 Okay, so I want to welcome everybody to the Amherst vaccine information session. I do see we have a big crowd in the room today, so thank you all for joining us. This evening, we are going to hear from two special guests and four special guests, actually. I'll introduce myself. I'm Brianna Sundred, the communications manager and community participation officer for the town of Amherst. And a quick note before we invite everybody in to speak and get a welcome. This evening, we are going to allow for question and answers using the Q&A function within Zoom, so you may put your questions in there, and after the presentation, we will try to field your questions live. If you've joined us from the phone, you can press star nine to raise your hand, or also by raising your hand in Zoom. So before I introduce all of our speakers, I want to welcome the Amherst Board of Health Chair, Nancy Gilbert, to give an opening message. Okay, welcome. On behalf of the Board of Health, I would like to welcome you to this COVID vaccine information session. The Board of Health works closely with the Health Department. Our mission is to promote health and well-being for our community through four public health functions. Tonight, we're focusing on the function of health promotion through education. This is to augment our COVID vaccine clinics. I would like to extend our gratitude to Emma Dragun, who has been our director of the Health Department only since November, and she hit the ground running, and it's just done amazing work. Along with Jennifer Brown, both of them have worked tirelessly on the COVID pandemic and now on the vaccine clinics. I would also like to thank Dr. Estevan Garcia and Joanne Levin, who have been in the front line helping all of us in Hampshire County address the pandemic. Little did we know last March 13th at our first and last in-person COVID regional meeting where we would be today. Thank both of you. I want to thank both of you for all of your work and all of your help to everyone here in our community. Thank you. And I will turn this back to you. Thank you very much, Nancy. OK, so now I'm going to introduce our special guests this evening before we transition into their presentation and subsequent Q&A. So first, I would like to introduce to you Dr. Joanne Levin. She is the medical director of infection prevention at Cooley Dickinson Hospital and serves as the chair of the Board of Health in Northampton. Dr. Levin earned her medical degree at State University of New York downstate and completed residency at Rhode Island Hospital, an affiliate of Brown University. Dr. Levin completed an infectious disease fellowship at Boston University. Since 1989, Dr. Levin has practiced in the Northampton community, both as part of an infectious disease medical practice, as well as a member of the Cooley Dickinson Medical Staff. She has worked as an infectious disease consultant for the past 32 years. Since the start of the COVID-19 pandemic, Dr. Levin has been at the forefront of Cooley Dickinson coronavirus response, serving as a part of the organization's incident management team and liaison to the medical staff. She and a small team of infectious disease staff have helped to lead the institution in decisions around testing and treatment, as well as isolation and quarantine, personal protective equipment and employee safety. She has partnered with the Board of Health to provide testing to at-risk population. Dr. Levin also lives in Northampton. Next, I'd like to welcome and introduce Dr. Estefan Garcia. He, Dr. Garcia has joined Cooley Dickinson Healthcare as a chief medical officer in 2017. Originally from Texas, Dr. Garcia earned his medical degree from the University of Texas Southwestern Medical Center and completed his residency in fellowship at Children's Medical Center of Dallas. Prior to joining Cooley Dickinson, Dr. Garcia was vice president and medical director of Hospitals Insurance Company, a risk management organization. He moved to Pelham from New York City, where he held a number of progressively senior administration positions, including leading emergency departments and serving as the associate chief medical officer for quality and safety. And I'm going to get this wrong, but Maumonoid's Hospital and Chief Medical Officer at Brookdale Hospital. Throughout his career, Dr. Garcia has continued to protect and practice clinically. He also pursued additional education advancement over the years, having earned a master's in public administration from NYU Wagner grad school of public service, a doctorate in public health from the City University of New York and becoming a certified physician executive. Among his many duties at Cooley Dickinson, Dr. Garcia is currently leading the COVID-19 response and vaccine implementation initiatives. Thank you for joining us, Dr. Garcia. And last, I would like to introduce Emma Dragon. She is the new director of public health for the town of Amherst. As you heard, she just joined us in November. She's a lifelong Hadley resident born at Cooley Dickinson Hospital. A registered nurse and EMT since 2007 with a variety of skilled areas of work, including emergency medicine and behavioral health. She also holds a graduate degree in emergency and disaster management and has worked on federal level projects for emergency operations, including the New York Javits field medical station in response to the COVID pandemic. During her spare time, Dragon and husband Kyle enjoy their three children under the age of 10 and being involved with community activities in Hadley. So quite quite the biographies there. So welcome to everybody. I am going to remind the group of live attendees that this is being recorded and to please refrain from asking any personally identifying health questions when it comes to the Q&A piece. I will now pull up the presentation and welcome Dr. Levin to begin her talk. Now, just a moment while I get that pulled up. Good evening, everyone. I'm glad to be here. So I thought I would just review a little bit about the vaccines that are available in Western Mass. And Dr. Garcia will pick it up sort of halfway through. Next