neither the El Paso Medical Society its members nor PBS El Paso shall be responsible for the views opinions or facts expressed by the panelists on this television program please consult your doctor in order to prevent the spread of the virus we all need to do our part one of the easiest ways to prevent that is by wearing a mask in order for Mass to do its job it needs to cover your nose your mouth and your chin first you should wash your hands with either sanitizer or soap and water before putting on a mask then pick up your mask buy it in one of the ear Loops to make sure that there's no tears or stains on the mask if it is dirty throw it away immediately if it's intact take both loops and put it over your ears like this and then press down on the bridge of the nose to make sure that it fits and there are no uh gaps once you are done with the mask please take it off the same way both ear Loops pull it away and put it either in a Ziploc bag or throw it away if it's a surgical mask if it's a cloth mask make sure to wash it with soap and water and keep it dry for the next use do not put your mask down at your chin or above on your forehead when you are starting to remove it as that just contaminates the mask thank you so much for doing your part to prevent the spray throughout the sink children and the covid vaccine we hear a little bit more about it each day at first it was 18 and over who can get the vaccine then it was 16 and over and we understand that there are clinical trials for younger children every day what does this all mean however for families who have multiple Generations living in one household we are here this evening to discuss coveted vaccine and Pediatric Health as you know this is a live program so give us a call with some of your questions that number is 881-0013 this evening's program is underwritten by the American Heart Association and we also want to thank the Texas Tech Paulo Foster school of medicine for providing the medical students to man our phones today with us we have Madeline Morris who is a first year here in El Paso she comes to us from Dallas and I said you will without question have better Mexican food here so thank you Madeline for helping us out we also want to say thank you to the El Paso County Medical Society for bringing this program to you each and every month good evening I'm Catherine Berg and you're watching the El Paso position [Music] once again good evening we are here with Dr Glenn fennelly this evening and we are talking about what's happening right now in the world of vaccines there were so many months we were just waiting for the vaccine to come then the last couple of times we had this program we were just waiting for the supplies to come it seems that that's really really happening now by the way El Paso is doing great when it comes to that but the big question has been and still kind of is now 18 and over that's been the thing but 16 and over can get the vaccine and they're starting to do clinical trials and there's some approval that is happening from 12 to 16. so we'll talk about that in just a moment but I'd like to give some background on Dr Glenn fennelly he is the chair of pediatrics at the Apollo Foster school of medicine he's also the chief transformation officer at the El Paso children's hospital and he has spent years in pre-clinical vaccine development uh specifically in measles and HIV and children so he understands the space of vaccines and understands a space of vaccines in younger people so I'm thrilled to have you here there are so many questions that I have and I know that our audience is going to be calling in so welcome number one and number two as the chief chair of Pediatrics I don't want to go into what you do all day every day I kind of ask that of all the doctors but I would love for you to talk a little bit about pre-clinical vaccine development measles HIV and again the whole new world that was kind of thrown your way and just the understanding of that with now the covid vaccines if you kind of just give a background about that sure I mean we know that children are different than adults they're certainly smaller and their immunity in some cases infants may not respond as strongly to certain vaccines on the other hand their immune responses could be much more vigorous so there are certain advantages to giving vaccines to younger infants it's also an opportunity as new vaccines come along we can integrate that into the routine immunization which pediatricians have done better than anybody for years and why is it why are pediatricians on that better well it's because it's part of what we do I mean and it's been it's contributed to the eradication of smallpox and the control of measles in the Western Hemisphere the erratic education of of polio in most of the world so that goes back decades and something I think as pediatricians we take pride in we know that vaccines are the strongest public health tool that we have exactly nicely said so we've been hearing uh over the last several months again there is something that the FDA to provide emergency use authorization so that that's kind of a new world that we're living in today if you can explain to the audience what that means and what kind of a process do they go through because even when there was a vaccine being talked about in November there still had to go through a process it's granted faster but how does that work out okay so the emergency youth youth authorization came into being after September 11th and it was really intended as a way to get new products vaccines Biologicals which could be some of the monoclonal antibodies you've heard about medicines that could counter bioterrorist agents we needed a better approach instead of waiting in 8 to 12 months for approval once the data was compiled so first of all you have to recognize this as an emergency which covet clearly is absolutely and the Secretary of Health and Human Services needs to declare an emergency officially that then gives the FDA the authority to approve under this mechanism okay so the process can take a matter of weeks as opposed to eight to twelve months for full approval it has to be prefaced though on really solid data on a phase three clinical trials showing the likelihood that it's probable it may protect well on the other hand there's a high likelihood of safety based on what is known now in the case of a covid vaccine the bar was set at about 50 percent Effectiveness or efficacy to get approval and safety had to be studied for a meeting of two months in subjects so we got there pretty fast and that threshold was surpassed absolutely so we have um and I'd love for you and I know that's not one of the questions that we discussed but I'd love for you to kind of talk about all these different and not about the companies but the fact that there are different vaccines from different companies there's a little bit of difference between age but that's that's just something that