COVID-19 Vaccine

The state of California recently contracted with Blue Shield to oversee the vaccine allocation and distribution to the different health systems, pharmacies, supermarkets, and others who are administering the vaccine to individuals. Although the system is still in transition, MemorialCare is in communication with the state and Blue Shield to receive a steady supply of vaccine.

In general, we get a limited shipment of vaccine delivered to our hospitals and select vaccine clinics on a weekly basis, but there is no guarantee that we will always get the vaccine supply or brand we request. This uncertainty can present challenges that can limit our ability to schedule patient vaccination appointments too far in advance. Therefore, it is best that you wait for notification from MemorialCare that invites you to schedule your vaccine appointment.

Currently, there are three vaccines approved for Emergency Use Authorization (EUA). Each is administered similar to a flu shot and given in the muscle of the upper arm:

The Pfizer and German partner BioNTech Vaccine was the first to receive EUA from the FDA on December 11, 2020.

• 95% efficacy
• Requires two doses, 21 days apart
• Recommended for ages 16 and above
• Must be stored in special low-temperature refrigeration (-80 degrees to -60 degrees Celsius / -112 degrees to -76 degrees Fahrenheit), making it more likely to be used at hospitals
• Uses Messenger RNA (or mRNA) technology 

The Moderna (in partnership with the National Institute of Allergy and Infectious Diseases) Vaccine received EUA from the FDA on December 18, 2020. 

• 94.5% efficacy
• Requires two doses, 28 days apart
• Recommended for ages 18 and above
• Requires standard refrigeration (-25 degrees to -15 degrees Celsius / -13 degrees to 5 degrees Fahrenheit), making it possible to be used in smaller health clinics or local pharmacies 
• Uses Messenger RNA (or mRNA) technology 

The Johnson & Johnson Vaccine (developed by the Janssen Pharmaceutical Companies of Johnson & Johnson) received EUA from the FDA on February 27, 2021. Per direction from the California Department of Public Health and the CDC on April 13, 2021, MemorialCare is pausing the use of the Johnson & Johnson vaccine. As we receive additional information and guidance, we will continue to share those updates in real-time.

• The J&J trial determined that after 28 days of receiving the shot, the vaccine was 100% effective in preventing hospitalizations and deaths due to COVID‐19 in all regions studied, 85% effective in preventing severe‐to‐critical COVID‐19 in all regions studied, and 72% effective in preventing moderate‐to‐severe COVID‐19 in the United States.*
• Single-dose vaccine
• Recommended for ages 18 and above
• Can be stored at standard refrigeration temperatures for up to 3 months 
  (2.2 degrees to 7.8 degrees Celsius / 36 degrees to 46 degrees Fahrenheit), making it possible to be used in smaller health clinics or local pharmacies 
• Uses genetically engineered common cold virus at its base
• Fetal cells aided in the development of this vaccine but are not present in the final product. Fetal cells were from laboratory-grown cell lines derived from a single 1985 aborted fetus cell.

* There is a lot of misinformation circulating about the Johnson & Johnson (J&J) vaccine and its efficacy. Our clinical experts have been studying this and advise that it’s not possible to accurately compare the effectiveness of Pfizer and Moderna vaccines to the J&J version. The vaccine developers of each designed their clinical trials to test for different outcomes. J&J’s trials tested whether one of its doses protected against moderate to severe COVID illness and the Pfizer and Moderna trials tested for symptomatic COVID infection. In addition, the J&J vaccine was tested in different geographic locations around the world and against the variants that have emerged since the beginning of the pandemic. The Pfizer and Moderna vaccines were tested earlier in the pandemic, prior to the emergence of the new variants.

Most medical experts state that all three vaccines are safe and effective, encourage people to ignore brand names, and urge them to accept any vaccine offered. Ultimately, all three vaccines do what they are designed to do—prevent severe complications, hospitalization and death due to the coronavirus. 

Immunity:

For Pfizer and Moderna Vaccines—Maximum immunity reached 5-6 weeks after both doses. In general, after a person receives the first dose of a vaccine, they will start to develop some immunity within 2-4 weeks, but this is not full or sufficient immunity to protect against disease. The vaccines require the second ‘booster’ dose to reach full 94.5% or 95% immunity which can take an additional one-two weeks after receiving the second dose. 

For the Johnson & Johnson Vaccine—Maximum immunity reached within four weeks (28 days). This vaccine's protection against moderate to severe disease starts about two weeks after a person gets vaccinated. By four weeks after the shot, data from the clinical trials showed there were no hospitalizations or deaths.

