Dr. Robin Trotman answers key COVID-19 questions

Dr. Robin Trotman addressed questions about COVID-19 vaccines and offered an update on where we currently stand during a Facebook live event on Wednesday, March 31.

Here is what he had to say on a variety of important topics. You can see the full video here.

On the safety of vaccines:

I am increasingly comfortable as more time passes and we see more vaccinated people exposed and not getting sick.

We are not seeing any signals of safety issues and the vaccine is more effective that I could have imagined.

I understand the trepidation. For what it is worth: My family is vaccinated, I am vaccinated and my kids will be vaccinated.

We have come a long way, quickly. The guardrails and safety processes for creating a vaccine have not been bypassed in any way. The process was the exact same, it was just accelerated.

The numbers to receive full FDA approval have been accomplished. The only missing piece is long-term efficacy data.

We don't have the luxury of waiting for years of efficacy data. And, it would be unethical to wait for it; people need the vaccine now.

On the latest data:

We know the vaccines are 100% effective in preventing hospitalization and death. There have been studies released in the last two weeks that offer encouraging data on their ability to prevent asymptomatic infection and transmission.

Studies from the CDC's journal and Mayo Clinic show the vaccines are almost completely effective. You may still find the virus in a person's nose, but they are not getting sick.

I never thought I would see the day when we are having 95%+ efficacy for vaccines.

On vaccine side effects:

In our bubble here at CoxHealth, we have given more than 61,000 doses. Of those, there was one person who had a severe reaction.

Nationally, we now have 3-4 months of safety data and there are no signals of any serious adverse events.

Allergic reactions are rare and if they occur, they occur in the observation period.

My personal PSA: Always get your two doses. Be prepared for more side effects (headache, fatigue) on the second one. Both doses are super important for the durability of the vaccine. You do not want your protection to wane in a few months.

On concerns about potential long-term side effects:

We know anaphylactic reactions are very rare. For a typical person who has no history of anaphylactic reactions, the adverse reaction rate is very low.

Pfizer and Moderna both had 17-20,000 people in their trials. We now have 6-7 months of data and if there were signals of side effects in those groups, we would have seen them by now.

Typically, side effects from a vaccine are seen in the first 90 days. These vaccines use an MRNA molecule that our own cells digest in a day or two.

In general, it is not a phenomenon to see long-term side effects from a vaccine at 6 months or a year. And, there are no signals indicating that these vaccines would be any different.

On the return to school:

Schools are safe. This looks like a big change from where we were just a few months ago. Large CDC trials are showing that schools can open safely, if mitigation efforts like masking and distance are strictly adhered to.

On variants:

All pathogens evolve over time. Their genetic material will change in a way that is advantageous for its survival.

This virus makes mistakes in its reproduction. When one of those random mutations proves to be advantageous for the virus, that will become the dominant variant.

The most important thing to remember is: To mutate and become super variants they have to have a host. The way you stop new variants is to stop ongoing transmission. That's why we do the mitigation strategies.

On vaccination after having COVID-19:

If you have had COVID-19, you still need the vaccine.

We don't know how long immunity lasts after natural infection. We know it starts to wane.

Vaccination prolongs your immunity. We know the vaccine confers more protection than your natural immunity after an infection. And we know the vaccine is more effective at preventing transmission than natural disease.

On confusion about the role of fetal tissue:

There is a lot of misinformation and confusion on this topic. I am very understanding of the concern – I personally would not want a vaccine with aborted fetal tissue in it.

There is no aborted fetal tissue in any of the COVID-19 vaccines. The cell culture used to study and manufacture the adenovirus contained in the J&J vaccine was part of an immortal cell line that originally came from a retina cell from a fetus in the 1980s.

When you do molecular biology, we grow a virus in the lab to study it and test it. You do that using a cell culture, where you keep tissue alive so you can grow the virus. The J&J used adenovirus, with the gene for the spike protein placed in that virus. The cell line used is PerC6 and is it used often in virus vector technology.

The virus was grown in a cell culture line that was an immortal cell line that originated with the retina cell more than 30 years ago.

It is a very common tissue culture line used for multiple platforms. Many drugs and a lot of viruses have been studied using this immortal cell line.

On pregnancy and the vaccine:

There are no signals of any serious adverse events and I am not aware of any data signals to give concerns.

These are risk benefit conversations to have with your provider. You can talk to your provider about risk tolerance and the consequences of having COVID-19. Our OBs are well-versed in the topic and have these conversations every day.

On vaccinating young, healthy people:

Our first goal with vaccination was to prevent illness and death. Now, we are working on the goal of preventing transmission.

We want to vaccinate young people so they don't transmit. Vaccination also prevents other consequences – like long COVID.

We want our ecosystem to be immune so we can resume a normal lifestyle. We want to get people back to their activities and continue to protect our more vulnerable populations. To do that, we need young people to be immune.

On where we go next:

We need to keep our foot on the gas with mitigation efforts.

There are still sick people out there. We need a large fraction of the community to be vaccinated – maybe 30% locally, assuming that 25% of our local population has already been infected.

Since kids aren't currently being vaccinated, it will be tough to hit the 70% for herd immunity.

There are diagrams on the CDC website for how to safely gather with others as more people become vaccinated.

And, you have to think about the big picture. There are 200 countries on the globe. 130 have never given a single dose.

We have to make sure people have equal access. We are one plane ride away from the rest of the world and we are not safe until the entire planet is immune to this virus.