al mismo tiempo?

 

Ashish Jha: Sí, le diré, creo que la respuesta es sí y explicaré por qué. En primer lugar, es totalmente seguro e igual de eficaz. Es decir, no hay problemas desde el punto de vista de la seguridad o la eficacia. Y la razón es que el sistema inmunitario es extraordinario. Su capacidad para reconocer múltiples vacunas diferentes y generar una muy buena respuesta contra todas ellas es bastante, bastante buena. Vemos esto en niños, y recuerdo cuando mis hijos eran pequeños, los llevamos al consultorio del pediatra y les ponen cuatro inyecciones en una visita. Y a los niños no les encantó, pero a nosotros nos encantó porque era conveniente. Simplemente obtiene todas esas vacunas en una sola visita. Esa es la razón principal por la que lo recomendé. Fui un día y creo que era un viernes, y recibí ambas vacunas en el mismo brazo y luego terminé. Ya estaba listo, no tengo que volver y hacer una segunda visita. De nuevo, seguro, fácil y muy conveniente. Por lo tanto, generalmente recomiendo que no haya ningún problema en recibir varias vacunas a la vez.

 

Bill Walsh: Está bien. Ahora déjeme cambiar de tema. Quiero hablar sobre un tema que es realmente importante para muchos de nuestros socios, y son los audífonos. Sabemos que el costo de los audífonos es considerable, pero, por supuesto, la FDA aprobó recientemente la venta de audífonos de venta libre. ¿Qué importancia tiene esto y qué debe saber la gente al respecto?

 

Ashish Jha: Sí, tengo que decirle que estoy muy entusiasmado con esto. Y de nuevo, sé que sigo trayendo de vuelta a mis padres ancianos, pero me dejará hacerlo una vez más si no le importa, Bill. Mis padres, mi papá, gastaron miles y miles de dólares en audífonos a lo largo de los años, y eran muy caros. Y simplemente no tenía ningún sentido para mí que fueran tan caros como eran. Y lo que sucedió fue que en el 2017, el Congreso aprobó una legislación bipartidista. Pero en realidad no sucedió nada dijeron que, básicamente, los audífonos podrían pasar a ser de venta libre. No sucedió mucho en los pocos años que siguieron. Pero cuando entró el presidente Biden, hizo de esto una prioridad y básicamente le dijo a la FDA, hagámoslo, hagámoslo. Y así, la semana pasada, vimos que todos los principales minoristas trajeron audífonos a sus estanterías. Entonces, Walgreens, Walmart, Sam's Club, Best Buy y muchos más. Y estos audífonos, como dije con la experiencia de mi papá, cuestan miles y miles de dólares. Así que ahora mismo estamos viendo audífonos en estos lugares por $200, $300. Y lo otro que les diré, que me emociona, es que no solo va a ser más barato. Algunas de las principales compañías de audio, Bose y otras, dicen que entrarán en este negocio. Así que creo que lo que va a pasar es que veremos audífonos, y los precios seguirán bajando. Vamos a ver que la calidad sigue subiendo. Creo que esto es realmente importante, y ha tardado mucho en llegar. Y estaba tan agradecido con el presidente porque nuevamente se había aprobado la legislación. Realmente le dijo a la FDA y a su Administración que ya era suficiente, hagamos esto y ahora estará disponible.

 

Bill Walsh: Está bien, muy bien. Grandes noticias para los consumidores. Tomemos algunas llamadas más de nuestros oyentes. Como recordatorio, presionen * 3 en cualquier momento en el teclado de su teléfono para conectarse con un miembro del personal de AARP y ponerse en línea para hacer su pregunta en vivo. Gil, ¿a quién tenemos en la lista ahora?

 

Gil Cabrera: Bill, tenemos a Susan, quien llama desde Alabama.

 

Bill Walsh: Hola, Susan, bienvenida a nuestro programa. Adelante con su pregunta. Susan, continúe con su pregunta.

 

Susan: Mi pregunta es, si no he recibido ninguna vacuna, ¿por dónde empiezo?

 

Bill Walsh: ¿Doctor Jha?

 

Ashish Jha: Buena pregunta, Susan, y la respuesta es, solo tiene que empezar. Creo que puede, básicamente, agradezco la pregunta. Creo que obviamente todavía hay alrededor del 10 al 15% de los adultos mayores en EE.UU. que no se han vacunado en absoluto. Y cuando hablo con ellos, y cuando están listos para vacunarse, lo cual siempre agradezco cuando lo están, les digo, simplemente comiencen, deben obtener la serie primaria, la primera de las dos primeras inyecciones. Y la razón por la que es realmente importante es que crea la base de su sistema inmunitario contra este virus. Así que todavía está ampliamente disponible. Simplemente llama a CBS, Walgreens, Highmark, lo que sea que esté cerca de Albertson's. Casi todos ellos todavía lo tienen. Llámelos, digamos, estoy lista para comenzar mi serie primaria. Y luego lo vacunan.

