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Jan 29, 2021

The COVID-19 vaccination rollout is starting in states around the country. Some are doing an okay job while others are not. This rollout reminds us of the Polio vaccination. Hilary’s mother had Polio in the 1940s and was one of those children in an iron lung. She remembers when she was growing up in the 1960s how adamant her mother was that she get the Polio vaccine.

About the Interview

In this episode of Hilary Topper on Air, Hilary interviews Robert V. Fallarino, Esq. of the Pegalis Law Group, LLC.

Robert will discuss the similarities and differences between the COVID-19 vaccine rollout and the Polio vaccine rollout. He'll touch upon the inoculation phases of the COVID-19 vaccination, who is eligible now, the two-dose timing and effectiveness, how the rollout is going so far, opting out of the vaccine, strains of COVID-19, and what's next. He will also offer listeners advice on how to medically protect yourself and your loved ones by learning from our missteps over the last year.

About Robert Fallarino

Robert V. Fallarino, Esq. is a trial attorney with more than twenty-five years of experience leading medical malpractice litigation, complex labor law, and product defect litigation.

Robert has dedicated his career to compassionately helping people who have endured life-altering and catastrophic injuries. He strives to resolve matters in the most advantageous setting for his clients, whether that means obtaining a jury verdict, a court conference settlement, or by use of a mediator. He is noted for obtaining the fourth highest verdict in New York State for medical negligence, and a top ten verdict overall, in 2012.

Robert has been named to the 2020, 2019 and 2018 Best Lawyers in America® which each year includes only 5% of attorneys across the country. He has also been named New York Metro Super Lawyers© List every year since 2012, for peer recognition and professional achievement. Robert is admitted to practice law in New York, North Carolina and the District of Columbia, as well as in the Federal Courts for Eastern and Southern Districts of New York and the Second Circuit Court of Appeals.

About Pegalis Law Group, LLC

Pegalis Law Group represents people suffering from preventable medical errors and personal injury. We strive for accountability by advocating for clients, which ensures safer medical practices and better patient care. To discuss your medical/legal situation, call Pegalis Law Group at 516-684-2900 or 1-866-MED-MAL7. There is never a fee for legal consultations. To contact Robert or learn more about Pegalis Law Group, visit https://pegalislawgroup.com or email him at rfallarino@pegalislawgroup.com.

Podcast Transcript

COVID vaccines are starting to roll out in States around the country. Some are doing an okay job while others are not. This rollout reminds me of the polio vaccination. You see, my mother had polio in the 1940s and was one of those children in an iron lung. I remember when I was growing up in the 1960s, how adamant she was that I get the polio vaccine. Today, we're talking about the COVID vaccine and its rollout. I'm Hilary Topper and this is Hilary Topper on air. Today, I have the great pleasure of speaking with Robert Fallarino of the Pegalis Law Group. Welcome to the show, Bob.

Robert - Thank you for having me. I'm glad to be here.

Hilary - So can you remind our listeners about your background and the Pegalis Law Group?

Robert - Where I met a call malpractice law firm, I've been practicing medical malpractice, since the mid 1980s, we handle all kinds of medical malpractice matters in terms of care and treatment at hospital settings and in the local community settings. And one of the reasons we're tracking the COVID vaccine distribution and what's happening is so that we can be prepared if some people call us about not so much the vaccine rollout, but in terms of the aftercare and the ramifications of the vaccine rollout and people who have COVID and their care at hospitals or their local physicians.

Hilary - Interesting. All right. So let's talk about the COVID vaccine. Can you discuss the phases and the different types of vaccines that are out there?

Robert - So let's start with the phases, the inoculation phases. We're currently, this is mid January 25th so we're in phase 1 - C in New York state. And pretty much similar from what I'm gathering across the country. And so right now, we initially are trying to make sure that the elderly, who seemed to be the most frontal and certainly had a large number of deaths associated with, would get the first big batch in terms of nursing home facilities and assisted living facilities and even rehabilitation facilities. So that seemed to have been going so well that New York opened it up to 65 and older. And then some of the other things that were supposed to be the next phase already in this phase. The next phase is going to be 1 - C, which will include a more broader range of essential workers.

And for a lot of people, state court personnel will be getting to that level so that the court system might open up sooner for criminal cases and also for any kind of thing so that the personnel won't be exposed. It won't be carrying it and won't be exposed to the people coming in. So that's an interesting little take so that we can open up more and more facilities. And now let's just talk a second about the different types of vaccines. There's a Moderna vaccine and a Pfizer vaccine, initially Moderna was going to be a one injection but they seem to have been spreading it out over two. And certainly Pfizer's was definitely going to be two. So there's been a little bit of a glitch, if you will, in terms of the distribution, because of how cold everything had to, you know, Switzerland to Pfizer is unbelievably cold and needs to be maintained. And Moderna was better but still needs to be in a refrigerated situation.