As for how long the immunity lasts for any of these three vaccines, this is still not fully known. At this point, we cannot say whether repeat vaccination, for instance on an annual basis, will be necessary.

Currently, for your convenience, we have set up vaccine clinics in select MCMG health centers in Long Beach and Orange County. When you become eligible to schedule your appointment, you will receive notification from us and be able to choose your date and time to be vaccinated at one of these clinics.

Additionally, there are a number of non-MemorialCare locations where one can get vaccinated. Look for the "Are there additional sites outside of MemorialCare that are providing vaccinations?" question below in this FAQ for links to city and county health department super POD vaccine locations as well as information on which pharmacy and supermarket locations are offering the vaccine.

MemorialCare is following the California Department of Public Health's guidelines which groups individuals into phase/tier categories that are then prioritized for vaccine eligibility. MemorialCare has been working steadily to vaccinate these prioritized groups, starting with at-risk frontline healthcare workers and expanding to include seniors 65 years of age and older, individuals between 16-64 years old with underlying health conditions, and most recently, adults 50-64. 

If you are a MemorialCare patient who falls within these currently eligible groups—and have been treated at one of our facilities within the last 24 months—you should be able to get vaccinated at one of our clinics. Using our data, we will be able to determine if you are eligible and will notify you using the contact information we have on file; this may be through myChart, text message, telephone call, email or regular postal service. If you have not already activated a myChart account, we encourage you to do so now so that you are prepared to schedule your vaccine once you've been notified. Until you receive a notification, there is no need to contact our offices to schedule a vaccine appointment. 

At this time, we are not vaccinating individuals at our MemorialCare Medical Group vaccine clinics that are not our patients and who do not fall within the current eligible groups as outlined by the CDPH.

The California Department of Public Health (CDPH) has developed the state’s prioritization guidelines which outline the phases in which individuals and groups are eligible to receive the COVID-19 vaccine. MemorialCare is following the CDPH's guidelines which, from time to time, get revised. 

The CDPH’s Guidelines (new updates added March 25, 2021):
Based on available supply, individuals described below are or will be eligible for COVID-19 vaccines.

Vaccine providers may continue efforts to reach current groups prioritized before offering the vaccine to persons in lower priority groups when: 

• Demand subsides in the current groups, or
• Doses are about to expire according to labeling instructions.
• Providers may temporarily adjust prioritization based on other resource constraints while continuing efforts to immunize higher priority groups as soon as feasible.

ELIGIBLE GROUPS

Phase 1a—

• Persons at highest risk of direct exposure: Healthcare workers / Long-term care facility residents

Phase 1b—  

• Persons at risk through their work (essential workers): Food/Agriculture, Education/Childcare, and Emergency Services
• Persons at risk due to age: 65+
• Persons at risk due to health issues: Individuals age 16-64 who are deemed to be at the very highest risk for morbidity and mortality from COVID-19 as a direct result of one or more of the severe health conditions included here.

Updates to eligibility announced March 25, 2021—

• Beginning April 1, 2021: individuals age 50-64 years old will be eligible for COVID-19 vaccines.
• Beginning April 15, 2021: every Californian age 16 and older will become eligible for COVID-19 vaccines.

Achieving equity—

• This age-based framework will be coupled with a vaccine distribution and engagement approach that prioritizes disproportionately impacted communities, settings, and populations to ensure those eligible for vaccines within these communities are more likely to receive it. 

Until we notify you that you are eligible to make your vaccine appointment and provide you with specific instructions on how to schedule it, you cannot make an appointment. Please do not call your doctor’s office since they will be unable to help schedule an appointment or provide further information.

Please be assured, as we receive a sufficient vaccine supply and as groups become eligible, we will be notifying them. Once notified, the fastest and easiest way to schedule your vaccine appointment will be through our myChart patient portal or by calling our Navigation Center at (877) MYMEMCARE (696-3622). At the time of vaccination, if you receive either the Pfizer or Moderna vaccine, we’ll schedule your second dose.

If you prefer, you always have the option of seeking the COVID-19 vaccine elsewhere. The cities and counties have set up vaccine super PODs (point-of-dispensing) such as the one at Disneyland, Anaheim Convention Center and Dodger Stadium, plus select pharmacy and supermarket sites (e.g. CVS, Albertsons, Rite Aid, Vons, Walgreens) are now offering the vaccine as well through the Federal supply system.

Orange County residents: schedule your vaccine appointment by going to Othena.com.

Long Beach residents: While the city is maintaining its VAXLB website to provide information, including links to pharmacy and supermarket vaccine locations, they are directing residents to the state's MyTurn site to register for an appointment.

