Let's start off 2021 with some hope! This week you'll hear from five health care providers who received a COVID vaccine in late December 2020. They all live with type 1 diabetes and share their experiences leading up to the vaccine and how they felt after getting it. These folks all got the first round of the Pfizer vaccine, which means they are all scheduled for another shot right around the time this episode goes live.

Back in September, Stacey interviewed a women with type 1 who is in the Moderna vaccine trial. Helene Cooper lives with type 1 diabetes and asthma. She has completed the vaccine part of the trial – two shots – and says she's had no bad reactions and no regrets.

This episode:

3:00 Danica, a diabetes educator

8:48 Dr. M, a pediatric endocrinologist

14:00 Michelle, an ICU nurse (who's breastfeeding)

18:40 Geoffrey, a hospital worker

22:30 Dr. Stephen Ponder, a pediatric endocrinologist who's lived with type 1 for 55 years.

Check out Stacey's book: The World's Worst Diabetes Mom!

Join the Diabetes Connections Facebook Group!

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Episode Transcription:

Stacey Simms 0:00

This episode of Diabetes Connections is brought to you by The World's Worst Diabetes Mom: Real Life Stories of Parenting a Child With Type 1 Diabetes available as a paperback ebook or audio book at amazon.com.

Announcer 0:19

This is Diabetes Connections with Stacey Simms.

Stacey Simms 0:25

Welcome, everybody. And Happy New Year, I am so glad to have you along for a little bit of a different and special episode of Diabetes Connections, I thought it would be a really nice way to start off this new year with some good news.

Look, we're far away from leaving 2020 and everything that happened behind right, there's a long way to go. But this is an opportunity to sort of turn the page and look ahead to brighter days, and give you some news and information and stories from people with type one, which as you know, is what I am all about. And if you don't know if you're new, Hey, welcome.

We aim to educate and inspire about type 1 diabetes by sharing stories of connection. I am your host, Stacey Simms, and my son was diagnosed 14 years ago with type one right before he turned to my husband lives with type two diabetes. And I don't have diabetes, but I have a background in broadcasting. And that is how you get the podcast

in about mid December. late December. I noticed like a lot of you did I'm sure that people I knew were posting photos of themselves getting the COVID vaccine, right. These are healthcare workers. These are our front line in hospital, usually who are able to get the vaccine in the very first batches. And how exciting is that? And the photos were really hopeful and really gave me just, I don't know, a feeling I hadn't really had for most of 2020. So I wanted to talk to some of these people and find out more and get you some information as you live with type one or if people in your family do, what to expect what their reactions were.

So here is what we've got. For this episode, I spoke to five health care providers who all live with type one who received a COVID vaccine in late December 2020. These folks all got the Pfizer vaccine. That means they're all scheduled for another vaccine. There are two doses in the Pfizer protocol. And for most of them, that second vaccine is coming right around the time this episode goes live. There are four shorter interviews with a diabetes educator and endocrinologist registered nurse at a hospital worker. And those are more about personal experiences. And then there's a longer interview with Dr. Steven ponder who is likely a familiar name and a voice maybe to longtime listeners, Dr. Ponder goes a little bit more in depth with me about the vaccine and about staying safe with type one. As we head into this new year. He also talks about things you might want to think about and questions you might want to bring to your physician.

Please keep in mind that all of these folks were kind enough to share their personal experiences. They are not speaking for their hospital systems or workplaces and they are certainly not giving medical advice.

Okay, Up first is Danica, who you might know as Diabetic Danica, she has been on the show before she has big YouTube and Instagram following and she is now a diabetes educator. I started out asking her about her reaction, when she found out she be able to get the brand new vaccine.

Danica 3:21

Or at first we didn't think we would get it so soon because we knew the frontline people were going to get it first. So we work in the clinic but we're not like on the floor that treats COVID patients. We have COVID patients, we do it via telehealth like on an iPad video call. So we've got to do a little bit but the day after or hospital got it we got to get it to so I was really excited to kind of definitely was the most I've ever been excited to get a vaccine before. Just because there's been all this buildup and it's been such a hard year. And I don't know just overall just excitement, which is kind of weird when you're just getting a vaccine.

Stacey Simms 3:56

No, I think we're all feel very hopeful, right? I mean, we all kind of started hearing about it and think I can't wait. So it just explained this is the the shot where you need two shots where you'd be going back for the second.