So the interesting rollout, what's currently out there right now, a two shot within 21 to 28 days. What's concerning me and then people who track these things is some of the discussions about spreading out that 21 to 28 days and trying to extrapolate data from the studies that were done in that 21 to 28 day reference time and extrapolate out, can it be given 40 days, even as far as 60 days out and still be effective. That's concerning and, hopefully, that won't come to pass because that might defeat the whole purpose of what we've already got accomplished since the end of the year through this first month of distributing it. This is one of those things that's the communication from our government, both state, local and federal, so that we understand that everyone who has gotten an inoculation is going to get it on schedule and I think New York state is doing that and is acting in that fashion but, it's kind of concerning in the sense that every state is kind of running it differently because the previous administration distributed it to the States to be distributed the state-by-state local basis. And now, I think we may have a little different distribution with this whole plan, which president Biden saying a hundred million inoculations in a hundred days, it might be a more robust distribution if the manufacturers have that robust district distribution to give us. So there's another interesting vaccine and then we'll talk a little bit about some of the plans with the president Biden plan and going forward is Johnson and Johnson's Vaccine, that is they're still doing the analysis, but it seems like it's in the very end stages.

And now the ones I have said, once they are approved, once they get through the final analysis they'll have a hundred million doses by the end of the spring. So that will aid us, I think, in getting to where we want to get to: reopening the country and getting that done. Maybe the tail end of a hundred million injections in a hundred days will help us get there. And supposedly that doesn't need to be as refrigerated. But throughout that's all data we're going to hear when they do the final analysis that they're putting together right now.

So that's an interesting overview as to where we've been and sort of where we're heading. Hopefully, the one will be available soon. Unfortunately, we seem to run out of vaccines and certainly in New York city. So they shut down last Thursday until Tuesday or Wednesday. If you go on the New York state website, there's only a few places that are still open once Plattsburgh. So I said, well, that's a long drive for us down here in the bottom half of the state. So that's, where we're kind of at, I think SUNY is an open place and Albany is also open. So those, you have to be proactive and I understand the letter sent to the governor probably within the last week or so asking for help for the senior population that it's not just a clicking on a website there's more a phone in where they can get an appointment in a manner where they can handle it and not realize they have to hit refresh all the time and things of that nature.

That's an interesting letter and hopefully that will work because we really do want that population to get it as early as possible cause they seem to have the most vulnerable component. So, I think what was announced by president Biden on the first day or so of his administration, is that he’s going to get involved in setting up a hundred center centers countrywide. And I'm hopeful that will have more equity in terms of the distribution and also equity in terms of who gets it and who doesn't get it and open up the doors to places that maybe don't have it, not so much in New York state, where we seem to be getting our share. From what I understand, New York state has been getting 300 doses a week and they just have used them all up, which is a good thing, you know? So it's like 1.4 million New Yorkers have gotten inoculated at least the first dose and maybe some of them the second dose already. So that's a good start.

The other thing that I think is important is health and human services is going to have recruitment to get more people who can administer and maybe disperse them. We're all waiting for the pharmacies to be able to give it to us where it's a little bit more convenient in a locale, or maybe the Johnson and Johnson vaccine will help us along those ways but it seems to be not a dearth, but not as many as we would hope that are trained in how to give it, how to handle it and how to store it. So, hopefully, that does help a little bit as well. And I think just the simple, the mask mandate, at least in federal buildings and federal places might spur more people to protect themselves, but that's an overview of where we've come with the vaccines and where we're at the current time.

Hilary - I have a couple of questions about what you just said. So my first question is they're giving out the vaccine to the first one, but we're not sure about that second dose. And it's supposed to be within the first, you know, 20 days or so. What if it's longer, you know, does that mean that we're going to have to all get the vaccine again? If we can't get it in that timely fashion?

Robert - Well, the data is clear in terms of how it was approved and how it was studied and the people who did it, who volunteered for the study, it wasn't a 21 to 28 day cycle. So that's where the data is good. When you get beyond that. You're trying to do extrapolations as to whether it's going to work or not. So I think that's a very good question and I don't think it's been sufficiently answered yet. And I think we need to see DC to really step up and make a promulgation as to where that falls for us. Cause I've heard estimates as much as 60 days, it should be effective as much as 60 days after the first dose, if you get the second dose and, I'm leery of that because of the length of time, that gap in time. And it was so clearly wasn't studied in along those ways. So there's no, I don't think there's enough scientific data that gets you there.

Hilary - The other question I had is about seniors. So you alluded to the fact that seniors are having a hard time getting on those websites, which I totally understand. They are very difficult to deal with and I've helped both my mother-in-law and my aunt tried to get an appointment and it's just impossible, I can't really seem to be able to navigate it myself. I mean, this is...

