June 20, 2023 • 28 mins
Do you know the true impact of COVID-19 vaccinations in preventing severe illness, hospitalizations, and death? Join us for a vital conversation with our faculty experts. Together, we uncover the latest research on the vaccines' role in preventing complications from the virus and reveal exciting new findings on potential anti-inflammatory benefits and a reduced risk of long COVID for those who have been vaccinated.
As new data is published, we should be continually providing that information to our patients. We can keep those conversations going by sharing that data in meaningful ways for our patients. Amid the misinformation that circulates, we can be a trusted resource for patients for reliable information about vaccines and their importance.
We also explore the importance of vaccination for high-risk patients, the risk factors associated with COVID-19 complications and how chronic illnesses can increase the severity of symptoms. Learn how to effectively communicate the risk and the benefits of getting vaccinated. Boost your resolve to be a role model and advocate for COVID-19 vaccinations in our healthcare practices and communities.
Topics include:
- Preventive benefits of COVID-19 vaccination
- Factors that contribute to a higher likelihood of experiencing severe issues from COVID-19
- Benefits of vaccines pre and post infection
- Incorporating COVID-19 vaccines into regular immunization schedules
- Research specific to pregnant women and children
- More evidence of safety and benefits of the vaccine
- Additional risks from contracting COVID-19 & other inflammatory or chronic conditions that might arise
- Recently added populations who are at higher risk of developing complications from COVID-19
Objectives
- Understand how to discuss the evidence for the continued recommendation of the COVID-19 vaccine
- Recognize the additional impacts of COVID-19 on special populations
- Identify the current higher risk groups for COVID-19 complications
Hosted by: Corinne Kohler, MD, FAAFP, Christina Wells, MD, MPH, FAAFP, and Santina Wheat, MD, MPH, FAAFP
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Carl Earl Lambert, Jr., (00:04):
Welcome back to season two of Beyond
the Needle a physician's guideto increasing COVID-19
vaccination rates.
I'm Carl Lambert, a familyphysician and a member of IAFP,
and I'm an assistant professorof family medicine at Rush
University Medical College.
This podcast series is broughtto you from the Illinois Academy
of Family Physicians, iafp,through the Illinois Vaccinates
(00:26):
or IVAC project.
Joining for this podcast seriesis provided by the Office of
Disease Control through theIllinois Department of Public
Health.
For more information on theIVAC project and receiving free
CME credit for these podcasts,visit illinoisvaccinatescom.
forward slash podcasts.
Thank you for joining us as wecome together to vaccinate
(00:49):
against COVID-19.
Corinne Kohler, MD, FAA (00:55):
Welcome to another episode of Beyond
the Needle podcast.
Today we will be talking aboutthe continued importance of
offering and encouragingCOVID-19 vaccinations.
We will review some of theevidence and updated research
concerning COVID-19 and thevaccines.
Today I am with Dr.
(01:17):
Santina Wheat and Dr.
Christina Wells.
I am Dr.
Corinne Kohler.
Dr.
Wheat, would you like tointroduce yourself?
Santina Wheat, MD, MPH, FAAF (01:27):
Hi , I'm Santina Wheat.
I'm the program director of theNorthwestern McGaw Family
Medicine Residency Program inHumboldt Park and a practicing
family physician at Erie FamilyHealth Center.
How about you, Dr.
?
Christina Wells, MD, MPH, (01:38):
Wells .
Hi, I'm Dr.
Christina Wells.
I'm a practicing familymedicine physician at the Mile
Square Health Center and I'malso faculty at the University
of Illinois College of Medicine.
Corinne Kohler, MD, FAAFP (01:52):
I'm Dr.
Corinne Kohler.
I'm currently a retiredphysician from a
family-qualified health centerand I'm also currently a
clinical professor at CarleIllinois College of Medicine.
Would you like to start withtoday with talking about why do
we need to continue to offerCOVID vaccines?
What are some of itspreventative benefits?
(02:14):
Would you like to start us off,dr Wells?
Christina Wells, MD, MPH, F (02:18):
Yes , thank you for that question,
Dr.
Kohler.
I think, just as in the pastwhen we have vaccinated for
things such as measles and polioand other childhood illnesses
and adult illnesses, weunderstand that COVID-19 has
some serious impacts.
(02:39):
People can have severe illness,hospitalizations and even death
, and we see that COVID-19 ishere to stay.
We've seen many differentvariants and so we know that it
is important that we continue toprotect people against this
virus, and being vaccinated canhelp to prevent that severe
(03:05):
illness.
It can be helpful intopreventing hospitalization and
it can be helpful in preventingdeath.
Santina Wheat, MD, MPH, FAAFP (03:15):
I think you made a really
important point there.
Dr.
Wells, you really talked aboutthe prevention of the severe
illness and of thehospitalizations.
We're not necessarily sayingthat the vaccines are here to
prevent illness at all, so thisdoesn't mean that you won't be
infected if you get the vaccine,and I think that's a really
important thing to make sure weare continuing to tell our
(03:37):
patients, as we're recommendingthese vaccines every day,
because we don't want them toturn around and say oh, i
thought you said that thisvaccine would mean that I would
never get COVID, and that'sreally not our intent.
Corinne Kohler, MD, FAAFP (03:50):
I think there's been a
preponderance of newer evidenceand data that also shows that
some of the severe morbidity andsequelae from COVID may be
reduced with those who have beenvaccinated, such as some of the
anti-inflammatory benefits ofthe vaccine.
So perhaps reduced post-COVIDdiabetes, perhaps reduced MISC
(04:15):
in children, and while the dataand evidence is still new and
emerging, it does seem to beheaded in increased protection
for those who have beenvaccinated, even when having the
illness.
Christina Wells, MD, MPH, FAA (04:30):
I think that's a great point, Dr.
