Since Dec. 15, 2020—when the University of Miami administered the first COVID-19 vaccine—the University has been vaccinating front-line employees who work in an area with patients who have tested positive for the coronavirus.
Following state orders, the process was expanded to add University of Miami Health System patients and members of the University community who are 65 and older, given their vulnerability to the virus. A committee of University leaders, health care professionals, and ethicists have devised the University’s phased vaccination plan which will expand during the coming months, based on vaccine supply and state and federal guidelines, to include University faculty, staff, and students. While the vaccine is voluntary, the goal remains to eventually give everyone access to it.
The following are some of the questions asked by our Coral Gables and Marine Campus faculty, staff, students, and parents during the University’s town hall, which was held Monday, Jan. 25. The panel discussion included President Julio Frenk; Dr. Roy Weiss, chief medical officer for COVID-19; and Dr. Susanne Doblecki-Lewis, medical lead of the vaccine task force and infectious disease physician.
How has the University distributed the vaccine and what is the timeline moving forward?
Dr. Weiss: The University of Miami has been distributing vaccines to those caring for or working in areas with COVID-19 patients and to UHealth patients age 65 or older, following state guidelines.
The vaccines that we have received, like all hospitals and health systems in Florida, have been distributed from the state. Because there is a limited supply, we have followed medical and ethical principles from the National Academy of Medicine and the Centers for Disease Control’s Advisory Committee on Immunization to determine who would be vaccinated first.
The first principle in triaging any limited medical supply is to maximize the benefit and minimize the harm for the most number of lives. The second is to promote justice and advance equal opportunity for maximum health. The third is to mitigate health inequities to reduce existing health care disparities.
Following the state guidelines to vaccinate those 65 and older, we applied a phased approach to our UHealth patients, identifying those with two or more comorbidities defined by the CDC.
Due to the vaccine supply, we had to develop a lottery system to randomize these individuals in this priority group and then send out invitations using their MyUHealthChart account. We have also called patients who do not have electronic health records to schedule their appointments.
We also were mandated by the state to provide vaccinations to community health care providers, including dentists and doctors who didn't get the vaccines delivered to their offices and were not associated with the University.
What phase am I in and what is the timeline for each phase?
Dr. Weiss: We’re currently in the University phases 3 and 4, which correspond to the National CDC Phases 1-1c. But unfortunately, because of the vaccine supply, we are not able to schedule any first-dose appointments at this time. We do however have sufficient vaccines reserved for everyone who received the first dose to get the booster. There is not a set timeline for each phase because we are dependent on the state for the vaccine supply and do not know when we will receive another shipment. As soon as we receive more vaccine supply, we will begin scheduling vaccine appointments for more members of our University community.
Note: If you are an employee and think that the phase listed for you in Workday should be changed, please contact your supervisor. Students will be provided an opportunity to opt-in to the vaccine soon.
If I receive my first dose outside of Miami can I receive my second dose out-of-state or vice-versa?
Dr. Weiss: Right now, you have to get not only the same vaccine brand for both doses, but you also have to get the second dose in the same place where you got the first dose. Although the vaccines are very similar, they're not identical in terms of the epitope—the particular part of the viral protein that the antibodies are being made against that is recognized by the immune system. So ideally, you would want to be able to get your booster—or second dose—to boost the immunity of the first dose. There has been some evidence to suggest that maybe the CDC would allow individuals to mix vaccines, but that is not what we recommend at this time.
Furthermore, based on the way the vaccines are distributed, they're distributed to a particular vaccination center with the understanding that the individual will receive a second dose there. So, if you were to get one dose in one city and then travel to another city, there's no guarantee that the other city will have the second dose available for you because it was already assigned to you in your other city.
Can someone who has received the vaccine transmit COVID-19 to someone who has not received it? That is, if the person vaccinated develops immunity, can they become asymptomatic spreaders if they later get exposed to COVID-19 but have no symptoms?
Dr. Weiss: That is to be determined. If you get infected before completion of the vaccinations or soon thereafter the virus may be detectable in a nasal swab PCR COVID-19 test, but it doesn't necessarily mean that the virus is infectious to someone else.
As of now, we're keeping our standard operating procedures intact until we learn more about the protection that the vaccines offer us. The next frontier of testing is indeed being able to measure accurately the neutralizing antibodies. We don't really have broad testing available for that. So, for now, we need to be cautious, and we need to be very concerned about spreading the virus to people who are not yet totally vaccinated. We’ll continue watching as we see what happens with the new strains of virus that are in our community.
Will the University offer vaccines to family members who are not UHealth patients?
Dr. Weiss: We would hope that, when we have sufficient quantities, we would be able to help the community and be able to provide vaccines as they become available.
The vaccine was developed so quickly. Is it safe?
Dr. Frenk: Yes, the development of the vaccine was achieved in record time thanks to present cooperation among scientists, but behind the technological development there are decades of solid, basic scientific research that then led to the possibility of assembling the vaccine. That research took years, and it's been confirmed. It has a very solid basis in biological science, so the vaccines are very solid.
So, even though we're not making it mandatory because the FDA granted Emergency Use Authorization, I think it's very important to leave out any fears about using science and not listen to uninformed voices that sometimes spread confusion.
Should individuals with allergies take the vaccine?
Dr. Doblecki-Lewis: While there have been reported cases of anaphylaxis with both vaccines, these reactions are still quite rare and completely treatable. All of our vaccine administration sites are prepared to monitor any symptoms and have the appropriate treatment available. Most importantly, these reactions have nothing to do with some of the other things that are commonly associated with allergic reactions, such as egg or latex allergies. There are no latex components in the vaccine or the bottles used to administer it, and it is safe for people who have food or environmental allergies.
Most people with allergies do not need to avoid either the Pfizer or Moderna vaccines. For those who suffer from very severe allergies, particularly to other vaccines or injectables, it is recommended that they discuss their specific situation with their allergist or their physician. People who have any history of anaphylaxis will be monitored for a longer period of time after receiving the vaccine (30 minutes instead of 15 minutes).
Is there a difference between the various vaccine brands?
Dr. Doblecki-Lewis: Both the Moderna and Pfizer vaccines are very similar. In fact, there are really not many, if any, reasons to distinguish one from the other. I would highly recommend getting the vaccine that's available to you when it's offered.
If I opt-out will my University experience be different; will I be banned from attending certain events?
President Frenk: No, students will not be limited based on vaccine status, but regular testing will still be required. Getting the vaccine is a personal choice and that's to be respected. I do anticipate that as more vaccines become available, not just at the University but in general, people being vaccinated will be allowed to do more things like getting more easily on a plane or attending a concert. That's likely to happen much later, but at the University, we wouldn't be dealing with that because we're not planning to have any massive events right now or for some time.
Even after being vaccinated, everyone is asked to continue wearing face coverings, and keep appropriate physical distance. It will take most of the semester to reach critical mass of vaccinations. If you test positive, you will be required to isolate, and those in close contact with someone who tests positive will still have to quarantine. None of that changes because of the vaccine. We are nowhere near ready to relax those protocols, but long term that will begin happening.
For more information, including frequently asked questions visit coronavirus.miami.edu.
