photo by: Contributed Photo/Heartland Community Health Center

From left, Dr. Cooper Nickel, a primary care provider at Heartland Community Health Center, and his father, Dr. Graig Nickel, a family physician at Watkins Student Health Center at the University of Kansas, receive the Moderna COVID-19 vaccine Tuesday, Dec. 22, 2020, at Heartland.

COVID-19 vaccinations in Kansas have been underway for a little less than a month, with priority being given to health care workers, EMS responders and residents in long-term care facilities. This past week, some health care workers received the second dose of the Pfizer vaccine, meaning they are now fully vaccinated.

That group included Shannon Fletcher, a respiratory therapist who was the first person in Douglas County to receive a COVID-19 vaccine. She received her second dose of the Pfizer vaccine on Wednesday and said she felt even more excited than she did after the first dose.

“This is the one that counts,” she said. She thinks she will now feel more comfortable seeing those she has not been able to see throughout the pandemic, but said she will continue wearing masks and practicing good hygiene.

“This is just an extra layer of protection,” she said of the vaccine. “I’m hopeful this will help our numbers in Kansas — I really hope.”

Kansas expects that all health care workers and long-term care residents will have received both doses by the end of January. Once that is complete, the state will move on to the second phase, which will include people 65 years and older, people living or working in congregate settings and workers providing critical services who are at high risk of being infected. Douglas County officials will announce the details of registration for phase two when it is ready at LDCHealth.org/COVIDVaccine.

This past week, the Lawrence Journal-World asked leaders from the health department and LMH Health important vaccine questions. These leaders were Kathy Colson, a retired public health nurse who began working for the health department during the pandemic; Christina Crowley, director of pharmacy at LMH Health; and LMH Health infectious disease doctors Jennifer Schrimsher and Christopher Penn.

Do people who have received both shots need to continue wearing masks?

Yes. Colson said experts are not yet sure how long the vaccine will be effective, and at this time the recommendation is to get both doses and then continue to wear a mask and practice social distancing and good hygiene.

Penn said the vaccine studies looked at whether the vaccine could prevent people from becoming sick, but they did not look at whether people who have been vaccinated can still transmit the virus. That is, “we can’t really make a comment that (having the vaccine) protects you from giving the virus to someone else,” he said.

In terms of general behavior, people need to keep up with the COVID-19 practices that have been in place since last spring.

“The answer that people don’t want to hear is yes, we need to continue to do what we’re doing,” Penn said.

Can people who have received both shots visit at-risk friends and family?

The providers the Journal-World interviewed seemed to differ a bit here.

Schrimsher said that “nothing changes,” and Penn agreed. Penn said the reason that vaccinated people shouldn’t visit at-risk friends and family yet is that it’s not known whether vaccinated people can still spread the virus.

Colson, meanwhile, said she does “see hopeful signs for people to be getting back to visiting their family in nursing homes and such,” and that she “will feel very comfortable about seeing people I have not been able to see.” However, she added that she would continue to wear a mask and practice social distancing when visiting friends and family members “until we know more” about how the vaccine affects the virus’ spread.

If someone has the vaccine but gets exposed to COVID-19, do they need to quarantine?

Different agencies have different answers.

George Diepenbrock, spokesman for Lawrence-Douglas County Public Health, said the health department is following the state Department of Health and Environment guidance. Those guidelines say that people who have received both doses of the vaccine will not have to quarantine, even if exposed to the virus, for 90 days after the second injection.

Kristi Zears, the spokesperson for KDHE, said the department arrived at its conclusion based on historical knowledge of how vaccines work and what is known so far about how the COVID-19 vaccines. And Schrimsher said that the state’s stance is also intended to “increase buy-in” for the vaccine.

“Their concern is that if people still have to quarantine, that they won’t bother getting the vaccine,” she said.

But Schrimsher also said the state’s guidance differs from that provided by the federal Centers for Disease Control and Prevention. The CDC guidance calls for vaccinated individuals to continue to quarantine if exposed.

Personally, Schrimsher said she would “tend to err on the side of caution” until more data is available on the vaccine.

“The mitigation measures we’ve been reiterating — masking, distancing, avoiding gatherings, etc. — significantly decreases the risk of transmission,” she said. “Vaccination is another layer of prevention.”

If someone has received both vaccine shots and still gets COVID-19, would that person’s reaction to the virus be less severe?

That’s what the experts expect, Schrimsher said, but she noted that there’s not a lot of data yet.

Colson said that if people received both doses of the vaccine and still became ill with COVID-19, it is likely that they would have a less severe reaction.

“The main thing would be hopefully to keep you out of the hospital, have a less severe illness, less long-term side effects from the illness. Everything should be much less,” she said, noting that it should also reduce the risk of death.

What happens if a person misses their second dose of the vaccine?

Both the Pfizer and Moderna vaccines require two doses: the Pfizer vaccine’s doses are given 21 days apart and the Moderna vaccine’s are given 28 days apart. If someone were to miss that time frame for a second dose, “the recommendation is to get it as soon as possible,” Schrimsher said.

If someone is slightly late to get their second dose, the indication is that the vaccine as a whole should still be just as effective, Colson said. But she added that she “would not wait around.”

According to the CDC, after both doses, Pfizer and Moderna have efficacy rates of 95% and 94.1%, respectively.

What side effects have people experienced from the vaccines thus far?

Crowley said a lot of people are reporting side effects that are consistent with what was experienced in the clinical trials, such as muscle pain and fatigue. She said only a few of the people vaccinated at LMH Health have seen adverse effects from the vaccine, and all have been mild. For example, one person had a rash following the injection.

At the health department, Colson said that of 40 staff members who had been vaccinated, 38 had a sore arm afterward. Two had headaches, two experienced nausea and four or five had red, swollen arms.

After receiving the second dose of the vaccine, how long does it take for it to provide protection?

Penn said it would take about two weeks for people to be “up to speed … with respect to antibody production.”

How long will the vaccine work?

At the moment, experts are saying 90 days. Schrimsher said early data is showing it might be more like four months, and Penn said it could be longer.

Colson said that although there has been talk about an annual dose of the vaccine, “that’s all a big unknown at this point in time.”

(Editor’s Note: Additional information continues to emerge, and this article reports six months to a year or longer could be more likely.)

Will the COVID-19 vaccines protect against the new, highly contagious variant that originated in the U.K.?

Schrimsher said new information was released Thursday noting that the Moderna vaccine might not be as effective against this new variant. She said there isn’t enough data to say anything definitely, but noted that it is a possibility.

However, Schrimsher also said that because of the way the vaccine was made, it could be adjusted to account for mutations.

Is one vaccine considered better than the other for people with allergies?

No, Colson said. If you have a history of allergic reactions to vaccines and are unsure of whether to get a COVID-19 vaccine, the best course of action is to talk to your doctor, Colson said. A person with a history of allergic reactions will need to be observed for 30 minutes following the injection of the vaccine — normally, the observation period is 15 minutes.

What else does the public need to know?

Crowley said it is of utmost importance that people do not become lax in their health practices after receiving one or both doses of the vaccine. The vaccine is not 100% effective, she said, so it’s important to also continue wearing masks.

Schrimsher agreed.

“I want people to know that this vaccine does not mean you can go out and party. It does not mean you don’t have to wear a mask,” she said. “If I had to pick one thing that I thought was most important, it’s that it’s still mask now, party later, until we get things more figured out.”