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COVID-19 vaccinations to begin in long-term care facilities

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Residents of the Princeton Care Center nursing home and the Acorn Glen assisted living facility, along with healthcare workers, are expected to receive the first COVID-19 vaccinations as the inoculation program rolls out during the week of Dec. 28, Princeton officials announced.

Arrangements have been made for the CVS and Walgreens drug store chains to administer the vaccinations – which come in two doses, 21 to 28 days apart – to the nursing home and assisted living facility residents.

Although people over 65 years old make up close to 10% of the world’s population, they account for about 40% of all COVID-19 cases and about 80% of all COVID-19 related deaths, said Dr. George DiFerdinando, who chairs the Princeton Board of Health. He is a physician and adjunct professor at Rutgers University School of Public Health.

In Princeton, 17 residents of the nursing home on Bunn Drive and the assisted living facility on Mount Lucas Road have died of COVID-19 since the pandemic exploded in March. They are among the 30 reported deaths related to COVID-19, some of which have been deemed to be “probable deaths” due to the virus, Princeton health officials said.

While there have been some questions about the safety of the COVID-19 vaccines developed by Pfizer/BioNTech and Moderna –  especially for the elderly – both vaccines have undergone extensive clinical trials before being granted emergency use authorization by the U.S. Food and Drug Administration.

The clinical trials included Blacks, Hispanics, Asians, Native Americans and Whites. Pfizer tested its vaccine in 39 states and Modern conducted its tests in 32 states.

Only a “modest” number of volunteers in the Pfizer and Moderna clinical trials have been at least 65 years old, and even fewer have been older than 85 years old, DiFerdinando said.

Of the nearly 44,000 people enrolled in the Pfizer clinical trials, 45% were between 56 years old and 85 years old. The Moderna clinical trials enrolled 30,000 people, of whom 64% were at least 45 years old – and of that group, 25% were at least 65 years old.

“One of the reasons that the Moderna vaccine was approved after the Pfizer vaccine is because Moderna expanded its volunteer pool to include more people older than 65 years old. It’s difficult to get people over 85 years old into the clinical trials because of exclusions for other reasons,” DiFerdinando said.

The results of the clinical trials showed that the effectiveness and safety of the Pfizer and Moderna vaccines are the same in people under 65 years old and those who are older than 65 years old, he said.

The side effects and the adverse effects have been essentially the same in all age groups – although in general, the older the person is, the less likely it is that they will experience a side effect or adverse effect, DiFerdinando said.

“The side effects are lower in people who are older. That doesn’t mean you can’t have chills. You can have a fever, you can have muscle aches, but it’s actually lower in people that are older,” DiFerdinando said. “There is no data at all on any severe reaction in people who are older – no hypersensitive reaction in older people.”

Typical side effects are soreness at the injection site, a slight fever, fatigue and muscle aches. The two pharmaceutical companies said that less than 10% of people experienced a side effect.

An adverse effect is an allergic reaction to one of the ingredients in the vaccine, and would occur within a few minutes to one hour after receiving the vaccination. Difficulty breathing, swelling of the face or throat, a fast heartbeat, dizziness and weakness or a rash are indicative of an allergic reaction.

The vaccines will decrease hospitalization and symptoms in many patients, but it is not known whether it will prevent infection, DiFerdinando said.

Prevention of infection is not the end point of the clinical trials, he said. Even with a vaccination, a person may become susceptible to becoming infected and also to infecting others.

Despite having received a vaccination, the preventive measures already in place – social distancing, mask-wearing and frequent handwashing – must be observed to stop the spread of COVID-19, DiFerdinando said.

It is unlikely that the general public will be vaccinated until sometime next year. Depending on its availability, some senior citizens may begin to get vaccinated in February 2021 and followed by other groups, he said.

The State of New Jersey has set a tiered system that sets out who will be vaccinated and at what point in the year. The goal is to vaccinate 70% of adults within six months.

 

 

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