Vaccine Town Hall

001good evening everyone thank you for being here my name is mike morris i'm the superintendent of schools here in amherst pelham and amherst palm regional district i want to thank you for coming to our vaccine town hall tonight i'm really really pleased i'll introduce uh some guests that are going to be able to talk through and share some information tonight and the orientation or the format tonight is uh well they've organized a slide deck that'll take you know 20 25 minutes or so to go through some of the science of vaccines we know this is a really important issue and then there'll be a chance for an opportunity for interactive q a so at the bottom right hand corner of your screen you should see a little your name and it has a blank that

002says say something and if you type in we'll be able to see those comments but the origin of this is is in my role i've been getting an increasing number of questions from staff members uh from families about themselves or their children about the vaccines and my degrees in something else so i felt ill prepared to answer all the questions coming my way so we're very fortunate our community that we have local physicians and others who are willing to come join us and share their expertise and be able to respond to the very real questions folks have um about vaccines for themselves their children or their community i want to really again thank them i also want to note that this the chat will be moderated so at the beginning it'll be much more presentation

003then we'll open it up and i'll just ask folks this can be a very contentious issue vaccines we know that i know that from living in this community as well as working here and we're just going to ask folks to really be respectful um if there's just a differences agree of perspective or disagreements that's perfectly acceptable but i really want to thank these folks who are volunteering uh after working uh non-stop for a very long time on on covid and this work and supporting our community to take another hour of their already busy schedule and away from their families you know i'm deeply appreciative so all that being said uh let me bring up our guests tonight and i think we'll just go in order and i'll ask them to do introductions so dr westerfer

004why don't you introduce yourself and we'll just go and order on our screen hey i'm laura westford i'm an er doctor down at bay state i am also a researcher and my spouse is a teacher in the amherst public school system uh as of note i am also currently pregnant and was vaccinated during early pregnancy and so that will be part of my perspective here thank you dr ernest hi good evening so my name is comma ennis i'm an emergency doc i've been at cooley for about 15 years at this point i've got two kids in the at uh over at wildwood a fourth grader and a sixth grader my sixth grader got her first dose of vaccine on friday i got my first dose back in december on the first day that cooley dickinson

005had it available i uh serve as the associate chief of the mercy department and medical staff president there thank you thank you and dr everett hi i'm peter everett i'm a pediatrician here in the community and i have a 5th grader an 11 year old at fort river and i'm excited to be here as part of this this group in this town hall to talk about these vaccines thank you and dr source hi everyone i'm bill soros i'm an emergency physician out of bay state mostly springfield a couple times up at franklin and we have three kids that are in various stages in the amherst school system so very happy to be here and talk with y'all thanks and dr garcia hi i'm estefan garcia i'm the chief medical officer at coulee dickinson hospital i'm

006also a pediatric emergency medicine physician and i live in pelham and my uh daughter uh just got her she's 14 and just was vaccinated on friday at the school so thank you thanks and representative dumb hi everybody i'm mindy dahm i'm the state rep for the third hampshire district i represent amherst pelham and half a granby in the massachusetts legislature my two adult children are graduates of the amherst public schools i'm thrilled to be here and um i'm thrilled to listen to these experts from our community and to hear the community's concerns and to make sure that we have the resources we need to take care of each other thank you thanks i should mention too i have a seventh grader and a first grader in the district and i guess we could have done

007this at the clinic on friday because i was there as my daughter uh received her first dose of pfizer as well um but thank you all you know sincerely for all be for being here um and i think uh dr westerfers can i think bring up some slides that we're going to go through there's a lot of them but they're jam-packed with information that i think is going to be really helpful for our community there we go it's just better uh then people at least can see you a little bit i think great um thank you everybody so i'm gonna start out with um kind of the introduction so again my name is bill soros um and i think the first thing is just just to start very broadly and and so we're all kind

008of on the same page especially when it comes to probably getting into some more of the details later um so the first thing is you know to know you know kind of who we are as medical providers um so we're not supported by pharmaceutical industries i think that's important and we're not employees of the school system um as you really heard we're all community members and we have families and children in the amherst schools and really these are our views based on the science and also based on some of our experiences you know i think what we see looking in as medical providers is you know at best it's really confusing out there and honestly there are some outright lies especially on things like social media about covet 19 and so really our goal today

009is to try to present the facts that are known about covid19 really with the idea of helping you come to your own decision you know we're not here to influence or tell you what to do but i think we are here to tell you what the science is and also to tell you when there's uncertainty because you know that is true that there is still some uncertainty on things so i think that's really important so let's start really basic for everyone for the adults why why do we need the vaccine um so the first thing is obvious right deaths and if we look you know if we look at our numbers in massachusetts the the graph the death rate is going down and this is in light of new variants and more contagious forms and

010other places in other countries where the death rate is skyrocketing so very basic to start with that hospitalizations preventing folks from getting really sick and this is especially for adults same thing looking at the graphs in massachusetts we're trending in the right direction as our vaccination rate especially as our vaccination rate of adults go up the number of people who are dying and getting critically ill is going down um those two are pretty obvious and then also we we think about complications um you know and and a few different complications for adults um thinking about kind of long-haul syndrome and a few other things that we'll talk about but then shift over what about for kids um and i think to kind of set the stage there are some things to talk about first although

011kids don't get as sick you know especially kind of the older type of kids they still can get sick from covid right this is not something where no children are getting sick in fact you know kind of going down if you start to look at hospitalizations in fact it appears there are more corporate 19 hospitalizations in this age group again older kids than in flu and again it's rare for kids to get hospitalized for flu but but understanding that this is not a never event that this still is an illness and that that kids especially as kids are going up and getting closer to adulthood um have some potential although more rare to get sick so that's one reason the other thing is this hopefully this idea of decreasing some of these rare complications and

