COVID-19 Surge, Idaho Activates Crisis Care

Dr. Robert Bobert
Dr. Robert Bobert



Current Visitor Restrictions at Madison Memorial:

    • There can only be one (1) designated visitor per patient, for the length of the patient’s stay (i.e., not one visitor at a time; only one visitor, who may come and go as needed, but is always the same person)
    • No one under 18 may enter the building unless that person is a patient
    • The Paragon Café continues to be closed to the general public
    • Parents of pediatric patients may request permission to both (jointly or separately) visit their child

September 16, 2021

The Idaho Department of Health and Welfare has activated Crisis Standards of Care for all of Idaho today, as stated in their press release, dated September 16, 2021:

“The Idaho Department of Health and Welfare (DHW) has activated Crisis Standards of Care (CSC) in accordance with IDAPA 16.02.09 – Crisis Standards of Care For Healthcare Entities. CSC is activated statewide because the massive increase of COVID-19 patients requiring hospitalization in all areas of the state has exhausted existing resources. CSC was activated on Sept. 6 in North Idaho. This activation, declared today, expands the declaration to the rest of the state.”

At Madison Memorial Hospital in Rexburg, we will follow the protocols for this activation and implement our predesignated CSC policies. More information will be forthcoming.

The best message we can relay at this time is not a new one. We encourage everyone to follow CDC vaccination recommendations, to wear masks when social distancing is difficult, and to avoid large gatherings wherever possible. Please be respectful of others, and help us reduce the spread of this virus.


FAQ (Frequently Asked Questions)

What are Crisis Standards of Care?

Crisis standards of care (CSC) are guidelines that help healthcare providers and systems decide how to deliver the best care possible under the extraordinary circumstances of an overwhelming disaster or public health emergency. The guidelines may be used when there are not enough healthcare resources to provide the usual standard of care to people who need it. The goal of crisis standards of care is to extend care to as many patients as possible and save as many lives as possible.

How will hospital care be different than at other times when there is not a crisis?

When crisis standards of care are in effect, people who need medical care may experience care that is different from what they expect. For example, patients admitted to the hospital may find that hospital beds are not available or are in repurposed rooms (such as a conference room) or that needed equipment is not available.

Who decides when a hospital needs to activate Crisis Standards of Care (CSC)?

The director of the Department of Health and Welfare or his delegate will declare the activation of crisis standards of care after careful consideration of the resource shortages that necessitate crisis standards of care and the measures that have been taken to address these shortages.

Can hospitals share resources instead of implementing crisis standards of care? 

Yes. Before crisis standards of care are implemented, every effort is made to secure resources from local, regional, and federal sources. Crisis standards of care will ONLY be implemented if sufficient resources cannot be obtained quickly enough to provide adequate care for patients.

How long will Crisis Standards of Care (CSC) be in place for select Idaho hospitals?

The crisis standards of care will remain in effect until there are sufficient resources to provide the usual standard of care to all patients.

If crisis standards of care are implemented during the COVID-19 pandemic, will all medical care be affected, or just COVID-19-related care? 

If crisis standards of care are implemented during the COVID-19 pandemic, all types of medical care may be affected. If, for example, a patient needs ICU level care for the treatment of a severe infection or a traumatic accident, and there are not enough ICU beds available to treat all the patients who need one, that patient would enter a triage algorithm just like patients with COVID-19 who need an ICU bed.

Has Idaho ever had to utilize crisis standards of care? 

The first implementation of the Idaho Crisis Standards of Care Plan went into effect for the first time in September of 2021. For the Idaho panhandle the process to initiate crisis standards of care began when resources were limited to the point of affecting medical care. The director of DHW convened the Crisis Standards of Care Activation Advisory Committee on Sept. 6, 2021, to review all the measures that were taken to address the staffing and bed shortages. The committee determined that the ability of northern Idaho hospitals and healthcare systems to deliver the usual standard of care has been severely affected by the staffing shortages, and all contingency measures to address these shortages had been exhausted. The committee recommended to the director that crisis standards of care be activated. Director Jeppesen issued his decision on Sept. 6, 2021, under the authority vested in him through the temporary rule

How can I get up-to-date information about the status of the Idaho health care system?

