As Chicago and Illinois officials prepare to roll out a coronavirus vaccine once one is available, there are still many questions left to be answered.
The city's top doctor, Chicago Department of Public Health Commissioner Dr. Allison Arwady, answered several during a Q&A session at a briefing Tuesday.
Here's what we know so far:
When will a vaccine likely arrive in the city?
Chicago is expecting to see its first doses of the vaccine in the third or fourth week of December, with multiple candidates currently before the Food and Drug Administration as they seek emergency approval this month.
Who will be among the first to get it?
After the CDPH held its press conference on Tuesday to lay out plans, the CDC voted by a 13-1 margin to include healthcare workers who care for COVID-19 patients and those working in nursing homes in the very first group that will receive the vaccine when it becomes publicly available.
The big question will be which group would be next to receive the vaccine, with those with underlying medical conditions, critical workers and senior citizens all potentially next in line for the treatment. The CDC has yet to make that determination, but with shipments of vaccines accelerating as more is produced and as more companies come to market with their own treatments, that decision will need to be made quickly.
How will the vaccine work?
The vaccine will be given in two doses.
"Both of these first two vaccines that we're talking about, you get a first dose and then you get a second dose either 21 or 28 days later," Arwady said.
How much will the city get for its first doses?
Arwady said the city is expecting to receive 20-25,000 doses of the coronavirus vaccine, and she says that the first wave of residents to receive the treatment will be scheduled to receive both doses that the Pfizer and Moderna treatments require.
Will all of those doses be given out immediately or only half, since the vaccine is a two-shot process?
Arwady said the city anticipates releasing the entire amount at the start, noting there is "a reserve in place" for those who receive the first dose to get their second dose.
"We don't know for sure exactly how much we'll get, but that is the estimation based on what the what the company has said is likely to be available at the beginning," Arwady said. "We are anticipating literally every single week, getting additional allotments. So our expectation is that that first week, maybe 20-25,000. If, for example, that's the Pfizer vaccine, if the Moderna vaccine is coming along just one week behind that, we would hope to not only be able to receive additional Pfizer vaccine, but be able to receive that first dose of the Moderna vaccine. And there's a federal system that's set up that basically allocates vaccine based on population, but then we have to be able to show that we are using that vaccine appropriately here. We have very good plans that will allow us to continue to scale vaccine at whatever rate it is made available."
Will a vaccine be mandated?
Arwady says that she “does not anticipate” that the vaccine will be required for city residents.
“We would not anticipate vaccine mandates in any setting,” she said. “I think time will tell as more vaccine becomes available on what decisions that have to be made in that regard.”
State officials have said throughout the pandemic that a hypothetical vaccine for the virus would not be required by law.
“There aren’t any mandates in place,” Gov. J.B. Pritzker said. “It’s certainly something that is always under discussion. What I know is that we’re going to be focusing on those populations that are most vulnerable, and also the people who treat the most vulnerable, and not just healthcare workers, but others who may work with the most vulnerable.”
Will you need to get the vaccine every year?
The answer to this questions remains unclear, Arwady said, adding that it's simply too early to know.
"We haven't even had COVID on this planet for a year at this point," she said. "So there's not been the opportunity to really do some of those longer term immune studies that we'll need to do to fully answer that question."
She noted, however, that experts "are feeling optimistic that this won't be an annual vaccine."
"Partly that's based on the fact we've not seen a lot of mutation in the COVID virus itself," she said. "That's very different from the flu vaccine, which we see a lot of mutation. There's a lot of different strains and so every year you have to create a new vaccine."
But the reason for the lack of mutation in the coronavirus could be due to a lack of treatment, Arwady said.
"There hasn't been a lot of pressure for mutation, so you could see some changes there," she said. "We know that some other coronavirus' natural immunization doesn't last that long."
Still, even if if becomes an annual vaccine, Arwady said it could still be "very effective."
"I think we're it's looking promising that it would have some more longevity, but it's just too soon to know for sure," she said.
Do you need to get the vaccine if you've already had COVID-19?
According to Arwady, the recommendation is yes.
"Because we are not sort of trusting whatever. There's a lot of variability in terms of levels of protection and how sick somebody was," she said.
Are there side effects?
The side effects from the vaccine can lay people up for a day or so, company officials have said. That's prompted officials to recommend that health-care facilities plan for workers to have time away from clinical care if they experience symptoms after getting vaccinated.
