Seniors, Caregivers and the Coronavirus Vaccine

On December 8, 2020, 90-year-old Margaret Keenan became the first person in the U.K. and the world to receive the Pfizer COVID-19 vaccine. On the same day, the FDA confirmed that the Pfizer vaccine was 95% effective and will be approved for emergency use in the U.S. Eight other companies around the world have vaccines in progress that are on the path to distribution. This is exciting news after a very tough and tragic year, but what does it mean for seniors and their caregivers in San Diego?

Initially, the supply of vaccine doses will be limited, and require special handling to maintain the very cold temperatures required (Pfizer’s vaccine must be stored at -94 degrees Fahrenheit!). Scientific American reports that “by the end of December, the U.S. Centers for Disease Control and Prevention (CDC) estimates the U.S. will have enough vaccines to treat 20 million people.”

It’s true that seniors don’t respond as vigorously to vaccines as younger patients because of their aging immune systems, but the vaccine will still save lives. The CDC affirms that “COVID-19 vaccination will help protect you by creating an antibody response without having to experience sickness.” On the question of when to get vaccinated, Joel Ernst, MD, Professor of medicine and chief, Division of Experimental Medicine, quoted in UCSF Magazine Winter 2021, says:

To be clear: I would say it’s a personal decision on when to be vaccinated, not whether to be vaccinated. It’s a societal imperative if we are to overcome this pandemic that all of us who can get vaccinated must get vaccinated. The recent data on safety and efficacy of three of the COVID-19 vaccines indicate that some of us will make that decision soon. To make sure a vaccine is safe for everyone, I’d personally feel most comfortable with six months of data from phase III testing*.”

The CDC has been working with the Advisory Committee on Immunization Practices (ACIP) to develop an official recommendation for how the initially limited supply of vaccines should be distributed. Currently, the County of San Diego confirms that they plan to vaccinate in this order:

  • Phase 1A: Critical care health workers and long-term care facility residents and employees
  • Phase 1B: Essential workers, “people who work in education, food and agriculture, police officers, firefighters, correctional officers and transportation workers, among others.”
  • Phase 1C: “adults with underlying medical conditions and people over the age of 65.”
  • Phase 2: Children and young adults under 30, and any critical workers not covered in Phase 1
  • Phase 3: the rest of the United States

The plan for the latter phases may change depending on factors like who is more likely to spread infection, who is more likely to have severe symptoms and even who is likely to be willing to get the vaccine. The experts will weigh all the data on how COVID-19 spreads, underlying conditions, super-cold transport and storage needs, and geography to plan the roll-out. The order may be set, but the timing is uncertain as the number of doses available to San Diego County will depend on the number of doses the United States contracted for with the manufacturers.

The elderly in home care aren’t at the very front of the line but should expect to their turn to come before June 2021. Caregivers are essential workers and health care workers, so their access to the vaccine will likely depend on the setting in which they do their work. New information about the virus and the vaccine is available on the CDC’s Coronavirus (COVID-19) web page, and Bloomberg.com is tracking vaccine options and progress globally.

In the meantime, all the rest of us can protect ourselves and our loved ones by continuing to wear a mask, vigilantly social distance, and keep washing and sanitizing our hands. Amidst this very unusual and trying holiday season, the best gift we can give one another is space and close adherence to infection prevention protocols.