Safety, efficacy, and access: Cleveland Clinic’s response to the COVID-19 vaccine

Progress is being made in the fight against COVID-19 with the number of cases in Ohio declining on a daily basis. Cleveland Clinic is working hard to increase vaccinations and keep the COVID-19 cases on the decline.

With three vaccines—Pfizer-Biotech, Moderna, and Johnson and Johnson—all approved for emergency use authorization (EUA), widespread vaccination is now available to anyone ages 12 years and up.

Cleveland Clinic has been the trusted voice in the ongoing response to the COVID-19 pandemic and remains committed to getting as many people vaccinated as possible.All three vaccines have been shown to be safe and effective at preventing COVID-19. “The majority of the vaccines we have given in this country are the Pfizer and Moderna messenger RNA (mRNA) vaccines,” says Dr. Michelle Medina, with the department of pediatrics and associate chief of clinical operations at Cleveland Clinic​​​​​​ Community Health. “With the data from the clinical trials and our experience with the vaccines since December 2020, we know these are very safe and effective vaccines.” 

As with any vaccine, some individuals may experience mild side effects. “In approximately one-third of patients who receive the vaccine, we see some immunization side effects,” says Medina. “These may include local injection soreness, muscle aches, some systemic malaise or chills, and a slight fever that may last a few days. These side effects are consistent with what we have seen with other vaccines.”

In clinical trials, the Pfizer and Moderna mRNA vaccines were 94% to 95% effective in preventing COVID-19 illness—including asymptomatic COVID-19 infection.

“The first dose of the Pfizer vaccine provides about 85% protection and sets up your immune system to recognize what it is supposed to be fighting,” explains Medina. “The second dose increases your protection to more than 95% efficacy and provides durability to your immune response. Our numbers are fairly stable with the clinical trials at about 95% efficacy for individuals who receive both doses.”

In a recent study, Cleveland Clinic found that of the 4,300 coronavirus patients admitted to Clinic hospitals between Jan. 1, 2021 and April 13, 2021, 99% were not fully vaccinated. This data reinforces how effective the vaccines are at preventing symptomatic infections, severe illnesses, and hospitalizations.

“It has been a little over a year since we heard about COVID-19 and less than a year since the vaccine became available, so we are all learning at an extremely rapid pace,” says Dr. Nazleen Bharmal with the department of internal medicine and geriatrics and associate chief of community health and partnerships at Cleveland Clinic “It is important to emphasize that these viruses mutate. Right now, all three vaccines in the U.S. at this time appear to be effective in preventing severe outcomes from COVID-19—like death—from the current global mutations, some of which spread more effectively than the original virus.” 

Cleveland Clinic has been the trusted voice in the ongoing response to the COVID-19 pandemic and remains committed to getting as many people vaccinated as possible. Since the pandemic began, Cleveland Clinic has performed more than 930,000 COVID-19 tests and since December 2020 has administered more than 315,000 COVID-19 vaccinations at its vaccination sites—the most of any health system in Ohio. The Cleveland Clinic home care team has also vaccinated more than 1,000 homebound patients.

Irma McQueen receives a COVID-19 vaccine at the Langston Hughes Health and Education Center. Overcoming barriers
Vaccine hesitancy continues to slow progress toward herd immunity. According to Medina, there are many reasons why people are still hesitant to get the COVID-19 vaccine, with many taking a “wait and see” stance.

“We have gone beyond the folks who actually wanted the vaccine and got it,” she says. “Now, we are focused on those who chose to ‘wait and see’ and we are changing our strategy to better understand and address their resistance.”

According to regional and national surveys, the majority of those wait-and-see individuals are waiting for their doctor to recommend the vaccine. With COVID-19 vaccines now available at the Cleveland Clinic primary care locations, primary care providers can now have a one-on-one conversation with their patients about their concerns, stress the importance of getting the vaccine, and provide the vaccine at the same location.

Others in the community, especially those who work in manufacturing, have expressed concerns about side effects and not being able to take a day off work. “This is an opportunity for us to have a one-on-one dialogue with employers about flexibility and how vaccinating their workforce contributes to better health outcomes for their entire workforce,” says Bharmal.

Cleveland Clinic has also been addressing COVID-19 health disparities through a regional community health response to reach vulnerable populations disproportionately affected by COVID-19 infections and deaths.

In collaboration with Northern Ohio regional hospitals and health department partners, the Community Health and Partnerships team has developed and implemented a proactive strategy focused on connecting and communicating with local officials, faith-based organizations, community leaders, government officials, schools, churches and other community organizations, and individual community members with a focus on outreach, education, testing and vaccine access in underserved areas.

“The foundation of our Community Health and Partnerships strategy is that it should come from our community partners who have the trust and expertise of their communities,” explains Bharmal. “We believe they are best able to relay the message about the importance of the vaccine and help us understand what the barriers to vaccination in their community might be.”

Community vaccination clinic at The Langston Hughes Center.Through this collaborative effort, Cleveland Clinic has been able to identify areas with lower rates of vaccine uptick and proactively partner on vaccination events in these areas in a culturally sensitive way.

According to Bharmal, one of the greatest aspects of Community Health and Partnerships team is thinking regionally and statewide. “We have worked with a number of partners that include other health care systems in our region, and with federally qualified health centers,” she explains, “specifically primary care centers for underserved populations including public health departments.”

The Community Health and Partnerships team has been meeting since last year on a weekly basis to address issues like testing and personal protective equipment (PPE), donations, and now, vaccine distribution. “Our community response has been to connect, communicate, and mitigate,” says Bharmal. “We are currently meeting with more than 30 community-based partners in addressing other specific areas and populations to help bring people to local vaccination clinics.” 
Cleveland Clinic currently has walk-in vaccination clinics at its Langston Hughes Community Health and Education Center in the Fairfax neighborhood, and Lutheran Hospital, which serves the large, surrounding Latinx community. By opening local walk-in vaccination clinics and providing needed resources, such as bilingual caregivers, the Clinic is eliminating barriers by providing local vaccine access.

In fact, the Community Health and Partnerships team developed a five-year strategy in 2019 right before COVID-19, which has accelerated that effort and created an increased awareness about health disparities on a whole host of issues.

“Our community health strategy is committed to our hospitals and health centers, local and diverse hiring, and investing back into our communities,” says Bharmal. “We are truly at the foundation of our health equity community partnerships. We are right there to be part of it and will continue doing this until we are certain we have reached everyone we can. Together we can ensure all patients, families, and communities have the opportunity to thrive and flourish.” 

his story is part of a five-part series on the Cleveland Clinic’s response to the COVID-19 pandemic and efforts toward recovery. To view the full series, click here.

Read more articles by Jo Donofrio.

Jo Donofrio is a marketing professional and freelance writer with a specific interest in medical and health care topics and human interest stories. In addition to Freshwater, her work has been published in Cleveland Magazine, MD News, Angels on Earth (Guideposts), Old Brooklyn News and Dental Products Report. She also teaches a business writing workshop at Cleveland State University and is an adjunct instructor for Southern New Hampshire University.