Kohler, because we know that ifyou get COVID-19, it's an
inflammatory condition that canimpact various different organ
systems And so if you can helpto prevent that inflammatory
disease of COVID-19, or if youcan allow people to have a
(04:54):
milder form of the disease, thenyou can help to potentially
reduce the inflammatoryconditions that might arise from
having COVID-19, cardiovasculardisease, diabetes, MISC, as you
mentioned, and the othersequelae of diseases that we see
(05:16):
that result from inflammatoryconditions.
Thank you.
Santina Wheat, MD, MPH, (05:20):
There's even a recent study that was
just released in the past coupleof days from this recording.
This was published in the JAMAnetwork open that talks
specifically about patients whowere infected with COVID and
their risk for diabetesafterwards.
There has been ongoing evidencethat COVID increases the risk
of diabetes and othercardiovascular risk factors
(05:43):
after being infected.
The data really is showing thatthat risk of having new onset
diabetes even after having theinfection goes down, so this can
really mean prevention.
For somebody for a long termchronic disease, this can be a
big deal.
Corinne Kohler, MD, FAAFP (05:58):
And I believe the evidence also shows
that the more times youactually have COVID infection,
the higher risk for long COVIDin sequelae.
And while vaccine may nottotally eliminate that risk, it
would reduce the risk of repeatinfections.
Christina Wells, MD, MPH, (06:16):
Right .
There was recently a study thatwas published by Cambridge
University Press that statedthat those who had been
vaccinated with at least asingle dose of either Pfizer,
moderna, astrazeneca or theJanssen vaccine, it was at least
29% effective at preventinglong COVID.
(06:40):
The protection was strongest atleast 35% effective for those
who were vaccinated before beinginfected with COVID.
Post infection vaccination alsohelped at least 27%.
So we can see here that havingthe vaccine can potentially help
(07:02):
to reduce your risk of thatlong COVID syndrome that we have
been hearing about and thediseases that results and
illness that result from havinglong COVID.
Corinne Kohler, MD, FAAFP (07:15):
Do you think that adding the
COVID-19 vaccine to the regularvaccine schedule is going to be
beneficial in our request tocontinue to offer the vaccine
that people see as quote morenormal?
Santina Wheat, MD, MPH, FAAFP (07:32):
I certainly hope so.
I have certainly startedtalking about the COVID vaccine
just sort of in the mix with allof the other standard vaccines.
So when I'm reviewing my caregaps I sit there and go oh, it
looks like you're due for yourtetanus vaccine, and maybe
you're due for your meningitisvaccine for my population, and
(07:55):
maybe you're due for yourhepatitis B vaccine and oh, by
the way, you're now due for yourCOVID booster, and so just sort
of lumping it in with the restof the vaccines and not making
it feel other, i'm hoping thatthis statement of including it
in the regular vaccine will helpwith that.
I also hope that it will helpwith fears that I think some
(08:17):
people have that it'll bechallenging to get the COVID
vaccine after the publicemergency ends, and so I think
just sort of incorporating intothe regular schedule will just
make it feel like part of ournormal health care.
Christina Wells, MD, MPH, (08:31):
Right , and I think too, Dr.
Wheat, that COVID is.
To us it seems like it's new,but we know that there have been
different strains ofcoronavirus for some time.
But I think as we start to makeit more of a regular part of
our practice and I think too isalso people start to kind of
(08:53):
understand it, maybe in thecontext of like the flu, and
they'll be able to understandwhy we have so many variants,
why we need a booster every year.
And so I think that as wecontinue to have the
conversations, as it becomesmore part of our routine
practice, then people can startto understand what it really is
(09:16):
more and more and more and beable to relate it to other
diseases, other vaccinationsthat we have seen and that we
have currently.
Corinne Kohler, MD, FAAFP (09:27):
I think that's a very excellent
point.
Dr.
Wells said, while we aspractitioners may understand the
variability of the vaccine andthe fact that it will mutate and
that we need to continue to bevigilant, so well discussing the
benefits of continuing to offerthe COVID vaccines, i know
(09:49):
there's been some recentincreased evidence and data on
the pregnant female population.
Would you like to address that,Dr.
Wheat?
Santina Wheat, MD, MPH, FA (09:59):
Sure , i was really excited actually
to see some of the new researchabout the outcomes for those who
are pregnant.
It had been my perception thatpatients who were pregnant and
came into labor and deliveryseem to be more sick.
They seem to have morehypertensive diseases, and there
(10:20):
actually was a recent articlethat did a review of many
patients who had had COVIDduring the time of their
pregnancy and, really looking atany of the trimesters, and
although it didn't necessarilyspeak to some of the things that
I was seeing, it did confirmsome of the recent data that we
(10:40):
had seen before that they weremuch more likely to need ICU
stays, they were much morelikely to need ventilation
support And we've known that fora while But also they are much
more likely to have preeclampsiaand other hypertensive
disorders of pregnancy, whichreally just has more morbidity
at the time of the delivery andalso has implications in the
(11:03):
long run Some of the things thatwe had talked about before,
like the cardiovascular riskfactors, and so this is a really
big deal.
Additionally, on the positiveside, though, the studies have
also been shown for our pregnantpatients that the vaccines are
safe, and so not only do we nowhave data about the initial
(11:24):
doses of the COVID vaccine.
But we also have data about theboosters during pregnancy And
again, that data is for allthree trimesters, and so we can
confidently say to our patientsthat the vaccines are safe.
We, unfortunately, can alsoconfidently say to our patients
(11:44):
that if you are to contractCOVID during your pregnancy,
that you are at risk for furthermorbidity, and that's even if
you get it in your firsttrimester.
So it's really important to besafe throughout.
Corinne Kohler, MD, FAAFP (11:57):
And in addition to that, I think we
had good evidence last yearshowing that women that got
vaccinated passed that pass ofimmunity on to their newborn and
that it is beneficial in thatinitial newborn period for the
infants that are not eligiblefor vaccination.
And we need to continue tothink, emphasize that with our
(12:21):
pregnant women that it'sbeneficial just for their health
and for the health of thenewborn.