the world is new to when you get the polio vaccine it's kind of like well that's the polio vaccine if you get the flu vaccine well that's a flu vaccine with the covet vaccine it's like well what'd you get Pfizer modernity AstraZeneca you talked a little bit about um Biologicals you also talked a little bit before we started here about um mRNA vaccines and then adenovo virus vaccines Etc and I know I'm throwing that all out there but in the space of how you work and just the questions that I'm sure people have been asking you because they know your specialty what are some of those questions and how can you explain some of those so first of all the the objective of vaccination is to if you will expose the body to a small part of a virus bacteria in the case of therapeutic vaccines cancer a small part of the cancer to sort of go through the process of preparing the immune system or enhancing the immune system without actually getting in an infection the big innovation with covet vaccines has been the messenger RNA technology the fact that you can manufacture a strand of messenger RNA which in effect is a message to the cell to say here are the instructions for how to make the Surface protein of covid so it's simply put into a lipid small lipid capsule in effect injected it's taken up by cells that message disappears very rapidly the protein is made and that's really what leads to these side effects that many people are experiencing I would love to talk about that and I said to you before the show I have my first vaccine don't have my second one I would was so excited that my body was feeling something because I felt like my body's doing something talk about that a little bit more because some people like oh the side effects and it's a complaint talk about how it's really a great thing that your body is reacting right so okay and and it's I mean the the second major vaccine technology that somewhat new is the adenovirus which is a sort of a recombinant uh weakened virus that in effect just delivers a message or DNA of the covid in a different somewhat different way okay so both of these are going to lead to side effects because your body is recognizing something that's foreign something that's not self and yes as you mentioned uh is this a correlation between the intensity with which we get these side effects in the response it could I think in time we may see there could be a correlation so that in the balance is good news rest assured that those side effects go away after two or three days and the overwhelming majority of people they're very prevalent up to 80 percent of people that get the moderna mRNA vaccine have pain at the end injection site for a couple days afterwards which is nothing for the protection in my opinion I'm saying that so out loud because it makes such a difference to uh to people if it's just a couple of you know sore again sore joints a little bit headaches maybe tough it out as you said um on that note I'm kind of going to skip skip to this other question here if there are any special preparations people should be on the lookout for or what they should or should not do before actually getting the vaccine so a lot of people have an appointment and they know what day they're going to get it and some people are hey I got there at five o'clock got it 10 minutes later great if you have time to prepare what kind of preparations should one take yeah so no first of all that you shouldn't get any other vaccine either 14 days before or 14 days after you get the covid vaccine that includes influenza shingles Pneumovax for many people that was sort of a decision do I get the flu vaccine first do I wait we don't know what the interactions could be second of all anticipate the side effects so don't plan to do a triathlon in the days afterwards after the first or second dose and also on the other hand you don't have to take medicines to prevent those side effects so avoid over-the-counter preparations for that if you have to take them for other reasons consult your doctor it's probably okay and if you do have side effects maybe even consult your doctor after to ask them for guidance on that if you take medicines that may suppress your immune system it doesn't mean you cannot get vaccinated it means the vaccine may not be as effective in you and that's where you would consult your doctor and see if you would take not take those meds for maybe a couple of days or whatever that would be that's very nicely explains it again you hear little spots of information on that the ibuprofen versus the acetaminophen again it's more the idea that if you don't have to it's better to kind of tough it out so to speak um I'd like to talk a little bit about pharmaceutical companies and they're they're working on emergency approval for use in children so we talked at the beginning of the show 16 and over now I think is is overwhelmingly accepted and you were talking about a clinical trial with youth of 12 to 16 years old I'd love for you to talk just about that and see where we might be futuristically for 12 to 16. okay so the the three vaccines that are approved for use in the United States are the Pfizer Mr advisor bioentec messenger RNA vaccine the moderna messenger vaccine that are based on very similar Technologies and the Johnson and Johnson vaccine that's based on the adenovirus which I described yeah the Pfizer has been approved for 16 and over since it got the first emergency use authorization because they had sufficient data to show that it's likely to be effective and that it's safe the rich data for less than 18 from moderna and Johnson Johnson isn't there yet okay Pfizer initiated studies going back to October where they enrolled about 2 200 children they randomized them into Placebo mm-hmm and getting the vaccine and they announced through a press release last week that in the children who got the vaccine there were no cases of covid in a relatively short follow-up versus 18 cases in the placebo group on top of that when one objective the main objective was to look at the level of antibody induced by the vaccine is it comparable to that which you see in adults that we consider to be protective good news is it was so-called non-inferior and Not only was it non-inferior it's actually about 75 percent higher in this cohort of children so based on this very exciting data which also includes the fact that it was safely tolerated there were really no serious adverse effects so it's on par with what's observed in the older individuals they're going to submit an amendment for emergency use authorization and they anticipate that if it goes as they would like then before the next school year 12 to 16 year olds could be immunized and that's such an um and I and it's just me I feel like I haven't heard much of 12 and under so this whole the elementary school oh my goodness and that's such a big group and that's the group too where parents need to find care if they're not able to go to