COVID-19 Cases Surge in Eastern Idaho as Hospitals Request Support

September 8, 2021

In communities across Idaho, we have celebrated the impact of our brave, dedicated healthcare workers as they fight against COVID-19. This pandemic, now in its 18th month, continues to take a relentless toll on the region’s caregivers. They have worked tirelessly and devoted themselves to caring for patients; now they need your help.

Hospitals throughout the region are currently experiencing COVID-19 hospitalization rates exceeding those of the peak surge in December 2020. While our facilities remain open and are capable of caring for patients in need, the current COVID-19 crisis puts a significant strain on hospital resources, including staff and bed availability.

This increase has caused local ICU and inpatient hospital floors to reach capacity on a regular basis. Our hospitals have experienced a continual flow of patients. To manage resources, hospital leaders at each facility monitor staffing and bed availability continuously throughout the day. Additionally, we collectively assess resources across hospitals to help meet the needs of our region.

In late spring, hospitals in our region had single-digit COVID-19 admissions. We were hopeful that the pandemic was ending. Unfortunately, this is not the case.

Four of the largest hospitals in the region (EIRMC, Portneuf Medical Center, Idaho Falls Community Hospital, and Madison Memorial Hospital) collectively admitted a total of 74 inpatients with COVID illness in the month of July. That number soared to 157 in the month of August, representing a 112% increase.

Patients hospitalized with COVID-19 illness are overwhelmingly unvaccinated. Hospitals in our region are experiencing similar COVID-19 trends to those reported in other states and around the nation. We are also seeing younger and generally healthier people needing hospital care after contracting the virus. We strongly encourage people in our area to get the vaccine and follow the CDC’s recommendations for preventing the spread of the virus, including guidance around mask usage, social distancing, and frequent hand washing.

The vaccine has been shown to be safe and effective, with 370 million doses administered across the U.S., as of September 1, 2021. As of this date, nearly 740,000 Idahoans are fully vaccinated. This leaves roughly 60% of Gem State residents unprotected.

The Food & Drug Administration has granted full approval of the Pfizer COVID-19 vaccine for individuals 16 years of age and older. The vaccine is also available for those as young as 12 under Emergency Use Authorization (EUA). The Moderna and Johnson & Johnson vaccines also remain in widespread use under EUA while seeking full approval.

The choices Idahoans make have a direct impact on whether hospitals have the human resources necessary to care for our community. We are imploring our community to get the COVID-19 vaccine. Protect yourself, protect our children, and protect the vulnerable members of our community unable to receive the vaccine. Do your part to make sure we can protect our precious hospital resources and care for those who need us most.

These hospitals in south and southeastern Idaho stand united in this joint statement.

  • Eastern Idaho Regional Medical Center
  • Portneuf Medical Center
  • Madison Memorial Hospital
  • Idaho Falls Community Hospital
  • Mountain View Hospital
  • Bingham Memorial Hospital
  • Steele Memorial Medical Center
  • Teton Valley Hospital
  • Bear Lake Memorial Hospital
  • Minidoka Memorial Hospital
  • Franklin County Medical Center
  • Nell J. Redfield Memorial Hospital
  • Power County Hospital District
  • Intermountain Cassia Regional Hospital

Johnson & Johnson’s Janssen Vaccine

Possible Side Effects

In the arm where you got the shot:

  • Pain
  • Redness
  • Swelling

Throughout the rest of your body:

  • Tiredness
  • Headache
  • Muscle pain
  • Chills
  • Fever
  • Nausea


  • In clinical trials, side effects were common within 7 days of getting vaccinated but were mostly mild to moderate.
  • Side effects were more common in people 18–59 years old compared to people 60 years and older.
  • CDC will continue to provide updates as we learn more about the safety of the J&J/Janssen vaccine in real-world conditions.

