COVID-19 Vaccine Information

COVID-19 Vaccine Webinar Video Transcript

(SPEECH)
LOUIE ST. GEORGE: Good afternoon, everyone, and thank you for spending your lunch break with us. My name is Louie St. George, and I'm the public relations manager here at Essentia Health. With so much interest and a little bit of uncertainty around the public rollout of COVID-19 vaccines, we wanted to connect directly with our patients and the communities we serve. So the goal of today is to provide you with useful information about the vaccine, its safety and effectiveness, and the distribution process. We'll also discuss the prevalence of COVID in our communities, as well as the virus's current trends and new variants. Again, we realize there are a lot of unknowns around the delivery of vaccines. Today's panelists will do their best to lend some clarity to the situation, clear up misperceptions, provide useful resources, and explain why these vaccines are the surest way out of this COVID-19 pandemic. We'll begin with brief presentations from five of our experts here at Essentia. They are Dr. Peter Henry, Essentia's chief medical officer, Dr. Amanda Noska, infectious disease physician, Roseann Hines, a pharmacist and Senior Operations Manager for Medication Use Management, Dr. Sarah Manney, who is our Chief Medical Information Officer, and Dr. Richard Vetter, Chief Medical Officer of Essentia's West Market. Additionally, each panelist has been asked to discuss why they received the vaccine or will receive the vaccine. I think you'll find they're all staunch advocates. The second half of the webinar will feature a question and answer session, and we encourage you to ask questions using Zoom's Q&A button at the bottom of your screen. And just based on the size of today's audience, I don't think we'll get to any raise your hand questions, so please use the Q&A button there at the bottom. My colleague Kim Kaiser will help with those questions. And as an FYI, we'll post a video of this webinar to our Facebook and YouTube pages. For future updates, be sure to visit EssentiaHealth. org, and click on the Vaccine Distribution link at the top of the homepage. I've already talked too much and we've got a lot of ground to cover here over the next hour. So with that, I'm going to get out of the way and let the experts take over Thanks again for attending. Dr. Henry.

DR. PETER HENRY: Thank you, Louie, and thank you, everybody, for being here today. We hope to be able to communicate the importance of the vaccine and the safety of the vaccine today, and give you a little bit of information about current COVID activity. I'll have you go to the next slide, if you would. So we've seen a lot of improvement in the prevalence of COVID activity in the last few months here. Back in November, when we were having very high cases, we had as many as 9,000 cases per day in Minnesota, and you can see the other statistics for North Dakota and Wisconsin. But as of yesterday, we now have 1,292 cases in Minnesota, 152 in North Dakota, and Wisconsin, 2,177. And our access to hospital and ICU beds is much better, but we're still not out of the woods. And it's very important to note that things can change very quickly. And a good example of that is what's happening in Los Angeles County in California, where they're really struggling with numbers, and other parts of the United States where they're seeing an upsurge of that kind of third wave that's coming through. So I want people to continue to be vigilant and recognize that although the numbers look much better, we have a lot of work to do. I'm going to have you go to the next slide, please. So we need to continue the key factors that help us to reduce the spread of the virus, and that's wear a mask, continue to social distance, practice good hand hygiene, and stay home when we can. Travel to other parts of the country, as well as internationally, puts us at risk for some of these various strains that are circulating the globe, and Dr. Noska will talk more about that. We're going to need to be continued to be vigilant, along with the vaccination process, to ensure that we don't see another surge coming in the near future. Can you go to the next slide, please. So the benefit of vaccines, you know, historically people were very willing to accept vaccines, because there were so many significant catastrophic circumstances from getting the disease. And good examples of that in the not too distant past are polio and smallpox, where people recognized that there were some risks associated with the vaccine, but the catastrophic illnesses that were associated with not getting the vaccine outweighed-- the benefits outweighed the risks. And so vaccines are still our best hope to control the pandemic that's killed over two million people worldwide and over 400,000 people in the United States. And tens of thousands of trial participants showed that there's a very effective vaccine with comparatively 95% effective. That means that it helps either reduce the severity of the illness of the disease or it prevents you from getting the disease itself. And the side effects that are there are typically minimal and self-limited. And we really won't be able to return to a true normal until we can get herd immunity. So we have an option of either vaccination and continuing social distancing. Hopefully we'll get advances in care. The other option is to not vaccinate and live with the 1% to 3% death rate that has been shown worldwide without doing something significant. So the vaccine is an important part of public health, and it's an important part of reopening our economy and our country. Can we go to the next slide, please. So in regard to vaccine safety, obviously, as a physician, I've dealt with giving vaccinations, receiving vaccinations throughout my career. And I am convinced that the science behind this and the processes for bringing this vaccine to market have been very carefully followed. I think I owe it to the community as a health care provider to set an example, but I'm not doing it just to set an example. I recognize that this is the best way to protect the patients that I serve, the organization, the colleagues with whom I work who help to deliver health care, and also, obviously, family members and friends. That's the key reason I got vaccinated, and I believe that the science is there, and it's very safe. And the cost of not vaccinating is immeasurable. So thank you, Louie.

LOUIE ST. GEORGE: Thank you, Dr. Henry. Now we will turn it over to Dr. Amanda Noska.

