President Joe Biden said last week that he would direct the states to ensure that all Americans be eligible for a COVID-19 vaccination by May 1, with a goal of a “return to normalcy” by the Fourth of July. To make that a reality, his administration continues to purchase hundreds of millions of doses of the Moderna, Pfizer, and Johnson & Johnson vaccines. The Centers for Disease Control and Prevention (CDC), however, notes that as of Tuesday only about 12 percent of Americans are fully vaccinated, so there is still a long way to go.
At Harvard, University Health Services continues to vaccinate community members based on the guidelines set forth by the commonwealth of Massachusetts, which is also in charge of allocating supplies. The University is also preparing to meet increased demand as more vaccine becomes available.
The Gazette spoke with Paul Biddinger, the medical director for emergency preparedness at Massachusetts General and the director of the Emergency Preparedness Research, Evaluation, and Practice (EPREP) Program at the Harvard T.H. Chan School of Public Health, along with Giang Nguyen, executive director of Harvard University Health Services (HUHS), to learn more about the current status of COVID-19 vaccinations in Massachusetts and at Harvard; the safety and efficacy of these vaccines; and what community members can feel comfortable doing, at home and more publicly, whether they are already vaccinated or awaiting their turn.
Paul Biddinger and Giang Nguyen
GAZETTE: Could you begin by providing the broad context on where we are right now with regard to COVID-19 vaccines, both nationally and here in the Boston area and at Harvard?
BIDDINGER: There have been slight increases in the supply of COVID-19 vaccines, both in Massachusetts and nationally, over the past couple of months. However, beginning in April, health care and public health experts expect Pfizer, Moderna, and Johnson & Johnson to dramatically increase their available supply. This should increase the rate at which we’re able to vaccinate individuals in the coming months. We also know that through our health care system here in Massachusetts and at other vaccinating venues set up by the commonwealth, we can easily handle at least twice the volume of vaccine that we’re currently receiving. So, we are confident in our ability to administer the vaccine as the supply rises.
GAZETTE: How many vaccinations per day will HUHS likely be able to handle?
NGUYEN: We plan to continue administering vaccine doses here at Harvard, and to do so at increased rates, once vaccines are plentiful enough for the commonwealth to provide us with higher supplies. To date, we have administered over 1,200 doses of vaccine to our communities. But we know that there are thousands more who are currently eligible to be vaccinated.
As we look ahead to April and May, HUHS is setting up protocols to vaccinate as many as 1,000 Harvard community members per day. But again, we can only vaccinate as many individuals as we have vaccines for.
While I’d continue to urge folks to keep an eye on what Harvard is able to offer, I’d also encourage our community members to simultaneously seek out resources for vaccination within the towns and cities where they live, and through the large-scale vaccination facilities set up through the state. Everyone living in Massachusetts should preregister to receive a vaccine at a mass vaccination site today. Don’t wait. Even if you’re not eligible right now, the state will reach out to you directly via text, email, or phone call to let you know when your turn comes.
GAZETTE: What would you say to those individuals who are still concerned about the safety of getting vaccinated against COVID-19?
NGUYEN: I’d reassure them that these vaccines are safe. Millions of people have been vaccinated across the United States, and things have gone very well. If reactions happen at all, they are minor, such as a day of soreness or fatigue. In Massachusetts alone, more than 2.5 million doses have been administered, and over 900,000 are now fully vaccinated in the commonwealth, meaning they’ve had either both doses of the Moderna or Pfizer vaccine, or the single dose of Johnson & Johnson.
These vaccines are very effective, more so than most vaccines that we’ve relied on for years against other infections. The flu shot, for example, is about 40 to 60 percent effective, yet it works very well in limiting its spread, and in particular, in limiting the severe cases that can lead to hospitalization or death.
It’s also important to remember that, even though cases of COVID-19 have been dropping nationally and in Massachusetts, we are not going to be able to get this pandemic under control without the vaccine being administered to the large majority of the American public. In fact, the last three weeks of data in Massachusetts show that cases are no longer dropping. We’re back to where we were in November of 2020, and that’s not good enough. And this underscores another important point — people need to continue to practice the physical distancing, mask wearing, and hand-washing practices until we can get to a point where the pandemic is under control.
I would add that the spread of variants of COVID-19 is a real issue. The United Kingdom variant is doubling in numbers every 10 days in the United States, and it is not the only variant that is here. Mutation only happens when replication of the virus occurs, and replication of the virus requires that it has passed from person to person. By reducing the amount of spread from person to person, we can reduce the development of new strains until enough of us are vaccinated to render these types of mutations insignificant.
GAZETTE: Clinical trials have shown that the Pfizer and Moderna COVID-19 vaccines are 95 percent effective, while the Johnson & Johnson vaccine is 72 percent effective. Should people consider holding out for the vaccines with higher reported efficacy?
BIDDINGER: In short, no. You can’t do a head-to-head comparison of all three vaccines, because they were studied at different times, in different parts of the world, and in different populations. Most importantly, however, there is a common set of facts among all three studies that is really important to point out — in all three trials, not a single vaccinated patient died of COVID-19. So, while you cannot guarantee that these vaccines 100 percent prevent death, it is compelling that no one died of the tens of thousands of people who were vaccinated during the course of these clinical trials. Similarly, hospitalizations from COVID-19 were extraordinarily low in vaccinated trial participants.
We’re also beginning to learn that the vaccines are highly effective at decreasing transmission. A recent study based in Israel, for example, found preliminary data to suggest that the Pfizer vaccine is 90 percent effective in preventing asymptomatic transmission of the virus. And as Giang said earlier, the only way we can get back to normal is to lower transmission. This is what will allow us to have more housing on campus together, to dine together, to gather in classrooms together, and conduct research together in ways that are closer to how we did these things prior to the pandemic.
GAZETTE: What guidance would you provide for community members who do become fully vaccinated, and who may be already engaged in work and activities on campus? What can people safely do now?
NGUYEN: Again, once a large number of people are vaccinated, we can see our lives get closer to normal. But we don’t want to be premature with how quickly we jump back into pre-pandemic behaviors.
The CDC has issued guidance on what fully vaccinated persons can safely do in their homes. One of the great benefits of getting vaccinated right now is that families can potentially get together again; vaccinated grandparents can see their grandchildren. Of course, there are rules on how to safely do this. A person who is fully vaccinated, which means that they are two weeks post-completion of a vaccine series, can visit with other fully vaccinated persons mask-free without distancing in private places such as homes. Folks who are fully vaccinated can also visit a household where not everyone in the household is vaccinated, as long as no one who is at high risk of COVID-19 complications is living in that household. These are very reassuring developments.
But we must keep in mind that these recommendations do not apply to public spaces, and they do not apply to workplaces. Harvard has not yet made any changes as to how we treat people who are vaccinated versus those who are unvaccinated on campus. This doesn’t mean that we will maintain these rules forever. But we remain cautious in our approach to this pandemic, which has been critically important in keeping transmission low, and our community members safe, over the past year.
BIDDINGER: You can probably hear the caution in both Giang and my responses to your questions. There are a lot of reasons to be hopeful about what’s coming. But there are also a lot of reasons that we need to not prematurely let down our guard. We’re not quite where we want to be yet. There’s still an awful lot of COVID-19 in the community. Our common goal is to get closer to normal, as soon as it’s safe to do so. Widespread vaccination, and the continued practice of mask-wearing and physical distancing until enough of us are vaccinated, will get us there.
Interview was lightly edited for clarity and length.