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The First Vaccines for Covid-19 Arrive in Northern MN

This week, our country passed the sad milestone of more than 300,000 people having died from COVID-19. But also last weekend, the first shipments of the Pfizer BioNTech vaccine rolled out of its warehouse in Michigan. We heard reports that vaccine had arrived at Sanford Health in Bemidji very quickly after that, on Monday.

Vaccines for COVID 19 give us hope. Dr. Colleen Swank from Sanford Bemidji Medical Center joined Dan Houg and Maggie Montgomery on Northern Community Radio's Wednesday Morning Show to talk about the vaccine and what to expect. Dr. Swank is a pediatrician and Sanford Health Vice-President of Clinics. You can find the audio of this interview below.

Maggie Montgomery:

Welcome, Dr. Swank. This is great news. The pandemic has been so stressful. How did you feel when you heard the first vaccines had finally arrived?

Dr. Swank:

I got to watch them arrive and it was really exciting. It is the light at the end of the tunnel. We still have to remember that we still have to travel the tunnel to get into the light, but we definitely can see the light from where we're at now.

Maggie Montgomery:

How did the vaccines travel - what were they packed in? what did it look like?

Dr. Swank:

It was pretty cool. So the vaccine, we got 975 doses on Monday, and it was packed in a box that was the size of a small cooler. And then inside is dry ice and also a GPS tracking device and also a temperature tracking device. And once you removed everything, the vials were in a box that was the size of a personal pan pizza box. So very small. So it was sort of like, oh, you know, you've kind of expected something grand and great. And it was very small. Then we put it into our freezer, which holds things at negative 60 to negative 80 degrees Celsius.

Maggie Montgomery:

That must be a special kind of a freezer that you have.

Dr. Swank:

Yeah. And that is one of the reasons that Sanford Health in Bemidji is getting the vaccine for not only for Bemidji, but for 11 other communities as well, because that freezer, you can't just pick up anywhere. We were lucky to have one and to be able to hold that vaccine for the other towns,

Dan Houg:

Is there an anticipated schedule of how many vaccines will come in per week or month? Any news on that?

Dr. Swank:

So the federal government decides what the allotment is…the CDC and the federal government decide what the allotment is to each state. And then each state decides basically where that vaccine goes. So we know about it ahead of time, but not far in advance,

Maggie Montgomery:

I'm sure you've had a lot of planning going into this moment. What has that planning been like?

Dr. Swank:

You know, the planning had started way back the summertime; July and August. One of the first parts of the plan was getting the freezer. So you can imagine that that took a little bit of time. And I think our freezer came in September. But also the planning of this first Pfizer vaccine; the temperature controls that we needed; what we need to do with it. And then once we're ready to give the vaccine, teaching everyone how to thaw it and then dilute it the appropriate way. And then it does get injected very similar to other vaccines that you've received.

Maggie Montgomery:

I saw that Indian Health Services in Cass Lake started vaccinating people on Monday. When do you think the first vaccinations through Sanford Health will begin?

Dr. Swank:

The Minnesota Department of Health is controlling when the vaccine can be given. And so we were, at the beginning of the week, told that that will be on Monday. It could be as early as tomorrow. And so we take our lead from the Minnesota Department of Health. You're right, the VA and Indian Health Services were allowed to give them right when they got them because they are under the federal system. But in Minnesota, they are putting a little pause to make sure that everybody's got all the education that they need in order to give the vaccine.

Maggie Montgomery:

So you're practicing and getting it all right. And then as soon as the health department gives the go ahead, you're going, it sounds like.

Dr. Swank:

We are ready to go. Actually, as soon as we're given the, go ahead, we have everything in place that we need to be able to get there.

Maggie Montgomery:

So can I ask you my really dumb question? That vaccine is at minus 70. You're going to warm it up before you give it to anyone, right?

Dr. Swank:

Yup. That's how it gets stored and preserved. But once it's time to give the vaccine, it's warmed up to room temperature, it's diluted. And then it's given in your arm. So it'll be the normal 72 degrees or whatever room temperature is when you get it.

Maggie Montgomery:

So it won't be a cold vaccine when you get it.

Dr. Swank:

Well, it's still feel cold, right? Because your body temperature is higher than room temperature, but it won't be a freezing for sure. Yeah.