Pfizer Vaccine

Possible Side Effects

In the arm where you got the shot:

  • Pain
  • Redness
  • Swelling

Throughout the rest of your body:

  • Tiredness
  • Headache
  • Muscle pain
  • Chills
  • Fever
  • Nausea


    • In clinical trials, reactogenicity symptoms (side effects that happen within 7 days of getting vaccinated) were common but were mostly mild to moderate.
    • Side effects (such as fever, chills, tiredness, and headache) throughout the body were more common after the second dose of the vaccine.
    • Most side effects were mild to moderate. However, a small number of people had severe side effects—defined as side effects affecting a person’s ability to do daily activities.
    • Although few people in the clinical trials went to the hospital or died, data suggest that people who got the Pfizer-BioNTech vaccine were less likely to have these more serious outcomes compared to people who got the saline placebo.
    • CDC will continue to provide updates as we learn more about the safety of the Pfizer-BioNTech vaccine in real-world conditions.


Moderna Vaccine

Possible Side Effects

In the arm where you got the shot:

  • Pain
  • Redness
  • Swelling

Throughout the rest of your body:

  • Tiredness
  • Headache
  • Muscle pain
  • Chills
  • Fever
  • Nausea


  • In clinical trials, reactogenicity symptoms (side effects that happen within 7 days of getting vaccinated) were common but were mostly mild to moderate.
  • Side effects (such as fever, chills, tiredness, and headache) throughout the body were more common after the second dose of the vaccine.
  • Most side effects were mild to moderate. However, a small number of people had severe side effects that affected their ability to do daily activities.
  • CDC will continue to provide updates as we learn more about the safety of the Moderna vaccine in real-world conditions.

Vaccination Dates and Locations

8 Things to Know Before Your Second COVID-19 Vaccine

Understand the do’s and don’ts of the two-dose coronavirus vaccination regimen
by Michelle Crouch, AARP, February 17, 2021

If you’ve already received your first dose of a two-dose COVID-19 vaccine, congratulations — you’re well on your way to being protected from the coronavirus. But to be fully immunized, it’s critical to get that second shot.

Across the country, some people are running into snafus as they try to get their second dose. Winter storms have shut down clinics in some areas, while others have closed because they temporarily ran out of vaccine. There are also scattered reports of scheduling glitches.

If you’ve had an appointment canceled, don’t wait for someone to call you — be proactive about rescheduling your second shot, advises William Schaffner, M.D., an infectious diseases specialist at Vanderbilt University Medical Center in Nashville, Tennessee, and medical director of the National Foundation for Infectious Diseases.

“We have told everyone these vaccines are 95 percent effective,” he says of the two-dose Moderna and Pfizer-BioNTech vaccines currently in use in the U.S. “But they’re only 95 percent effective if you indeed get that second dose.”

Here are a few more things to know about the second dose:

1. Your side effects will likely be stronger

Many people who had little to no reaction to the first vaccine dose are reporting that the second one packs a punch — surprising even those who study vaccines for a living.
Greg Poland, M.D., an infectious disease expert at the Mayo Clinic in Rochester, Minnesota, and director of Mayo’s vaccine research group, had only mild symptoms after his first dose. But the second one left him shaking — literally — with chills and a temperature of 101.

“I took one Tylenol and went to bed and woke up the next morning 90 percent improved, and by midday I was back to normal,” Poland says. “This is not an indication of something going wrong; it is an indication of a vigorous immune response.”

There is no live virus in the vaccine, so you can’t get COVID-19 from being vaccinated.

Participants in clinical trials of both vaccines had experiences similar to Poland’s. In Pfizer’s clinical trial, for instance, 31 percent of participants ages 18 to 55 reported a fever after the second dose, compared to only 8 percent after the first one. Fatigue, chills, headache and muscle/joint pain were also more common after the second injection for both vaccines.

The good news is, older adults were less likely to experience vaccine reactions, the data shows.

Among those age 55 and up in the Pfizer trial, 22 percent experienced fever after the second dose, and 3 percent had a temperature after the first dose.
Schaffner recommends not making any big plans for the day after your scheduled vaccine appointment.

2. You should avoid taking pain relievers before your shot

If you’ve been hearing stories about second-dose side effects, you may be tempted to take a pain reliever before your appointment.

