Chris McCoy, director of EBCI Communications, interviewed Dr. Richard A. Bunio, Cherokee Indian Hospital Authority executive clinical director, and Vickie Bradley, Secretary of EBCI Public Health and Human Services (PHHS), about the arrival of the COVID-19 vaccine in Cherokee. This was aired via Cherokee Cablevision Channel 28 and streamed by Communications. Here is an edited transcript of the Q&A session on Tuesday, Dec. 15. All answers presented below are marked VB for Bradley or RB for Dr. Bunio.
When will we see the vaccine coming to town?
VB: I’m so excited, the vaccine is here. It arrived this morning (Tuesday, Dec. 15)
So, who will get the vaccine?
VB: There was a team. There’s a mass vaccination team that consists of a lot of workforce between Cherokee Indian Hospital Authority and Public Health and Human Services. And we’ve been meeting for quite some time to develop mass vaccination plans for this vaccine. And so, our team elected to follow the Federal guidelines and the CDC recommendations to vaccinate those that are most vulnerable. Which obviously is our frontline work force and our healthcare workers. So, we have three phases in our plan. In that first phase are those frontline healthcare workers, public safety (EMS, Fire, and Police), and then those who are most dear to us in our community, and that is our high-risk elders. Most of our Cherokee speakers are our elders. And those who hold our knowledge, they hold our culture, they teach us. Knowledge keepers.
Phase two will be the remainder of healthcare workers, our workforce that is front facing and serving the community. And then adults who are high-risk with two or more of what we call comorbidities.
And then phase three is everyone else.
You derive these priority groups through these meetings and federal standards?
Yes, the federal guidelines are very strict about who we could and could not vaccinate. And then of course eligibility will be based on the same eligibility criteria we’ve done for testing. Anyone who is an enrolled member or resides on the Qualla Boundary, works in our community, or has close contact with someone or has the potential to infect our community.
Dr. Bunio, COVID-19 has shown to affect our elders the most, is that why they will be the first in line for the public?
RB: Yeah, that’s correct.
What should people expect with the vaccine?
RB: Well, again, this is very exciting. This is a new type of vaccine. It uses something called MRNA. The ‘m’ stands for messengers. And so, this sends message to cells of our body to produce a protein that looks exactly like what’s called the spike protein on the virus itself. Our body will develop an immune response to that and so that if you encounter the virus, then your body’s already got antibodies that can fight it off. This technology’s been around for over 10 years but it’s really good because we can mass produce this, there’s no live virus, it’s not grown in eggs, and there’s no preservatives in this vaccine. It has shown to be quite safe and very effective.
Is the vaccine mandatory?
VB: No. This is not a mandatory vaccine, but we do encourage everyone to take the vaccine. The more people we have, the better immunity our community has and the safer we all are.
I’ve heard the term ‘herd immunity’, is that what we’re referring to?
VB: It is. And to get ‘herd immunity’ we would need to get approximately 75% of the population to take the vaccine. We know 40% would give us decent immunity. But if we really want to get back to normal and we want to move passed the pandemic, 75%.
Dr. Bunio, if you can still get COVID-19 with the vaccine, should you still take the vaccine?
RB: Oh absolutely. Just to reiterate what Vickie said. You want to be part of the solution. You want to be contributing to that herd immunity that’s going to protect this community. You also will get over 95% effectiveness at preventing severe COVID disease. So, it’s good for you, it protects you, it protects your family, it protects the community. So, we really would encourage everybody to get this vaccine as soon as it’s available to them.
Taking the vaccine doesn’t meant that you can’t still contract COVID-19, is that right?
RB: That’s right. We’re still looking into that. This vaccine was developed and really looked at intensely to show that it prevented severe COVID disease, and that’s what it’s 95% effective at. We don’t know for sure if it’s going to prevent you from getting a milder case where you might be able to spread it.
It primarily looks to reduce the severe symptoms?
RB: That’s what we believe, that’s what the science is showing. And that’s going to keep people out of the hospital, out of intensive care units, and reduce these tragic deaths that we’ve been seeing.
If I’ve already tested positive for COVID-19 should I still take the vaccine?
RB: Yes. What we know is that after you’ve had a natural infect, you have some immunity for about three months. So far, the vaccine is showing a good immunity for at least four months, and it may be longer. Remember, we’re still monitoring this. But it looks like the vaccine is going to protect you even more than the natural infection. So, we recommend everyone get the vaccine, even if you’d had COVID.
Is this safe for children at this time?
RB: We think that it is, but it’s not approved for children under the age of 16 yet. The trials are looking at younger age groups. I know that a couple of the vaccine companies are looking at 12 and up. But remember, children tend to have less severe disease. So, we really want to focus on our elders, our most vulnerable first anyway. I think that day will be coming.
Vickie, what measures are in place to monitor potential side effects to the vaccine?