Dan Houg:

In three weeks, the people that have been vaccinated have to return for their second immunization. Is that a system that people will just have to remember; is there a tickler system to let people know? How does that work?

Dr. Swank:

So really this is not different than a lot of the vaccines that we give, where there needs to be a set amount of time before a second one is given. So you can't get it earlier, but it won't harm you or decrease the efficacy if you go longer. But yes, once we start vaccinating the general public, we'll give them reminders and set up return appointments, right. At the time that they get the injection.

Dan Houg:

That's actually news to me and good to know that that three-week window isn't exact, you don't have to return on day 21 exactly.

Dr. Swank:

I mean, yeah, you can't go before, but later will be fine. We'll encourage people to get them. Really, in order to get that 95% efficacy, it's after getting that second vaccine. So you won't be fully protected until after the second vaccine. So it makes sense that we would want to get them as close together as we're allowed to. But again, it won't harm you if it ends up being later,

Maggie Montgomery:

We know that not enough vaccine for everyone is ready yet, and not even really enough for all the healthcare workers even. How's the vaccine being rolled out?

Dr. Swank:

So within Sanford Health here in Bemidji we have a list of healthcare providers and we're giving the opportunity to get the vaccine to the healthcare providers that are in the hospital, working with sick patients or specifically COVID patients every day. So certainly those nurses and staff and physicians that are in the COVID unit or in the ER, they will have the first opportunity. And then it will go to the physicians and staff working in the clinics, and so on. Also long-term care residents and those people working with long-term care residents are in that 1-A group.

Maggie Montgomery:

Some people are wondering how fast they can get the vaccine and others are wondering if they want to take it at all. For most of us, it's going to be a little while before we have to make that decision. But meanwhile, there's a lot of misinformation out there. Is this vaccine mandatory?

Dr. Swank:

It is not mandatory. You know, I'm a pediatrician. I think vaccines are wonderful. I think if that's not the number one best medical invention, then it's gotta be in the top five. So I will always be pro-vaccine. But I don't think it should be mandated for every person. My hope would be that people would educate themselves and be informed about it. And once they get that information that they would choose to be vaccinated.

And I think getting that information is, is really important. But I think there's a lot of misinformation out there. And so I think it's really important to look at the sources where you're getting your information. And so I get asked a lot, like where should I get information? And so I tell people the CDC and the WHO websites are great, but then people say, well, that's a government website. I don't know if that's where I want to get my information.

All right. Well, go to Sanford Health dot org and we've got information about the vaccines on our webpage. But then people will say, well, I don't know…if I want more information, where do I go for that?

Well, then you can look at other medical health systems - Johns Hopkins, Harvard Medical, Stanford, Cleveland Clinic, Mayo Clinic - all of them will have, on their web pages, information about this vaccine. And then sometimes I get, well, you know, medical systems, of course they're going to be pro-vaccine. So what are other resources, if I want something else?

Well, then you can look at the scientific journals. So the Journal of the American Medical Association the Lancet, or the New England Journal of Medicine; their websites will have that. Another one that's an easy read is science mag dot com. And so they'll have information about the vaccine. And so there's lots of reputable sources that you can get information from.

But I think it's important to remember in the weeks and months coming up, there will be a slick campaign for those who are against vaccines, and it will look very reputable. But it will be filled with junk science and half-truths. And so again, it's just really important to make sure you know where you're getting your information from.

Maggie Montgomery:

Yeah, I would say that's really important. And we do live in a time where misinformation and disinformation are really out there. And when people are on the internet and other places…it's really hard to tell a reputable thing from a non-reputable thing on the internet. I've seen people say that the government is going to use the vaccines to “chip” us, or that the vaccine is going to alter our DNA. I hear this is a messenger RNA…is this safe?

Dr. Swank:

So let me go to the chipping one first. So yeah, I've heard that one too. First of all, I don't believe that we have the technology to do that. Second, I can't imagine that there'd be enough people to get together and decide that we're going to do this. When you think of like a mask mandate, we can’t all agree to that. So I just kind of imagine that the people that are deciding how and when and where to use this vaccine, will all agree that everybody in the world is going to be chipped. It just doesn't make sense.

Maggie Montgomery:

Well, we're all carrying around cell phones now that make it easy to locate us and find out what we're doing already.

Dr. Swank:

That's easier and cheaper, honestly, right?