school Etc where do you and again this is this is I respect that there's not a lot of information out there but where do you see that being with the elementary school kids so those 12 and under within let's say by the end of 2021 okay let's let's make it right out there all right so the reason that the trials are progressing in this way first of all is that we do want to establish safety in somewhat older children they're going to begin to look at lower dosing in younger age groups enrollment is already happening down to Age Two for the Pfizer vaccine enrollments say repeat that if you don't mind enrollment of children as young as five between the ages I'm sorry between the ages of two years and 11 years of age are are happening I think beginning this week okay so the data will be accrued the the approval may take longer in that you're going to have to look a little bit more close to make sure now your point that parents need to get their kids back to school many as districts have already opened we know we can do that safely just using what we know Works already masking hand washing distancing three plus feed or more in in the classroom some degree of ventilation symptomatic screening some schools have integrated screening the good news is that 12 to 16 that's an important demographic in that in certain States like Michigan there's evidence that that's the age group that's sort of the Leading Edge of the epidemic now particularly the circulation of the b117 strain that may have been the group that in certain States uh it's driving the transmission maybe organized Sports maybe not playing on the field but what goes on after games and this sort so that is going to get there perhaps just in time to prevent that spread also older children we've known are more likely to transmit and the balance gets sicker than the younger age group so that's the good news we may have to wait until early to mid 2022 to get enough data and approval for the younger age groups okay which makes sense and that kind of brings me to transitioning to multi-generational households and and that has been an issue since day one right it's like grandparents separate if you can different rooms what have you so now we have let's say we have a two-year-old and then a six-year-old and a you know and let's say from Two and above soon Lee that's not a word but say there's a brand new baby a couple of elementary school kids mom and dad and then Grandma and Grandpa and maybe even a Great Grandpa or Grandma on there what is the advice now from the medical field and maybe it's the same advice uh going forward with let's say most if not eighty percent of the households vaccinated but there's a couple that aren't you're talking about the spreaders of the of the age groups so that's something we can bring into yeah so there's there's a lot to unpack there in terms of the different age groups again what we know is what we know we know that if you're gonna be together with people from other households people that you don't live with you really have to respect the social distancing and masking and that would include relatives as well if they're unimmunized if you have a group of adults 16 and over that are all immunized you can probably get together safely even indoors we know that the vaccine protects against severe illness and disease and now we know from Real World evidence I for example have two doses I'm more than two weeks out you've been vaccinated recently after two weeks Wednesdays after two weeks the evidence in first line responders that were looked at systematically for infection after immunization after a single dose two weeks out you're about 80 percent protected after the second dose two weeks out you're about 90 percent protected against asymptomatic shedding so that's very encouraging talk about that I mean interrupting you because that's talked about a lot and it's never explained against asymptomatic shedding describe what that means with most infections with most viruses we can be infected and we never know it the majority of kids at some point over a couple week period are going to have maybe what's called a rhinovirus or some other common cold virus and they may not show any symptoms this is hypothetically possible with covid we want to make sure we don't create situations where there are people that could be carriers of it that could pass it to people that are vulnerable in particular the elderly so going back to your question if you have a grandmother in a household that's 90 and for whatever reason they're on immunized you don't want to expose even somebody that's vaccinated you want to take that precaution until we know more about how the vaccine is effective at preventing that transmission and it's nice to to validate the fact that this is a new frontier so there are answers that we have and there's a lot of answers we don't have and we just need to respect that that's the case and it's just simply going to take some time um so here's a question and I it's almost like opening up Pandora's Box the question is what kind of things can I do now that I'm vaccinated and we can look at I like how you were putting into stair steps of different ages maybe we can look at and let's say it was the first group of 65 and over and let's say they have a bridge group or they have dinner club or whatever if everyone is fully vaccinated meaning a good two weeks after their second vaccination is that something that oh now we can convene again it's I don't want it to be a controversial question but it's the questions that everybody's asking yes and and the CDC has given guidance that families that are fully immunized can congregate without masks indoors should it go for a bridge group again CDC guidance isn't fully there but I think that's where we're headed there should be a modicum of reassurance around that if you can do things outdoors that might be more acceptable but yes if everybody's immunized I think you can assume there's a very high likelihood that everybody's going to be safe and this is assuming that RNA vaccine the Johnson Johnson vaccine the the post marketing or real world data isn't quite in yet on the transmission or the infection data that's available for the MRNA vaccines okay but it may move in a similar Direction so we can look at since people can see you and I sitting together we're six feet apart five feet apart I don't know how are we I'm sure we're six feet apart so I have my second vaccine April 14th May 1. if we're doing this program would it be appropriate for you and I to sit here without masks on doing this show as we're talking really loud to each other and all those lovely particles are coming out of our mouth yeah but barring the emergence of variants that could not be if you will countered by the current vaccines yes okay that's a good idea I'd like that um so we've covered the vaccines walk so the things that uh and I know I'm going to go back to sort of the beginning when you were