Speaker 1 (00:01):
Welcome to on the pandemic, a Rutgers cast series where university experts and leaders in health examine the critical challenges we face in our recovery from the COVID-19 pandemic. This episode is hosted by Mario Dowd, the executive director of health systems and population health integration for Rutgers biomedical and health sciences at Rutgers university. Previously, she led the New Jersey department of health as commissioner, after serving as the deputy commissioner and chief of staff. Joining the discussion today is Dr. Eddie Breznitz former New Jersey department of health, deputy commissioner, and state epidemiologist adjunct professor for Rutgers university school of public health, and currently serving as medical advisor on the COVID 19 response to the New Jersey department of health. 

Speaker 2 (00:47):
Hi, this is Mario dab from Rutgers university. I'm here with Dr. Eddie Breznitz, who is currently the medical advisor for the New Jersey department of health COVID-19 response effort. Welcome Dr. Presents. Thank you for joining us here today. Um, first I want to start off by just thanking you for coming out of retirement to rejoin the state health department, um, in their time of need in responding to the, uh, COVID-19 pandemic. You have a wonderful wealth of experience, both as a public health physician at the state health department, um, when we work together, but also working at Merck in vaccines. And so I think that combination of background is really, really critical for the challenges that, um, we're experiencing across the state and country today. So thank you for your service for almost a year now, um, to the state of New Jersey. Um, I wanted to ask you if you could just share a little bit with us about what your role has been since you rejoined the health department, um, last March and what the biggest challenges have been 

Speaker 3 (01:58):
Well, Mary, thanks for having me as your first guest. It's been, it's been, um, we've interacted over the years. I was just telling before we got on the call that I think we go back almost 20 years. Um, if you can believe in your various roles in mine as well. Um, and my retirement was quite short. I was only, I think, two months into retirement with, um, the commissioner called me and asked me to come back and, and help to support her and the department and the governor's office and the COVID-19 response. Um, you know, the, I I'm serving as a medical advisor to the commissioner and to the, to the governor's office. And, um, and my major activity has been, uh, overall has been chairing the COVID-19, um, New Jersey professional advisory committee. You're a member of that. It's a 28 member committee that is very diverse. 

Speaker 3 (02:50):
It's um, it's got a lot of disciplines that are on there. We have nurses, physicians, ethicists lawyers, uh, heads of various, um, um, organizations like the medical society and nursing society and the hospital association, former commissioners like yourself. And we have a couple of others. And the major activity of this, um, advisory committee has been basically tackling the issue of, of allocation of scarce resources, essentially. Uh, we started off with ventilators and develop a policy around that, and we revise that policy, um, major revision once. Um, we also address the issue of allocation of various drugs to treat COVID-19. Those are drugs that were initially some all under initially and an emergency use authorization, some have since been licensed. And currently we're focusing and have been for several months on how to prioritize the vaccines, understanding that for several months after these, these vaccines would and have become available, that they would be in score and scarce supply. And so that's been our focus recently all within the lens of equity and fairness and transparency. 

Speaker 2 (04:03):
Let's talk a little bit about, um, the vaccine and, and where we are right now. Um, the first vaccine in the United States was approved by Pfizer, um, but approved by the FDA and then, um, recommended by the CDC. And then Madonna was shortly thereafter with another vaccine that was also approved in December. Um, the CDC is reporting, um, as of January 8th, that over 22 million vaccines have been distributed across the country and nearly 7 million doses have been administered here in New Jersey. Um, I looked on their website this morning and they're reporting nearly 200,000. Um, first doses have been administered and nearly 15002nd doses. Um, the very first dose, uh, that was given here in New Jersey was on December 15th at university hospital in Newark. Um, and that was the Pfizer vaccine. And I know that there's been some disappointment expressed about the speed in which this, um, vaccine distribution has gone, but from my perspective, you know, this is an enormous undertaking. Um, the speed at which this has taken place is actually remarkable when we take a step back, but of course, everyone wants this to go as quickly as possible. Um, can you talk a little bit about, you know, how you see the vaccine program going so far, given your background and expertise? Um, I personally feel like it's going fairly well, um, with a few bumps in the road, but really we're just in that first month still. So can you talk a little bit about that? 

