12 Dec 12-11-20 COVID-19 Update
Coronavirus updates as of December 11th, 2020
For the most up to date CoVid-19 testing, diagnostic criteria, and release from isolation guidelines I have added a link to an interactive algorithm on our website https://www.alpinewoodsmedical.com/covid-19/.
As you may or may not be aware, there are multiple companies in active production and validation of a CoVid-19 vaccine. Pfizer, Moderna, & AstraZeneca are at the front of this race with Pfizer receiving Emergency Use Authorization (EUA) for patients aged 16 years and older from the FDA yesterday 12/10/20. Moderna’s vaccine will be reviewed for EUA next week (12/17/20). In addition, as of 12/8/20 Pfizer’s CoVid-19 vaccine has already been administered to the first “general population” patients in the U.K.
Unfortunately, Pfizer’s vaccine has already demonstrated significant side effects in individuals who have had a history of severe allergic reaction (anaphylaxis). For this reason, Pfizer is advising patients with a history of anaphylaxis to any drug or food NOT receive their vaccine at this time. Although other causes of anaphylaxis (e.g., bee stings) have not specifically been identified as restrictive criteria, I recommend patients with ANY history of anaphylaxis, regardless of cause, avoid the Pfizer vaccine.
Differences between the three vaccines (Pfizer, Moderna & AstraZeneca):
– 95% effective in preventing CoVid-19.
– Requires long-term storage at “ultra-freezing” temperatures of -94 degrees Fahrenheit in central hubs distributed throughout each state until transport to local pharmacies (CVS & Walgreens) for administration. Once removed from the “ultra-freezer” it can be stored at refrigerated temperatures for 5 days and then at room temperatures for no longer than 6 hours. Because of the strict storage requirements for the Pfizer vaccine CVS is planning an on-line tool for people to schedule their appointment to receive the vaccine.
– Two-part series of injections separated by 3 weeks.
– 94% effective in preventing CoVid-19.
– Requires long-term storage at “freezing” temperatures of -4 degrees Fahrenheit. Can then be stored at refrigerated temperatures for 30 days, and room temperature for no longer than 12 hours. Due to the less restrictive storage requirements for the Moderna vaccine we may see more retail pharmacy distribution.
– Two-part series of injections separated by 4 weeks.
– 60 – 90% effective in preventing CoVid-19 depending on the dose administered. AstraZeneca still attempting to identify the most effective dosing protocol.
– Requires only refrigerated temperatures (36 – 46 degrees Fahrenheit) for storage of at least 6 months.
– Two-part series of injections, dosing protocol yet to be determined.
Colorado makes up 1.69% of the U.S. population, so we can expect to receive 1.69% of the available vaccine. Once the FDA authorizes a vaccine, Colorado will receive a regular allocation of vaccine from the federal govt. and place orders on behalf of providers every week. For the two initial vaccines (Pfizer and Moderna), two doses will be required, and the same vaccine product must be used for both doses.
Current Colorado Prioritization
Phase 1A: Set to occur in Winter 2020/2021
Health care workers spending more than 15 minutes with CoVid-19 patients in any 24-hour period.
Long-term care facility staff and residents.
Phase 1B: Set to occur in Winter 2020/2021
Health care workers with less direct contact with CoVid-19 patients.
Workers in home health/hospice and dental settings
EMS, firefighters, police, correctional workers, dispatchers, funeral services, other first responders and CoVid-19 response personnel.
Phase 2: Set to occur in Spring 2021
People aged 65 or older.
People of any age with obesity, diabetes, chronic lung disease, significant heart disease, chronic kidney disease, cancer, or are immunocompromised.
People who interact directly with the public at work, such as grocery store workers and school staff.
People who work in high density settings like farms or meat-packing plants.
Workers serving people who live in high-density settings.
Other health care workers not covered in Phase 1.
Adults who received a placebo during a CoVid-19 vaccine clinical trial.
Phase 3: Set to occur in Summer 2021
Anyone aged 18-64 without high-risk conditions.
Note: Native American Tribes, Ute Mountain Ute and Southern Ute, have the authority to determine how vaccine supply will be prioritized for their populations, even if their prioritization scheme is different than what the Colorado Department of Public Health recommends. Federal entities such as the Bureau of Prisons, Department of Defense, Department of State, Veteran’s Hospital Association, and Indian Health Services will be vaccinated by the federal government. Children and pregnant people are not included in this preliminary phased approach; they may be prioritized for vaccine contemporaneously when/if safety and efficacy data are available with the appropriate ACIP recommendation.
As always if you have any questions or concerns, please do not hesitate to contact me anytime.
Eric J Hernandez, M.D.