Santina Wheat, MD, M (12:27):
Absolutely .
And that sort of brings me onto our children as well.
We know that that time beforechildren can get vaccine, so
they can't get it until they'reat least six months old.
So that pass of immunity, likeyou said, is wonderful for our
pregnant patients, and if ourpatients also happen to be
breastfeeding or chestfeedingthat is really beneficial.
(12:48):
But also this reiterates theimportance of the special
population of children, that wewant them to get vaccinated as
well.
Some of our initial observationsof COVID in children was that
there weren't necessarily asmany complications as we were
seeing with adults.
And while that still might betrue, further analysis has
(13:08):
indicated that if children whocontracted COVID, we are seeing
more MISC than we had initiallythought.
Some of it had beenunderreported based on
self-report.
When our researchers have goneback and looked at the claims
data and looked at other things,we've really seen that COVID
has impacted our children muchmore than we thought that it did
(13:30):
, and so many people have sortof written off this as a benign
cold when our kids get it.
And so why is it so importantto vaccinate the kids?
But this really just highlightsthat we can't say whether
you're going to have a benigncold or whether you're going to
have a serious illness.
So it's just worthwhile to usethe old adage of an ounce of
prevention It's worth a pound ofcure.
(13:52):
It just sort of prevents youfrom having all of those
complications that you mightsave.
And if you can as a mom, if Ican save my kid from being in
the hospital, of course I woulddo that, and so really
presenting it in that way, ithink, can be beneficial.
Corinne Kohler, MD, FAAFP (14:09):
And in addition, the data has
definitely shown the vaccinesare safe in children, that we
have numbers of doses and someof the concerns and risks of
vaccine related illness has notproven, certainly not higher
than other vaccines, and I thinkthat is definitely very
reassuring that the safety ofthe vaccines, that we now have
(14:32):
data on that.
Santina Wheat, MD, MPH, FAAFP (14:34):
I think that's absolutely right
And I will bring back what yousaid before about the COVID
vaccine being part of theregular vaccination schedule in
a way that's similar to how theinfluenza vaccine is part of the
regular vaccination schedule,regardless of at what age you
are at, Because this is the timeto think about, as new children
(14:55):
are being born now that we'vebeen in this pandemic for a
while.
Just because somebody doesn'thave the vaccine yet doesn't
necessarily mean that they'renot open to it.
It might be that somebodyforgot to offer it to them when
their child was six months old,or forgot to offer it to them at
that one year old visit.
I know the person who cares formy children mentioned to me
(15:17):
that her son hadn't gotten hisCOVID vaccine, not because she
wasn't open to it.
She got it when she waspregnant with him and is around
me and sees me getting mychildren vaccinated and knows
that I wouldn't recommendanything for her that I wouldn't
recommend for my own family.
But she mentioned to me thatnobody offered it to her And
it's not as easy to get it forsome of the little kids as it is
at like the pharmacy or otherthings, as it is for adults and
(15:39):
older children.
Corinne Kohler, MD, FAAFP (15:41):
I think some of us have just to a
certain extent been so ingrainedin our vaccine schedule that
when it changes it can be hardto sometimes integrate that
change.
What I think has been reallybeneficial is when they came out
with the change that said yourthird hepatitis B has to be on
(16:02):
or after six months.
That actually has been abenefit because before that we
were sometimes giving that thirdset of vaccines at somewhere
between the five to six monthsand COVID can't be given for
that six months.
When they came out with thatwe're seeing those six months,
those infants at or above theirsix month milestone.
(16:24):
So I think it's easier in ourmindset to actually add the
COVID-19 vaccine.
Christina Wells, MD, MPH, F (16:30):
And I was also going to add along
to that.
I think that it's important forus to remember that how someone
feels today may be differentthan how they feel tomorrow, and
we know that there has beensome vaccine hesitancy, and so I
think that it's important thatwe always keep those
conversations going and that, asnew data is arising which is
(16:56):
why we're having thisconversation today we should be
continually providing thatinformation to our patients,
keeping those conversationsgoing so that they can
understand all the data that ispresent.
We can be a source of trueinformation in the midst of all
the misinformation that may beout there, and be able to be a
(17:20):
place where, on a good resourcefor patients to be able to get
reliable information aboutvaccines and their importance.
Santina Wheat, MD, MPH, FAAFP (17:31):
I think that's a great point.
Dr.
Wells, i will remind us allthat there was a group of early
adopters that were like, yes, iwill get that vaccine right away
, no matter what.
There was a group of folks thatwere like, no, i'm not going to
get this vaccine, it's too new,i want nothing to do with it.
And then there was a group ofI'm going to wait and see how
(17:51):
this impacts your body.
And I think that there's thepotential for wiggle in both of
those later two groups, becausewe have the evidence to say to
the folks who are initially theknows, we have evidence now in
lots of stages, in lots ofdifferent ages, that this
vaccine is beneficial and notharmful.
And for that group that wantedto wait for the early adopters
(18:14):
to sort of to go through theirtime, we can have evidence to
share with them too.
So using those motivationalinterview skills that we talk
about all of the time in peoplestages of change is really
important for thinking aboutthose patients who don't have
the vaccine yet or maybe havetheir initial theories of the
vaccine and haven't gotten theirboosters yet when you're having
(18:35):
these conversations.
Corinne Kohler, MD, FAAFP (18:37):
I think that also brings up the
point of making sure peoplecompleting their vaccine series.
Sometimes you've gone throughthat hesitancy and you know
they've started their vaccinebut we need to make sure they're
completing their vaccine series, hopefully getting their
boosters and ongoing, that theywill continue to get their, you
(18:58):
know, yearly vaccine also.
So one of the things that I hadseen recently, also from CDC,
was talking about some of theyou know higher risk for severe
COVID-19 and how that might beaffecting our patients And I
think, going forward.
(19:19):
you know, as we said, thosewith vaccine tend to have less
risk for severe complications indifferent areas.