Danica 4:07

Yeah, so it's a two shot one. But it's nice because they have you schedule it while you're waiting afterwards. Because just to be safe. Since it's a newer vaccine, they want you to wait 15 minutes after to make sure you don't have like an allergic reaction. So while we're sitting there, they had us just schedule our next one. So I already have it scheduled. And I'll just go in and get it just something. I honestly was a little nervous after I got it. I was excited. But I was like, Well, what if I do have a reaction? You know, because that's what everyone's worried about. I feel like and that's the majority of the questions I got afterwards was How are you feeling? Was that effective you had I think everyone's really worried about that but I felt fine. I the only side effect I had or symptom, wherever you want to call it was my arm was sore, just like the muscles in it. But that happens to me when I get my flu shot. So it wasn't super alarming to me. I'd say the arm soreness was worse for me than with a flu shot but the actual poke it didn't even feel so like when I got the shot. There was absolutely no pain for me. And then later, I just got sore for about a day like probably 24 hours. I didn't notice any changes in blood sugar, it seems like just run of the mill for me. I don't think it affected anything there.

Stacey Simms 5:14

What has it been like for you in the clinic? Can you talk about your routine and how you stayed safe?

Danica 5:18

Yeah, you know, it was it was really stressful at first because things were changing. And it was very and so like, every day, I felt like we were getting multiple emails about new protocols and things we had to do. Now it's more routine, which is helpful. You know, we wear masks and eye protection. And we really thoroughly wipe down high touch areas, they call it in our patient rooms, the doorknobs and the chairs and the keyboards and everything, this stuff that kills the virus. And I guess I thought it was I don't know, if anything major has changed. I mean, other than me looking at the numbers every day to see how they're going up or down and making sure I'm on top kind of what's new with the virus, just in case patients ask. But I thought it was a lot more stressful at first, like we're getting super used to wearing masks in the room, but I'm still looking forward to the day when I don't have to because it's kind of hard to talk to someone for an hour with a mask and everything covering your face. You know,

Stacey Simms 6:10

how has this year been for you? I mean, you've been able to go to work, which I think is probably has been very helpful. But what has it been like, you know, how are you holding up? I guess is what I'm asking.

Danica 6:20

Yeah, it was it was harder for us, like I mentioned, just work stress, that kind of thing. My day to day work, life hasn't changed a whole lot other than the extra precautions. And initially, we were shut down in my state. So I, I couldn't see my family and I was spending a lot of time at home. So mostly on weekends, I would notice it the most where I'm like, I'm not doing anything fun. And then it opened back up. And so with precautions, we could go out and do things. I feel like I'm hiking a lot more this year for the outdoors and distance and just beautiful one so fun to do. But in my personal life, it's actually been a great year, it is so funny to say to say overall, it's been such a crazy year, but my parents moved to the same town I live in which I'm super excited about. I became an aunt this year, and my little niece was born. And I started seeing my boyfriend as well. So just a lot of like personal life things that have been really exciting for me. So it's been kind of nice to have those as a happy distraction in the midst of the

Unknown Speaker 7:13

craziness.

Stacey Simms 7:14

I'm so glad to hear that. It's great to talk about good news. That's wonderful.

Danica 7:18

I know. Yeah, there's always something good. And all the bad.

Stacey Simms 7:22

I wonder to the people who are giving the other health care workers the vaccine, were they very Matter of fact about it. Were they excited? I imagine there was more words in your mouth. It's like there be more joy than there hasn't been for a while.

Danica 7:37

I thought it was exciting. Yeah. Anyone the person one of the people who checked me in and someone I worked with in the diabetes clinic today, she's a nurse practitioner. So we were just catching up to and talking about that. We were excited about it. She hadn't got her vaccine yet. So she was looking forward to getting it most people working there hadn't gotten it yet, you know, because they're just volunteering, I assume to to kind of help out with it. So it was a cool process to be a part of. She ended up getting it low later that night, because they had two extras, and they were already out of the freezer. So they had to give them so Wow, that was kind of fun to hear about later, too. But yeah, I think overall compared to me getting my flu shot, it was a much more exciting thing. And you could tell it was a little new just because they they couldn't remember all the questions they had to ask me they had to look at their little cheat sheet, which is totally fine. And you could just tell she's like, I gotta do this a couple more times to be able to drink it. But it was like a teamwork. And yeah, they were doing a really good job.

Stacey Simms 8:29

My next interview is with Dr. Jacob masse check. He's a pediatric endocrinologist who was diagnosed with type one as a teenager. He's been in and out of the hospital this whole year and his clinic as well. And he goes home to his family, which includes two children. So he was thrilled to hear that the vaccine was available through his hospital.

Dr. M 8:48

I feel excited about it as well. I think this is, you know, the light at the end of the tunnel. So I'm thrilled that we have vaccines. I know

Stacey Simms 8:57

you work in an office that probably more than most has had so many questions about COVID because you treat kids with type 1 diabetes yourself live with type one, what was your reaction when you found that you'd be among the first

Dr. M 9:10

I'm very excited to receive the vaccine, we get regular updates on vaccines and get a sneak peek into how these vaccines are developed and how they work. And I actually think that this vaccine will be very similar and will work in a very similar fashion to the way that the flu vaccines work. So I think it's a safe vaccine. And I'm excited that it's going to be available for most of us very, very soon.