So yeah, as far as the vaccine altering the DNA, I've heard that one a lot too. I guess the best way to explain it is to think of…back in your science class, the way that a cell looks. So a cell, if you remember, has a membrane around it, and then it has cytoplasm - that jelly stuff - and then the nucleus, and the nucleus holds your DNA.

The way that this mRNA vaccine works is that the mRNA, it's a code for the protein on the COVID virus. You know, that spiky part of the virus when you see the picture - it codes for that spiky part. And so the vaccine is injected, that mRNA goes through the cell membrane into the cytoplasm, and then it uses the machinery in your cytoplasm to make the protein, the spiky parts. And then it releases the spiky part out of the cell. And the body thinks that it's kind of like the whole virus, even though it's just the spiky part and attacks it. The mRNA vaccine never goes into the nucleus or does anything with the nucleus or the DNA inside the nucleus.

Maggie Montgomery:

That is good to know. And the other question that kinda comes to mind when people are thinking about misinformation is that this vaccine was developed so fast that it can't possibly be safe.

Dr. Swank:

Yeah. And I think when you think about a vaccine or medication being developed, the company that's developing it first wants to know that it's going to be something that is utilized. And so here is a situation where the need for the vaccine is huge. The whole world will utilize the vaccine. So that box is checked.

Next, because of everyone wanting a vaccine, and because of being in the middle of the pandemic, we really needed to put all of the resources in on this vaccine. So you can think of all the money and all the people really working on it, 24/7, versus, you know, another vaccine where there isn't this need for it right away. It's going to be slower because there's fewer people working on it. There's fewer resources. I think that's the biggest reason that it's gone so quickly.

Also, the thing to remember is the mRNA vaccine, even though it's the first vaccine like this, it has been studied for a long time and worked on for many years. And so it wasn't like this is brand new.

The other thing is, when you think of the way that our traditional vaccines have worked, it's usually either taking the virus that’s killed or taking the virus and attenuating it or removing the part that infects us, or taking a part of the protein of a virus or a bacteria and injecting it into us. And that can take a really long time to have to grow and manufacture all of the pieces to that vaccine. With this vaccine, the mRNA vaccine, remember that they just had to figure out the coding of it. And our bodies are the one that manufactures that protein, that our body works against to develop our immunity. And so those are some of the reasons why this vaccine was able to go faster than a typical vaccine.

Dan Houg:

I was going to ask you if the vaccine imparts greater immunity than actually having COVID itself

Dr. Swank:

And that'll remain to be seen, but they think that it does. It's a little bit complicated. The vaccine works on two different pathways of our immunity. So they think that that will elicit a longer, greater response. Compared to when you get the virus, I think only one pathway is released or is triggered. And that's why they think that people with asymptomatic cases or a mild case may have their immunity wane after a period of time.

Maggie Montgomery:

So we're all going to have to make our own personal decisions about whether or not this vaccine is something that's right for us. What happens if not enough people are willing to be vaccinated?

Dr. Swank:

Remember that part of vaccination is the herd immunity. When a virus enters the community, if enough people have immunity to that virus, then it can't travel between people as easily. So then fewer people get infected or no people get infected.

Think of measles. You don't hear about very many cases of measles, but then if you hear of a community where people don't get vaccinated, then it enters their community. And then all of a sudden there's an outbreak. So very similar to that. Really the safest and easiest, fastest way for us to all develop immunity is to get the vaccine.

Maggie Montgomery:

Anything you want to add?

Dr. Swank:

To remember - to be patient - that there will be enough vaccine for everyone. Your listeners don't need to be calling their doctor's office to get on a list. Their doctor's office and health care systems and the state will let you know when it's your time to get the vaccine and we'll make sure that you get it.

I think the other thing to remember is that we don't know yet if, once we get vaccinated, if we can pass the virus on to other people. We feel really comfortable that after two doses of the vaccine, that that will prevent us from getting the infection, but we don't know for sure if it could hang around in our nose and we could pass it to somebody else. And so, even though all your healthcare workers are going to be vaccinated, we'll still be wearing masks and we'll still be taking the precautions that we have been.

And finally is to remember that even though we can see the light at the end of the tunnel, we still have a little ways to go, and so to not be lax. Still take care of themselves and to still mask and be careful. And just remember to have hope.