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Transcript of the May 13 Ask MAC live streamed Q&A

Speaker 1 (00:00:05):
Let me go ahead and I'm going to count you down Dr. Jenkins five four, three, two.

Speaker 2 (00:00:14):
Good morning. I am superintendent Barbara Jenkins. And today we have the privilege of having the school boards, medical advisory committee, providing answers to questions we have received regarding the COVID 19 vaccination. I want to emphasize as publicized. This panel is here to talk about the COVID 19 vaccination. I know individuals are interested in face mask debates. We will have some comment on face masks, but our topic today is a COVID 19 vaccination. On April 15, we opened up the submission of questions from the community. And as of May 10, we had received 735 questions. Questions we will ask are some of the most frequently and pressing questions that we received. I would like to take the opportunity to introduce our esteemed group of medical professionals who assist the staff and our school board in dealing with a global pandemic here in orange County. We call this initiative, ask MAC, standing for a Medical Advisory Committee.

Speaker 2 (00:01:24):
So, starting before I introduce them. Let me also note that we have three board members present here today. That is Angie Gallo, Vicki Elaine Felder and Melissa Byrd. And it's my understanding that Linda Kobert is also online. So our medical advisory committee starting on the far end of the dais, Dr. Annette Nielsen, pediatrician at Treehouse Pediatrics, Dr. Brian Harris, behavioral developmental pediatrician at Orlando health, Dr. Omayra Mansfield Chief Medical Officer at Advent Health, Apopka, Winter Garden, Dr. Adriana Cadilla, Infectious Disease at Nemours, Dr. Mercedes Rodriguez, OCPS Pediatric Physician consultant, Dr. Reagan Schwartz, Chief of Emergency Medicine, Advent Health, Dr. Vincent Hsu, online, Executive Director, Epidemiologist and Infection prevention at Advent Health and the Mac chair and Dr. Akinyemi Ajayi, Pediatric Pulmonologist, children's lung asthma and sleep specialist is also on the phone. Dr. Michael Muszynski, Professor Emeritus, Clinical Sciences, Florida State University, online with us and nurse Darcy Ravndal, Nurse Practitioner, Healthcare Providers of Florida is not in attendance, but we do want to acknowledge she is a part of the Medical Advisory Committee. So,

Speaker 1 (00:03:04):
OK. Have you heard any word, any word on?

Speaker 2 (00:03:09):
So, we'll, we're going to need to mute that for a minute.

Speaker 1 (00:03:15):
We're live. We are live,

Speaker 2 (00:03:18):
We are live. All right. So, um, yeah. Dr. Muszynski and Dr. Hsu are going to comment, uh, just briefly because, uh, the elephant in the room is whether or not the board has made any determination about face masks for next year. I can tell you the board has made no determination or change in policy at this point. Certainly, they will rely on the tremendous expertise of this panel, of their advisory committee, as well as Florida Department of Health and Dr. Pino's team that has been a wonderful partner, a wonderful partner with us throughout this very trying time. So, over the summer, there will be some discussion, June, July there have to be some discussions, and eventually it'll have to be a determination about face mask, but I've asked Dr. Hsu and then Dr. Muszynski, to at least opine briefly on the whole debate around the science of face mask. So, Dr. Hsu, and then we'll have Dr. Muszynski and then we'll get to some additional questions. Dr. Hsu.

Speaker 1 (00:04:20):
So
Speaker 2 (00:04:20):

If you're speaking, we can't hear you in the chamber. Dr. Hsu, Dr. Muszynski. You want to comment on face mask or we'll come back to it at the end. If we need,

Speaker 1 (00:04:39):
I hear you who's there? At the end, we'll get to additional questions. So, if he's speaking, we can't hear. Hi, good morning. I hope you can all hear me. We can hear you. Go ahead, Dr. Hsu. I'm on right now. Can you hear me? We can hear you. Go ahead. Now. We can't hear you.

New Speaker (00:05:06):
I'm here. Can you Hear me? Dr. Muszynki, we can hear you.

Speaker 1 (00:05:11):
This is Dr. Muszynski. Good.

Speaker 2 (00:05:14):
Go ahead and comment on, go ahead and comment on face mask for us, doctor.

Speaker 1 (00:05:19):
You can all hear me. I can hear you. Great. Um, yeah, we can hear you. Got it. Thank you very much. We've been a year in the pandemic. People are tired. We all want to get back to our normal lives and mask remain one of those barriers. We're moving slowly back to normal because transmission is slowing. Yes, I'm sorry. We are moving in a right direction, but I do want to make sure that we understand that data suggests that, [pause] I'm sorry, some, some maintain, uh, incorrectly that we should all remove mask effectively because master ineffective at preventing transmission of SARS-CoV- 2, which causes COVID-19, but this claim is absolutely and unequivocally false. So, let me explain. This is a disease that's caused by respiratory viruses that circulate in the air, um, and using a mask that filters out the breathable air to weed out the viruses, um, is something that can protect. And from an extreme example, we know that the N 95 mask protect, they filter out 95% of these tiny particles and without the protection that these mask afford, we would have significant, um, uh, transmission to our healthcare workers. Um, from a community standpoint, community mass also does protect. And I want to show you some of the data and explain why that, uh, why that is, uh, uh, why it does work.

Speaker 3 (00:07:06):
We have seen studies that wearing a multilayer cloth mask blocks at least 50 to 80% of the release of viruses. And this has been done in a laboratory. Um, if you are infected and wear a mask, we call this source control and reduces the risk that an infected person could spread it to other people, but also wearing a mask to protect yourself has benefits. And there have been studies that have demonstrated that if you are wearing a mask and someone else is infected, you can also, protect yourself by wearing that mask. It protects the wearer. There are also many, many real-world effective studies that have been published, demonstrating effectiveness. Remember, we're not going to have a real world of gold standard trial called a randomized controlled trial because that's unethical. You don't want to infect people deliberately with not wearing a mask, but we do know that these trials or these studies that have been published, do show support that wearing a mask is, effective much better than not wearing a mask.

