June 29, 2021 -- A new study shows surprising evidence that COVID-19 vaccines from Pfizer and Moderna may offer longer-lasting immunity than thought.

This comes after studies published last month found that boosters may not be necessary for people who were previously infected with COVID-19 and later vaccinated, The New York Timesreported. For those who were previously infected and then vaccinated, the protections could last years.

The new findings published on Monday in the journal Nature suggest that there may also be prolonged immunity for people receiving the Pfizer or Moderna vaccines and have no prior history of COVID-19.

The study did not investigate whether there would be similar effects with the Johnson & Johnson vaccine.

The scientists, led by Ali H. Ellebedy, PhD, of the Department of Pathology and Immunology at Washington University School of Medicine in St Louis, found that after a single dose of the Pfizer vaccine, immune cell responses, located in the germinal center of the lymph nodes, remained active longer than expected. This suggests that these mRNA vaccines may offer extended protection against the virus.

Forty-one people took part in this study, some of whom had recovered from COVID-19. The scientists studied lymph node samples of 14 of them.

3 Metrics Will Tell Us When COVID-19 Is Over, CDC Director SaysWebMD's Chief Medical Officer, John Whyte, MD, speaks with Rochelle P. Walensky, MD, MPH, Director, Centers for Disease Control and Prevention (CDC), about top COVID-19 concerns and recent changes to COVID-19 guidance.1188

[MUSIC PLAYING]

JOHN WHYTE: Hi, everyone.

I'm Dr. John Whyte, Chief

Medical Officer at WebMD,

and you're watching Coronavirus

in Context.

Today I have a very special

guest, Dr. Rochelle Walensky,

the Director of the Centers

for Disease Control

and Prevention.

Dr. Walensky, thank you

for joining us today.



ROCHELLE WALENSKY: Thank you,

John.

I'm delighted to be with you.



JOHN WHYTE: Well, let's start

off with,

remind us who does and doesn't

need to wear a mask and when.



ROCHELLE WALENSKY:

So the first thing to know

is anybody who feels more safe

wearing a mask should wear

a mask if they want to wear

a mask, right?

People should look

to the local guidance that has

been given and be deferential,

certainly, to the guidance.

If you are in a public place

that is asking you to wear

a mask, please wear a mask.



In general, however, if you are

vaccinated and you are not

immunosuppressed or don't have

an immunosuppressant-- are not

on an immunosuppressive agent,

it is really safe for you

to be able to take off

your mask.

If you are not vaccinated,

you should continue to be

masked.



JOHN WHYTE: The CDC recently

raised awareness

of hospitalizations increasing

in kids 12 through 15.

What do you think is causing

this?



ROCHELLE WALENSKY: So this was

data that was from March

through October that essentially

said that hospitalizations

among adolescents

was two to three times

higher associated with COVID

than it had been

to prior influenza.

That's really important

because that was true even

in the context of schools being

closed.



And so the reason that I think

that that's such important data

to emphasize

is people have been wondering,

are my adolescents

at a high enough risk

if they get COVID to merit

vaccination.

And I think these data were

really important to say,

not only were they getting

hospitalized, but they were

ending up in the ICU

and oftentimes

on mechanical ventilation.

And so-- I should say sometimes

on mechanical ventilation.

And so we really wanted

to demonstrate that this should

yet be a reason why parents

understand it's really

important for their adolescents

to get vaccinated.



JOHN WHYTE: And we know

that vaccination rates are going

down, particularly in adults

in certain areas of the country.

We're addressing these issues

of hesitancy,

particularly in communities

of color.

I wanted to ask you,

what's the role of physicians

in helping to get out

the message about really

evaluating risk

and helping patients make

that decision?



ROCHELLE WALENSKY:

So first thing to say

is, we expected vaccination

rates to not continue

at the sky high levels

that we had them at.

We knew that there was going

to be this period of time,

this inflection point,

where all the people who were

rushing to get vaccinated

would soon get vaccinated

and then we had to do

the hard work of reaching people

who were not rushing to get

vaccinated, and that really is

the role of the physician,

of WebMD, of Medscape,

to get the message out

to physicians.



