Interview with a Frontline Worker

By: Sofia Choudhri

The early stages of distribution of the COVID-19 vaccine have sparked many feelings across America: hope and relief, but also fear and uncertainty. While many Americans are excited at the prospect of a finish line to this seemingly never-ending pandemic, a large proportion of the country is also concerned about the validity of a cure to this politicized virus. Frontline workers were the first to receive the vaccine after FDA approval and have been sharing their stories to help convince the public to do the same. I had the honor of speaking to the newly appointed Medical Director of the Columbia Pediatric ER, Dr. Nazreen Jamal (who also happens to be my aunt!)

Dr. Jamal has already received both doses of the Pfizer vaccine. Only frontline healthcare workers were eligible for the first stage of the vaccine, 1-A.  Columbia Medical Center defined this as anyone who faced patients in the emergency setting or in the ICU. This included security workers and food delivery workers in this area.

“It was a light at the end of the tunnel. It was the closest thing we had to a party since the pandemic started.” She said, despite all the frustrations of distributing the vaccine. “Vaccinating so many people so quickly is a massive undertaking. There are lots of unknowns that come from the state level, including the unknown of how many vials the hospital would be receiving.”

Dr. Jamal eagerly described how her team has just begun vaccinating the community. They opened a vaccine center late during the week of January 4th. They have started with citizens 75 and older but have since moved onto 65 and older in phase 2.

The administrative side of vaccine distribution is the limiting factor. As of January 14th, only 11 million of the 30.6 received vaccines in the US have been distributed. The temperature restrictions are especially challenging, as the Pfizer vaccine is unstable at room temperature. It requires a very cold environment and needs careful regulation because it only has a certain number of hours before it is no longer stable. As the vaccine is covered across the nation, the hospital tries its best to not to waste the doses it has during this short period of stability. 

At vaccine distribution sites across the country, clinics try to get people in and out as quickly as possible. It takes a long time to confirm eligibility, which has led to long lines at the distribution sites. A station system has been established to allow for a 15-minute waiting period after vaccine administration. The monitoring is in case of the extremely rare vaccine-associated anaphylaxis, or an overreaction to the vaccine. It can show up as difficulty breathing and fainting. It only occurs in approximately 1 out of every 100,000 people, but without an EpiPen, it could be fatal. 

Other less severe symptoms include a sore arm, and some viral symptoms like a fever or fatigue can also result from receiving the vaccine. From Dr. Jamal and her coworkers’ experiences, the second dose was much worse than the first. A coworker of hers conducted an informal survey on 40 of her colleagues, and 60% of them had reactions- chills, cold, everything hurt. The CDC is still looking into the vaccine reactions and the causes behind these reactions. 

With the arrival of the vaccine, one huge question remains: how will safety guidelines shift and how we can regain some sense of normalcy? There is still a 5% chance that vaccinated people can contract the virus and scientists are unsure whether they can still transmit it, so PPE guidelines have not shifted. Dr. Jamal is still careful with her mask and sanitation.

However, the question we really should be asking is: will people continue to social distance and wear their masks, and how quickly can we vaccinate the community? “Time will tell,” Dr. Jamal said, and that really is the only answer anyone has. If the answer is yes, because of the effectiveness of masks and social distancing and if everyone is vaccinated, it will become just like any other virus. President Biden enforced a partial mask mandate, but it is up to the people to decide how quickly we return to normal. The “anti-vaxxers” pose a problem and are increasing in number for this virus, but they have valid concerns. There have not been long-term studies on these vaccines and certain demographic groups, such as pregnant women and children, have not been tested. Dr. Jamal explained that since the vaccine has MRA technology, rather than a live virus, it should not cause any long-term effects. As more and more people are vaccinated successfully, people will be more willing to get vaccinated. “They don’t want to be first in line,” she said.

Dr. Jamal also addressed the rising concern of new variants of the virus. “This is a normal pathway for a virus,” she said. “The vaccine should affect these new mutations as well.” Viruses undergo genetic variations over time, but the current PCR tests do not distinguish between the variations. With continual mutations of the virus, scientists will develop a test to detect which variant a person has contracted if there is a reason. Currently, it is too early to tell whether these variants spread quicker or are more fatal.

Dr. Jamal emphasized that this is a matter of “wait and see.” She hopes we will regain some normalcy within a year if everyone is vaccinated, but it is hard to tell. What we do know is that masks work, social distancing works, and there is no way out without vaccination.

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