talking about being involved in years of pre-clinical vaccine development what are some of the things that are actively being learned right now and I know you covered some already but you're that guy that's you know watching all the studies and watching all the reports and all the research what are we actively learning right now or your group okay learning right now with that so we've always known that immunization of a mother can translate into protection for her infant for years we've been recommending influenza immunization during pregnancy because we know that that can prevent hospitalization and severe illness in their infant because the antibody is passed across the placenta right going back to your scenario of the multi-generational house there's a newborn baby potentially that baby could be protected if the mother's immunized now the guidance on that it's not a hundred percent shown to be safe however the risk benefit analysis shows that the benefit is probably in the favor of immunization for pregnant women given that they may be at risk for complications from covid above and beyond other non-pregnant populations their infant also probably gets the benefit of that passive immunity so that's one thing that that's being learned the vaccine is going to be studied down to six months of age is that the lower limit perhaps not but for flu vaccine we know that they're not very effective before that that's probably where we're going to settle so I think based on the the four of the evidence of other vaccines that's how this is going to pan out we've also known that the HPV vaccine for example it's intended to prevent HPV which is often sexually transmitted but the younger you give it the more effective it is if it's given at age nine you get an antibody tighter that's much much higher than if you wait until age 11 or 12. okay and that makes sense to me um you hit on something too that was kind of interesting so six and let's just talk about flu vaccine and you know what take a drink of water because I know you keep reaching for it but we're all about acknowledging the obvious on this show yes um and I'll just take a really long time to ask this question go ahead so six months and younger the flu vaccine you said isn't necessarily always uh works as well as someone six months and older why is that right if you have that answer I mean it part of it is the development of the immune system okay infants don't respond as briskly to certain certain proteins certain antigens certain certain viruses okay that makes perfect sense um the whole idea and we discussed this a little bit as people are getting vaccinated um there is the now more Brave to go out and do things and I think it's it's important our show too to kind of talk about we don't know who all's been vaccinated uh going out and having a big birthday celebration either at somebody's house or a restaurant where are we now and let's let's look at today is April 8th today is April 8th and what we see in El Paso with vaccines versus other parts of the world again we're pretty okay what is the advice from you as a doctor on those kind of gatherings right it depends again on What proportion of people are vaccinated and I think at large Gathering whether it's going to be going to a Chihuahua's baseball game even with a partially full Stadium until we get to a much higher rate of immunization overall that's probably not going to be safe and it could lead to spread of a virus this is what's been seen in other states again going back to schools that have competitive Sports where teams have been traveling or congregating that's where a spread has been occurring in the school situation you have to be mindful of that we touched base on and it kind of goes with this too and you know I always have a hard time saying this immunity immunity immunity immunity so herd immunity we've been hearing about that since day one you know there are theories about this and that and the other if you can explain that to the audience and maybe even the myths around it so we can kind of understand where vaccines come in where our knowledge just let everybody get it and they'll be fine antibodies Etc explain the several the different myths and the questions that you've been getting over the last year okay so herd immunity basically is the proportion of people that need to be immunized to to cut down on the transmission of a virus from measles we know that 90 plus percentage of children in a school setting for example need to be immunized to protect against measles most school districts are up around 95 97 because of the requirement for immunization before school entry we don't know yet what the percentage will be for covid but it's probably going to be around the 70 80 plus percent range before we can say we can begin to reopen more we can begin to relax some of the restrictions in place in terms of indoor dining uh wearing masks Etc now if we don't include children in that children less than 18 make up about 22 percent of the population add to that the adults that may be hesitant let's say about getting vaccinated you're not going to get anywhere near that 70 even we have nowhere in this paper but I work for the El Paso Community Foundation we have uh proactively put out a vaccine hesitancy PSA Public Service Announcement I would love for you to talk about vaccine hesitancy uh what our rate in El Paso is compared to others but just as a doctor this is a place to just throw out the sales pitch foreign I think we've known since the vaccine became available that the risk of diet from covid was one about one in a thousand cumulatively the risk of getting even a minor of what could be construed as an allergic response to the vaccine was about one in a thousand as well okay so as you put it the benefit to you for getting that the smaller degree of pain it's way up here so each of us has to do that sort of risk benefit right we have to know as well we must trust in the science we must trust in this process the whole eua mechanism it's for the greater good it's for the public good this is an emergency and we have acted accordingly and we have the data showing wonderfully that it's highly effective the MRNA vaccines and the Johnson Johnson vaccine and they're safe we can quantify even the severe anaphylaxis reactions all vaccine centers are set up to treat that it's going to be one in hundreds of thousands where it can happen we know it happens within 15 minutes in the majority and then within a half an hour in almost all we anticipate what that severe side effect is so you will be safe getting immunized not to be immunized you're continuing to expose yourself if you're a parent think about your child forty thousand children have lost a parent to coping 40 000 children have lost a parent to covid now that's a number um on that note too I do want to give out the information in case you have not registered for the vaccine yet and you'd like to registering for the vaccine