W.The chickens of the Disease Control and Prevention Advisory Committee voted Tuesday that residents of long-term care facilities should be at the front of the line – with health care providers – for Covid-19 vaccines, the only disagreement came from a researcher studying the vaccine in older adults.
Helen Kip Talbot – known by her middle name – raised serious concerns during a meeting of the Vaccination System Advisory Committee about the use of the vaccine in the elderly, noting that there are no data yet to indicate vaccine function in this population.
Covid vaccine U.S. All Phase 3 tests are based on people aged 65 and over. But none of the long-term caregivers have tested the vaccine specifically. No findings in people over the age of 65 who are healthy enough to be acceptable for clinical trials are every indicator of demographics, he said.
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At an earlier ACIP meeting, Talbot warned that vaccinating this population early in the vaccine rollout is risky, as long-term care residents have high medical rates of medical events that can be confusing as a side effect of vaccination and weakening trust in vaccines. . “And I think you’re very upset, ‘my grandmother got vaccinated and she died,'” he said at the time.
STAT spoke to Vanderbilt University Associate Professor of Infectious Diseases Talbot on Zoom and asked why he voted against putting long-term care residents in “Phase 1A” for the Covid-19 vaccine, which is likely to begin. . In the second half of December.
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The conversation has been slightly edited for clarity and length.
Watching ACIP was a bit unusual – which is an evidence-based decision-making group – recommend on the assumption that vaccines will work in frail older people.
I think they made it based on data. It was data on the number of deaths in that population. The number of deaths in that population is far from the proportion of infected numbers. And that was the main reason for the vote.
You study the vaccine in the elderly. Tell me why you think vaccinating long-term care residents is not the right approach.
I think if we have the data it is the right approach.
He is the same kicker. We tested them regularly, and more recently for almost all of our adult vaccinations, in college-age children and Army recruits and found that they have been used and used by older adults.
The first example is the flu. In 1960, the Surgeon General said, well, it works in young, healthy adults, so in older adults it should work at least partially. It has been around since 1960, “because it will probably work partially.”
Assuming these vaccines work we really need to quit and really design it and test it in this population and use it properly.
Are you worried that these are doses that will be wasted?
I will not say in vain. But they are not used as effectively as they could be.
If I know it works in a healthy health care worker, I would instead vaccinate all health care workers so that when they are around the weak elderly, they do not make the weak elderly sick.
We do not yet have enough vaccines for all health care workers. We will eventually, but we are not yet.
Do you have any safety concerns about vaccine use in long-term care residents?
More than anyone else? No. But I think what we usually have for the adult population is a randomized controlled trial to look at the safety data.
What do you mean
If something happened to me following the vaccine, can we go back to the control trial data and see if this has happened in both groups? Whether or not it happened in the placebo group. We can’t do that for a long-term care facility because no trial was done in the long-term care facility.
And you can’t extraplate from a normal Phase 3 trial?
We can try. But that is not crucial. Because it is a population of very different and obscure people.
And the likelihood of something like a stroke or death in the 30s, 60s, or any days after vaccination is much higher in long-term care residents
[Talbot nods vigorously.]Here’s the deal. All events are temporarily associated. But how can you explain to the nurse’s assistant that he cares for the patient and loves her like his own grandmother? Who then decides not to get vaccinated and tells everyone else not to get vaccinated?
In the general population, the health event seen after vaccination is a way of tormenting whether it is caused by it or it is only temporarily connected – it happened around the same period – knowing the basic rate of such incidents so you can say: this period This number is within the range of numbers we expect in this population.
Aren’t the rates of those events known to long-term care residents?
I googled the mortality rate in nursing homes and found nothing. Now, I had a call with a group of geriatricians and I asked. Some of them – not all of them – knew that data. I don’t know how common that knowledge is.
What is your fear How do you see this playing?
I am afraid of losing confidence in the vaccine. That vaccine will actually be really safe, but there will be temporary related events and people will be afraid to use the vaccine. And we won’t be able to bring our kids back to school and people will be able to get back to work – which is important.