Los Angeles residents: schedule your vaccine appointment through the County of Los Angeles Public Health Department's website. 

Statewide Vaccination site: All California residents can sign up through MyTurn to register for a vaccine appointment. You will receive updates about new appointments and locations.

Pharmacies and Supermarkets: Those interested in getting vaccinated at their local pharmacy or supermarket should check those individual businesses' websites. Go here to find out more about this Federal program. Plus, the GoodRx website, which collects vaccine inventory and appointments from sites across the country, is an additional resource to help one find out about locations in California.

Because we do not know how much of each vaccine brand (Pfizer, Moderna, Johnson & Johnson) we will receive or have available for our patients, we cannot control which vaccine will be offered when you make your appointment. Therefore, you will not be able to choose which vaccine type you want. If you make an appointment and upon arrival find out it is not the vaccine brand you prefer, you will have the choice of accepting the vaccine we have available or canceling your appointment.

Please note, many medical experts recommend that you take whatever vaccine is offered to you as soon as possible:

• All three of the vaccines offer protection against severe illness and death from COVID-19.  
• The vaccine supply is limited and will be for a while still. It may be weeks of waiting to get vaccinated by your vaccine of choice.
• To slow down virus mutations, we need to vaccinate as many people as possible as quickly as possible so that additional variants that might be resistant to existing vaccines do not have time to develop.
   

Each of the vaccines have undergone multiple phases of clinical trials. In late-stage trials, they have been tested and monitored on tens of thousands of human volunteers.

Additionally, the FDA, which has the power to quickly approve medical products during times of public health emergencies, has stated that although the COVID-19 vaccines are being fast-tracked, their testing process has closely mirrored the standard rigorous testing and approval process that any non-emergency vaccine would require before it is approved.

MemorialCare's medical experts have studied the findings of these clinical trials and the scientific data and agree with the CDC and FDA recommendations that the vaccines are safe, effective and will lead to a significant reduction in the spread of the virus.

Per a joint statement from the CDC and FDA, people who received the Johnson & Johnson vaccine who develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider. If you have any concerns about your health, whether related to vaccination or otherwise, please contact your primary care physician immediately.

Of course, if you feel you are having a life-threatening emergency, please call 911.

With over 6.8 million doses of the Johnson & Johnson vaccine having been given in the United States, the CDC has only been notified of six individual cases, so this appears to be an extremely rare issue.

No. The Johnson & Johnson vaccine uses a completely different method of causing immunity to the COVID-19 virus than the Pfizer or Moderna vaccines. The blood clotting problem reported in these few cases of the Johnson & Johnson vaccine have not been reported in the tens of millions of people receiving the Pfizer or Moderna vaccines.

The recommended interval between the first and second doses of the Pfizer and Moderna vaccines are:

• Pfizer vaccine requires two doses given 3 weeks (21 days) apart.
• Moderna vaccine requires two doses given 1 month (28 days) apart.

If you receive either of these vaccines, you should get your second shot as close to the recommended interval as possible. However, your second dose may be given up to 6 weeks (42 days) after the first dose, if necessary. You should not get the second dose earlier than the recommended interval.

It is possible you may experience side effects after vaccination. This is normal for each of the vaccine brands. Recipients have complained of pain at the injection site, fatigue, chills, fever, muscle aches, nausea, redness of the skin, swelling, and headaches. For most people, the side effects of these vaccines are mild or moderate and last only a day or two.

WARNING:
People who have a history of anaphylaxis to another vaccine or injectable medication should be carefully monitored for 30 minutes if they choose to get the vaccine. Anaphylaxis is a severe allergic overreaction of the body’s immune system, which can be life-threatening. Those concerned or who have been told by their healthcare provider to carry an EpiPen should speak with their physician before receiving the vaccine.

Age Restrictions:
Currently, the vaccines are not recommended for all ages. While the Pfizer vaccine is not recommended for those below the age of 16, both the Moderna and the Johnson & Johnson vaccines are not recommended for those below 18.

Pregnant and breastfeeding women:
Although pregnant and breastfeeding women did not take part in any vaccine clinical trials, the American College of Obstetrics and Gynecology has issued a statement that pregnant and nursing women should not be excluded from receiving a vaccine. If a woman has concerns, it is advised they discuss the vaccine with their physician.

Fetal cells and the Johnson & Johnson vaccine:
The Catholic Church has issued an ethics statement regarding the involvement of a cell line derived from a 1985 aborted fetus in the original development of the Johnson & Johnson vaccine (noting that there is no fetal tissue or product in the vaccine itself). While some U.S. Catholic leaders have issued opinions opposed to use of the vaccine, a statement from the Vatican recognizes the greater good for use of the J&J vaccine to prevent disease and death and considers it morally acceptable.

