Colorado's top infectious disease expert answers your COVID-19 vaccine questions

vaccine q and a_michelle barron.jpg
Posted at 4:14 PM, Feb 12, 2021
and last updated 2021-02-17 14:05:42-05

DENVER — It's been almost a year since we've all lived with the novel coronavirus in one way or another. Fortunately, there is a light at the end of the tunnel, and it has come in the form of a vaccine.

While vaccinations are well underway in Colorado and the rest of the country, people still have many questions about their safety, their efficacy, how they work and what its side effects are, among many other things. Which is why we at Denver7 are committed to getting you answers to your most pressing questions.

On Wednesday, we invited Dr. Michelle Barron, the medical director of infection control and prevention at UCHealth University of Colorado Hospital, to talk about the vaccine and answer some of your concerns surrounding the two vaccines currently available to the public.

Please note: Some of the questions and answers have been edited for brevity and clarity. The full version of this Q&A can be found in the player above, as well as a full 30-minute special.

JASON GRUENAUER: The first – probably the most widely asked question out there right now: Is the vaccine safe?

COVID-19 vaccine Q&A with Dr. Michelle Baron: Is the vaccine safe?

DR. MICHELLE BARRON: Yes, it is very safe. So, I think one of the things that people were very worried about was that it was done in a very short time frame, and so that maybe people cut corners or things weren't done like we normally do.

The scientific design was the standard that we use for all sorts of studies, including the standard vaccines. The big difference was – obviously it was done sooner and quicker and the reason why? We had lots of money. Studies are not typically funded to this degree with this amount of support. I mean, they actually had a mobile clinic that they could drive around and bring access to individuals interested whereas most of the time, they have to take off work and then come in and do all these things, so they had a lot more resources than we've ever had, but all the safety standards were met; I reviewed all the data – a lot of people have reviewed this data, and it certainly… – there are side effects but from a safety standpoint, it is very safe. I took the vaccine. My family is getting their vaccine as appropriate, and so, I certainly would encourage others to consider it if things when they become eligible.

GRUENAUER: I read an article that basically said it's rare if ever that all of science is dedicated towards one thing at one time and that includes the funding behind it, which goes to, to your comment about the timeline of getting this vaccine out that literally it was everyone around the world goal was to get a vaccine and that's why we got one out so quickly.

BARRON: It is, and it truly is the biggest scientific achievement that we've had in my lifetime. There's been a lot of things we've moved in medicine and this one is remarkable because exactly that: The brightest people in the world figured this out…. – the technology is not new, too, I think that's something that I really want people to really understand. Some of this has been… people have been working on this technology for decades, it's just never actually been used because we didn't need to, and here we are. So, I think it's really one of these amazing things that all the money came in, people collaborated, having people having to collaborate in different countries, to be able to bring this all together, but it just tells you the need that was there and why it's so important that we have this as a tool now to potentially combat the pandemic.

GRUENAUER: You spoke about the technology being out there and I think that we kind of want to shift gears just a little bit into the actual vaccine: What's in that little vial? This is an mRNA vaccine. Can you explain what that is?

COVID-19 vaccine Q&A with Dr. Michelle Baron: Can you explain what an mRNA vaccine does?

BARRON: Sure. So, messenger RNA is one of the ways that is sort of the coding sequence that then produces proteins or different things. … If you were working with a virus, this is how it copies itself. So, the mRNA, what we do is we take pieces of the coding which makes the virus and in this case it's what's called the “spike protein.” So, just think about it as like you're trying to replicate my hair and my face so that you would be able to recognize me when you see me. So, the mRNA is the precursor of the code that would then make my photo up here. And then when it appears in your immune system and then the immune system says, ‘Hey, she looks familiar. She's doesn't belong here. We need to get rid of her.’ So that's how the vaccine, in theory, works.

When you get the booster, the body's now said, ‘Yeah I've seen her before and she does not belong here.’ And so, then again, the immune response is to basically attack and remove – in this case, the virus, hopefully not me – and allows that to actually do its job so that's the technology behind it. And the mRNA is very delicate – this is why you need all these freezers and all these things that sort of add to the complications of how to get the vaccine.

So, it doesn't live in your body. It literally gets into your body, produces the protein with that picture so that your immune system recognizes it, and then it disappears, because I think there was a lot of stuff out there that, ‘Oh, it gets into your DNA and then it mixes’ – mRNA doesn't work that way and, and in fact, our bodies – we make our own mRNA. That’s how our hair grows, that's how our skin will reproduce itself. This is a common thing we normally have; it's just manipulating it for our immune system to do what it's supposed to do.