So have you seen in your ownpractice evidence between those
who have had the vaccine versusthose who have not but yet still
end up testing positive?
(19:40):
I think?
Santina Wheat, MD, MPH, FA (19:42):
that most of us could probably say
that we've seen differences,particularly amongst those who
are high risk of thecomplications that occur when
somebody has been vaccinated ornot.
My patient story that I canshare is I have a patient who
meets all of the complex riskfactors.
(20:03):
He is a person who's livingwith HIV, he has diabetes, he is
obese, he has multiple chronicconditions that make him at risk
.
I mean he recently had COVID,but he'd had all of his vaccines
and his booster and he said, oh, it wasn't so bad, i'm so
thankful that I had the vaccine.
And so it was.
It was a win.
It goes back to what Dr.
Wells was talking about beforeof he was really able to not get
(20:26):
those severe complications.
He didn't end up in thehospital but was at risk for
doing so, and so I think that Ithink that the list is on the
CDC website of all of the peoplewho are at high risk When they
are vaccinated.
I am seeing much betteroutcomes than those who aren't.
I'm fortunate to say that Ihave a large population that is
(20:48):
vaccinated, so I think I wasseeing less of the really bad
side effects, at least oncevaccines were available.
Corinne Kohler, MD, FAAFP (20:57):
I think, as we all deal with
different patient populationsand our practice, that it isn't
going to remember maybe some ofthose outliers on the higher
risk groups and not to forget,while we all are aware of things
like age and race and ethnicityand socioeconomic group and how
those different disparitieshave definitely impacted
(21:20):
COVID-19, that there are someother risk factors for
complications.
And again, you mentioned aftera week there was a great list on
the CDC underlying medicalconditions associated with
higher risk, and not only isthat the things that we all
think of, like cancer andchronic lung and diabetes, but
(21:44):
also things like obesity, poornutrition And one that struck me
with some of the mental healthconditions, including the mood
disorders, that also puts you athigher risk for complications.
Physical inactivity, but isalso one on there And for some
(22:04):
medications like chronic steroiduse it may not be think of.
Have you had very much impactwith that with either you, with
your populations?
Christina Wells, MD, MPH, FAA (22:16):
I would say that I think that per
I've had not exactly the sameexperiences, Dr.
Wheat, but I will say that, formy patients with chronic
disease who have been vaccinated, that they have had less severe
illnesses, most of thosepatients that I've had have not
(22:40):
been able, have not had to behospitalized, and have been able
to be managed in the outpatientsetting, and I would say,
though, is that, you know, thisshould just be a reminder to all
of us that we need to bethinking about our patients who
(23:00):
have chronic illnesses andmental health being one of those
things and thinking about howtheir chronic illnesses impact
their overall and how, if theywere to acquire COVID-19, that
would cause even more morbidityin terms of their chronic
(23:21):
illnesses, and so really havingthose conversations with those
patients and advising them oftheir increased risk and then
also letting them know of thebenefits of being vaccinated
against COVID-19.
Santina Wheat, MD, MPH, FAAFP (23:39):
I really agree with that, Dr.
Wells.
I think that really, looking aswe are wonderful at doing that
as family doctors looking at thewhole person, thinking about
their health as not just onepiece, but looking at what are
all of the things that arecoming together, what is their
living situation like, what areall of the pieces that impact
their life And this is just oneof those that can be
(24:01):
incorporated into that fullpicture- I think we are all in
agreement that we should becontinuing to offer the COVID-19
vaccine.
Corinne Kohler, MD, FAAFP (24:12):
I think we will continue to see
more data and more evidencecoming out as to the benefit of
those that have been vaccinatedversus incomplete or
non-vaccinated.
Would you like to offer anyother words of wisdom to those
listening to the podcast that asto, maybe, why they should
(24:33):
continue to offer the vaccinesand promote them in their
practice?
Dr.
Wells.
Christina Wells, MD, MPH, (24:40):
Yeah , i think I will say that we
have, over the last three years,seen the devastation that has
resulted from COVID-19.
It is forever changed our livesAnd as we think about how do we
impact people, how do we helpkeep people healthy, i think
(25:01):
that we think about offeringCOVID-19 vaccines as one of our
tools And the importance that wecontinue to keep this on the
forefront and help people tounderstand its ongoing impact in
our lives and the ongoingimportance of vaccination.
(25:21):
And then again, as Dr.
Wheat said, thinking about itin the totality of people, in
their overall health, lettingthem know that this is
vaccination is very, veryimportant.
It is one of our tools inhelping our patients to remain
healthy and that, as we thinkabout their overall health,
(25:42):
their physical activity, whatthey're eating, what their
lifestyles are like, helpingthem to be able to have a
holistic approach, to be able tobe in the best possible help as
they can be, helping them toprevent severe illnesses,
hospitalizations and, ultimately, death, and thinking about
COVID-19 vaccination as a partof that process, I think that
(26:08):
was so well said, Dr.
Wells, Dr.
Wheat, wow that is tough tofollow.
Santina Wheat, MD, MPH, FAAFP (26:13):
I had the non-patient specific
focus as a reminder that we doalso have the evidence that says
that the COVID vaccine has notonly been very impactful for
individuals, but it's also beenvery impactful for our system,
and so it's a great argumentthat you can use for your
(26:34):
healthcare system if they areconsidering not offering the
COVID vaccine anymore, if notholding it in stock or thinking
that maybe they will get it whenthey haven't gotten it yet.
The vaccine has prevented somany hospitalizations.
It has prevented so manymorbidities and so many deaths
(26:55):
that it really has impacted oursystem in so many ways, and so
by continuing to providevaccines for our patients, we
are saving our system and we aresaving the experiences for all
of those who are in the hospitalworking with our patients.
We're providing a better spacefor everyone.