slide, please. So which vaccines will be available to us? There are two vaccines that are approved in the United States and we will have access to both of them. They're referred to as the Pfizer, which was originally created by the BioNTech company that's from Germany and Moderna. Moderna is a company that's right outside of Boston. Both vaccines are very similar. They're both made with messenger RNA inside and a lipid bubble on the outside. And that's how it gets into into our cells. They are slightly different that way for exactly what part of the spike protein that the messenger RNA is made to and the composition of their lipid particle is slightly different, but that basically the same idea. Neither of them contains eggs, preservatives, such as thimerosal, except for ones that I'll mention later. There is no mercury. There is no latex even. There's no cap on the top that has latex. Both were approved under an emergency use authorization by the FDA. And I know some people are concerned about how quickly they were approved. But I will say that I believe in the process that they went through, they were reviewed and approved by the CDC. In our system, we're affiliated with Mass General Brigham and they have some very, very smart people there. And one of them was a lead investigator and one of the vaccines. And they've also been approved by my hero, Dr. Fauci. So I feel comfortable in the process of approval for that these vaccines went through. Both required two doses and they are given in the arm, in the upper arm muscle. You cannot get COVID from either of these vaccines. They are not alive. There are some vaccines which are alive, like measles, mumps, and rubella, but these are not. But one thing everyone should know is that it's advised that you not take it within two weeks of taking another vaccine. So this is not the time to catch up on your flu vaccine or your pneumonia shot if you're anticipating that you'll be getting your COVID vaccine in the next few weeks. There are some minor differences in how they are administered. The Pfizer vaccine was approved for age 16 and over and the Moderna was approved for age 18 and over. The way the studies were designed is that the Pfizer vaccine, the two doses were 21 days apart and the Moderna vaccine were 28 days apart. Why the scientists created them that way and studied them that way? We do not know, but that's the way they were studied. So that's the way that they are recommended to be given. Next slide, please. Great, so people are curious about the actual details of the study and you can find it on the internet. It was published in the New England Journal of Medicine and you can read the study itself. There were about 43,000 volunteers who were given the two injections and half the group were given the vaccine and half the group were given saltwater injections. So nobody, either the patient or the people doing the injections knew which they received. And then they followed them over time. These studies were done in many different sites over the United States, usually through, I think through July through October and that was a time where there was not as much COVID going on, but in different places had different amounts of natural sort of COVID in the population. But when they looked at who developed COVID, they found that the people who, so it was around 20,000 or so in each group, only eight in the vaccine group and 162 in the placebo group got disease. And though, so when you hear people talking about 95% efficacy, it really is comparing those two groups. It doesn't mean there was a 95% chance of getting the disease. It was that when you compare the placebo group to the vaccine group, there was a 20-fold difference. It was a 95% drop in getting COVID if you had had the vaccine. And they measured this about two weeks after the second dose. 10 of the volunteers had severe disease and nine out of the 10 were in the placebo group. As far as reactions to the vaccine, it's very, very common to get an injection site reaction. Pain is swelling at the site of the injection after the first dose, 83% and after the second dose, 78%. And that usually is mild. You have a sore arm, you can take a little Tylenol and it usually resolves pretty quickly. Systemic reactions, which are more of what some people refer to as flu-like, fatigue, headache, muscle pain, joint pain, also occurred in about half after the first dose and a little bit more than half after the second dose. Again, these reactions tend to happen in the first day and can be as long as three days until they're completely resolved. But tend to be generally mild and tolerable. Some people might miss a day of work because they're just too achy to get out of bed and have a lot of fatigue. But considering what we're doing, meaning getting a vaccine for COVID, most people are willing to take that risk and that discomfort. Next slide, please. The Moderna vaccine is very similar. Here, they studied 30,000 volunteers. That was around 15,000 in each group. Two injections, here they were given four weeks apart. They did not know and the injectors did not know which group they were in. And here, again, the number of people who got COVID was low, but comparing the two groups, 11 in the vaccine group and 185 in the placebo group out of 15,000 in each group, the difference was 95% drop in disease. For the vaccine group. In this study, 30 of the volunteers had severe disease and all of them had received placebo. I mean, none of them had received the vaccine. And again, very similar injection site reactions are common, pain and redness and swelling in about more than three quarters with the first dose and also quite common in the second dose. Systemic reactions are not quite as common as injection site reactions, but again, about half with the first dose and three quarters of people with the second dose. Again, most people tolerate this fine and it's self-limited. Next slide, please. So we receive a lot of questions about who should get it and who shouldn't get it. And basically most people, it's recommended that most people get this vaccine. Pregnancy is one group of pregnant people is a group