DR. AMANDA NOSKA: Hi, everyone. Thank you for inviting me to be part of this. You can go to the next slide, Louie. Thanks. So I'm going to be talking briefly about the SARS-CoV-2 variants. Coronaviruses do mutate over time, and SARS-CoV-2 is among the coronaviruses. SARS-CoV-2, which is the virus that causes COVID, mutates at approximately half the rate of influenza and about a quarter of the rate of HIV. The CDC is now actually as of January 26 planning to begin mandating a negative SARS-CoV-2 swab before entry into our country, because of the risk of international travel and spreading the different mutations that are around the world. Routine surveillance is ongoing in all 50 states and being sent to the CDC to make sure we know about these variants and the effect that they have in our communities. Next slide, please. The three that we're very aware of and most concerned about right now that have been in the news, in particular, the UK variant, the B117 variant, it has an unusually large number of mutations. And as of January 18, we do have five cases here within Minnesota. Three of them were among young individuals aged 15 to 37 who had recently been on an airline, and so I think that that's very important to keep an eye on. As far as we know, that UK variant is not quite as high of a risk for vaccine escape, meaning the vaccine will be-- we expect the vaccine, at least in the immediate future, to be effective against that and protecting against it. The other variants are the South African variant, the B. 1. 351. That's not been-- as of the 18th of January, has not yet been detected in the United States. That one we are more concerned about being able to evade the vaccine response and neutralizing antibodies created by the vaccine to protect you from COVID in the longer term. It may be protect it in the short term because a vaccine immunology is more complicated than just one single antibody against the spike protein, but it is very important to keep an eye out for that, because that one has the potential to be more significant. The Brazilian variant, the P. 1 variant, has also not yet been detected in the US, and that too has a mutation that involves the spike protein, which may be capable of evading the immune system in the future, the immune response from the vaccine. So we need to keep an eye out for that, as well. And as of the 18th of January, it was not yet in the United States. Next slide, please. You can see here, the CDC has a wonderful map that they update regularly of the cases of the B 117 lineage of SARS-CoV-2. Minnesota has five cases thus far, Wisconsin one, North Dakota zero. The biggest states with these variants are California, Florida, and New York. But with even national travel, you can understand that this could be readily transmissible. Next slide, please. The B117 variant was first discovered in the United Kingdom in September of 2020. It is increased-- it is associated with an increased transmissibility, meaning it could be more contagious, and it's more rapidly spread. There's no evidence to date to suggest that it has more severe disease associated with it or that it alters vaccine efficacy, although there's a lot of debate about this in the infectious disease and public health communities. We don't at this point have reason to suspect that it will-- that we have reason to suspect that the vaccine will be effective against protecting from this particular variant. There may be higher rates of asymptomatic carriage, meaning people without symptoms carrying around COVID and being potentially infectious, as high that-- I've seen in some literature as high as 59%. I think that may be an exaggeration, but just a slight one. And that's risky, because you don't know if people have covered unless they're symptomatic or have a test. And it's suspected that it could be more common among young adults in an asymptomatic form, or no symptom form. Next slide. So what could this mean for our community? I think there's some concerning things about this. One, because it's more efficiently spread, we could see another surge coming as a result of this. And certainly, California is experiencing that right now, and and Florida, as well. Higher rates of hospitalization could be one of the downstream effects of this more efficient variant. And then the subsequent use of scarce resources that we have. As far as why I got vaccinated, I think it's very important when there's something that can prevent death to pay attention, especially with science. And this is something that can prevent death more than anything else that we have. It's 94% effective, which is wildly effective. And I not only feel like it's the right thing to do, but I'm interested in preventing death. And I also want to be able to get back to a normal life. And I believe it's our best chance of doing that. Thank you.

LOUIE ST. GEORGE: Thank you, Dr. Noska. Roseann, you're up.

ROSEANN HINES: Thanks so much, Louie. So as he introduced earlier, my name is Roseanne Hines, and I'm a pharmacist at Essentia. Next slide, please. At Essentia, we've been vaccinating our community health care workers and team members for a little over a month. And I'm happy to report that within that one month period, we have given over 15,000 individual vaccinations. On the slide here, it really breaks down two groups, those that have completed their series as well as those that are still in their vaccination journey. So we have over 5,000 health care workers, and those that are Phase 1A, individuals that have completed their vaccination series from Essentia Health-- that is both that first and second dose. And then an additional, almost, 4,500 health care workers Phase 1A individuals that have received their first dose and are awaiting their upcoming second dose. The COVID vaccine is one of the most effective vaccines ever produced with efficacy rates of approximately 95% after two doses. It is essential to have the two dose series to achieve that max efficacy, and really this vaccine is on par with those other vaccinations for measles and chicken pox that we use currently. Next slide, please. Essentia Health has facilities and footprints in three states, and so the next several slides, I'll be going over the processes and distribution and vaccination work we're doing in North Dakota, Minnesota as well as Wisconsin. In North Dakota, we have started vaccinating those that are 75 years of age and older who are North Dakota residents or live in that border area and have a health care provider within North Dakota. Next slide, please. North Dakota Department of Health has released Phase 1B vaccination recommendations and sub-prioritizations within that. At Essentia Health, we are actively contacting eligible patients who are 75 years of age and greater through MyChart and via phone. We are recommending that patients schedule and use MyChart as much as possible as it is easy and efficient. And Dr. Manney will be going over those steps later in the presentation. Within our North Dakota facilities at Essentia Health, we are currently vaccinating at Fargo, Wahpeton, Jamestown, and Valley City. Next slide, please. It's been an exciting week in Minnesota and Wisconsin as well. On January 20, so Wednesday of this week, it was announced that we can begin vaccinating our community members who are 65 years of age and older while we finalize and complete that Phase 1A group. Within Wisconsin, we have received similar notification and can begin vaccinating our community members who meet the criteria of 65 years and older starting next week on Monday January 25th. In both Wisconsin and Minnesota, we have not yet received specific guidance and information around Phase 1B prioritization and anticipate that in the next coming weeks. We do continue to experience limited supply and work very closely with our state departments of health and other local community health care partners to ensure active vaccination and movement of supply. Next slide, please. At Essentia Health in Minnesota and Wisconsin, since we have not received that sub-prioritization information from the state departments of health as of yet, we have identified two key initial pathways for vaccination and distribution to our patients that are 65 years of age and older in our communities. We'll be using a randomization process to notify those who meet that 65 year criteria by MyChart and phone, and then also continue to actively partner with our community outreach team within Essentia to target those vulnerable populations and underserved groups who are 65 years and older. Next slide, please. As many of you likely saw, Governor Walz announced this past week nine key pilot site locations within Minnesota to support COVID vaccination. This past week they have scheduled and started vaccination processes for individuals in our community that are 65 years of age and older, educators as well as child care workers. And you can go to the MDH website to determine your eligibility and registration. And so in line with the other reasons for vaccination, there's really a multiple reasons to do it. There's the science behind it, but for me the two main drivers are community and my family's safety. I'm a mom of two young children, and my husband and I both work in the health care industry. And I want my kids to see their grandparents, and I want their grandparents to be safe as well, so that was one of our key drivers as a family to get vaccinated. Additionally, I have the opportunity to get vaccinated, and many in our community may not, whether it's due to health care conditions or age restrictions. And so by getting vaccinated, we create that herd immunity and really protect our community members who may not have that option for that element of safety. Thank you so much.