GRUENAUER: Almost, giving our body the instruction list for how to fight the virus, not actually introducing the virus itself into our body, like other vaccines might do, like the flu vaccine.

BARRON: Absolutely, so that's very well stated. It's like a checklist and so, and again, the idea is that your immune system is like your army and it's ready to fight if an intruder comes. In this case it's the virus and this is its way of being able to say, ‘I know you're the enemy, I need to attack.’”

GRUENAUER: So, a lot of questions out there about side effects. Can you speak to what side effects are out there or what side effects people who might get the vaccine might deal with?

COVID-19 vaccine Q&A with Dr. Michelle Baron: What are some side effects of the vaccine?

BARRON: Sure. So, obviously the first side effect that someone can have is some kind of an allergic reaction, and that is why it's recommended that you'd be watched after you get your vaccine, they’ll have you sit down, they’ll watch you somewhere between five to 15 minutes to make sure that you don't have any immediate swelling of your mouth or difficulty breathing… – that happens incredibly rarely.

Most people are going to have a sore arm after the vaccine. Some people will have mild fevers. Some people have headaches, some body aches. It seems to be worse after the second vaccine, and I can actually attest to this. After the second vaccine, I felt really, really tired. I had some really terrible muscle aches and body aches, I had a fever, and then it went away. You should not have any respiratory symptoms after either one of them (vaccines). So, the vaccine can certainly make you feel like you have the flu, sometimes you can get rashes as well, that's another thing that's been commonly reported. You should not have a cough or shortness of breath or a runny nose.

You can still get COVID between getting your first shot and your second shot, and even after the second shot you need at least 14 days for fu ll effects, so if you develop any of those respiratory symptoms, that is not a common side effect and you probably want to talk to somebody that takes care of you, one of your providers, to make sure that you haven't by chance developed COVID.

GRUENAUER: So, let's break that down into a couple different things that you mentioned there. … When we talk about a cough, a fever or feeling tired, those are some symptoms of COVID-19 itself. So, where is that dividing line, I guess? Your advice would be people should still get the vaccine even if there's the potential for getting those types of side effects, is that right?

BARRON: Absolutely. And I think the way to think about this, it’s… It can be inconvenient, and by no means am I saying that it's something that should be minimized… The other thing I want to be clear on is that these side effects typically only last 24-48 hours maximum. Most people that I've actually talked to or that we've been monitoring, usually less than 24 hours and then they're gone. And so, the difference is, if you actually had COVID, those symptoms can last much longer and you can get a lot sicker from it. And so I sort of joke with people always about the old saying, ‘an ounce of prevention is worth a pound of cure.’ And so, even though you could probably do okay with COVID, you'd be knocked out for a much longer period, so that little window of time, if you've even have side effects, because not everybody does is worth, it’s still getting the vaccine.

The most severe reaction that can be seen is anaphylaxis (a severe allergic reaction) and this typically occurs within 15 minutes of administration. Other reactions are typically milder and can include fatigue, fever, headache, muscle and body aches, and occasionally rash. These symptoms typically last less than 24-48 hours.

QUESTION: Is it OK to take aspirin or Benadryl (or any antihistamine) before the shot, especially the second one?

BARRON: It is recommended that you avoid taking anything other than routine medications before your shot. If you do develop a reaction after either the first or second shot, you can take medications at that time for the symptoms, but you might want to be sure that your provider has no concerns of Tylenol, ibuprofen, or an antihistamine interacting with you current medications.

GRUENAUER: And one thing that you mentioned that one of our viewers has asked: Can you still get COVID-19 after you get both doses of the vaccine?

COVID-19 vaccine Q&A with Dr. Michelle Baron: Can you still get COVID and spread it to others after getting the vaccine?

BARRON: That's a great question and the answer is yes.

So, the key thing to understand about this vaccine is that it's highly effective. We can tell you with almost certainty that if you get the vaccine, you're probably not going to get hospitalized and you're probably not going to get very sick. The question is, it's not 100%. They reported anywhere from 94% to 95%. So, there's still that window where you could get sick, that you may have very mild infection, you may have a runny nose, you can have a sore throat, you may just feel tired for a couple of days. And so that's why we're still looking to see how long this lasts (immunity from the vaccine), and that's the other question: How long does it last? So, we know once you get your COVID vaccine, you should be protected but is that for three months, is that for six months? And we don't know the answer completely at this time.

