Ebony Jade Hilton, anesthesiologist and critical-care medicine specialist at the University Hospital, and Daniel Engel, a professor at the School of Medicine, spoke Tuesday in a virtual town hall to answer the public’s questions about the COVID-19 vaccines. The virtual COVID-19 Vaccine Education Town Hall series, launched by more than 50 scientific experts across the United States, aims to bring factual, scientific knowledge about the vaccines to people across the country, especially to communities of color that have been hit the hardest by the pandemic.
Engel and Dean Kedes — professor of microbiology, immunology and cancer biology — are co-chairs of the town hall series, along with Felicia Goodrum of the University of Arizona and Mariano Garcia-Blanco of the University of Texas Medical Branch at Galveston. The program is sponsored by the American Society for Virology and the American Society for Microbiology, two of the country’s leading professional organizations in the field of infectious diseases.
Hilton, who was one of the first U.Va. Health staff members to receive the COVID-19 vaccine, touched on three main topics regarding the vaccines — the importance of mass vaccination, safety concerns and the issues surrounding vaccination.
On the importance of receiving the COVID-19 vaccines, Engel noted that all of the vaccines available at this point are very similar in terms of their effectiveness at preventing death, despite high-level technical differences. For example, the Moderna and Pfizer shots are mRNA vaccines, but the Johnson & Johnson vaccine is a viral vector vaccine.
Hilton added that the effectiveness also takes into account the much-improved conditions of illness — such as the decreasing likelihood of being admitted to an intensive care unit — for those that were infected with COVID-19 after being vaccinated.
Despite the effectiveness of the COVID-19 vaccines, Hilton emphasized that mask-wearing and social distancing are still crucial at this point, and individuals have to be hypervigilant in protecting themselves, regardless of the type and number of doses of vaccines they have received.
“We don’t have enough of our population vaccinated at this point,” Hilton said. “You have one in every three adults that has been vaccinated from COVID-19, so that is 33 percent, but we need 70 percent to 80 percent [of the entire population vaccinated].”
According to a daily report from the White House COVID-19 Response Team, more than 442,935 new cases emerged in the last seven days, with an increase of 12.4 percent from the previous seven days. More than 34,000 patients were admitted to a hospital with COVID-19 in the past seven days, representing a 5.6 percent increase. This comes at a time, though, when vaccination rates are on the rise as well. In Virginia, 17.5 percent of the population has been fully vaccinated, with 31.9 percent of people having received their first dose.
Health officials warn that the country is now facing a more difficult time than in earlier stages of the pandemic as strains of COVID-19 variants arise around the globe, threatening people with a boost in transmission efficiency and a deadlier effect on health.
In response to the rising coronavirus variants around the globe, the town hall audience expressed concerns about the effectiveness of the present vaccines in protecting people from future coronavirus variants. Hilton explained that the accumulation of coronavirus variants arose due to the reproduction of the virus at such a high rate. Therefore, achieving herd immunity — which limits the coronavirus’s ability to reproduce itself — is crucial and might be the only possible step to halting the pandemic.
The available vaccines at this point still allow protection from the three current COVID-19 variants — the UK variant B.1.1.7, the South African variant B.1.351 and the Brazil variant P.1 — present in the United States. However, Hilton explained that the longer the coronavirus is allowed to spread around the country and the globe, the more likely it would generate a mutation that is stronger than the vaccines.
“Unfortunately, the virus is smarter than us and it is changing itself faster than us,” Hilton said. “Reaching that herd immunity … is going to be our best bet of getting back to normal and keeping ourselves alive to see 2022.”
Following the emphasis on mass vaccination, Engel touched on some potential safety concerns regarding vaccination, including negative effects in people with autoimmune conditions and pregnant women. Engel revealed that both groups were not part of the clinical trials, however, there are vaccine clinical trials happening right now that involve both groups of people. The current results show no concerns.
“There’s no group for which we can say that the vaccine is unsafe,” Engel said. “There are just a few groups for which we can’t make the positive statement that it’s safe yet.”
In regards to other issues with vaccination, Hilton examined how COVID-19 mortality is unequally impacting certain communities. According to data from the APM Research Lab, at the national level, “Pacific Islander, Latinx, Indigenous and Black Americans all have a COVID-19 death rate of double or more than that of white and Asian Americans, who experience the lowest age-adjusted rates.”
Hilton explained that Black and brown people are more likely to be infected with COVID-19 not because they are biologically prone to coronavirus infections, but because of their roles as essential workers, who have to maintain face-to-face interactions with people. They are also more likely to experience difficulties in affording homes that allow social distancing due to socioeconomic inequity.
“When we are saying to social distance to mitigate the spread, that is impossible when there are 10 people living in a three-bedroom home,” Hilton said. “With COVID-19, we had a health crisis but also a financial devastation, where millions of people lost their jobs and were unfortunately evicted from homes and had to condense into smaller places.”
Reflecting on the regulations of vaccine rollout, Hilton pointed out that age- and employment-based vaccination rules did not effectively protect vulnerable Black and brown communities. By linking vaccination eligibility to age, Black and Latinx communities did not receive equal protection as Black and Latinx projected life expectancy shortened by almost three years within the past year. Prioritizing health care workers and essential workers first for vaccination also excluded vulnerable Black and brown communities as people of color comprise only 40 percent of healthcare workers and many Black and brown people lost their jobs at the start of the pandemic.
“We are seeing in our COVID-19 cases now starting to surge again because of the fact that we haven’t taken care of the most vulnerable people of our population,” Hilton said. “We have to start thinking big picture on how we can make sure that we are addressing wherever the weakest flaw of our system [is], so that we can be stronger together.”
The town hall series continues through mid-April with hosts from various higher education institutions. All events are free and open to the public, although registration is required. The maximum capacity for each town hall is 300 people. Continuing the vaccine education series, Prof. Britt Glaunsinger from the University of California, Berkeley and Prof. Rich Condit from the University of Florida will host the next event on April 2.
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