Stacey Simms 9:38

It's going to be interesting for you to balance being a healthcare provider. You know, you want a vaccine because you see patients you're in a hospital system, but you also live with type one, any more thoughts kind of for yourself in your protection or all about your patience or a little bit of both?

Dr. M 9:53

Well, being a type one, I am at a greater risk for having poor outcomes. If I worked To catch COVID and develop severe symptoms, so that thought is always in the back of my mind, being able to get the vaccine will put me at, I guess at a more comfortable level, seeing patients every day, knowing that I, I am protected. And knowing that I'm also less likely to develop it not only because of my risk, but also the risk of my family members that I love.

Stacey Simms 10:26

I imagine that most of the people that you see, I'm making an assumption here, but you know, your pediatric endocrinologist, most of the kids are not eligible, certainly this first wave of the vaccine coming out. But you some of your patients will be some of your older kids and maybe some young adults that you see, what are you telling them? When they're asking, should I take the vaccine? Is it safe? What do you know? What are you advising patients?

Dr. M 10:48

My understanding, and I am not an infectious disease expert. But from the kind of peek behind the curtain that we have received as physicians is that I think it will be a safe vaccine, it will work very similarly to the flu vaccination. So I think it's safe, sort of advise my patients to follow the restrictions on their, you know, local scale or state scale. But don't rush out of restrictions are lifted, wait and see what happens wait on the sideline, ever restrictions get lifted, or bans get lifted, we kind of have to think that we are, you know, at a higher risk. And it's better to wait and see what happens instead of rushing out if things open back up. So that's been my advice from the very getgo is, don't be a trendsetter when, when restrictions get listed,

Stacey Simms 11:45

when I look at the pictures of health care providers getting vaccinated right now, it has surprised me how excited I am, was that your reaction to tell me a little bit about your you know, the emotion of it.

Dr. M 11:59

I think having vaccines that are FDA approved, and that the FDA feels are safe, I think is a wonderful step towards seeing the light at the end of this tunnel. I think it gives us hope that we will soon be able to put this horrible year in the past and move towards a more normal life. I'm very excited about it. I'm thrilled. I think it's everybody's stress level will go down as we see that these vaccines are safe and are working. And we see that trends will start going in a positive direction. By positive I mean fewer numbers of patients testing positive and having complications. I feel great about it.

Stacey Simms 12:46

I know you're not like an operating room all day. But I imagine when you come home from work, you've got to take a lot of precautions to

Dr. M 12:51

absolutely make sure that I changed my clothing I wash up before I give them a hug. And that is something that I do. And I've been very fortunate knock on wood that I've stayed healthy during this entire ordeal.

Stacey Simms 13:06

I've talked to a couple of health care providers who have similar stories of you know, changing outside and doing this for so many months. I can't imagine how great that's going to feel the day that you can be like, come on, I can hug you I'm home.

Dr. M 13:18

I think we all look forward to that day. There's a lot of things that we look forward to and you know, this year has been very trying but it also made us appreciate kind of the silver linings in a lot of things. And it's been a reset for a lot of things. So I think we'll come out of this ordeal being stronger and having a greater appreciation for things that we may have overlooked in the past.

Stacey Simms 13:43

You will next hear from Michelle, she's a registered nurse and she has spent this year working with COVID patients. She has two small children. And as you'll hear, she's breastfeeding which was something she gave a lot of thought to before she decided to get the vaccine. I asked her to kind of describe of what's going on with her day to day.

Michelle 14:02

I'm I'm busy. a mom of three year old and a 10 month old. I'm a wife.

Unknown Speaker 14:10

I'm a registered nurse,

Michelle 14:11

I work taking care of COVID patients. Normally I work in the ICU and like on a telemetry unit. And then I'm also in grad school pursuing family nurse practitioner. So I have a lot going on.

Stacey Simms 14:24

Yeah, what is this year been like just with COVID patients? Well, we

Michelle 14:27

we prepared in March for this huge surge because we're in Pennsylvania and New York's right next door, and it didn't come. But our surge is now like our inpatient census is around 100 patients total for our hospital and we have 60 COVID patients right now. It's more than we can handle. It's all hands on deck.

Stacey Simms 14:46

What's your routine like for coming home?

Michelle 14:48

So with the two little ones, they don't understand that you can't touch mommy. So I shower at work. And then I come home so I end up getting home kind of late. If I finish everything On time 715 731 I've done so I don't get home till 815 at the earliest.

