Mark Jaben

Dr. Mark Jaben

Q: How many people in Groups 1 and 2 are on a waiting list in Haywood County and how many doses are being received each week for the first shot? This information would be helpful to us in understanding the wait times. Gary Arrington

A: There is no way currently to check an individual ranking on the list. Those who have registered are asked to allow at least two weeks before calling the hotline about their status. Public health officials are working through the names as fast as possible, but most will have to wait at least a week or so for an appointment. Only those from the current eligible group are being called.

Q: Once a couple has had both vaccine shots, and has waited the full two weeks after the second one, would it be safe to travel on a commercial airplane? If so, is there any indication yet of how long the vaccines will remain effective? Bill Kinyon

A: How long effective immunity lasts after a full vaccination is not yet clear. It depends on the vaccine, the virus, any mutations that affect the subsequent immunity produced by the vaccine, and a host of other factors. Having said that, the thought is that for a 90 day period after full vaccination (two doses and two weeks after the second dose), there should be enough immune protection so that a person with a close contact exposure to a known positive would not have to quarantine since the risk of infection and contagiousness is felt to be so low as to not pose a risk to others.

However, within that 90 days, if the vaccinated, exposed person develops symptoms, they would need to isolate and test. And we do not yet know if after 90 days, this person reverts to having to quarantine if exposed because the level of immunity is no longer so protective.

As far as it is safe to fly after full vaccination, remember the two vaccines we currently have available are 95% effective at preventing illness, particularly severe illness. So there is still risk of contracting and spreading the virus, although far reduced compared to someone not vaccinated.

Airlines have shown themselves to have done a good job with preventive measures on planes. It is probably riskier moving through the airport than on the plane.

The bottom line is full vaccination does not mean you cannot get infected and/or sick with COVID. As far as we currently know, it does not mean you cannot get infected and give it to someone else, even if you have no symptoms. It does mean the chance for either is way, way less.

Think of vaccination as another slice in the Swiss cheese stack of protective measures; it does not replace face covering, limiting the time around others outside your home, distancing, and good hand hygiene.

If you employ the full package of preventive measures, vaccination included, you markedly reduce your own risk and the risk to others, but there is still risk. You have to decide how comfortable you are with that risk now that you have been vaccinated.

The good news is case counts are down all over. But they are not yet low enough. Once enough of us are vaccinated and counts are low enough, we will be able to relax some of these precautions. Until then, be as careful as you have been, vaccinated or not.

Q: Through online research and church teachings, I understand testing for the COVID vaccine may have been done on aborted human stem cells by some if not all of the companies currently producing the vaccine. Is this so? If so which companies did use aborted human tissue? Which did not? Norene F. Langford

A: Thanks for asking this. In the past, stem cells have been used for manufacturing and/or testing some vaccines. However, both Moderna and Pfizer, the two available Covid vaccines, have stated they have not used stem cells. These mRNA vaccines are manufactured in a lab, not in cell cultures. This is corroborated by many sources.

Making a choice as to how critical this is to your decision making is essential. As stated many times, that choice is based on a balance of one’s comfort level given beliefs and risk, and often it is a conflicted balance. There is a wide range of opinion on this, from those who adamantly oppose any use of a vaccine that did use stem cells in research, manufacture, or testing to the opinion of the Vatican and others, who reflect these concerns in the context of the concerns for people’s lives and obligation to themselves and their communities. My only recommendation is to be sure you are researching multiple sources across the full spectrum of opinion in order to get the fullest view in making your own choice.

Having said that, here is a fairly balanced review from a religious perspective-

While I do not necessarily share or endorse these views, you have asked a meaningful question I’m sure others are grappling with as well. Perhaps this will be helpful.

Q: Regarding the state allocating more vaccine to metropolitan areas than rural areas, should we be writing our state legislations or the governor to complain? It does not make sense that Haywood County that has an efficient vaccine dispensing process should be penalized to support larger metropolitan areas that are not as efficient.