Speaker 3 (05:44):
Yeah. Um, well clearly vaccines, the, um, making big news at the same time, we're seeing, uh, an unbelievable surge in the incidence of COVID-19 disease and the population, um, beyond anything we experienced before. And so these are two topics that are clearly of importance and they're related. I do want to just, um, sort of, uh, clarify what you said about, um, the two vaccines being approved. They actually are not approved, they're authorized, and there's a difference, you know, the FDA, um, has different pathways for utilization of vaccines or, or bylaws or, or drugs. Um, the typical pathway is a pharmaceutical company will, will file a biologics license application. It goes through a review process, usually takes almost a year and then the product, whether it's a vaccine or otherwise then is approved or not. Um, in this case, we're talking about an emergency use authorization, which is not approval. 

Speaker 3 (06:52):
It's basically an assessment by the FDA that the, in this case, the vaccines have a benefit that is greater than the risk that's been in allies based on a submission of a file by the manufacturers. So, so just as a clarification now, when we're talking about, you know, getting vaccines into people's arms, we have to start with the vaccines. And I just want to highlight that from the time that the virus was first identified, which was last January to the time that these emergency use authorizations were issued by the FDA. It was less than a year, which is an amazing, amazing, um, short period of time without any short cuts in terms of evaluating the safety and the efficacy of the vaccines under normal circumstances, without an, you know, where there's not this pressure and the, not the resources that were put into vaccine development by the federal government and the dedicated resources put into by the, by the manufacturers and the researchers, it would take years to get the vaccines to this point in time. So that really is the key. 

Speaker 2 (08:01):
Can I ask you, you, you've made a point about the difference between approval and authorization night. I understand that, but for, for generally speaking, um, can you talk about how the authorization process reviews the safety and efficacy data, um, and why it was able to happen on the shorter timeframe? 

Speaker 3 (08:25):
Well, for a couple of reasons, one is that, um, as I was alluding to the federal government through operation warp speed, put a lot of resources into, uh, gave a lot of resources or made grants to a number of different manufacturers around the country to accelerate their research process, including, um, producing vaccines, um, on speculation. Then in fact, the vaccines would work normally, uh, a pharmaceutical company would not put in the money until they had a good, uh, estimation that there was a high probability of success that their, that their vaccine would be licensed. Otherwise they would be producing vaccine on spec. And if it wasn't licensed, they would basically have to throw away that vaccine. So that was one part of the acceleration process. The other is, um, as vaccine or as the clinical trials were ongoing, uh, the, and as data was accumulating, um, the manufacturers were submitting data, whatever data they had for, for example, on the, um, on the issue around manufacturing, there's a lot of data that has to be submitted to a company, to the FDA, um, quality control for the manufacturing process. 

Speaker 3 (09:34):
And so that was being submitted at the same time, as, as opposed to waiting to submit it all at once. So the FDA had a lot of advance material to look at in, uh, in advance of the actual submission or application for me, UA. And then the FDA threw a lot of resources into reviewing the application once it came in and did it, you know, within, I think a week or 10 days, which was, you know, really when a manufacturer submits a, um, a file, it takes the FDA has almost a year to review it. I mean, everything was accelerated. However, the data that was accumulated through the clinical trials and the review process of the data by the data safety monitoring board that the manufacturers had in place to basically look at the data as the trial was ongoing by the FDA advisory committee that was in place and reviewed the data by the advisory committee on immunization practices and advises the CDC. 

Speaker 3 (10:32):
It also looked at the data. There was lots of levels of looking at the data for safety and efficacy that provided in my, in my opinion, but in lots of folks who opinion or assurance that in fact, that the efficacy of the vaccine, which was amazing for both of them, 95% and the safety profile indicated that the benefit outweighed the risk without a final approval process, which we'll be coming probably within, um, six months. Uh, and the reason for waiting now is that the manufacturers have to submit more safety data, longer term safety data before they can actually file for full approval. 

Speaker 2 (11:11):
So it's your opinion then that these vaccines are both safe and effective and should be distributed as quickly as possible. 

Speaker 3 (11:21):
There's a term safe and effective. So yes, but it's really efficacy, not effectiveness, uh, efficacy relates to clinical trials and effectiveness is really the term we use for post licensure or post EUA when it actually gets out in the population. And yes, the safety profile is, is, is basically like other vaccines. 

