April 11, 2021


Getting the vaccine to remote places is a challenge. Stehekin is a village at the top of Lake Chelan in the North Cascades. I have never been there but it is on my list of places I want to see. To get to Stehekin, you either need to take a float plane, a boat, or hike in after the snow thaws. Public health officials worked with locals to get COVID-19 vaccines by boat to Stehekin and Holden Village, which is even more remote than Stehekin. They were successful by using local health workers who already knew the people they were vaccinating. The locals were happy to be vaccinated so they can re-open to visitors and travel safely.

Those residents have now received both doses of the Moderna vaccine, which is a relief for them. They didn’t have to take a risky trip to get their vaccines. Many remote places have been hoping to get the Johnson & Johnson vaccine because its one dose simplifies logistics. However due to the factory mishaps the supply of Johnson & Johnson vaccine is decreased for the short term. Also disappointing to many who are hoping to get “the one and done” shot. They may have to wait a little longer or opt for another.

Some are afraid of the rare allergic reaction to Pfizer or Moderna. Concerns about whether to get the second shot are being addressed in innovative ways- a study using a series of smaller, graded doses to build tolerance, similar to allergy shots or desensitization protocols, is working well with antibodies detected later showing effectiveness.

I get lots of questions and worries about side effects, but even more questions and worries about not having side effects. If they had no side effects, did the vaccine work? Be reassured that the vaccines are still effective. In the studies, 60-80% (many of them younger patients) had side effects which meant 20-40% did not. The data to know is that the vaccine was still effective 95% of the time.

The other questions are about how soon are you protected after your vaccine, but also what about the breakthrough cases we hear about. This article in New York magazine breaks down the data and explains it pretty well. But breakthrough infections still occur, rare now, but the jury is still out about how the new variants will play. Post-vaccinations cases are still rare, but may be higher in the elderly or those with compromised immune systems, so masking and distancing with ventilation are still advised, until we reach a certain level of herd immunity, still to be determined.

Wash your hands, cover your nose, keep safe six, to help keep others safe.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.



https://www.medpagetoday.com/infectiousdisease/covid19vaccine/91960 graded dosing