012and we'll talk about that more but there are two rare complications that we'll probably bring up one is this idea of multi-system inflammatory syndrome of children and the other is again we mentioned this for adults but this long-haul syndrome this idea that there are some especially as we think about older kids that may have some persistent symptoms that may interfere with their life and their activity after having coveted for we don't know how long but i think there are some couple unique things with kids that again we're going to talk about and one is hopefully the improvement in mental health um this has been a time period where kids have really had to adjust and i have to say the kids that i have known and seen have done an amazing job adjusting to this

013new world but we also know and many of us you know work in the emergency department and have seen some of the mental health tolls and the increase in the number of kids with depression anxiety and it is taking a toll and so part of that reason uh to think about kids and vaccine is to be able to allow them to get back to life that is a bit more normal that interactions are a bit more normal that matt they don't need to wear masks that they are not afraid of hugging other kids so that's kind of a really important one that they'll highlight and then there's kind of the the more epidemiologic the more group idea of of protecting others in our community you know the whole point of vaccine is to decrease that

014susceptible population right whereas if no one's vaccinated then someone we know that has copen 19 can easily spread as more and more get vaccinated that reservoir decreases and that's important because for adults we're never going to hit 100 vaccination there are many reasons some very valid reasons why adults and some people at risk might not get vaccinated and so if you know being safe being able to help others in those in the community can be an important part to that so with that i want to hand it over to dr westifer to continue and talk about some the specifics about some of the different vaccines all right and just a note here is you you may see some uh qr codes on the bottoms of the slides and those are uh links to references so

015if you um don't want to take our word for it or you're just more interested in something you can just point your your phone to that qr code and that should take you to the resource where we got our information and today we're going to spend the bulk of the time talking about one specific vaccine because that's what's approved for for the kids but we're going to talk a little bit about the vaccines in general and there are two different types and they work in very similar ways they're the mrna vaccines and these are the referred to as the pfizer and moderna vaccines and then there are the viral vector vaccines the johnson and johnson vaccines and these are uh they essentially kind of do the same thing is what they do is they they

016get the vaccine the vaccine gets the body to make a spike protein which is it's just highlighted here um in that that brighter square it's just one teeny teeny tiny little piece of the virus that can't go on to cause covenanting it can't go on to make you sick or anything like that it's because it's just this one little piece um and basically the body the the vaccine gives the recipe to your body to make that and it works in the muscle of your arm that's why when you get a vaccine and you get the flu shot you get the tetanus you get the cavity vaccine your arm hurts usually the next day is because that's where all the work is taking place um the vaccine itself the particles etc they don't enter the bloodstream

017they work right there usually in that muscle of the arm in the mrna vaccine which is the one that has been sort of most used in the united states and one that is currently available for kids basically all it is is a recipe that self-destructs so think like somebody sends you a snapchat um of a recipe and then it goes away that is essentially what the mrna vaccine does it says hey body you make this one little protein um for just a teeny bit of time and then the instructions go away and this isn't novel people talk about mrna as new or novel but this is what happens if you were to get infected with any virus except it wouldn't be a recipe for that teeny tiny little spike protein it would be for the

018whole virus so that the virus can hijack the cells in your body to replicate and make you sick so that's just a general overview of how those vaccines work and what happens is your body produces an immune response to that little bit of the virus so it recognizes it and can fight it off in the future so that hopefully you don't get sick or if you are exposed you do get sick you're not ended up in the hospital you're not ending up dying from it you're not ending up with those complications and one thing that we we've seen is that this vaccine came on so quickly and it's caused some concern that steps were skipped in the process but steps actually weren't skipped and this is a really fascinating thing is that typically when you

019have a vaccine research happens and as a researcher i can tell you research goes really really slowly there's not a lot of funding for it you have to get the money you have to get your teams together and you get these ideas and then you test and then you go to approval and then you you start making the batches and then you figure out delivery and that's the traditional and that's why it takes so long in addition to oftentimes you're looking at viruses um that may not be that common because people are immunized against them um or may take a long time to develop now on the bottom you'll see an example of the covid19 vaccination timeline so the same steps are all there but things happened sort of all at the same time for

020some of these so the research happened and as they were developing promising candidates what happened was they started working on development and delivery of them but it still went through the same testing and it still went through the same levels of approval so no steps were skipped in that no steps in monitoring none of the safety steps they still all went through those really sort of key and vital steps it's just it was expedited it happened more quickly because there was funding for it and people were trying to really get together and pull their resources it was basically a teamwork approach now this kind of gets into safety so one of the things that concerns people with safety is what work steps skip well they weren't and then what do we need to know looking

021forward like what are side effects and what we know about vaccines in general whether it's the flu vaccine the tetanus vaccine other things is that if something bad is going to happen you're pretty much going to see it six weeks within that six weeks from vaccination usually pretty early on but sometimes it may take a while to catch something so that's why for the vaccine studies you have to have two months of follow-up for like most of your participants most of the people in the study they have to be followed for two months because that then you're gonna capture the safety events you're going to capture anything bad that might happen and by now we have a lot of data on these vaccines so in the united states alone over 250 million doses of the

022vaccines have been given and most of these are in fact to adults not into children but we have that means we have a lot of information on the safety of these vaccines and what we found is that with regards to the mrna vaccine so these are the pfizer modern vaccines there really aren't any major safety signals people were a little bit worried about allergic reactions but then we found out that those were actually very very very uncommon nothing else really turned up in terms of oh my gosh we should be worried about this or this is a common side effect now with the johnson and johnson vaccine which it works in a little bit of a different way there is this rare blood clotting disease um that has been found to be associated with this

023vaccine that is very very very rare so we're talking about um of if you look at all people that might get this vaccine it's under one in a million if you look at those that might be more likely to get this and here you're looking at women who are age 18 to 49 it's seven per million so still very very very rare but something to be aware of if you're thinking about getting a vaccine i mean you're trying to figure out which vaccine might be right for you this is this is one uh one safety signal that has arisen with this and i think that by finding something that is so very rare this is a testament to sort of the surveillance around it so it's not like they develop the product and then they're