Speaker 3 (00:08:11):
When they've done studies and outbreaks, they have demonstrated that people who wear a mask have less of a chance of getting infection as opposed to those that didn't wear the mask. And it didn't matter what the setting was. It could have been in the community, in a hair salon, on airlines. When they have done studies to look at healthcare workers wearing a mask, they actually saw a reduction when they've masked patients initially, and then they also masked the healthcare workers. And there were significant declines in infections among that. We've seen mask mandates shown to reduce community transmission, such as in Kansas and Arizona. So even a small increase in self-reported mask wearing can increase the likelihood of stopping transmission in the community. We want to get transmission down because that is a critical step to getting normal.

Speaker 3 (00:09:01):
So, in summary, I just wanted to let the audience know, yes, mask wearing is not the ideal situation we want to get back to normal. But we also need to make sure that it is safe to do so, when community transmission has decreased to say that masks don't work is just wrong. We will continue to advise as the Medical Advisory to use science and data, to make recommendations to the Orange County Public School Board on these issues for the safety of our children and community. Thank you.

New Speaker (00:09:38):
Thank you, Dr. Hsu, Dr. Muszynski.

Speaker 4 (00:09:44):
Yes. Thank you. I agree with everything that Dr. Hsu said, one of the best references that you might want to read, and it requires a little bit of medical understanding in order to read the document is a publication by the proceedings of the National Academy of Sciences. It was published in January of 2021, and it's an evidence-based review of mask efficacy for preventing the spread of COVID-19. This review is not written by just one person or one person's opinion. This is an evidence-based scientific review of all the studies that are out there, and it shows the absolute best design studies to go over. And it's an article that was written by individuals from 23 different university institutions, not just in the United States, but across the world, and it unequivocally concludes that the review shows that widespread mask use is a strong source of control to reduce community transmission of this virus and public mask wearing, however, is most effective when, when the majority of people are or a vast majority, like a high number of individuals comply with using masks.

Speaker 4 (00:11:08):
So, it's like a double-edged sword. If you use masks, you're going to do well or better for yourself, but if everyone uses mass, we're all going to do much, much better for each other. The other question that always comes up is masks are dangerous, for not just adults, but also for children. There is no data at all to support this. This is all conjecture and it's out there in the web. You can find it everywhere that masks are dangerous. Things like you're going to breathe in your own germs, which doesn't make a lot of sense. If you think about it, you have your own germs and you're breathing them every day. So, concentrating them is not going to make you any sicker. They're the same germs you live with on a daily basis. Masks get dirty, so that's a problem. You can self-contaminate yourself.

Speaker 4 (00:11:57):
True. That's true. That's why we have to change masks daily and launder them. This risk increases when you wear a mask longer than six hours. And in most people, except in the healthcare setting, don't wear masks that long, uh, throughout the day on a consecutive basis. But, you know, wearing your same mask every single day without cleaning, it's like wearing the same underwear every day without cleaning it either. So that's the whole, issue with that. There is no data that really suggests that children suffer any kind of respiratory consequences of mask wearing. The only children who will have definite difficulties with masks from the start can be children who have special needs in educational settings, as well as in personal settings where masks become obtrusive to them and where claustrophobia is an issue, and we we've addressed that as a school board, very, very carefully.

Speaker 4 (00:12:53):
And we have exempted children from wearing masks if they meet the appropriate criteria. So, all in all, masks are used as an adjunct right now until such time that they can be relaxed. I'm looking forward to relaxing mask usage. I mean, not just relaxing it. In fact, I'm looking forward to ending mask usage for all of us, but that will come only with vaccination and only with immunity. So hopefully vaccination rates will increase high enough where mask usage will not be necessary because the rate of COVID in the community will decrease to a level that will make it safe or safer for children to not don masks anymore. It Is absolutely going to be necessary to wear masks indoors for a while until vaccination rates are up. Thank you.

Speaker 2 (00:13:48):
Thank you, Dr. Muszynski. I will also answer a question that we had from Nicole, who is a parent at Corner Lake Middle School. Will we be required to have children receive their COVID 19 vaccine in order to start the 21-22 school year? And I can tell you that answer is no. There is no requirement for students to produce evidence of a vaccine in order to enter school for the 21-22 school year. We don't hear any such rumblings, even at the state level. So, we suspect it will not be an issue. That does not mean that we don't encourage parents to please consider taking the vaccine. Next question, I'm going to direct to Dr. Nielsen. Sonya who's a parent at University High School asked why are students 16 and up or 12, and up only allowed to receive the Pfizer vaccine, but not the other vaccines like J &J or Moderna. And adding to your question is a parent David from Avalon. When do you think all children will be eligible to receive the vaccines, Dr. Nelson?

Speaker 5 (00:14:53):
So, all three drug makers made great products. Pfizer was lucky enough and fortunate enough to go ahead and start their studies a little quicker and a little bit more organized in a fashion so that we can get data back faster. So basically, we know how the Pfizer vaccine works. We have good data that supports its efficacy just the other day. We learned that you can take it up from 12 years old and up, which is wonderfully exciting. We don't have that data on the J &J shot or the Moderna shot. So as a nation, we're being cautious in which vaccine we're putting into children. And that's really important. We are being careful. We're taking definite steps to offer and place into our children and our population in general, safe vaccines. And so that's why it's being the Pfizer one that is being allowed. And it is again, starting from 12 years old and up.

Speaker 5 (00:15:45):
And this weekend, OCPS is actually having two sites in high schools where 12 year old's and up can go ahead and get the vaccine so that they'll have a better summer this summer, be able to do more things hopefully. We anticipate that the Pfizer data from the 2 and 11 year old group that they studied will be out before the fall, or at least in the early fall. And with any luck that vaccine will then roll out for that next group in the early fall. And again, it's simply because Pfizer provided the studies. They did it a little bit faster. They had a deeper breadth of statisticians and individuals who could evaluate that data. So, it's a good vaccine.