To be honest, physicians are

the place that patients go

for their medical knowledge.

They are the trusted person that

people come to.

And so I would say physicians

have a really important, really

active,

and I hope proactive role

in understanding who

their patients are, what might

be their reason for not wanting

to be vaccinated,

and for being very

proactive in reaching

out and saying,

these are all the reasons why we

think it's important for you

specifically to get vaccinated.



JOHN WHYTE: What about doctors

who say, you know what?

I don't have time to do that.

I have a busy clinical practice.

It's not my job.

You feel it is our job to help

educate patients

and help them evaluate the risk

and benefit of COVID

and put it into context

for them.

People are

concerned about the risk

of a blood clots, potentially

from vaccine, yet the risk

of blood clots from getting

the disease is much greater.

We don't always explain that

well as clinicians, do we?



ROCHELLE WALENSKY: Right.

And I think one of the things

that's really important

is to understand why people

might have not stepped up to get

vaccinated yet.

And we as physicians, I

personally am a data person,

I like to see the data,

but data don't drive everybody.



What might drive somebody's

decision

is seeing their neighbor who had

headaches the day

after their vaccinations,

so they may not be likely

wanting to get it.

And so I think we really

do understand what people--

what are the reasons that people

might not have stepped up yet.



We as physicians, our job

is to educate,

so I think that this is really

part-- and our job

is prevention.

And so really, I think this is

squarely in what we should be

doing.

I recognize that there are a lot

of competing needs in any given

visit for what you need

to accomplish in taking care

of a patient,

but I think the prevention

of COVID-19 disease,

of severe COVID-19 disease,

really, right now fits squarely

within the mission of what we

need to do for our patients.



And I would say it may not be--

it may not take a ton of time.

It may take-- it may be

some others in the practice that

can help deliver some

of these messages.

It may be that you can deliver

them via video.

It may be-- there are a lot

of different creative ways

that you are able to answer

questions for your patients.

So I would say

be creative in how you do this

and, in fact,

be persistent, because it may

not be the first

or the second call

or visit that gets them to be

vaccinated, but really

the third or fourth.



JOHN WHYTE: You know, I have

a few patients that say they

want to wait because they're

hearing about boosters,

they're hearing about variants,

so they don't want to end up

getting three shots.

So I want to ask you,

what's our current thinking

on the need for boosters,

and if so, when might we need

them?



ROCHELLE WALENSKY: So this I

think is a really important

message that we as physicians

need to be sending.

First is, after you get your one

dose of JandJ

or your two doses of Pfizer

or Moderna, you're protected.

You're protected two weeks after

and you're protected immediately

two weeks after.

And you probably have

some increasing protection even

over time before then.



The question about boosters

is, does that protection wane

over some period of time.

So far, we have data out to six

months.

We don't have that much data

much further than

that because the vaccines

haven't been around that long.

But what we are doing now

is collecting the science

and the data

to understand when we might need

them if we might need them.



And so I really want to make

sure that everybody understands

and knows, the question is not,

am I protected today,

do I need a booster later

to protect myself today.

The question is, in a year

from now,

might I need a booster to remain

protected.

And I think that those are

really important conversations.

Of course, we want to be

prepared.

We want to be in a situation

where we're not catching up

in a year from now,

so we're collecting that science

right now.



JOHN WHYTE: Do you think it'll

be at least a year,

based on past experience of SARS

and some other viruses?



ROCHELLE WALENSKY: You know, I

think we have seen so far

that these are durable at six

months.

I think a lot has to--

I don't know the answer

to that question and a lot

depends on what variants are

circulating at the time,

in the United States

at the time, what variants might

come in.

So far, we've been

in a fortunate situation

that all of the variants

that we've seen here

in the United

States our vaccines

are protecting against.



JOHN WHYTE: I want to ask you

about some predictions if I may.

I want to ask you about the fall

and elementary schools.