Stacey Simms 15:05

So tell me about the COVID vaccine. When did you find out you were eligible? And how quickly did you say? Yes,

Michelle 15:11

so I've been thinking about it long before it was even a possibility, and doing research and reading. And when I saw that the Pfizer vaccine was approved, our CEO, she's awesome. She's very transparent. She sent us emails all along. And she said that our hospital had applied to be a distributing center. And then she emailed us and said that we were approved, so I knew it would be coming. And I had already done my homework to know that I care for COVID patients, right, I see like the worst of what COVID can do. And to me a vaccine with a little risk or COVID with intense risk,

Stacey Simms 15:48

it wasn't really much of a question. Were you concerned? Or did you ask about type 1 diabetes? Did you talk to your endocrinologist? Or did you say, Okay, I know enough, I've seen enough.

Michelle 15:58

I actually, my endocrinologist doesn't know that I took it, I I did talk to my primary care doctor, who's also the pediatrician for my children, and I am breastfeeding. So I just wanted to check and make sure that it was going to be okay in that way. But the research shows there hasn't been breastfeeding research on the vaccine. But in general, vaccines are safe for moms to get when they are breastfeeding, and the chance of passing through breast milk is very small. So I considered all that I consider the risk for myself of getting COVID with type 1 diabetes, and I just didn't feel like the vaccine was going to be the big risk. Actually, I think I haven't gotten the COVID assignments as much as some of my other co workers have. And I honestly think that's because nobody else say it out loud. But my co workers know I have type one. And I think they're looking out for me, which is huge.

Stacey Simms 16:52

I'm curious what advice you would give as a you know, as a health care practitioner, as someone with type one who has seen COVID this year in a way that most of us have not, you know, what is your message about the vaccine? Oh,

Michelle 17:04

I think Americans like to think that life is about us and my choices as an individual and individual freedom. And the reason that I got the vaccine is actually about all the people around me more than it is about myself, I got it because my in laws are in their 70s. And they're helping provide child care for my kiddos. And if we give them COVID, and they get really sick, that's a big deal. If I as a nurse, bring home COVID and give it to other people I love. That's a big deal. So I got the vaccine to try to protect other people. Now at this point, though, I do want to say it hasn't been demonstrated that the vaccine keeps other people from getting sick, it just helps the person who gets the vaccine to not get a severe case of COVID. So protecting other people still needs to be demonstrated. But that's generally how vaccines work. So that's, I'm hoping that it works that way.

Stacey Simms 17:54

What was it like in your hospital,

Michelle 17:56

the message I keep seeing people say is hope. And that's how it feels. It's like this huge drop of hope that there could be an end to this huge thing. I don't know, there's so much I could say I think there's so much skepticism about vaccines and what it can cause but I just want people to remember, look into history, look and see what measles did to people before we had a vaccine. Look at what polio did to people before we had a vaccine, look at the impact of disease. And also think about that, when you think about the risk of a vaccine, what's the risk of not getting it?

Stacey Simms 18:35

My last sort of personal interview is with Geoffrey, he works in more of an administrative role. But he does spend enough time in the hospital and around staff that does see patients that he qualified to get the vaccine, he wasn't originally thinking that he would get the shot in this first batch. But then he explained why he changed his mind

Geoffrey 18:54

what my original thought was that I was going to talk to a number of providers a number of people and get their opinions. I wasn't going to do this based on my own research. I was gonna do it based on the research of my doctors. And my original thought was that I was going to wait a while to let more people get it and see what happens. But once I had the opportunity to do it, then after talking to a handful of doctors and decided the basic sentence was why wait, what are you waiting for? What do you want to see? And I kind of realized that what I want to see is I want to see people 234 years out with no complications and realize that I don't want to wait four years to get the vaccine. So what I want I couldn't get so I decided let's just do it.

Stacey Simms 19:35

So then what was the process like

Geoffrey 19:37

it was very quick, got signed in, got the shot, waited about 10 minutes 15 minutes, and was clear to go for me again. This was super early. It was really exciting for me because I got to see a lot of physicians that I know from what I do for work and and seeing all these doctors and that obviously believe in this enough to be standing there. first in line, this is required of us. So everyone that was there wanted to be there wanted to get this.

Stacey Simms 20:06

How about afterwards? What was your blood sugar? Like any issues? You know, sometimes with vaccines people have. I mean, Benny really never had any issues. Sometimes he had slightly elevated blood sugar, you know, when he was very tiny and he'd get the measles, mumps and all those vaccines, but he was tiny, but flu shots never really elevated his blood sugar. I'm curious what your reaction was.

Geoffrey 20:26

Now, I can't tell you for sure. This is a reaction from the from the actual vaccine, but my blood sugar's were low for a while. Whether it was really related to the vaccine, or if it was just sometimes you just run low for a day or two. I don't know, I don't have a clear cause for it. So it's a possibility, but I can't guarantee and waiting to hear some some things for other type ones that get that, honestly, the biggest issue that I struggled with, and it wasn't really struggle, I wouldn't say struggle. The biggest issue that I had was arm pain. There's a little bit worse than your normal intermuscular flu vaccine, but nothing horrible, nothing that prevented sleep, or there's just noticeable.