 

Bill Walsh: Bueno, ese es un punto muy interesante. Así que no debería pedir la nueva vacuna bivalente. Ella debe pedir la dosis original de la vacuna.

 

Ashish Jha: Sí, la serie primaria original sigue siendo lo que recomienda la FDA para las personas que no están vacunadas. Y la razón, Bill, es que esa serie original realmente creó esta amplia base de inmunidad que puede ser muy, muy importante para las personas. Así que eso es lo que todavía se recomienda. En el futuro, podemos ver cambios en eso, pero en este momento eso es lo que se recomienda y eso es lo que sigo recomendando para las personas.

 

Bill Walsh: Bien, gracias por eso. Gil, ¿a quién tenemos ahora?

 

Gil Cabrera: Bueno, en nuestro canal de YouTube, Bill, tenemos a Alina, ella está haciendo una pregunta de dos puntas, ¿cuál es la causa de las variantes? ¿Es verdad que los que no están vacunados son los que están creando las nuevas variantes?

 

Bill Walsh: Dra. Jha.

 

Ashish Jha: Esas son muy buenas preguntas. Lo que está causando la variación es esencialmente la evolución de un virus que, como dije, ha resultado ser un flujo muy, muy formidable. A medida que vacunamos a las personas, a medida que las personas se infectaron y comenzaron a desarrollar la inmunidad de la población, se crea esta presión sobre el virus para que evolucione porque, al evolucionar, puede tratar de eludir esa inmunidad. Y no hay duda de que muchas de las infecciones que conducen a variantes están ocurriendo en personas que no están completamente protegidas, cuyo estado inmunitario no está completamente actualizado. Pueden estar inmunocomprometidos, es posible que no hayan recibido sus vacunas y, a menudo, son la fuente de muchas de las variantes. Así que es una imagen complicada. Una de las cosas que es realmente importante es que si todos se pusieran al día con sus vacunas, definitivamente se reducirían drásticamente las infecciones. Se mantendría bajo el número de variantes. Pero el problema es... Siempre recuerde que no es solo lo que está sucediendo en Estados Unidos lo que importa, esta es una pandemia global. Y entonces podemos incluso hacer un gran trabajo aquí para mejorar nuestras vacunas, y continuaremos trabajando en eso. Si hay grandes partes del mundo donde las personas no están vacunadas, también pueden convertirse en fuentes de variantes.

 

Bill Walsh: Está bien. Gil, tomemos otra llamada.

 

Gil Cabrera: Claro, Bill. Tenemos a Kim, de Maryland.

 

Bill Walsh: Hola Kim, bienvenida a nuestro programa. Adelante con su pregunta.

 

Kim: Sí, recibí dos vacunas y dos refuerzos, y todo con Moderna. Pero esta bivalente es, no sé por OMS. Y tiendo a tener reacciones alérgicas a los medicamentos, así que hasta ahora no había tenido ninguna. Y me pregunto qué hará para mezclarla porque he estado recibiendo numerosas llamadas telefónicas, llamadas para recordarme que debo ir y recibi4r la quinta dosis.

 

Bill Walsh: Gracias por esa pregunta, Kim. Dr. Jha, ¿puede abordar eso? ¿Realmente no hemos hablado de personas que han tenido reacciones alérgicas o quién fabrica la vacuna bivalente?

 

Ashish Jha: Sí, gracias. Gracias, Kim, por esa fantástica pregunta. Así que, dos cosas. Dos empresas la fabrican. Son las mismas dos empresas que fabricaban las principales vacunas que recibimos la mayoría de nosotros, Moderna y Pfizer. El riesgo de reacción alérgica era algo que nos preocupaba en esa inyección inicial, esa primera inyección. Lo que hemos encontrado es que una pequeña parte de las personas tienen esa reacción alérgica a esa primer... Ella no la tuvo en la primera. Había poca o ninguna posibilidad de que lo tuviera para la segunda, tercera o cuarta. También es muy seguro mezclarlas, lo que significa obtener Moderna antes, obtener Pfizer ahora. Lo que le diría, Kim, es que me sentiría bastante cómodo con que la Pfizer, si recibiera un Pfizer bivalente, estaría bien. Pero si dice, mire, tengo cuatro vacunas de Moderna y me gustaría obtener otra Moderna, eso es más que razonable, y ambas están ampliamente disponibles ahora. Entonces, algunas farmacias tienen una, otras tienen otras. Así que es posible que tenga que investigar un poco y mirar alrededor para ver quién tiene Moderna. Pero definitivamente están ahí y en muchos, muchos lugares.