That’s not a good idea, according to the U.S. Centers for Disease Control and Prevention (CDC), unless you’ve been advised to do so by your doctor. Pain relievers taken preemptively ahead of a shot could dampen the effectiveness of the vaccine, Poland and Schaffner say.
However, it’s OK to take acetaminophen (Tylenol) or a nonsteroidal anti-inflammatory drug like Advil

or Motrin after your vaccine to treat side effects such as pain, fever, chills or headache.

3. The timing between doses doesn’t need to be exact

The second dose of the Pfizer shot is supposed to be given 21 days after the first; for Moderna, the recommended interval between doses is 28 days.

However, if you can’t get an appointment on the exact day — or if you have to miss your scheduled appointment for some reason — the CDC does allow some wiggle room. Although the agency recommends trying to stick to the suggested interval, it says the second dose can be given up to six weeks after the first.

If your appointment is scheduled earlier than the recommended date, ask for a later appointment, Schaffner advises. “Your immune response will work perfectly well if you take more time,” he says. “But if you do it too early, the second dose may not invoke an optimal response.”

4. Your second dose should be from the same manufacturer as your first

Doctors are already hearing from patients asking if they can get their second dose from a different manufacturer, often because they realize the other type of vaccine is offered at a location that’s more convenient. But the CDC recommends against it: The Moderna and Pfizer vaccines “are not interchangeable with each other or with other COVID-19 vaccine products,” the CDC says. “The safety and efficacy of a mixed-product series have not been evaluated.”

The CDC does allow the mixing of Pfizer and Moderna shots in “exceptional situations,” such as when the vaccine used for someone’s first dose is no longer available due to a supply shortage, or if it’s unclear which vaccine they got for their first dose.

5. A rash at the injection site isn’t a reason to skip your second dose

If you experienced a rash at the injection site three to 10 days after getting your first shot, that doesn’t preclude you from getting your second shot, the CDC says, although it recommends getting it in the other arm.

A small number of people have developed such rashes, sometimes called “COVID arm,” after vaccination. Doctors say it’s likely a mild allergic reaction that can be treated with an over-the-counter antihistamine such as Benadryl.

In guidance released Feb. 10, the CDC says the reaction is not believed to represent a risk for a more severe allergic reaction when you get your second dose.

6. You should temporarily avoid all other vaccines

It might be time for your shingles or Tdap vaccine, but you should hold off if you are between COVID-19 vaccine doses. Because there’s no data on the safety and efficacy of COVID vaccines administered at the same time as other vaccines, the CDC recommends avoiding other immunizations in the two weeks before and after both doses. Holding off also helps prevent confusion about the cause of a reaction if you experience one.

The CDC does allow exceptions in circumstances where avoiding the vaccine would put you at risk, such as a tetanus shot after a wound or a hepatitis shot during an outbreak.

7. Full immunity is not immediate

It takes two weeks after your second dose for your body to build full protection to the virus. After that, you should have almost zero chance of developing severe disease if you are exposed to someone with COVID-19, Schaffner says. The CDC also says you no longer have to quarantine if you’re exposed to someone with COVID-19 — as long as you meet these criteria: you don’t have symptoms and it hasn’t been more than three months since your second vaccine dose.

One possible exception is immunocompromised people, Schaffner says. They will get some level of immunity, he says, “but they may not reach the 95 percent because their immune system is already somewhat compromised, no matter how strong these vaccines are.”

8. You still need to wear a mask

Experts are divided about whether it’s OK to hug your grandchild or gather socially with other vaccinated people after you’re fully immunized.

But they agree you should continue to wear a mask and practice social distancing in public. For one thing, there’s a small chance you could get sick even after you’ve been vaccinated.

In addition, it’s possible that you could still carry the virus and silently transmit it to others who haven’t been vaccinated, even if you don’t develop symptoms.

And there’s one more reason. Until the country reaches herd immunity — the point when a significant portion of the population becomes immune to a disease — it’s important for everyone to wear a mask to stop the spread of the virus, Schaffner says. “If we have some people walking around maskless and others not, people left and right are just going to discard their masks,” he says. “We are not ready yet for that for society. Let’s all stick to masks a little longer until we get the all clear.”