024done with it they just give it to millions of people what happens is they're collecting so much data from people to try to figure out and really go through and figure out okay is anything bad gonna happen and that's part of uh the v safe registry so if you get vaccinated you'll probably get a sheet and if you don't get a sheet you can still go to this website um through the cdc and basically they send you a text message every day that says how are you feeling today good fair bad did you have to miss work today are you pregnant okay did you have any of these symptoms um and and what they're trying to do is figure out and really get from people what are you feeling after the vaccine did anything bad

025happen did you have to go visit a doctor to really get that from millions and millions of people just by sending text messages to your phone for a couple months now it's not like there aren't any side effects from the vaccine there are side effects and they typically are more common after the second dose of the mrna vaccines and what these are is these aren't like diseases that it causes it's side effects related to your immune system response so basically your body is reacting to the spike protein getting ready to fight it off if the virus were to come around and that creates a little bit of an immune reaction and so these are things like chills body aches headaches and fever these are the most common things people might experience after a vaccine but

026not in everybody and so when they look at this like almost everybody has pain at the site where they get the vaccine that's where it's doing its work a lot of people will have fatigue and headache and muscle aches and some joint pains um some people will have chills and few people will have fever and when they have fever it's usually like in almost all patients is below 102 fahrenheit but even if you look at those that got the salt water injection like a lot of people still had fatigue and headaches just kind of showing that you know it's not that 60 of people had fatigue caused by the vaccine probably an additional 40 did because let's face it we're all pretty tired at baseline we've got kids we've got jobs we're taking care of

027people there are other reasons for these now fats are looking at this and looking at how effective it was and how safe it was in adults they started studying this in younger and younger people right now we have data on the 12 to 15 years old they're already studying it in younger kids as well um in in the pfizer and the modern vaccine and so they administered the pfizer vaccine in the study to over 1 000 kids and another 1 000 got salt water and what they wanted to know is what did these kids experience and basically these kids they had an immune response to the vaccine and here i chose sort of the more severe numbers just if anything to kind of give an overestimate of what people might experience here but the same

028sort of thing some pain where they got the injection in their arm they were kind of tired they had some headaches maybe some muscle aches um a decent number did get fever but almost all of them were under 102 fahrenheit um so so not high or dangerous fevers and again in the placebo group which is basically just a saltwater injection that's all it is um people still had some of these symptoms as well so that's just an overview of the the vaccines and their general safety and how how they came about but there are other groups um in which we kind of worry about things a little bit more and when you're looking at kids or even if you're looking at adults one question that has come up is covered 19 vaccines and fertility is

029there a link here and what we know at this time is that available data and there's a good amount indicate that covid19 vaccines do not cause infertility and what they've done is is the companies do standard uh standard studies which the people do with all kinds of medications and they figure out they give it to rats which is you're like you're they're massive humans but this is what we get all of our data about fertility really on um and they injected they made them and they say okay is that normal and then they give it to they give them the vaccine um when they're pregnant and they figure out are there any effects on either fertility or the development at that time these are called developmental reproductive toxicity studies and they found that these these

030vaccines have no effect on fertility and in fact the viral vector vaccine which is the johnson johnson vaccine that's been previously given um for things like ebola before um and and nothing was found there as well we also can look at the data about people who have gotten the vaccine and become pregnant and people who have got got the salt water or the placebo and got pregnant and it was about the same numbers of people in both so it wasn't there wasn't a signal in these thousands and thousands and thousands of people or millions in real life data um who got the vaccine and the number of people who got pregnant in each arm now you may have heard there are some similarities between the spike protein which is what the the vaccine sort of

031gets your body to make and things on the placenta that help feed the baby or the fetus now this it really this is really jus nothing more than a rumor but i thought it was important to address because people did studies based on this rumor to just show that there's no there's nothing here um there's no cross-reactivity between those and what happens is there are tiny little stretches in this genetic code um that are similar but otherwise they're completely different so it's like saying well you know that goldfish and that human are similar well yes they both breathe or there might be some similarities there but obviously like your body would not mistake one for the other and they they have confirmed this both like in the lab um and then as well as like

032theoretically just thinking about how might this work so uh people that spend their time helping people get pregnant so the american society of reproductive medicine recommends hey if you're contemplating getting pregnant now in the future we still recommend you get the vaccine because the side effects um of the vaccine with regards to fertility um are are not no we they don't see any at this time with a decent amount of data but we know that copin 19 is bad now what about during pregnancy and this is something that i struggled with as well because i'm an er doctor and covid was essentially my life in december when we were having yet another surge and oh by the way the vaccine was released and i had found out i was pregnant the week before so here

033i was five and a half weeks pregnant and trying to sort through this data so i'm going to go through this sort of about how i thought about it and some of the worries that were on my mind and the first thing that was on on my mind was few medicines are tested on pregnant people like none of them um and here so far we have data on over a hundred thousand pregnant people who have gotten to covet 19 and registered with the cdc so if i were thinking about this now i'd be a little more comfortable because a lot of people have gotten these vaccines and are being followed and reporting it to the cdc so we have data on a lot more people now and what we know about this um is that

034uh nearly 5 000 pregnant people who received a coveted vaccine are being followed in detail by the cdc i am one of those people and i can tell you what they do um is they call you and they talk with you they take a full history it's like sitting down with a nurse or a midwife um and then they also ask for the name of your ob gyn or your midwife and they get records from them and they call during the first trimester and the second trimester and the third trimester and then they call after um delivery and then they call again um a couple months later so they're really trying to actively find this data and follow it up they're not just kind of waiting to see what happens and we have some some

035data on some preliminary numbers from this so um of about 4 000 people who were vaccinated um 827 thus far had completed pregnancies so for example i am one of those ones that have not had a completed pregnancy because i am still pregnant so a lot of these are not completed because people got vaccinated in the first and the second trimester and of those 820 who were completed 712 were live births yay um that's 86.1 that means that some were not and you may be worried like i was like what about early pregnancy loss this is something that we we struggle with and we worry about vaccine or not it's a nerve-wracking time and part of the the reason it's nerve-wracking is because we know that early pregnancy loss happens in 10 to 25 percent

