YORKTOWN, N.Y. - On Friday, Jan. 15, Yorktown Town Supervisor Matt Slater chatted about COVID-19 vaccines with Dr. Lewis Kohl, chief medical information officer, senior medical director, and chief safety officer at CareMount Medical.
This interview has been edited for clarity and length.
Can you give us an update on the vaccine, specifically for our area?
The state and feds have unfortunately done a bit of over-promising and under-delivering to this point.
When you read what’s going around—“sign up, sign up”—it seems like you can just get the vaccine this weekend. That’s not the case.
New York State is only getting 600,000 doses a week, which is just not enough to vaccinate everybody.
The good news is: Production is ramping up for the Pfizer and the Moderna vaccines that are already on the market. And we have two more vaccines—the Johnson & Johnson and Astrazeneca—that I’m figuring we’re going to get on the market in the next four to six weeks, maybe eight weeks, and that will really improve supplies and make things better.
So, I think everybody should just take a breath—we’ve made it this far and this long—and realize you’re probably not going to get vaccine this week and you might not get it next week, but you’re going to get it.
But it’s going to take some windup. The state is putting a lot of energy into their centers—the big vaccination centers—like the Westchester County Center, and they’re running very nicely but it’s a limited number of patients with a limited number of vaccine. You’re going to see vaccine in some of your pharmacies. Some businesses are supposed to become sites. And eventually medical practices will.
I think the main point is: There will be enough vaccine. Each one of these companies is planning on millions and millions of doses. And especially, when the other two companies come online, they’re a little easier to manage also. With the Pfizer vaccine, you’ve got to keep it frozen at -80 degrees. These two [new] vaccines are just either a regular freezer or regular refrigerator. And the Johnson & Johnson is a single dose instead of the regular two doses.
So far, we have received no doses, and we don’t really know when we will. How I manage it is going to be very different if they give me 300 doses next week vs. 6,000. We’ve asked for more than 4,000.
Everything’s going to be by appointment. The state wants us to hold a certain number of appointments open for the general public—people who aren’t necessarily our patients. We are, of course, going to do that, but you’ll have to go on the state system to sign up for those.
For our patients, we’re going to do it for the people we think are at greatest risk. The reality is: If you’re 32 and perfectly healthy, you don’t need the vaccine as badly as someone who’s 75 with 12 medical problems. On the other hand, I really want the 32-year-old to get vaccinated, so they stop spreading it to the 75-year-olds.
As we get vaccine, we will start notifying you, that you can come in and you can book these appointments. For folks who don’t have internet access or email, we’ll end up calling them, particularly if you are in any of our care-management programs. I would expect that other medical groups and medical practices will do this. For the pharmacies and the Westchester County Center, those are going to be sign ups with the state.
Some of the hospitals, like Northern Westchester, are going to be holding vaccine clinics as well. And right now, you probably have to sign up with the state. But the big systems—like NewYork Presbyterian and Northwell Health—will probably, in the next week or two, have their own sign ups. So, you’re going to see a lot of advertising. If you’re our patients, and somebody wants to give you vaccine, I wouldn’t tell you not to get it.
This is a vaccine where if somebody offers it to you, take it. We think everybody should be vaccinated. The vaccines are safe. So, don’t wait on anyone in particular.
You don’t need to call your medical practice because no medical practices have received vaccine. A few urgent care centers—not the CareMount urgent centers—in the area got vaccine. It was supposed to be for their staff. But they ordered too much. And the state said, if you ordered it, you can give some out. So, you may see some in local urgent cares. The hospitals tend to have it first. But other than that, it’s going to be a little while.
Individuals who are immunocompromised but under 65, do you know if they’re a) eligible and b) can you provide some advice for them if they should be vaccinated?
They absolutely should be vaccinated. New York State has not opened up vaccination to them yet. But they’re going to. The governor, from what I heard, had planned to announce that this week. But the reality is there’s not enough vaccine around for everybody.
If you have or are prone to allergies of medication, what steps should you take to make sure that you’re getting the vaccine in the safest environment?
There are different types of allergies. There are what we call, in medicine, immediate allergies; immediate hypersensitivity to allergies. And then delayed. Delayed basically means rash. Immediate means you can’t breathe, your blood pressure goes down—that’s what we call anaphylaxis. A lot of people will have that to bee stings, so they carry EpiPens to jab themselves with.
If you have a history of having immediate reactions, I probably would not choose to take a vaccine outside of a medical facility.
Right now, we’re being told you’re really not at risk if you have a bee-sting allergy, for example. I know some of those people have been vaccinated recently and they did fine. But if you couldn’t breathe and you ended up in an emergency department because you got an injectable medication or a different vaccine, I would want to be vaccinated in a medical facility.
We are seeing people who are very prone to rash from drugs who got a rash from this vaccine. It’s still just a rash. But it’s not a bad idea if you’re still really concerned about having a lot of allergies to see an allergist.