that has not been well studied. They were not included in these studies or not knowingly included in these studies, but the scientists feel that there's not really a good reason why they shouldn't get vaccine. It's not a live vaccine that could potentially be a risk, but this is not a live vaccine. So it's recommended that people who are pregnant talk to their providers and making that decision about whether this is a good time for them to get vaccine. I think some people are thinking, well, maybe first trimester, maybe I delay, but maybe third trimester, I'd want the vaccine because I might want those antibodies to be passed to my newborn. People who are pregnant do have a slightly higher risk of having more severe disease. And so they are in a recommended group that an at risk group. So all of these factors should be taken into account when discussing whether to take the vaccine when it's their turn. Next, please. So lactation, again, these were lactating. People were not included in these studies, but there's theoretically no reason why it would be dangerous. It's not a live vaccine. It is recommended that if the mother is in a risk group and wants to take vaccine, there doesn't seem to be a reason not to do that. But again, that's something to be discussed with a provider. Next slide, please. Seems to be a problem with the slide advancing. Could just give me one second. Here we go, okay. So what about people who have had COVID? Should they take the vaccine? The recommendation now is that, yes, people who have had COVID may have vaccine and probably should have vaccine. People who have had COVID may develop antibodies from the disease itself, but it's not reliable. Some people develop really great antibodies that neutralize the virus and some people don't develop antibodies or some people develop antibodies that may not neutralize or work that well against the virus. So it is recommended that even people who have had COVID get the vaccine. However, first of all, we don't want to give any vaccine to anyone who's acutely ill with anything. We also don't want anyone who has symptoms of COVID to be coming to our clinic and possibly transmitting to other people. So we want people who have had COVID to be completely done with their isolation time and feeling better. If a person was infected in the last 90 days, they may choose to defer vaccination. There's no rule about this right now, but it is thought that they are protected from getting another case of COVID during those first 90 days at least, maybe longer. So if there's a shortage of vaccine, I think some states are considering making a rule that if you've had COVID in the last 90 days that you defer until a later date, that's not a rule currently in Massachusetts. But one caveat is if you had COVID and you were treated with either monoclonal antibodies or convalescent plasma, those substances could potentially interfere with the efficacy of the vaccine. So it is recommended that you wait 90 days after having those treatments before having a vaccine. Next slide, please. How about immunosuppressive therapy, cancer chemotherapy? Can the people on those drugs or with those conditions get vaccine? Yes, immunocompromised people can get vaccine unless they have other contraindication. What's unknown here really is whether it works well in them. People on immunosuppressive drugs and on cancer, having cancer or on cancer chemotherapy may not mount a good immune response and the vaccine may not work that well. And right now there's no recommendation for a revaccination or any other different schedule of vaccination, but work is ongoing and they're studying these folks to find out if maybe they need something different or additional doses at some later date. So there's no reason not to give immunocompromised people the vaccine at this point because it is not a live vaccine. Next slide, please. So there are some people who should not receive this vaccine and this is mainly people who have severe allergies. So if you have a severe allergic reaction, meaning anaphylaxis, to a dose of either one of these vaccines, you should not have the second vaccine. This is really, really rare. I think it was something like 11 and two and a half million people or something had anaphylaxis, really, really rare. There are people who do have allergies to two components. One is called polyethylene glycol. That is in the vaccine. So if you know you have an allergy to polyethylene glycol, you should not be taking this vaccine. There's another substance called polysorbate, which is sometimes a food additive. It is related to polyethylene glycol. So people who are allergic to polysorbate should not, severe allergy should not have this vaccine. And really those are mainly the only contraindications, meaning that these people should not have vaccine. Everyone else is recommended to have the vaccine. Next slide, please. So again, cautions, as we mentioned, people with moderate or severe acute illness for any cause we don't like to vaccinate. And the other group to be cautious with are people who have an immediate allergic reaction known as anaphylaxis, to any other vaccine or injectable therapy because there are some other vaccines or other kinds of injectable therapy that have similar components. So you would want to evaluate that allergy before going ahead with a vaccine. So these folks should probably see an allergist. There is a skin test that allergists can do for the polyethylene glycol. And so this is something that would require some intervention before going ahead. Next slide, please. So after a vaccination, what kind of side effects would you expect? We talked about this already, pain or swelling where you got the shot. And that's very, very common. Fever, chills, tiredness, headache, could be one day, three days, not longer than that. And you can talk to your provider about it over the counter-medicine as makes some sense. You can put cool washcloth or ice on the area. Some people feel like if they exercise their arm, it relieves it more quickly. If you're having fever, obviously, drink plenty of fluids. But again, these reactions are sort of