there's a couple places you can do that the website is EP think of El Paso covid vaccine com it's a super easy site once you get into that site there will be a tag on the top it says register for covid vaccine you tag that and it will take you through and you're registered if you'd like to do a telephone call and try to do it that way 915 [Music] - 212-1032 and uh Dr fennelly and I we can kind of walk you through what will happen once you are registered you will get a telephone call or a textured email whatever it is that your it's your preference and they will say come to this place at this time and when you do go you know sometimes there's a line the experience I've had in most of the people that I know you're there less than a half an hour an hour you know sometimes it's more but you get your vaccination and they do have you sit for 15 minutes if you would like to sit for 30 minutes just to double check if there's a space at Social distance it is so organized good job good job El Paso medical community super duper organized um and again if you would like to do it I'm going to throw it out again EP covidvaccine.com um it is a big decision we get it and you know it's one of those things that when you talk and I like when you say risk benefit analysis the risk benefit analysis and it goes back again to this herd immunity that we're talking about as well I've got a couple questions here from the audience and I have not heard this but again I want to respect this question going forward from the audience the question is is the vaccine only good for six months I have not heard that but that's the question well we have to get the vaccine every six months let's just say on my end extending that is this something that we would get every year going forward like the flu vaccine these are both great questions the real world data that I talked about in terms of the 80 90 after dose one and two that was relatively short there was another paper published this past week that showed that after six months the antibody titer remains very very high after the MRNA vaccination okay now it begins to drop more rapidly in the older age cohorts the other question is whatever the other sort of secular trend is we have the emergence of these variants of concern that may not be fully neutralized by these vaccines if those evolve more then yes there might have to be a new vaccine that will cover them so that would be the rationale for annual boosting also by just boosting with the same vaccine we've already gotten could also go a long way towards enhancing protection so these are the this is in the category of we don't know yet in time I do anticipate this being like annual influenza immunization okay and that makes sense um since part of your special you were talking about you're an expert in pediatric infectious diseases and you brought up the variance and I think that's too once the first variance like oh my and then there's another one and then there's Brazilian there's this there's that um without freaking everybody out explain what the very you know mutations where the words used sometimes variants explain what is happening physiologically I guess with a with a strain and how these other strains come about just one day it pops up how does that happen how does another one pop up just one day somewhere else likely when the the vaccine I'm sorry the virus enters an individual the immune response will select out in a way the virus that is passed to the next person will have changes in its surface protein that allow it to avoid neutralization by that previous host say that again sorry explain that a virus enters your body right you have an immune response right certain viruses are going to survive that immune response because they have changes in their surface protein that are targeted and those changes occurred how because there's already something entered into your body changes are what is referred to or variation is part of of biology these are viruses that are sort of messy in the way that they make copies of themselves HIV is even Messier within an individual with HIV you could have millions of different variants in one individual here it's probably a lower number of variants but these variants that just sort of happen and then are selected through immunity shutting down those that sort of pre-existed or they were pre-exposed to or that immunity gives us protection against these sort of Escape variants can get out in time okay so we are just realistically to expect several more variants and maybe even annually but again the boosters are eventually so the race now is between vaccination getting that highest percentage of people within the shortest amount of time before the variants spread to to broadly or until they vary even more okay that to me is fascinating how all that works out a question from the audience what are the ingredients in the vaccine and I know that you talked about you know there are two different types there's a mRNA so the messaging RNA vaccine and then also the adenovirus messaging so that's a big question right so messenger RNA it's simple just the message which we have RNA in our bodies and it's in sort of encapsulated or covered in lipid biolayer one of those compounds is called the pig and that might be one thing that can induce allergy in a small subset of individuals adenovirus it's a virus that really doesn't divide itself it is just delivering that message okay and that's the efficient part of these vaccine they get the message into the cell where it belongs okay so they don't have a lot of extra chemicals or adjuvants there could be certain preservatives but if you have a known allergy to any of them you should not get immunized but we don't know yet okay and and that was and I don't again I don't want to blow that up but if there are people that and there are just some people that are allergic to everything you and I both know that person or those people but we have to distinguish sort of the the common allergies to this very rare it could be predictive if you've had a severe anaphylaxis to an antibiotic or an injection you want to tell the vaccinator okay you may want to be observed for 30 minutes instead of 15 minutes afterwards and I'm thinking the peanut algae people you know it's like that I feel like that's something that they've been talking about no evidence of we know what we know and we know those that have had anaphylaxis peanut allergy doesn't I bet you're sick of getting all these questions that we just not at all not at all um I am going to I'm reading this cold uh caller question it says uh caller said that they are taking prescribed oh listen that write it in our topic callers that they are taking prescribed allergy medication now uh singular and levocetirizine and are getting the covet vaccine Saturday good for you um should they not be taking the prescribed allergy shot or medication now while getting ready for the vaccine so I'm glad that you were