LOUIE ST. GEORGE: Thank you, Roseann. Dr. Manny.

SARAH MANNEY: Thank you, Louis. My name is Sarah Manney, and I'm a pediatrician by training, and I serve as Essentia Health Chief Medical Information Officer. And the purpose of my presentation today is to discuss the technology that we have built to conduct a successful community vaccination campaign I'm very proud to work with a group of IT specialists and operations leaders, and I'm excited to show you the workflows today. As Roseann discussed, there will always be a phone option for those who do not have access to technology. But in any way possible, we really need your support and the community support to use the technology that we have in place. You may have read articles about systems crashing because everybody wanted the vaccine and called all at once. And we are fearful that that may happen here, so you can help us and we'll discuss that today. Next slide, please. Our process and workflows is surrounded and led by MyChart. MyChart is our patient portal from our EHR which is called Epic. It's a web-based portal. You can use it on the internet or on a mobile app. And if you are an Essentia Health patient, it can give you 24/7 information into your medical record. You can check labs. You can send a message to your provider or even schedule an appointment. But even if you are not an Essentia Health patient, you can use MyChart just for the purposes of COVID vaccination through Essentia Health, and we want to encourage you to do so. Next slide, please. The way this would work is we want all community members to sign up for MyChart, whether you choose to receive your care at Essentia Health or not. If you want your vaccination, please use MyChart. We will ask you to fill out a form, and when it is your turn to receive the vaccination through our prioritization groups, you will receive a scheduling ticket. And that alert will come to your email or to your MyChart, and then you can easily click and schedule a vaccine time that works for you. When you receive the vaccine, we'll have you sign up for your second dose right there so we can have that scheduled and ready to go. Right now it's easy for an Essentia Health patient or for anybody who's received a service at Essentia Health to sign up for MyChart. And early next week, we will have a few processes in place that will make it just as easy for other patients who are nonessential patients to sign up. If you've tried this in the past, we ask you to try again. We'll have a few pieces in place early next week to make this happen. Next slide, please.

SPEAKER: During this COVID-19 pandemic, Essentia Health is using MyChart to assist everyone in scheduling their first and second doses of the COVID-19 vaccine.

SARAH MANNEY: Those here at Essentia Health who have developed a video that we'll show here.

SPEAKER: If you would like to receive your COVID vaccine from Essentia Health, we encourage you to register for MyChart for efficient scheduling of your vaccine. Download the MyChart app from the app store, or go to EssentiaHealth. org and click MyChart. Enter an activation code or click Sign Up Online. Complete the security check, then create a user ID and password. From there, you can complete the COVID vaccine form. Essentia Health is following guidelines from our state health departments and distributing the COVID vaccine. We will send you a MyChart scheduling ticket when you are eligible and the vaccine is available for you. The scheduling ticket prompts you to receive an alert through your email and MyChart inviting you to schedule your vaccine. Thank you. SARAH MANNEY: Thank you so much. So as you can see in that video, we will ask you to fill out a vaccination questionnaire, and you can find that through the Symptom Checker section of your MyChart portal. This information is really helpful for us as we guide our scheduling tickets based on our guidance from our state's Department of Health, so we'll ask you some information. On the next slide, we'll see some more details. We'll ask you some information about chronic health conditions, if you're willing to share, and some more information about Essentia worker status. So this information is very important so we can send out the scheduling tickets and prioritize groups based on the guidance that's received from the state's Department of Health. Next slide, please. So when you're eligible, again, you'll receive an eligibility scheduling ticket in MyChart and then you'll be able to schedule. And it's very easy, it takes about three clicks to make that happen. Next slide, please. As Roseann discussed, we do have an uncertain timeline here. We are uncertain, from each of our states, what our vaccine allocation will be, and it is possible that our appointments for the vaccination may change subsequent to the allocations that we receive. So we do ask that you continue to check your MyChart account and our website and any social media accounts, too, for any updates. We also will have that video that you just saw available, so you can use that with your family members, community members, and try to get everybody signed up for MyChart in preparation for them to receive their COVID vaccine. So why did I get vaccinated? I'm a pediatrician, and I am very passionate about vaccination. And it is the most powerful public health tool that we have at our disposal. I am very honored and blessed that I received my second vaccination this week. My arm was a little bit sore, but, otherwise, I feel just fine. And I received that vaccination because I wanted to protect my family. I want to protect my patients. And I also want to protect the community that my husband and I have chosen to raise our children in. And I love this community, and I love that I'm here, and I want to protect everybody. So there is light and there is hope, and the way out of this pandemic is through vaccination. So I really encourage you and all of your family members and friends to please get vaccinated. Thank you.