Speaker 2 (11:39):
And so when you say like other vaccines, what should people expect in terms of any kind of negative side effect? 

Speaker 4 (11:47):
Well, 

Speaker 3 (11:48):
Typically the most common side effect is a local site. So like a 

Speaker 2 (11:54):
Sore arm, 

Speaker 3 (11:57):
There may be some swelling. There may be a little bit of pain and tenderness. Um, you know, those are the sort of common local effects. There also can be systemic effects like fatigue or, or headache, um, sometimes chills, um, occasionally fever that management that has happened, certainly with both vaccines and with these two vaccines, they pretty much have the same safety profile. Um, a high percentage of innovatives will have some sort of either local injection and or systemic, um, uh, ham adverse effect. Um, but again, these are typically mild to moderate and nature lasts from one to two days and then pretty much resolve on their own without, um, you know, this was some supportive therapy. Now it turns out that younger individuals, because they probably have a more robust immune system tend to have a little bit more significant responses and older individuals. And it turns out for both groups. The second dose seems to actually result in perhaps a little bit more significant, um, of these adverse events in the first dose, probably because of the immune system's already primed in. And so it's reacting differently, but again, um, you know, as I say, these are the kinds of, uh, adverse events that you would expect with other vaccines, you know, like the same exact scene for, uh, to be able to prevent shingles as an exam. 

Speaker 2 (13:18):
So are you recommending to your family and friends that they get the vaccine if they're eligible? 

Speaker 3 (13:25):
Absolutely. Um, there's no question about it. And I think that's a great question because in early on in the development process, there were a number of surveys that are done both by the state and nationally. And there was a lot of, um, hesitancy by even folks like myself, because we really didn't have a good feel for how the review process would occur. There was a lot of unknowns. The FDA did set out some very stringent guidelines for the manufacturers and what they expected, um, in terms of conducting the clinical trials and submitting a file for emergency use authorization or even full licensure. But once we actually saw the data, I think many of the folks who are knowledgeable about vaccine development and the way that this test, the data themselves and the data were made available publicly, I think all of us felt like, wow, this is pretty good. 

Speaker 3 (14:14):
It doesn't seem like they cut any corners. If anything, they provided even more scrutiny around the vaccine. And so there was a change in opinion, from lots of folks about whether they would take it themselves or whether they recommend it to family and friends. I have no hesitation in getting the vaccine. I wish I could have gotten it yesterday. Um, but I'm not eligible at this point. Then I think there are a lot of people who are wanting to vaccine now that they've seen the results of the clinical trials. And now that they're hearing a scientific leader saying, yes, this vaccine is something that everybody should want to get. I mean, Tony Fowchee has been the national spokesperson. Um, and if Tony Fowchee saying that you should get it, then, you know, we're saying, yes, you should get it. There's another, um, individual Paul Offit from children's hospital, Philadelphia, who was a well-known vaccinologist. And I know that I'm talking to my friends and I know Paul personally, and my feeling wasn't Paul says to get it, then, then I, then I'm okay with that. And of course I'm looking at the data myself, but that's how, how much, how much esteem we hold. People like Paul and Tony Fowchee. 

Speaker 2 (15:19):
Yeah. I have to say that I've looked at the data for this vaccine more than I've looked at any other vaccine. And, um, and I've gotten all those other ones. And, um, you know, in full disclosure I have a sister who's a, a resident down in Delaware. Uh, my sister-in-law's an ER doc here in New Jersey and I have an aunt down in Maryland. Who's a nurse and they've all been actively working with and treating COVID patients throughout this pandemic. And all three of them have gotten their first vaccine and I have to, and I have registered with the state registry and we'll get to that in a minute. Um, I'm not eligible yet either, but I do have to say it was quite an emotional response. When I saw the pictures of my friends and family getting their first dose of vaccine. I had a very emotional response of relief that, um, that we were coming to hopefully an, uh, close, um, or the beginning of the end of this experience. 