listening to what we were talking about earlier that's a really good question I would encourage them to consult with their with their doctor I'm not exactly sure why they're on it is it just sniffles that they get or is it something more severe um hypothetically could it interfere with the vaccination very small chance so it's probably okay but that's the category where I would encourage them to talk okay to their doctor and sometimes we're here because they don't have access to a doctor so just in case they don't if it's uh and let's kind of look at the differentiation there if it is an allergy type medication for the pollen that's in the air in the spring then maybe it's not going to be a big deal so that's something that we want to to talk about we talked about this a little bit but I want to go into it a little bit more as people are getting out and again adults and let's just say everybody above the age of 16 is vaccinated and and let's talk about birthday parties I feel like that's the easy thing to do we're all past everybody wants to get together and now you're going to a birthday party for seven-year-olds do you go is an at an uncle is it better not to go and again aunt and uncle is vaccinated how how and I know we've kind of asked that question already how does one navigate that when you know there's a group of kids there right I think part of that would be how old are they do they have underlying illnesses was the vaccine effective in them are they fully immunized has it been the full 14 days after the second dose if one of one or the other is immunocompromised the vaccine isn't protecting them that then it's better to avoid it okay um this is a great question if you've had covid before do you need to wait to get the coveted vaccine you that's a whole subset of questions we haven't talked about yet yeah let's do something to ask the question um when the vaccines were first developed the guidance was wait 90 days now there's no reason or no rationale to wait to get vaccinated you can anticipate on the other hand that you've had coveted relatively recently the side effects may be enhanced so anticipate that okay let's talk more about that let's talk about um let's talk about yes you had covid you're now recovered you're fine and then there's that the very unfortunate group of long-haulers that have just residual symptoms residual issues going forward um and maybe it's just something as simple as my headache won't go away or the aches and pains won't go away or I'm just not breathing the way I used to when they're looking at that group and let's hope that they are with a doctor that they're Consulting but let's say they're not um do they look at getting the vaccine anyway even if they're continuing to have what they may seem to think are long hauler symptoms so to respond to that first the vaccine will not give us covet it will not expose us to the virus it's a very small part of the virus that itself doesn't infect second response is there's emerging anecdotal evidence that after vaccinations certain lawn haulers are people with long covid feel better that's something that used to be explored more what's the basis of long covid it's probably not Persistence of virus per se but there it is possible based on this what's thus far anecdotal evidence that it could improve okay okay so now let's let's talk there have been people that have had covid twice same situation there and I and I don't know if it's something that they're more susceptible or they're just in areas of work where they're able to you know get it a couple of times um and I'm just asking because I'm about at the point where I'm just going to say just say anything that you want to say that we haven't talked about yet so the reports of reinfection with few exceptions if any have been asymptomatic very very good to know okay so there's been a few reports of two courses of very severe covet so recovery from covid this turns them out to pretty good immunity against severe disease oh what a lovely thing right I really like that take your drink because this is a perfect time for me to give out the information again and yes he's got Vodka in his cup in case you're wondering but again if you are interested in registering for the covered vaccine you haven't done so yet that website is EP think of El Paso covidvaccine.com sorry I'm in Zoom meetings all day so I'm looking at the screen versus the camera my apologies but again epcovidvaccine.com and if you want to dial a telephone number you will be on hold for a little while but the telephone number is 212-1032 and if you just want simple information on what's going on up-to-date information daily information on what's happening with covid around the region you can always go to the El Paso strong website and there is an area on that website that talks about what's happening with kovid you can also register there you just have to kind of look around a little bit but again the covidvaccine.com epcoted vaccine dot com website has a registration right there question from the audience before I just let you lose so to speak because there's going to be a point I'm just going to have you talk about everything you want to talk about before you got here is aspiration performed with the covet vaccine sorry that I read that cold um I don't know exactly what they're asking inspiration performed that doesn't make sense I'm not sure I mean I've heard technically before in when you insert the syringe that filled with the vaccine solution plunger back to make sure that we're not in a vein which is a rare rare very rare likely that may be what they're asking okay and I have to say I've been I I myself have volunteered to vaccinate at Texas Tech uh as you said earlier uh this community has done a marvelous job stepping up getting it to the elderly getting it to everybody the students have been volunteering faculty our president and Dean at Texas Tech has volunteered so they're all very good vaccinators they're all very good vaccinators I like that everybody can line up and learn how to give a shot so here is my question to you I know this is full of information we've covered so much um but let's talk about what we haven't covered that you've been getting asked questions for just in general your thoughts we've got a good 15 minutes to fill up that spot and I just really want to hear from you as a person who's been doing this for years developing these vaccines for years um I'm all of us want to sit at the dinner table with you so now now is the time just to just talk to us very good very good well aside from from from the work I've done the objective there is to to get children immunized at the earliest possible time after birth measles is still a public health threat we've had outbreaks in the U.S it's still a major killer the vaccine doesn't work well in young infants which is why we started looking for alternatives to protect the most vulnerable the biggest threat to immunization in