LOUIE ST. GEORGE: Thank you, Dr. Manney. Dr. Vetter, you are up.

RICH VETTER: Great, thank you. And thank you all for joining us today as we learn more about the COVID vaccine. For my portion of this webinar, I've been asked to discuss vaccine development as well as the safety and efficacy of the COVID vaccines that are currently available. Next slide. So I know and we know that there's been a lot of concerns expressed about the rapid development of these vaccines, and that has raised some concerns about the safety of these vaccines. And I, first of all, just want to let you all know that there was no-skip steps, but the phases all occurred at the same time, which helped kind of accelerate the development of this vaccine. As the vaccine data was developed and came out, top medical and scientific experts worked feverishly around the clock, backed by a significant amount of resources from the federal government as well as local and private agencies which really helped accelerate the vaccine development. And then just also wanted everyone to know that there was a thorough review of the data by independent experts, including the FDA, as they looked at the safety and efficacy data. Next slide. The two COVID vaccines that have been currently approved through the emergency use authorization process have included over 70,000 participants in the phase two and three trials. Looking just at the Pfizer vaccine trials, there was 170 cases of COVID in that arm of the trial, 162 of those were in the placebo group, but only eight in those who received the vaccine. For the Moderna vaccine trial, there was 95 cases of COVID infection, 90 of those were in the placebo group, and only five in the vaccine group. So this shows and this is where that 95% effectiveness rate after getting both doses comes from. Next slide. You've heard a lot about messenger RNA vaccines, and although these are new vaccines, the technology has been underway for many years actually, and researchers have been studying and working on messenger RNA vaccines for quite some time. The interest has really grown in this vaccine process because of the readily available laboratory methods and also the way that they can be standardized and scaled up in a much more rapid pace than was historically done as we make vaccines. The development of messenger RNA vaccines are really a new way to help protect us against infectious disease. To trigger an immune response, many of the vaccines in the past have taken an inactive or weakened vaccine or germ and injected it into our bodies to develop that immune response. The messenger RNA vaccines, on the other hand, really teach ourselves how to make proteins that are representative of the outside of the virus and that helps trigger an immune response within our body so that when we are exposed or the virus attempts to get into our body, those antibodies help protect us against the virus. I just want to remind people, also, that these vaccines do not alter your DNA, and eventually the messenger RNA that's used in the vaccine is eliminated over time. Next slide. Side effects. There's been a lot publicized about side effects as well. Most of the side effects that we've seen to date are really similar to what we see with other vaccines. Those include mild fever, headaches, and fatigue, maybe a pain at the injection site. And they're really pretty minor compared to the seriousness of a COVID-19 infection. The risk of serious reactions is actually quite rare. If you look at the concerns that have been raised-- or if you do have concerns that are raised about getting the vaccine, we would certainly ask that you talk to your physician or primary care provider-- though really the only contraindication at this time to a vaccine is a history of a severe allergic reaction or anaphylactic reaction to an injectable vaccine or medication. Next slide. So in closing, I just want to say that vaccines are a critical step in protecting yourself and your loved ones. They are highly effective, have been shown to be exceedingly safe. Tens of millions of doses have been given. The CDC and others are tracking the safety data as well as side effects to the vaccine and to date have proven to be extremely safe. We are working hard as an organization to get these vaccines out to our patients and our communities. And will continue to work and get those distributed as quickly as supplies allow, so we would ask for your patience. We want to remind you to continue all those public health measures we've been talking so much about over the past nine months, which include masking, social distancing, avoiding large gatherings, washing your hands as well as staying home if you don't feel well. Why did I get vaccinated? Like the others on this call have articulated, it's really the same reason I support other vaccinations. It's a way to keep myself, my patients, my family, my colleagues, and my community safe. And I hope that you will all consider that and get the vaccine when it's available to you as well. So, again, thank you for joining us today, and we'll look forward to answering some questions.

LOUIE ST. GEORGE: Thank you, Dr. Vetter. And thank you to all of our panelists for joining us today. I know you all have hectic schedules and so we appreciate your time. As Dr. Vetter alluded to, now we'll open it up to questions. As a reminder, please use that Q&A button at the bottom of your screen, and we'll get to as many questions as time allows. Planning to wrap it up right at about 1:00 PM. And I'm going to turn it over to my colleague Kim Kaiser, and she will kind of facilitate the Q&A. And, again, please use the Q&A button, and we'll do our best to answer as many questions as we can. Kim?

