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Covid-19 Vaccination Q&A

Jewish Foundation for Group Homes (JFGH) is monitoring federal, state and local policy as regards COVID-19 vaccinations. We are pleased to offer the following Q&A in order to answer your questions, dispel any rumors or myths, present facts, and address issues and concerns. Nothing here is intended as medical advice or recommendations, and everyone should consult with their doctor or other licensed healthcare professional when seeking healthcare advice or information. We have and will continue to review data and facts, peer-reviewed scientific research, and official governmental reports and guidance as they inform our COVID-19 protocols and our planning for the vaccination.

If you have additional questions that are not satisfactorily answered or questions that are not addressed at all here, please direct them to vaccinationQ&A@jfgh.org.

Questions & Answers
1. Are the people that JFGH supports in all of its services a Phase 1, Phase 2 or Phase 3 priority?

On 5 January, Maryland Governor Hogan announced that Marylanders with IDD are Phase 1B vaccination priority. As details emerge, we will update this information. Governor Hogan estimates that Phase 1B will commence at or near the end of January 2021. In Virginia, people with intellectual and developmental disabilities (IDD) appear also to be Phase 1 priority for vaccination. Both of these relatively recent developments are the result of grassroots advocacy—to every member of the JFGH community who wrote a letter or sent an e-mail or made a phone call to push people with IDD being top priority for vaccination, THANK YOU!

2. What about JFGH staff—will they be vaccinated?

Yes. JFGH staff in both Maryland and Virginia are considered essential healthcare workers for the purposes of vaccination. As part of JFGH’s Infectious Disease policy and procedures, the COVID-19 vaccination is required. (There are medical exemptions, which will be considered on a case by case basis. As a matter of agency policy, being free of infectious disease is an essential function of our work.) County departments of health in both states are inoculating essential healthcare workers, and JFGH staff began receiving their vaccinations on Monday, 11 January.

3. Can family members of people supported by JFGH be included in JFGH’s vaccination allocation/access?

No. Staff of JFGH are considered by both Maryland and Virginia as essential healthcare workers, and they are assigned to Phase 1A accordingly. People with IDD who are supported by JFGH are, in both Maryland and Virginia, assigned to Phase 1B. Neither state nor any of the county jurisdictions through which the vaccinations are being administered name family members as part of JFGH’s vaccination access.

4. Does JFGH have a vaccination plan?

Yes, we are developing a vaccination plan for all people who receive our supports. We are identifying people in tiers of risk in order to prioritize them for vaccination. We have been in discussions with both Walgreens and CVS, who have been identified by the federal government as the national pharmacies through which vaccine will be provided. Details on which we are working include (as above) prioritizing who will be vaccinated first; where and how many vaccination clinics will be established, equipped and staffed; and, securing consents from people we support and/or legal representatives to be vaccinated. There is more, but these are the most important parts of the plan on which we are currently working.

NOTE: We will communicate with our community as these plans develop and evolve; and, we will contact people or their legal representatives, friends and family members when appropriate. Please DO NOT CALL to find out when you or your loved one is being vaccinated—we don’t know. Whenever that is determined, which will happen in consultation with and as directed by either Walgreens or CVS, we will contact everyone, as appropriate.

5. How will JFGH determine priorities for who gets vaccinated first?

This will be done with an eye on the following:
• Who is at significant risk for severe outcomes based on risk factors, including age, co-existing conditions, and/or prior COVID-19 infection, to name a few.
• Who has medication allergies that may or are likely to result in a reaction to the COVID-19 vaccination.
• Where does the person(s) live and/or work, and are those settings congregate (this means, for example, that people in group homes would be priority over someone living at home with their family).
• Individual choice and preference will be taken into account.