Robert - You know, why I'm hopeful that the letter will open up the door to telephone calling for the, this certainly this, you know, 75 and older, and maybe even as a 65 and older ground, it's clearly a difficult website to, you know, and it has to do with volume, not the difficulty in how it's set up. It has to do with the amount of people trying to get in. And the younger generation knows that you just gotta keep hitting it until you get in and get to the window. But some people who don't understand that as they think they're doing something wrong as opposed to keep trying. So I think that's an important little adjustment. I also think as it becomes more available, outside of distribution centers are more available to their own physicians. I think that's got to be something that has to be a key in the next distribution site is gerontologists and people who cater to the elderly population and maybe, one of the benefits which we find hasn't been a benefit to healthcare is that mega hospitals buying up all the practices, but in this instance, it may be a very good distribution route is when the hospitals who have the physicians on the contract, they get it, they can disperse it. What's the cost when it's not refrigeration needed, they can disperse it to the healthcare providers at the local site and the elderly can just go to the doctor, then regular visit and get the shot. So that's hopefully the next wave when the refrigeration issue was dealt with. Much happier doing it that way.

It'd be interesting if that does happen. So that would be an interesting and helpful way for the elderly to be able to get into their regular doctor or someplace maybe a pharmacy as a local pharmacy, as opposed to a big center where they're waiting on line three hours in their car.

Hilary - I want to go back to the beginning of this interview, where I was talking about my mother and having polio and how it reminds me of the same type of polio vaccine rollout. Can you talk a little bit about that?

Robert - Yeah. You know, what was interesting about the polio vaccine is when it was rolled out, it was rolled out in schools. And that was a situation where the government wanted to inoculate all the youngsters so they wouldn't get polio and bring it into the next generation going forward. So it was literally a line up and get your shot. And so that's an interesting difference. I think they tried to use that and that model to a little extended nursing home health care facility rollout, but obviously not. There's a small percentage of the 75 and older population there than there used to be. There was a lot more at home, a lot more stayed at home, cared a lot more, you know, nursing, even if there's nursing care, it's at the home site.

So that's been stymied a little bit. So, that's where we need to get the distribution out. To broader numbers. I do hope quite frankly, we’ll be using that model before the school year ends. In terms of, even though we know the students have been safe in school that hasn't been that mass Communication once everyone started wearing a mask and six foot social distancing, but we have a great number of our population who are now going home to their parents. And when they have grandparents living with them, all those, you know, like where we live on Long Island, there's a large number of people with either caretaking for their parents or close by where the students dropout of high school students drive food over.

So you also don't want someone who has to carry it to be able to distribute it. So you would want to knock that out. So I'm hopeful that at some point in, as the spring, before the school year ends, that they do a distribution because many of the many other school districts outside of New York city, of course, but many of the school districts, either half population or full population or certainly every third day, there's someone coming into the building. There are a lot of options, but that's a different model, but we have a good number of students every day in the facility. One of the things , as you know, I sit on my local school board. So one of the things we organize for our teachers is we get in touch with one of the urgent care centers, the stat cares of the world. And we contracted out to basically come on a Saturday afternoon. If they had extra they could set up, some teachers were open. So it could be a way of maybe if we could do that on a wider scale of getting all the teachers in our communities that, you know, inoculated by having it brought right to in mobile vans to the facilities. The interesting by-product of that though is only 77%. How about teachers take advantage of that? So it's an interesting, I don't know if they, I don't know if 25% opted out to opt out forever or they already had it set up in a different fashion. So that's an interesting problem where we have the opting out.

Hilary - Yes. And I would like to actually ask you about that, so I know a lot of physicians and nurses who refuse to take this. I mean, do they know something that we don't know?

Robert - Well, we're taking this. Hopefully not. Hopefully, I know that we've been given by Moderna and Pfizer is accurate data and the CDC has analyzed it, but, I think there's always a concern when a new vaccine comes in as to whether it's efficacy and if it's safe and things along those lines, it is an AMR and it's not a DNA per specific vaccine. So there are always concerns with those in terms of what it means. And, uh, and it's an interesting topic that I think when we get to the end of this, we should really explore. And it'd be interesting to see if doctors, nurses, support staff and see the demographics, how it breaks out that way. Cause there's always the problem with social media is good cause it gets things out. But the problem with social media is you don't know the source. So once something comes out that maybe is trying to present their own bias in terms of whether it's efficacious or not, you then have that word of mouth in different settings where there's a concern. That really isn't true. So the issue you broke it down very nicely is based on the data we know. They should be taking it because they should be sick.