KIM KAISER: Yes, thanks, Louie. And thanks so much to everyone who has shared their questions with us today. We won't be able to get to all of them, but there are many similarities in the questions that have been asked, so we'll try to ask some of the more common ones. And I do think that many of the questions that were asked have actually been answered during the course of the presentation, so I hope everyone joining us today is finding that to be helpful. We have gotten several questions about the process of signing up for MyChart, and I'm wondering, Dr. Manney, if you could tell us a little bit more about the timing for when those folks who are not currently Essentia patients will have that ability to sign up for MyChart. We've also gotten questions about when that questionnaire will be available. I believe it's not available today, and I think it would be helpful for people to know when that is an option and when they can use that questionnaire.

SARAH MANNEY: Absolutely. Thank you, Kim. What we would ask is that in preparation for this, we have everybody sign up for MyChart. I saw a few questions in the chat about when they should do it. Should it happen now? So if you are an Essentia patient or have received care at an Essentia site, you have an easy process to sign up, so please go ahead and do that. The form that we described will be available on Monday, and so you'll be able to complete that vaccination form starting on Monday. And for the non-Essentia Health patients who choose to vaccinate with Essentia Health, we expect that our expedited process will be set about Tuesday, but that is a little bit vague at this time. We just have two minor technical things we need to put in place to make that an easy solution for our non-Essentia Health patients.

KIM KAISER: So more to come on that. It's exciting work. And then some people also wondered if they need to wait until they're part of that age group that is eligible to receive the vaccine to sign up or you do the questionnaire, but it's not like it can be anyone.

SARAH MANNEY: Yeah, and I would ask that people do it as soon as they can. Because what that does is it helps populate our data so we are able to reach out to you as we follow our guidelines from our state's Department of Health. And so I saw several questions about that as well and it is in flux. We don't have guidelines yet from the state of Minnesota or from Wisconsin that are specific to chronic diseases, but gathering this information will help when that time comes.

KIM KAISER: And that is a great segue to another question that we have here. Many folks are wondering, is there any prioritization that our State Department of Health have given us within age groups in terms of chronic diseases or other considerations? I was wondering if Roseann Hines might be able to address some of the guidance that we've received from our state's departments of health on this matter.

ROSEANN HINES: Sure. So all three states, Wisconsin, Minnesota, and North Dakota, have provided specific guidance for Phase 1A, which was our health care workers and long-term care team members. North Dakota currently is the only state within our footprint that has provided specific guidance for Phase 1B, which also aligns with some sub-prioritizations. And so that is why in North Dakota, we have specifically started with 75 years of age and greater, and then have next steps and patient populations based on that state specific guidance. Within Wisconsin and Minnesota, we had received interim guidance this week that we can start to look at and help vaccinate those 65 years of age and older, but we have not received specific Phase B guidance and/or that some prioritization or breakdown of patient populations.

KIM KAISER: Thank you for that. One person asks, my wife who is 71 years old received a message that she could schedule her vaccination, and says, I'm very happy for her. And he is 72, and he wonders, why didn't I receive a message to receive the vaccination? Maybe you could talk a little bit about the process, Roseann, that we're notifying people.

ROSEANN HINES: Yes, so currently within outside of North Dakota, which had that specific guidance in Wisconsin and Minnesota, are 65 years of age and older is that criteria we have from the state, and so we have selected a randomized patient selection process. We understand that certain chronic diseases may put individuals at higher risk, but we also know that sometimes medical records aren't up to date. If it's a non-Essentia Health patient, we may not have that information for them and so have elected to move in a process of using an age range until we receive other specific guidance from the states.

KIM KAISER: Thank you. And this is a question, I think, for Dr. Noska. The question asks, if a person has had COVID, do they have immunity or do they still need to be immunized?

AMANDA NOSKA: Yeah, that's a really great question. Thank you for asking that, whomever did. We know that people have a short-lived-- many people, not all people, but most people-- have a short-lived immunity, if you will, or a short-lived antibody response to COVID. That tends to last about three months according to the current data that we have available to us. It may last longer in some individuals, but we can't rely on it lasting longer than that at this moment. Of course, everything changes with COVID frequently because we're all still researching the immune response after COVID. So the shorter answer is that, yes, you may have persistent antibodies to protect you from reinfection from COVID, and we think those lasts for about three months. So if you're interested in getting a vaccine, which I would highly recommend for anybody even if you've had COVID, the timing of that might be best after the three months or three months after you've had COVID. Those who are most likely not to have such a robust immune response are those who have very, very mild disease. But we expect the vast majority of folks with COVID will have at least a three-month window where they should be relatively protected from reinfection, so getting vaccinated after that three-month mark might be the best plan for some of you. Now some of you may choose to get vaccinated within that three-month window, and that's also a reasonable possibility. But certainly after the three-month window from the time of your symptom onset or diagnosis of infection, we would encourage you to think about getting vaccinated.

