Dr. Mark Sicklick of Cedarhurst Shares COVID Vaccine Update

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Dear Residents:

In our continuing effort to keep our community advised and informed regarding the COVID pandemic and responses to it, we have once again invited Lawrence resident and immunologist Dr. Marc Sicklick to update us on the status of vaccines and current treatments.

Please stay well and safe.

Thank you,

Alex H. Edelman
Mayor

Marc J. Sicklick, M.D., F.A.A.A.A.I., F.A.C.A.A.I.
Allergy, Asthma, and Immunology

February 10, 2021

VACCINES

The primary purpose of a vaccine, any vaccine, is NOT to prevent all disease. The purpose for the recipient, in descending order of importance, is:
to prevent death
to prevent hospitalization
to prevent serious illness
to prevent moderate illness
to prevent mild illness
to prevent infection
Herd immunity, which I expect will need to include about 90% of the population in order to be protective, is a separate and important goal.

If a vaccine is only 50-70% effective in preventing infection (infection means a positive swab, it does not mean illness) but no one dies after having received the vaccine, that is a very beneficial vaccine. If it cuts hospitalizations, that’s even better. Reading a headline about someone who was exposed to COVID after two shots who then tested positive, but wasn’t sick, is not bad news. It’s GREAT news. The vaccine worked. Headlining the infection sells advertising. Headlining that someone isn’t sick doesn’t.

There are also many headlines about the new variants of COVID and the fear that the vaccines may be less effective against them. Read this with the same basic approach. Fear sells. Comfort doesn’t. We simply don’t know the answer yet and laboratory measurements of antibody response do not always translate to clinical reality. My best guess that we will be getting an updated vaccine annually, very much like we do for the flu.

I also expect to have the Johnson and Johnson and/or Astra Zeneca vaccines released soon, and this will add 10s of millions of doses. Combining these new sources of vaccine production, increased production of the existing vaccines by Pfizer and Moderna, and the larger than expected number of people who are refusing the vaccine, I anticipate that the supply will become adequate over the next couple of months and the limiting factor in immunization will continue to be the distribution system and the extremely non-user friendly and frustrating registration system. I expect that the distribution and registration problems will disappear when vaccines are in local physician’s offices.

We need local distribution for everyone. Proximity increases success potential. The need to travel cuts the vaccination rate. This is why Village of Lawrence Mayor Alex Edelman, and Village Administrator Ron Goldman and Deputy Administrator Gerry Castro, have repeatedly offered the use of the Lawrence Yacht and Country Club for use as a Point of Distribution.

SHORT TERM PROJECTION

The newest projections show a doubling over the next 2-3 months of both new cases per day and deaths, before the numbers come down again, very much like last spring. This is because of the slow roll out of the vaccines and the new, more contagious strains reaching us. This short term rise can be tempered by social distancing, masks, hand washing, and common sense.

LONG TERM VIEW

While herd immunity is an important landmark to achieve and will protect some of those unable to be immunized (such as children, immune deficient patients, those allergic to the vaccine, and others who cannot get the vaccine), COVID is not going away. COVID will not disappear into the sunset. Instead, like with many other viruses, we will learn to live with it and have a new normal.

Vaccines will help us control COVID outbreaks and we will, in my opinion, need boosters on a regular basis, not unlike the flu vaccine, and the boosters will be directed against the genetic changes in the virus. Areas with low vaccination rates, and people who don’t get vaccinated, will be at higher risk. They will be at higher risk for outbreaks and will be spreaders even when they are asymptomatic.

New therapies will also help change COVID into a more easily confronted enemy.

We will have more and quicker testing. I doubt that people will fly, cruise, attend concerts and sporting events, or do any mass gathering without testing and perhaps a vaccination passport.

Weddings and other parties will return to the smaller sizes that they were in my parents’ time, with more spacing, unless people want to risk endemics.

Massive shutdowns of the economy, which did little other than cause additional hardships without eliminating the pandemic, will, hopefully, not happen again. Schools, which are low risk locations, should remain open. Children are safer in school than out, and zooming is hurting their social development and education. The shortages brought on by panic, such as the shortages of alcohol wipes, disinfectants, gloves, paper towels, and the most dreaded shortage of all, toilet paper, should not recur. Fear of food shortages, medicine shortages, parts for cell phones, computer parts, and other headlines from last spring that added to the feeling of gloom, doom, and impending disaster, were just that. Headlines, not reality.

In other words, the overall picture of daily life should return towards normal, but with more caution.

The vulnerable will remain with the highest risk and will need to be the most cautious. Deaths will occur just like there are deaths from the flu and other infectious diseases. But the numbers will be decreased and we, as a society, will adapt.

Sincerely yours,

Marc J. Sicklick, M.D.



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