SoCS: flood anniversary

Linda chose “where” as a prompt for this September 11th, assuming, perhaps correctly, that most posts would be about where we were when we found out about the 9/11 attacks in the US twenty years ago.

In Broome County NY where I live, besides the twenty year retrospectives of the 9/11 attacks, we are having the ten year retrospective of a record high flooding event on the Susquehanna River. The ground was still saturated from hurricane Irene when the remnants of tropical storm Lee dumped about ten inches of rain.

Where my house is is near a flood wall for a creek that runs into the Susquehanna. The creek came up fast with the river flooding a bit later as it collected all the run-off from the creeks as well as what was running off the hills and being dumped by storm drains.

The power was shut off in our neighborhood as the houses closer to the river started to flood. If we didn’t have a generator, our basement would have flooded when our sump pump lost electricity. One of my Memories on Facebook helpfully reminded me that two blocks from us houses had basements totally full of water and two blocks in the other direction the road was washed out and a gas main was broken. Three blocks away there was standing surface water. A big intersection of Main Street and the Parkway was underwater, too.

Most of our neighborhood had been evacuated the night the flooding began, but our little section was only under evacuation order for a few hours on the third day of the flood. We later discovered that the reason was that they were afraid of the flood wall being overtopped. Even though the creek itself had begun to recede, the flooding of the river had backed water up into the creekbed so that the water was within a foot of the top of the wall. (Just to clarify, this is an earthen/stone flood wall, not a concrete one.)

We have been lucky not to have had another severe flood like that one in the last ten years. The prior record-setting flood had been in 2006 and I fully expected we would have had another horrible flood by now.

Unfortunately, I know it is just a matter of time. Looking around the US, we have catastrophic fires in the West and flooding aftermath in Louisiana and the South, in Tennessee, and across a swath of the Mid-Atlantic and Northeast. There are fires in Siberia, floods in Germany and other areas in Europe, killer heat waves, and on and on. While the events themselves are natural, they have been made worse by human-caused climate change.

We have so much work to do to try to stabilize the climate and protect human, animal, plant, and marine life. And we are far behind in our efforts.

I’m upset because scientists and activists have been warning about this for decades. I myself have tried to amplify the message about climate change. It seems that people are finally listening but the amount of change of policy and behavior now will have to be huge to make a dent. Our family has tried hard to reduce our carbon footprint and to advocate for change but the world needs those in power to finally step up and lead. Governments and businesses need to put people and planet over profits. The money won’t be worth much if the planet becomes uninhabitable.
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This less-than-cheery post is part of Linda’s Stream of Consciousness Saturday series. Join us! Find out more here: https://lindaghill.com/2021/09/10/the-friday-reminder-and-prompt-for-socs-sept-11-2021/

Pfizer vaccine approval

Today, August 23, 2021, the United States Food and Drug Administration has announced the full approval of the Pfizer/BioNTech vaccine against SARS-CoV2, the virus that causes COVID-19, for people aged 16 and up. People aged 12-15 are still being immunized under the emergency use authorization. It is also expected that, in the coming weeks, Pfizer will apply for emergency use authorization for children aged 5-11. Research is ongoing on children 6 months-4 years. Also, most adults will become eligible for a third dose to boost immunity, given from 8-12 months after the second dose.

Meanwhile, both Moderna and Johnson & Johnson, the other two vaccines available under emergency use authorization in the US, are continuing their research and applications to expand their age ranges and gain full approval, too.

It’s possible that, for some people who have been reluctant to be vaccinated, the full approval of the Pfizer vaccine might be enough to convince them to receive it. The US has seen many more shots being administered in recent weeks as the delta variant has surged and people realize that nearly all the people being hospitalized and dying are those who were unvaccinated. Unfortunately, it takes several weeks to build immunity from the vaccine so the delta surge will likely continue into the coming months.