036of pregnancies without a vaccine so you don't get a vaccine 10 to 25 percent of pregnancies can have pregnancy loss and often that's called a miscarriage and in the vaccine group it happened in 12.6 which is well within the range of normal so again no sign of increased early pregnancy loss it's about what you would expect you would expect it to be suspect if it were significantly lower or significantly higher either of those two would be worrisome because obviously it's not going to protect you from it um so that would be worried that we're not getting good data we're not having good science around it there's also no sign of congenital anomalies so as a pregnant person my worries were oh my gosh i don't want anything to happen to this pregnancy in terms of

037losing it i also don't want to cause any harm to my potential fetus and you know when at that time i was thinking about vaccines are safe in pregnancy i'm scheduled to get my tetanus shot this week in pregnancy like i've gotten with my prior pregnancies but we kind of lose some of that and i was just so worried about this but now we have some data typically occurs in three percent of pregnancies without a vaccine no vaccine three percent and when they follow this and the with the covenant vaccine data 2.2 pregnancies without the vaccine had a congenital anomaly so the preliminary data does show safety no signs of pregnancy loss um increased risk or congenital anomalies now it may also benefit the fetus as well studies have found that antibodies are passed to

038the fetus when you get immunized and you're pregnant so then there may be some protection there after you give birth so if you're trying to think about your risk of getting cover 19 you'll see the qr code in the corner at they say we developed a decision aid to help people who are struggling with this and try to figure out whether it's right for them um have created a decision that's been used internationally and try to think about things what's your risk of getting kevin 19 can you stay at home can you and those around you always wear a mask and can you really stay safe think about your risk of coping 19 outcomes are worse in pregnancy outcomes are worse if you have other medical problems if you got high blood pressure or if

039you have breathing problems at baseline um if you have extra weight those things can make you do worse if you get coveted and think about the unknowns of the vaccine and how that sits with you we won't have long-term data for a long time and this is because in pregnancy in general we almost never have good high quality definitive data even for stuff we routinely give it just doesn't happen because we don't study pregnant people that way so you know there's always going to be some level of unknown and you got to think about what can you you know how can you you sit with that and think about the other risks that you might have and so the summary here is that kevin 19 vaccine it's been found in essentially millions of people to

040be safe and effective both in the studies and then in the real world studies that they've done to follow up what happens when you vaccinate nations and communities and this includes in pregnancy and then i didn't speak about it specifically happy to give more resources but also in lactation and then the other bottom line is getting the vaccine right now that's that's your choice um you know there are always going to be some unknowns uh but there are a lot of knowns both about covid19 the risks associated with coven 19 and also the vaccines there we go i don't know why that happened but thank you so much for that thorough presentation i put the direct link uh in the chat for anyone who's watching who wants to you know who might have missed the

041qr code uh scanning it because i think that that decision guide i looked at it before i think it'd be really helpful for folks so what we'd like to do now is to open up to questions we did get a number of questions emailed to us beforehand so we can start with those but if you have a specific question again in the bottom right hand corner of your youtube screen you should be able hopefully to see a bar a line there and you could type in any question or comment for anyone in the panel but why don't i jump in one question that we received via email was most uh most if not all medical interventions are determined on a case-by-case basis why are vaccines treated as a one-size-fits-all model so i don't know if

042anyone is willing to jump in on that one uh yeah i can uh jump in on that i think it's it's an interesting question um about the vaccines and it is it is true that the um you know the codexing that's out right now at least the moderna and the the the pfizer vaccine are basically one dose you know you come into your vaccine you're going to get the same dose and so that is true for this vaccine but it's not necessarily true for for all uh vaccines we've seen that with the flu vaccine there's a number of different vaccines that have been developed over the years there have been different doses sometimes for different age groups uh and i think part of part of the thing is that um you know we did there

043was a push we did want to get this vaccine out and vaccinate people as you know promptly as we can to fight the vac to fight the illness um and so what you do is you go out you find a dose that's effective safe for the vast majority of people which which done what they've done you've seen that this is a safe and effective vaccine and then you want to get that dose and regimen out to as many people as you can and get them protected now as time goes on with this ongoing research and reviewing of the vaccine there may be some more specific vaccine recommendations but you'll see this this is one of the reasons why the the vaccine recommendations for the younger kids the you know six months two years up to

044up to 12 is going to take some time because part of the studies are going to involve you know what you know would be smaller kids is there a smaller dose that is you know can be as effective maybe have fewer side effects so that's but i think this is the kind of thing that down the line as we get more information and these mrna this mrna technology gets more refined you may see more specific vaccines being developed for more specific interests anything else people want to add that was a feeling like a very thorough response but i'll just add a little bit to that in that most medical treatments occur after illness and this is very much a preventative measure and so it's uh it is more possible to really apply it broadly to

045a broad range of people because you're not necessarily looking for every single individual to have a 100 response we know that not everybody's going to respond to the vaccine but the goal is really to minimize severe illness for any given person and maximize the number of people who are immune so that we can just stop this thing altogether so it's really not necessarily about you know like when you're treating cancer you want to treat that one person's cancer this is treating a whole community with the vaccination to allow us all to get back to normal life and prevent severe illness thank you um a question that came in by email again but people can jump in live as well what reason should people have to trust a vaccine we know historically what the government has

046done in the name of science to people of color and other ethnic groups and i don't know if anyone was interested in responding to this one mean i'll start and give you a chance just i mean the only thing i'll say is i found it interesting uh there's some data that came out just yesterday that um the vaccination rate over the last few weeks of people of color has um was over 51 of the shots which is uh people of color right now make up 40 of the general population um so i think we are seeing some changing trends in terms of who's getting the vaccine i think there's a whole bunch of complicated reasons why some i think i know some i'm sure i don't as to uh why that's happening but i just