Speaker 2 (00:16:21):
Thank you, Dr. Nelson, and thanks for the plug as well. East river high school, and Wekiva High School, will be hosting from 8 a.m. till noon vaccine clinics Saturday. And if you're looking for other locations, you can go to OCPS.net and we have a link there that will show you other locations around the community where you can get your vaccine. Dr. Muszynski can you, we have another parent from Boone High School. You sort of already spoke to this, but I'll pose it for a brief response. How will the COVID-19 vaccine return us to normalcy when the CDC is recommending that vaccinated people continue to socially distance and wear masks?

Speaker 4 (00:16:59):
Yes Dr. Jenkins. This was actually an excellent question because intuitively it doesn't seem to make any sense. You would still recommend that vaccinated people continue to socially distance and wear mask. Since we assume that the vaccination is protective as Dr. Nielsen informed us. However, there can be infections after you received the vaccine. Now, those infections in people who have gotten a vaccine happen very unusually, however, if it does happen, those people are still infectious and can infect others. So, until the amount of COVID in the community is down to a certain safer level. The CDC has acted in a very conservative fashion to say that you should still wear masks if you're indoors, crowded in public or traveling, let's say flying on an airplane. Or if you're in a school setting indoors that you should still wear the mask, even if you're vaccinated for the time being. But I have a feeling that eventually they will change that recommendation with more data in the next couple of months. So, we will, we eagerly await that and hopefully mask usage will be further decreased for all of us. I look forward to it.

Speaker 6 (00:18:21):
Thank you, Dr. Muszynski. Dr. Schwartz, talk to us about this question from an employee Kelly from Sunshine Elementary School said if children began getting the COVID-19 vaccine soon, would we have reached herd immunity by next school year? And while you're at it further, for those who are not familiar, would you also address what is herd immunity?

Speaker 7 (00:18:44):
Absolutely, and I think that's a great question. First of all, let's talk about herd immunity. Herd immunity actually can better be understood if we refer to herd immunity as herd protection. What it is, is the percentage of the population that is immune to the infectious disease that is spreading in the community. So, there are a couple of ways that you can become immune there's natural immunity. If you've gotten the infection, then you're immune to reinfection for certain period of time. We're still learning about this virus, and we're not sure how long that natural immunity lasts. The second way that you can get immunity is from the vaccine. Most of the studies to date have shown that a vaccine actually confers a stronger immunity to the virus than even the natural immunity. So, the goal in a population, is to get as many people in the population immune as possible.

Speaker 7 (00:19:48):
There's something called the herd immunity threshold. And what that is, is an estimate of the percentage of population that's required to be immune before you see a drop or eradication of that disease. The question that, Kelly asks is a good one because the goal is to get as many people vaccinated as possible to hit that percentage where the virus no longer becomes a threat in terms of spreading. It's a difficult question to really answer because we are not sure based on the vaccine rate and vaccine hesitation, how soon we will get there.

Speaker 6 (00:20:25):
Thank you, Dr. Schwartz. Dr. Mansfield, Laurie, who is also an OCPS employee asks, if you have already had COVID, do I still need a shot and will it be too many antibodies? So that's a great follow-up question to what Dr. Schwartz was just saying as well. So, when you've had COVID, you have had some kind of antibody response, some kind of immune response, but as Dr. Schwartz mentioned, we know that will wane over time. And so ultimately those antibodies will subsequently not necessarily protect you from becoming re-infected. So yes, we do highly encourage even those who've had COVID in the past to take the vaccine because we also believe that taking the vaccine can actually augment your protection and your levels of antibodies. So that is greatly encouraged. Thank you, Dr. Mansfield. Dr. Ajayi, sort of along the same train of thought can an actual parent at Olympia High School named Carrie asked this question, can someone who received the COVID 19 vaccine still contract and transmit the disease?

Speaker 8 (00:21:38):
So, the answer to that is fairly simple and also quite complex. When the vaccines were released, the first thing that they spoke about, especially when Pfizer released the vaccine initially was how effective it was in reducing symptomatic infection, as well as the likelihood that people would end up in hospital with poor outcomes related to COVID-19. So, the initial data was all-around could we reduce the risk of severe infection. Now what's happened over time and actually as recently as last week, which came up in Lancet and this week from what Pfizer presented along with their data for the 12 to 15 year age groups, is that, I'll break this down. If you have one dose of the, for example, Pfizer Biotech vaccine, your risk of being able to have asymptomatic infection was decreased by 52%. And after the second dose, it was decreased by 90%, which basically means that to a large extent, 90% of the patients who had received the vaccination in that regards were unlikely to have an asymptomatic infection of any sort among the people who would have symptomatic infection the rates were down to 57% after one dose and up to 92% after the second dose. In children, we're actually saying that the rate of asymptomatic and the rate of symptomatic infection is pretty much zero it's a hundred percent effective against symptomatic infection. The Pfizer vaccine that is currently available now, but is there is no doubt that some individuals who receive the vaccine will still get infection. And that is true of virtually every vaccine that is out there. It does however seem that the numbers are going to be incredibly low. And therefore, the expectation is that transmission will decrease some of the other stuff that is now. What we're also saying is that people who are vaccinated tend to have a much lower, about three to four times, four and a halftime fold decrease in amount of nasal pharyngeal, viral, um, secretion rates.

Speaker 8 (00:23:46):
So, if you measure how much virus that is actually in the nose of someone who's being vaccinated against COVID, as compared to someone who was not vaccinated, especially if they were infectious, there isn't, especially if they had the bar, um, they were infected with the virus, they counseling to the much lower will that have a role to play in determining how contagious that person becomes or is as compared to someone else. But data is still out there because we don't know exactly how low the viral count has to be in each, in an individual for them to not be infectious to someone else. Does it have to be zero? Well, was there a number in between that actually makes us contagious? So, the expectation and probably the longer short answer and this situation is that, um, if you have been vaccinated, then it's a significantly lower possibility that you will contract COVID infection and then even lower likelihood that you are going to transmit COVID-19 to someone else. But it doesn't mean that you have no risk at all.

Speaker 2 (00:24:47):
Thank you, Dr. Jive, Dr. Muszynski. I have a question here from a parent, Wendy of Eagle Creek elementary school, and Chris, who is an OTPs employee, had the same question. Do we expect the COVID vaccine to be needed every year? Just like the influenza and how long does the vaccine last? Does it protect against the variations precedent?