 

Bill Walsh: Pero parece que en realidad, no importa, ¿verdad? ¿Qué versión de la vacuna bivalente recibieron Kim u otros? No tienen que hacerlo, podrían mezclar y combinar, es lo que estoy diciendo.

 

Ashish Jha: Absolutamente.

 

Bill Walsh: Está bien.

 

Ashish Jha: Y es tanto así, que el día que recibí mi vacuna bivalente no sabía ni cuál me iban a poner. Y cuando estaba sentado ahí en la silla y la enfermera estaba a punto de ponerme la inyección, le pregunté cuál me ponía y me dijo que era Moderna. Y yo dije: "Está bien". Pero claramente no significó ninguna diferencia para mí. Solo me enteré unos 10 segundos antes de que entrara la inyección.

 

Bill Walsh: Ahora, ¿lo mantuvieron allí después de que recibió la inyección? Sé que originalmente, cuando recibimos las vacunas, querían vigilarnos durante 15 o 20 minutos para ver si había una reacción alérgica. ¿Siguen haciendo eso?

 

Ashish Jha: ¿Sabe qué? Algunos lugares todavía están haciendo eso, no lo hicieron. Recibí la mía en una clínica de salud en Washington D.C. No lo hicieron en mi caso. Creo que muchos lugares todavía le piden a la gente que simplemente se quede allí. Quiero decir, he estado en CVS donde, o creo que en Walgreens, donde le dicen a la gente: " Oiga, quédese en la tienda. No salga", porque solo quieren asegurarse. Pero estas cosas son tan raras ahora. Si inicialmente no ha tenido una reacción alérgica, las posibilidades de que tenga una ahora, son extremadamente bajas.

 

Bill Walsh: Está bien. Gil, tomemos otra pregunta.

 

Gil Cabrera: Claro, Bill. Tenemos a Natasha con nosotros desde Tennessee.

 

Bill Walsh: Hola Natasha, bienvenida a nuestro programa. Adelante con su pregunta.

 

Natasha: Sí, hola. Gracias por responder a mi pregunta, que es: me estoy preparando para recibir mi refuerzo de Moderna. He recibido todas las series hasta ahora y en aproximadamente una hora, estoy usando el CVS local y realmente están perfeccionando su aplicación. Solo por mencionar eso, para que pueda hacer una cita. Y ahora recibí una alerta que dice: Por favor, avísenos cuando esté en la tienda, para que puedan prepararse para mí. [risas] Entonces, la pregunta es y estaba buscando información sobre nutrición, qué debo comer o beber antes de un refuerzo, o si me puede recomendar que sería mejor ir allí con el estómago vacío, o no. Cualquier consejo en ese nivel sería útil.

 

Ashish Jha: Absolutamente. Entonces, lo que recomiendo básicamente antes de cualquier extracción de sangre, antes de cualquier infección, es que hay algunas personas que tienen más probabilidades de marearse. Y la mayoría de la gente no. Por lo tanto, generalmente recomiendo eso, asegúrese de haberlo comido o bebido agua o un jugo o lo que le guste beber. Obviamente no alcohol, pero básicamente creo que en general no debe ir con el estómago vacío. No debe pasar mucha hambre porque simplemente no quiere marearse después y sentirse mal. Pero aparte de eso, creo que la gente debería incluso beber normalmente e irse, y mientras lo haga, debería estar bien.

 

Bill Walsh: Está bien. Muchas gracias. Gil, tomemos otra llamada.

 

Gil Cabrera: Claro, Bill. Tenemos a Charlotte, de Texas.

 

Bill Walsh: Hola Charlotte, bienvenida a nuestro programa. Adelante con su pregunta.

 

Charlotte: Está bien, sí. Recibí las dos primeras vacunas contra la COVID-19, pero no recibí la tercera y no sabía nada sobre la cuarta. Entonces, ¿qué debo hacer en este punto?

 

Ashish Jha: Sí, Charlotte, es una pregunta genial, y la respuesta es simple. Solo necesita una inyección en este momento, es decir, debe ir y recibir esa nueva vacuna bivalente. No necesita ponerse al día, no necesita recibir las que son anteriores ni nada de eso en este momento. Esta nueva vacuna bivalente que está disponible gratuitamente significará una gran diferencia, aumentará sustancialmente su protección porque si solo ha recibido esas dos inyecciones iniciales, no tiene el nivel de protección que realmente necesita en este otoño e invierno. Así que estoy agradecido por su llamada y la respuesta es simple. Sólo necesita esa nueva inyección.

 

Bill Walsh: Y creo que lo dijo anteriormente en el programa, Dr. Jha, que las personas no tienen que solicitarla específicamente, que es la vacuna que recibirán si se inscriben para recibir una vacuna.

 

Ashish Jha: Sí, si solo anota que se está inscribiendo para recibir una vacuna de refuerzo, esa vacuna adicional, recibirá la vacuna bivalente.