Corinne Kohler, MD, FAAFP (27:17):
Again , very well said, and I would
also like to add that, ashealthcare providers, we need to
remember that we also need toparticipate and have our
vaccines and be role models andleaders and strong advocates,
not only with our patients, butwith our healthcare systems,
public health systems And, asyou said, the population impact
(27:39):
of not only COVID itself but theongoing sequelae and the fact
that the vaccines can definitelyhave an impact.
I'd like to thank everyone whotuned in today and listen and
continue to look for furtherevidence of beyond the needle
and have a great rest of yourday.
Carl Earl Lambert, Jr., M (28:02):
Thank you to our expert faculty and
to you, our listener, for tuninginto this episode.
For more episodes of Beyond theNeedle, please visit
illinoisvaccinatescom.
Here you'll also find links toan online toolkit, how to join,
learning, collaborative and bootcamps, podcast transcripts,
speaker disclosures andinstructions to claim CME credit
(28:25):
.
Subscribe to Beyond the Needleon your favorite streaming
platform.
Welcome back to season two of Beyond
the Needle a physician's guideto increasing COVID-19
vaccination rates.
I'm Carl Lambert, a familyphysician and a member of IAFP,
and I'm an assistant professorof family medicine at Rush
University Medical College.
This podcast series is broughtto you from the Illinois Academy
of Family Physicians, iafp,through the Illinois Vaccinates
(00:26):
or IVAC project.
Joining for this podcast seriesis provided by the Office of
Disease Control through theIllinois Department of Public
Health.
For more information on theIVAC project and receiving free
CME credit for these podcasts,visit illinoisvaccinatescom.
forward slash podcasts.
Thank you for joining us as wecome together to vaccinate
(00:49):
against COVID-19.
Corinne Kohler, MD, FAA (00:55):
Welcome to another episode of Beyond
the Needle podcast.
Today we will be talking aboutthe continued importance of
offering and encouragingCOVID-19 vaccinations.
We will review some of theevidence and updated research
concerning COVID-19 and thevaccines.
Today I am with Dr.
(01:17):
Santina Wheat and Dr.
Christina Wells.
I am Dr.
Corinne Kohler.
Dr.
Wheat, would you like tointroduce yourself?
Santina Wheat, MD, MPH, FAAF (01:27):
Hi , I'm Santina Wheat.
I'm the program director of theNorthwestern McGaw Family
Medicine Residency Program inHumboldt Park and a practicing
family physician at Erie FamilyHealth Center.
How about you, Dr.
?
Christina Wells, MD, MPH, (01:38):
Wells .
Hi, I'm Dr.
Christina Wells.
I'm a practicing familymedicine physician at the Mile
Square Health Center and I'malso faculty at the University
of Illinois College of Medicine.
Corinne Kohler, MD, FAAFP (01:52):
I'm Dr.
Corinne Kohler.
I'm currently a retiredphysician from a
family-qualified health centerand I'm also currently a
clinical professor at CarleIllinois College of Medicine.
Would you like to start withtoday with talking about why do
we need to continue to offerCOVID vaccines?
What are some of itspreventative benefits?
(02:14):
Would you like to start us off,dr Wells?
Christina Wells, MD, MPH, F (02:18):
Yes , thank you for that question,
Dr.
Kohler.
I think, just as in the pastwhen we have vaccinated for
things such as measles and polioand other childhood illnesses
and adult illnesses, weunderstand that COVID-19 has
some serious impacts.
(02:39):
People can have severe illness,hospitalizations and even death
, and we see that COVID-19 ishere to stay.
We've seen many differentvariants and so we know that it
is important that we continue toprotect people against this
virus, and being vaccinated canhelp to prevent that severe
(03:05):
illness.
It can be helpful intopreventing hospitalization and
it can be helpful in preventingdeath.
Santina Wheat, MD, MPH, FAAFP (03:15):
I think you made a really
important point there.
Dr.
Wells, you really talked aboutthe prevention of the severe
illness and of thehospitalizations.
We're not necessarily sayingthat the vaccines are here to
prevent illness at all, so thisdoesn't mean that you won't be
infected if you get the vaccine,and I think that's a really
important thing to make sure weare continuing to tell our
(03:37):
patients, as we're recommendingthese vaccines every day,
because we don't want them toturn around and say oh, i
thought you said that thisvaccine would mean that I would
never get COVID, and that'sreally not our intent.
Corinne Kohler, MD, FAAFP (03:50):
I think there's been a
preponderance of newer evidenceand data that also shows that
some of the severe morbidity andsequelae from COVID may be
reduced with those who have beenvaccinated, such as some of the
anti-inflammatory benefits ofthe vaccine.
So perhaps reduced post-COVIDdiabetes, perhaps reduced MISC
(04:15):
in children, and while the dataand evidence is still new and
emerging, it does seem to beheaded in increased protection
for those who have beenvaccinated, even when having the
illness.
Christina Wells, MD, MPH, FAA (04:30):
I think that's a great point, Dr.
Kohler, because we know that ifyou get COVID-19, it's an
inflammatory condition that canimpact various different organ
systems And so if you can helpto prevent that inflammatory
disease of COVID-19, or if youcan allow people to have a
(04:54):
milder form of the disease, thenyou can help to potentially
reduce the inflammatoryconditions that might arise from
having COVID-19, cardiovasculardisease, diabetes, MISC, as you
mentioned, and the othersequelae of diseases that we see
(05:16):
that result from inflammatoryconditions.
Thank you.
Santina Wheat, MD, MPH, (05:20):
There's even a recent study that was
just released in the past coupleof days from this recording.
This was published in the JAMAnetwork open that talks
specifically about patients whowere infected with COVID and
their risk for diabetesafterwards.
There has been ongoing evidencethat COVID increases the risk
of diabetes and othercardiovascular risk factors
(05:43):
after being infected.
The data really is showing thatthat risk of having new onset
diabetes even after having theinfection goes down, so this can
really mean prevention.
For somebody for a long termchronic disease, this can be a
big deal.