047thought it was an interesting data point that that i saw but uh in terms of the larger question uh as presented i don't know if anyone is willing to jump in on that one i'm happy to jump in on that as well i think that i mean i completely understand the distrust uh in the medical community in the scientific community given the lack of attention to populations of color force i am one i'm an immigrant from oops wrong way from jamaica um and you know life in the u.s and the impact of systemic racism on medicine and healthcare is it's impossible to deny that being said this vaccine i think one of the things that makes it somewhat more trustworthy than it may otherwise feel given the speed with which it was developed is that

048you know the first people to the line were healthcare providers i was one of the first people at globally dickinson to be vaccinated and knowing that there's still so much more to learn but also understanding that we can trust the science and it also doesn't hurt that uh dr cosmetia corbett is one of the uh scientists behind the pfizer vaccine and she is a black woman from hillsborough north carolina who has been doing this work for you know close to a decade um this was not designed only by people who are in the majority this was defined designed and uh developed by an inclusive uh community of scientists and i think it makes sense to to question things but also to rely on the answers that are the truth which is that this is safe

049for all of us thank you anything else from uh on that question um i can just jump in if i may might and just say that you know i want to echo what dr enos said and i don't think presenting information on the vex on the cover 19 vaccine eliminates the history of medical racism and medical bias in the united states and particularly as it involves vaccines and other kinds of treatments but i think we also this is one of those situations where you really look at like so what is the impact of coba 19 on different communities and there is a real disproportionate impact on bipod communities from this virus and we need to respond to being able to make sure that everyone's safe so i just want to throw that out there as

050well thank you dr eunice for your comments absolutely all right next question um longer one kind of goes on too but adolescents have shown a very strong immune responses to the vaccine so far with antibody levels measured well above those age 16 plus is there any cause for concern around the this enhanced immune response and possible development of missc especially which was referenced earlier especially several weeks out from the second vaccine dose sure um hi sorry uh the power went down the internet went off uh i'm not sure i'm not in amherst right now i'm actually out on the cape um with the family so anyway i'm back and i'm using my phone to keep me um on so um just wanted to chat a little bit about just misc in general so the risk

051of misc is about one per hundred thousand that's the multi-system inflammatory disease in children or syndrome in children and um so uh you know and i have taken care of you these um kids not at cooley but when um with my work at umass um and i think it's important to understand that the the um vaccine itself is really um as lauren spoke about really to the spike protein so it's one very small component is what the immune response is to um and while it's a very vigorous response it's to that one component in general the um vaccine if you get covid um you know the concern is that you have a fairly significant response to the entire virus and um probably where the misc is coming from though we don't know what's causing it

052um uh is very likely to be one of the other pieces of that virus that the body is reacting to as opposed to um just the spike protein the um that the vaccine is for so that's good news um uh we certainly haven't seen any misc post vaccine again it's um and the younger age group just started um that's not something we're anticipating seeing at all and if anything the vaccine is likely to be um really protective if you encounter um the um covid later it protects you and it um also probably protects lots of these other pieces of the virus from coming in and the body having a reaction to it um so i think there's there's from my opinion nothing to worry about when it comes to the vaccine and the immune response

053leading to misc which is incredibly rare anyway all right anything else that anyone would like to share okay got one i'm going to pause from the emailed ones because we got one live one and i don't think it's off topic at all so i appreciate the question um jennifer how would you describe the risk level for unvaccinated kids under 12 at this time what extra precautions do families with kids under 12 need to take and and i think this question uh i appreciate it multiple levels both professionally because i'm the superintendent of a district that has kids as young as three and as old as 21 and 350 64 days um and also because in my own family and like many other families i have one child who's above the age of 12 i referenced

054earlier and one who's below and they're living in the same household so i think it's a really critical question it's frankly one i'm getting a lot and so i'm so glad you asked it so we have this group of panelists who are much more capable of answering it than than i would be so any thoughts about the under 12 population precautions um you know of children who are not going to be vaccinated you know particularly soon right you know you know all the things i'm reading are you know sometime late summer early fall is at the earliest in terms of when uh vaccines would be available to this population i can let the pediatrician weigh in in just a minute but just looking from um like a numbers perspective and looking at also i've struggled

055with this because i'm vaccinated my wife is vaccinated but i have a three and a half year old and a one and a half year old who are very last in line um and the cdc has also put out some guidance on this specifically when they first kind of dealt with some recommendations about a month ago thinking about okay uh what can vaccinated people do safely one of the things that they said was vaccinated families can get together in small play groups with other vaccinated people who are also low risk um so without masks and part of that is is weighing what what are the risks of you and the people around you because vaccines aren't a hundred percent in general um and not every six-year-old or three-year-old or two-year-old is the same some have

056um chronic illnesses some may be more susceptible to illnesses so you know unfortunately this is one of those times when there's not a one-size-fits-all answer um because it kind of depends on it or all the people around that person vaccinated so for me it had to do with were all of their teachers vaccinated um all the work study students at their daycare were they also vaccinated because i wouldn't want them you know my one and a half year old she she wears a mask at the playground but she's not always great at it um and so it's you know trying to figure out like who else am i exposing it's my mother-in-law who watches the kids also vaccinated because she's you know over 70. um you know and so a lot of it comes down

057to those very personal dynamics um and then also there is just that level of risk tolerance and trying to figure out how do i let my kids be normal and get that social capital but also not so for me for example i'm still fairly conservative i would let my kids go around other families who are vaccinated but we do stuff mostly outdoors and my kids are like kind of normal about wearing masks and staying far away from people which is kind of sad um at this phase but like it's the weather's great outside right now it's sort of like a great experiment to just get outside and play and do those things um but the cdc has put out some guidance sort of being a little more lenient for the the kids um and saying

058that you know if they're not maxed and they're not vaccinated that being said given the opportunity i would vaccinate my children um when the numbers come out if it shows that the vaccine is safe um and and sort of recommended in that population because um at the same time i want to do anything i can in the world to protect those sweet little babies yeah that that's great that's that's really um that's spot on it is it is a really difficult question because uh about the younger kids who aren't won't be vaccinated until probably this fall at the earliest um and so i think that that decision kind of comes down to multiple factors like you mentioned which is you know what are the individual risks to the family um you know how many kids