Stacey Simms 21:07

What's it been like over the last 10 months of it's a horrible year to be where you are hasn't been very difficult as has been busier.

Geoffrey 21:15

It's definitely been busier than normal. It definitely has not been easy. I think the energy right now is still we're, we're exhausted from all of the work we're putting in. But we're excited because we're starting to see the light at the end of the tunnel.

Stacey Simms 21:30

And what would you say for other people with type one, but what would you say to people who are you know, kind of asking about it or thinking about it? What should they do?

Geoffrey 21:38

I mean, if they've got questions, talk to your physicians like these doctors, especially in this, but what are we calling 2020. In this unprecedented time?

Stacey Simms 21:47

I'm calling it the great awful.

Geoffrey 21:51

During during the Great awful these doctors are spending a lot of time doing research, especially these specialists, they're trying to figure out how the Coronavirus and everything else related to it is going to affect their specialty patients. So I'd say talk to your specialists and and see what their get their thoughts on the matter.

Stacey Simms 22:11

I'm going to link up a lot of information in the show notes. But as everyone has been saying, of course, please check with your own physician. We took a lot of information here from Dr. Steven ponder, I was really excited that he made time to talk to me about his personal experience and a lot that he's learned Dr. Panda has lived with type one for more than 55 years. I started out asking him about the great photo he posted when he got his vaccine.

Dr. Ponder one of the nicest pictures I've seen on social media recently was when you posted yourself, I believe in a Santa hat with a big smile, getting the COVID vaccine. Tell me about that day.

Dr. Stephen Ponder 22:47

That day, I was coming back from an outreach clinic, I was contacted by the chairman of our department asking if I was interested in getting the vaccine that evening, as opposed to, I suppose waiting several weeks, because they just come into the vaccine. And the system is prioritizing getting all the health care providers vaccinated. I instantly said yes. And so I arranged for that evening to go in and get the vaccine done was given about 730 on Thursday evening, last week, it was very, not painful. It was just like a flu shot. Even very straightforward. They had a very, very sophisticated process for handling all the people that were coming in, they had a scheduling system, you filled out a piece of paper and look to get your disclosure paperwork for the vaccine, the vaccine Information Statement, which is about nine pages long, then you go right in get your injection, they give you a card where they give the lot number for the vaccine and the date you were vaccinated. And you're supposed to bring that back with you. For the second vaccine, which is approximately three weeks later, they watch you then for 15 minutes to make sure you don't have any adverse effects from the vaccine. So you're oftentimes sitting out in the large lobby with people you might know that are six to 10 feet away from us chatting for about 10 or 15 minutes. And if you've not had any, then you walk up to the check in desk, give them your little time card, which gave you the time you needed to wait. And then you're done. And you go on home. One thing I did do was I did sign up for the Wii safe, which is an app that's part of the vaccine Information Statement, which you can use to track your daily outcomes. ask you if you've had any soreness or any side effects that gets affected your work or your health in general. And I get a message like that once every day since I've got received the vaccine. That's interesting process from beginning to end.

Stacey Simms 24:42

Is that app something that's local to Texas, or is that a nationwide app?

Dr. Stephen Ponder 24:46

It's actually a CDC app. It's actually there's a QR code that everybody that receives the vaccine should get a vaccine Information Statement that's universal for any vaccine. You probably remember that with yourself or with your family members, but it In the last page, they have a an advertisement, if you will, for the be safe program. It's optional completely. And so you just need to go to the website, download the app, or you just scan the QR code that's on the ninth page of the vaccine Information Statement and download the app, it takes 1015 seconds to do the question. Every day, there are three or four questions in that said, I'm not sure how long it will continue. But I've been answering it every later in the afternoon every day. As I said, 15 to 20 seconds is all it takes to do it comes to the text message, time for your check in and just go in and answer the same questions. And all of mine had been negative, except for the first two days, which said I had a little bit of arm soreness where I received the injection. And by two days after that was done, I had no more symptoms whatsoever.

Stacey Simms 25:49

And I'll be nosy and ask as a person was type 1 diabetes, How were your blood sugar's because there's always a little bit of concern after vaccinations or anything like that, that blood sugars could be a little bit more erratic.

