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Adrian Popp

Adrian Popp

Adrian Popp, chair of Infection Control at Huntington Hospital/Northwell Health and associate professor of medicine at Hofstra School of Medicine, spoke with TBR Newspapers to discuss the current state of vaccinations in Suffolk County, the return to school in the fall, workplace issues, and tic-borne challenges for residents. Please find below an abridged version of the interview below. If you’d like to listen to the entire interview, view the video above.

COVID-19

TBR: How close are we to the 70% threshold for herd immunity to COVID-19?

Popp: We were hoping vaccination would start rolling out pretty fast and actually that happened. Over the last several months, more and more people got vaccinated. Right now, it’s open more or less like just show up and you can get a vaccine. You don’t even need an appointment anymore. The number of people vaccinated in Suffolk County is, percentage-wise, around 55% of eligible persons.

TBR: What about the rates at which people are seeking the vaccines? Has that slowed?

Popp: The number getting vaccinated has somewhat plateaued. The most eager people who wanted to get vaccinated did. Now, we’re seeing people who are actually still willing to get vaccinated and doing it and also some of people who are on the fence getting more information and speaking with other people who actually received the vaccine. More and more people are getting confident that the vaccine is safe, efficacious, and I hope this trend will continue.

TBR: What about schools in the fall? Will students return without masks and at full capacity?

Popp: At this point, the rate of coronavirus in Suffolk County is very low and has been decreasing since March steadily and is at almost a minimum even compared to last year. The question is, what will happen down the road? What will happen in the fall? We know that coronavirus has a propensity to be more active in cold environment. It’s hard to predict, because of these variants coming from different parts of the world. We should be hopeful that the fall will look good as long as more and more people get vaccinated. Hopefully, by September, we’ll reach about 70%, then going back to school will be easier.

TBR: As offices reopen and people return to work, how should companies handle rules, especially if some people aren’t vaccinated?

Popp: Offices vary in size, the number of people, how many are sitting in one room, close to one another. One has to make a decision on a case-by-case basis. Ideally, everyone working in one office should be vaccinated. It’s a difficult situation, mandating people to get vaccinated. It’s a fine line between your personal liberties and public policies.

TBR: When might a booster be necessary?

Popp: The need for the booster is being debated [as] the efficacy of the vaccine, the immunogenicity of the vaccine is probably higher than what I expected to see. From the early stages of December, we do find that they hold their antibodies quite well. The expectation is that this could last maybe two years or so. We don’t know that yet. One has to give it time and really find out.

TBR: What about weddings?

Popp: The wedding situation is quite a big situation. A lot of people have postponed the wedding in the hopes of having a real thing later on. The approach people have taken varied from A to Z. There is no cookie-cutter way to say this is the right thing to do and that’s the wrong thing to do. A friend of mine getting married is asking every person to be vaccinated. If you’re not vaccinated, you’re not allowed in the wedding. This is the decision of the groom and bride. Other venues are obviously more open, and they invite everybody and so forth. In the end, you have to be comfortable with the decision you make and you’re going there to have fun, you can’t have fun and celebrate if you’re truly nervous.

Tick-borne diseases

TBR: What about tick-borne diseases? Is there messaging people should keep in mind?

Popp: In the last three years, I have seen more tick-related diseases than before. We’re not talking only Lyme disease, could be also babesiosis, ehrlichiosis, and Rocky Mountain Spotted fever. Rocky Mountain Spotted fever used to be very unusual on Long Island. Now, we do see cases. I have already seen cases this year. When you go somewhere walking or hiking in some woods or meadows that may have ticks that may be around there, what you do at the end of the day when you come home, you get your shower, do a body check. Have someone else look at areas you can’t see well on your back, back of your legs.

Adrian Popp, chair of Infection Control at Huntington Hospital/ Northwell Health and associate professor of Medicine at Hofstra School of Medicine, spoke with TBR News Media newspapers to discuss vaccinations and COVID-19. Please find below an abridged and edited version of the discussion.

TBR: Why do some people have a stronger reaction to a second shot?

