Full FDA approval, boosters and other things you need to know about the COVID-19 vaccine

Delta. Gamma. Alpha. (Blue 22. Oma-HA! Set, hut!)

With all of the variants floating around out there these days you might think that Peyton Manning came out of retirement to work for the World Health Organization. Unfortunately, there are just so many of these variants that health’s governing bodies have finally thrown up their hands and resorted to the Greek alphabet to keep track – because let’s face it, we all know it’s just a matter of time before Double Zeta is breathing down our necks.

As of July 16, according to U.S. Centers for Disease Control and Prevention, the Delta variant was the dominant strain of COVID – a sobering reminder that this virus is constantly trying to figure out a way to adapt and become more troublesome. But there is some good news here: Though hospitalizations from the coronavirus are trending up, 97% of those who are being admitted are unvaccinated. So while the virus is getting craftier, it’s still not happy when it runs into a prepared immune system.

“It’s just a matter of time before it figures out a way around the current vaccines,” said Danielle Scheurer, M.D., MUSC Health System chief quality officer, who oversees all things vaccine for the hospital system. “Right now, it’s found a way to be more infectious, but it’s not a worse disease. So it’s not all bad news.”

With the vaccine landscape still in a state of flux, we are periodically checking in with Scheurer to ask her the most pertinent questions that are hanging in the balance.

Q. Percentage-wise, where is Charleston County in terms of who has been vaccinated?

A. Right now, around 58% of Charleston county residents age 12 and older are fully vaccinated. 

Q. Who isn’t vaccinated still, and is there a particular reason?

A. Mainly it’s young people. The 18- to 40-year-old range is a big one. As for why they aren’t, it’s the same hesitancy issues that we’ve been dealing with all along. It’s the fear of short- and long-term effects and still this misguided notion that COVID won’t make them that sick. I think everybody has their own experience of somebody they know getting it and not getting that sick, so they’re not that worried about it. That’s a dangerous game to play. As for access, it certainly isn’t an access issue anymore. If you want the vaccine, it is not hard to find a place to get it.

Q. So finding a place to get the vaccine is still a piece of cake? 

A. We have made sure that any MUSC Health site or clinic has the capability to administer the vaccine on-site that same day. But because the uptake has stalled so badly – people just aren’t getting vaccinated anymore – I worry that across the state, vaccine sites will start dwindling because of a lack of traffic. Luckily, I think places like retail pharmacies will always have it. 

Q. When will kids under 12 be able to be vaccinated, and are we still thinking that’s the best approach?

A. The trials are just taking a long time because the COVID prevalence has gone down over the past few months. That’s a good thing for society, but for studies, the less data you have to work with, the slower the going is. That said, I think by the fall, we should see one for kids under 12. 

Q. Why haven’t these vaccines – in particular Pfizer and Moderna – been given full FDA approval?

A. The FDA is taking the normal amount of time it would; it just feels like forever. If you look at the normal review process, it usually takes this long – or sometimes longer. It’s not unheard of for these sorts of things to take years. Understandably, they can’t just go, “Yep, we’re good,” but at the same time, you can’t help but feel like we’re in this time of extenuating circumstances, and maybe we don’t have the luxury of being super methodical. So they’re in a tough spot. But I will say this: The slow pace of approval is undermining public confidence in these vaccines. 

Q. What makes this virus different from other respiratory viruses?

A. Almost all of these viruses have long-term symptoms, but the thing about COVID that is different is we can find traces of it in almost every organ once someone has been infected. That’s not the case with the more common respiratory viruses. What makes it unique – and scary – is that COVID has figured out how to get in your kidneys and heart. It can go everywhere. It is a full-body virus. 

Q. The subject of a booster has been tossed around a lot lately. What do you think the likelihood of having to have a third shot is?

A. I think it’s any person’s guess. And there’s still no evidence that a third dose will even make a difference in most patients. But having said all that, I do think there will be some support to have a booster for those who need it – like elderly or immunosuppressed people.

Q. What should people be doing in their daily lives when out in public at places?

A. The CDC just changed its guidance and is saying that fully vaccinated people should wear masks in indoor public spaces in certain parts of the country. So, like in an airport or grocery store, you don’t know who you’re with. At the end of the day, it’s still a little less than a one in two chance that the person in front of you or behind you isn’t vaccinated. So I do think that it makes sense to still wear a mask indoors. Frankly, commercial flights haven’t ever stopped requiring travelers – vaccinated or not – to wear masks on planes. And if you’re wearing it on the plane, you might as well wear it in the airport. I do think people are having this internal conflict, and again, don’t look now, but I’m afraid we’re going to come back to the idea of avoiding indoor dining again. So yes, the smart play is just to be safe and wear a mask in indoor public spaces. If people need a more specific reason: Do they really want to risk getting sick? I certainly don’t.

**Have a question you'd like answered? Email it to donovanb@musc.edu with the subject line "Vaccine Q."