6. With what pharmacy is JFGH working on vaccination planning?

As above, we are actually working with both Walgreens and CVS. We initiated dialogue with Alco, our pharmacy partner, months ago; however, Walgreens and CVS have been identified by the federal government as the pharmacies to distribute vaccination, administer it, and provide any related supports because they are national chain pharmacies. Alco and JFGH remain in very close contact and will continue through the process—Alco’s relationship with JFGH beyond the vaccination process remains unchanged at this time.

7. What do we know about the vaccines?

Quite a bit, and the news is all good. We have spent quite a lot of time reviewing FDA technical reports and the Vaccines and Related Biological Products Advisory Committee reports from 10 December (Pfizer/BioNTech) and 17 December (Moderna), as well as related peer-reviewed research.

For the Pfizer/BioNTech vaccine, information is available from the FDA HERE. Information from the FDA on the Moderna vaccine can be found HERE. If you are interested in reading the Emergency Use Authorization Review Memoranda on these two vaccines, the links to each are shown below.

Pfizer/BioNTech Emergency Use Authorization
Moderna Emergency Use Authorization

We have also reviewed information with our Medical Advisory Panel, and have spent time consulting with the American Academy on Developmental Medicine and Dentistry, as well as a number of national organizations, to review reporting on side effects and efficacy.

8. It typically it takes 10 years for a drug company to research, design and test a new vaccine for safety and effectiveness. How can we be sure that this vaccine was developed safely and scientifically?

When the government realized the potential of this pandemic it removed all the typical bureaucratic obstacles, which are substantial. The same large animal and human studies were conducted, massive federal funding was provided, stages that were typically conducted separately were allowed to be combined and critical research was shared by the researchers. The scientific rigor applied to the process—by pharmaceutical companies around the globe and all at once—was substantial and there is little, reasonable debate over the safety of the vaccines.

9. Are they safe?

Yes. There are side effects, like there are with virtually any vaccine or medication. The vast majority of side effects are both minor and temporary; however, there are serious side effects about which we all need to stay aware and vigilant. In recent news reports, a lot of attention is being paid to significant allergic reactions to the vaccines called anaphylaxis, which can be life threatening. The number of these cases is exceptionally small, and amounts to less than 1% of the total number of vaccinations administered.

10. What are side effects?

Most common side effects are pain/soreness, swelling and/or redness at the injection site, headache and fatigue. Some have reported chills or developing a low-grade fever, feeling achy—what appears, by description, to look like COVID-19—and diarrhea.

Serious side effects in the clinical trials were experienced by 0.6% of the vaccine group, and included myocardial infarction, atrial fibrillation, and sudden drops in blood pressure resulting in fainting (all heart issues), appendicitis and, as outlined above, anaphylaxis (allergic reaction).
NOTE: It is not clear in the clinical trials whether these side effects were caused by the vaccine or were the result of other factors.

Arrangements are being made, as part of JFGH’s planning, to allow for up to 30 minutes immediately following vaccination for monitoring for any of these or other side effects by a trained healthcare professional.

The Centers for Disease Control and Prevention (CDC) has recently published this infographic that speaks to side effects:

11. I’ve seen reports of side effects related to “cosmetic facial fillers.” What does that mean?

Facial filler is material used in cosmetic, plastic surgery. The vaccine, once administered, activates the human organism’s immune system—exactly what it is designed to do. The immune system essentially identifies the foreign material (the facial filler) and begins to attack it. It causes swelling, which is easily and quickly treatable.

We recognize that facial fillers are exceptionally uncommon among people with IDD; however, out of an abundance of caution, we also want to pay close attention to other prostheses as a potential trigger for similar inflammation and swelling.

12. Will they work?

Yes. Both vaccines are from 94% to nearly 95% effective, overall, against COVID-19, per the clinical trials, which between the two vaccine candidates, included nearly 75,000 people. From the Emergency Use Authorizations linked above:

We also note that the effectiveness—in the language from the clinical trials and subsequent reporting, the efficacy—was essentially unchanged across groups defined by age categories or the presence of co-existing conditions. We believe this is essential information when considering any potential increases in risk or changes in efficacy specifically for people with IDD. (Note that there is no way to know if any of the 75,000 participants in the clinical trials for both vaccines were people with IDD; however, we do know that people with IDD tend to live with significantly greater prevalence of co-existing conditions, such as obesity and related cardiovascular issues, pulmonary disease, and diabetes, all of which are known conditions that make COVID-19 infections far more dangerous.)