Michelle Crouch is a contributing writer who has covered health and personal finance for some of the nation’s top consumer publications. Her work has appeared in Reader’s Digest, Real Simple, Prevention, The Washington Post and The New York Times.

First COVID-19 Vaccination in Idaho received at Madison Memorial Dec. 14th, 2020

A number of Madison Memorial employees who work on the front lines of the pandemic are excited to have been among the first in Idaho to receive the newly approved COVID-19 vaccine. Dr. Steven Lofgran, MD, who participated in the Pfizer trial, and Dr. Hancock who have both now received the vaccine answer some of the most commonly asked questions regarding the vaccine, below. A majority of the healthcare workers at Madison Memorial Hospital have now received the vaccine. The vaccine consists of 2-shot series with a few weeks between each shot.

Your Top 5 COVID Vaccine Questions, Answered

1. Will the vaccine give me COVID? No. That is impossible. Other types of vaccines sometimes carry weakened viruses; this one does not. It contains ZERO coronavirus, living or dead. Which means, there’s zero chance that it can give you COVID-19.

2. Will I have an allergic reaction? You might. That is a risk with any vaccine, but it will most likely be mild. Roughly half of all MMH employees have now received the COVID vaccine. About one in ten of them are reporting mild fever and bodyaches, lasting for about a day. Almost everyone, however, reports a bit of stiffness or swelling in the shoulder for a few days, but very little else. Even with millions of doses now administered, there have been very, very few serious reactions to the vaccine.

3. Because it was rushed through, was the vaccine not adequately tested? One reason that the approved vaccines were able to be approved so quickly was because they demonstrated a very high success rate, and a very low complication rate. The approval would actually take longer to receive if either of these things was more questionable.

4. Will vaccination protect me against new mutations of the virus? Yes, we think so. The mRNA vaccine targets a spike protein, rather than a single strain of the virus, leaving the body to manufacture its own broad range of effective antibodies. It’s expected that these antibodies will continue to work on future mutations, as well as on the currently known versions of the virus.

5. Will the vaccine make me infertile? No. Almost 3 million people in the US have now received the vaccine, with no known impact on reproductive ability. The infertility rumor began with a now-debunked Facebook post. There have been other rumors circulating on social media, and there will likely be more. We will stay abreast of the actual facts regarding complications and effectiveness of vaccines as they continue to be administered to large populations.

First COVID-19 Vaccines in Idaho – Madison Memorial Hospital

Madison Memorial Hospital front-liners were the first to receive the COVID-19 Vaccine in Idaho.

How quickly will the pandemic end in Rexburg?

Dr. Lofgran, Madison Memorial Hospital’s Internist expresses his view. I am very optimistic, more so than a lot of things that I read from national doctors, about how quickly this can end. I think we will be shocked at how quickly our rates of covid-19 will go down.

There’s a lot of pessimism, even for people that are pro-vaccine. Even some of our national leaders. I don’t share their pessimism at all. I think this problem is going to go away quickly as soon as we can get their vaccines if people are willing to take them into our communities at large. We hope people will consider it seriously. It is safe. It’s a reasonable way to take care of yourself. The side effects are almost nonexistent

Who in Rexburg will get the vaccine first?

There’s an advisory committee that is going to formulate the stratification of who receives the vaccines first. The idea is that healthcare workers in the front lines will receive the first doses but that will be followed very quickly with doses for those who live in long-term care facilities. For those who are the most vulnerable among us. There probably won’t be a major amount of time in between these different strata of vaccinations. It’s going to be less of an issue that people might think

I already had COVID-19. Do I still need the vaccine?

For people who have already had covid-19, your immunity wanes about three months. We already have people in this area that have their second case under their belt documented. My understanding is it’s not any more pleasant the second time around. You would be absolutely wise to get a vaccine. If you had COVID-19 you probably have immunity against it for a few months. It’s hard to say how long it lasts.

How long will my immunity last?