The other expected impact of the full approval of the Pfizer vaccine is that more employers may mandate that their workers be immunized before returning to in-person work and more businesses may require immunization (or alternatively a recent negative test) for their patrons.

As regular readers may remember, my spouse B, daughter T, and I are all part of the Pfizer Phase III trial for the vaccine. B and T were lucky enough to receive the actual vaccine in August 2020 while I wound up being in the placebo group. When the vaccine received emergency use authorization, the study was unmasked so that people in the placebo group could receive the vaccine, which I did in February 2021. I will continue to be followed as part of the original study through August 2022. B and T, meanwhile, have entered into the third dose phase of the study. They will be providing data for the continued study of how much immunity boost occurs with the third dose and how long it lasts.

I continue to mourn for all those who are suffering as a result of the pandemic. Please, everyone, listen to the public health specialists in your area, receive the vaccine as soon as it is available to you, and mask, distance, and wash hands as directed. Please, do everything you can to protect the health of yourself, your loved ones, and your community.

SoCS: more on covid and vaccines

Here in the US, we are facing another wave of COVID. I think it is considered our fourth wave, but that has become pretty hard to define over the many months of the pandemic. What is different this time is that this wave is almost exclusively confined to the unvaccinated population, at least in terms of serious illness, hospitalizations, and mortality.

In New York State, where I live, the Northeast in general, and a few other states with high vaccination rates, you are seeing case numbers climb somewhat, largely because the delta variant is causing more breakthrough infections among the vaccinated, but you aren’t seeing extreme impacts on hospitals being overwhelmed and lots of serious illness and deaths.

In states like Missouri and Mississippi, with low vaccination rates, we are seeing conditions that look like the early days of the pandemic in New York, with hospitals overflowing with very sick patients, more than they have space, equipment, and personnel to handle. While in the first-wave, most of the very ill were elderly, now we are seeing that most of the very ill are younger adults. Even in these low-vaccination-rate states, the elderly are the ones most likely to have been vaccinated, so they are less impacted by this current wave, even with the delta variant making up a larger and larger share of infections.

As people who read Top of JC’s Mind from time to time may recall, I, spouse B, and daughter T are all part of the Phase III trial of the Pfizer/BioNTech vaccine. B and T both were in the original vaccine group and were vaccinated last August. They are now both enrolled in the follow-on study of booster shots and their efficacy. Like the original study, it is double-blind, so neither the participants nor the researchers know who received the actual booster and who received the placebo injection.

However, B and T are both having side effects similar to their other doses of the vaccine, so we are pretty sure that they got real booster shots, not placebos. For the record, last August, I got placebo shots. When the study was unmasked after the emergency use authorization was approved, I was offered the real vaccine, which I got in February. I remain in the study as part of the design to follow participants for at least two years. I don’t know if I might, in the future, wind up participating in a follow-on study for boosters as well. It will depend on how the results of the booster study that B and T are now in play out and whether more data is needed. It’s also possible that Pfizer may re-formulate in response to current and future variants and need a pool of test subjects for that. My family will continue to participate as long as we can be of use to help advance the science and protect public health.

It is so very sad to know how many people are suffering from COVID, especially now that we do have good vaccines available. I’m sad for people in countries or regions that don’t have access to the vaccine. I’m upset that there are so many who do have access but still remain unvaccinated, often because of misinformation about COVID and about the vaccines. Choosing to remain unvaccinated doesn’t just impact the individual’s health if they get infected. It also impacts public health, giving the virus more opportunities to mutate and create new variants. It also can spread the virus to others, which is especially dangerous if those people are also unvaccinated. Sadly, we are seeing an increase in hospitalizations of children, who aren’t yet eligible for vaccination, and teens, who are eligible but still have low vaccination rates in many states. Earlier this week, the state of Tennessee announced that it is ending all vaccine outreach to teens. It would be bad enough if this was just COVID vaccine but they are also ending outreach for other vaccines, like TDaP, HPV, hepatitis, and MMR boosters.

It’s appalling.

