VA Pacific Islands Health Care System

Director

March 5, 2021

VAPIHCS Veterans, 

This past week I had the opportunity to see many of our VA employees in action at the COVID Vaccine event at Keehi Lagoon Memorial and I had the opportunity to meet many of our Veterans. Thanks to our hard-working staff we were able to provide 590 vaccines to our Veterans. This was a perfect example of everyone working as One Team, One Ohana!  Our VAPIHCS Ohana is dedicated to providing you, our Veterans, with what you deserve. The energy was so great, I saw  from the moment you checked-in there were staff meeting you with aloha, to the moment you were cleared to go…all the doctors, nurses pharmacy staff, medical service assistants, social workers, and service chiefs pitched in to provide you with the safe, compassionate, quality care you have earned.  It was an all-hands-on-deck experience and I am happy to see Veterans getting the vaccine.  Together, we are going to get through this pandemic!  

I also had the opportunity to meet with Army Lt. Gen. Ronald Place, Director, Defense Health Agency (DHA), who was on island last week.  We were able to discuss all the work VA Pacific Islands is doing co-located here on Tripler Army Medical Center (TAMC) and my vision to integrate more specialty care into TAMC to support their mission of providing care for the active-duty service members, family members and our Veterans in the Pacific Islands.  I believe VAPIHCS can provide staff in harder-to-hire positions to support their staff who may be deployed or may get permanent change of station (PCS) orders. My vision is our VA staff can help fill the gaps needed and expand the care to all eligible beneficiaries…this can be a win-win for both VA and Department of Defense. Read article here.

Mass Vaccine Event

VAPIHCS will be hosting mass COVID Vaccine distribution by appointment only –1-800-214-1306, no walk-ins at this time.

MARCH 9 - HOMELESS VACCINE EVENT:  Homeless Veterans who have pre-registered will receive COVID vaccines at Cloudbreak, Barbers Point.  VAPIHCS will provide vaccination to eligible Veterans in the Homeless Veterans Program on March 9, 2021, from 9:30 a.m. to 3:30 p.m. 

MARCH 13 - VACCINE EVENT: Ke’ehi Lagoon Memorial Park - Veterans who have pre-registered for the event by calling 1-800-214-1306 will receive the COVID vaccine.  VAPIHCS will provide vaccinations to eligible Veterans who are registered for VA health care on March 13, 2021, from 8 a.m. to 4 p.m. 

Currently, we are vaccinating our Veterans who are 60 years old or older, high risk, or an essential/frontline employee.  Appointments are made by calling 1-800-214-1306 and are available Monday- Fridays until 8 p.m. and Saturdays until 4 p.m. Currently, we have vaccinated more than 6K people. 

COVID Update

To date VAPIHCS has vaccinated: 7625

1109 Employees

6516 Veterans

VA continues to expand its efforts to vaccinate Veterans and caregivers

We expect the first shipments of the new single-dose J&J (Janssen) vaccine this week, which was authorized for emergency use by the FDA last Saturday. We now have three highly effective vaccines available in the US, particularly against such severe COVID-19 outcomes as hospitalization and death.

The Center for Disease Control and Prevention (CDC) general mask use guidance has been updated to recommend masks that fit well to the face (snugly) and consist of multiple layers including the use of double masks. The goal of the new guidance is to minimize the leakage in and out along the edge of the mask. Information on this change can be found at: https://www.cdc.gov/coronavirus/2019-ncov/your-health/effective-masks.html

The new CDC guidance does not change Veterans Health Administration policy as masks continue to be required at Department of Veterans Affairs (VA) facilities. Patients, visitors, and staff should be informed of the new CDC guidance and VA facilities should review the appropriateness of masks they provide to these individuals. VA staff can continue to wear their own masks that meet CDC guidelines in VA facilities unless they require personal protective equipment (PPE) for a high-risk exposure to COVID-19.

Keep up the 3W’s!

