Dr. Sara Oliver, Lead for the COVID-19 Vaccines ACIP Work Group, joined the LeadingAge Coronavirus Update Call on March 24, 2021. She responded to questions from Ruth Katz and from callers.

Q:​We know that an increasing number of vaccine options are becoming available. What are the implications?

A:​Hopefully, it means more people will soon have access to the vaccine. There should be shorter waits, a broader vaccinated population, and perhaps even the ease of access at a local pharmacy. More supply and more different vaccines means more shots in arms.

Q:​Many of our member settings for older adults were among the first groups to be vaccinated. Questions are coming up about the Janssen/J & J vaccine. While the single dose seems convenient, it this vaccine as effectiveas others?

A:​There has been some concern about data across age groups and this has to do with how people were enrolledfor the trials. J & J started first enrolling younger healthier people, then younger people with medical conditions, then older adults without medical conditions, and then older adults with medical conditions. Enrolling the third group took longer than anticipated as it was harder to find older adults with no medical conditions.  So, the data rolled in at different times. That does not mean that the vaccine works differently in older adults, but only that there was less follow up time to look at the data for that group.  When we looked at the data over time, the differences between age groups leveled out. And, of course, we will continue to get more data going forward.

Q:​ How were older adults defined?

A:​Older adults were people aged 60 and over. 

Q: ​As supplies of J & J increase, if you were an aging services home and community based provider and you had the chance to offer a clinic with the J & J vaccine, would you say yes?

A:​We always say that the best vaccine is the vaccine you can get. All of these vaccines have good efficacy against COVID serious enough to require hospitalization or death. When there are adequate supplies of many different vaccines, one might consider whether one dose v. two doses, freezer capabilities, or other variables would influence preferability in one setting versus another. However, the immediate goal is to get as many people immunized as quickly as possible. I would be happy for my family members to receive the J & J vaccine.

Q:​We have been hearing a great deal about the AstraZeneca vaccine in the news. Please help us to understand what we are hearing. 

A:​Globally, vaccines are being rolled out across millions of people in many countries. As this happens, you are going to see events in vaccinated people which sometimes would have occurred in those individuals regardless of vaccine status. We look at background rates – what would we expect to see in a population normally. Then we ask whether this phenomenon is happening in the vaccinated group more than we would normally expect. That’s what researchers in Europe are looking at now with regard to blood clots. In the U.S., we are also monitoring many types of data. In trials we compile and look at the data at regular intervals. The last look at AstraZeneca was in February, but we will soon look at updated data when it is submitted to the FDA and ACIP. We will conduct independent reviewsof efficacy and safety data. Both groups then will have public meetings and will make recommendations. 

Q:​Do you have a sense of when this process will occur for the AstraZeneca vaccine?

A:​I do not know precisely when, but it is likely weeks rather than days away.

Q:​Are there other vaccines in the pipeline?

A:​Novavax is also conducting Phase 3 trials of its vaccine. That is a two dose, protein subunit vaccine which is more like our traditional vaccines.

Q:​Is there any information about how long vaccines willprotect against COVID and/or whether we will need annual shots or boosters?

A:​We have only had experience with these vaccines for a short time. We will continue to gather information going forward to answer these questions. We hope that the antibodies will continue to work, but the key question is whether the virus will change in ways that require modified vaccines or additional vaccinations. 

Q:​Do we know yet whether vaccinated people can transmit the virus?

A:​We are getting regular updates on that as information becomes available. We do have some data from Modernaand from J & J and so far, it seems like the transmission risk is reduced but we will need more information to be certain.

Q:​ Some of our members have not mandated vaccinations because the vaccines only have Emergency Use Authorization. When might some of these vaccines be fully approved?

A:​The FDA has said that before they would consider full approval, they need six months of data. For Pfizer and Moderna we are approaching that, but the full authorization application requires many additional pieces of information. We are likely to see the requests for full approval by summer or fall.