Please, everyone, remember that we are still in a pandemic – and will be until we can get COVID under control globally. If you have access to vaccines, please take them for your own good and for the good of others. Everyone needs to be vigilant to following public health and infection prevention measures recommended by public health professionals in your region.

COVID doesn’t care about your political views or whether or not you believe it exists. It is a virus that is just looking for a host to make it possible for it to replicate as many copies of itself as possible. If you are infected, you might be lucky and have mild symptoms, but you could pass it on to someone who might become seriously ill or even die. Or you might be unlucky and become seriously ill or die yourself.

The virus won’t care.

Your loved ones will.

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Linda’s prompt for Stream of Consciousness Saturday this week was to base your post on your least favorite word. I don’t often think of having a favorite or least favorite word, but I thought that COVID definitely qualified as being my least favorite entity at the moment. If you’d like to join in with SoCS, you can find out more here: https://lindaghill.com/2021/07/16/the-friday-reminder-and-prompt-for-socs-july-17-2021/

Vaccinated and (mostly) unmasked

Shortly after I wrote this post, the US Centers for Disease Control and Prevention published new guidance regarding mask wearing/distancing among fully vaccinated people in response to newly published research findings.

The good news is that fully vaccinated people can stop wearing masks indoors with extremely low risk of contracting or spreading coronavirus. Mask wearing is still recommended in medical settings such as hospitals. Requirements to mask on public transport remain in effect, as do any mandates or policies put in place by state/local governments and businesses.

The bad news is that people who are not fully vaccinated might also stop wearing masks – and wouldn’t stand out because others would just assume if they weren’t wearing a mask that they were vaccinated – and so could be exposing themselves and their contacts to coronavirus, which would drive up infection rates. This is not helped by states that have already dropped their mask mandates or never had them in the first place.

Some governors immediately dropped their mask mandates while others, such as Governor Cuomo of New York where I live, are reviewing the situation before making any changes.

Personally, I expect that I, though vaccinated, will not be making many changes in my mask behavior immediately. The few stores that I frequent are likely to keep their mask policies in place for now. Visiting my father in the health care building of his senior community will probably still require masking because, although they are vaccinated, the residents are still vulnerable due to their age and underlying health problems. If the state does drop the mask mandate, small businesses, such as hair salons and restaurants, may decide to let vaccinated customers unmask and could easily ask for proof of vaccination to give peace of mind to their employees and customers.

I am frustrated by the media commentary surrounding this CDC announcement. For weeks, commentators have been complaining that the CDC was too slow in changing its recommendations for vaccinated people and that it was a disincentive to get vaccinated. The CDC was waiting for additional scientific findings to be published before making changes, but, now that they have, the commentators are complaining that it happened too fast.

They are also complaining that the CDC guidance is confusing. It’s not. It is meant for use on an individual level and it’s very clear about what activities fully vaccinated individuals can do without masking/distancing and what activities unvaccinated people can do without masking/distancing. The CDC and the federal government are not the ones with authority to require masks in stores, churches, etc. State and local governments and businesses do that.

So, please, everyone, stop whining, learn about the recommendations from the CDC and the policies in place in your local area, and behave accordingly for the safety of yourself and others.

If you are eligible for vaccination but haven’t done it yet, make arrangements to do so as soon as possible so you don’t become seriously ill or pass the virus on to someone else.

Remember to be kind and respectful to others. Some vaccinated people will choose to continue wearing masks because they are immunocompromised and more susceptible. I know people with allergies who are continuing to mask outdoors to protect themselves from high pollen counts. Some parents of children who are too young to be vaccinated wear their masks to be a good example for their children. It is not your business to criticize someone else’s decision and masking is never a wrong choice when it comes to public health. In some countries, masks have been common for years, especially during flu season or when there are air quality problems.