If you are the “I took this medication and I almost died” kind of allergy, I probably would not take the vaccine in a pharmacy, because all the pharmacy can really do is call an ambulance for you. But most people that we have seen so far, and several million have been vaccinated already, are doing just fine. You are more likely to have a rash, from what we’ve seen so far, than the flu vaccine. But most people are doing just fine.
Should they avoid a place like the County Center?
The County Center has EMS and paramedics there who can at least start Epinephrin. The County Center said it’s ready to handle medical emergencies.
It’s not a medical desert. There is attention there. So, it’s probably something in between. It’s not an allergist’s office, but there will be people who will attend to you.
What types of reactions are people having to the vaccine?
These vaccines cause more reactions than something like flu vaccines. They do make a lot of people achy. We’re seeing fevers, we’re seeing aches. For most people, that’s gone by the next day. In the first two or three days, it’s not unusual for people to feel a little bit cruddy. That’s not scary. That’s telling you that your body is reacting to the vaccine. That’s what you want. You want to make an immune response, so that if the virus shows up, your immune system stomps it.
Some people are getting low-grade fevers. But they’re not sick. They’re not coughing, their nose is not running. None of these vaccines, the vaccines that are going to get approved in the next six months, they are not a whole virus. They are not a weakened virus. They’re tiny pieces of the virus. They cannot give you COVID. They can’t give you the flu. They can’t give you a COVID-like illness.
What about the second dose? Should they expect similar reactions to the first dose?
Yes, people are definitely having reactions to the second dose. Some a little bit more than to the first dose. There are people who had [no reaction] to the first dose but after the second dose they were achy and fever-ish. So, it’s achiness, fever, and fatigue. Most people don’t get fever-ish. A few have. We’re seeing achiness, we’re seeing soreness in the arm where you got vaccinated, we’re seeing redness three, four, five days later. The arm swells a little bit at the site and is getting red. It’s not an infection. It’s just a local reaction to the vaccine. There is nothing you need to do about it. Nobody’s going to the hospital for it. But it is so well worth taking this vaccine. It’s the only way we’re going to get our world back, is to take this vaccine.
If somebody gets their vaccine, they get the double dose, is the expectation that it’s a one-time or are they going to have to come back, whether it’s next year or a few years down the road, to get vaccinated again?
It’s a great question. We don’t know yet, unfortunately. Because the problem with these viruses is they can mutate. So, we already see it mutating. We see this strain running around that makes it more likely to spread. It doesn’t make it more dangerous, but more likely to spread. Viruses mutate, and they mutate as they go through more and more and more people.
In Asia every year, flu virus goes from people to chickens to pigs to people and back to chickens—and that’s why it mutates so much—which is why every year we have to get a new flu vaccine, and we have to guess which strains are going around. Hopefully birds and pigs won’t pick up this virus, so we won’t see that chain with farm animals like we do with the flu. But the bottom line is we don’t know yet. We hope this is long lasting, once in a lifetime protection. But it’s too soon to tell.
Our seniors are just so concerned, they’re nervous, they’re frankly scared, and they’re trying desperately to get this vaccine. What guidelines can we give our seniors as they wait to receive their vaccination?
They should be doing what they’ve basically done now for a year, which I hope they’re good at: Stay in their bubble. The only bubbles that most people seem to have seen on New Year’s Eve were champagne bubbles with their friends, which is why so many people got COVID.
Stay in your bubble, wear your mask. We’ve made it this far. We’re going to make it a couple more months. Don’t invite people into your house without masks. I don’t care if you know them. I don’t care if it’s your nephew or your cousin and she’s such a nice girl. She’s going to give you COVID. I guarantee it.
We’re in the homestretch. It’s kind of like you’re in the trenches in World War I and you just heard that there’s going to be peace signed tomorrow but you stuck your head up and you got shot in the head. You’re the last one to go down. Don’t do that. There’s just a little time left. Be careful. Be a mask wearer.
For anybody who tells you that the masks are not protective, they’re wrong. They’re highly protective. We have kept our medical staff safe. Our urgent care centers have literally been pounded with COVID over the last year. They’re all safe. Our staffs have not gotten sick. The patients coming through our facilities have not gotten sick. And it’s because we mask. That’s number one, two, and three.
CareMount has a great presence here in Yorktown, and I hope we can count on that presence to continue. And I know you’re working diligently to bring the vaccine here to our residents.
We will have—I’m not going to say where—a vaccine clinic in Yorktown, but it’s going to be by appointment. Honestly, I think in May, we’re going to have all the vaccine we want for everybody. When that happens, we will just open the doors, and just like a flu clinic, it’ll be a walk-in clinic. We’re a little bit a way, but it’s going to be this year.
The million-dollar question that’s out there is: Is the summer going to be the summer?
Personal prediction? Don’t hold me to it because I’ve lied before, but I think we’re going to have a real summer. I think we’re going to get our lives back for the summer. I think we will have enough people vaccinated or with natural immunity that we’re going to have a summer.