Speaker 9 (00:25:16):
Thank you for the question. Um, I'll start out by saying Panther pride. Um, and, uh, I'd like to break this question up into a couple of different sections. So, first one, how long is it going to last? How long will immunity last? We don't know we've already, um, discussed it amongst here. I think some answers, uh, touched on that, but the studies are ongoing. We started vaccinating people in July of 2020 for the marinade vaccines. And that was about 10 months ago. They are doing continued studies to determine how long these people will continue to have immunity amongst others as well. And so, I, I, we don't know what the answer is, but it is favorable right now that people began with vaccination again, sometime in July of last year. And, um, the protected titers seem to be, uh, persistent this far out. So definitely more to come on that, um, as far as protection against variants, uh, this is also interesting, uh, because we are continuing to assess this.

Speaker 9 (00:26:20):
There are multiple variants out there right now. In fact, the variant [inaudible] from the UK right now is about, um, comprising about 70% of us cases. Uh, we do know that previous studies performed in Qatar, for instance, with the Pfizer study, demonstrated 90% efficacy against this variant and against other it's a little lower, but it still remains an unknown, uh, modern vaccine is currently working on a booster dose, which may be more effective against some of these variants. And so, uh, we need to continue to, uh, follow the science and monitor for variant and determine whether or not we're going to need a booster vaccinations to be more effective against these, which leads me to the last part of that question, which was, are we going to need to have vaccines yearly, like the flu it's too early to tell? Um, again, it will depend a lot on the variants and how coverage against these variants are, which new ones begin to surface in the U S and whether or not the immunity wanes. And so still too early to guess. Uh, but, um, the, uh, outlook is very promising so far. Thank you.

Speaker 2 (00:27:35):
Thank you, Dr. Kadir, let's move to Dr. Rodriguez. So, Judy, a parent at Blankner school asked what is the plan to provide continuity of education for medically vulnerable students who can't get vaccinated and will benefit from continued universal masking in the event that DOE pressures districts to remove mask mandates.

Speaker 6 (00:27:59):
So, part of this question regarding the department of education and district that sort of thing, but as it was discussed at the beginning of our session, um, we currently have a process in place where we take on a case by case basis, um, recommendations from parents and physicians in the community when a child needs to come to school without a mask. Um, we have a very low number of those children that have requested to come mask lists. We do provide on a case by case basis, a waiver for a certain amount of time while they're in school. Sometimes it's only for 60 days until they can become accustomed to wearing a mask. Uh, the school staff does assist children in learning that, so that has worked out well. There are a very, very low number, less than 1% actually, of children who are coming to school without a mask at all.

Speaker 6 (00:28:57):
Um, with regard to having a vulnerable child, um, who may benefit from universal masking. Um, I really think that, uh, we could look at that on a case-by-case basis as we do now when they request a waiver and that those children's, uh, those children's physician and parents can submit information to the school. And I will be happy to review that like I have in the past. I think that could possibly be an option where once we start the new school year that some child may want to continue to wear a mask. And we take that on a case by case basis.

Speaker 2 (00:29:36):
Thank you, Dr. Rodriguez, let's move to Dr. Hsu online. Uh, a parent Sarah from Howard middle school asks, is there a current schedule for teens and preteens to get vaccinated before fall of 21?

Speaker 3 (00:29:51):
This is a real timely question because this week the FDA approved or authorized it on emergency use the Pfizer BioNTech use of the vaccine for 12 to 15 year olds. And the CDC advisory committee also agreed with that as well. So, if your child's 12 or older, the time you can receive vaccine is now get it as soon as possible. So, you'll be ready before the school season starts in 2021 and fall 2021. Remember this is a two dose schedule, so you'll need to receive your second dose three weeks after the first and for your child who is under 12, we will have to wait until the trials in younger children are complete and the application for FDA authorization is submitted. But again, if you're 12 years or age and older, the time to get the Pfizer, BioNTech a vaccine is now.

Speaker 2 (00:30:44):
Thank you, Dr. Hsu, Dr. Nielsen as a pediatrician, I'm sure you've had this question several times. Uh, a Sue who is a parent at Dr. Phillips elementary school says I have been vaccinated, but I am unclear about how safe it is. What are the recommendations for vaccines for children? How safe is it?

Speaker 5 (00:31:03):
Hi, Sue. So, like you I've been vaccinated. Um, my child, however is 10 and a half and he is unvaccinated. My family had COVID in January, so we still tread cautiously outside because I don't want to ever go through that experience of having COVID or him having COVID. Again, either the vaccine itself is wonderful because what it does is it makes your body attack the shell of the virus. So, if you think of it like an M and M the vaccine is actually attacking the coding of the M and M so what's inside can change. So, if you think about it, if I'm attacking a shell, then your body can kill what's in the shell. And that wins that MRN is out of your body in 72 hours, based on the studies that we have making a really, really good vaccine. And that's also how it helps that with the variants of the vaccine, the inside of them and them changes.

Speaker 5 (00:31:56):
You still have good protection for the shell of the M and M the shell of the virus itself. So, I would say, even though you're vaccinated, still tread cautiously, we're max. Cause if you're in a crowded space inside, if you're outside, be a little bit more lenient, if you're an open air, you know, everybody's just kind of been vaccinated around you. You know that you're in a good space, take your mask off, enjoy your summer, but be willing to get your child, the vaccine too, because they deserve to feel comfortable and more relaxed in that classroom inside.

Speaker 2 (00:32:28):
Thank you, Dr. Nelson, Dr. Harris, this is right up your area of expertise. So, Katherine whose parent at Oak Ridge high school said both of my grandkids are in good health, but they have had emotional problems. So, will this shot hurt their emotions more?

Speaker 10 (00:32:51):
Uh, Katherine, this is a wonderful question. Um, and I think it's so important to talk about mental health, uh, which often takes its toll in silence. It's also important to recognize and validate these feelings and worries that are present in both ourselves and our children. The COVID pandemic has impacted all phases of our lives profoundly. Certainly, along with us, we've seen an increase in individuals having difficulties coping with the uncertainty created by all of this individuals are more socially isolated from loved ones, missing out on important milestones. Some may persistently worry about their health or the health of others. Um, and many wonder, when is this going to end? Now, we all want to get back to a sense of normalcy. We all want to travel, eat out, visit the theme parks, and certainly around this time of year celebrate our milestones. So, it's very important that we all work together to continue to practice standard precautions, to keep everyone safe.

