With experience in every facet of geriatric medicine, Dr. Arun Rao has committed 20+ years to providing quality care to older adults. His contributions include serving on the faculty of Weill Cornell Medical College’s Division of Geriatrics, managing LIFE St. Mary, the PACE program at St. Mary Medical Center and serving as the Medical Director of Erickson Living’s Seabrook Village, a continuing care retirement community (CCRC). He currently serves as the Medical Director of Care Coordination at Penn Medicine Princeton Health.
Today, Dr. Arun Rao sheds light on what we know about the COVID-19 vaccine and what seniors can expect going forward.
How effective is the vaccine? And how effective is the first dose compared to both doses?
The Pfizer and Moderna vaccines have both been approved within the United States. Preliminary studies show that the Pfizer vaccine is about 95% effective at immunizing people against COVID-19 after the second dose. The Moderna vaccine is about 94%-95% effective. Reports indicate that either vaccine can result in 50%-55% immunity to COVID-19 after the first dose. It is imperative, however, that people take both doses in order for the vaccine to be its most effective and for us to achieve herd immunity sooner.
Does the vaccine protect against the new strains of COVID-19?
It’s important to remember that COVID-19 is a novel virus and that the information our scientific, medical, and public health communities have is very new. Recent studies indicate that the vaccines in circulation are effective against the new strains from the United Kingdom, Brazil, and South Africa. Although data about these strains is still emerging, the concern is not that they will cause a different or more serious disease; the worry is that they are much more transmittable and, therefore, infectious.
What reactions to the COVID-19 vaccine can seniors expect to experience?
After the first dose, most people can expect to have a sore arm. Some people may also experience a low-grade fever, chills, and body aches. The second dose could result in the same — but possibly more pronounced — reactions. There have been no reports of fatal reactions to the vaccine. And out of the thousands of vaccines provided, only a handful of severe allergic reactions have been reported, which is minimal. Generally, symptoms should last about 24 hours after either dose. If they last beyond 48 hours, be sure to notify your, or your loved one’s, provider.
Once the elderly population is largely vaccinated, can we expect a surge in other diseases like the common cold? How might the elderly population protect themselves?
I don’t think so. What’s been interesting about this year is that all of the restrictions we’ve put in place — from wearing masks to social distancing — have resulted in a relatively mild flu season. My hope is that we continue to practice common sense in terms of personal hygiene and infection control. Doing so could potentially protect us from the transmission of several diseases, including the common cold. While it’s very hard to generate a vaccine for the common cold — since the viruses that cause it are so mutable — getting more and more people vaccinated against diseases that we know are preventable will go a long way.
What should seniors do if they can’t find a vaccine? What is the best strategy to try to gain access?
I would suggest first registering with your state’s registration site. Some have even had luck checking for volunteer social media accounts in their area that alert people to vaccination sites with openings.
In addition, I would check in with your local senior center(s), township, and all local hospitals/hospital systems as they also may have registration sites to get on a waitlist. Finally, it would be worthwhile checking with local retailers such as some grocery chains, pharmacies, and urgent care centers where vaccines are being given as well.
Be prepared for long wait times, frustration, and waitlists. This is due to the mismatch between vaccine supplies and demand. I am hoping this will be remedied in the near future as supply chains are boosted by government efforts. Eventually, you will get an appointment for a vaccine. Once you do, make sure you keep your appointment and consider taking your name off the other waitlists to allow other eligible adults to get their vaccines.
Why has it been challenging to get vaccines to homebound seniors and how might this change?
I think one of the challenges in disseminating the vaccines to such a population lies in its storage. The Pfizer vaccine has to be stored at an extremely cold temperature – in industrial refrigerators and freezers. These are not commonly available and usually found only in larger institutions. The Moderna vaccine also has to be refrigerated, but at more moderate temperatures. It can be stored in the medical refrigerators found at certain practices and facilities, but needs continuous monitoring. Both vaccines have specific regulations regarding how soon they need to be dosed after being removed from the refrigerators. Hence, we are still working on how to get these effectively to some of the frail older adults who may be homebound.
In the near future, government and public officials may potentially ramp up the distribution of vaccines to medical practices, community centers, and senior centers within the community, as well as offer governance and guidelines on how to safely reach and vaccinate homebound seniors.
If an elderly adult gets vaccinated, can they safely convene with family and caretakers who are also vaccinated?
Theoretically, yes, because you have a group of people that has already been vaccinated against the virus. But realistically, it depends on each individual. Without herd immunity — where close to 90% of the population has been vaccinated — the risk of transmission is still high. So unless you can guarantee that everyone in everybody’s sphere of contact has been vaccinated, coming together still poses a risk of transmission.
The goal is to get as many people vaccinated as quickly as possible, ideally by the spring of 2021. Only at that point will we likely see a change in COVID-19 restrictions. Until then, it is critical that we continue to adhere to precautionary measures like wearing masks, washing our hands, and social distancing.
Based on COVID-19’s impact on vulnerable populations like the elderly, what are your views on the ideal setting for one to grow older?
Ideally, all older adults would have the opportunity to “age in place.” This is dependent on a person’s medical condition, functional status, cognitive status, and — most importantly — on having the support and resources they need to live comfortably at home.
For those who are unable to live at home, there are a host of options, from independent living communities to continuing care retirement communities that allow seniors to transition between independent living, assisted living, and long-term care as their needs change. It all boils down to choosing what’s best for a person’s particular situation.