PETER HENRY: Kim, this is Pete. May I just add just a quick comment. So we've been focusing a lot on the vaccine and that's an exceedingly important thing, but recognizing that how quickly we can vaccinate everyone will depend on how our supply of vaccine coming to us from the federal government occurs. But there are other things that I think are extremely important that we need to know. The first is that there are therapies out there that are very effective in keeping people from having to be hospitalized or getting severe disease should they contract COVID, and that's called monoclonal antibody therapy, and that is available at Essentia Health and many other sites and health care systems. And so one of the pleas that I would make to everyone that's on this call is if you develop symptoms that are consistent with COVID, even if you question them, please either contact your health provider, but get a test and get a test early. Because these therapies are most effective early in the course of the disease, and they can have a dramatic effect on reducing the risk of hospitalization. Some of the early studies on these therapies showed that your risk of getting hospitalized after contracting COVID was about 2% if you got these therapies, 2% to 3%. And if you didn't, it was about 13%. We're finding that it's actually even higher than that. That the benefit is even greater than what the initial phase one studies are showing, so the key message and takeaway I want people to wait while you're waiting to get the vaccine, which we'll try to get to you as quickly as possible based on our supply, if you have symptoms, or if you know somebody who has symptoms, have them get tested early. And we have a process of getting you in and getting this therapy which can be very, very effective in preventing you from being hospitalized which will help us to continue to deliver health care to other of the medical needs of the patients we serve. Thanks, Kim.

KIM KAISER: Thank you, Dr. Henry. Here's another question for Dr. Noska that has to do with the variance that you were discussing. Do we believe that the surveillance is thorough enough? That just because the South African or Brazilian variants have not been detected in the United States that they're really not here yet?

AMANDA NOSKA: That's a beautiful question. Thank you to whomever asked that question. I know that our CDC is trying very hard to do surveillance and that the Minnesota Department of Health is sending regular samples from Minnesota to the CDC, but it's a very good point that you bring up in that-- no, I don't think we can ever be 100% confident. The UK variant, for example, we think has been here potentially much longer than we thought it had been, and so even though we are doing surveillance, they're not sending every single swab in every single state to the CDC. We obviously don't have the ability to do that. So I think for right now we do encourage folks to be careful and do all the things that we've talked about repeatedly for the last 11 months, which is to please wear a mask and to keep your distance and to avoid unnecessary travel. And part of it is that we really want to make sure we have a better handle on COVID with the vaccines before we liberalize travel to that degree, and it really could make a dramatic difference. So thank you for bringing that up because we certainly could have those variants here and not yet know about them. Nothing is 100%.

KIM KAISER: Thank you. We have a couple of questions that ask about the protection after you are vaccinated. Some people are saying, how long after the second shot are you considered immune or what is the expected duration of protection after receiving the two vaccines?

AMANDA NOSKA: Did you want me to take that one, Kim?

KIM KAISER: Sure.

AMANDA NOSKA: OK. I didn't know. I'm sorry. So the maximum protection that you would have is 14 days after your second dose of vaccine. Most folks have a pretty good amount of protection after the first one but certainly not 95% after the first vaccine dose. And it does take a couple of weeks after the second vaccine to get your immune system fully ready with the various immune cells that you need to protect yourself so two weeks after the vaccine is the time frame. And then the second question, Kim, was how long does it last?

KIM KAISER: Yes.

AMANDA NOSKA: Yeah, so there have been several theories out there, but I'm not clear about absolutes. We do know that the vast majority of folks in that 70,000 person cohort that did receive the vaccine have at least four to six months of immune protection thus far. And Moderna seems to be suggesting that there should be at least a year protection. I'm not sure if others on the call want to comment on that.

ROSEANN HINES: I would just echo-- this is Roseann-- I would echo what Dr. Noska said. As it is a new vaccine, you have to wait that timeline for people to go out that far, but the information she provided was what I have to date as well.

KIM KAISER: And I'll ask one more question along the same lines before we switch gears a little bit. Asking, what is the efficacy rate of having just one dose of the vaccine? Roseann or Dr. Noska, either one of you could answer this.

ROSEANN HINES: So within the trials, they look at titers and/or antibody response, but they don't necessarily report actual efficacy data with the interim first dose and so for that full 95%, you would need to complete that second dose. Dr. Noska, I don't know if you have additional comments you would like to make.

AMANDA NOSKA: Yeah, I think that's a really good question. It's hard to answer with absolutes because, you know, I saw another question on here was about being on immunosuppressives while getting the vaccine. So the vaccine response is individual to your person and your immune system. And I'm not trying to evade the question, but the 95% is in-- they did stratify folks by age, and by some comorbidities like diabetes, but as far as folks who have other immune-- or on other immunosuppressive-- you may have less of a robust immune response to that so that kind of alters things. As far as the first dose of the vaccine, I don't know good data on that. There have been some theories that it is reasonably effective, but I would be making a number up out of thin air to tell you anything beyond that. So I think one dose is better than no doses, but two doses is the 95% that we really are hoping for. And it's reasonable to get the second vaccine if you should forget or not be able to schedule it at 21 days, which is what we hope for to kind of make that vaccine the most effective it can be. Getting it after the 21 days is also an option, and we think that it's reasonable if you have to, to get it later. And so we don't want folks to feel discouraged if they can't hit the 21 days on the absolute mark. Although that would be ideal in a perfect world. As many people that can do that as-- we would hope that you do it. But for those who missed that for some reason or another, all is not lost. Please try to get the second vaccine in the future.

KIM KAISER: Thank you Dr. Noska. And I think I'll direct-- oh, yes, go ahead please.

PETER HENRY: This is Pete again. Dr. Henry. If I may ask, Dr. Noska, just to briefly comment to these. I'm seeing some of the questions around-- once you have the vaccine, what is the behavior or does the behavior change? And I think that's a really important thing for our patients to know about the efficacy of the vaccine because it is a very effective vaccine. But just a little bit of information around that would be, I think, extremely helpful. Thanks.

