Rising temperatures, third shots and other things you need to know about the COVID-19 vaccine

March 02, 2021
freezer with one pint of ice cream
Move over, frozen treats. Let's make room for some vaccine in there. Photo by Dev Benjamin for Unsplash

With the weather starting to warm up, it’s fitting that vaccines are following suit. 

In the past week, the Food and Drug Administration (FDA) authorized Johnson & Johnson’s new vaccine – a single-dose option that can be stored at standard refrigeration temperatures – as well as eased guidelines on how cold the Pfizer-BioNTech vaccine needs to be kept. Previously, Pfizer’s vaccine was required to be stored between -112 and -76 degrees Fahrenheit, a temperature range impossible for many potential vaccinators. Now, the FDA has determined it can be safely stored at standard freezer temperatures of -13 to 5 degrees Fahrenheit for up to two weeks, opening up more possibilities for the vaccine and who might be able to offer it.

Headshot of Scheurer 
Danielle Scheurer, M.D.

"Anything that increases the time the vaccine can remain outside of the ultra-cold range makes a huge difference,” said Danielle Scheurer, M.D., MUSC Health chief quality officer. “Even for us, who have plenty of the super-cold freezers, it’s a hard restriction to comply with. So anything that extends its lifespan is a big deal.” 

As for the other player in the vaccine game, Moderna, it has now entered the MUSC orbit, albeit for possibly a short time. MUSC was recently given some surplus Moderna vaccine from long-term care facilities that didn’t need them. Scheurer said she’s not sure if this will be a one-time thing or if the hospital will continue to receive more Moderna, but these allocations were specifically given to counties where vaccine uptake has been low. She also said that MUSC will happily accept the Johnson & Johnson vaccine if it becomes available to them.

With the vaccine landscape changing almost daily, each week we are checking in with Scheurer to ask her the most pertinent questions that are hanging in the balance.

Q. The number of new COVID cases has stopped declining in the U.S., and S.C. leads the nation in the highest rate of new COVID cases. What do you attribute that to? And does that concern you?

A. A little bit, but I’m not overly concerned. I think people are just getting tired of the social restrictions, and it’s being reflected in the numbers. We are on the lower end of state populations being vaccinated – we’re at around 7% of the population being fully vaccinated (e.g. two doses) – plus with the weather changing, everyone is out and about again. It’s very difficult for people to restrain themselves from resuming “normalcy” for this duration of time.

Q. Are you at all worried that the Johnson & Johnson vaccine will be viewed as a second-rate choice?

A. A little bit, yes. Lots of people just look at the 72% efficacy number and compare it to the 95% of Pfizer and Moderna. But when they do that, they’re not getting the whole picture. The way the study was done for the Johnson & Johnson vaccine, they didn’t look at all COVID, just how it fared against moderate to severe COVID. So their bar was higher. Not to mention, they started their trials later, when there were more variants out there. To simply compare numbers between the vaccines is an apples-to-oranges comparison. This is not an inferior vaccine, and all the vaccines are extremely effective at preventing death, which is obviously the ultimate goal.

Q. What should people do if they need or want to fly somewhere?

A. I think a big safety concern is the airport terminal itself. It’s super hard to maintain social distance in an airport, so it’s a risk for sure. And before you fly, make sure you know what your particular airline’s protocols are. If they are putting people in all the seats on the plane, that’s a hard pass for me. But if there’s some distance and everyone’s wearing N95s, it’s less risky. But there’s just no way to get around the fact you’re in a closed box and sharing air with dozens of people. Direct flights are preferable. Anything that reduces your contact with more people. Flying is a risk, there’s no doubt. But if you’re fully vaccinated, I think the risk does go down. 

Q. What is the latest guidance for those who have had COVID? Do we think they have better immunity and thus don’t need to be vaccinated, or are they supposed to get it anyway?

A. There is still a lot we don’t know about this virus. Immunity is one of those areas. How long are people immune? Is it better to have gotten COVID and recovered or to have been vaccinated? Now there’s emerging data that people who have recovered from COVID might only need one dose of the Pfizer and Moderna vaccines, but the CDC has not yet endorsed that as a practice. Right now, if you’ve had COVID and recovered, we are asking those who are eligible to wait 90 days before getting vaccinated.

Q. What is a reasonable timetable for reaching herd immunity? The Centers for Disease Control and Prevention estimates that more than 83 million people in the United States had COVID-19 by the end of 2020, putting the nation about a third of the way to herd immunity, the point at which enough people are protected against a disease so that it cannot spread through the population. If the pace of vaccinations continues at the current rate, the country could approach herd immunity through a combination of natural immunity and vaccination around June.

A. June sounds a little too early to me. That would be great, but I was thinking mid-summer. If we’re able to get this under control before kids go back to school for the fall semester, I think that’s a win. To me, that’s a more realistic goal.

Q. How likely do you think a third shot (or additional booster) will be?

A. It totally depends on all of these variants. I know Moderna has come up with one and Pfizer is working on one, but will they be needed? It’s hard to say. 

Q. Is there a chance that one of these variants could make the vaccines we currently have completely ineffective or is that unlikely?

A. I don’t think that’s very likely. I don’t fear going back to square one, but having that third shot? I can see that coming into play.

Q. Are people still having their first doses canceled? If so, should they be assured MUSC will call them back with the new time or is action required by them?

A. I know it’s frustrating, but they just need to hang in there. We will reschedule them when we have vaccine. Right now, we have over 40,000 people on a waitlist – people who actually scheduled doses and were told they were temporarily canceled. If we could receive 30,000 doses per week, we could catch up in one to two weeks. But we are currently receiving a fraction of our requested doses each week. Vaccine supply is really out of our hands, and I know it frustrates people. It frustrates us too. 

**Have a question you'd like answered? Email it to donovanb@musc.edu with the subject line “Vaccine Q.”

About the Author

Bryce Donovan

Keywords: COVID-19, Features, Trending Topics