It takes at least 14 days from the second dose of the vaccine to have full protection. Right now, research suggests that the Moderna and the Pfizer vaccines are still protective against some of the circulating variants so it is less likely that you can become infected with them but this is not completely known. Because the vaccine is not 100% effective in preventing disease, you can get a mild infection or display no symptoms of COVID-19 even after vaccination and you could potentially transmit the virus to other people.

GRUENAUER: So, the other question that we got from a viewer in regard to still being able to get it (the virus). If you receive both of your doses of your vaccine, you could still contract COVID and spread it to other people. Can you just clarify that for all of our viewers out there?

BARRON: Yes, that's completely correct. So again, the biggest protection it does is, it prevents you from getting very sick or ending up in the hospital. It also mostly protects you against getting infected but not 100%, so you can get infected, you can potentially spread it to others, and you may not even realize it because you may be feeling just mildly ill and just think, you know, ‘I'm just tired because I didn't sleep well last night.’ And that's why it's so important at this point in time to continue to wear your masks, to continue to do hand hygiene, social distancing, limiting gatherings. I completely understand everybody wanting to be able to live life as freely as possible, and we're getting there, but we're just not quite ready yet to give up on these other things, for those ‘just in cases.’”

QUESTION: Are the two different vaccines safe for those who have severe drug allergies, such as Stevens-Johnson syndrome?

BARRON: There is no correlation between reactions to other medications and these vaccines. If you have had a severe reaction to medications or other things in the past, let your vaccinator know and they will plan to monitor you a little longer after the vaccine is administered.

QUESTION: We've seen incidents of people dying after receiving a COVID-19 vaccine. Why would this happen?

BARRON: There have been some deaths due to underlying chronic medical conditions that there are no reports of patients dying directly related to the COVID-19 vaccine.

GRUENAUER: How does the COVID-19 vaccine affect people with autoimmune diseases, for example, someone who might have lupus?

COVID-19 vaccine Q&A with Dr. Michelle Baron: How does the vaccine affect people with autoimmune disorders?

BARRON: Yeah, that's a great question and so at this point, there's no contraindication for people with autoimmune diseases or other types of things that might affect the immune system in terms of getting the shot itself. There is lack of data and for some of these diseases, you can be on medications, like steroids or other things, that may potentially suppress your immune response. And so, we don't know if the immune response is as strong as it would be if you didn't have these medications on boar. But it is still highly recommended because even if it's not 95%, maybe, let's say it was 70%, or even 60% - that's still so much better than zero. And so the protective effect is still likely to be beneficial. And there's nothing to suggest that it would cause a flare of your underlying lupus or other autoimmune disease, but we certainly recommend discussing this with your provider to make sure that they don't have any concerns about you getting the vaccine.

QUESTION: Can the COVID-19 vaccine cause infertility in both men and women?

BARRON: There are no reports that have shown an association between the COVID-19 vaccine and infertility.

GRUENAUER: Let's talk about vaccine distribution, because the big question that everybody has out there is, ‘when am I going to get mine? So: Where are we, who is eligible, if we can just start there?

BARRON: Sure. So, all of this is being dictated on the state level. And so, the CDC put out initial guidelines just globally about, ‘Here are the people that are most likely to have hospitalization or to die,’ and that's where the states then took those recommendations and then said, ‘Okay, from our standpoint, this is what makes sense.’ So, in the state of Colorado, health care workers were the first group, nursing home and long-term care facilities were also the first priority group because of risk of repeated exposure. Then the 75 and over (group). We now are into the 65 and over, and additionally, we also are vaccinating teachers with the idea again, that they are potentially at risk of getting exposed in the school environment and I know there's a lot of hope to get the schools up and running and back to the normal standards that we would have had.

GRUENAUER: Why are we vaccinating teachers so early when we haven't finished vaccinating all of those 70 years of age and older?

COVID-19 vaccine Q&A with Dr. Michelle Baron: Why are we vaccinating teachers when we haven't finished vaccinating those 70 years and older?

BARRON: Yeah, I think it's a great question and I think there's always going to be this debate as to, should you finish one group and then start the next, or how do you do this? And I think the goal really is to get as many people vaccinated as soon as feasible and so, certainly with some of the older population it can be a little challenging sometimes because of mobility or other things to get them into the clinics. We know that most of the teacher population is mobile and they're all equally important in terms of ending this pandemic.