We don’t know how long the immunity will last with the vaccine. We’re hoping for years. There’s probably going to be some degree of boosters that are given by nature of the way that the vaccine works in the future. That’s okay because once we can end the pandemic covid-19 and it becomes perhaps a seasonal thing like the flu, we’ll know how to vaccinate against it to prevent it. It’ll be a hopefully mild regional problem. I would hope that nobody gets it, but if we have a few people to get it rather than a pandemic we can much more easily deal with it in the healthcare setting.

How strong will my immunity be?

That is a difficult question to answer because we don’t have long-term data at this point. This may not be the final vaccine that comes out. There may be other vaccines that are made available that would work even better than this. In fact, that’s the hope. We’re hoping to always improve things.

There are different levels of immunity that will be achieved by the vaccine. It depends a little on the age of the person involved. Some of the data that was reported on December 3rd showed that the antibody level did decrease a little bit with age. Meaning there might even be a need for a booster vaccine down the road sometime. That’s probably going to be the case. Possibly this becomes something seasonal, kind of like influenza. You might consider receiving a booster every year. Interestingly though, the immunity of people who received the vaccine, even the elderly in this study was significantly greater at 120 days after receiving their vaccine than it was for people who had just had covid on average 34 days out. Meaning you could be sick, miserable with symptoms 34 days later, or you could take somebody that had a vaccine four months later. That person who had the vaccine four months later is many times better off with their immunity. That’s important and good news.


Will I need to get one shot or two?

The vaccines that are coming out, hopefully soon for the 2nd, in this country by Pfizer and by Moderna are both very similar. They’re both two-shot series. The Pfizer vaccine is the one that I’m the most familiar with. I was actually involved in that clinical trial, and essentially we think that the immunity starts within about 10-days of the first dose. I’ve also seen five days recorded.

The idea is, it’s very similar to filling up your gas tank at the gas station. When you’re on fumes the first few seconds of you putting gas in will probably get you to Rigby or to Idaho Falls. If you keep filling it up until the thing clicks off you’ll have enough gas to go to Utah. Sometimes we like to top it off and add a little tiny bit more. Topping it off is probably what that second dose does. It doesn’t do nearly as much as the first dose does but it’s helpful. It’s the recommendation so we do it. They’re separated by 3-weeks, and they can be extended a little bit past that point. Three weeks is the recommendation for the second dose that’s called the booster dose. The first dosage is prime.

How many people in the Pfizer trial had side effects?

Of the 18,904 patients with the vaccine, only eight have side effects that were significant enough to stop the trial. Meaning they decided that they didn’t want to take a second dose. Whereas, five in the placebo arm has side effects significant enough. Remember these are patients getting a shot of saline in the arm. I was one of them.

It hurts a little bit, but it wasn’t too big of a deal. So not only are those numbers incredibly low with side effects, but there’s no real significant difference between those who receive the placebo on those that receive the real vaccine. That’s good news. That means that there are no significant side effects in this very large group of people such that they had to stop the clinical trial. That’s a city the size of a Rexburg without the college. You can be assured that if there are major side-effects to occur, not only would you have heard it. The fact of the matter is that most vaccine side effects occur within the first 24 hours or less time. This has gone on for several months now without any reports of any bad side effects. Pretty good data, good news.

The total number of people in the Pfizer trial, and again that’s the one with which I’m the most familiar, was around 44,000. They published data on around 38,000 of them so far. The reason for the disparity of the numbers is some of them were added later on. Some of those late additions included aids patients and other patients with immunity issues. A number of the patients had comorbidities obesity and coronary disease diabetes COPD, lung diseases, and things like that. It’s a pretty good cross-section through the typical American population health-wise. It was roughly, well it was almost exactly 50% placebo. I was in the placebo alarm. I don’t know how to be a winner at things myself. 50% were in the treatment arm.

What side effects can I expect?

The most common side effects reported were localized pain or swelling. There is a term we use in medicine called malaise. It’s a catch-all bucket for feeling bad. People reported malaise. Typically it peaked out at about one and a half to two days. Then it went away.

Those are the types of side effects that we would expect with any vaccine. In fact, that’s an indication that your body is doing something with the vaccine. That shows proof that you are building an immunity. That’s good news. When you have some of those symptoms. You can take some Tylenol, and throw a baseball for a few hours. Then work it out. It’ll go away. No big deal

What about long-term effects?