general now is vaccine hesitancy as you pointed out before the pandemic it was identified as one of the greatest threats to Public Health by the World Health Organization so it's very important that we learn how to engage right we need to trust in our leaders we need to trust in our process the FDA is one of the most thorough um ethical in everything that they do authoritative bodies in the world these vaccines would not have been improved for eua unless they were found to be safe most likely which we know they are I believe within certain parameters and highly effective it's a matter now of engaging communities that might be it's interesting what I've learned is my assumption would be that most people would want the MRNA vaccines because the perception was they're more effective certain people just want to get it over within one dose so how do we engage people what's going to work best for you how do we get to the vaccines to the people that need them maybe we'll want to supply more of the Johnson Johnson in in in certain areas we need to also make it much easier than it's been in time I want it to be as easy as going for your flu vaccine exactly at your local pharmacy and we're getting there and we're getting there fast so that's what really encourages me I like when you said just getting your regular flu vaccines I I you know just being in a rotary club for example there'd be that day you know Thursday October whatever and at that time DNA or whatever they just go get your flu vaccine um and there wasn't pre-registration at the end of the day you're taking a you know a questionnaire so to speak do you think that we might be there and I'm going to say by let's say 2023. let's skip 2022 and that question because again there's so many unknowns that and I know this is Pie in the Sky future you know glass ball looking at um but what are your thoughts about that no I think by 2022 early to mid we're going to have approval across the lifespan for covid vaccines in the U.S okay in the U.S and that's the key point so I was going to ask you about global yes so questions are going to begin to emerge should it be required for school entry the way measles vaccination is chickenpox vaccination many states are now insisting on flu and in terms of the threat to Children flu vaccine I'm sorry flu virus kills upwards of maybe 180 children a year that was a banner year for flu covet has surpassed that there have been 280 deaths due to covet in children we have to be mindful of that and also to protect the teachers to make sure that all families feel safe in those environments it's going to be important that everybody be vaccinated so should it be a personal choice to a degree it should be but I think jurisdictions are going to be begin to look at that states have the authority to mandate vaccination for school entry hospitals can have the authority to mandate that their staff be immunized and many I think institutions are beginning to look at that I'm glad that you brought that up and and we try in every way shape or form not to be controversial on the show um but that again you talked earlier this is public health this is for the greater good does the end justify the means I'd like to take that thought process and now we are in America it's it's one thing right across the border we're having a bit of a harder time Distributing uh getting supplies as I said before the show all of my family aside from my immediate family all of my family is in Western Europe um and you know when I got my vaccine I took a little picture of my arm and they got mad at me it's like oh and don't be a show-off globally and maybe we can talk about travel maybe not I'd write I'd like to kind of stay on the public health Spectrum what is happening globally and you even joked about not joked but you know one of the vaccines that we're getting in America so easily is actually developed in Germany that's where most of you know my family's from how is that how does that work like how I know you purchase a vaccine as a country I I feel like I read about it differently and I'm not sure how it works myself I think there were a lot of Wagers that went on early on with the MRNA vaccines the U.S government contracted with most both moderna Pfizer biontech Johnson and Johnson AstraZeneca to a degree the rest of the world invested very heavily in the AstraZeneca approach it was really designed in certain ways to be an affordable vaccine that didn't need the cold chain for storage there was a lot of Hope there unfortunately it hasn't held up well against certain of these variants there is a the serum Institute in India that was ramped up to produce a billion plus doses so the production is there it's affordable it's being distributed through Kovacs which is an international organization that gets the vaccine to less developed countries or at a cheaper rate so Mexico can get it through that entity South Africa so there was great hope there that that would be the vaccine for everybody unfortunately we're not there and I I think there's opportunity to develop a newer version of that that could be more effective but that's going to take time okay and when you say so talk about Kovacs is I I one of my favorite I just love Al jazeer's and BBC again I I consume International media and I hear about Kovacs a lot but I don't it's a great organization how are they receiving their funding do people donate to organizations do companies donate globally to this how how is that working all the above it's governments and the US government has stepped up more under the Biden Administration to contribute to that uh The Gates Foundation gavi is a similar organization that sort of houses Kovacs that is an entity that really makes vaccines accessible against childhood diseases so when we hear about measles vaccination polio eradication it's it's gavi that is facilitating that okay so I would like to talk about the compromises as people would say the underlying conditions and uh you said earlier too and it's not an alarming number until you look at the whole idea it's like oh kids are immune kids you're immune kids you're immune I know we're past that idea that we definitely want to get kids vaccinated not only for themselves but for people around them but talk about some of the issues that children have if and when they contract covid and one of them that we've talked about before on this program is misc the multi-system inflammatory syndrome in children um because for the longest time it's like oh the kids are fine the kids are fine don't worry about them but they're not fine and I'd like to explain that a little bit okay so when thinking about Covenant children first of all cumulatively there have been three and a half million cases reported we know that children like adults can have long covet so in a cohort in the UK they've observed long covid what they're calling based on lingering symptoms for five weeks or more and 10 to 15 percent of children