Local Doctors Weigh in on COVID Vaccination for Older Adults

As of late January, the COVID-19 pandemic has infected more than 25 million Americans, killed more than 420,000, and left millions of people out of work. The pandemic has also strained our nation’s hospitals and frontline healthcare workers to the breaking point.

And because of their vulnerability to the disease, older adults and residents of long-term care facilities have suffered the most, accounting for about one-third of all fatalities.

But help is on the way, with the arrival of two vaccines that have proven to be extremely effective in extensive testing. In December, the Food and Drug Administration gave both vaccines its stamp of approval for emergency usage in persons ages 16 and older.

“COVID is a very deadly disease,” says Dr. Thomas Ma, who chairs the Department of Medicine at the Penn State Health Milton S. Hershey Medical Center. “The risk of the disease and the benefit of the vaccine to me overwhelmingly favor getting a COVID vaccine.”

Ma adds that both vaccines have proven to be effective for healthy individuals but also for those who need it most: the elderly and people with chronic illnesses, such as diabetes and heart disease.

In what has been the nation’s largest vaccination program in history, more than 3.5 million Americans have received both doses of the vaccine at the time of print. Priority has been given to essential healthcare workers and employees of long-term care facilities.

But seniors are also high priority, and many area nursing homes have begun vaccinating their residents and employees.

The American pharmaceutical firm Pfizer, working with the German company BioNTech, developed the first vaccine to receive FDA approval. The American biotech firm Moderna followed soon thereafter.

Both organizations tested tens of thousands of volunteers over many months and found that their vaccines are more than 90% effective in preventing symptomatic COVID infections.

According to Ma, that’s an amazing success rate for new vaccines.

Because the federal government has already paid for hundreds of millions of doses, the vaccines will either be free or very low cost to all Americans.

In other words, the vaccines can end the pandemic and return life to normal.

The vaccines use a cutting-edge new technology that differs markedly from how traditional vaccines have worked. This new method is almost guaranteed to be safe and effective.

Most previous vaccines, for diseases such as polio, smallpox, and measles, would give a person a weakened or inactive strain of a pathogen. These traditional vaccines train a person’s natural immune system to attack and kill an actual pathogen.

But the Pfizer and Moderna vaccines work very differently by taking advantage of recent advances in the field of genetics.

The novel coronavirus that causes COVID-19 comes in two basic parts: a spherical structure and protruding spikes. The sphere contains the virus’s dangerous genetic material that causes the disease.

The sphere’s outer shell has thin, protruding spikes made of proteins that give coronaviruses their distinctive structure. Although these spikes appear to be nasty, they do not cause illness. But they enable the virus to attach to human cells, so the dangerous genetic material can get inside and trigger an infection.

The Pfizer and Moderna vaccines contain genetic material that tricks our body’s cells into manufacturing spiked proteins similar to the ones on a coronavirus.

These proteins are totally harmless. But a person’s immune system sees them as potentially dangerous intruders, so it makes antibodies that destroy them.

If a vaccinated person is later exposed to the actual coronavirus, antibodies will quickly recognize the spikes as intruders and wipe them out before the actual virus’s genetic material can infect cells.

Because the two vaccines do not contain a strain of the actual virus, Ma says there is no way for an immunization to cause COVID-19.

Of the 2.8 million Americans vaccinated by early January, only a dozen or so experienced strong allergic reactions. All of these patients quickly recovered. Ma says that people should sit and be monitored by a healthcare provider for 15 minutes after receiving a shot, just in case they experience a strong allergic reaction.

Dr. Bernice Hausman, who chairs Penn State Hershey’s Department of Humanities, notes that “people who get the vaccines tend to experience short-lived but sometimes significant side effects, such as arm soreness at the injection site, fever, muscle and bone ache, and fatigue.”

These side effects are relatively minor and are signs the vaccine is generating an immune response, which means it’s working. The symptoms usually wear off in one to three days.

But a few patients have experienced significant swelling or high fevers. Ma recommends that anyone experiencing strong reactions should take a painkiller, such as Tylenol or Advil.

Inevitably, a few people will get sick or die soon after receiving a vaccine for reasons having nothing to do with the vaccine, so Hausman advises people to be skeptical of anecdotal accounts.

“What we will see, I believe, if these vaccines do prove to be safe and effective for larger population groups over time, is a growing confidence,” says Hausman.

The bottom line, medical experts contend, is that receiving the vaccine involves far less risk than being infected with COVID-19. This disease has a fatality rate of about 1% for the general population, but seniors are at a much greater risk.

Moreover, the disease is causing serious long-term health problems in people of all ages.

The two vaccines appear to be equally effective. They require two doses for maximum protection. For the Pfizer vaccine, the two doses come three weeks apart. For Moderna’s vaccine, it’s four weeks.

Testing indicates that even the first dose offers considerable protection from symptomatic COVID infection after one to two weeks. Following the second dose, it takes about a week for the protection to take full effect.

Testing only started last April, so it remains unclear how long the two-dose protection lasts. So until vaccinated people have been monitored for long stretches of time, we won’t know whether a two-dose vaccination will protect people for many years or whether doses will need to be administered once or twice a year.

For now, the Centers for Disease Control and Prevention recommends that people who have already had COVID-19 should still receive a vaccine. As Ma said, there are a few people who have gotten the disease twice, so receiving the vaccine will prevent a later infection.

It was also unknown at the time of this writing whether the vaccines will prove effective against the new strain of the coronavirus, which entered the United States in late December.

“The current view is that they’re most likely to still be effective,” says Ma.

Another important unanswered question is to what extent vaccinated people can infect other people. It might take several months of experience with the vaccines before physicians can determine the answer.

But, as Ma says, “Based on everything we know, it has to be highly, highly effective.”

Until a large percentage of the American population has been vaccinated, Ma recommends that immunized people continue to wash their hands regularly, wear masks, avoid large crowds, and practice social distancing. This will minimize the chance of spreading the virus.

It also remains uncertain when the United States can achieve “herd immunity.” That’s the point when enough Americans have become immune to the disease that the coronavirus can no longer find enough hosts to continue spreading.

Only when the nation has achieved this key milestone will the pandemic grind to a halt. Medical experts estimate that 70-90% of Americans will need to be vaccinated before we reach herd immunity.

Ma asserts that getting vaccinated benefits everybody.

“The vaccine is protecting me. But more important, it’s protecting everyone else. I am taking the vaccine for my mother, my friends, my colleagues, for the country, so that we can get to herd immunity, so that people who are unemployed can get back to work, and we can get back to life as normal,” says Ma.

Other companies have also developed vaccines that have yielded encouraging results in testing, although at the time of this writing, they had not yet received FDA approval.


Robert Naeye is a Hershey-based freelance writer who specializes in science reporting. His website is www.robertnaeye.com.

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