The CDC recommendations rely on public trust. Unvaccinated people need to demonstrate that they are worthy of trust by following the public health guidance. Overall infection and death rates are down, but they will spike again if people don’t continue to vaccinate and mask/distance until they complete the vaccine process. A spike might not happen until colder weather drives more people indoors, but it won’t happen at all if we can get the vast majority of teens and adults vaccinated by fall.

The prospect of the epidemic phase of COVID-19 being over by fall is within reach, but only if people follow this guidance and get vaccinated.

Let’s do it!

Another Pfizer vaccine advance

Yesterday, the Pfizer/BioNTech vaccine against COVID-19 was granted emergency use authorization for children aged 12-15, extending the prior age range of 16+. These younger teens can receive the same dosage as older teens with similar effect. This is good news because all high school and most middle school students should be able to be protected before schools open in August or September 2021.

Pfizer and other vaccine suppliers are currently studying the proper dosage for younger children. These eventual approvals will probably be split into several groups, 5-11-year-olds, 2-4, and 6-23 months. The research with these younger children takes longer because they have to start with lower doses and increase to find the lowest possible dose that will still mount a strong immune response. Until these children can be vaccine protected, they need for all the teens and adults to get vaccinated to reduce their chances of being exposed. While young children tend to be less sick than adults if they get infected, they can become very ill, even fatally, and suffer long-term symptoms. Even if they have mild or no symptoms, they also keep the community spread of the virus going, which means that the pandemic phase cannot end.

Canada gave authorization for 12-15 for the Pfizer vaccine last week. It’s expected that Moderna will be doing so soon. Pfizer has also applied for full authorization in the US, a process that will take several months to complete. I am especially pleased with the success of the Pfizer vaccine because data from spouse B and daughter T are part of the research findings that are showing how safe and effective the vaccine is. Monitoring for them continues to see how long immunity lasts and whether boosters are needed. I also continue to participate in the trial, but, because I was originally part of the placebo group, I didn’t receive the vaccine until February so my data are not useful for the longevity factor, although I could become part of a test group for boosters in the future if warranted.

Internationally, vaccine companies are continuing their research and manufacturing, but distribution is neither fast nor broad enough. India is particularly tragic, with widespread disease, scant treatment, and, despite being a major manufacturer of pharmaceuticals and vaccines, very little vaccine protection among its residents. President Biden has joined growing calls for vaccine companies to suspend their patent protections so that countries around the world can manufacture vaccines for their regions. This would also entail making available the raw materials, supplies, and expertise to manufacture the vaccines, some of which require new techniques such as mRNA.

I feel an odd mix of hope, dread, and sorrow. The COVID rate in New York State where I live is very low now. We are gradually relaxing some of our restrictions and I am planning to go on a writing retreat later this month. This summer, we think we are finally going to be able to travel to the UK to visit daughter E and her family and get to hold our granddaughter JG for the first time, although she is almost walking on her own and may not want to stop long enough to be held by the time we can get there.

At the same time, there are still people sick and dying in my state and exponentially more in other states and countries. It’s frustrating because we have treatment tools and vaccines now that we didn’t have a year ago but they aren’t reaching all the people that need them. What’s most frustrating is people who do have access but don’t take advantage of the opportunity, letting their fear, ideology, contrariness, or sense of invincibility stand in the way of personal and public health.

Please, everyone, continue to do all that is within your power to end the pandemic. This will look different depending on personal and community circumstances, but mask in indoor public spaces, distance when appropriate, be careful about the size of gatherings, stay home if you are sick, vaccinate when it’s available for you, keep up to date on the newest public health recommendations.

Show your respect for others and do your best to protect them. Pandemics are, by definition, phenomena that affect us all. It takes all of us working together to end one.

more good vaccine news

An update to my last post on coronavirus vaccines in the United States:
The Johnson & Johnson vaccine did receive emergency use authorization over the weekend and is currently being distributed. Because the company had manufactured some doses in advance through Operation Warp Speed, there will be some large shipments going out followed by a lag as Johnson & Johnson ramps up their manufacturing operations.