expected and they may indicate that your body is mounting an immune response. I was a little disappointed when I didn't have a reaction to my second vaccine. So, and they're short-lived. And, but one thing to note is that the vaccine does not cause respiratory illness. It will not cause stuffy nose, sore throat, cough, any of the things that we commonly associate with COVID. It is possible to have COVID after your first vaccine and even after the second vaccine. So certainly if you have symptoms that are consistent with COVID, even if you've just gotten your vaccine, don't disregard that. If you need to be tested for COVID, get tested for COVID. That's still a possibility. We've actually had a number of people who had COVID probably was incubating at the time when they had their vaccine and they became symptomatic after they had their vaccine. Next slide, please. So when you get your vaccine, you'll be asked to enroll in this CDC study and a program called V-safe Vaccination Health Checker. It will send you emails and messages, text messages about reporting your symptoms and give you some guidance about what to do with your symptoms. And that can be helpful. Next slide, please. So there I am on the left, getting my vaccine. So reasons to be vaccinated, to protect yourself, of course, to protect your family, to protect others in the community and creating herd immunity. It's always nice to be a role model and show others that it can be done safely. In the future, it may be required at some point to attend school or to go to work. We're not there yet, but that may be coming. I'm gonna hand it over to Dr. Garcia now. Next slide. So unlike Joanne, I did have some symptoms after my second vaccine last week. And yes, they were very short-lived. While I didn't have any fever, I did have some headache and I felt as if I had just worked an overnight shift and I haven't worked an overnight shift in quite some time. So it was an interesting feeling for about 12 to 24 hours. And then I was back to normal. So that's great. So I think the most important part of this conversation I'd like to have now is just who can be vaccinated now, right? That's the big question. And starting just the beginning of this week. So starting yesterday, we've entered the phase two. What that means is that everyone from phase one that wasn't already vaccinated and those were predominantly healthcare workers and first responders in that group can still be vaccinated. And then as of two one, the other folks that can be vaccinated are individuals age 75 and above. And we'll go through this in a little bit more detail but we've started at our organization an outreach to individuals that have either primary care providers at Cooley Dickinson or have been seen by one of our consultants or subspecialists and have made outreaches. And we're essentially doing it. The system is doing this in three ways. They're doing it through the online portal. They're doing it through email, phone call or text and really working with that group to get them registered and to give them an appointment. And I know it's working because I've heard from individuals in the community plus we know that all of our eligible slots for vaccine this week have been filled already. And I'll go through that next slide. So where can you get vaccinated? So certainly there are hospitals, medical centers, medical groups, as well as the Department of Public Health and all of their resources. And then there are other statewide areas. And if you go to the website, you can find them. Obviously what we have here is the big Y recently added Amherst Regional High School and Fill Mall and lots of other sites or more sites keep coming online. So it's, I think an opportunity to reach out to any of these to look for potential vaccine availability, which will increase. We understand that as a state we've had some limitations going into February with limited Moderna vaccine. And we're hopeful that those numbers will be increased over the next couple of weeks. So just a way to check where you could potentially be vaccinated. It's clear that this is not a Cooley only issue. It's not a Department of Public Health only issue. It's not a state only issue. It's all of us working in conjunction to make sure we get the community vaccinated as quickly as possible. It's the shots and arms idea. And we're very excited that we're there. Next slide please. So Cooley Dickinson will start tomorrow with our 75 and above age group. As I mentioned earlier, all of our slots for this week and we only have 360 doses of vaccine that were given to us for this initial week as a part of the health system. And they were all notified as we talked about there and we did multiple outreaches and we got individuals vaccinated. We're opening up additional slots for next week. And then our vaccines will be at the Atwood location to start on Wednesday, Thursday and Friday this week. And then we will eventually go to 10 hours on Saturday and Sunday, initially at our Atwood site. And then we'll be moving to as we get more vaccine to the Amherst site as well. So that's our medical group site. So that's exciting. And we'll be starting it as soon as we can. We have been vaccinating some individuals through the hospital as we've had the no waste doses. So occasionally there's a cancellation and unlike other vaccines these can be put back in the fridge. So we have to use them when we thaw them and when we have them drawn up. So we do that by calling individuals that are patients as well and have had people come in. You can imagine the snow storm yesterday made it interesting towards the end of the day. There were a couple of extra vaccines. We actually were able to get a patient's son in the emergency department, an older grown son, not a child. And as we were looking for individuals to vaccinate pretty rare that we get to that point. But with all the guidance says do everything you can not to waste a dose and you have to use them essentially within six hours of thawing them and having them reconstituted. Valley Medical has also already started vaccinating. Again, based on their distribution of vaccine