059are getting together where where are they you know if you have a you know you're getting together with one other family outdoors or you know and you know this family pretty well and everybody else has been vaccinated except for the younger ones as being outdoors are the mask the risk is going to be a pretty low risk we do know that kids you know it does seem that kids who are under 10 you know will transmit un transmit the virus you know less than an otherwise unvaccinated adult so there is at less risk but as far as compared to vaccinated adults you know there still is at risk potential of of sharing it um so i think you want to kind of weigh that in with how many people are around are you indoors or

060outdoors how long are you together uh and what are the risks to the family and what your tolerance for risk is um decide uh you know but given the opportunity when that when the vaccine is available like i said we have a 11 year old and you know for you know when she's around when she's you know like at school for instance you know you're outdoors you know with lots of people indoors you want to be wearing your mask but you know at home with one other family she's outside running around with um with her friends uh without a mask on you know as long as we know the people that she's with that's good i think i think you know it really is an individual this has got to be an individual um question

061and decision for each family based on what peter and lauren said really the the kind of um child the whether the child is is ill has any uh chronic illnesses or co-morbidities that you would worry about but in general remember that because the fam if the rest of the family is vaccinated even if they were to um you know the family was to get exposed um as the adults or or those that are vaccinated to covet the likelihood of them having asymptomatic spread is is really very low and and also the viral load in those individuals right so the amount of covid that a vaccinated person has is much less so it's much less likely to spread as well so you know pretty good protection around your child um i think and yes i echo

062outdoors in groups that you you trust um is really the right thing to do i think especially moving into the late spring and summer i think that's the the best way to go about it yeah i i agree i think um you know so practically we have a five seven and nine year old and and it's hard and and the cdc you know even when i read when when guidelines change and especially as they relax it's it's nerve-wracking and i've kind of hinged and i will say you know i'm lucky that my my kids are healthy um i've kind of hinged on a few things first outside really seems pretty safe there don't seem to be major outbreaks when people are outside um it just doesn't i mean i suppose it could happen but it

063really doesn't and the second is i've noticed with my kids they are remarkable with the mask um you know i wear a mask and i notice it all the time and i'm futzing with it and if i have glasses then my glasses fog up and i kind of take it down and then i put it up and and my kids will just come home and they'll just keep wearing their mask and they'll just run around and i had to tell them we had the sprinkler on today i'm like you should take off your mask because now you're going to suffocate because it's getting wet um so i i think you know their ability to do some of this stuff and and for better for worse they have adapted to that and you know you can

064take it as is and we've told the kids you know when you're outside it's okay and i think the fact that others are vaccinated and the fact that overall as a community our rates are going down means to me now there can be slip ups and i don't worry a kid can go inside and use the bathroom and hang out with another kid for a little while and i'm less worried about that and i can start to do more oh you know they had a birthday party and they moved inside for cake for 10 minutes so it provides just a little bit of extra buffer for kids to not be you know they hug someone great wash your hands afterwards for right now and we're good and otherwise so so that's been what we've tried

065to do yeah and i think something i'll just take from it from a non-medical perspective but i think you spoke everyone spoke about a bit is how individual this decision is right the individual risk factors are so different um but the one thing i also heard is that you know because our community is doing pretty well and our state's doing really well vaccinations that actually has a side effect of making it safer for these other situations for the unvaccinated folks you know um and so you know i think for me you know i'll just say frankly personally you know it the my daughter who can get a shot getting her shot makes me personally i don't know if i'm right or not but it makes me personally feel better as she's on the road to

066vaccination about my younger child who can't get a shot right and just you know it's it's not the reason we made that decision as a family uh but i think there is some logic to it that the more vaccinated folks like that slide you had up earlier the less spread you know is possible within our family and then beyond so you know i think it is about not just the individual choice about getting vaccinated but actually the community-wide impact uh of having you know lots of people with that strong immunity and that makes it safer for the folks who you know either for medical reasons who can't get vaccinated or for who vaccines aren't eligible yet if there's anything wrong please correct me i'm totally okay because this is not at all what last science

067course i took was a long time ago i'll put it that way um i think the other thing i just mentioned here is that i think a lot of times we want to have black and white like you need to wear a mask now you need to not wear a mask then and this isn't all it has been an area where there's there has been and this has been difficult a lot of gray area in there for different people like different people are going to have different levels of risk tolerance and we're not going to go straight from okay now we have you know 60 vaccinated so nobody should wear masks there's going to be this kind of gradation of time when we're gonna get used to it re-enter the world and kind of what's

068safe and what's not and i think that's what the question is trying to get out like what is safe and what's not and i think we just need to to get there and and and figure it out and if you feel like you know there'll be times when i feel like i need to wear a mask and i know i'm fully vaccinated there'll be times that i put a mask on just because i know somebody else might not be comfortable and there's times if i'm out running or outside then you know i you know don't feel like i need to wear a mask so it is a process sorry just one one last thing cause i can't help myself one thing that was helpful for me in thinking about this was thinking about countries that

069have controlled coveted very well um so for example new zealand um australia to some extent and then countries that have immunized their populations vaccinated a lot of people very well like israel and what happens when they vaccinate a lot of people is that they were able to drop restrictions on kids and things like that but they didn't see these huge rises in cases so people were able to go to soccer games and i guess there it's football i'm not sure um and and do all these fun things like they would have before um even though not everyone was vaccinated because they couldn't vaccinate those kids just because of that whole idea that you really protect the unvaccinated i.e those kids when you have enough levels in the community so that's just the other thought here

070is that if you're really interested in this and trying to figure out am i comfortable with it am i not what what activities do we as a family personally feel good about um looking at some of those uh things might help make that decision and um i want to echo what everyone else has already said and just sort of add the point that you know because it is an individual decision people who have sort of a first or second degree contact that may be immunocompromised so if you have if your eight-year-old's buddy has a grandmother that cares for them who is a cancer patient and has not been able to respond as well to the vaccine or as a transplant patient and would not necessarily respond as well to the vaccine that is a special