President Biden announced on Tuesday that another large pharmaceutical company with vaccine expertise, Merck, will be helping Johnson & Johnson to manufacture its vaccine. Merck ended a couple of vaccine trials it was conducting due to ineffectiveness and will be aiding the country in manufacturing its rival’s vaccine under the Defense Production Act. This Act is also being used to increase production of other needed items, such as vials.

Unlike the Pfizer/BioNTech and Moderna mRNA vaccines, the J&J vaccine is a more conventional vaccine, using inactive adenovirus to carry the vaccine into the body and activate the immune system. It only requires one dose and can be stored at refrigerator temperatures, so it is much easier to distribute to more rural areas.

While President Biden had previously said that any adult who wanted to be vaccinated would be able to be by the end of July, he now expects that to be possible by the end of May. This would allow most of us to resume what we have been calling “normal life,” although I think that some changes from our old ways of doing things will probably be in evidence indefinitely.

However, there are some big ifs. The first is that individuals would need to almost universally accept the vaccine to prevent it spreading in the community and to minimize the impact of new, possibly more dangerous variants. This would need to happen in every state – and in every country, if unrestricted international travel is allowed to resume. The second is that people would need to continue masking, distancing, limiting gathering size, etc. until most of the adults in the community were immunized or could be rapid-tested to show they were not likely currently infectious. New York is currently piloting holding sporting events using technology to screen for immunization/negative tests to allow higher occupancy for fans.

Another consideration is teens and children. Currently, only the Pfizer vaccine is authorized for use in 16- and 17-year-olds; it is currently being tested in 12-15-year-olds with plans to test in younger children after that. Other companies are also now beginning to study their vaccines in children and teens. Wide adoption of the vaccine among adults is the quickest route to protecting children, given that widespread vaccine use is unlikely for them until 2022.

The wild card continues to be how long-lasting vaccine effects are and how well they prevent serious illness from current and future variants. To that end, spouse B and daughter T are having blood draws this week to evaluate how their immunity is holding up as part of the Pfizer Phase III trial. They received their immunizations in August 2020 and will continue as part of the study into 2022. It’s also possible that Pfizer will be piloting the use of booster shots or of new vaccine formulations to better deal with variants, using the subjects already enrolled in Phase III. They have begun some of this research with Phase I/II participants.

Other vaccine researchers are continuing to study boosters and new vaccines, as well as longevity of immunity. Part of the story about Merck helping to produce the J&J vaccine and other similar partnerships around the world is that the extra doses may be needed as boosters in the future. If not, the surplus vaccines can be distributed through the COVAX initiative internationally to reach underserved populations.

All in all, it’s a hopeful time, but only if people are informed, thoughtful, and community-minded. Please, observe safety measures, get vaccinated when it is your turn, and be kind. We can end the pandemic sooner if we all work together.

good news, bad news, and uncertainty

Yesterday, I got my second dose of the Pfizer/BioNTech coronavirus vaccine as part of their ongoing Phase III trial. As I have written about previously, spouse B, daughter T, and I are all participants but they both received the vaccine last August, while I was in the placebo group. After the vaccine received emergency use authorization, Pfizer unmasked the study so that placebo group folks could receive the vaccine as well, which I gladly did.

B and T both had a day after their second vaccination that they didn’t feel very well, so I planned today as a down day for me. I do have a sore arm, headache, some body aches, fatigue, and a low-grade fever, but ibuprofen and rest are helping somewhat. Only a small minority of people have this level of side effects, but I am more than willing to not feel well for a day in order to have as much protection as I can from the severe form of COVID-19. While the science is not yet clear if the vaccine prevents asymptomatic or mild disease, the data show that moderate and severe cases that lead to hospitalization and/or death are rare.

I am grateful that Paco was among the first at the Health Center in his senior residential facility to receive the vaccine. Two weeks from now, when I will be considered to have peak immunity, it will ease my mind when I am allowed to meet with him indoors to know we are both fully vaccinated. We will still need to wear our masks and keep some distance, but it will feel safer than it has over this past year.