probably all four sites is what we understand they'll be doing. Next slide. So I think the concept of, we've seen a couple of questions. So when am I eligible if I'm under 75? And so the hard part for us is to know at what point do we open up vaccine to that group? The belief from our system alone is that it will take us the better part of, six weeks, two months potentially to be able to vaccinate everyone that's 75 and above in our patients. So it is going based on our current distribution. We think that will go up. There's lots more to come about that, I'm sure. But based on our current distribution we're just starting, it's just the tip of the iceberg to get the vaccine out. So I don't know what the governor is going to do and whether they're going to say start, you can start vaccinating under 75, down to 65 with co-orbidities. At the end of the month or our March, it's hard to know but for now we're focusing on trying to get the highest risk group vaccinated that we can. Next slide. So just a little bit about when we talk about the co-orbidities, so things that can cause your illness to be more severe, whether it's things like cancer, kidney disease, certainly congestive heart disease, heart conditions, COPD as many of us know, obesity with the numbers that are listed there. We've talked about pregnancy already, sickle cell, diabetes. These are all considered co-orbidities or diseases, even a temporary like pregnancy that puts you at increased risk for this disease for COVID. Next slide. So I think we'll hold on the questions and answers and be happy to answer some questions or whatever the team would like to do next. Great, thank you both for that presentation. I would like to invite our Public Health Director for Amherst-Dragon to put in any local perspective or any updates to information on how Public Health Team is dealing with the vaccine. Yeah, so it's really terrific to hear about all of the great work that our local hospital and systems are doing here with their boots on the ground, if you will. Us on Public Health side have really been energized throughout this entire process of COVID, really a real focus on our work that I think has not been felt in a very long time and transitioning from doing the majority of our focus on contact tracing to now engaging the contact tracing collaborative to help assist with that work. So we can focus on more of our ability on vaccine distribution to our local community. So here locally in Hampshire County, the town of Amherst Health Department and the Northampton Health Department partnered to be two regional sites to cover all of Hampshire County. And that's because as we know in Western Massachusetts, we have a lot of smaller communities that don't have as built up of supports and staff to be able to help provide, be able to provide these really high scale clinics that are complex. There's a lot to getting the vaccine, destroying it, documenting it and making sure that we're distributing it in a safe and effective manner for our community. So locally, I know also Senator Joe Comerford has a great site with information for vaccine locations in the district and in the region for constituents. And Greenfield has a site at their CVS. They also will be setting up at Big Y in Amherst. We have our site at the high school, but I also wanna note that we do have a site on UMass, which is a general site for the state that will accept residents no matter where they live. And they have a pretty high throughput there. And then also down in Northampton is providing a site at the Big Y and then also the senior center which is our parallel setup in Northampton. So with the Northampton Hampshire County site and our Hampshire County site, we have the potential capacity to do up to 3,000 vaccines a week, be able to do my mind just left me. But I know in Amherst alone, we had the potential to do just under 10,000 a month. If we were able to get great enough volunteers and resources to assist us with that. Already we are starting our first clinic at the Amherst High School tomorrow morning. And I just want to applaud all of the overwhelming community engagement and willingness for our community volunteers to step up at this time and help with vaccinating our public. I think that's something really great to highlight that is really enriching to me and makes me really happy to live where we do at this time. So previously in our clinics, we were distributing Moderna vaccine. This week is an exciting time for us because we are switching to Pfizer. That means that we are getting larger amounts of vaccine. We are getting previously, we are going to be allocated to receive 100 doses of Moderna for the month of February every week. And now, since we are going to be a Pfizer distributor, we are going to be seeing just under 1,000 doses a week, which has certainly drastically increased the amount of arms that we're going to touch and our community outreach to our partners. Cause we certainly want to be able to help assist those that might not be able to leave their home that are homebound or live in congregate settings. So those are things that we're thinking about. We're not forgetting about you. Just getting the vaccine to you is a little bit more challenging and we're really wanting to have a good plan when we are going to be able to get out there to you to do that. So that's a little bit about our vaccines with our new clinic at the Amherst Regional High School Tomorrow 21 Mattoon Streets. This has really been a group effort with a wonderful partnership of our emergency manager Paul Chief Nelson and our firefighters have been great volunteers on the team. It's like facilities has really helped me set up and IT has gotten us all of the equipment that we're going to need to be able to document what we need in real time and run the clinic. And I just, it's such a great thing to see something come together. We're setting this in the high school gym. So we've really transformed it into a clinical space and we're just gonna be excited to see everybody tomorrow morning. Great, thank you, Emma. So I know we've got a lot of questions coming into our Q and A right