About 10% to 15% of people report noticeable side effects from the vaccines, according to Dr. Moncef Slaoui, who is leading the Trump administration's COVID-19 vaccine program Operation Warp Speed. The people who've suffered from side effects have reported redness and pain at the injection site as well as fever, chills, muscle aches and headaches, he said Tuesday, adding most people have no noticeable side effects.
Arwady said the city expects to learn more about potential side effects in the coming days.
Will you need to show proof that you've had the vaccine?
The answer to this question is being heavily discussed by experts and officials across the country.
According to Arwady, while there may not be a city or nationwide requirement, businesses may ultimately require the vaccine.
"Certainly, I think down the line, we may see some employers or or businesses, you know, requiring vaccine," Arwady said. "We are not anticipating at this point a sort of a city requirement around vaccine, or a national requirement around vaccine. And in this early stage, where it's still under emergency use authorization and where it's just not widely available, we would not anticipate vaccine mandates in any setting. I think time will tell as more vaccine becomes available on decisions that are that are made in that regard."
What information will be stored if you do get the vaccine?
According to Arwady, plans are underway to set up a system for those who do get the vaccine to report any potential problems.
"There's been a lot of work to make sure that as people are being vaccinated, their information is being stored privately, but also in a way that will keep track of who has been vaccinated with which vaccine, have they gotten both doses," Arwady said. "The CDC is setting up a post-vaccine monitoring system where people who are vaccinated will have the ability to receive text messages to be able to report if they have any side effects or any concerns to have some follow on."
Are people planning to get the vaccine?
According to the city, data shows people have said they do plan on receiving the vaccine.
"I'm very optimistic," Arwady said. "I'm thrilled with at least how this preliminary data looks. I am certainly planning to be vaccinated myself very early. And I'm very hopeful that we'll see health care workers and others who are early available, and then essential workers really taking advantage of the opportunity to protect themselves and their community. But this will be a choice that people will have particularly early on."
Are hospitals prepared for the vaccine?
Both the Pfizer and Moderna vaccines require storage in exceptionally cold settings, with Pfizer's vaccine needing -80 degrees Celsius. Moderna's vaccine would not require temperatures quite as cold, but would still be well below the temperatures normal vaccines are stored in, Arwady said.
Some Chicago hospitals do have the capacity to store the "ultra cold" vaccines, but most do not, she noted. For those that don't have ultra cold capacity, the Chicago Department of Public Health is preparing to store the vaccines for them.
"We have absolutely committed at CDPH to ensuring that all hospitals are able to get that vaccine really approximately at the same time," Arwady said. "So we've built up at CDPH the capacity to handle more than 130,000 doses at a time - even of the ultra cold - and have plans to be distributing to the many hospitals that don't have that ultra cold capacity. There's a lot of logistics in that, but we felt very strongly that we wanted to make sure all hospitals, including smaller safety net hospitals, would be getting access to this vaccine. And even the distribution there we've done equitably based on their numbers of employees and their numbers of especially these higher risk employees directly caring for COVID patients."
What is the plan to ensure everyone is aware of the vaccine distribution plan and updates?
Arwady said the city is currently discussing distribution plans with hospitals for the first doses, but she noted "there's not going to be enough vaccine to vaccinate even all of the healthcare workers who work in hospitals."
"We anticipate, for example, essential workers being part of that next tranche of who this is made available to. And we'll be working very hard, as you've seen us do for testing and everything else, to make sure that we are pushing messaging, that we are encouraging a lot of extra sort of outreach in areas that have been hardest hit by the vaccine," she said. "And so this Protect Chicago initiative that we launched a number of weeks ago has both a broad component where we're thinking about getting messaging out sort of digitally and broadly across the city, as well as very focused even door-to-door work in a lot of our census tracts that have been hardest hit. The vaccine will fold right into our Protect Chicago campaign and so as there is messaging available. We've thought a lot about how we are able to kind of get that messaging out there so that people know when it's available to them. And then finally, I would say we're doing a lot of thinking and planning about how to create the space for conversations at a community level. Thinking about pairing healthcare workers who work in certain zip codes and are feeling supportive of the vaccine and willing to spend some time pairing those people up with community leaders, church leaders, groups who are interested in having conversations, especially in communities of color here in Chicago, where we're anticipating perhaps less initial uptake, partly based on some of that history."