 Hi, I'm Kristen Whitney with the University of Maryland Medical Center. Joining me today is Dr. Silky Neeterhouse, Associate Professor of Surgery and Dr. Kapil Saharia, Assistant Professor of Medicine, both at the University of Maryland School of Medicine. Dr. Neeterhouse specializes in kidney transplantation, pancreas transplant and laparoscopic and single port donor nephrectomy at the University of Maryland Medical Center. She's also received two kidney transplants herself bringing a unique perspective to the field of transplantation and immunosuppression management. Dr. Saharia is fellowship trained in infectious disease and completed a postdoctoral fellowship at the National Institute of Health's Vaccine Research Center. He joined the University of Maryland School of Medicine's Institute of Human Virology in 2012 and currently serves as the Chief of the Transplant Infectious Disease Service. Thank you for joining me today. Thanks for having us. And thanks for all of you watching at home. Please be sure to like this video to let us know that you're watching. So to begin with, what vaccines are currently available in terms of COVID-19? Right now, we have two vaccines that are available. One is a vaccine made by a company called Moderna. The other is a vaccine made by a company called Pfizer BioNTech. Both of these vaccines are what are called mRNA vaccines and these are new types of vaccines. They use a delivery system to deliver a code and that code instructs ourselves to make a specific protein that the virus uses to attach to our cells and it trains our immune cells to react to that protein and that is how we develop our immune response to the virus should we see the virus or get infected with the virus. So those are the two that are available now and there are many others that are still under investigation that we may hear about in the coming months. How safe are the vaccines? Yeah, that's a really good question. And I think that's something that a lot of people are concerned about, especially because these are relatively new vaccines. But the answer is that these are actually quite safe. These vaccines have been administered to over 70,000 individuals over the course of several studies. And by and large people have tolerated the vaccines quite well, apart from just kind of the general expected side effects. I think the biggest safety concerns that have come up are several cases of severe allergic reaction that people have had to the vaccine. It's not unexpected. People who are given a new medication or even a vaccine can have allergic reactions. And so I think the most important thing is that patients are monitored for a period of time after the vaccines are administered. But overall, I think what's been shown is that there is a pretty good safety signal from these two vaccines. And could someone potentially get COVID-19 from the vaccine? Well, there's no vaccine, no virus in these vaccines at all. So there's zero chance of getting COVID from them, although you can get sick from some side effects. What are some of the side effects from the vaccine? So most of the side effects are rather mild and it includes things like local side effects at the injection site. So it would be things like arm pain or swelling or redness. There can also be some systemic side effects, things like fevers or chills and headache, nausea, just not feeling quite perfectly for a couple of days after the vaccine. And are side effects different in transplant patients? Well, for now we really don't know. I can tell you that as a transplant patient I went for one of my two shots so far. And I did have pretty good arm pain that started about 12 hours after the vaccine, followed by some fevers and chills, even like a light headache and just feeling tired for a day or two. Some of my other friends who are transplant patients have had a vaccine and they've only had arm pain with it. But this is, you know, all anecdotal evidence. The truth is, neither of these vaccines were studied in the transplant population. So we really don't know on a large scale if the side effects are exactly the same or slightly different. How did your vaccine go? Yeah, okay. So I had quite a bit of pain at the site of injection. But the good news is it did wear off after about 24 hours. I did feel a little bit fatigued and had some mild chills. But again, these were all very short-lived. And, you know, I think that these were some of the side effects that had been written about and expected. How is the vaccine given? So the vaccine is given as an injection in the arm. And with the two vaccines that are available right now, the Pfizer vaccine and the Moderna vaccine, they both require two injections. With the Pfizer vaccine, the two injections are supposed to be about three weeks apart. And with the Moderna vaccine, the two injections are about four weeks apart. Great. And how well does the vaccine work? Go ahead. So the data that has come out so far has shown that the vaccine seems to be about 95% effective. So what that means is that out of 100 people that have received the vaccine, 95 of them will not have COVID infection. And that is actually a really tremendous number. You know, a vaccine, for a vaccine to achieve that kind of efficacy, I think is really amazing. The vaccine, the two vaccines do not necessarily prevent the transmission of COVID-19. But I think what the data shows is that they do prevent the infection from developing. And in the rare circumstance that you may still get the infection, these vaccines seem to be fairly protective against having severe infection with COVID-19. And how well does the vaccine work in transplant patients? Again, we really don't know. Because no transplant patient was really enrolled in the, you know, efficacy studies. So there are ongoing studies for transplant patients that to enroll in to figure out if it is as effective or if it's effective at all. Based on the side effects that three of us have had, I would guess that there is at least some efficacy, but that's completely unproven at this point in time. Well, thank you so much doctors, Neaterhouse and Dr. Saharia. Now I'd love to ask you some questions that we received on our Facebook