Speaker 2 (16:15):
And we still have a long way to go. Um, and I'm hoping you can talk a little bit about why healthcare workers like those, um, doctors, nurses, um, environmental services staff, even, um, security workers and such those in the front lines of our healthcare system and public health infrastructure were prioritized as the very first group of people to get the vaccine. And we can talk a little bit more about the phased approach that we're going through, but, um, part of what your work has been is trying to figure out how to distribute the vaccine and in what order. And so could you talk, start with that first phase one a and how we came to that? 

Speaker 3 (16:57):
Well, early on in the vaccine development process, there was a recognition at the national level that, um, if, and when vaccines was available through either emergency use authorization for licensure live, the problem would not be enough vaccine initially, and probably for many months to vaccinate all those folks in the U S in order to achieve community protection. Um, what people often call her herd immunity, but I like to call community protection. And so, um, the, um, there were several organizations that basically issued guidance, um, to basically, uh, to folks and States to, to how to prioritize the vaccine in the, in the face of a scarce supply. It started off with a report from Johns Hopkins university. They put out the initial report on what their sort of ethical underpinning for prioritization. And then there was the national Academy of science sciences report. Um, also providing a framework for prioritization. 

Speaker 3 (17:57):
Um, those frameworks then informed, um, uh, deliberations by the advisor community immunization practices that, um, issued its recommendations. There were several sort of iterations of that, but their final recommendations with December and throughout that process, the New Jersey, uh, COVID-19 professional advisory committee or PAC that I mentioned that I was chairing was also meeting and reviewing these reports and making their own assessments about how best to prioritize, um, individuals in New Jersey when once the vaccines became available. And, um, every single organization I can honestly say, including the pack felt that healthcare workers both paid and unpaid healthcare workers who come into contact with patients who have a risk of acquiring infection, whatever their age, or whatever their professional or non-professional background, that these individuals who were at the highest risk potentially of getting acquiring COVID-19, but also most probably equally importantly, is that we need these people to take care of people who did get COVID-19. 

Speaker 3 (19:04):
So there was a sort of a multiplier effect here in terms of why these individuals have been in are being prioritized the same time. There was a recognition that one of the, one of the sort of criteria for, um, prioritization was preventing morbidity and mortality. And it's clear that the highest more, um, morbidity and mortality in particular has been older individuals. And when you look at the curves, the older you are the higher risk of getting sick and dying. In fact, um, uh, something like, uh, I don't remember the exact percentage, but it's something like 50% or more of the population. It's probably more than that in our state has died, actually nationally have been over the age of 50. I mean, it's a really high percentage. And so recognizing that nursing homes have a higher percentage of older individuals with comorbidities, very vulnerable people where in New Jersey, um, 40%, uh, account for 40% of our deaths in the state cumulatively, that that would be also a priority group of individuals, both staff and residents, and in the third group is other congregate settings. And prior in, in, in, in phase one, a so, um, for example, prisons where we have people in Congress centers, there's been terrible outbreaks of prisons, uh, group homes is another category of, of a congregate setting where we're also focusing our efforts. 

Speaker 2 (20:26):
So is it fair to say that the people in one a where those who are most at risk for getting the disease because of the work that they did or being exposed, um, as well as living in environments where they themselves were at higher risk because of that living environment and the results of the mortality rates that we've seen so far? Yes. And the fact 

Speaker 3 (20:48):
That they have pretty much had no choice about, you know, living in those environments. Um, so, and with the epidemiologic evidence that in fact, we saw a tremendous amount of disease that, um, you know, that was hard to prevent. 

Speaker 2 (21:02):
So let me ask you just one more question. What phase are we in now? And I know that this is a bit of a moving target, but I think that the health commissioner recently began to transition to one B. So can you talk a little bit about who's eligible right now, who should be reaching out to the vaccine sites to get their shots, if they are ready, willing, and able 

Speaker 3 (21:26):
Anybody who's in one, a even as we transition into our other phases are still continuing to be eligible. There's a large group of people in one age who are still a little bit hesitant in getting vaccinated and a significant number of people or percentage. Um, and so we don't, you know, they don't always necessarily their place in line. Um, it's not like, um, you know, they're now going to have to go to the back of the line. Uh, one B as you mentioned, um, we've shifted begin to shift into that category. And that includes, uh, sworn law enforcement, uh, firefighters. Um, EMS is actually one a, but they're also continuing to be, uh, vaccinated along with the, these new people in one B there are other categories of one B, and there's a one C category, and there's a phase two phase one, a one B one C phase two phase two is really when we have enough vaccine to meet demand. 