It depends on your viewpoint of how are we trying to balance vaccinating those that are higher risk of having a complication, and also opening up our society and being able to function, like, not completely normal, ‘cause I don't know what normal is anymore, but back to a more typical way that we're used to doing it and I think there's trying to balance those things and I think that's where obviously education is important. A lot of kids are having challenges being at home and trying to learn from home, so I think it's not just one thing that I think when they're looking at who goes next or what order should we be going in, and I think the supply is becoming so much more consistent that the ones… - the older people that have not yet got their vaccine will get their vaccine. I think that was one of the worries is that, if we introduce all these new groups, then my chance to get a vaccine is gone – certainly not the case – we are getting adequate supply now to where it may take a couple of days longer, but I think the priority is to continue with that group but allowing others to access, so again, we can keep moving forward.

GRUENAUER: What about people out there that have parents or grandparents who have signed up on lists, but haven't heard anything back? What should people do if they're signed up, and they're waiting, but they haven't heard back yet?

BARRON: So obviously make sure that the way you've signed up has the correct information so that you can be contacted. I know not everyone has access to the internet or to computers. There are now hotlines and phone numbers that can help work you through this and they can make sure that you get that call. Like all things, unfortunately, it's being patient. I know that's really hard, given how long people have been waiting for this. I can tell you from having parents that live in other states, we are still so far ahead of the game in terms of our process, and it does take some time, but I think it's certainly a little simpler to some degree in that, you know, you'll get that phone call, you'll get that email or that message, and it will come, it's just again, and I will tell everybody, sign up.

There is no need to stay within the group that may be your insurance is with or your doctor is affiliated with, you literally can sign – in the state of Colorado – you can sign up with any hospital system or the state anywhere, and that just maximizes the chance that, ‘oh, this group is going faster than this group,’ they got you in and so I would just say that being on multiple lists is not a bad thing.

GRUENAUER: We've heard and gotten multiple emails from folks that have said, ‘Well, I'm 68 and I have a prior health condition’ or ‘I'm 65,’ or ‘I'm 55 and I have some serious other health conditions.’ Why prioritize 70+ so much?

BARRON: Yeah, so that's a great question and actually, if you look at the statistics, it's fascinating to see the difference. So, if you are 75 and above, the likelihood of you dying or ending up in the hospital is like – and don't quote me on this because I don't have it in front of me – but the CDC website has a really nice chart on this. It's like 20 or 30 times higher than if you were young and healthy. … If you actually look at the likelihood like, 60 year olds are three times more likely to enter the hospital compared to somebody that's 18 years old and unhealthy.

And so, I think that was the initial way - if you looked purely at who's at most risk of being hospitalized and dying, the 70+, without a doubt, was so many magnitudes higher than every other age group, that that was the decision of, they are the most vulnerable, they are the ones that probably need the most protection, realizing again, there will be exceptions, there will be others and other age groups that also could be potentially at risk, but there's no sort of way to do this in a very systematic fashion without making some rules and in some of the rules, some people even though they should have qualified don't, but they still will get the vaccine. I think that's the long-term goal, is that everybody will have access to a vaccine in the near future.

GRUENAUER: Should you get tested for COVID-19 before your vaccine. If your immune system is already fighting COVID, what would happen if you got a vaccine for it?

COVID-19 vaccine Q&A with Dr. Michelle Baron: Should you get tested for COVID-19 before your vaccine?

BARRON: That's a great question and so the answer is no, we don't routinely recommend that you get a COVID test, unless you are having symptoms.

So, if you're having symptoms, then you want to obviously get a COVID test for two reasons: One, there are medications available, even in the outpatient setting, that you could potentially get administered that will help you get through it. Number two: You don't want to continue to spread it, so you do have to be in isolation, and we would want to be able to contact those around you that potentially were exposed.

Let's say you're feeling good, you're one of those people that didn't have symptoms and you don't know and you get the vaccine, the vaccine will still work, and there's no data in the studies, when you look at people that got the vaccines in the trials. They, after the fact, took some blood and checked to see if people had antibodies, which means that you were probably exposed and a good chunk of them had, and they didn't necessarily have any difference in terms of their outcomes as far as more side effects, or any kind of issues related to the vaccine administration, and so the key is that you just don't have active infection, so you don't show up to a vaccine center and then potentially spread it around without knowing.

GRUENAUER: What would be your advice for people, when their group pops up, that want to wait because they feel like they’re healthy and feel like they don’t need the vaccine as much as someone who is not as healthy?

BARRON: If you get access to it, you've got to get it because, not that you're never going to get it, but then your turn may be diminished.