So kids primarily less than 12

years of age,

is it your expectation

that elementary school kids will

need to wear masks in the fall

and what are the metrics

that the CDC is going to use

to give guidance to the school

systems?



ROCHELLE WALENSKY: In the fall,

I want everybody to understand

that we believe that schools

should be open five days a week

and our children should lean in

and be back at school.

Now, what I think

are going to be some

of the metrics

that we're going to be looking

at the local level

and where we will be

at the local level is, what are

your vaccination rates

at your local level, what are

the disease

rates at your local level,

to really start formulating

discussions about what should be

the policies at the local level

for our kids under 12.



Also to note is we are really

hoping that, by the end

of the year,

we will have vaccines that will

be available to younger aged

children.

So I'm hopeful that, over time,

not only will we have better

data on higher vaccination rates

and continued low disease rates,

but also a way to keep

our younger children protected

as well.



JOHN WHYTE: But does that mean

elementary school kids will have

to wear masks until there is

a vaccine?

Are those being tied together

in your mind?



ROCHELLE WALENSKY: We're looking

at those data right now,

and so I think it's too

early for us

to say whether we will recommend

that kids wear masks

or not wear masks.

I can say that there are

proponents of both sides

of that.

I've heard from many people

on both sides of that request.



JOHN WHYTE: But when we look

at the science

and we know that the disease

behaves somewhat differently

in elementary school kids

than it does in older teenagers

and adults, is that right?

And we have to really assess

that risk versus the other risks

of distance learning as well,

correct?



ROCHELLE WALENSKY: Absolutely,

and that's why I am saying

I don't really--

distance learning, in my mind,

you know, we need to get all

of our kids back in school.

And if the way to have everybody

in five days a week

and to have everybody

feel comfortable includes masks,

then maybe we should be doing

that.



On the other hand,

I think you're exactly

right that we've seen more

disease in school systems

when the kids are

among the teachers

and among the older kids.

That said, we have to see,

with those populations now

vaccinated, will it move

to the younger kids.

And so all of those

are going to be part

of the equation in weighing

this.



JOHN WHYTE: You know, Dr.

Walensky, the other day I was

asked,

what are the metrics we're going

to use to say that the pandemic

is over.

And I said, you know what?

I'm going to talk to the CDC

director next week.

Let me ask her because I'm not

sure.

So at some point in time,

you're going to have to make

an assessment.

How do you decide at least

that the epidemic in the United

States is ended?



ROCHELLE WALENSKY: I think we're

going to be living

with this disease

for some period of time.

I am really cautiously

optimistic

that, as of this morning,

our seven day average of cases

in this country

is less than 15,000 a day,

which is really

extraordinary from where we

were.

So we are going to be looking

at case rates.

We are going to be looking

at vaccine rates.



We have this push this month

to get 70% of people

with a single dose

and I would emphasize not just

70% of people

with a single dose,

but ultimately over 70%

of people with their double dose

if they merit a double dose,

getting the Pfizer and Moderna.

So I really do want to focus

and make sure everybody

understands not just one dose,

but two.



And so-- and then we're really

going to have to look

at the trends with regard

to what's happening

with variants across the country

and in other countries.

But yes, we're evaluating

that right now and making

those determinations

and decisions.

But again, vaccination rates,

disease rates, and testing

rates, and really trying to make

sure that we're, in places

that we're not seeing disease,

we're doing adequate testing

to make sure that that's

happening as well.



JOHN WHYTE: There's been a lot

of discussion

lately about the origins

of the virus and that, perhaps,

it originated in the Wuhan lab.

What's the latest thinking

about the origins?

And some people would say,

does it really matter?



ROCHELLE WALENSKY: So we know

that most coronaviruses, when

they come into human disease,

like the first SARS as well

as MERS, have jumped from animal

hosts.

So that has standardly been how

we have been introduced

to coronavirus disease

in other kinds

of coronavirus disease.

So it's not-- it's

understandable to say, well,

that may very well be how

this coronavirus came as well.



The first WHO report did not

give us enough transparent data

for us to understand,

could this, did this come

from a lab

or did this come from the animal

source.