Speaker 3 (22:18):
And that's when it's open to everybody we're months away from that, uh, phase one B um, we, we lay out at least from a draft perspective, the various phases in our leisure vaccination plan that's available on site. Um, that last plan was last updated in December and is currently actually being updated as we speak. So some of the, some of the sort of, um, groups that are contained in the categories, one, B and C that are on the cider are going to change a little bit. Um, but right now, for example, what hasn't changed is fire police. Um, and, um, teachers will be in that category as well. Um, there's other, well, you can go on like I, 

Speaker 2 (22:59):
To date, to stay up to date on who is eligible and whether or not you are, you can go to the state website or the information hub and see what phase we're in. And then there's also a link to a registration system. And I, I shared that I've already registered. I'm not eligible. They let me know, but they are sending me, um, notes, letting me know they have my information and will let me know when I'm eligible. And, and I think it that's something that you could do today, if you were interested in getting the vaccine. Um, 

Speaker 3 (23:32):
In fact, as of this morning, there were a million, 100,000 people who've registered already. And the website for that is, um, COVID-19 dot.gov/vaccine. Um, and if you take off the vaccine and that's the information, how, if you want more information about COVID-19 and what the state is doing, you mentioned, 

Speaker 2 (23:56):
And that, um, just because you're in one a and you haven't gotten vaccinated yet, and we're moving into the next phase of potentially going to parts of one B so more and more people will become eligible for the vaccine. Those, those people in one day are still eligible. There's a little more competition to get the vaccine now, because more people have become eligible, but they can still go and register. 

Speaker 3 (24:21):
Correct. Okay. 

Speaker 2 (24:23):
And you, and I wanted to just check also, I thought I had read that those 75 and older were also included in the current eligibility criteria for who's eligible now, but did I miss 

Speaker 3 (24:35):
There? We haven't really opened it up to that group right now, 20 people in one B are sworn law enforcement and firefighters. They'll be some to be determined, transition, or opening it up to other categories in one B, but we're not quite there yet. Okay, 

Speaker 2 (24:54):
Great. Thank you for that clarification. 

Speaker 3 (24:56):
The problem we have is that, you know, there's demand and supply, and then there's the availability to provide the vaccine. So the various points of dispensing, and right now we have over 300 points of dispensing that are basically certified to prove vaccinate individuals. Um, but we have a limited amount of vaccine that we can distribute around the state. And so that, that is a, you know, a hesitation on our part to sort of open it up before we can meet the demand. You know, clearly there's a lot of demand. It's just the fact that overlay and people have already registered, uh, online, uh, tells you that there's people who wants it. But if we're talking about adult population, we're talking about, um, we're thinking there's like four more than four and a half million people who we want to vaccinate in order to achieve our aspirational goal of 70% vaccinated by, you know, our groomer July. So we've got a long way to go and we need a lot more vaccine than is currently available. And we need actually more vaccine from other manufacturers. And two manufacturers, uh, together are not going to be enough to give us, there's not going to be enough doses. That's going to be allocated to New Jersey, just relying on local manufacturers to achieve our aspiration goal 

Speaker 2 (26:13):
Are other vaccines in the queue. I know that Rutgers participated in some of the clinical trials, for example, with J and J and they're, they're in the process of going through the FDA review, um, as well as AstraZeneca, um, is in process as well. And they've actually started distributing that vaccine in the United Kingdom. For example, when you look at globally, there's a lot of different vaccines going through different processes, but it looks like, at least from my perspective, the American process is fairly, um, rigorous and looking at a lot of the traditional elements of, of safety, um, that we hold. So dear, 

Speaker 3 (26:53):
Yeah, the, the, the Yonson Jane and Jane product, you know, we're, you know, we're thinking that we may see some data by the end of this month or sometime next month. And then they have to submit their EOA to the FDA. The AstraZeneca product product for a number of reasons is probably being many more months off, um, in the U S the, the J and J product is a single dose product. And so, um, that's going to have some benefit. These other two vaccines, we have are two dose products separated by, you know, 21 or 28 days. And of course, that's makes it a little bit more complicated because people have to come back to your question early on about, you know, you asked me about, um, sort of the, uh, what was perceived as being a slowness to the rollout on the vaccination program. 

