Asian Health Institute

VIDEO #1
Question: Which vaccine is the best? I know they say just take whatever vaccine is available, and the % of effectiveness are slightly different, but is there a best choice between Pfizer, Moderna, and Johnson & Johnson? I heard that the Moderna vaccine is better for APIs but that the Pfizer is better for seniors – what is the difference and which one should I pick?

VIDEO #2
Question: Will the vaccine give me COVID-19? If others in my family haven’t gotten the vaccine, won’t I get them sick? Can I still pass on COVID-19 to other people after getting vaccinated?

VIDEO #3
Question: What if I have a preexisting condition like heart disease, kidney disease, or diabetes, how will the vaccine affect me? Will it make things worse? Can I take the vaccine if I am on medication? Will the vaccine interfere if I have ongoing diseases/allergies? (high-blood pressure, anemic, diabetic etc.)

VIDEO #4
Question: Where can I get a vaccine in San Francisco? Why is it so challenging to get a vaccine? Do I need medical insurance? Will the vaccination ask me if I have a labor certificate?

Who can get vaccinated now? Click on Vaccine Eligibility Expansion to Persons Under 65 with Qualifying Conditions (San Francisco)
(3/15/2021) As 27% of San Franciscan adults have received at least one dose of vaccines, the City has expanded its vaccine eligibility requirements to include individuals who:

• Are age 16 to 64 at high risk for severe COVID-19 due to one or more health conditions
• Are age 16 to 64 with disabilities
• Live or work in high-risk congregate care facilities, including correctional facilities, homeless shelters, and other congregate residential care/treatment facilities
• Are experiencing homelessness

Eligible people can schedule a vaccination appointment through the state’s MyTurn system, county vaccine websites, and some health care providers.

Do I need to prove if I have qualifying conditions in order to get the vaccine?
Verification policy varies across counties and providers at this time.

But for UCSF and other publicly-run sites in San Francisco, they follow State and City guidance that relies on attestation and will not require verification.

For those UCSF patients who need proof of eligibility for health conditions, we have a template letter in MyChart (the electronic medical record) that clinicians can type in.

I am worried about getting the vaccine because I heard the side effects are very severe
From the CDC website:

You may have some side effects, which are normal signs that your body is building protection. Common side effects are pain, redness, and swelling in the arm where you received the shot, as well as tiredness, headache, muscle pain, chills, fever, and nausea throughout the rest of the body. These side effects could affect your ability to do daily activities, but they should go away in a few days. Learn more about what to expect after getting a COVID-19 vaccine. Some people have no side effects.

What if I have a preexisting condition like heart disease, kidney disease, or diabetes, how will the vaccine affect me? Will it make things worse?
From the CDC website:

People with underlying medical conditions can receive a COVID-19 vaccine as long as they have not had an immediate or severe allergic reaction to a COVID-19 vaccine or to any of the ingredients in the vaccine. Learn more about vaccination considerations for people with underlying medical conditions. Vaccination is an important consideration for adults of any age with certain underlying medical conditions because they are at increased risk for severe illness from COVID-19.

Specifically, how do the vaccines differ from each other?
Vaccine manufacturers report information from clinical trials, including demographics and underlying medical conditions of people who participated in COVID-19 vaccine trials. You can find additional information on COVID-19 vaccine clinical trials at clinicaltrials.gov, a database of privately and publicly funded clinical studies conducted around the world.

Information on Pfizer/BioNTech COVID-19 Vaccine:
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Pfizer-BioNTech.html

Information on Moderna COVID-19 vaccine
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Moderna.html

Information on Johnson & Johnson (Janssen) COVID-19 vaccine
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/janssen.html

Will the mutations of the virus mean Pifzer, Moderna won’t be as effective?
From STAT:
Both the Moderna and Pfizer-BioNTech vaccines finished clinical trials before the emergence of B.1.351 and other variants of concern, so there are no clinical data for how they defend against the newer iterations of the virus. But in their trials, both were shown to be greater than 90% efficacious at preventing symptomatic Covid-19, so some experts have argued that even if they lose some of their oomph against particular variants, they have enough cushion to remain highly protective.