POPP: These two vaccines are very well tolerated. Yes, there are some side effects after getting the shots. Indeed, even in the trials, it has been shown that the second shot is sometimes more prone to have side effects. There is pain, tenderness at the site of the shot. Sometimes people can get fatigue, fever and even a chill. It is rare to have something more severe than that … From my experience, most people tolerate them well, including the second shot.

TBR: Should people try to take at least a day off, if they can, after the second shot?

POPP: That is not necessarily unreasonable. A lot of my colleagues did take the shot later in the afternoon and then go home and rest for the evening. If you can afford to have a day off the next day, that’s probably not unreasonable.

TBR: Does having the vaccine free people up to interact with others?

POPP: What we know from the Moderna and Pfizer trials is that the effectiveness of the vaccination is 95 percent to prevent symptomatic disease … Can a vaccinated person develop a light form [of the disease]? In theory, yes. There are not completely safe in [not] transmitting the disease to someone else.

TBR: Have the Black and brown communities, which have been somewhat resistant to taking the vaccine, been included in the clinical studies?

POPP: Those studies with Pfizer and Moderna included these populations. They are well represented in these studies. There’s no significant difference in the side effects in African Americans, or less efficacy in the Black and brown communities …. [The Black and brown communities] should feel comfortable that it’s as safe or as efficacious as it is in a Caucasian person.

TBR: Have people from the Huntington Hospital or Northwell community asked you about the safety of taking the vaccine?

POPP: I do have conversations like this every day with different members of Huntington Hospital [as well as] the community at large … I bring up one very recent study that will probably help in kind of showing a few things. I’m going to bring in Israel, a smaller country with a centralized health care system that has been very good in vaccinating people …. More than 50 percent of their population has received the COVID vaccination. Specifically, the senior population, 65 and above, has received the vaccine in percentages even higher … In a study in the New England Journal of Medicine of more than 600,000 people who received the vaccine, [they] compared the incidence of COVID without the vaccine. They found the protection is more than 90 percent … That tells us the vaccine is very effective.

TBR: What do you hear about the Johnson & Johnson vaccine?

POPP: The best thing about the [J&J] vaccine is that it’s only one shot and the second thing is that it can be stored at normal temperature compared to the other vaccinations [which require deep freezing] … That allows it to be distributed more easily … It will probably be a good vaccine as well.

TBR: After the shots, what is the immunity?

POPP: After the first shot, approximately a week or two weeks after the first shot, you develop quite a significant level of antibodies. There is a certain amount of protection. With the second shot, the level of antibodies shoots up probably 10 times higher than after the initial shot … Full immunity is one week after you receive the second shot.

TBR: Some reports suggest that people who have COVID and develop antibodies may only need one shot. Is that true?

POPP: There are infectious disease experts looking into this. We do know that after getting COVID, you do develop a certain level of antibodies … That varies widely from person to person … The jury is still out on this one. Truly, we have to look at it in a more scientific way. We’ll find out if this will be an option down the road. At this point, as the recommendation stands, you do have to get both shots, even if you had COVID disease before.

TBR: Do we know more about why one person gets very sick and another has only mild symptoms?

POPP: Up to 50 percent of people who get COVID are either asymptomatic or have really minor symptoms. There are risk factors for developing a serious disease. We know that obesity, hypertension, diabetes and specifically certain immunocompromised conditions are risk factors for more serious disease. I have seen older people in their 90s who do have a mild form of the disease, then I’ve seen somebody in his 40s who has very severe disease … There is no real good way of saying who will develop a more severe disease versus somebody else who will have a milder form.

TBR: What about the aftereffects of COVID?

POPP: I have seen quite a few cases of people who … develop quite severe symptoms. On the milder end, people have a loss of taste and smell. This can last for some time … From my experience, most people will recover from this. On the other hand, people with more severe illness, people who get hospitalized, I have to say that the virus can take a significant toll on that person. I have seen patients who have lost 20 to 40 pounds over a period of a month or a month and a half … Recovering from such a hit of being sick for such a prolonged period of time takes a toll on people. Some patients also develop some degree of cognitive impairment.

TBR: What keeps you up at night?

POPP: Even though [the infection rate] is coming down in New York, it is still not insignificant. It’s still an issue. Until we get … a significant number of our population vaccinated, we’re still going to be in trouble … The only way we can stop the whole thing is by vaccinating as many people as we can.