13. Can I get the COVID-19 virus from the COVID-19 vaccine?

No. The vaccine does not contain any live virus and therefore you cannot contract COVID-19. Instead, the vaccine consists of genetic material that instructs the body’s natural immune system on how to identify the COVID-19 virus and how to attack it and prevent it from entering your cells and replicating.

14. Can I get sick with COVID-19 even though I’ve gotten the vaccine?

Yes. There are three potential ways of contracting COVID-19 after being vaccinated. First, while both FDA-authorized vaccines (Pfizer/BioNTech and Moderna) are between 94-95% effective, there is a small chance that the vaccine won’t work on a very small number of people (the 5-6% delta between the efficacy ratings of the vaccines and 100%). We note that no vaccine is 100% effective, so this is a fairly standard and extraordinarily small chance the vaccine won’t work. Second, because both vaccines require two doses, between 21 and 28 days apart, there is a chance someone could contract COVID-19 between doses. And third, it’s possible—improbable, but possible—that someone could contract COVID-19 after receiving both doses of the vaccine if there has been inadequate time after the second of the two doses for the body to fully develop the antibodies the vaccines are designed to trigger. It’s not altogether clear how long the body needs to develop immunity once the vaccination is fully delivered, but estimates are two to “a few” weeks. To this end, we continue to urge everyone to wear your masks, wash your hands well and frequently, and continue to practice physical distancing even after becoming vaccinated.

15. How does the vaccine work?

Both the Pfizer/BioNtech and Moderna vaccines consist of two injections. For the Pfizer/BioNTech vaccine, the two injections are 21 days apart; and, for the Moderna vaccine, the two are 28 days apart.

16. How is the vaccine administered?

The vaccine is administered by intramuscular injection—they’re shots. There is no other administration vehicle at this time.

17. If someone JFGH supports refuses to be vaccinated or the vaccine is medically contraindicated, what will JFGH do?

Working with that person or those people, we will consult with primary care physicians and members of the persons’ support teams to address their needs, allay fears and concerns, and make certain that are making fully informed healthcare choices.

18. I’ve heard that I can wait a little longer between dose 1 and dose 2—is this true?

No. Both Pfizer/BioNTech and Moderna have specified dosing schedules, which should not be altered. There’s been some reporting in the news that states and local communities are considering rationing vaccine in order to preserve their supply; and, one way that’s been reported to accomplish this is to lengthen the time between doses 1 and 2. This has been roundly rejected by the FDA. The delays between doses 1 and 2 for the Pfizer/BioNTech vaccine is 21 days. The delays between doses 1 and 2 for the Moderna vaccine is 28 days. These timeframes cannot be altered. Read the FDA statement HERE.

19. What do we do next?

At the moment, nothing. Our work right now is working with Walgreens and CVS on logistics planning. We are collecting and submitting demographic and other data for people JFGH supports and our staff, as required for the process and requested by the two pharmacies. You may be contacted by a member of our team to review the consent with you, so don’t be surprised if you get a call or an e-mail to that purpose. Otherwise, as we are advised by state government and/or Walgreens or CVS as to any details, we will communicate them to our community as soon as possible. You may be contacted by a member of our team to review the consent with you, so don’t be surprised if you get a call or an e-mail to that purpose.

Please know that we are working exceptionally hard to make certain that everyone is vaccinated. Information is changing constantly and the environment in which all of this is occurring is fluid. We will update our community using our social media platforms, out weekly e-blasts and Facebook Live Updates, and these Questions and Answers. Should circumstances warrant, we will send out information by e-blast off-schedule as well.

 

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