If you've already had COVID we don't know the degree of immunity that you have to COVID for the second time, how long that lasts. We've been saying about 90 days, so you could potentially wait but then you may not… there's a lot of this that is more complicated than we'd unfortunately like it to be. We do know that you can get reinfected with COVID even though you've had it before, there are new variants that are starting to populate that, even if you had COVID (before), this may be new enough to your system that you end up getting COVID again, and really, at the end of the day, we want to make sure that we have enough of what's called herd immunity.

And so by going by these groupings and getting your vaccine when it's offered to you just sort of moves that process along in terms of making sure that the everybody else ends up protected over time as well.

GRUENAUER: Can you bring us up to date with what the latest is on vaccines and dealing with variants here in Colorado?

COVID-19 vaccine Q&A with Dr. Michelle Baron: What's the latest on vaccine efficacy and the COVID-19 variants?

BARRON: Variants are normal. This is something we expect to see. When the virus copies itself, it doesn't have a machine that can do it for it. It literally is copying itself by hand. Imagine if you had to write the same sentence 100 times, at some point you're going to make an error and that maybe a letter change, maybe a word change, and maybe it's significant, maybe it's not, and so that's really what a variant is. Most viruses have proofreaders, but they don't always catch all the errors and then that potentially new strain develops, and sometimes it meaningful, sometimes it's not. As far as we know, based on all the studies that they've done - again, not knowing all the pieces because we haven't seen it in mass in the United States – the current vaccines available still seem to be very effective. Now, are they still at 95%? I don't know that we know that answer, but certainly it looks like they're better than 50% and probably still pretty high.

Even if it's diminished and it's not as good with what we call the “wild type strain,” which is the original one, there's still benefit from getting the vaccine and it's, again, as we sort of go through this, having people… even having 70% immunity is still again very valuable.

GRUENAUER: What if we get one (dose) and the second isn't available? Or, I would even add to that, what about the intermediate month when you just have one? There’s still some good that comes out of that?

COVID-19 vaccine Q&A with Dr. Michelle Baron: What happens if you get one dose but not the second?

BARRON: There is and so, it depends on the vaccine itself. There's two to get vaccines that are currently available: The Pfizer and the Moderna. The first shot for both of them boosts your immune system, it alerts it, puts it on - not on fire - but it certainly gets it revved up, and so it's probably anywhere – for both of them – somewhere between 65 to 70%, so you're already halfway high or 50% higher than you would have been with just your regular immune system. The second dose, really, is what takes it to that next level.

And so, if you end up missing the second dose, if for some reason it's delayed, their structure is that for Pfizer, you get the first one, then it's 21 days (to get your second dose). For Moderna, it's 28 days for the second dose. They have actually extended the timeframe and know it's safe that up to 42 days after that second dose, you can still get your vaccine and you don't have to start the series over and you still, again, have some level of protection – the second one is that enhancement, and so with vaccine supplies being really good, if for some reason you didn't get the second vaccine for whatever reason on that day, you still have six weeks after that to get the vaccine and get that second dose.

GRUENAUER: What are your closing thoughts when it comes to this vaccine, as we sit here right now?

COVID-19 vaccine Q&A with Dr. Michelle Baron: What is your message to people as the vaccine rollout continues?

BARRON: I think it’s a great thing that we have access (to the vaccine). I strongly encourage individuals to access the vaccine when they have availability. If you have questions, please ask your provider, ask someone to get good information, so that you can make an informed decision. And then I don't want people to – once you get the vaccine – until we tell you otherwise, it's still really important to follow the rules: Masking, hand hygiene, social distancing – all of these things are different layers of protection that keep us safe and keep us healthy. Just like when you get in your car. You have a seatbelt. You have airbags. You have speed control by not going too fast. All of those things are helpful in terms of keeping you safe, and we want to keep doing those things ‘til we know that it's really okay to back off on them.

QUESTION: What would you say to Coloradans who refuse to believe health experts, or who are skeptic about the information health experts are putting out about COVID-19 and the COVID-19 vaccine? Any advice for how people can talk to family members who are getting wrong information from unreliable sources?

BARRON: Most health experts have actually received the vaccine in order to protect themselves, their loved ones, and the patients they care for. I think that speaks volumes about how they view the safety profile of the vaccines. Additionally, at this point, almost everyone knows someone who knows someone who has had COVID-19. Talk to them about their experiences and they will tell you about the impact it can have on your health.

GRUENAUER: I'll ask you one more time: Is this vaccine safe?

BARRON: The vaccine is safe and is our way out of this pandemic. We need to do this and get enough people vaccinated to keep you out of the hospital, to keep you healthy and so that we can live our lives fully again the way we'd like to do.

Have more questions about the COVID-19 vaccine? Check out our updated FAQ here.