Dr. Stephen Ponder 25:59

My blood sugar's were fine. It did not change anything, quite honestly, Stacy, everything was nice and steady. As you know, I've developed a set of skills that I've shared with the world about how to manage this. And I really didn't have to invoke any additional skills to stay in control, I maintain my usual diet intake, insulin regimen, course I have a continuous glucose monitor on which allows me to see things as they are happening, which gives me a huge advantage in being able to detect changes before they become significant, and then decide how and when I'll step in and do something about them. So that process never changed. In fact, that process allowed me to do better, and to maintain the control over my, my diabetes, in the wake of this vaccine. That's great. And just to be clear, and I know you never self promote, but

Stacey Simms 26:50

you're talking about sugar surfing, and I always link up information when I speak to you because people are always curious. But to be clear, you didn't have to do extra sugar surfing to stay in range after the vaccine. That's what you're saying,

Dr. Stephen Ponder 27:01

right? I don't want to make sure you're serving sound to, you know, way up there. It's basically decision making based on pattern recognition on these cgms. I look beyond just the number I'm looking at the trending pattern. And as you probably know, from the research you've done on this, it's more involved with shapes of the trend lines, and learning how to to interpret those shapes and then in turn manipulate them. If you activity, food intake, insulin, what have you, it's really nothing more than a decision making model that looks at information coming at you dynamically as opposed to a single point in time, which is what blood glucose leaders have given us for decades, and form the whole basis of pattern management, which was looking at trends over large stretches of time, looking at short stretches of time, with data in motion, that's what sugar Surfing is really all about is interpreting those data.

Stacey Simms 27:55

I am sure that your patients have had many, many questions about the vaccine as information started coming in a couple of weeks ago, what are you telling them? I mean, many of them are too young to get the vaccine, I would assume but what kind of questions and information you're sharing with most of your patients?

Dr. Stephen Ponder 28:11

Well, the information I've received from our infectious disease experts, the data I've read and heard from other sources are overwhelmingly in support of receiving a vaccine if you happen to have diabetes. As you know, there is an increased risk, whether you have type one or type two diabetes, for having more severe outcomes, and if you don't, so there's a huge onus on encouraging more people to get this vaccine, assuming they're eligible, assuming they don't have a history of adverse reactions to vaccines. The CDC has a well described list of considerations you should take into account when you're contemplating getting the vaccine. I would certainly review those. Anybody that's listening to this podcast, review those and making your decision. But assuming you don't have any of those contraindications, I would wholeheartedly endorse COVID vaccination for anyone with diabetes, and quite frankly, anybody without diabetes is eligible as well. This is not just focused just on diabetes friends, yeah.

Stacey Simms 29:15

Are there situations where parents have asked you, you know, hey, should my 10 year old with type one look at a vaccine, you know, what are we doing for younger kids? Can you reassure parents of younger people with type one?

Dr. Stephen Ponder 29:26

There are two points of view answering that question. One point of view is if you're a 10 year old with type 1 diabetes, what is your relative risk of having a severe outcome with COVID-19? I have patients, I've had patients over the last several months that have come down with this to a person they have all gotten through the infection successfully. Some have had some mild symptoms, some have had virtually none at all. On the other hand, their parents and other members of the family who are older or who may have other comorbidities were while are likely to show signs of illness, some of them moderate to many Maybe even severe, requiring hospitalization. So, for the individual that young with Type One Diabetes, their chances of getting through this without a vaccine is quite good. It's very, very high. Quite frankly, I'm unaware of anybody with Type One Diabetes that's had a very, very serious outcome. That doesn't make me totally knowledgeable of what's happening out there. But it's been my experience in my clinical experience. I'm in clinic five days a week. I think that from the larger perspective, children may be included at some point down the road. As eligible for the vaccine. Those studies still need to be done. The Pfizer vaccine covers down to age as young as age 16. And the maternal vaccine is 20. I don't know about the other vaccines that are still under phase three twapp trials yet, but there is a discussion ongoing that children should be included in trials over the next year, and to determine who would best benefit from the vaccine. Now, if your child with type 1 diabetes could serve as a vector to the disease, I can see those who are more prone to illness in the family would be at risk. So dismissing them or ignoring them into consideration of who gets the vaccine could be harmful in the long run if they're trying to fully eradicate or get as much herd immunity against this condition as we possibly can.

Stacey Simms 31:20

Can you speak a little bit to autoimmunity and this vaccine? In other words, I've seen people posting on social media, and it's a little confusing, and they're worried about people who have compromised immune systems, or have you know, immunosuppression, and type 1 diabetes, which is an autoimmune disease, which is different. Could you just take a moment and talk to us about the maybe the difference there or if people with autoimmune diseases are okay to take the shot?

