Dr. Timothy Gieseke, who served as the Medical Director at Spring Lake Village from its opening in 1986 until 2019, sat down on Monday, December 14 for an interview with Laura Darling, Covia’s VP of Communications and Spiritual Care, to give his perspective on the safety and effectiveness of the COVID-19 vaccines. Gieseke is a member and past President and Board Member of the California Association of Long Term Care Medicine (CALTCM). The full interview is available online here.
Dr. Gieseke gave an overview on how these novel vaccines were developed and how they work. Using a well-established technique that has been in use for the past 10 years for cancer therapies, scientists created a messenger RNA, or mRNA vaccine for SARS CoV2. Not using the COVID virus itself, the mRNA vaccine “creates a sideshow, if you will…so the body sees it as a foreign protein and makes antibodies against it. So that when the virus actually does infect us, or attempt to affect us, very quickly it’s identified as something foreign to be destroyed and the virus is destroyed.”
Like every other therapy approved by the FDA, Dr. Gieseke explained that the COVID vaccines went through three trial phases. “Physicians get interested in the phase three study, which is where they had 43,000 volunteers” – 30% of whom were from ethnically diverse backgrounds, and 45% between the ages of 45 to 85.
After a phase 3 trial lasting two weeks longer than the usual period and review by committees, including the Vaccine Related Biologicals Products Advisory Committee (or VRB PAC), “at a federal level, they felt that this vaccine was effective at a 95% level, which is really amazing.”
It’s effective. But is it safe? Dr. Gieseke explained that although “this was a rapid review, rapid approval process, but the actual scientific process was the same.”
“There’s things that we don’t know about this, but that’s true of everything in medicine, that’s new,” he says, “But the potential value of this vaccine is so large that I can tell you I’m signing up, all my associates at Spring Lake, Drs. Greene and Rao are signing up. I had another colleague say, ‘Where can I get it?’ And I can tell you, physicians are just really excited that this vaccine is available.”
A review of the side effects did not raise any alarms for him. “I mean, there are always problems with these medications and there’s problems even after you get your emergency use, but the common ones were the ones you’d expect,” he said. Side effects were similar to those of the flu vaccine: soreness at the injection site, or a systemic immune response, “feeling like you’re getting the flu, because that’s part of your immune system, how it gets rid of the flu and actually SARS CoV2 as well.” Dr. Gieseke said these side effects were found in less than 3% of trial participants after receiving the first injection, and less than 7% of people after receiving the second.
The vaccines are given in two doses because “you get more effectiveness and better safety if you split the doses,” Dr. Gieseke explained. “So rather than giving a big dose all at once, you give a tolerable dose and then you repeat it three weeks later.”
“I think it’s effective and safe and it’s something that when your turn comes I would be, ‘I’m gonna be the first in line,’ quite frankly,” Dr. Gieseke says.
The Pfizer vaccine has already been approved, and the Moderna vaccine is not far behind. Dr. Gieseke thinks the Moderna vaccine may be the one more likely to be given to Covia residents and staff. “The Moderna vaccine which is an mRNA vaccine has very similar 94.7% effectiveness, differs in that it does not require the cold storage that the Pfizer vaccine does. So it’s more like a normal vaccine, has a better shelf life.”
So when will we all be vaccinated? “Hard to know,” Dr. Gieseke says. “Experts are predicting anything from May, June, to more likely the Fall, September, something like that, because these companies are selling to the world. It’s not just the United States.”
In the meantime, Dr. Gieseke says we need to continue to follow public health guidelines – including wearing masks, avoiding gatherings and enclosed spaces, and cleaning. “What we know about SARS CoV2 is public health actually works. But you really have to practice it effectively and I’ll just give you a couple principles that you may not want to hear:
“Now that medical masks are available, that’s what you should be wearing. And the reason medical masks are more effective than the cloth masks is, they actually have electrostatic forces that trap the virus embedded within them,” he says. Dr. Gieseke reuses his masks, storing them in a paper bag to allow them to dry out and be used again.
“Number two: Always use a mask when you’re outside your apartment because you just don’t know… all it takes is one person to not mask to blow the whole thing open, and I see that happen all the time.”
Number three: “follow public health guidance. So right now we’re on lockdown. Because in December, every week we’re doubling and tripling the prevalence of COVID. And what we know is the more common the COVID is in the community, the more likely we are to get COVID.”
Dr. Gieseke says that, even with the vaccine, “continue to do all the public health measures until public health says this no longer makes sense.”
Dr. Gieseke does have words of encouragement for everyone who has been dealing with the limitations imposed by COVID over the past year: “Number one, this is not forever.”
“I think the vaccines is going to allow us to have a more normal life, even if the virus has the ability to change like influenza and becomes a persistent problem,” he says. “I don’t think we’re going to see it out of control, like it is right now…Going forward, I think this will be a part of our lives. But I think it’s going to be a manageable part of our lives.”
Although the vaccine is good news, for right now his guidance is, “mask as much as you can. That’s kind of where you live at this point in time.” But, Dr. Gieseke assures us, “this too will pass.”