And that's really where I think

we're all leaning in and saying,

we really need another report.

The president has said we need

another report that is more

transparent in the data, that

gives the line item

data for the scientists

to really understand,

could this have come from a lab,

did this come from animals.



And I think it is important.

I think it's important for us

to understand because, in fact,

this is how we learn.

This is how we prevent

the next time.

And so I think that the etiology

really is critical for us

to understand so that we can be

prepared for the next time,

better prepared

for the next time.



JOHN WHYTE: Will we be better

prepared the next time?



ROCHELLE WALENSKY: I think we've

learned a lot of lessons

in the last year and a half,

and one of the things that we

learned here in this country

is that we had

a frail public health

infrastructure in order

to be able to deal

with a pandemic

of this magnitude.

Public health works for you when

you don't know that it's

working, and that means

that when there's

a small measles outbreak,

or a legionnaires outbreak,

or a salmonella outbreak,

that it can be quickly shut

down.



We didn't have the capacity

to do this with something

of this magnitude.

We are working towards

and have received some resources

to improve that,

and I think everybody now knows

and understands what the CDC

does for public health

in this country, what

your state

and local jurisdictions do,

what your health care practices

do to try and keep America safe.

And then I think we--

I'm hopeful we'll have

the resources and the workforce

to build up to make sure we're

in a better

place for the next time.



JOHN WHYTE: And I want to give

you an opportunity to respond

to what some folks have

commented

on our social properties,

as you know,

that the CDC seems to be giving

out conflicting information

or they change their mind.

A lot of our clinical colleagues

are really looking to the CDC

for guidance,

recognizing that sometimes

the data are not clear-cut.

They're gray.

It's not black and white.



So what do you say

to our clinical colleagues who

sometimes, let's be honest,

are getting a little frustrated?

And they don't always have time

to dig deep into the data,

as you pointed out, to figure

out what's the best guidance.

It's a tough job trying to sort

through all this.

So what's kind of your advice

to clinicians who are also

burned out?

We're asking them to do more

things, right?

And they're already

overwhelmed in many ways.



ROCHELLE WALENSKY: So maybe

I'll--

three things.

First, just, like,

huge gratitude to everybody

in the health care workforce

for what they have endured

over the last 15 months

in trying to keep their patients

safe and in trying to understand

and keep up with an evolving,

rapidly evolving literature.



And not just in reading

the published literature,

but now so much is sort of

in the media

on the prepublished literature,

and that means that we

as physicians have to do

the peer review ourselves

to understand whether this is

a good paper or not

a good paper, and that's

hard too.

So huge thanks and gratitude

to the workforce

and to all of you physicians out

there who have been doing

that hard work.



Second, I think that we get two

major areas of challenges.

One is, people say it's too

complicated.

And yes, the truth is this

has been complicated.

And so much of what we have

to say is, well, it depends.

It depends on how

the ventilation system is.

It depends on how crowded

the classroom is.

It depends on whether you're

wearing masks or not.



And so while everybody sort of

wants to say, in this situation,

can I go visit Grandma,

it really does depend.

Is grandma immunosuppressed?

So there have been--

we have tried very hard

and worked very hard to make

sure our messages can be simple

enough so that people can

generally follow them,

but there is some complexity

here.



And even in the complexity

of messaging, really, as we were

scaling up vaccines,

we had some high case rates.

We had a lot of people who were

vaccinated.

It does depend.

So it has been complex to try

and extend that.

And then the other thing

is, the science is changing.

The science is evolving.

And so decisions that might have

been made even three months ago,

between the science evolving

and the epidemiology involving,

our guidance has had to change.



And so we really do try to do

the hard work for you all

to distill the science,

to update our scientific briefs,

to convey to you the synthesis

of all the science that's

out there that leads

to our decisions.

And so yes, I will acknowledge

it is complex

and it is changing,

and it is because that is where

we are in the status

of this disease.



We have resources for health

care providers.

If people have questions

about how they should handle

questions,

please come to our CDC website

and call us for resources so

that we can give you

those resources to

empower you to make your job

easier.



