As coronavirus vaccination efforts — locally, at state levels and nationally — have stalled, even residents of the Twin Tiers considered priorities for vaccination are still awaiting doses.

Dr. William Mills, chief medical officer of Upper Allegheny Health System’s Olean General Hospital and Bradford Regional Medical Center, addressed the lack of vaccine, when there might be more available and what vaccination means for individuals moving forward.

• What can you tell residents about when vaccine will be more widely available?

Presently there are only two vaccines that are being used under the FDA’s Emergency Use Authorization (EUA). These are the vaccines made by Pfizer and Moderna. There are two more companies that are most likely within weeks of receiving an EUA at which time they will enter the U.S. market. These are being manufactured by AstraZeneca and Johnson & Johnson.

The J&J vaccine will be a single-dose vaccine and the others are two-dose regimens spaced three or four weeks apart. There are other vaccines in the development and testing process.

The widely available issue comes down to one of supply and demand. There currently is not nearly enough vaccine for the number of people in the priority groups. The CDC (www.cdc.gov/coronavirus) lists the priority groups in a phased approach and currently New York is vaccinating groups 1A and 1B, while Pennsylvania is still vaccinating only group 1A.

Additional confusion arises when each state adds to the CDC groups, e.g. both states added people age 65-75 to phase 1A when that group is in phase 1B, according to the CDC. By doing this, the number of people eligible for vaccination far exceeds the available number of doses.

That is a lot of background information to answer the question of when vaccine will be more available, but a simple but true answer would be “no one knows.”

At the moment, the federal government determines how much vaccine each state receives. Then the state governments determine how to fairly and equitably distribute the vaccine allocated to each state. Both BRMC and OGH were allocated doses of vaccine to be used in accordance to the state’s guidance.

Both hospitals have placed orders for additional vaccine and to date, have not received any additional first doses (both hospitals have received their shipments of second doses, which are restricted to second dose use only, per state regulation).

The complexity of the distribution process is enormous, but the staffs at both hospitals are working through it. Both states have promised additional vaccine, and the creation of vaccination PODs (point of dispensing) as more vaccine becomes available.

An educated guess is that the priority groups will be receiving vaccinations over the next 3 months and that the general public will not be able to receive vaccinations until the late spring/early summer. Hopefully as more companies begin manufacturing vaccine, these time frames will be shortened.

• Once I get the vaccine, can I take off my mask and stop social distancing?

The short answer is no. The more complete answer is that not everyone who is vaccinated will be immune to the SARS-CoV-2 virus.

Both the Pfizer and Moderna vaccines are 95% effective. This doesn’t mean that you will only be 5% sick, it means that five people out of every 100 will not be protected.

There are ways to determine if you are protected by using some sophisticated laboratory testing, but this will not be widely available, either. The goal of widespread vaccination is to achieve “herd immunity” which means that around 75% to 80% of the population is protected.

Those unprotected people, if they become infected, won’t cripple the world as we have seen during this pandemic.

• Can I see my grandchild after I get the vaccine?

This question has many answers based upon the individual scenario, but hopefully the following will provide some general guidance. Remember that there is no guarantee that any person who gets the vaccine is protected (95% will be protected). As with most medical decisions, the risks and the benefits have to be weighed.

Typically, children who get COVID-19 are not as sick as adults; however children of all ages have died from this disease. Also remember that school-age children are frequently sick, so they may actually have and transmit COVID to someone who is not protected.

Quick advice: if either the grandparent or grandchild is sick, then don’t visit.

The first vaccine starts providing protection within a few weeks of the vaccination, but it is not until a few weeks after the second dose that you have full protection. So everyone is safer after the second dose than after the first than those not vaccinated.

• Can I visit a loved one in a nursing home?

This answer will most likely remain no for a while. Although many nursing homes are allowing limited visits that do not occur in the resident’s room, both states’ departments of health have prohibited unrestricted visitation in congregate settings.

The rationale is that if an asymptomatic, COVID-positive person visits a nursing home and infects a resident, then that resident will likely infect another and then you have a situation like a California wildfire destroying everything in its path.

• Do I still have to quarantine if I go out of state or get exposed?

At the moment, the answer is yes. There have not been enough people vaccinated to date for there to be any change in the travel restrictions.

There have been people joking about showing your vaccination card to get on an airplane or go across a state line. That may not be a joke in the future. A general principle to remember is that until 75% to 80% of the population has been vaccinated (herd immunity), the rules won’t change.

• If I’ve had COVID-19, do I still need the vaccine?

Yes. The reason is that we do not know how long “natural immunity” will last. We also don’t know how long immunity from the vaccine will last, but we have data on vaccine immunity from other diseases and the way these vaccines work in the body suggests that the vaccination immunity will last much longer (months to years).

Remember that the one-year anniversary of the first confirmed case in the U.S. was Jan. 21, 2021, so longterm data isn’t available.

• Will the vaccine last a lifetime, or will I need one every year?

This is a great question. That response typically means “I don’t have any idea.” That’s what it means this time. But this question leads to a slight detour to the virus “variants” or “mutations.”

As one expert recently stated, since we are now looking for mutations, we will find many of them. Currently we are hearing about the United Kingdom variant, the South Africa variant, the Brazil variant or any number of variants described by the place they were first identified. It is very common; actually, this is the norm, not the exception, that viruses mutate.

Many of the mutations are “minor” and the vaccine will still prevent the disease (e.g. the UK variant). Most likely there will be mutations that the current vaccines will not prevent. This may well require a change in the vaccine to prevent the disease, in a manner very similar to the yearly flu shot.

Time and ongoing research will be needed to get to a point where life returns closer to a pre-COVID state. Until then, please continue to wear your mask, wash your hands and maintain appropriate social distancing.

Since the vaccine is safe, effective, free and will help all of us get back to a more “normal” life, get yours as soon as it is available to you.