 

Bill Walsh: Entiendo. Muy bien Gil, tomemos otra llamada.

 

Gil Cabrera: Claro, gracias, Bill. Tenemos a Francis, de Kansas.

 

Bill Walsh: Hola Francis, bienvenido a nuestro programa. Adelante con su pregunta.

 

Francis: Hola. Cuando recibí mi tercera inyección, tuve una reacción grave. No inmediatamente. No fue hasta el día siguiente, y tardé unos 10 días en superarlo. Estoy muy reacia a recibir otra vacuna.

 

Bill Walsh: ¿Qué tipo de reacción tuvo, Francis?

 

Francis: Dolor extremo. Apenas podía moverme. No comí durante tres días.

 

Bill Walsh: Dr. Jha, qué-- Adelante, adelante Francis.

 

Francis: Simplemente me sentía fatal.

 

Bill Walsh: Sí, lo siento mucho. Dr. Jha, ¿qué le diría a Francis y otras personas que han tenido malas experiencias como esa?

 

Ashish Jha: Sí, en primer lugar, lamento escuchar eso, Francis. Suena como una experiencia horrible. En su lugar, tendría una conversación con el médico sobre esto. Aquí hay un par de ideas. En primer lugar, hay momentos en los que puede premedicarse, dependiendo un poco de la reacción, si creemos que hay un componente alérgico, a veces se podría, lo que llamamos, premedicar a las personas con medicamentos antialérgicos que pueden significar una diferencia. y realmente puede marcar la diferencia si es de naturaleza alérgica. Obviamente, dada la cantidad de COVID-19 que todavía hay, es muy importante que las personas estén al día con sus vacunas. Si realmente usted y su médico dicen juntos que realmente no puede recibir una vacuna, entonces creo que deberían pensar, hay algunos de acción más prolongada, lo que se llama anticuerpos monoclonales. Estas son otras formas de aumentar su protección. Así que es una situación complicada. Exploraría esto un poco más con su médico. Piense si la premedicación con algún medicamento puede hacer una diferencia y tengan esa discusión. Y si al final decide no hacerlo, me aseguraría absolutamente de tener un buen plan sobre cómo será tratada si termina con una infección, en términos de Paxlovid o algo así.

 

Bill Walsh: Está bien, muy bien. Gil, tomemos otra pregunta.

 

Gil Cabrera: Claro, Bill. Tenemos a Bill, de Nueva Jersey.

 

Bill Walsh: Hola Bill, bienvenido a nuestro programa. Adelante con su pregunta.

 

Bill: Hola Dr. Jha. Gracias por hacer esto. Me pregunto si recomendaría un sitio web que tenga autoridad sobre qué cosas, como el formato de preguntas frecuentes, podrían usarse o algún otro formato que permita a las personas usar hipertexto para seguir respuestas autorizadas a preguntas razonables sobre esto. ¿Hay algún sitio que pueda recomendar?

 

Ashish Jha: Sí, creo que los CDC han hecho un muy buen trabajo al actualizar muchas de sus preguntas frecuentes de los consumidores, de los pacientes sobre vacunas y tratamientos. Así que ahí es donde envío a la gente, ahí es donde envío a mi familia. Todavía creo que está por ahí. También hay otras buenas fuentes externas. A muchos les gusta la Infectious Disease Society y otros grupos clínicos. Pero realmente sugeriría que comience en CDC y cdc.gov y lea su información sobre coronavirus. Porque sigue siendo la mejor información que existe.

 

Bill Walsh: Sí, cdc.gov es bueno. Bill, también sugeriría, y tal vez para todos nuestros oyentes que visiten aarp.org/coronavirus. Tenemos las últimas actualizaciones sobre vacunas, tratamientos y la trayectoria del propio virus. Y también tenemos preguntas frecuentes que también pueden consultar. Y, por lo general, extraemos nuestra información de los CDC y de expertos como el Dr. Jha. Así que creo que es bastante informativo. Ha sido una discusión muy informativa la de hoy. Quiero agradecer al Dr. Jha por toda su información. Ha sido muy útil y quiero agradecerles a nuestros socios, voluntarios y oyentes de AARP por participar hoy. AARP, una organización con 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. Ante esta crisis, estamos brindando información y recursos para ayudar a los adultos mayores y a quienes los cuidan a protegerse del virus, evitar que se propague a otros mientras se cuidan a sí mismos. Ahora, todos los recursos a los que hicimos referencia hoy, incluida una grabación del evento de preguntas y respuestas, se pueden encontrar en aarp.org/coronavirus, a partir del 24 de octubre. 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 que pueda ayudarlos a ustedes y a sus seres queridos a mantenerse saludables. Regresen nuevamente el 10 de noviembre para participar en otra teleasamblea sobre la COVID-19. Hasta entonces, gracias y que tengan un gran día. Esto concluye nuestra llamada.