When it comes to concerns over vaccine side effects, Dr. Wachter says, “You’re still better off getting vaccinated than not, the risk of COVID-19 is far higher.”
INTERVIEWER: But let’s begin with major COVID-19 headlines today. There are many, ranging from survivors suffering mental disorders, to California fully reopening by mid-June, to new worries about the AstraZeneca vaccine.
Joining us now to get some answers, is the chair of the Department of Medicine at UCSF Dr. Bob Wachter. Dr. Wachter, good to have you here.
DR. BOB WACHTER: Pleasure to be here. Thank you.
INTERVIEWER: All right, let’s start with a new study published in The Lancet about two long-term disorders we’re seeing in COVID survivors. Can you talk to us about that?
DR. BOB WACHTER: Uh, we’ve known for a while that a fair number of people that have COVID have long-term effects of it. And the new studies uh, show way, I think higher than expected rate of cognitive problems or– and depression, anxiety a whole bunch of things that are yet one other reason why if you can avoid having COVID that would be, that would be great. It’s not entirely clear whether the numbers are as high as they cite. I think they cite about one in three people because a fair number of people have those symptoms anyway. But it certainly is higher than the baseline and it’s yet another reason to get vaccinated.
INTERVIEWER: And we also don’t know if that’s something that might fade over time, right?
DR. BOB WACHTER: Yeah, we’ve been studying these folks at UCSF, and a fair number of them will get better over time. We don’t yet know what the best treatment is. There some anecdotal evidence that vaccination may help. We don’t know that for sure yet, but we’re studying this group and certainly we hope that they get better over time that we find answers.
INTERVIEWER: Yeah, definitely do keep us posted on that. Meanwhile distributing developments on the AstraZeneca vaccine which has not been approved for use in the US. But, you know, we have millions of doses waiting and it may still get the go ahead. So, what did European regulators determine today about AstraZeneca and blood clots?
DR. BOB WACHTER: Well, when I first heard about these issues with blood clots, I, my feeling was blood clots are really common. You know when I take care of patients in the hospital a lot of people come with blood clots in the leg or pulmonary embolism when it goes to their lungs. What they have seen is rarely, but a higher than expected number of pretty unusual syndrome of blood clots. Blood clots in the brain associated with a low platelet count.
And they have not fully worked out for sure whether that’s a side effect of the vaccine. But my guess is it’s going to turn out to be a rare kind of one in a million side effect to the vaccine. You’re still better off getting vaccinated than not. The risk of COVID is far higher. But this is an unexpected side effect, and it has led some regulators to say, we’re not going to give it, for example in younger, in younger patients who are at lower risk of dying from COVID.
In the US right now it’s not one of the three vaccines that are approved, I’m guessing it will not be approved in the US. So it’s not going to be an issue for, us but it’s a big issue for the rest of the world.
INTERVIEWER: Yeah, all right. um, you said for the unvaccinated this may be the most dangerous time in the pandemic. Why do you say that?
DR. BOB WACHTER: Well, if you’re unvaccinated, first of all, congratulations because you must have been very careful over the last year to remain uninfected. So I’m talking about if you’re uninfected and you’ve never been infected and you haven’t been vaccinated, then you have no immunity. And instead of the virus that you are facing in 2020, there’s a decent chance that you are now facing if you encounter a person with COVID, uh, facing a virus that’s better that’s job. If it’s either the West Coast virus or the UK virus uh, these viruses are more contagious.
At least the UK virus is also more serious and more likely to be fatal. The West Coast version we’re still working that out. So if you one, if you’ve not had prior COVID and you don’t have, and you haven’t been vaccinated yet, this is a time where you really, really want to be careful, and as soon as you have an opportunity be vaccinated. It’s yet another reason why you should be.
INTERVIEWER: Right. But of course eligibility aside, it could take a while for people to actually all get vaccinated. So given that uhm, and what you just mentioned with a variance and all, what do you think about the state planning to reopen everything and lose the colored tears that we’ve gotten used to by June, 15th.