Corinne Kohler, MD, FAAFP (05:58):
And I believe the evidence also shows
that the more times youactually have COVID infection,
the higher risk for long COVIDin sequelae.
And while vaccine may nottotally eliminate that risk, it
would reduce the risk of repeatinfections.
Christina Wells, MD, MPH, (06:16):
Right .
There was recently a study thatwas published by Cambridge
University Press that statedthat those who had been
vaccinated with at least asingle dose of either Pfizer,
moderna, astrazeneca or theJanssen vaccine, it was at least
29% effective at preventinglong COVID.
(06:40):
The protection was strongest atleast 35% effective for those
who were vaccinated before beinginfected with COVID.
Post infection vaccination alsohelped at least 27%.
So we can see here that havingthe vaccine can potentially help
(07:02):
to reduce your risk of thatlong COVID syndrome that we have
been hearing about and thediseases that results and
illness that result from havinglong COVID.
Corinne Kohler, MD, FAAFP (07:15):
Do you think that adding the
COVID-19 vaccine to the regularvaccine schedule is going to be
beneficial in our request tocontinue to offer the vaccine
that people see as quote morenormal?
Santina Wheat, MD, MPH, FAAFP (07:32):
I certainly hope so.
I have certainly startedtalking about the COVID vaccine
just sort of in the mix with allof the other standard vaccines.
So when I'm reviewing my caregaps I sit there and go oh, it
looks like you're due for yourtetanus vaccine, and maybe
you're due for your meningitisvaccine for my population, and
(07:55):
maybe you're due for yourhepatitis B vaccine and oh, by
the way, you're now due for yourCOVID booster, and so just sort
of lumping it in with the restof the vaccines and not making
it feel other, i'm hoping thatthis statement of including it
in the regular vaccine will helpwith that.
I also hope that it will helpwith fears that I think some
(08:17):
people have that it'll bechallenging to get the COVID
vaccine after the publicemergency ends, and so I think
just sort of incorporating intothe regular schedule will just
make it feel like part of ournormal health care.
Christina Wells, MD, MPH, (08:31):
Right , and I think too, Dr.
Wheat, that COVID is.
To us it seems like it's new,but we know that there have been
different strains ofcoronavirus for some time.
But I think as we start to makeit more of a regular part of
our practice and I think too isalso people start to kind of
(08:53):
understand it, maybe in thecontext of like the flu, and
they'll be able to understandwhy we have so many variants,
why we need a booster every year.
And so I think that as wecontinue to have the
conversations, as it becomesmore part of our routine
practice, then people can startto understand what it really is
(09:16):
more and more and more and beable to relate it to other
diseases, other vaccinationsthat we have seen and that we
have currently.
Corinne Kohler, MD, FAAFP (09:27):
I think that's a very excellent
point.
Dr.
Wells said, while we aspractitioners may understand the
variability of the vaccine andthe fact that it will mutate and
that we need to continue to bevigilant, so well discussing the
benefits of continuing to offerthe COVID vaccines, i know
(09:49):
there's been some recentincreased evidence and data on
the pregnant female population.
Would you like to address that,Dr.
Wheat?
Santina Wheat, MD, MPH, FA (09:59):
Sure , i was really excited actually
to see some of the new researchabout the outcomes for those who
are pregnant.
It had been my perception thatpatients who were pregnant and
came into labor and deliveryseem to be more sick.
They seem to have morehypertensive diseases, and there
(10:20):
actually was a recent articlethat did a review of many
patients who had had COVIDduring the time of their
pregnancy and, really looking atany of the trimesters, and
although it didn't necessarilyspeak to some of the things that
I was seeing, it did confirmsome of the recent data that we
(10:40):
had seen before that they weremuch more likely to need ICU
stays, they were much morelikely to need ventilation
support And we've known that fora while But also they are much
more likely to have preeclampsiaand other hypertensive
disorders of pregnancy, whichreally just has more morbidity
at the time of the delivery andalso has implications in the
(11:03):
long run Some of the things thatwe had talked about before,
like the cardiovascular riskfactors, and so this is a really
big deal.
Additionally, on the positiveside, though, the studies have
also been shown for our pregnantpatients that the vaccines are
safe, and so not only do we nowhave data about the initial
(11:24):
doses of the COVID vaccine.
But we also have data about theboosters during pregnancy And
again, that data is for allthree trimesters, and so we can
confidently say to our patientsthat the vaccines are safe.
We, unfortunately, can alsoconfidently say to our patients
(11:44):
that if you are to contractCOVID during your pregnancy,
that you are at risk for furthermorbidity, and that's even if
you get it in your firsttrimester.
So it's really important to besafe throughout.
Corinne Kohler, MD, FAAFP (11:57):
And in addition to that, I think we
had good evidence last yearshowing that women that got
vaccinated passed that pass ofimmunity on to their newborn and
that it is beneficial in thatinitial newborn period for the
infants that are not eligiblefor vaccination.
And we need to continue tothink, emphasize that with our
(12:21):
pregnant women that it'sbeneficial just for their health
and for the health of thenewborn.
Santina Wheat, MD, M (12:27):
Absolutely .
And that sort of brings me onto our children as well.
We know that that time beforechildren can get vaccine, so
they can't get it until they'reat least six months old.
So that pass of immunity, likeyou said, is wonderful for our
pregnant patients, and if ourpatients also happen to be
breastfeeding or chestfeedingthat is really beneficial.
(12:48):
But also this reiterates theimportance of the special
population of children, that wewant them to get vaccinated as
well.
Some of our initial observationsof COVID in children was that
there weren't necessarily asmany complications as we were
seeing with adults.
And while that still might betrue, further analysis has
(13:08):
indicated that if children whocontracted COVID, we are seeing
more MISC than we had initiallythought.
Some of it had beenunderreported based on
self-report.
When our researchers have goneback and looked at the claims
data and looked at other things,we've really seen that COVID
has impacted our children muchmore than we thought that it did
(13:30):
, and so many people have sortof written off this as a benign
cold when our kids get it.
