The vaccine rollout in Massachusetts has been plagued with problems, including issues for seniors trying to schedule their vaccination online and vaccine supply outpacing demand. Many state legislators, including Sen. Eric Lesser, are calling on Governor Charlie Baker to address these issues immediately.
Dr. Andrew Artenstein is the Chief Physician Executive at Baystate Health and leads up the COVID-19 response at western Mass’s largest health network. Dr. Artenstein shares his view on the problems with the vaccine rollout process and if the vaccines will protect against newly emerging variants of the coronavirus.
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Zydalis Bauer, Connecting Point: Now, the vaccine distribution has not been without difficulty. What have been some of the major issues that have hampered it and what can be done to rectify it?
Dr. Andrew Artenstein, Baystate Health: Well, that’s a great question. And really, it starts at the national level. This is really, as you as your listeners know, this — the vaccine program has been a spectacular scientific achievement, going from not even knowing about this virus just over a year ago, to the onset of the pandemic in the United States about a year ago, to several vaccine products going into people’s arms in the United States that have proven to be safe and effective, and several others coming online within the next weeks and months.
So, I mean, we’re talking about spectacular achievement, but it’s been hindered to some degree, and predictable to some degree, by issues related to manufacture, supply, and allocation across the states. The time frame has been very truncated, which makes this all very difficult.
Everyone wants to get vaccine into people’s arms as soon as possible because it will help stem the tide of the pandemic and reduce transmission of cases and prevent deaths, which is what we’re really trying to do here, prevent people from getting sickened and potentially dying of this terrible illness. But that generally takes some time for things to catch up.
And I think we’re in that period now where we’re pushing for things to catch up. And there’s been a change in national government, obviously, with the inauguration of the new administration several weeks ago. And I think things will start to change quickly now. They already have.
We’re already seeing more vaccine. It’s up about 18 percent nationally. Those doses getting out. And that will continue to rise. And Massachusetts, like every other state, has its own allocation and distribution system based on its supply from the federal government.
And systems and other health care organizations within the state have to deal with their distribution based on supply from the state, which comes from the government. So, you can see that it’s all a series of dominoes that has to work relatively seamlessly from a logistics standpoint.
Zydalis Bauer: We’ve been hearing about this new strain of COVID-19 that’s been reported all over the world, now being reported in our country as well. Do we know yet if this vaccine will protect against these new variants?
Dr. Andrew Artenstein: Yeah. So there’s several of these so-called virus variants. There are — there is at least three that have been documented, one called the UK variant, the South African variant, and the Brazilian variant. They’re found other places, but that’s where they were first identified for the most part. That’s why they get the names.
And these are mutations, mutant strains. What happens when these viruses replicate, they reproduce in cells billions upon billions, up to trillions of times a day. And there’s always a chance there’s going to be some errors made when they reproduce. That’s just — they’re big viruses.
So there’s a lot of reproduction to go on and mistakes can be made. Most of those mistakes, which are called mutations, don’t help the virus. They actually are dead ends. They result in less replication ability. Some of the mutant strains though, seem to reproduce themselves better in cells. One of these or two of these strains you’ve mentioned may be like that. They appear at least in the cells, in laboratories, to maybe be more reproductive capable, which means they could be more transmissible in humans.
There’s some preliminary evidence in some cases, but we don’t know with certainty. And what we don’t know yet is whether the vaccine that we’re taking, that allows us to produce antibodies, whether those antibodies will still work in the same way as well against these mutant virus strains. There’s some evidence that they will. And then in some cases, there’s some question.
So we just don’t know yet. There’s not enough information. But yes, it’s not surprising. No one is we should be surprised about this because this is a big virus that replicates so many times. This is bound to happen. The question is, will it be significant clinically? In other words, will it make a difference for people’s health and well-being as they try to avoid this disease?
And we just don’t know the answer yet. But we will, it will just take a little more time to see what happens with more study and more cases. But, yes, these are being found in the US, and it’s not surprising because the same way the virus got to the US and got around the world is the same way these strains travel.
Zydalis Bauer: You have been one of the leaders at Baystate Health in confronting the coronavirus head on, even making headlines last spring for purchasing PPE and being questioned by the FBI for doing so.
Currently, right now in western Massachusetts, there’s one mass vaccination site at the Eastfield Mall in Springfield. What do you think can be done to make the vaccine distribution more equitable?
Dr. Andrew Artenstein, Baystate Health: Yeah, again, fabulous question. That is the most important question, both the state and the country and our region, obviously, I think a couple of things.
First of all, we need more supply from the federal level sprinkling down to the states and then the states distributed based on a combination of population and vulnerability. I mean, in an ideal situation, right, there would be enough vaccine for every adult, because those studies have not been done in children yet. But for every adult over the age of 16, which is what the studies were done, who wants the vaccine to be able to receive it, and two doses of those vaccines that require two doses, obviously. We’re not quite there yet.
I do believe we will get there and I do believe we will get there. There’s a lot of push from the highest levels of government now, and that’s what’s needed. I do think we will get there over the next four to six months will be in a much better situation. We’ll also have new vaccines coming online that will expand the supply and expand the options.
Now, in terms of make sure there’s equitable, you asked about equitable distribution, and that is sort of the the one million dollar question. Because that’s really an important nut to crack and a difficult nut to crack, not only with this vaccine, with every vaccine, actually.
And if you look globally — I mean, we’re just thinking about the United States — but this is a global issue because as we learned from this pandemic, we are only as safe as the rest of the world is safe. An outbreak anywhere could be a potential outbreak here. I think we learn that again and again. And we learned it most recently a year ago, that an outbreak in China can quickly become a global pandemic if it’s not appropriately stymied. And that’s the way it is in the twenty first century or in twenty twenty one.
So, I think that what we need to remember is we need to pay careful attention to equitable distribution. That is both to vulnerable communities in the United States, in Massachusetts, in the United States. Some of those are rural. Those are also urban communities of color. And it’s determined on a number of levels. But we know those people are disproportionately impacted by the COVID pandemic, in terms of prevalence of serious infection, hospitalization and death. And we need to address that.
And also globally, we need to address those poor, undeveloped or developing nations that also need protection in order to protect the security of the rest of the world.