Q&A with Dr. Drevets and Dr. Bratzler: The Latest on COVID-19 and the Vaccines

While it’s been almost four months since the COVID-19 vaccines became available, there are still many questions about the vaccines, the current state of the pandemic, and what precautions need to be followed after receiving the vaccine. Dr. Doug Drevets, Chief of the Infectious Diseases Section in the OU College of Medicine, and Dr. Dale Bratzler, OU Chief COVID Officer, share their thoughts and give guidance on how we can continue to slow the spread.

Q: What do we know about the COVID-19 vaccines’ ability to provide immunity, and what do we not know?

Dr. Drevets: Vaccines currently available in the United States are highly effective at preventing symptomatic COVID-19 disease. “Highly effective” means that after two doses, the mRNA vaccines prevented more than 94% of cases in their clinical studies, or after a single dose, the Johnson & Johnson vaccine prevented 72% of symptomatic cases in the United States in its phase 3 study. These results are not directly comparable because they were done at different times and use slightly different protocols. It should also be emphasized that the Johnson & Johnson vaccine prevented at least 85% of severe cases and hospitalizations, and there were no COVID-19 related deaths recorded in anyone who received this vaccine.

Q: Public health officials have said that people who have been vaccinated should continue to wear masks and follow other COVID-19 precautions. Why is this important?

Dr. Bratzler: Despite increased numbers of people who are vaccinated, COVID-19 continues to cause disease in Oklahoma. While we know that individuals who have completed the COVID-19 vaccines are much less likely to have symptomatic infection of COVID-19, there are little data yet about whether the vaccines keep you from getting an asymptomatic infection of COVID-19 that you could spread to other people. This is particularly true if you are in public settings where you do not know the vaccination status of those around you.

The CDC just released new guidance that allows you to be without masks if you are with a small group of family members who are vaccinated. However, in most settings outside of the home, you will not know if those around you are vaccinated, and there is also concern that some of the new variant strains of the SARS-CoV-2 virus could cause infection even in people who have been previously vaccinated. It’s also important to remember that on all OU campuses, the masking requirement remains in place, even if you have been vaccinated.

Q: What are some considerations to take into account if you haven’t been vaccinated and want to visit someone who has been vaccinated, or vice-versa?

Dr. Drevets and Dr. Bratzler: You want to remember that meeting outside is quite safe and safer than meeting indoors in a closed area. You also want to respect the other individual and wear a mask, particularly if you have a cough or are feeling poorly. If you are feeling ill, you should not meet until you are feeling better. We will be able to give better guidance as we see the levels of community spread continue to decline. We are still unsure of what the next month or so may bring with events such as spring break, where lots of people get together and for the likelihood of spreading the virus that causes COVID-19 increases.

Q: Can two people who have been vaccinated hang out together unmasked?

Dr. Drevets: Yes. Fully vaccinated individuals can visit other fully vaccinated people indoors without wearing masks or social distancing. However, it’s important to remember that on all OU campuses, the masking requirement remains in place, even if you have been vaccinated.

Q: Why do some people experience side effects after being vaccinated and not others? If I don’t experience side effects, does that mean the vaccine didn’t work?

Dr. Drevets: There are a lot of factors that go into determining a person’s reaction to a vaccine. These would be the same as why people feel differently when they both have the same infection. Perhaps the most easily identifiable factor is age. The clinical studies show that younger individuals tend to have more noticeable side effects than older individuals. It also depends if you are already taking anti-inflammatory medications for conditions such as arthritis. Nevertheless, there is no convincing evidence to suggest that you have more immunity against infection if you have a strong vaccine reaction or that you will have poor immunity against the virus if you do not have a strong reaction.

Q: It’s been almost four months since the COVID-19 vaccines first became available. How has this impacted the number of COVID-19 cases we’re seeing in Oklahoma?

Dr. Bratzler: Oklahoma has done a good job of getting COVID-19 vaccines into the arms of our citizens. As of now, approximately 10% of Oklahomans have been fully vaccinated and about 15% have had at least one dose of the vaccine. Initial efforts have focused on getting vaccine to those people 65 years of age and older who are most likely to be hospitalized or die from COVID-19. While vaccination cannot yet account for the steep drop in the number of cases in Oklahoma, it has likely contributed and certainly had an impact on the number of people hospitalized.

Q: How might COVID-19 precautions change as more and more people are vaccinated, if at all?

Dr. Bratzler: On March 8, the CDC relaxed some of the precautions around wearing masks if you are fully vaccinated and are around others who are fully vaccinated. If you are fully vaccinated against COVID-19 and are exposed to someone with the disease, you no longer must be quarantined. Small family groups coming together can now do so without masks if all are vaccinated. I anticipate that as vaccination rates increase and case counts continue to come down, we will be able to relax some of the mitigation strategies such as wearing masks and social distancing. However, we are not there yet, and OU’s masking requirement and other safety precautions remain in place.

Q: There’s been a lot of talk about the efficacy rates of the different COVID-19 vaccines. What does vaccine efficacy mean?

Dr. Drevets: The simplest definition would be how effective vaccine is at preventing disease. That said, you can look at it several ways. For example, the studies looked at all COVID-19 disease regardless of severity, then they also broke it down into severe disease, hospitalizations, and COVID-19 related deaths.

Q: Do the vaccines protect against the new variants of COVID-19? How can vaccines be adapted to treat other variants that might emerge?

Dr. Drevets:  The current vaccines will protect against many of the viral variants now being discovered. It is likely, however, that some variants will not be completely protected against, and a booster shot may be needed in the future.

It is relatively easy to adapt the mRNA vaccines to new variants. Because the sequence of the variant spike proteins are being identified and studied, the manufacturers can insert changes into the mRNA that is used for immunization. Similarly, the other vaccines can also be adapted to new variants with good precision.

Q: With warmer weather just around the corner, travel becomes more and more tempting. How should members of the OU community protect themselves if they choose to travel?

Dr. Bratzler: Current federal rules issued by the president’s executive order require you to wear a mask if traveling by bus, train, or airplane. Because transmission of the virus has clearly been documented in mass transit, it is important to wear a mask from the time you enter the terminal until you leave the terminal at your destination.

It is also important to understand the COVID-19 disease burden where you are traveling. Some destinations will have higher rates of community spread of the virus than Oklahoma. Some destinations may have more cases of COVID-19 variant strains. Also, remember that if you travel internationally, you must test negative before you fly back to the U.S., and you must quarantine for at least one week when you return.