now which we're going to get to and we've had questions that were pre-submitted. Some folks are asking about the FAQs that they saw briefly on the screen. We are gonna go through those as well as make the slides available after the fact. Just a quick reminder to everybody who's in attendance, please use the Q and A function within Zoom. And I do see we have a couple of callers from the phone. We don't wanna leave you out. So if you would like to raise your hand by pressing star nine from your phone, we can hear your question as well. So I will get started with one of the questions that I see popping up multiple times is do we get to choose which vaccine we get? We've heard about the two types or brands. So can someone address that question, please? I can say that we don't even get to choose the type of vaccine that we get at the organization. So it really is what the state has on hand. The concept early on was that Pfizer was a little bit more difficult, maybe a lot more difficult to store because of the kind of freezer needs which aren't your typical freezers at your home. And so hospitals like ours really got very little Pfizer initially because we don't have those specific types of freezers and we were gonna relied on Moderna. So we got quite a bit of Moderna and to Emma's point, it did come in larger doses, larger packages, smaller packages initially, the Pfizer came in 975. And so you really had to be able to split that off and use it pretty quickly. So the answer, the long answer here is that, no, you can't really choose at this point, but our hospital will be giving out Pfizer probably for the next two to three weeks. We know that because Moderna for the state is in a bit of a shortage. Emma, I'm not sure if you think you're gonna, or do you know if you're getting Moderna back again or are you gonna stick with Pfizer? Do you have any idea? Yeah, I think we don't know. I know for the month of February, we're gonna be getting Pfizer. Yeah. So but after that, I'm not quite sure. I'd like just to add that while you also can't choose if you have a spot in the clinic, I would recommend you just take it. No matter what vaccine they have, they're really very similar. But once you have the first dose, you have to take, you really have to take the same vaccine as your second dose. Because the vaccines are not constructed, they're not made exactly the same. So the antibodies that develop are developed to that specific vaccine. So usually at most clinics, at the time you get your first dose, you make a date to get your second dose and it's up to the clinic to be sure that the people getting their second dose are getting the same vaccine. And you get a card that has the name of the brand of the vaccine that you got. So you can be sure. And they're also reported to the state. The state has a system for every vaccine gets reported into the state. So anyone can look it up. Anyone in the healthcare or in the clinic could look up and be sure which vaccine you have for your first dose to be sure you get the same thing for your second dose. Dr. Levin, we kind of have a follow-up question that just came in that's related to that topic. This person asks, if someone gets the Pfizer as their first dose and it's out of stock when it comes down to get their second dose, what happens then? Well, we're hoping that that doesn't happen. We're hoping that over time, I mean, these clinics are keeping track of who they're giving first doses to and planning that three or four weeks later they're gonna be needing the second dose. And the state is trying very hard to supply those second doses on time. So the CDC says that you don't wanna take your second dose early, right? You have to wait those 21 or 28 days, depending on which vaccine you get. But it probably is okay if you get it a little bit late. Ideally, close to on time, but if it's delayed a week or two there shouldn't be a problem. But I think the goal, I think everyone's goal is to get those vaccines pretty close to on time. And I think that will be prioritized by the state. If you have a second dose coming up, those second doses will be given before those first doses are released. So I'm hoping and anticipating that that's not gonna be a problem. Dr. Garcia, do you agree with that? Yes, thank you. That's what we've been promised by the state and I think it makes sense. We wanna make sure that's second dose. And again, we're trying to get the second dose in either 21 or 28 days later. But sometimes if it's a weekend or something we'll move it from a Friday to a Monday and that's completely appropriate and it's still within that timeframe. So it's not imperative that it's that 28th day, it could be 29, so. Thank you. And another question that we have here and I've seen this come up with several times now. How long will my immunity last and will I need a booster shot at some point down the road? Good question. We don't know. We anticipate that our immunity will last at least three months. The patients from the studies that were given their doses in July are still under study and this is yet to be seen. I'm guessing that at some point we will need booster doses and that ties into the questions about the variants and do the variants need to change show what kind of vaccine we get maybe next year. We will need a booster dose and it will be slightly different vaccine based on what variants are circulating. I sort of anticipate that but our immune systems are very interesting. We have memory cells in our immune system. So even when our, if you were to measure antibodies for example and the antibodies are high after you're a vaccine and then they start to decline the immune system has memory cells. So if you were to see that pathogen again you were to see that virus again your body will remember and those antibodies will get regenerated. So it's yet to be seen even if antibody levels drop somewhat whether our bodies will continue to remember how to make those antibodies. So that's still under study and we will all find out at the same time. Another question I have here is will these vaccines work on the new variants that we've been hearing about? So