And so why is it so importantto vaccinate the kids?
But this really just highlightsthat we can't say whether
you're going to have a benigncold or whether you're going to
have a serious illness.
So it's just worthwhile to usethe old adage of an ounce of
prevention It's worth a pound ofcure.
(13:52):
It just sort of prevents youfrom having all of those
complications that you mightsave.
And if you can as a mom, if Ican save my kid from being in
the hospital, of course I woulddo that, and so really
presenting it in that way, ithink, can be beneficial.
Corinne Kohler, MD, FAAFP (14:09):
And in addition, the data has
definitely shown the vaccinesare safe in children, that we
have numbers of doses and someof the concerns and risks of
vaccine related illness has notproven, certainly not higher
than other vaccines, and I thinkthat is definitely very
reassuring that the safety ofthe vaccines, that we now have
(14:32):
data on that.
Santina Wheat, MD, MPH, FAAFP (14:34):
I think that's absolutely right
And I will bring back what yousaid before about the COVID
vaccine being part of theregular vaccination schedule in
a way that's similar to how theinfluenza vaccine is part of the
regular vaccination schedule,regardless of at what age you
are at, Because this is the timeto think about, as new children
(14:55):
are being born now that we'vebeen in this pandemic for a
while.
Just because somebody doesn'thave the vaccine yet doesn't
necessarily mean that they'renot open to it.
It might be that somebodyforgot to offer it to them when
their child was six months old,or forgot to offer it to them at
that one year old visit.
I know the person who cares formy children mentioned to me
(15:17):
that her son hadn't gotten hisCOVID vaccine, not because she
wasn't open to it.
She got it when she waspregnant with him and is around
me and sees me getting mychildren vaccinated and knows
that I wouldn't recommendanything for her that I wouldn't
recommend for my own family.
But she mentioned to me thatnobody offered it to her And
it's not as easy to get it forsome of the little kids as it is
at like the pharmacy or otherthings, as it is for adults and
(15:39):
older children.
Corinne Kohler, MD, FAAFP (15:41):
I think some of us have just to a
certain extent been so ingrainedin our vaccine schedule that
when it changes it can be hardto sometimes integrate that
change.
What I think has been reallybeneficial is when they came out
with the change that said yourthird hepatitis B has to be on
(16:02):
or after six months.
That actually has been abenefit because before that we
were sometimes giving that thirdset of vaccines at somewhere
between the five to six monthsand COVID can't be given for
that six months.
When they came out with thatwe're seeing those six months,
those infants at or above theirsix month milestone.
(16:24):
So I think it's easier in ourmindset to actually add the
COVID-19 vaccine.
Christina Wells, MD, MPH, F (16:30):
And I was also going to add along
to that.
I think that it's important forus to remember that how someone
feels today may be differentthan how they feel tomorrow, and
we know that there has beensome vaccine hesitancy, and so I
think that it's important thatwe always keep those
conversations going and that, asnew data is arising which is
(16:56):
why we're having thisconversation today we should be
continually providing thatinformation to our patients,
keeping those conversationsgoing so that they can
understand all the data that ispresent.
We can be a source of trueinformation in the midst of all
the misinformation that may beout there, and be able to be a
(17:20):
place where, on a good resourcefor patients to be able to get
reliable information aboutvaccines and their importance.
Santina Wheat, MD, MPH, FAAFP (17:31):
I think that's a great point.
Dr.
Wells, i will remind us allthat there was a group of early
adopters that were like, yes, iwill get that vaccine right away
, no matter what.
There was a group of folks thatwere like, no, i'm not going to
get this vaccine, it's too new,i want nothing to do with it.
And then there was a group ofI'm going to wait and see how
(17:51):
this impacts your body.
And I think that there's thepotential for wiggle in both of
those later two groups, becausewe have the evidence to say to
the folks who are initially theknows, we have evidence now in
lots of stages, in lots ofdifferent ages, that this
vaccine is beneficial and notharmful.
And for that group that wantedto wait for the early adopters
(18:14):
to sort of to go through theirtime, we can have evidence to
share with them too.
So using those motivationalinterview skills that we talk
about all of the time in peoplestages of change is really
important for thinking aboutthose patients who don't have
the vaccine yet or maybe havetheir initial theories of the
vaccine and haven't gotten theirboosters yet when you're having
(18:35):
these conversations.
Corinne Kohler, MD, FAAFP (18:37):
I think that also brings up the
point of making sure peoplecompleting their vaccine series.
Sometimes you've gone throughthat hesitancy and you know
they've started their vaccinebut we need to make sure they're
completing their vaccine series, hopefully getting their
boosters and ongoing, that theywill continue to get their, you
(18:58):
know, yearly vaccine also.
So one of the things that I hadseen recently, also from CDC,
was talking about some of theyou know higher risk for severe
COVID-19 and how that might beaffecting our patients And I
think, going forward.
(19:19):
you know, as we said, thosewith vaccine tend to have less
risk for severe complications indifferent areas.
So have you seen in your ownpractice evidence between those
who have had the vaccine versusthose who have not but yet still
end up testing positive?
(19:40):
I think?
Santina Wheat, MD, MPH, FA (19:42):
that most of us could probably say
that we've seen differences,particularly amongst those who
are high risk of thecomplications that occur when
somebody has been vaccinated ornot.
My patient story that I canshare is I have a patient who
meets all of the complex riskfactors.
(20:03):
He is a person who's livingwith HIV, he has diabetes, he is
obese, he has multiple chronicconditions that make him at risk
.
I mean he recently had COVID,but he'd had all of his vaccines
and his booster and he said, oh, it wasn't so bad, i'm so
thankful that I had the vaccine.
And so it was.
It was a win.
It goes back to what Dr.
Wells was talking about beforeof he was really able to not get
(20:26):
those severe complications.