Additionally, the local Diocese of Orange has addressed the issue of the vaccines in the following video:
Click here for English
Click here for Spanish subtitles

Those with allergies to any of the vaccine ingredients:
The following three vaccines do not contain eggs, preservatives or latex. The ingredients for each vaccine are listed below, but for more information on each vaccine along with individual vaccine fact sheets, please visit the CDC's vaccine webpage.

• Pfizer COVID-19 vaccine ingredients:
  mRNA, lipids ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate), 2 [(polyethylene glycol)-2000]-N,N-ditetradecylacetamide, 1,2-Distearoyl-sn-glycero-3-phosphocholine, and cholesterol), potassium chloride, monobasic potassium phosphate, sodium chloride, dibasic sodium phosphate dihydrate, and sucrose.
• Moderna COVID-19 vaccine ingredients:
  Messenger ribonucleic acid (mRNA), lipids (SM-102, polyethylene glycol [PEG] 2000 dimyristoyl glycerol [DMG], cholesterol, and 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC]), tromethamine, tromethamine hydrochloride, acetic acid, sodium acetate, and sucrose.
• Johnson & Johnson COVID-19 vaccine ingredients:
  Recombinant, replication-incompetent adenovirus type 26 expressing the SARS-CoV-2 spike protein, citric acid monohydrate, trisodium citrate dihydrate, ethanol, 2-hydroxypropyl-β-cyclodextrin (HBCD), polysorbate-80, sodium chloride.

The CDC recommends that people who have had COVID-19 still be vaccinated. The risk of reinfection is very low in the first 90 days, so some people may choose to wait that long, but that is not necessary. People with current COVID-19 symptoms should wait, however, until their acute illness has resolved before being vaccinated.

Because this is a new virus, we are still learning about short and long-term immunity. Medical professionals are not certain how long a person can remain immune after having been infected. Therefore, those vaccinated will either gain immunity or potentially extend or strengthen existing immunity.

Because it will take time to vaccinate and immunize everyone and there is a small chance that a vaccinated person can still get and spread the infection without getting sick themselves, it is strongly​ advised that even after being vaccinated, you continue to social distance, mask, and wash your hands frequently.

Recently, the Centers for Disease Control and Prevention (CDC) issued its interim set of
recommendations on activities that people who are fully vaccinated against COVID‐19 can safely resume. The new guidance – which is based on the latest science – includes recommendations for how and when a fully vaccinated individual can visit with other people who are fully vaccinated and with other people who are not vaccinated. The guidance represents a first step toward returning to everyday activities in our communities, but with many caveats. The CDC will continue to update these recommendations as more people are vaccinated, rates of COVID‐19 in the community change, and additional scientific evidence becomes available. The most up‐to‐date information can be found here.

The following are the CDC’s new guidelines for those who are fully vaccinated:

• You can gather indoors with a small group of fully vaccinated people without wearing a mask. Note: per CDPH, this does not apply to healthcare settings or other public places.
• You can gather indoors with unvaccinated people from one other household indoors without wearing masks or staying 6 feet apart if everyone in the other household is at low risk for severe disease.
• If you’ve been around someone who has COVID‐19, you do not need to stay away from others or get tested unless you have symptoms.

On March 11, 2021, the White House announced that all American adults would become eligible to sign up for COVID-19 vaccines no later than May 1st. And on April 6th, the administration changed this deadline to April 19th. President Biden's goal, based on the work his administration has done to ensure an accelerated vaccine supply, is to allow Americans to gather in relative normalcy by July 4th.
 
For residents of California, our governor announced that every Californian age 16 and older would be eligible for the COVID-19 vaccine beginning April 15th. Until this date, MemorialCare will continue to follow the California Department of Public Health's vaccine group priority guidelines that currently focus on vaccinating seniors 65 and older, patients 16-64 of age with underlying health conditions, and as of April 1st, patients between the ages 50-64.

The speed at which we can administer the vaccine to everyone who is eligible is highly dependent on receiving a sufficient vaccine supply.

All hospitals and healthcare providers who administer the COVID-19 vaccination doses are required to report this information to the California Immunization Registry (CAIR) within 24 hours. In order to be able to do this, they must be registered with CAIR and have an immunization information system ID number.  Vaccine providers must also report to the Vaccine Adverse Event Reporting System (VAERS) any moderate and/or severe adverse events following a vaccination.

For more information on COVID-19 and the vaccines, please visit the CDC website:
COVID-19
Vaccines