Dr. Stephen Ponder 31:49

They are in general they are I had a request from a former patient of mine, who's now in her 30s, who had a renal transplant A number of years ago, and she's on program, which is an anti rejection medication, and prednisone relatively low dose, both of those medications are used to prevent her kidney from being rejected. Her question was, just as you asked is, is my compromised immune system a reason why I should not get the vaccine. I wanted to verify that I would give her the most accurate answer. I asked my infectious disease experts, is this a problem? And I knew what he was going to say. But I wanted to make sure I could tell the family that I heard the strep in the source, yes, they should consider getting the vaccine. The only caveat would be that the compromised immune system might result in less of an immune response to the vaccine, not that it would be harmful or hurtful to her renal transplant, but that it might blunt her individual response to the vaccine. And that's just one isolated example of a question like that auto immunity in general is become more or less a tagline or become a category. Unfortunately, because type 1 diabetes is You and I both know an autoimmune disease. Most forms of thyroid disease have some element of autoimmunity, celiac disease, and the list goes on and on and on. And so I think we've gotten lost in a categorization a stereotype if you will, what autoimmunity really nice. If you're talking about a compromised immune system, the result of that is most likely that your response to the vaccine might be blunted, but not necessarily eliminated. That's important to remember. I think, as always, because there's so many different forms of compromised immune systems, that it's wise to discuss with your primary care provider or the care provider that manages your particular condition which creates the immunocompromised state, and ask them their opinion on whether it would be wise to take the vaccine or not. So my general response is, there should not be any major reasons not to do that, unless there are specific elements of your immune system that are known to result in perhaps a significant overreaction to the vaccine. And that's where I think a lot of people are getting confused, is they're thinking more in terms of the the adverse side effects like hives and, and anaphylaxis. And those are conditions that anybody can have, regardless of whether they have a classic autoimmune disease or not. And to that point, as I referred to earlier, when, after I received my vaccine, the CDC has recommended, at least in the short term, that all the vaccine sites be adequately staffed and equipped with medication to manage an acute immune reaction like an anaphylaxis and so our injection area was right adjacent to the emergency department within about, you know, 100 yards. And so just in case Plus, they would have epi pens epinephrine tans, in case somebody were to develop an acute reaction to the vaccine. As far as I know, there were no reports of any significant immune reactions and certainly you can add hives and itchiness and so on, but you're talking about the situations where somebody gets an enlarged tongue may have some problems breathing, and so on. Those are some of the reports that have made the new the national news international news. And those are treated effectively with epinephrine injections. And in many cases, these individuals already knew they had those kinds of responses to certain things. And they've already well equipped or prepared with FM Fm 10s,

Stacey Simms 35:20

just with autoimmunity and type 1 diabetes, to put a fine point on it. I think many people are concerned that by getting vaccines when they already have an autoimmune issue, that their immune system may somehow become confused or overreact to the vaccine. It sounds like you're saying that's not what is happening with the COVID vaccine.

Dr. Stephen Ponder 35:37

I've not seen any evidence of it say that if I receive the COVID vaccine, that I need to be worried about having a higher risk of developing other autoimmune conditions, I've looked at this autoimmune condition for 55 years, as you know. So that's not a consideration. I also think that we have to look at this in the big picture of risk. And if there is a risk, it would be infinitesimally small compared to the much greater risk of getting COVID and having an adverse outcome from the COVID. So we live in a world of risk, whether we acknowledge that or not. And we make our decisions based on our perception of that risk. If we over perceive a risk, which is not as great as it really is, then it's going to tend to deter many of us from doing something that might be in our best interest, such as the COVID vaccine, but just to be safe, certainly Always consult with your primary doctor, if you have any questions about whether I should or shouldn't take this vaccine, or perhaps wait a little bit longer. But again, even delay, in theory increases risk further, since we now do have a way to at least fight back against this pandemic.

Stacey Simms 36:43

You know, it's been such a rough year for everyone. My family's been so fortunate we've been home or doing our part has meant watching Netflix and podcasting and you know, being here, but for folks like you, you have been in hospitals, you've been in clinic, you've been seeing patients, I'm sure you have you are tired of wearing your mask and you want to hug your patients again, can you give me a little bit of your perspective of what it was like when you when you walked into get that vaccine,

Dr. Stephen Ponder 37:10

nothing could have been more hopeful and optimistic. And I'm sure my mood and attitude may have changed. And in the days following the vaccine, I did feel I was doing something constructive, that was going to ultimately result in an improvement in my health and reduce my risk of getting this condition. On the other hand, they were very clear about the fact we need to continue to wear our masks, wash our hands, maintain our distance, avoid crowded places, and so on. I'll be honest with you, Stacy, as you were asking that question, I was thinking back to the fact that for 55 years, I have to take injections every day, I have to do certain things to stay healthy and live with diabetes. And eventually they became sort of just routine and Matter of fact, for me, and it dawned on me that wearing the mask and doing the hand washing is also over the last several months become kind of a matter of fact, behavior for me. And I don't personally my personal personality is not to begrudge that I just do what I need to do, because I'm helping other people as well as myself, family members, you know, neighbors, co workers, patients. And so, to me, I don't see it as an excessive sacrifice, given the benefits that I get from it, from hopefully staying free of the virus, which I have been able to do for the last whatever nine or 10 months since we've been doing this. And I do work with patients on a regular basis. I'm sure I come across patients who may be sick or may have this but I have my mask on I keep my distance I keep my hands away from my face. I do things I didn't do as much of a year or so ago. But those behaviors have now become kind of ingrained in my behavior and I no doubt probably in yours too. And you don't necessarily think about it but then it becomes kind of a way of life. So just like the diabetes has become a way of life. Now I know that many of us look forward to the day when we don't have to wear the masks and but I'm not sure that we look forward to the day where we don't have to wash our hands. I don't know about that one. I didn't know about that.