AMANDA NOSKA: Yeah. Thanks, Dr. Henry. I'm going to give you the lack of information that we have on that instead, unfortunately. Many of us think that folks are much, much, much, less likely to transmit COVID after getting a vaccine, obviously, or we wouldn't have said to protect our family and our loved ones. But we don't know that without a shadow of a doubt yet because as I said, there's a lot of asymptomatic viral shedding that can happen especially with these new variants. And we don't have hard data, the scientific studies, yet from the Pfizer and Moderna vaccines to prove that people do not shed virus, live virus, after getting the vaccine that could be contagious. You'll also see that the efficacy data was 95%. It was not 100% and that was in ideal situations, which I was just talking about the variations on the ideal. So 95% is pretty good, but it's not 100%. Meaning at least 5%, in even the most perfect of studies, could still get COVID and could still potentially transmit it. So there's a lot of unanswered questions, and the CDC is still grappling with those. As of right now, we have not changed our transmission guidance at all for the public or for our patients. We think that everybody's much safer with getting the vaccine, and of course, we're all very, very eager to liberalize our activities. I think we're all ready to be done with this, but I would caution folks from assuming that data until we kind of know it. And I know that we have a lot of brilliant scientists internationally working on getting it, and the CDC is actively reviewing it. So in the short term after getting the vaccine, we would highly encourage you not to change any other behaviors. Please continue to wear masks and socially distance if you can because we don't know that you would still not be able to give COVID to somebody else. You're much less likely to get it-- not 100% but 95%-- in the best of scenarios. So I think it's important to-- yes, thank you for bringing that up because it's important to recognize that distinction.

PETER HENRY: Thank you, Dr. Noska. You did a very good job of-- much better than I would have on that. Thank you.

KIM KAISER: Thank you for bringing up the question, Dr. Henry. That is one that we've received several times on here. We've also gotten several questions about side effects, questions about the side effects. I was wondering if Dr. Vetter might be willing to talk a little bit more about some of the reactions that could be concerning to folks.

RICH VETTER: Sure, I'd be happy to, and, again, that's a great question. And I know it's got a lot of press, and, I think, raises a lot of concerns about the safety and-- am I going to be developing a lot of side effects from this vaccine? The initial studies showed about a 2% to 4% kind of minor reactions that I discussed in my presentation-- you know, the stiffness, the low-grade fevers, maybe feeling fatigued, similar types of symptoms that you get from pretty much any other vaccine that we utilize. The more serious one around this anaphylaxis-- first of all, anaphylaxis is exceedingly rare. It's not that common. We do have some safety protocols in place where we do, per guidance from the manufacturers, monitor people for 15 minutes or 30 minutes, depending on their history, after getting vaccinated. And we have the appropriate treatment available for that if that should occur. The CDC is starting to publish a little bit of safety data that they've been receiving, so we're monitoring internally and CDC and the state health departments are monitoring externally some of that safety data and are reporting it out. I saw last week, two million doses of vaccine and doses reported to the CDC, and I think the incidents of side effects was about 4,000 and most of those were mild to moderate. Severe reactions were in the 22 per 2 million, which is about 11 per million, which again is exceedingly rare. So we're starting to track some of that safety data, and we'll be reporting that out. So minor ones, yes, quite common. Severe reactions can happen but we're taking the appropriate precautions to be prepared for those.

KIM KAISER: Thank you, Dr. Vetter. And we have received several questions about MyChart, and so I'll direct this question to Dr. Manney. The concern is or the question is what if some folks don't have access to computers and are still wanting to make sure that they're in consideration to be notified? Could you talk more about that?

SARAH MANNEY: Yes, absolutely. And I might need to share this answer with Roseann. So there will be a phone option available for those who do not have access to technology, and so that will always be available. But we do caution that we're worried about our phone systems crashing if everybody tries to call, so if you do have the technology, please use the MyChart to sign up for that. Roseann, do you have any more information on that phone sign-up?

ROSEANN HINES: Yeah, so as Dr. Manney said really wherever we can use the MyChart application that allows you that flexibility and that notification and easy scheduling versus sitting on hold potentially for quite a while. We do, and we'll be publishing within the notification when you are eligible for the vaccine, a phone number. And we'll have one available for the public as we move to those public realms. We are implementing then a wait list process which then would be incorporated and put into that randomization work based on interest. And so wherever possible, to help Dr. Manney's point, please use the MyChart as that is a quick way for us to gather the interests and the data available, not bog down the phone systems. Because some of our patients also will need the phone for other pieces of their health care that cannot be accomplished via MyChart, and so really we're trying to balance the patient access around COVID vaccine, as well as the standard care that we need to provide to our communities on a daily basis.

AMANDA NOSKA: And if I could, Roseann-- this is Dr. Noska, Amanda Noska-- but I just wanted to pipe up and say that my second shot I was able to schedule through MyChart. And I thought it happened faster, much faster than waiting on hold for somebody to answer, so you may have a faster chance of getting it scheduled.

ROSEANN HINES: Correct and I think at our locations, part of the standard work that we are implementing is once you receive the vaccination, depending on your history, you have to be monitored for 15 to 30 minutes post vaccination administration. And in our community sites, we will be taking that opportunity to work with our patients, to schedule their second vaccination on site. And so you would leave with your second vaccination scheduled which would then also help with the efficiency and awareness of that next step for each individual on their vaccination journey.