071consideration that the kids may not have to think about but as adults we just need to to really weigh into that and make sure that you're having an informed conversation with the other parents um about what what feels comfortable and what feels safe and how to proceed so you know if you're if everyone in your circle and your kids friends circles are you know otherwise well and unlikely to have any severe illness and potentially also vaccinated then you can really relax a lot more but i think it's really thinking about those other people who are less able to to be protected that's what we i mean that's what that's the overall goal of herd immunity and that's i think when we're thinking about exceptions to the rules what we need to consider for um for

072our younger kids as well who can't be vaccinated just yet thank you um next question came through via email thanks jennifer you definitely got the group talking quite a bit on that important issue um so the next question was uh what is the research if there is any on the effect of vaccine on pubescent girls is speeded up stall or does not affect puberty any effects on fertility i think the fertility one was probably directly addressed in the in the slides but probably less so on um puberty pieces so i don't know if anyone has seen evidence around that looking through the data i mean this is not something that uh they have really just in the time frame um not something that that you would be able to see um theoretically there's not a

073like really a link there there have been some thoughts that maybe um that the vaccine is associated with uh variation and menstrual cycle um but to be honest a lot of things are associated with variations in menstrual cycle and so i think that some of the thought may be um related to those just because hormone balances um change with with every little thing but again thinking about how those might also change with regard um to uh an illness so with regards to kevin k if you were to get covered 19 or something like that um so what everything i can't speak definitively on this um so i just have to be transparent and honest about that um but there from what i've seen there's no reason to be concerned um that it would affect the

074onset of puberty or the development um or um and that we know at this time that there's there's no link with regards to fertility or potential i think that's a great point i think lauren brings up a great point that crosses over in thinking about the the risk benefit right the vaccine is specifically designed to make one tiny piece of that virus and realizing that if you choose not to and someone gets the virus they are still getting that one piece right so if that spike protein has something they're still going to get that spiked protein because they get coveted because that's what's going to happen your body eventually will make that immune response you'll get sick from covid but also your body is going to be exposed to all of the other proteins and

075all of the other inflammatory issues so when it's weighing you know i'm not sure because of this spike protein realize that that's what covett is doing we're just the vaccine is just taking that one little specific piece and so thinking about the risk you always have to weigh it with well what about the risk of actually getting full-blown covet in that disease there's one for me actually on this uh maybe representative dom wants to jump in as well but um tell it's not going to be a science one will vaccines be required for students at the beginning of the school year um so the beginning school year is in august we're in may um so it's a really long way away and i think you know what we've seen in the last six weeks is

076pretty significant shifts in terms of guidance from state and federal authorities so uh i'm loath to predict things that are that far away uh i think it's a good question because i know i've seen some superintendents even in the last three days come out very clearly stating that if the you know emergency use authorization goes away that they will be requiring it in their district um i've seen some that have said that they would require it for athletics and extracurriculars only so i think we're seeing people talk about it and i'm not here to critique folks who are ready to make those statements but i've not had any conversations with with our town health department and thank you i think emma dragons on this call who's been awesome partner in all of this work uh

077all year long so thank you emma um i've had no conversations with the school committee uh so you know i think at this point it'd be premature to distinctly answer that question i am aware because i've been reminded this question's come up multiple times and last especially since the colleges i think put out the um requirements the five colleges uh was a couple weeks ago i think um you know i've been reminded that it takes five to six weeks to become fully vaccinated so it's not necessarily a decision one can make on like august 20th and then assume that that'll happen so i you know i just want to share with with the folks here that that i am aware of that fact it is something that as we head to summer we will be

078looking to the state uh department of health and and perhaps even beyond for that information uh and guidance on it and you know in the legislature you know may have some opinions about that i know there's a bill in the state house not particularly this issue but talks about uh vaccine and vaccine exceptions not specific to covid so i i think you know i'd love to be definitive on it except i really wouldn't because i think you know what i've learned over the course of this one of the things i've learned of the course of this year is that pacing is really important we don't exactly know exactly the pacing of how this will roll out what we're seeing is folks who are vactine hesitant some populations really switch you know the more time passes

079and uh we don't know exactly the tracking of the virus right you know i'd love to know on what what's going to exactly be our case counts on august 20th none of us here can truly predict that so it's a really hard one to have specific uh specifically respond to i know the state department of education will in the next couple weeks be coming out with their sort of fall guidance document i don't know if this will be involved in it or not so i hate to have a non-answer but i actually think it was a really important question at least to respond to publicly because i know it's on a lot of people's minds and you know frankly when superintendents talk about this it makes lots of news um and that's happened in the

080last 48 hours so at this point i'm going to wait and see approach i think i've been very public and and gotten some virtual tomatoes but not too many that i'm pro-vaccine right um that i think it's a good thing and you know our focus last week last two weeks actually we've had a 16 plus clinic and then the 12 plus clinic is really around access we want to provide as much access in our community and that's why we ran our clinics the way we did in terms of intensive special needs which are among the highest risk populations we all talked about you know individual risk factors of students who can't always be masked that's going to be an increase in their risk factor we had it ran it during the school day which unfortunately

081pulled out some students but it meant that they didn't need to rely on transportation of their parents being present to have that one student told me it was an incentive to miss a little bit of the friday afternoon class on a beautiful day as well so not exactly the ohio million dollar lottery uh incentive but you know for this 13 year old it seemed pretty darn important and and perhaps a little bit motivating uh to miss their last period a part of their last period class um but in all seriousness you know we'll wait and see and it's something that you know we will talk about publicly and and have some communication if uh if that you know if it goes in a specific direction and and i will say last thing i'll say on

082this and open up if anyone wants to comment is uh you know i've got people all over the map on this some people are really asking and almost demanding um that we put a mandate in and other people are much more cautious and very concerned that a mandate would be uh placed in and i think it's like much in the public policy world as representative dom knows very well of covet is that you know people are in really different places on this and we're trying to understand where people are and let that develop over time to make the best decision for our community i don't know mindy if you had anything you wanted to add from your your end i thought your answer was great i also want to shout out emma dragon who i