JOHN WHYTE: And finally, what

does spring 2022 look like?

I'm not giving you the fall,

but I'm saying the spring, March

or April of next year.

What does it look like?



ROCHELLE WALENSKY: Oh, gosh.

I-- thank you.

I am really cautiously

optimistic.

And I know I use that term--

it would be

naive, in this pandemic that has

thrown us so many curveballs

and so many disappointments,

to not keep our eye on this ball

and to not make

sure that we are doing all

the due diligence

we need to make sure that spring

of 2022

is a really, really bright

spring.



We know the variants are

out there

and so we have to watch that

carefully.

We know that the potential

for waning immunity

is out there.

We have to watch that carefully.

But now we're prepared.

We know we need to watch.

We've scaled up

genomic sequencing

extraordinarily here

in this country,

and so I am really cautiously

optimistic that we will have

a bright, bright spring of 2022.



JOHN WHYTE: Well, Dr. Walensky,

I want to thank you for all

that you are doing,

for all that your colleagues are

doing in Atlanta

and throughout the world at many

of the offices

in keeping us safe,

and keeping the world safe,

and really advancing the mission

of public health.



ROCHELLE WALENSKY: Thank you so

much.



[MUSIC PLAYING]

John Whyte, MD, MPH, Chief Medical Officer, WebMD. <br>Rochelle P. Walensky, MD, MPH, Director, Centers for Disease Control and Prevention (CDC)./delivery/aws/50/06/5006ee8a-a636-3eed-a1b9-b74a0e2f7561/Walensky_060721_v4_,4500k,2500k,1000k,750k,400k,.mp406/08/2021 19:03:0018001200Walensky_060721_1800x1200/webmd/consumer_assets/site_images/article_thumbnails/video/covid19-images/Walensky_060721_1800x1200.jpg091e9c5e821b736d

The researchers also found the Moderna and Pfizer vaccines provide robust protection for at least 12 weeks after a second dose and could provide low-level protection for at least a year.

“The study shows that the germinal centers have prolonged B cell responses,” William Schaffner, MD, a professor of preventive medicine and infectious diseases at Vanderbilt University, tells WebMD. “The anticipation is that these memory cells are going to persist for a substantial period of time.”

Schaffner says that while the response of B cells -- a key to the immune system -- wasn’t very long, the study offers insight into the biology of what happens after someone receives an mRNA vaccine. But the findings should not lead to quick conclusions.

“It’s one thing to have this lab affirmation of biology of immune response,” Schaffner says. “It’s another thing to study the duration of the protection of substantial populations of people.”

He says the findings also add to current discussions of whether people who have been vaccinated will need booster shots.

“The two big issues are kind of addressed here,” Schaffner says. “One is what is the actual duration of protection that’s provided from initial immunization. The other is could there be variants that can evade this protection. Or the antibodies we create won’t specifically provide protections.”

He notes that there is optimism in the fact that neither of these issues has arisen, even 6 months into vaccine distributions.

“Studies like this suggest that it could be a year or longer,” Schaffner says. “That would be fabulous.”

But exactly how long immunity lasts remains a question.

“The authors are very careful not to make specific projections,” Schaffner says. “That would be very difficult.”

He says that while booster shots may be a popular topic of conversation, they should not be too much of a concern, even with current variants.

“The vaccines we do have offer pretty good protections for the variants that are active,” Schaffner says. “So there is no immediate need for a booster as of right now.”

WebMD Health News

Sources

William Schaffner, MD, professor of preventive medicine and infectious diseases, Vanderbilt University.

Nature: “SARS-CoV-2 mRNA vaccines induce persistent human germinal centre responses,” “SARS-CoV-2 infection induces long-lived bone marrow plasma cells in humans.”

The New York Times: “Pfizer and Moderna Vaccines Likely to Produce Lasting Immunity, Study Finds,”  “Immunity to the Coronavirus May Persist for Years, Scientists Find.”

© 2021 WebMD, LLC. All rights reserved.
Click to view privacy policy and trust info