It’s important for everyone to continue using all the tools available to help stop this pandemic, even after vaccination, Veterans and employees should continue to:

• Wear a face covering
• Watch your distance (stay 6 feet apart)
• Wash hands frequently

Please continue to follow federal, state and local safety guidelines

• VAPIHCS is currently administering the vaccine on Oahu and asks all Veterans and VA health care personnel for their patience during this initial rollout.
• As more vaccine becomes available, VA’s goal is to offer the vaccine to all health care personnel and Veterans who choose to be vaccinated.
• VA to address vaccine misinformation and disinformation campaigns
• Inaccurate and misleading claims, such as “the vaccine changes my DNA” and “it is unsafe and causes permanent side effects,” must be countered with facts and assurances from medical professionals and other influencers in public settings, as well as social media platforms utilized by VA leaders.
• Concern about which brand of vaccine is better should not prevent getting vaccinated as soon as possible. No one worries about which brand of flu vaccine is better! Continued use of masks, physical distancing and handwashing needs to be emphasized to control the spread of the coronavirus and new variances.

Johnson and Johnson (also referred to as Janssen) Vaccine is now approved for prevention of COVID-19

• The J and J vaccine was 100% effective at preventing death and hospitalization due to COVID 28 days after vaccination.
• The Moderna Vaccine prevented 100% of deaths and hospitalizations due to COVID starting about 2 weeks after the 2nd dose.
• The most important outcomes we worry about are death and hospitalization. Both vaccines do a good job preventing these outcomes.

Frequently Asked Questions

Question: I heard the J and J vaccine isn’t “as good.”

Answer: Clinical trials may have different groups of people and different outcomes of interest.

Different populations: The J and J vaccine trial took place in the United States, but also in Brazil and South Africa. Brazil and South Africa are experiencing COVID due to COVID variants that are more infectious, more deadly and can evade antibodies.

Different outcomes: The outcome that Moderna was investigating was preventing symptomatic COVID. This could be mild symptoms (a runny nose) or severe life threatening COVID.  Moderna accomplished this, protecting 94% from symptoms of COVID and 100% from hospitalization and death.

The outcome of the J and J was moderate to severe COVID (efficacy at prevention was 66), severe to critical COVID (efficacy 85%), and death (efficacy 100%).

The J and J vaccine performed better in the U.S., likely reflecting the fact that we have not had a large number of COVID variants of the worrisome type from Brazil and South Africa. 

Question: How is J and J different than the Moderna vaccine?

Answers:

• J and J is just 1 dose!
• The full effect of the vaccine is seen in 4 weeks, not 6 weeks!
• How vaccine is delivered is different: The J and J Vaccine is a vaccine that is delivered by a viral vector (an inactivated cold virus). This doesn’t mean the vaccine will cause a cold-it does not.

The Moderna Vaccine is mRNA molecules delivered in a liposomal (a form of fat) system.

Question: Is one vaccine recommended over another for pregnant or lactating women?

Answer: NO. The CDC does not recommend one type of vaccine versus another for this group. 

The CDC recommends people who are pregnant, and part of a group prioritized to receive the COVID-19 vaccine may choose to be vaccinated. If they have questions about getting vaccinated, a discussion with a healthcare provider might help them make an informed decision.  CDC notes that pregnant women are at increased risks of complications if they contract COVID-19 while pregnant and vaccination will likely be protective. 

Question: What about new variants?

Answer: Ability to protect from COVID -19 variants. Good news.

Moderna was studied before there was as a significant number of variants. Some work has found that in test tubes, the antibodies produced by the vaccine may not be as effective-but that doesn’t mean the vaccine won’t work. A test tube is different than a person!

The J and J vaccine was studied in Brazil, the U.S. and South Africa, so the fact that it protected 100% from death is good news, since variants have been problematic in South Africa and Brazil! 

There is ongoing work to determine how vaccines protect people from the variants.

Question: Are side effects better for either vaccine?

Answer: The J and J vaccine was not studied head to head against the Moderna, so it is hard to answer that question.

Side effects were fewer in people over age 60-65 years in both studies.