Speaker 3 (27:40):
And I started off by talking about how quickly the vaccine had been developed without cutting any corners. And I thought that was amazing progress. I mean, think about it, we're less than a year. And we have these two vaccines. What if I had told you they didn't work? We would've been sitting here with no vaccine whatsoever. So we were in a great place when you consider what the normal development process by vaccine, but, you know, the slow start that everybody perceives this happened is not mainly surprising, given the complexity and scale of the vaccination campaign. And there's so many factors that have led to what is perceived to be a slow start, but I think it's, it's what I expected. First of all, the vaccine came out around the holiday time. Second, these are vaccines that have significant storage issue. Third, we have people vaccinating in mega clinics, initially, hospitals that had not done that not been done before fourth. 

Speaker 3 (28:37):
We had a, um, a pharmacy partnership program where CVS and Walgreens for the first time was launching a campaign to, you know, to basically vaccinated vaccinate people in long-term care facilities. Um, and there was the uncertainty of how much doses we were going to get. What we thought we were going to get was less than we, we got less than with what we thought we were going to get. So it's hard to plan that way. And then there's a staffing issue in many places, as well as particularly around the holiday. So there was a lot of, a lot of factors that have gone into sort of this slow start, but in many ways, it's not unexpected. Some of these early glitches are smoothing out and as time goes on, and these various points of dispensing get started up and get used to it, um, basically providing it as we expand our phases, we will have many more people getting vaccinated, um, and leading to eventual community protection. 

Speaker 2 (29:32):
No, I know we're running short on time. So there are two questions that I really want to see if you can answer. One of the things that I really wanted to ask you was, is there anyone who should not be getting the vaccine right now? We've read a little bit about people with allergic reactions to the vaccine, but could you highlight that just a little bit? Cause there are a lot of people out there that ha carry an EpiPen. 

Speaker 3 (29:53):
Yeah. So that's a great question. There have been some reports of allergic reactions and some, some cases out of alactic reactions to, um, to the Pfizer vaccine in particular. Um, the maternal vaccine may have had some as well. I mean the, the guy, the CDC has put out some very good guidance around this based on, uh, a CIP recommendations. And the bottom line is the person who shouldn't get the vaccine is somebody who has a known Anna Anna Filactic reaction to one of the components of the vaccine. And don't ask me what the components are because they're technical chemical names, or if they've gotten the first dose and had an anaphylactic reaction after the first dose, they should not get the second dose. Um, but just having a history of allergic reactions, or even having a history of Anna collective reaction to some other drug or some other and food, for example, is not a reason not to get it. But if you had that history, then the typical post vaccination observation period, or 50 minutes should be doubled to 30 minutes. And so that's really the advice, um, that the CDC has put out, uh, in terms of that accident and those individuals who may have had previous allergic or, and in fact, Anna Filactic reactions to other products. 

Speaker 2 (31:08):
And I think that the vaccines are recommended for different age groups. One starts at 16 years old and the other 18. Now this doesn't necessarily impact us right now with the small supply, but it will when we get to larger vaccine, um, uh, populations. But is there anybody else other than the age that should think twice about getting the vaccine? 

Speaker 3 (31:30):
Well, it's the studies that were done excluded women who were pregnant, for example, um, and, um, individuals who were immune compromised because of underlying disease or because of therapy they were receiving or both. And so the EOA doesn't include those individuals okay. Specifically, but that doesn't exclude them as well. And clearly people who have, we know that pregnant women will have a higher risk of actually getting COVID-19 potentially and mean there are complication. And certainly that's true for individuals who are immune compromised for what, for whatever reason, and because it's not excluded in the EUA. Um, the CDC has provided considerations about vaccinating, those individuals. And the bottom line is, is that, um, the advice is to have a conversation with their healthcare provider about the risks and benefits of their being vaccinated, um, with either one of these COVID 19 products. And so that's the advice I would give. They're not excluded, but I think something that they, if you, your question was about thinking twice, I think thinking with their significant other and thinking with their, um, um, with their healthcare provider would be the way I w I would consider thinking twice, I'm not recommending or not recommending, I'm saying talk to your healthcare provider. 