He didn't end up in thehospital but was at risk for
doing so, and so I think that Ithink that the list is on the
CDC website of all of the peoplewho are at high risk When they
are vaccinated.
I am seeing much betteroutcomes than those who aren't.
I'm fortunate to say that Ihave a large population that is
(20:48):
vaccinated, so I think I wasseeing less of the really bad
side effects, at least oncevaccines were available.
Corinne Kohler, MD, FAAFP (20:57):
I think, as we all deal with
different patient populationsand our practice, that it isn't
going to remember maybe some ofthose outliers on the higher
risk groups and not to forget,while we all are aware of things
like age and race and ethnicityand socioeconomic group and how
those different disparitieshave definitely impacted
(21:20):
COVID-19, that there are someother risk factors for
complications.
And again, you mentioned aftera week there was a great list on
the CDC underlying medicalconditions associated with
higher risk, and not only isthat the things that we all
think of, like cancer andchronic lung and diabetes, but
(21:44):
also things like obesity, poornutrition And one that struck me
with some of the mental healthconditions, including the mood
disorders, that also puts you athigher risk for complications.
Physical inactivity, but isalso one on there And for some
(22:04):
medications like chronic steroiduse it may not be think of.
Have you had very much impactwith that with either you, with
your populations?
Christina Wells, MD, MPH, FAA (22:16):
I would say that I think that per
I've had not exactly the sameexperiences, Dr.
Wheat, but I will say that, formy patients with chronic
disease who have been vaccinated, that they have had less severe
illnesses, most of thosepatients that I've had have not
(22:40):
been able, have not had to behospitalized, and have been able
to be managed in the outpatientsetting, and I would say,
though, is that, you know, thisshould just be a reminder to all
of us that we need to bethinking about our patients who
(23:00):
have chronic illnesses andmental health being one of those
things and thinking about howtheir chronic illnesses impact
their overall and how, if theywere to acquire COVID-19, that
would cause even more morbidityin terms of their chronic
(23:21):
illnesses, and so really havingthose conversations with those
patients and advising them oftheir increased risk and then
also letting them know of thebenefits of being vaccinated
against COVID-19.
Santina Wheat, MD, MPH, FAAFP (23:39):
I really agree with that, Dr.
Wells.
I think that really, looking aswe are wonderful at doing that
as family doctors looking at thewhole person, thinking about
their health as not just onepiece, but looking at what are
all of the things that arecoming together, what is their
living situation like, what areall of the pieces that impact
their life And this is just oneof those that can be
(24:01):
incorporated into that fullpicture- I think we are all in
agreement that we should becontinuing to offer the COVID-19
vaccine.
Corinne Kohler, MD, FAAFP (24:12):
I think we will continue to see
more data and more evidencecoming out as to the benefit of
those that have been vaccinatedversus incomplete or
non-vaccinated.
Would you like to offer anyother words of wisdom to those
listening to the podcast that asto, maybe, why they should
(24:33):
continue to offer the vaccinesand promote them in their
practice?
Dr.
Wells.
Christina Wells, MD, MPH, (24:40):
Yeah , i think I will say that we
have, over the last three years,seen the devastation that has
resulted from COVID-19.
It is forever changed our livesAnd as we think about how do we
impact people, how do we helpkeep people healthy, i think
(25:01):
that we think about offeringCOVID-19 vaccines as one of our
tools And the importance that wecontinue to keep this on the
forefront and help people tounderstand its ongoing impact in
our lives and the ongoingimportance of vaccination.
(25:21):
And then again, as Dr.
Wheat said, thinking about itin the totality of people, in
their overall health, lettingthem know that this is
vaccination is very, veryimportant.
It is one of our tools inhelping our patients to remain
healthy and that, as we thinkabout their overall health,
(25:42):
their physical activity, whatthey're eating, what their
lifestyles are like, helpingthem to be able to have a
holistic approach, to be able tobe in the best possible help as
they can be, helping them toprevent severe illnesses,
hospitalizations and, ultimately, death, and thinking about
COVID-19 vaccination as a partof that process, I think that
(26:08):
was so well said, Dr.
Wells, Dr.
Wheat, wow that is tough tofollow.
Santina Wheat, MD, MPH, FAAFP (26:13):
I had the non-patient specific
focus as a reminder that we doalso have the evidence that says
that the COVID vaccine has notonly been very impactful for
individuals, but it's also beenvery impactful for our system,
and so it's a great argumentthat you can use for your
(26:34):
healthcare system if they areconsidering not offering the
COVID vaccine anymore, if notholding it in stock or thinking
that maybe they will get it whenthey haven't gotten it yet.
The vaccine has prevented somany hospitalizations.
It has prevented so manymorbidities and so many deaths
(26:55):
that it really has impacted oursystem in so many ways, and so
by continuing to providevaccines for our patients, we
are saving our system and we aresaving the experiences for all
of those who are in the hospitalworking with our patients.
We're providing a better spacefor everyone.
Corinne Kohler, MD, FAAFP (27:17):
Again , very well said, and I would
also like to add that, ashealthcare providers, we need to
remember that we also need toparticipate and have our
vaccines and be role models andleaders and strong advocates,
not only with our patients, butwith our healthcare systems,
public health systems And, asyou said, the population impact
(27:39):
of not only COVID itself but theongoing sequelae and the fact
that the vaccines can definitelyhave an impact.
I'd like to thank everyone whotuned in today and listen and
continue to look for furtherevidence of beyond the needle
and have a great rest of yourday.
Carl Earl Lambert, Jr., M (28:02):
Thank you to our expert faculty and
to you, our listener, for tuninginto this episode.
For more episodes of Beyond theNeedle, please visit
illinoisvaccinatescom.
Here you'll also find links toan online toolkit, how to join,
learning, collaborative and bootcamps, podcast transcripts,
speaker disclosures andinstructions to claim CME credit
(28:25):
.
Subscribe to Beyond the Needleon your favorite streaming
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