A: Yes, the allocations for this three-week period do seem frustrating. However, the big events in other areas of the state that resulted in fewer doses allocated to Haywood County were done in an attempt to prevent more long lasting reductions, as North Carolina was in danger of receiving less ongoing allocation from the federal government if not showing the ability statewide to better administer the doses. So we in Haywood County do benefit from the state’s choices.

The process works like this for first doses. Once the state receives the allocation from the federal government, NC DHHS determines where the doses go. There is a baseline number determined for each county based on population, diversity, and ability to administer vaccines. Counties can apply for ‘special event’ additional allocations. You can be assured we are doing so each week. Second dose allocations are determined by the number of first doses administered. There has been no issue with receiving appropriate second dose allocations.

We are approaching the third week of the current 3 week cycle. It remains to be seen if our allocations will go up now that those big events elsewhere in the state have taken place. We are hopeful our allocations will return to at least what they were before this current 3 week cycle. As vaccine manufacturers ramp up their production, and if additional vaccines are approved, then the supply of vaccine doses will rapidly enlarge, and our allocations should go up as well.

If you want to contact your legislators or the governor, please indicate your viewpoints be referred to NC DHSS. And so you know, they are well aware of the efforts we have made in Haywood County to administer doses.

Q: My wife and I got the first Pfizer vaccine at the fairgrounds. At that time they gave me a card with Feb. 11 for the second shot. I read the information on the County website and also in the Mountaineer. Both said I would receive a call or email informing me of the time/ date/ location of the second shot. I have heard nothing, Trying to follow instructions I did not go to the fairgrounds on 2/11 for the second shot, maybe I should have. Twice I called the hot line but it hung up on me before I was able to talk to anyone. What should I do now? Daniel & Elizabeth Cronin

A: Sorry the system missed you two. The glitch was found and has been corrected.

For everyone, here’s how it should work. The card you receive at the time of the first dose has a date on it for the second dose. A day or two before that date, you should receive notification about the appointment time through the same automated system that contacted you for the first dose appointment. BUT in the event that does not happen, plan to come to where you received your first dose at the same location in the morning. Present your card to verify this is the proper date.

(Editor’s note: While the first portion of this question was printed previously, the bottom portion was inadvertently omitted.

Q: Our son-in-law, a practicing dentist, refuses to get the COVID vaccines because he is allergic to sulfa drugs and shellfish. Also, one of his patients came in last week with lockjaw, which he blamed on the vaccine. Any way to assure him his fears are unrealistic?

A: As of Jan. 29, in the U.S., the incidence of anaphylaxis, the most severe adverse reaction, is on the order of 2-6 per million doses given. That means 999,994 out of a million people receiving either vaccine, will not have such a reaction. To date, in Haywood County, after 10,000 + people have been vaccinated, there have been no cases of anaphylaxis.

There have no reported cases of tetanus related to either of the current vaccines.

Tetanus, what some refer to as ‘Lockjaw,’ is caused by the toxin from the bacteria Clostridium Tetani. People get this from a contaminated wound, which is why your doctor asks about immunization status if you have a laceration or other wounds. Immunization for this is contained in a DT or DPT shot, and after a full course of 3 doses and a booster every ten years, this is essentially prevented for life. This disease sometimes starts as spasm of the jaw muscles, but proceeds to spasms all over the body. The incidence in the US has dropped markedly since 1900 and since survellaince started in 1947, incidence has plummetted. There were no reported cases in 2018 and 2019. No data is available for 2020 yet.

So could the patient your son-in-law saw in his office actually have had tetanus. I suppose so, but I hope not as it is a miserable, deadly, and totally preventable illness. And there are many other causes for a person having their jaw ‘locked up,’ like temperomandibular joint syndrome (TMJ syndrome), dislocation or partial dislocation of the temperomandibular joint, or dental abscess to name a couple. These are much more common.

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