Unknown Speaker 39:06

Yeah, I

Dr. Stephen Ponder 39:06

think I think closer being closer and masks are fine getting rid of those, but I'm okay with people still washing their hands. Me too.

Stacey Simms 39:14

Hey, before I let you go you share wonderful photos of your granddaughter Cammy Do you mind if I ask how how she's doing and how. And I don't be too nosy if she's still living with you. You know what what your routine is like coming home we just protect not just her but the other people that you live with. You know what have you been doing the last couple of months as you come home from work?

Dr. Stephen Ponder 39:32

Well, my granddaughter Cameron, she is actually in a preschool setting, which is very safe. It's she's been there for six months and nobody's fallen ill that was COVID she's been doing fantastic there. She wears her mask faithfully every day. They hand sanitizer and of course it is a daycare for four year olds three and four year olds, so they're all in each other's faces all the time but so far we've been very fortunate where we live not to have any obvious outbreaks. She still living with us. She's actually visiting part of her family down in the US Virgin Islands right now. And I have to tell you a funny story. She was at the beach down there. She's on St. JOHN. She was telling her father, I'd like you to take me to another beach tomorrow. And he asked her why Cameron, because this speech is too salty.

Unknown Speaker 40:19

Oh, I love it.

Dr. Stephen Ponder 40:21

She's used to going to Lake up here. Yeah. And so they took her to a different beach yesterday. Of course, it's ideal like down in the Virgin Islands. And that's where her where her father and grandparents live. So she's down there visiting right now for three weeks. And she'll be back with us in about three weeks. So we're looking forward to having her back. And yes, it's interesting, being a full time grandparent with your grandchild who lives very close to you. But it's a blessing as well. And it's one of my primary motivations for taking care of diabetes, for staying waiting COVID my motivations are not medical motivations, mine are very personal, for taking care of myself, and I want to see that little girl grow up, I want to see my family thrive. I want to be able to continue to help people in whatever way I can. And that's why I take care of myself now, because I'm looking for some agency or something or some time and range light sensor. But for more transcendent types of purposes.

Stacey Simms 41:16

Well, I always appreciate you sharing the information. It's always so useful. And this time, right now is such a turning point. I hope it'll be a long way to go. I certainly don't expect to throw off the masks in a week or two or anything like that. It'll be a long time coming. But it's so nice to have something hopeful. Finally, and I gotta tell you, this is a selfish episode for me talking to all you people with, you know, in the healthcare industry, because I'm so excited when I saw the photos, it just made me happy. Who knows when we'll get the vaccine here. You know, I'm younger. I don't know. I'm not that young anymore. Doctor ponder, but I, you know, I'm not in healthcare here. Yeah. Yeah. So it'll be it'll be a while. But boy, thank you so much for sharing your stories. And you know, you I know you'll keep us posted on social media. But thanks for everything you've done to encourage people to, you know, to stay safe and stay healthy. We really appreciate it.

Dr. Stephen Ponder 42:02

Well, thanks for all you do for the diabetes community, Stacy and getting the word out and being the advocate that you are. It's an honor to know you and it's an honor to speak to you this morning. Thank you very much.

Announcer 42:17

You're listening to Diabetes Connections with Stacey Simms.

Stacey Simms 42:23

It is possible by the time this episode airs that 20 million Americans might be vaccinated against COVID. I don't have anything more profound to say than that. Yes, it is the beginning of a new year. It is hopefully the end of what I jokingly called there the Great Awful when I was talking to Geoffrey and I have been referring to that throughout the year. It's gonna be a while before we go back to normal before we can stop wearing masks. Everything that all these wonderful health care workers that I talked to, for this episode, have said,

So again, I will link up more information in the show notes, you can always go to Diabetes connections.com and click on the episode homepage. There's a transcript for every episode. I started that in 2020. And we are working backwards now to fill in the previous five years of transcripts as well started this in the summer of 2015. My goodness, a lot of episodes to get transcriptions for but I am working on that.

If this is the first episode you've heard, thank you so much for dropping by and checking it out. I hope you liked what you heard. I put out new episodes every Tuesday, and you can find out a lot more on the website. Please join our Facebook group as well. That is Diabetes Connections, the group and you can follow me on social media, Stacey Simms or Diabetes Connections on pretty much every platform still not Tick Tock. That's not gonna happen. Not even 2021 Thank you, as always to my editor John Bukenas from Audio Editing Solutions. Thank you all so much for listening. Happy New Year. Here's to brighter days ahead. I'll see you back here next week. Until then, be kind to yourself.

Benny 43:57

Asthma & Allergy