083think is on the call um for the amherst health department who's been just such an incredible champion all things public health and probably could speak more to um getting last minute sort of advisories from the state and having to implement them on a dime so i think that what's going to happen here is we're seeing as mike mentioned more and more colleges and not only in our area but across the state are requiring it as part of the enrollment in the fall that's one piece of it so that's not k-12 but that is that does affect a community like amherst because we are are a host community so i know there was concerns that people had when um students came back to campus without a vaccine so now we can feel maybe a little bit

084more um at ease and comfortable knowing that the colleges in the connecticut river valley are all sort of making that a requirement i tend to think on the state level they're going to wait and see if cdc comes out with a recommendation um the governor seems to be very comfortable aligning the state public health practices with what the cdc speaks about not only because now the cdc has moved away maybe from being kind of a politicized organization but it's also run by somebody that many people in boston know um dr welinski comes from mass general and people feel comfortable and trusting um of her expertise so i think what we'll we should look out for i think um is what is the cdc saying during the summer because that's probably foreshadowing what we'll start hearing

085from the state um government that would be my only prediction though at this point anybody else want to wade into that one well i i did want to just jump in and just make two quick comments one is just to just to point out and really thank you superintendent morris and emma dragon everybody who put together this amherst clinic at the schools this past week and from all reports that you went really smoothly and i think more that we can do to get vaccines clinics like that out and to the kids and make it easier for them to get there it's going to make a big difference in getting vaccines um into people and to protect our community so i really appreciate the efforts there and and i guess the second thing i wanted to

086just point out is that as we get closer to this fall and if you know if the recommendations come out that the two through 11 year olds you know or can get the code of vaccine this fall it's going to run as everybody knows into flu vaccine season so one of the questions has come up over the year over this past several months has been well you know can we give other vaccines at the same time as the covet vaccine and initially during the studies you know the studies were run to such that you know you only were able to do the study if you got the code vaccine and nothing else so initially they had said you know don't get vaccines together but the american academy of pediatrics has come out uh just this

087past week with a statement saying that it is it's okay to give the cover vaccine together with the other regular childhood vaccines um part of the reason for that is that they're in the past there's been few to know instances of any kind of vaccine interactions that would affect cause problems or affect side effects or um effectiveness i think the one example that i can think of is that there were maybe some mild increase in risk of fever with a flu vaccine and a pneumonia vaccine given together but even then the recommendation came out that it was still good to give them together and the main reason for that is that over this past year you know with covet and you know everybody's been staying home or doing virtual business and not coming in you

088know initially back in last march you know maybe not going in for their uh initial visits i'm sure you're all getting your calls from the doctor's office now saying come in for your visit um but as you know many kids didn't come in or missed maybe got behind on some of their vaccines and we know that's something we want to catch back up on because we don't want to you know get behind on that and suddenly find out that we're dealing with other uh you know issues related because we're not vaccinating our kids against pertussis for instance or or the flu uh this coming fall so that's just something to be aware of that when you come in um it is okay to give those vaccines together if you need to can i say one

089more thing i just want to point and thank you dr everett for that that plug to make sure that people keep up with their other vaccines for their kids but i also want to give a hat tip to you mike morris because by putting the vaccine by making the vaccine clinic on the school grounds for students during school it also sent a message that our kids really need to hear is that we're caring about them and that we're continuing to care about them enough to do something like that and i think particularly after the year we've had and how students lives have been really altered that is a beautiful message to give students that day so i want to thank you for that thanks and really i appreciate that tremendously but you know emma and

090the amherst health department not every and i don't i don't know how to say this uh fairly but not every health department either you know is able to or willing to come on site right and you know uh it was emma's focus is the same as all of our focuses how do we provide vaccine equity how do we get to kids where they are if they're there for them and their families are willing to do it and i also want to give a huge shout out to our staff who for families who had barriers whether it's linguistic barriers or other barriers how much outreach went on that was behind the scenes that got kids there it was a tremendous amount so i'm just fortunate to be able to work with really really good people i

091know that sounds cliche but it's just it's really the truth you know i just got to watch uh watch the scene and uh watch kids as i was mentioning before we started act really tough so many parents came up to me and said i want public vaccination for all my kid for everything else because there was no complaining there was already none of that so uh that wasn't true for every kid but for a lot of kids it worked really well and even though there was privacy it really did work well both of the 16 plus which we did the week before uh as well as the 12 plus last week and we've got the second shots already lined up and people you know parents should have gotten those emails uh same time same place

092three weeks later so um we are at time um so um i don't know if there's any final words that anyone would like to share no one certainly has to but i don't know if there's anything that um i have a little wrap but if anyone like to share anything they're welcome to i want to point out that there's four locations in amherst where adults can go and get walk-in vaccine that they don't need to schedule an appointment and one of those places is the bank's community center through the amherst health department on mondays and thursdays so they have a walk-in clinic you don't need to have an appointment tomorrow between 9 and 12. umass still has their vaccine clinic it's also walk-in and the two cvs pharmacies have walked in thank you thanks mindy

093well with that i just want to thank all of you for being here uh as someone who as i said before has been publicly pro-vaccine i feel even more pro-vaccine because i i know the science of it a lot more uh and i think the way you describe particularly the risk factors for individual populations as well as the the history of medicine in certain populations in our community uh is really helpful for you all for me to hear and hopefully helpful for the community here if you're watching you know we'll put this in our friday newsletter this link but you know this link will stay live this video so if you watch and said oh i know someone who would like to watch it the youtube link you're on uh about five five minutes from

094now will will be good to go and you can just email that out to anyone who you think might benefit from seeing it but thank you all for being here spending part of a what was a beautiful evening outside um with us and again thanks to our guests for spending uh you've been you've been in the trenches working on this uh for 14 months and beyond so i really appreciate you sharing this your expertise with our larger community thanks for being here and have a good night