Speaker 10 (00:33:57):
And certainly, the next step is to get as many people as possible vaccinated to extend that protection and bring this pandemic to an end. A recent study released by the CDC shows that over 87 million people to date have been vaccinated around 400, uh, adverse events have been reported amongst that 87 million to put this into perspective, that's about a probability of 0.0005%, which would be less likely than when you leave your house today of being struck by lightning today, there has not been any adverse events that are directly tied to mental health conditions, but certainly continue the longer that this pandemic continues to endure, this is certainly a risk that we all must consider. So, we strongly encourage that once you are eligible. And now that includes everyone 12 years old and, and older, when you have the opportunity, please go get backs unaided.

Speaker 2 (00:35:09):
Hey, Dr. Nelson, let me ask Dr. Muszynski. I'm sorry. Thank you, Dr. Harris, let me ask, I'm going to skip over one. That seemed like a duplicate. Let me ask Dr. Muszynski to rate weigh in on this next one. Zacky is who's a parent at X and elementary school said if I choose not to vaccinate my child, will her immune system not develop resistance naturally based on herd immunity?

Speaker 10 (00:35:36):
Well, this a good question,

Speaker 4 (00:35:38):
Because it shows how complex the understanding regarding herd immunity can be and how immune system response to things like infection and vaccines also can be confusing to the average individual. Uh, I would definitely be confused. A lot of my family members are also a little bit confused in the same way. I would tell you that if you choose not to vaccinate your child, uh, her immune system, uh, Zach is, uh, will not have resistance, uh, unless your child gets infected and has resistance from the wild strain infection, uh, which is not a good idea because you don't want your child to get COVID. Cause we don't know the long-term side effects of COVID and children. And we do know that it can kill some children. So, what about herd immunity though? Well, you heard a little bit about this previously from Dr. Zhi, if you were listening, uh, earlier on in this broadcast, our herd immunity is a complex issue.

Speaker 4 (00:36:45):
That's hard to calculate. However, there are epidemiologic, uh, equations and calculations that can be done on an academic basis to try to figure out approximately what percent of a population needs to be immune for the virus to have no place to go. In other words, the virus can only infect people who are susceptible and it goes out searching for those people. And if it searches and searches and searches, and can't find anyone because they've either had the disease or they've been immunized, and hopefully it's immunization that is really driving this protection and the virus is going to die out. Once it gets down to a certain level, we we've seen that with every pandemic. Uh, and especially we saw it in 1918 to 1919 when the pandemic influenza, which killed millions in the United States, died out on its own because it ran out of people to make sick. So, herd immunity will protect your child because others will more likely give the virus to your child, but your child's best protection is to eventually at whatever point in time based on age gets vaccinated.

Speaker 6 (00:38:01):
Thank you, Dr. Muszynski, Dr. Mansfield, I'm going to direct the next question to you. It's from Darlene, who's a parent at timber Springs middle school. She asks if my child is healthy and those who are immune compromised or others decide to get the vaccine. Why should I subject my child to this vaccine? That's a great question. And one, I know as a parent, uh, you, you want to ask yourself certainly when you give children their vaccinations, really. Um, I think as parents we're always looking to do what's in the best interest of our children physically, emotionally, mentally, and what the vaccine confers is one added advantage to protect your child. Um, the other thing I would add though, is that, um, as, um, other of my colleagues mentioned, we really don't know what the lasting repercussions of our, of this particular virus. And we have seen very healthy children, um, have really significant symptoms, become severely ill and actually some having what are evidence of more long-lasting symptoms.

Speaker 6 (00:39:02):
So, I look at it as a parent to say, if there is one thing I can do to protect my child, um, just as I do with other vaccinations, which are very commonplace, why would I not? Um, and then finally, I would just mention that what you are also doing is being a good steward in our community right now, there are still populations such as those that are two to 11 or 11 and under who are not eligible. For example, if they have siblings, this is one way to protect those still vulnerable people in our population who just at this time are not eligible for the vaccine. So, there are a number of reasons that our healthy children should get this vaccination. And for first and foremost, I would just say, I think it's an act of love. Thank you, Dr. Mansfield, let's go to Dr. Schwartz heard this question before, why to the vaccine have people reacting with symptoms without a live virus, whereas other vaccines don't cause symptoms

Speaker 7 (00:39:57):
Again. Uh, I think this is a great question. Uh, I know there are lots of questions about vaccines and about, uh, these particular vaccines that were released on their, uh, emergency use authorization. Uh, first of all, any vaccine that you get can give you side effects or symptoms, uh, like this particular vaccine. In fact, it is actually expected, uh that you would get some symptoms, even though many, uh, recipients do are asymptomatic. A significant number of people will get those symptoms and what those symptoms are. It shows that your immune system is actually responding to the vaccine. It's making antibodies that attack the virus. Should you get it? So, it's, it's evidence in a sense that you're getting immunized against a virus that you can possibly get. So, uh, the thing to keep in mind, uh, the side effects or the symptoms from the vaccine, uh, you will, may get is very, very mild in comparison to what you can get. Should you get the virus? We have to keep in mind, uh, right now in, in the United States, uh, the virus has caused, uh, over half a million deaths. There are long hauler symptoms that patients are getting, uh that we're not even fully aware of, of what that means. And only time will tell, uh, sort of side effects of muscle soreness, fever, malaise, and some of those things that you normally with vaccine

Speaker 4 (00:41:34):
Is fully expected. Uh, I just wanted to make a common on the first dose of the MRN vaccine. You can get mild symptoms, a little bit of soreness in your shoulder Malays. And in the second dose, you may actually have more of a moderate kind of, uh, uh, effect more chills than perhaps a little bit more punished shoulders, but most of those symptoms go away within 24 to 48 hours.
Speaker 2 (00:41:59):
Thank you, Dr. Schwartz, uh, let, let me feel this next one. Diane, who is a parent at timber Creek high school says my husband and I have been fully vaccinated for months and have tried unsuccessfully to resume our volunteering in the elementary school. Essentially. She wants to know if we are truly trying to do what is best for children, shouldn't our product be normal fee and make life a little less stressful for children and teachers alike. So, I'll answer that twofold one while as we consider what happens next year, we certainly make, consider, um, any, some kind of guideline, uh, under advisement for those who volunteer this year. Uh, if you recall, from the beginning of the school year, we've been extremely cautious and actually have an agreement with both of our unions that we will not have additional volunteers on campus that is intended to protect both children and employees.