there's several variants out there. There have been variants all along. It's just that they were not predominant or did not sort of catch on. That's normal for viruses to have variants. And the British variant I think we should be calling them by their proper names that's B117 is probably gonna become the predominant variant in the United States in the next month or so. It is thought to be probably more contagious and probably not any different as far as the disease that it causes. We do believe that the vaccines we're getting now will provide adequate protection. There is one variant now which is referred to as the South African variant that there's some question about our vaccines providing total protection or 95% protection but it may be 70% protection. But another thing to remember about these vaccines at least what we've seen so far is that although they may not protect against all disease some people in the vaccine group may get sick. Some of them, very few people will get very sick either requiring hospitalization, ICU care, ventilator care and it does appear that these vaccines even if some people may get asymptomatic or mild disease it does appear even for the variants that right now that they will protect against the most severe disease. So that's still something to really celebrate. Great, I'm seeing a couple of questions coming in from the room now. So I'm gonna kind of summarize these into one communication slash outreach question. People wanna know how they can sign up to be notified about when it's their turn and what about people who do not have access to an iPhone, internet or cell phone or email address and how are they supposed to be notified? So I know I can speak to that on the local level because that's actually a great thing that we thought about with our town of Amherst team because we certainly didn't wanna miss those people or have people not being able to be notified when their turn does come up for the new part of phase two. So what you can do is you can go to our town of Amherst COVID website and on there you can fill out a form, right Brianna? And in your category that you identify in, the 65 plus and two plus comorbidities or another one and what that does is that'll send you into our town alert system or notification system and you'll be able to select whether you wanna be called on your phone or sent a text message or an email when that time comes up. In addition to that, we also worked with our local councils on aging and our COVID concerns line and we made an email available to so that individuals that don't have email could still sign up because it is a necessary thing for to make these appointments. So our local council on aging are aware of that of our email address that would be used and then we are on our local health department. We are working with those council on aging to circle back with those individuals that use that email address to book their second appointments so that close case follow-up. So no one's missed in that. And I'll just add because another question came in as you were describing some of our systems, Emma. This person wants to know they have no internet access. How does one sign up? So you can call, we have a COVID concerns hotline that is staffed Monday through Friday, 8 to 4 30 PM and sometimes even outside those hours but mostly during those hours and you can call and speak with someone who will take your information live and put it in for you so that you don't have to have internet access if you're unable to get there and it can work on a landline as well. You don't need to have a cell phone or internet necessarily to receive that call. I hope that answers that for that question that came in. Yeah, one thing that some individuals might see when they sign up as well for our signups with Amherst is it'll start to ask you insurance information from after receiving some feedback from this group that just went live. We were finding that it was, it was confusing and complicated and really that's something that we can help you with onsite to input very quickly when you arrive. So we took that off of our registration needs for when you complete registration through our platform but we will be asking for that documentation when you come and that is even though this vaccine is arrives free from the federal government there are incidental administration charges and needs that we have to incur to provide these great clinics that we are all gonna see you in. So the health insurance is to cover those costs. There is no cost to you. There is no copay. And actually Brianna that kind of leads me into something that I know we were keyed in this morning is that money should never be requested from a legitimate source when you're signing up to get your vaccine. Credit card information should never be needed. So that should be a red flag for individuals if they start to see that when they're signing up for a COVID and someone's asking for your credit card information that should make you worried and don't go for that. We did put a notification on our town website for that because we had some feedback. Great, thank you, Emma. Yeah, in our system just quickly, the system Emma described it much better than I can. We are trying to do some outreach into anybody who has been within the past two years at Cooley Dickinson for care. And that is it will include at some point even potentially mail and other things to make sure we're reaching folks because we do rely heavily on phones, cell phones, texting those kinds of things as well but we know there are people we're missing so I think everyone's trying. Great, thank you for adding that, Dr. Garcia. It's something we've been talking about in our meetings about how to reach people in new ways instead of digital first. So I appreciate that addition. Here's one question I believe that was asked and answered by Dr. Levin but I think the room who's watching might benefit from this. So this person asks, should you make appointments at several centers just so you can get in as soon as possible? I've heard this before, what's your advice? Well, we certainly want to have enough spots for