Well, I think it’s always reasonable to ask yourself a question: is there something long-term that we haven’t seen consequences, unforeseen that might show up later. It’s very unlikely the way vaccines work. They work quickly to build immunity in hours and days, not months or years. Although the immunity lasts months or years, I cannot foresee any long-term side effects. I don’t think it will happen.

What I am very well aware of is the long-term effects of covid-19 on select populations. I would even say not necessarily a select population as much as I would say random populations. Probably a better way to say it for 40-year olds that are healthy that walk for a living for their job that can no longer walk across the room without taking a breath. For 70-year olds who are hunting elk 5 days before they contracted covid-19 in Island Park that right now are dragging an oxygen tank 5 liters per minute. This isn’t quite enough to watch the space shuttle, but it’s getting close. There are a lot of people that are dreadfully ill from this, and it persists. Those are the long-term effects that I’m concerned about. We don’t fully understand what long-term effects will happen from covid-19. It is absolutely imperative that we nip this in the bud as quickly as possible. We have an opportunity to do so in a safe and effective and proven manner.

How exactly does the vaccine work?

Fortunately, in just the last few years we have had some really groundbreaking, breathtaking advances in how we make vaccines. These are called messenger RNA vaccines. These have been around for a long time in equine communities. So horse vaccines are mRNA vaccines, but we haven’t figured out how to make them work in humans until recently.

Essentially how these are made is you have almost like a 3D printer if you will that synthesizes a strand of nucleic acid in a freezer somewhere in Michigan or in Belgium. This is where they are making them right now. That is called messenger RNA. Messenger RNA is something that we normally produce off of our DNA. It’s like a blueprint that’s taken in the cell to another place called the ribosome. The ribosome is like the custom contractor that builds the house to suit. Will then unfurl that blueprint, and make the proteins according to how the blueprints describe it. In the case of the mRNA vaccines, the Pfizer vaccine, for Moderna vaccine, we are creating that messenger RNA. Putting it in a lipid vehicle so it is taken up by the cells. It’s kept very cold at 70 degrees below zero. It’s thawed-out thankfully before it’s injected. Once it’s taken up by cells in the body, that blueprint is unfurled in our cells. Then instead of making the normal proteins for a short while the cells make, they use that blueprint. They build a spike protein that is the spike protein on coronavirus. But there’s no virus anywhere in any of this. That Spike protein is then dumped out into the bloodstream by these dendritic cells, these other cells. Then your immunity sees that little flagstaff with a flag flying on it and builds immunity to it. It’s kind of like if the military were trained to recognize the flag of a potential enemy to the United States, they would realize the flag for what it is. A marker of an enemy and they would act accordingly in their training. So that if somebody attacks the United States with that flag they would recognize it. There would be a standing army ready to kill. That’s how immunity works with messenger RNA vaccines. It’s an absolute miracle how quickly these have been developed. Without this new technology we would be doing the backstroke upstream trying to find a vaccine for this still.

After vaccination can I stop wearing my mask?

After the vaccine, I’m going to wear my mask. I would suggest it for other people to do as well. I think there will come a time when it’s not necessary. I hope it’s soon. I hate wearing a mask. I think most people that wear it hate it as well. I think it’ll go away pretty quickly. As soon as the rates come down, which again will happen with vaccines

Does the vaccine contain live virus?

It absolutely does not contain a live virus or any viral particles whatsoever. There is no component of the virus in this vaccine at all. It’s a fully synthetic product. No viral particles. No killed virus. No virus in the factory that makes this. There’s no virus.

Is it safe for the elderly?

It absolutely is. That was a large portion of the enrollees in the clinical trial. They did very well. We would expect that this would be a very wonderful, and very safe vaccine for those that are in that age range.

Can I get the vaccine if I currently have COVID-19?

You should convalesce from covid-19 before you get the vaccine. So I wouldn’t advise that.

What if I’m immuno-compromised?