recovering from covert that's one part of it one in 50 hospitalizations are in children I mentioned the statistic of 280 deaths which far exceeds any deaths due to flu in a typical year in children and the misc there have been upwards of 3 000 cases now it can happen to anybody regardless it really there's no known predisposing Factory that can lead to hospitalization it's killed dozens of children and it can have long-term sequelae in terms of effects on the heart the kidneys we don't know if there are any neurocognitive impact of that either so that's another very compelling reason exactly we get everybody vaccinated and everything's growing you won't know right away question from the audience and again this is a media thing that that everybody's hearing about has blood clotting been associated with covid vaccine again uh there's a lot around that and uh the start stop start stop in Europe and other places too explain from your point of view and globally because that's what we're hearing the start stop situation and why why that is happening right so is there an association it's not clear yet is it causal we certainly don't know that there have been several reports and as you point out there's been a lot of stopping and starting most analyzes have shown that this happening in this percentage of individuals is no higher than it would have happened in the absence of vaccination as much as I know of as of right now okay part of it may be you certainly remember when you got vaccinated I remember when I got vaccinated it's a huge event and then something happens in the wake of that do we attribute it to the vaccine that may be what's happening here I just wanted to explain that because that's that's my thought process as well uh question here from the audience just came in reading this call old when do we need to think about getting the vaccine a second time so we talked a little bit about that we're not sure yet but meaning the second time meaning this year so the studies that are happening now are looking at two main questions with the variants for example is it sufficient just to give another dose of an mRNA vaccine for example will that give us an antibody level and breadth that can neutralize these variants or do we need to come up with a new strain so I think moderna is well alone in terms of coming up with a new messenger RNA sequence that reflects variants so they're they're going to immunize in in well-controlled studies take the blood from the individuals and ask the question how well will that neutralize in in vitro so you doing what you do in development of vaccines again this is where it's fascinating so you're talking about now getting vaccines are going to have a little bit of a different formula to them for the years to come and again like flu flu and like talked about flu vaccine because every year you get a flu vaccine it's not the same flu vaccine you got two years ago or three years ago there's a little bit different each year am I correct when I say yeah they're up to in any given year you may get up to four different flu variants we can call them or strains in one injection okay and the reason I'm asking that is that it would be very normal and very expected for this to be with covid and I guess my question too would be now would it be ever a point where you get the flu vaccine and it's combined with the covid vaccine so it would be one vaccine that you receive once a year it's unlikely again okay for the reason that it's potential for them to interfere we want to allow the immune system to luxuriate an exposure to flu for a while recover and then we'll expose it to Kobe that's that's generally I love that we do I mean in in children we do come combine up to five different what we'll call antigens or proteins into a single immunization otherwise children would be pin cushions with the number of vaccines we give nowadays we know that these vaccines are safe Beyond just the pain of the injection and the swelling and redness they get afterwards we we know that there's not much other risk I was on a meeting today when in Old Timers if I say it that way but I'm an old-timer too but back in the day I don't know have you been in El Paso all your life I arrived in August of 2020. you will remember this from New York City I have to give a nod to Dr Lawrence Nikki and there was the vaccine campaign uh two four and six months El Paso Juarez and Las Cruces and it was all about those months or when your babies get vaccinated um the reason I bring that up is that you are you said and I remember my little ones it's like wow they get three shots today and next time they get two shot and I remember thinking to myself how's the body dealing with all these so taking what you just said into that idea with young ones and now going forward with the other vaccines because I know for example when my kids went to college they had to now get the oh gosh the meningitis vaccination as well so it's beautiful that these are all happening but I would love for you to explain how again physiologically your system is dealing with three vaccines at a time we can be reassured in the balance that our children are being exposed to fewer vaccine proteins than they were in the era when we all got smallpox vaccine so smallpox just a single dose of that will expose you to dozens of different proteins so children are not being exposed to more proteins also a lot of attention is paid to safety now that wasn't paid 50 years ago exactly we also have to ask what's the alternative right as a medical student I went down to Nicaragua in the early 80s for a rotation and I needed a flu booster because polio was rampant in Central America yes so to me the the fact that we are on the cusp of Vex of elimination worldwide is a thing to celebrate I've seen children die from measles in New York City in the 1990s younger infants that were too young to be immunized so it's a Dreadful thing and that's why as a community as a society we owe it to everybody to be responsible get vaccinated ourselves get our kids vaccinated to protect the most vulnerable those that may not be able to get vaccinated against covet those that are immunosuppressed that may not respond to the vaccine and again it's it's again all about reducing the risk worldwide and Countrywide city-wide household-wide Etc um again if you have not registered for the vaccine and would like to that address is EP El Paso just think El Paso EP covid vaccine.com number 915-212-1032 if you only caught part of this program I like to catch uh the program again you can go to www dot pbselpasso.org you can also find us on the El Paso County Medical Society website and that's www.epcms just think El Paso County Medical society.com you've been watching a very informational phone uh show Dr Glenn fennelly has been with us this evening thank you very much you've been watching the El Paso physician I'm Catherine Berg good night thank you [Music] [Music] thank you [Music]