page. The first one, Rose asks, well, I still need to wear a mask and keep my social distance after I get the vaccine. I'll tackle this silky. That's all right. So, so unfortunately, even though these vaccines seem to be highly effective in preventing infection, we don't have enough data yet to say that these vaccines prevent the transmission of the COVID-19 virus. So as a result of that, I think the general recommendations are that we still practice social distancing and that we still wear a mask around in public. But, you know, the hope is that as we get more data, maybe those recommendations might change. But as it stands now, those measures that we've been implementing for the last six to nine months are still what we should follow. Maria wants to know, can I get vaccinated if I've already had COVID-19? Yeah, you can. I think at the moment, the recommendation is that if you've had COVID-19 before that you wait some time. I think currently the recommendation is about three months before you get your vaccine. But as you go along, you can still get vaccinated and we believe that you probably should still get vaccinated because after COVID we don't know how strongly your immune system responded and how protected you are from that response. And I'll just add to that. And that's I think especially true in our transplant patients that, you know, transplant patients may end up having a lower response rate to the actual infection. And we talk about, you know, these protective antibodies that can develop after infection. So we don't know how long those will actually last in transplant patients and it may not last as long as it would in someone who's not transplanted. So I agree with what Dr. Neeterhouse said that, you know, that it's certainly you should get vaccinated, but wait those 90 days or so. Sam asks, is it okay to get different COVID-19 vaccines? So, you know, we really don't know how one vaccine will interact with another. And so right now, I think that the safest thing to do is that if you start off getting one vaccine that you should complete the series with that vaccine. So if you started out with the Moderna vaccine, make sure that you finish with the Moderna vaccine. Likewise, if you started with Pfizer, that you finish your series with the Pfizer vaccine. Joe says, I had a kidney transplant at UMMC six months ago. What vaccine should I get? Joe, you should get whichever vaccine you can get whenever you can get it. I think that's the best advice that we have for now as more vaccines come out and as we finally start learning about how these vaccines work in transplant patients, those recommendations may change. But for now, probably the safest thing is to get vaccinated as soon as possible and with whatever vaccine you have available to you where you live. Dr. Neeterhouse, you touched on this question from Lisa a bit. She was asking, are there any COVID-19 vaccine trials for transplant patients? There are. There are several. At the moment, there are some trials looking at whether the vaccine generates an antibody response so it involves getting blood draws. There's also a registry study to just sort of learn about, you know, how transplant patients felt, what side effects they had after vaccines, and I'm sure there's many others out there. The thing with studies is there's usually so many that it's hard to keep track of them all. Kathy wants to know, should I get vaccinated? I think we've answered that and the answer is yes. You know, I think we feel strongly that, you know, this is a vaccine. These vaccines that have come out thus far are quite effective and from the data we have, you know, that they're safe. And so we certainly would encourage, you know, our patients to get the vaccine when they do become available. Kathy asks, if I'm on the transplant wait list, when should I get vaccinated? That's a bit more of a tricky question. I think if you're on the transplant wait list and you don't have surgery scheduled and you don't have a living donor surgery plan for you, I would go ahead and get vaccinated. And that's partly because you don't know when the transplant will happen. Also, probably your immune system is stronger now than it will be after transplant when you've had all sorts of medications for preventing transplant rejection. So probably the best time is to get vaccinated now. If you're in the process of going through living donor, then, you know, you may have to talk to your team about the best timing for that. And our final question, Beth asks, I had a liver transplant a year ago, should I get vaccinated or excuse me, she asked, when should I get vaccinated? Yeah, so I think it's similar. You know, I think that the timing of the vaccination after transplantation isn't known yet. You know, you've heard that quite a bit this afternoon. You know, we just don't know. You know, I think based on our experiences with other vaccines, certainly, you know, the longer you wait from the time of transplantation, the more likely you are to respond. But the dilemma is that if we wait too long, then you may lose the benefit of getting a vaccine while we're in the midst of the pandemic. And so, you know, if you're you're out from transplantation, I think you should certainly move forward and get the vaccine. I think it's for the patients that are more recently transplanted where we're just not sure whether it's best to wait one month, three months. And that's I think a discussion that just needs to happen between the patient and the provider to figure out really what is going to be the best time to get that vaccine administered. So how can viewers learn more about transplant services at the University of Maryland Medical Center? So there's tons of information on our website, which you can find at umm.edu slash transplant. Great. Well, thank you so much for your time today. We've been speaking with Dr. Silke Niederhaus and Dr. Kapil Saharia on COVID vaccine basics for transplant patients at the University of Maryland Medical Center. Thanks for watching today. If you have any additional transplant questions, please leave them in the comments below and make sure to like this video or share it with a friend or family member.