Speaker 2 (00:42:51):
Now, as we have more that are vaccinated that can potentially change in the future. Legally, we're not even allowed to ask folks who want to volunteer, have you had your vaccine? And so, we will certainly have those discussions for next year. This year, we were extremely cautious and under agreement with our unions that we would keep additional nonessential, uh, volunteers off-campus in order to keep the campus more safe. All right, let's go to, um, Dr. [inaudible] again, uh, Corinne, I'm sorry. Felicia who's a parent at Windermere high school said she is scared of the side effects. What do you say to those individuals who are reluctant to get the vaccine, even adults because of the side effects and is one vaccine less likely to have the side effects than others?

Speaker 4 (00:43:41):
Felicia, this is a very valid concern for all people who get vaccines, as well as for parents who are going to give them potentially to their children. Uh, there's real, no reason. It really no reason as you heard to really fear these side effects. Uh, the side effects by in a way, far and away are not serious ones. They're ones that are more uncomfortable than serious. And what ends up happening is the side effects. As you heard occur more commonly with the second dose of the vaccines that require the second dose. Uh, the side effects last approximately 18 to 48 hours, 40 hours at the absolute most, but almost all of them are gone. And most people who get them by 24 hours, except for maybe a sore spot in your arm where you got the injection, uh, the, there is a reluctance for anyone to try something new, which they feel they haven't heard enough about potentially.

Speaker 4 (00:44:43):
But I can tell you that the data that's out there for all three vaccines, uh, in adults, especially show that it's incredibly safe vaccine. As you heard, the number of adverse reactions is spectacularly small. One thing I could say about the two M R N a vaccines, these vaccines are nothing short of medical, spectacular developments. I don't know of any other vaccines that are quite as safe and as effective that were developed in such a short period of time ever occurring in the history of medicine, not just modern medicine in the history of medicine, uh, even the vaccines such as polio, measles, and, uh, the smallpox vaccine took longer than this to get under development. Those vaccines rival the COVID vaccines with the COVID vaccines are amazingly safe, amazingly effective, and you shouldn't be afraid of the side effects. I think if I could give you some caution, uh, Felicia, I think you should really be more worried about the long-term side effects of getting COVID itself, which are spectacularly higher than any chance you'll have anything bad happening to you beyond two days from the vaccines.

Speaker 2 (00:46:10):
Thank you, Dr. Muse, NC Dr. Nielsen. So, uh, uh, Q1, who is a parent at Avalon, middle-school asked with the vaccine being rolled out so quickly due to need shouldn't we be concerned or concerned about how safe it is for children.

Speaker 5 (00:46:31):
I know it may feel like it was rolled out quickly, but in reality, it wasn't this technology, the [inaudible]. So, a portion of the virus, not even at the virus, but of the shell, protein is attached to this MRI and a component that technology has been around. We used that to kick Ebola's rear end and make it go back to the, where it belongs. We've used the MRI and a vector in cancer therapy to treat children and adults for years. We just don't really talk about it. And I think that's one of the problems is we haven't taken time to say, Hey, you know what? The technology behind this vaccine is not brand-new. It's been here. We just haven't shared it. We've shared it in the groups that needed to know about it. And then suddenly we had this pandemic, we said, Hey, here we are with an MRI and a vaccine, but we kind of skipped over the step that said, this really isn't brand-new technology.

Speaker 5 (00:47:28):
We just haven't had to it in America. So, I understand being worried about the thought that this is rushed quickly done without hesitation, but it's really not. In 2004, when I worked at Vanderbilt children's hospital, we were using this technology and one of my patients with a liver tumor. And so, I'm familiar with it. I feel safe with it. And my patients will tell you, I won't recommend something that I wouldn't do to my own family. And this is something that my son will be getting as soon as it's available for him. So, don't fear it embrace it. It's pretty cool.

Speaker 6 (00:48:02):
Thank you, Dr. Neilson, let's ask Dr. Mansfield, uh, Andrea who's a parent ed Okoye high school said my daughter actually had COVID in January of 2021. Can or does she need to get the vaccine? Yes, most definitely. Yes. Um, on average, we do think that there again is some immunity conferred immediately after having the infection, but we also know that the level of immunity can be unpredictable, um, can actually depend on how sick the person was. So, with that in mind, yes. Resounding yes. As soon as you can. Yes. Thank you. Uh, Dr. Jive, Corina, who's a parent at chain of lakes, middle school said, why would you think this benefits the community when the vaccine is not guaranteed and doesn't actually protect you from COVID. Why aren't we following the usual protocols for vaccines? Why are we, why are we telling people that their child can go back to school, but the virus is now spreading more so that,

Speaker 8 (00:49:08):
Right? So, so that's a whole lot of questions there. So, I'm going to try and just go down all of them one at a time. I'll start by answering the second question where you said, when you mentioned that the vaccine isn't guaranteed and doesn't protect you from COVID. Well, the vaccine does perfect. Does protect you from COVID. As I mentioned earlier, um, it's over night, it's over 90% effective for reducing the risk of asymptomatic infection, as well as symptomatic infection. Actually, the numbers are higher with both asymptomatic and symptomatic infection, once you are fully vaccinated. So, it does actually prevent you from getting COVID. What is the benefit to the community? You need to realize that COVID-19 is what you call more of a public health than a personal disaster issue. When we really look at it. And when you think about yourself receiving COVID-19 vaccination, you will actually also serve in as your brother's keeper.