– DR. BOB WACHTER: June 15th, is a long way off. Eh, you know I think by June 15th, I have no doubt that every person in California will have had the opportunity to be vaccinated. That’s not going to happen immediately on April 15th, through 16th, when the list go away and everyone’s eligible to sign up. But I suspect within two, three, four weeks everybody will be able to uh, have access to vaccination. Now you’re not done if you only get your first shot of the Pfizer Moderna, you still have to wait the three or four weeks and then it’s two weeks after that that you’re fully vaccinated.
So we’re talking about six weeks after let’s say mid-May. And I think by that time, everyone who wants to be vaccinated, and I hope everyone does, will have had the opportunity to be vaccinated. I think there’s every reason to believe that California will continue to do well, we’re doing great right now. But we’re not completely out of the woods when you look at what’s happening in Michigan, the cases are skyrocketing. So we still have to be on our guard, still have to be careful. And I just really hope that everybody who has a chance to be vaccinated grabs at the first, their first possible opportunity.
– Yeah, well, the CDC today said most new infections are caused by uh, actually, they’re saying that young people are driving the latest surge in infections nationwide. Why do you think that is? Is it because they haven’t been vaccinated? Is it because they’re mingling more? Going to school? Playing sports? And when do you think that age group will get the vaccine?
– Well, the reason is all of that. The reason is that we started out vaccinating the people that were the highest risk of a bad outcome of getting hospitalized and dying from COVID. And so most older people are now at least partly in many of them fully protected with vaccination. Younger people are not, and yet we are opening up. And so it’s sort of a– It’s an hard time where things are massively safer than they were if you’ve been vaccinated. But actually somewhat riskier than they were if you haven’t, and yet everybody is hearing the good news, at least in California and beginning to do more stuff.
Now the good news about younger people is if they get COVID as everybody knows, they’re less likely to get super sick. But if a lot of them get it, we are seeing people in the hospital, we are going to see some people die. So, it’s a good time to be careful. Uh, you know the list opens up to everybody in California in a couple of weeks. And I think within a month everybody will have had the opportunity to be vaccinated.
Come June, if you are not vaccinated it will be because you have made a choice not to be vaccinated. I think that is a really bad and dangerous choice, but uh, that may be the situation where some people may have chosen not to be vaccinated and uh, and they are at pretty high risk of getting the virus and potentially getting very sick.
INTERVIEWER: So do you think schools and employers should be able to require vaccinations? Uh, do you have any concerns with that?
DR. BOB WACHTER: Well, the data I mean, there is certainly have some concerns about it. It’s going to be tricky to do politically if we thought masks were the big battle of 2020. I think this issue of immunity, passports, or vaccine authentication is going to be the battle of 2021. it’s Is already lining up as the governors of Texas and Florida have outlawed it.
I personally think it’s a good idea. I personally think that for certain workplaces, working in a nursing home, working in a school, having the kids in school once the kids are eligible for vaccination, I think it’s perfectly reasonable to require vaccination. Certainly, the entire place is safer if everybody is vaccinated.
If you’re choosing not to be vaccinated after May or June, you have made a choice. Uh, but that choice is not just a choice– It’s not just you choosing to hang glider or drive fast or smoke cigarettes, your choice does impact the risk of everyone else. So I think it’s going to be a big debate, but I personally do think it’s reasonable to install vaccine requirements in certain settings.
INTERVIEWER: All right, Dr. Bob Wachter, I should just mention that next time I got to let you ask the questions because you’ve been guest hosting a podcast called In the Bubble. It’s terrific. So next time we’ll turn the tables, but I’m not the expert that’s the only problem. You will have to ask the question and answer. All right Dr. Wachter thank you. Stick around for one second because over on Facebook Live during commercial break we want to get to a viewer question. Will be right back.
All right, real quickly, I feel bad if I didn’t get in Zion’s question about, how long does it take to get maximal immunity with the J&J vaccine?
DR. BOB WACHTER: It appears to be two weeks after your last shot for any of them. So we’re talking about two weeks after your second shot for Pfizer Moderna, and two weeks after your J&J shot. Now the studies show that your immunity probably continues to go up after that. But I think you know the ground rules are two weeks after you’ve gotten your J&J shot you are good to go, and you’re considered to be fully vaccinated.
INTERVIEWER: All right Dr. Wachter. Thanks so much really appreciate to see you next time. Take care.
DR. BOB WACHTER: My pleasure and nice seeing you.
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