Novavax and J&J trials reported drops in efficacy in against the variant. Moderna, last month reported that its vaccine was also less potent against B.1.351 in lab experiments, but said it believed the levels of antibodies generated should still be protective.

From CDC:
Preliminary results from the United Kingdom demonstrate that vaccination with two doses of Pfizer-BioNTech COVID-19 vaccine was highly effective (85–86%) against SARS-CoV-2 infection and symptomatic COVID-19 during a period when B.1.1.7 was the predominant circulating strain. Similarly, high Pfizer-BioNTech vaccine effectiveness (92%) against infection was observed in Israel in the context of multiple circulating strains, with the proportion of cases due to the B.1.1.7 variant increasing to 80% towards the end of the evaluation period. Preliminary data suggest that the Janssen COVID-19 vaccine may have reduced overall efficacy against the B.1.351 variant. In the United States, efficacy was 74% and in Brazil (where ~69% of infections were due to P.2) efficacy was 66%, but in South Africa (~where 95% of infections were due to B.1.351) efficacy was 52%. However, Janssen vaccine efficacy against severe or critical disease was high and similar across sites (73–82%) .

The Pfizer and Moderna vaccines are made with a piece of genetic code called messenger RNA that tells the body how to make some harmless copies of the spike protein that train immune cells. To update the vaccine, they can simply swap out the original genetic code with mRNA for the mutated spike protein.

Can a person who has tested positive get vaccinated?
The CDC also addresses this question in a post titled, "I've already had COVID, should I still get vaccinated?"

The answer, the CDC writes: "Yes, due to the severe health risks associated with COVID-19 and the fact that reinfection with COVID-19 is possible, you should be vaccinated regardless of whether you already had a COVID-19 infection."
However, the CDC adds the caveat that if someone was treated for COVID-19 symptoms with monoclonal antibodies or convalescent plasma, they should wait 90 days before getting a COVID-19 vaccine. If you’re unsure what treatment you received, the CDC urges you to consult your doctor. (Having those synthetic antibodies or having convalescent plasma can actually reduce the efficacy of the vaccine because it basically stops the vaccine from working before it gets started.)

Is the vaccine only effective for a few months?
We don't know how long protection lasts for those who were vaccinated.
Experts are working to learn more about both natural immunity and vaccine-induced immunity. CDC will keep the public informed as new evidence becomes available. COVID-19 has caused very serious illness and death for a lot of people. If you get COVID-19, you also risk giving it to loved ones who may get very sick. Getting a COVID-19 vaccine is a safer choice.

My WBC has dropped recently to 3000 only, not sure which of my previous cancers is recurring. With my poor health condition & compromised immunity, can I still take the Covid vaccine?
Dr. Ko: Yes, it is still safe for cancer patients to receive the vaccine, including those with compromised immune systems (i.e. from receiving chemotherapy).

I am undergoing chemo, can I take the vaccine now or wait till the treatment is finished?
Dr. Ko: Yes, it is still safe for cancer patients to receive the vaccine, including those with compromised immune systems (i.e. from receiving chemotherapy). In general, we recommend trying to separate the timing of your vaccine from the day you’re receiving chemotherapy, by at least a few days.

For people in stage 4 cancer, should they take the vaccine?
Dr. Ko: Yes, it is still safe for cancer patients to receive the vaccine, including those with compromised immune systems (i.e. from receiving chemotherapy).

I had a liver transplant 3 years ago, and am taking immunosuppressants. Should I take the vaccine? Does it matter which type?
Dr. Ko: Yes, post-liver transplant patients are recommended to take the vaccine. Moderna and Pfizer would be good choices as they are mRNA vaccines (i.e. do not contain attenuated virus).