That arm of the data is going to be forthcoming soon. They added on another approximately 6000 patients into the Pfeiser trial later on. We don’t have all that data, but those patients include patients with AIDS. Patients with other immunocompromised issues.

Certainly, there were a lot of diabetics for the first time. We know that they did well. To some degree, there’s immunocompromised with that. Age alone compromises one’s immune system. These patients that we do have data on seem to have done very well with the vaccine. From my perspective, I can’t see any reason not to get the vaccine if somebody has immunocompromised. it certainly is not going to give somebody covid or make them more ill as compared to people who have a fully intact immune system.

Does my immunity not begin until I receive the second shot?

Some of the data on how quickly the immunity kicks in with the first shot has just been published this week. I was reading some news reports the other day that shows that some really impressive immunity occurs within ten days. Maybe even sooner than the first shot.

That’s sort of like gassing up your car. You fill the tank, the thing clicks off. You can then top it off a little bit more. It doesn’t move the needle that much, but there’s a little bit more gasoline in the tank. Based on the manufacturer’s recommendations we will give two doses of this, but you’re probably a lot safer than you had been within a week of the first dose of the vaccine.

Is it safe for pregnant women?

The answer is we don’t know. Testing medications or vaccines in pregnant women is the third rail in medicine that nobody’s going to touch. Interestingly though in the trial for the Pfizer vaccine, if women were pregnant they were excluded from the beginning.

There were 23 women who became pregnant at some point. Either after they’d received the first dose, or perhaps they didn’t know they were pregnant when they received the first dose. At some point in the clinical trial 23 women became pregnant. Two in the trial had a miscarriage, and they were both in the placebo arm. These are the data that are probably not worthy of dissection much more than that, because it’s such a small sample size. It’s interesting to know that so far at least there isn’t any reported concerns with those 23 women who found out they were pregnant.

Is there any chance that the vaccine might actually give me COVID?

There is absolutely zero chance you can get covid-19 from this vaccine because of the way that it is created. There is no virus involved in any step of the vaccination process. Neither in the production or the delivery. Some of the fears go back to what happened in the 1950s with the early polio viruses. I can see where there might be some concerns from the bad history that happened. That is not the case here. Because there was no virus involved in the production of this vaccine. Won’t happen.

What’s the possibility that the vaccine could cause autism?

There is a lot of concern that vaccines might cause autism. There’s no evidence of this whatsoever. It stems from a paper that was published in the British of medical journals back in the 1990s. It was thoroughly rebuffed and recanted in 2010 in the same medical journal.

The doctor that published those data lost his license, because you made a lot of stuff up that’s not true. The Fallout continues to this day, unfortunately. Autism is a very sad condition. Parents with children with autism deserve our deepest sympathy, but autism is not caused by vaccines.

Are you yourself going to get the vaccine shot?

I tried to get one. I flew to Phoenix on my own dime twice to get a saline shot. That’s part of science. There are placebos, importantly in these studies. So that we can compare those who didn’t get a true vaccine to those who did. I tried to get one. I plan to be at the front of the line for one as soon as I can as a healthcare worker.

My wife is excited about it, my parents are excited about it, and I’m excited to protect them. Protect my wife’s parents. People that we love. We want them protected with this vaccine. We’ll do it.

In my mind, I can see no other way at all that this problem will go away except for vaccines. We cannot expect that this will go through our community and that it will confer immunity based on people getting sick like brucellosis through a herd of cattle. That is not the way that this is going to end. It’s not a reasonable thought at all. This will only end as we immunize, and we can thoroughly stop this very quickly.

Academically speaking, I have had more interest in this problem than I have in anything else in my 16 years of doing this. Because I’ve never seen anything cause medical problems like this before. I’m very comfortable with the research that I’ve read that this is how we’re going to end this pandemic. I can see it happening in no other way. My encouragement is to get the vaccine. The wonderful thing is if we can all get the vaccine we can all go back to normal very quickly. it’s not years, and it’s not months, it’s a couple of months. Then we’ll all be protected. We can go back to playing ball, watching ball games. We can go back to church and other worship activities that we’ve all been missing. Really there is probably no other way that that will happen.


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