Speaker 2 (32:57):
So, so would it be fair to say that anyone who has concerns about their own individual health or whether or not, you know, being pregnant is something to be concerned about that they should talk to their doctor about what's best for them in terms of getting this vaccine? 

Speaker 3 (33:13):
That's correct. And then of course we have women who are of childbearing age, and there has been some, you know, talk, um, you know, concerns from women who are thinking of getting pregnant, um, about, um, these vaccines causing infertility because of the technology used to manufacture vaccines. And there was no evidence that in fact, they need to be concerned about that. 

Speaker 2 (33:34):
So there are a lot of myths and rumors out there. So it's really important that people check valid sources of information, go check the department of health website. For example, I know you have a lot of resources in many different languages. People really need to educate themselves and talk to their family and talk to their healthcare providers about what the benefits are of the vaccine and any risks they have concerns about. 

Speaker 3 (33:58):
Absolutely. And I think the department of health website and the CDC website are really good, great sources of information. I mean, there's a lot of information Maryland. The challenge is to find it. 

Speaker 2 (34:09):
So, one last question after you get the vaccine, is everything fine? 

Speaker 3 (34:12):
Well, the good news is that both at least for these two vaccines, they both have approximately 95% efficacy, which is fantastic of the efficacy. And that efficacy continues. Um, even when you do subgroup analysis, like based on race, ethnicity, or, or older ages, or the Medan, or vaccine has a little bit lower in an older population, but it's still, it's still pretty close to what the Pfizer vaccine is an older population. So, but it's not a hundred 

Speaker 2 (34:39):
And effectiveness. And you're talking about effectiveness, efficacy, 

Speaker 3 (34:44):
Efficacy, uh, effective. So just to elaborate on that, when now in the U S there've been, you know, I don't know how many, but several million people have already been vaccinated. If you now assess how much diseases prevented in that population over time, you will get a number that measures effectiveness, not efficacy, because it's not a clinical trial efficacy refers to the measurement in the clinical trial. Um, no it's, but it's not night if it's not a hundred percent efficacious, right. It's not on a hundred percent number one. So you, you're not a hundred percent sure that you're productive. You get it, even though we know it works well in all populations. So you still have to continue to practice these non-pharmaceutical interventions like mass squaring with keeping, um, you know, keeping out of crowds, physical distancing from people, what is called often social distancing, 16 or more, um, washing your hands, you know, good gut hygiene. It also will prevent other respiratory infections. You know, we're in the middle of flu season, we've hardly seen any flu, to be honest with you. I mean, very, very little flu because all of these measures that prevent the transmission of COVID-19 are preventing transmission of all these other respiratory patents 

Speaker 2 (35:59):
There or not. We should do this. Every flu season is a topic for another show. But I think, um, I think what's really important is that we remind people that even after getting vaccinated, they have to continue some of these public health measures. As you talked about the masking, um, you know, trying to stay outdoors more than indoors, uh, being physically distant six feet or more. And there's lots of different strategies for different types of situations that the CDC has been putting out over the course of the last year, about how to keep yourself and your family safe, uh, in particular, those people who are most vulnerable and haven't had a chance to get the vaccine yet, um, because it's not, nothing's a hundred percent and not even this vaccine. And so while there is a sense of relief that we've initiated this campaign, there are still a long way to go, and we need to continue to work together with all of these strategies to make sure that we protect one another and stay healthy until we can get this more under. 

Speaker 3 (36:58):
And that's going to be for quite some time. 

Speaker 2 (37:05):
Is there anything else that you think it's really important for people to be considering or thinking about during this time? 

Speaker 3 (37:14):
Well, I, I think I I'm, like, I think the thing when it comes back to, I guess the one area we haven't really talked much about is, uh, I mentioned that there was this issue of a large percentage of people, even in the health among healthcare workers in phase one a are hesitant to get back vaccinated. I'm not talking about the people say, there's no way I'm going to get as many people ranking vaccine or completely afraid of a vaccine. It may be hard to convince them to get vaccinated, but I think that's, what's important is, um, addressing the concerns are people who are hesitant and that's a large fragment on the population. It's not just in healthcare workers, it's, it's, it's other segments of the population as well, and everybody's concerns are different. And so the messaging to those folks is going to have to be tailored to what their concerns are. 