More good news on the vaccine front is that Pfizer and Moderna have been able to ship more doses of their vaccines than they had previously and that the Biden administration has improved distribution in conjunction with the states and local pharmacies and health centers. Pfizer has applied for permission to store its vaccine at regular, rather than ultra-cold, freezer temperatures for up to two weeks, which will make distribution easier. Another positive development is that the Johnson & Johnson vaccine candidate may receive emergency use authorization as early as this weekend. It is a one-dose vaccine that can be stored in the refrigerator, which will make distribution in rural areas and neighborhoods without good transportation options much more effective.

The worry, though, is that more variants of the virus are appearing. Some of them are more easily transmitted and may cause more severe disease. It’s not clear how well some of the vaccines work against some of these variants. It’s also not always apparent which variants will become widespread. For example, a new variant has been identified in New York City, but no one knows if it will become dominant, cause greater sickness, or be prevented by the vaccine.

To combat this, both Pfizer and Moderna are looking at changing their mRNA vaccines to account for new variants, as well as studying if a third dose – or even an annual booster – might be necessary to tame the coronavirus and keep it at bay. It’s part of the reason that it is so important for the Phase III trials to continue collecting data, so we can keep immunity levels in the populations as high as possible.

For now, I’m resting, cuddled under a black fleece throw that the clinical research center gave me, with their name embroidered on it, of course. While study participants do receive a stipend, they also occasionally receive little gifts and it’s nice to have this throw to keep me warm today. The best thing, though, is knowing that the vaccines are helping people and that, despite the uncertainties, we are gaining ground in the battle to end the pandemic.

There is still a long way to go and I beg people to continue to wear masks, keep appropriate distance, wash their hands, and avoid large gatherings. Get whatever vaccine is available to you when it is your turn. Check on vulnerable people in your community to see if they need help to stay safe. Support efforts to get the vaccine to vulnerable people around the world.

It takes all of us working together to end the pandemic and rebuild our communities.

first Pfizer vaccine dose!

Yesterday, I officially shed my membership in the placebo group of the Pfizer/BioNTech coronavirus vaccine Phase III trial and became part of the vaccine group.

Yay!

There was a blood draw first, so they can check to see if I already have antibodies, which is unlikely given my personal history, and can compare it to my bloodwork from earlier in the trial after my placebo shots. There was also a COVID test to see if I have an active infection, which is also unlikely because I have no symptoms and community spread is quite low in our area at the moment.

While I was waiting for thirty minutes for the vaccine to come up to room temperature and for thirty minutes after injection to make sure I didn’t have an adverse reaction, I was able to get some family business done. With spouse B and daughter T’s consent, I was able to pick up their vaccine cards, showing the dates back in August when they received their immunizations. Although we had long suspected that they had received the vaccine and I had received the placebo, we are happy to have the confirmation – and the documentation to prove it. As a higher proportion of the population gets vaccinated, we may need to be able to prove our vaccination status for accessing public transportation, employment, visiting privileges with Paco in his senior community, etc.

The Biden administration is working to get more Pfizer and Moderna vaccine doses out to the states for distribution and the United States may soon have a third vaccine receive emergency use authorization. If approved, the Johnson & Johnson vaccine would be a big help in getting more people vaccinated in more locations around the world more quickly. It is administered as a single dose and can be stored at regular refrigerator temperatures, making it much easier to distribute than the current mRNA vaccines which need very cold storage and two doses. The J&J vaccine will be much easier to get to rural folks and places that don’t have good access to public transportation and medical centers.

The more vaccine available and the more people vaccinated, the sooner we have hope to end the pandemic. This needs to happen everywhere around the world, though, for the pandemic to end. There have to be so few people that are susceptible to the virus that it can’t find enough hosts to continue spreading in the community. Until that point is reached, people will still need to be careful about masking, distancing, and hygiene.