KIM KAISER: And along those same lines with questions about the phone, we've had a few questions saying, well, if you do get notification by phone, will you see Essentia in the caller ID? I don't know if that's something that we have any information that we can share with people about.

ROSEANN HINES: I can start. So depending on if you have MyChart and/or don't have MyChart, when you are identified within that randomization process, the communications will be pushed out in both avenues. So you would still see a MyChart notification as well as a generated phone call. I know on my phone, when I get an appointment reminder from our health systems, it does identify as Essentia, so I think it would depend on that spam and/or phone set-up and blocking information.

KIM KAISER: And, Roseann, many of the questions that we are receiving are folks who are saying, I live in Duluth or Hayward or Moorhead, and they're all saying, when will I be eligible for the vaccine? And I'm just wondering if you wouldn't mind just reiterating, in Minnesota and Wisconsin, the process and where we've started with some of the 65 plus and 75 plus vaccination, especially for people who maybe weren't on the call at the very beginning of it.

ROSEANN HINES: Sure, happy to. Thanks. So within our health system, our initial allocations were directed to our hospital locations throughout our Essentia Health footprint as those initial hub or spoke locations for vaccine allocation and distribution. Currently within each of those areas, we are setting up clinics and/or access points for the vaccine. For example, in the Duluth market, we are looking at some of our locations up in the mall area. In our Fargo location, the initial clinic is out of the 32nd Avenue clinic as well as those rural areas. And so within each of those hospital footprints, we are identifying the key locations for those vaccine access points to support patient access and ease of access as initially they were within that hospital system. As far as when you would anticipate vaccination, as we started in North Dakota, per the direction of the State Department of Health, about one week ago and this past week as we continue to expand that work. Within Minnesota, we have some locations that are actively setting up their schedule and have received allocation from the state and would anticipate vaccinating either by early next week. Additionally, we have other sites that we have not received the specific allocation yet for the 65 plus, and so we are awaiting that information that would open up schedules as soon as possible. We anticipate though, in all of our locations within the next week to two weeks at the most, we would be opening up and be able to support vaccination of those individuals that meet that state specific guidance and criteria.

KIM KAISER: But it sounds like one of the key messages here today is asking for patience for all of the folks in our communities. And that we're working to do this as soon as we receive those supplies and what not. I do have one quick question for Dr. Manney because others might be confused by this. Someone asked, if you are already on MyHealth, does this automatically enroll you in MyChart? And we recently changed the name from MyHealth to MyChart, and so there could be some confusion around this, and I'm wondering if you could clarify that.

SARAH MANNEY: Yes, absolutely. We were an early adopter of this patient portal, and so it was branded as MyHealth early on. And so just a couple of weeks ago, it's been rebranded to MyChart. So it matches the MyChart app in the app store, and it also matches our name here at Essentia Health. You'll also see some features that are new and exciting and make it easy to use. Kim, if I may. Some of the questions that are coming through are talking about the form and I just want to maybe reassure people. If you are a current Essentia Health patient, and if you are a current MyChart or MyHealth user, you are in our database, and you will be part of that randomization. So the form that's available on Monday, we would love if you would also fill out because it will give us more information as we need if we are asked to prioritize based on other conditions or worker status. If you are not an Essentia Health patient, then we don't have all of your data, and so when you sign up, then we do. And again, if you fill out that form, we will have more information to help better prioritize if we are asked to by our state's Department of Health.

KIM KAISER: Thank you for that. There were many questions about that so that was wonderful. And then I will just put this last question out because we've gotten so many questions about prioritization based on risk and why that isn't part of the process at this point. I'm wondering if you, Dr. Henry, could mention that.

PETER HENRY: So there have been a lot of questions in the chat that I did see about prioritization. And currently the guidance that has come from most of the departments of health has really been age based. And there are questions about-- my doctor knows the best, most about me. And we have to mine a lot of data in our electronic health record for us to retrieve that. Recognizing that we want to get the vaccine in as many people who are appropriate for it as possible, we, and along with almost every other major health system in the state of Minnesota, chose to move to age criteria only, recognizing that each individual may feel that their personal risk factors may weigh more heavily than someone else's. But I think it was the most equitable and fair way to do this and get it into the most people's arms as quickly as possible. And we are also mirroring what other health care systems have chosen to do. Now if we get guidance from state departments of health as we move through these different phases that we need to prioritize certain individuals over other individuals based on risk criteria, we will follow those guidelines. And I would welcome Dr. Manney or Roseann to add anything to that if they feel that it's not accurate.

KIM KAISER: Well, I see we're getting very close to the end of our time. I will toss it back to Louis to help conclude our day. I'm sorry we couldn't get to all 300 plus questions, but we did our best to highlight some of the big topics.

LOUIE ST. GEORGE: Great. Thanks, Kim. Indeed, we're out of time, and a sincere thank you to everyone who participated today, who asked questions, who tuned in. I think the attendance surprised some of us and is just proof that there is so much interest around COVID-19 and the vaccine process. And thank you again to our panelists for taking time to answer questions and provide some really valuable information to our patients and our communities. You'll be able to find a recording of this video on our Facebook and YouTube pages if you'd like to access it later. And please continue to visit EssentiaHealth. org for updates, and we'll do our best to provide as much information there as we can. Thank you, everyone, and have a great rest of your Friday.

PETER HENRY: Louie asked them to spread the word. And we encourage people to go to our website and look at the video and tell your friends about the information that's out there and available. Thank you.

LOUIE ST. GEORGE: Thanks, everyone.