Headache, Fatigue and aches were major side effects in J and J and in Moderna. Side effects were more common in the Moderna study; however, the study populations were slightly different. 

Question: Who should not receive the vaccines?

Answer: J and J vaccine should not be given to someone with an allergy to any of its components.  These allergies are rare. 

Moderna vaccines are contraindicated in people with severe allergy to mRNA vaccine, Polyethylene Glycol (PEG) or polysorbate (in paclitaxel).

VAPIHCS would like to make sure vaccination is as safe and effective as possible.  Please note the following:

Precautions:

• Anyone with a history of a severe reaction to anything-food, bee stings, medicine, etc-will be watched for 30 minutes after the vaccine. Everyone else will be watched for 15 minutes.
• Improving your immune system’s ability to respond:
• We recommend you receive no other vaccines within 14 days of a COVID vaccine.
• Some medications used for people with Multiple Sclerosis or Rheumatologic conditions (like Lupus or Rheumatoid Arthritis) may need to be timed precisely with the COVID vaccine. Talk to your Neurologist or Rheumatologist.
• Cases continue to decline nationally and within VA. VISNs are reporting dramatic drops in inpatients and the number of employees unable to work because of COVID-19 continues to fall with more vaccinations.
• Employees should continue to work with their healthcare providers, community and State to schedule their COVID-19 vaccinations, as opportunity allows. Veteran employees should access the Keep Me Informed tool.

March Highlights

VA Celebrates Women History Month

This year’s theme is “Valiant Women of the Vote: Refusing to Be Silenced.” VA Insider features resources for VACO and field offices to celebrate women Veterans and the many contributions of women to the nation.  The number of women using VA health services has more than tripled since 2000 and 41% of women Veterans (800,000) are enrolled in VA care today (44% of men). One of every three new enrollees is a woman Veteran.

Social Worker

VA Pacific Islands Health Care System is celebrating Social Work Month in March with the theme “Social Workers are Essential” to highlight the invaluable contributions Social Workers make while serving our veterans, especially as this nation addresses the Coronavirus pandemic. VAPIHCS has more than 100 Social Workers, across various service lines including Mental Health, Ambulatory Care, and Geriatrics, and Extended Care. During Social Work Month, we urge you to learn more about the essential work of Social Workers and what you can do to help members of this profession do their positive, life-changing work. Happy Social Work Month!

This week’s 75th anniversary – We are highlighting Dental Service.  At the VA Pacific Islands HCS, our dedicated Dental Team consists of 6 dentists (to include one Prosthodontic Specialist and one Periodontal Specialist), one Dental Hygienist, eight Dental Assistants, and two Dental Laboratory Technicians.  Not only do they care for Veterans through direct F2F care, they oversee a robust community care program to ensure timely, quality dental care for Veterans who reside on the neighboring islands, Guam, and Saipan. 

Throughout the pandemic, the Dental Team consistently reported on site to take care of Veterans’ acute and emergent dental needs, as well as participate in the labor pool to assist with the Swab tent and door screening efforts.

Special shout outs and gratitude to our committed, compassionate, and resilient dental assistants for Dental Assistant Recognition Week, March 7-13, 2021.

It is our honor to provide you with safe, compassionate and quality care!

One Team, One Ohana!

Adam M. Robinson, Jr., MD, MBA, CPE

Director, VA Pacific Islands Health Care System

VADM, MC, USN, (RET)

36th Surgeon General, USN

Stay Informed

• Website: hawaii.va.gov – submit your email to get our updates
• Facebook: https://www.facebook.com/VAPacificIslands
• Instagram: https://www.instagram.com/va_pacific_islands/
• VAPIHCS USAJOBS: https://www.hawaii.va.gov/careers/index.asp
• Weekly Radio VA Updates:

Tuesdays, 8:30 a.m. on AM830, KHVH with Rick Hamada

Thursdays, 5:30 p.m. on AM690, The Answer - Aligned with Veterans hour with Mike Buck