We also need to be vigilant about virus variants and the length of time immunity lasts after infection or immunization. That’s why I’m proud to be able to play my small part in the fight by participating in the Pfizer trial. The data from this latest batch of former placebo group members will show if the vaccine remains effective against the new variants in circulation and add to the statistics of how long immunity lasts as we will be followed for at least another eighteen to twenty-four months.

Today, I have a sore arm and a bit of a headache, both expected side effects from a first dose. It’s a very small price to pay for the beginning of personal protection and the advance of science to help the world understand and defeat COVID-19.

progress for Pfizer

Today is an important day for the Pfizer/BioNTech coronavirus vaccine.

In the United Kingdom, the first doses are being given, predominantly to those over the age of eighty. The recipients will need a second dose in three weeks.

In the United States, the Food and Drug Administration has published a 53-page review of the Pfizer/BioNTech data and confirmed the findings of safety and 95% efficacy. This clears the way for a public hearing on Thursday and possible emergency use authorization within days. Distribution will start within 24 hours of approval.

It is good that so much of the data is now public because you can see that the vaccine is safe and effective across different age, racial, and comorbidity groups. There is also evidence that some protection develops from the first of the two doses, although the highest level of protection begins about a week after the second dose.

As a Pfizer trial participant, I expect to hear back from the researchers shortly after the approval goes through. Pfizer plans to offer the vaccine to people in the placebo group in order to continue their long-term study on efficacy and safety. Among our family in the study, we expect that we have two who have already received two doses of the vaccine and one who is in the placebo group.

I can assure you that the suspected placebo person is anxious to join the vaccine group as soon as possible!

the Moderna vaccine

Today, Moderna announced that their early data indicate their coronavirus vaccine is 94.5% effective. This follows the announcement last week from Pfizer/BioNTech that their vaccine, with which I and two members of my family are participating in the phase III clinical trial, is over 90% effective in the immediate time period after the second immunization.

Like the Pfizer vaccine, Moderna’s is a messenger RNA vaccine. The caveats that I wrote about here apply, but there is now hope that there will be two effective vaccines approved for emergency use in the United States before the end of the year. I’m sure the companies are also pursuing approval in other countries, as well.

Unlike Pfizer, Moderna accepted US government funds for the development of their vaccine. Like Pfizer, the US government also pre-ordered 100 million doses from Moderna. Initially, priority will be given to health care workers and other front-line occupations, expanding to highest risk people. Availability, pending full approval, for the general public will not be until spring 2021.

The Moderna vaccine will be easier to distribute than the Pfizer one because it can be kept for up to a month in a refrigerator. The Pfizer vaccine currently needs a super-cold freezer or dry ice for transport and storage.

Having two good candidates that might be available for the most vulnerable this winter is great news. I’m hoping that more of the vaccines currently in Phase III trials will also be shown safe and effective in the coming weeks. The more vaccines we can make available, in the US and around the world, the better, so we can get the pandemic under control globally.

Meanwhile, Pfizer, Moderna, and other companies need to continue their trials, following everyone who received the vaccine for the coming months to watch for how effective the vaccine is over time, if it protects some people better than others, e.g. seniors or children, and how much it might reduce symptoms in vaccinated people who do become sick with COVID versus unvaccinated. It’s possible that the placebo group may be released early from the studies when the vaccine is fully approved for ethical reasons. The companies may very well ask those participants if they would like to join the study as a second set of vaccinated subjects, doubling the amount of data on vaccine efficacy over time.

So, more good news today, but we have to keep in mind that masks, distancing, restrictions on gathering, etc. will need to stay in effect for months still. Until we have a large majority of the population fully vaccinated – and both the Moderna and Pfizer vaccines need two doses several weeks apart – we need to stay on guard. Sadly, the United States passed 11 million cases recently and is approaching a quarter of a million deaths. We need to do better now, not let more people suffer while we wait for the vaccines to be generally available.