Speaker 3 (38:08):
Um, and they have to be tailored and delivered by the appropriate individuals as well. And, um, you know, changes a process. It's not, not a single event. And so if somebody sends it in one day and you have a conversation or they hear a talk by someone, and they're not quite convinced, it doesn't mean that they won't change their minds the next day or the following week. Um, I think as more and more people are vaccinated and more and more people that they know who have been vaccinated in particular, they know people who've suffered or die from COVID-19. Those people who are on the fence are more likely to eventually jump over the fence and get vaccinated. And so we have to be patient with those individuals as healthcare providers, and we have to acknowledge their concerns. We can't demean their concerns. Um, and we have to provide them information so that they can basically reform their opinions about getting vaccinated. 

Speaker 3 (39:06):
And, um, that's, you know, it's going to be, it's easy to vaccinate those who, you know, who want to get vaccine initially, it's like picking those, you know, the low-hanging fruit, those people are easy. They, their, their response is when can I get it? Um, and then as you get higher on the tree, you know, it gets harder to pick the fruit and, but you still got to work at it. Some, sometimes you need the fruit at the top of the tree because you can't get through it. Those people never want to get vaccinated. Um, so kinda that's my, my way of thinking about how to approach it, just patience and constant education and messaging by lots of different people. 

Speaker 2 (39:43):
And, and it to be fair. I mean, a lot of people were hesitant. You even said yourself when, before the data came out. And, um, and so I think it's a sign of intelligence to question, right? And I think the good news is, is that there's been a really rigorous, thoughtful process. And now, um, there's continuing monitoring of the safety. And so I heard a lot of people to your point say, I'm going to wait until the first a million people get the dose. Um, and now I think we're past 7 million or at least around there. And so I, more and more, data's coming out more information even about the, um, allergic response. And, and so I think when I read that most recent data, I said, Oh, it's not nearly as bad as the media made it. Look when it, when they first reported on someone having an allergic reaction to the dose. So I think, you know, information and data is really, really, really, very powerful. And so thank you for putting it out there and continuing to read it and send it out to all of us. 

Speaker 3 (40:45):
Uh, we have a medical director in the communicable disease service of Dr. Ed Lipschitz and he had last week, I didn't know that there was a quarter of the day by some journal, some are newspaper, and I don't, I'm paraphrasing what he said, but he said, you know, we've had millions of people. Who've had COVID-19 in this country. It's something like 22 over 22 million people today. And 365,000 deaths. Um, and many, many people who've had significant more morbidity. And, um, no one has died from COVID-19 vaccination is so he said, I'll take my chances with the vaccine. 

Speaker 2 (41:30):
Well, and I think that's a really important point. Yeah. So one thing to fear some unknown of the vaccine, but if you get COVID now and you're in a high risk group, you're going to be pretty sick and you have a good likelihood potentially. Well, thank you very much, Eddie. I appreciate your time. Um, again, everyone, this is Dr. Eddie Breznitz. Who's been working with the state health department in their, um, COVID-19, uh, response and recovery efforts most recently around the vaccine campaign and prioritization efforts. Um, thank you again, Eddie, and to all of the state health department, staff and leadership, it's been a very long road, um, and we appreciate your continued efforts and that thanks goes out to our healthcare, um, and essential worker population as well. Cause they're out there every day taking on risks that not everyone has to. So we very much appreciate it. Um, and that concludes our conversation today. Um, again, if you want more information, there are plenty of websites available. The state health department has information about the current vaccine eligibility and a state registration system that you can go on to learn more about the information available on the vaccines, as well as to, um, submit your own personal information, if you would like to be notified when you are eligible to receive it. Um, thank you very much and have a good day. Thank you. 

Speaker 1 (43:00):
Thank you for listening to on the pandemic. We'll be back in two weeks with the latest information on the COVID-19 pandemic to learn more about how Rutgers is making a difference during the COVID-19 crisis, visit rutgers.edu/united.