VB: We expect to have minimal reaction. You mean have some side effects, and Dr. Bunio can talk about what to look for in just a moment. But, when we do our points distribution when we’re inoculating populations, our healthcare workers or elders or anyone in the community at which time we start doing that, we will have paramedics on site. And we will ask people to remain in the area for about 15 minutes, let us know if they’re feeling anything different, and then if they have questions later on they can come to their primary care provider.
Dr. Bunio, is the vaccine safe?
RB: Yes. So, for this particular one, the first one that’s arrived, the Pfizer, over 44,000 people were enrolled. They saw a really good safety profile. As with any vaccine, we’re going to monitor for that really rare reaction. We’ll be prepared for that.
Is it 100 percent perfect? Are there going to be outlier issues that we’ll have to address along the way?
RB: Well, as Vickie mentioned, people are going to experience some side effects. A lot of people will have a sore arm, fatigue, headache, maybe some muscle aches are fairly common with a vaccine. But it’s important to know that when you’re feeling that that’s an indication that your body is reacting to the vaccine and that it’s actually working. Only 3.8% have fatigue severe enough where they have to stop their daily activities. Pretty minimal. But a lot of people are going to feel something. We just think that it’ll be fairly easy for them to push through it.
How was the vaccine created so quickly?
RB: Normally a vaccine can take about 10 years, from start from to finish. This one created quickly by taking – there’s a lot of steps you do, there’s phase one, two and three trials. You would do one, and then you would wait months to maybe a year to you analyze that data before you start on the second trial. What they did here is they sort of compressed all that. So, they started the phase one trial, and as soon as soon as they were comfortable that it was safe, because phase one trials usually have a small number of people and they want to make sure the vaccine is safe, they started phase two trial right away. So, they kind of condensed everything. Then with phase two trials, they’re again looking at safety and trying to find out what the right dose is. And as soon as they’re comfortable with that they moved to phase three, which where they had thousands and thousands of people getting the vaccine, looking for safety, and trying to establish how effective it is. I like to compare it to if you’re building a house. If you’re painting the outside of the house, you’re not going to wait for the paint to dry before you start putting in the heating system or laying the carpet. They were able instead of doing these one after the other, they were doing them at the same time, but they did not compromise the safety and the science. They’re doing all the same stuff; they’re just doing it in parallel.
Vickie, do you plan to get the vaccine? And how did you come to that determination?
VB: Yes, I will take the vaccine. Absolutely. And why did I come to that conclusion? Because I believe in science. I believe in fact-based evidence. I don’t trust this virus. I have some health issues, and I don’t know how my body would react if I get this virus. But I do trust science. I believe as a leader in the community, I take that very seriously, and I believe that I am not going to ask any of you to do anything that I wouldn’t do. If I can’t say that I trust this vaccine to be safe and effective and the best prevention we have to get back to a normal, then I wouldn’t ask you do that. So, I’m willing, hopefully, to inspire others to take it. I want normalcy again, and I feel like this is just another tool to be able to do that. I want to be able to live without fear of this virus.
We talk about the three phases. I’m not a frontline healthcare worker. I do work with the public a lot. So, I’m not in phase 1A. But there are three phases. Based on the supply chain to you and everyone as quickly as possible. We will move through phase one and then as we get supplied, we will expedite getting those that are in phase two, and then everyone else. We would ask the community to be patient, watch our social media posts. We will notify when it is your turn, or whose group when the turn is. We don’t know at this time what our supply looks like and how soon we will be getting it, how it will trickle in. But as soon as we get it, know that our teams are ready to expedite the process of getting it into the community.
Dr. Bunio I’ll ask you the same thing.
RB: I do. I think we’ve talked before about how comfortable I am with the science behind it. So, as a scientist and a doctor, I do feel very comfortable getting this vaccine. On a personal note, I intend to get this vaccine because I’m tired. I’m tired of being vigilant all the time. I know that I where my mask and I try to stay distant from people. But I can’t stop that person from coming up behind me in a grocery line not wearing a mask. And I’m tired of looking over my shoulder. With this vaccine, if it is next tool to get us to herd immunity, expressing this vaccine and getting back to normal, then I want to be a part of that. I want to protect my family.
Does this mean we can stop doing the three Ws?
RB: No, and there are many reasons for that. First of all, this is a two-shot vaccine and you’re going to get some immunity after the first shot, but you’ve got to wait at least 21 days to get the next shot. And it’s only seven days after that second shot that you have that 95% effectiveness. So, you’re still vulnerable but as I mentioned before, when they looked at this vaccine, they showed that it was very effective at preventing serious illness. But you could still get the virus, you could spread it. Until we know more, we think it will prevent that, but we don’t know for sure. Until we know more, wearing masks, social distancing is still going to be one of the tools to get this virus suppressed.