Speaker 8 (00:50:10):
That is the thing that people tend to forget. This is one time when in public health, we are being asked, not just to serve ourselves, but to also serve as a brother's keeper. You're not necessarily, you know, most people who get COVID-19 infection are unlikely to get a severe infection. In fact, most are likely to have an asymptomatic infection. However, the person beside you may get a severe infection, or you may be the link between that person getting COVID the outcome that they end up with and that person navigating COVID. So, the benefits to the community, uh that because you receive your vaccination, you reduce the risk of spread of that virus from one person to another, you reduce the risk of propagation by reducing the risk of propagation. You also reduce the likelihood that this virus will have time to mutate into another variant, which may actually prove to be more dangerous, more, more virulent, and possibly not even protected by what we're doing so far.

Speaker 8 (00:51:09):
And for us wanting to return to normalcy in general, which is what everyone of us, once our ability to return to normalcy involves us getting rid of this virus, which means immunity, herd, immunity, all of that has to be taken care of. When you talk about protocols for vaccination and saying that we didn't follow the right protocols. Well, this vaccine was tested. It was tested vigorously. And at the time that we are asking our children to receive this vaccine, we're talking about a vaccine that if you look at the worldwide number of people who have been vaccinated against, COVID not just in the United States, but worldwide, you're looking at a vaccine that probably over 400, 500 million people have received before. We're asking people 12 to 15 years of age to start participating. There is a lot of data from across the planet. Israel is putting out really good information.

Speaker 8 (00:52:02):
The United Kingdom is putting out really good information. Israel's got over 50% of the population vaccinated. The UK has had over 47% of the population has received. At least it does. I mean, steps have been taken. Surveillance is going on. People are looking to make sure that this vaccine is safe. There is a lot of safety, and there's a lot of safety in numbers. When we think about side effects of vaccines in general, we normally talk about the effects of one in a hundred thousand one in 500,001 in a million when talking about a vaccination that over 500 million people have probably received at this point in time. So, we've had enough people receive it to know if we, if this is going to be safe or not. So, I would suggest to you that there is a role and it is comfortable that you should consider it.

Speaker 8 (00:52:51):
Also, at the moment the virus numbers are actually not spreading. They're actually leveling up and going down. And even if they were going up, part of the reason why we would be telling you that it's OK for your child to go back to school is because we also now realize that we're able to give your child something, to protect them from this virus. So, it is safer for us to put them back into their environment, even if the numbers are going up, because we now have a tool to protect them, which we did not have before.

Speaker 2 (00:53:20):
Thank you, Dr. Jay, Dr. Schwartz, uh, uh, Jesse, who is a parent at sunset park elementary school expressed, um, that he felt the district was pushing a vaccine on people that is not approved by the FDA. What do we have to say to those parents who feel the same?

Speaker 7 (00:53:37):
I think again, uh, this is a very good question. Uh, what we have is a situation where we're dealing with an infection that we have not encountered before, and that prompted, uh, the FDA and the CDC to recommend what we term emergency use authorization. Uh, and the question is, uh, the concerns that many parents and many of the community may have about the process for approving, uh, the use of an agent that had not been used prior. So, uh, I have to tell ya, uh, anytime something is, uh, approved emergently or for use, uh, there's always going to be concerned because it hadn't been, uh, used before, like Dr. Neilson mentioned, this is not exactly new technology it's been used before for years. The scientific community is very familiar with that, uh, for this particular or these particular vaccines, some of the largest clinical trials that were done, for example, uh, the Pfizer, uh, vaccine had, uh, over 38,000 participants, Madonna, uh, again, uh, over 30,000 and the, uh, Johnson and Johnson, almost 50,000 participants.

Speaker 7 (00:55:02):
So, the science and the clinical trials that were done, uh, for use emergency use of this particular vaccine was not change. Maybe the administrative process was cut back to allow us to use it earlier. We fully expect that full approval of these vaccine will occur very soon. Uh, again, uh, the safety, uh, of these vaccine was proven into trials. Uh, so it's not something that's being pushed. It's something that's being recommended, uh, in a situation where, uh, the outcomes are that bad. We're, you're essentially inundating your healthcare system and the ICU use, uh, with the mortality rate of what it is. It is over 500 people, 500,000 people dying. You have to have some, uh, form of treatment, hence, uh, the reason for that emergency release. But again, the safety profile has been proven in those clinical trials.

Speaker 2 (00:56:03):
Thank you, Dr. Schwartz, have a question here. Uh, this is the last of the questions that we'll cover. I'll ask, uh, members of Mac to, um, be thinking of any last minute comments that we've not actually covered in the question that you'd like to make as we get ready to close out. But this question comes from Lindsay, who is a parent at Avalon middle school. She I'm going to cover this one because I know the answer. Uh, and I feel so smart being able to field any of these questions among these great giants in the medical field. So, Lindsay asks the question, what percentage is a school board looking for on herd immunity? So, children do not have to wear a mask. I know that answer. There is no percentage at this point that we are looking for the board will have discussions in the coming months, uh, mag will be advising them as well as our local FTO H around the issue of mask.

Speaker 2 (00:56:55):
But we do not. At this point, have a set number or percentage of individuals who have been immunized in order to have herd immunity and negate the need for masks. Do you know that answer? Everyone gives me a nod that that was pretty succinct. I used herd immunity appropriately. Dr. Schwartz. All right. So, let me just take a moment as we get ready to wrap things up here, want to have an opportunity such brilliant minds and experts for those who are listening in. Um, No. 1, if you had questions around mask, there was commentary at the very beginning. This will be on our website. You'll be able to go back and listen to what the experts had to say about math, but this panel was around the vaccine, ask Mack about the vaccine. So, I want to thank, uh, our outstanding panel. I would be calling on our school board chair, Theresa Jacobs, to close us out.