everyone and there aren't right now but you would not want to take up two spots. So if you sign up for a clinic and then you look around and you find something that you might like better it's closer to home or sooner than cancel the other one. Don't take up too many spots that other people might want to be using. Great, thank you. So I will remind folks we've got a couple more questions that were already submitted to go through but we are coming up on our eight o'clock our hour with our special guests here. So please feel free to put in a question if you haven't had a chance to yet. If your question does not get answered live please feel free to email us at covidconcerns at amherstma.gov so that we can help you after the fact if you have any other remaining questions. So I just got a question here what is the phone number to call in Amherst about vaccine questions? So you should call 413-259-2425 that's our covid concerns line staffed eight to 430 p.m. Monday through Friday. Let's see. I have a couple of questions here about trying, I tried out the vaccine appointments website for my brother just to see how it worked. I was on the website for one and a half hours and then it refreshed. That was the only appointment slots that showed up. Is this a coincidence or is it necessary to keep refreshing? We've heard this question a lot about getting the end of the form and having to refresh and recalibrate if anybody wants to speak to that. Yeah, I know for our software that we're using it is a nationally based and supplied platform throughout the United States. That was really redundant the way I just said that but it's for all Massachusetts local health departments and local boards of health. So there are things in it that unfortunately we can't customize as much as we would like to but we are just so happy to have this platform so that way we can get all of you in and get everyone vaccinated as soon as we can but we do acknowledge that there's some quirks and kinks in it that we don't have control over. And one of the issues with the Cooley rollout is that it's centralized through Mass General Brigham. And so anybody who is contacted can get vaccinated any place across the system. So while you maybe don't wanna drive to Boston they may have additional vaccine slots if ours are full, if you're contacted and we've had folks from Worcester over come out as well if they were healthcare providers within the system. So that's something just to be aware of is that there are options as to where you might want to go at some point for folks as well. Great, and I do see that we're coming up on our time. So I'd love to give the opportunity for our special guests to maybe leave the attendees or viewers with some last words or calls to action maybe something that you didn't get asked that you wanna share with everybody. And I'll start with Dr. Garcia because you're in my top screen here. Sure, I just wanna thank you for your time and we're in good hands with Emma and Amherst, I can tell you that. So I'm excited that and we're opening up the vaccines here locally tomorrow. So that's fantastic. We will continue to work together as a group to as your healthcare providers and healthcare services in Western Mass to make sure that we have vaccine available and we get you in. Be patient, understand it's gonna take us some time but we wanna get you in and get you safely vaccinated. Thank you, Dr. Garcia for joining us tonight. Dr. Levin. Again, I'd encourage all those who are eligible to get vaccinated but I also do wanna mention that the rest of life goes on and people have medical illnesses and other things come up. And just to let you know that although last spring Cooley Dickinson and the entire state healthcare system was sort of shut down because of COVID that we now can walk and chew gum at the same time. We can actually take care of people with all kinds of routine problems as well as taking care of COVID patients. So and ever do that safely. So I wanna encourage people not to ignore other medical problems, other routine care, video visits, in-person visits, whatever they need that we are available to do that. Great and thank you so much for joining us Dr. Levin. I'll give a chance for Emma for her final say. Yeah, so I just really want this is a new time, right? When we're all excited about the vaccine and I'm just enthralled with the amount of people that want it now, right? That over pouring show of people that are interested and I think that's great. I don't want us to forget about our mental health and wellbeing. I think that this winter can be very lonely. So I want people to call on that neighbor that you maybe haven't heard or reach out to that elderly person that you know lives down the street and then just even your own family or friends and even yourself, just recognize your needs and the things that really keep you grounded and do those small things. Makes time throughout the day because this is a marathon that we're in and it certainly isn't a sprint and the things that are gonna be able to get us through are gonna be those little treasures that'll just warm our hearts and be able to help us all carry on until when this is someday over. But it's gonna be through all of us doing this really great work together that we're all gonna be on the other side of this pandemic someday. And thank you for that, Emma. And before I close everything out I'll just say a few logistical reminders. I will put this video up on our YouTube channel and on our website and with the permission of the doctors we'll also put the slides up. Again, if you have questions, concerns you can email us at covidconcernsatamersonmay.gov call us at 413-259-2425. And if you are a senior in need of assistance for registering and you don't live in Amherstruppelum please contact your local senior center or council on aging for assistance. If you need their numbers feel free to call ours and we can help you with that as well. So again, a big thank you to Dr. Joanne Levin and Dr. Esteban Garcia for joining myself and Emma and our Nancy Gilbert our chair of our Board of Health. Thank you all. Thank you so much for having us.