Speaker 2 (00:57:45):
She is indisposed due to, uh, uh, personal family loss. Our, our thoughts and prayers certainly go out to cheer Jacobs and her family. Let me thank you on behalf of the entire school board and our chairman in her absence for giving your time, uh, anyone who's interested, go on our website and read the bio. The expertise of this panel is just outstanding, and we appreciate you voluntarily coming to spend time with us, not just for this panel, uh, but on a monthly basis and beyond helping to advise the school board during this pandemic. I want to thank each of you individually and collectively for being a part of Mac. And now I want to give you an opportunity. Anyone who's got a last word they'd like to share with us that the question did not make room for any comments that you'd like to give. Uh, we certainly want to make room for that. Now I'll start on the end with Dr. Nielsen.

Speaker 5 (00:58:38):
You know, this is a lot of information fast in a year ago. We never would have imagined having this conversation at all. So, I think it's important for parents, teachers, administrators, everyone out there. If you have questions, don't be afraid to ask. And if your healthcare provider can't answer that question, keep asking, reach out to the school, send more questions in. There is no dumb question. Don't be hesitant, find out information and keep learning because it's really, it's going to change every month, but for right now, please go and get your child, the vaccine. Thank you.

Speaker 2 (00:59:12):
Thank you, Dr. Harris, any last words Dr. Mansfield?

Speaker 5 (00:59:19):
I just want to point out to any family

Speaker 6 (00:59:22):
Members, um, parents, children, um, take a deep breath. This is a lot of information and you have to make a decision. Certainly, that's personal. We want to make sure though that when you make a decision, it's as informed as possible because there is a lot of misinformation and just the partying thought I'd leave you is, um, you're so resilient. It is unremarked. It's just remarkable to me to see what our children, um, have done this year, how they have adapted, and that has everything to do with how you as family members are supporting them. So, you know, just recognize this has been a very challenging time, but you're eight days away from the end of the school year. And just think of everything you've done to get here successfully. So, what's to come we'll hopefully be better, but we know that taking the vaccine is one significant step toward getting to that better time.

Speaker 1 (01:00:19):
Thank you, Dr. Maxwell, Dr. [inaudible].

Speaker 9 (01:00:27):
Um, I would just like to say thank you for tuning in and listening because there is a lot of information out there. A lot of it is incorrect and knowing where to turn it's often difficult for, um, even for us in the medical field, there's just so much data out there that we need to decipher through it and understand what's correct. What's not and what we can trust. And, um, if you're asking the questions, that's a step in the right direction and we would love to continue to have these conversations and just so help you make the most educated decision for your child, um, by knowing that we all support this vaccination efforts. Thank you.

Speaker 1 (01:01:06):
Thank you, Dr. [inaudible] Dr. Rodriguez. Um,

Speaker 6 (01:01:10):
Just a few words to say that it's a real privilege to be on this committee and to work with all the physicians and I pretty much echo what they have been saying. Um, so yeah. Thank you for allowing me to participate.

Speaker 1 (01:01:21):
It's been great. Thank you, Dr. Rodriguez, Dr. Schwartz.

Speaker 7 (01:01:25):
I just wanted to echo what, uh, Dr. Rodriguez says I can tell my patients is always a privilege and an honor to be able, uh, for you to listen, uh, to what I feel about what I do and, uh, make no mistake about it. The people sitting, uh, in this room is not to force anyone to do anything is, but to give our recommendations about how we would treat our own family members and ourselves, uh, with all the confusing, uh, data out there, it has been a privilege to sit in and serve you. And I agree, ask the questions. Thank you.

Speaker 1 (01:02:03):
Thank you, Dr. Swartz, Dr. Hsu chairman. It has been a privilege to serve. What we want to do is, is really create an environment. That's a safest hospital for our children and for the community.

Speaker 2 (01:02:20):
That's why we're here. And while we recognize that the data are changing and recommendations, change our commitment to the board and to the community is really, uh, to do what we believe to make the best recommendations to keep our families and our children safe. Thank you. Thank you, Dr. Hsu, Dr. Jai,

Speaker 8 (01:02:42):
I would just like to say, I think the kids in orange County have been amazing, um, to watch them go through this year, deal with all this stuff, and yet be so helpful in preventing the spread of this virus in society, just by doing the tough things that we've asked them to do, which have even been hard to do for grownups has just been an amazing thing. The job the board has done the job the schools have done in encouraging the kids to be such great citizens in our community has been amazing. And this is why I enjoy what I'm doing. It's because it's so nice to see the people we're trying to help also trying to help other people. So, it's just amazing. Thank you for this opportunity.

Speaker 2 (01:03:28):
Thank you, Dr. Jain, certainly join you in commending our, our resilient children and thinking our, our parents and all of the OCP S team as well. Dr. [inaudible] last comment.

Speaker 4 (01:03:40):
Yes. Um, it's also been an honor for me to have been asked to serve on the medical advisory committee. Uh, I think, uh, Dr. Jenkins, I, I think, uh, chair Jacobs, I thank the entire school board for their consideration of putting me on this panel. Uh, I offer my humble, uh, what I hope is an expert opinion for people to mull over and think and use some make decisions. Uh, I, I am so encouraged by how orange County schools have handled the pandemic. I, I was really, really scared in last summer, how it would be handled yet. This County is this, uh, board of directors for the, for the school board, um, has handled this in a model fashion. We, we, I think are the model for how it should be done, and we have kept your children as safe as possible in school. And I think the school board, I think the entire school it's staff, it's teachers, it's children, it's parents and loved ones, uh, should all be quite proud of what's happened here. And, uh, once again, I thank you for listening today and hopefully we'll have more of these in the future to answer any questions that might come up later.

Speaker 2 (01:05:06):
Well said, thank you, Dr. [inaudible]. We allowed about an hour for our time together here, and that has now expired. Want to remind those who are listening and those that you might share it with. If they missed it, they will be able to, to access this on our YouTube channel. That link will be shared on our social media sites, go to OCP s.net also, and look at our COVID graphic. And you can click on FAQ's and information about vaccination sites. Anything that you would be interested in that we've discussed, you can go on our website. You can also look at the Mac page with lists, which lists the full bios of this outstanding expert panel that we've had with us today. Thanks for tuning in. Thanks for listening. And thanks once again to our panel. Goodbye.

Speaker 11 (01:06:53):
[inaudible].