And that's the data that we know, that's been given to us now, if they know some data that we don't know, that's going to be an interesting little kicker, but it doesn't seem to be so because we've gotten a month worth of, there's been 41 million vaccines distributed across the country, 20 million have been given out and, and we haven't heard any adverse reactions. I'm sure there's one idiosyncratic reactions out there, or a handful of those, but it hasn't been a report. Like, Hey, stop, this isn't working, or this is giving people COVID or any concern there hasn't been a backlash and there's 20 million people have gotten it, you know? So even 10% or 5% is a big number there's a big number of people and there was such a risk that it was what was out there.

So I think that should give us who haven't gotten it yet, comfort. But there hasn't been a big number of reports. And as we know, as the delay goes on and maybe the second dose has given, those of us who are below 65 and in the healthy category, we'll have a lot of data before we have to actually get it. So I think that should allay everyone's fears. But I think that'd be interesting to see, and that's why I got the data from our little school district, if that plays out nationally, if it's the microcosm of the world or is it just our little district?

Hilary - Yeah, definitely interesting stuff. So. Tell me Bob, how can people protect ourselves from this virus? I mean, where do you play into this?

Robert - I think it goes down to what the mask wearing again is actually the best and the six feet of social distancing and just general hygiene and self protection we seem to have worked. And now what the problem is, you know, as a boomerang across the country in various areas there's been different strains that are starting to pop up. So the one thing in terms of protection that I think is concerning is it seems to be three strains, UK strain, Brazilian and South Africa that are changing in terms of, they seem to be, certainly the UK and the South African in particular seem to be more transmittable. And so there are different theories. There are two theories that sound interesting in terms of whether the transmissibility has to do with volume load. Is there just more volume load in the nose and mouth and sneezing and coughing and things like that. And it also seems to be a theory that, these are theories until proven, it's just more sticky in terms of the virus, the cells themselves just adhere better. And so it'll be interesting how that plays out, but that's, it goes right down to the mask is the way to protect yourself. And it's interesting how you say in terms of where, how our firm would play a role out front would play a role more. And, unfortunately, the people that get it, there's this thought out there that all only the old die from this or people with really bad comorbidities, but when you break it down to age, the CDC through December 16th had broken down the age group so of the overall deaths and the, and there were similarities, it's basically 10% across all age groups die once their hospital. Once, you know, COVID takes over, you know, 45 to 54, where everyone thinks is safe is 9% and 85 and above is 10%. So there's not a statistical difference. It's just a number I get that sick from it. So the issue we will look at is in terms of the younger population. Those who passed away from it were medical errors in terms of how they went about treating it, that they gave and things of that nature that have been somewhat protective.

And then did they do the, as we spoke about previously on the COVID, did they not intubate intubate in the appropriate manner that they try proning and things like that before intubation. So those are the issues we'll be looking at. And there is a potential that you have to have a highest standard if you have a COVID related death, but still that can be missed, in terms of how care has been given. So we will certainly, if someone wants our help, they can certainly contact us if the loved one of theirs has passed away or God forbid. And in terms of additionally having long-term qualifications where they're in a rehab facility for eight, nine months, you know, trying to get over it. And we'll look into that as well. But those are all, those are somewhat individual roles that we can play. And that's why we're tracking all this data because it's interesting that it's really dead 10% across the board. And the other thing that's interesting is the death rate has just gone out by the number of deaths from COVID. So it's not as though it's not as, it's not that you know, people would be dying from something else. If this didn't happen now the extra people who have died, 400,000… So for everyone who's listening, protection is still the way they go in terms of mask, the simple mask wearing. Because it's respiratory. It is, you know, you happen to be in the wrong spot at the wrong time. When you know someone either. Coughs or sneezes and you walk the grocery aisle the next three minutes and it happens to be there. So that's where you're at in terms of protecting yourself. And the other way to protect yourself is not wait. You know, if you get some of the early signs and symptoms is, you know, get to the next level of health care, don't assume it's sinuses don't, assume why don't you certainly, once you get to have these signs we all hear about cough, but one of the other leading predictors is fatigue. So that may be a little different than people who were like saying, Oh, I have sinuses or I have a little runny nose kind of thing. Once you go into the knee, once you get, certainly into the next levels, you gotta be very protective and you have to be protective of the people in your own house.

Once you have any sign, you should be quarantining yourself. And, it's only for a 10 day period, if you don't have it because you're shed cells. And that first 10 days when you don't really think you have it. And that's why the quarantine is only 10 days. That's why it got reduced all the way from 14 down to 10 is because that seems to be the most contagious time.

So, I think that's a very important way that people protect themselves and protect the people they love is, once you have some signs of symptoms, don't expose yourself to someone else and wear the mask to protect the other people and maybe wear the mask in the house for the first five, seven days or quarantine and isolate and set up your own bathroom, if you can, for your use until you make sure.

Hilary - Thank you so much, Bob, this was really informative. Could you tell our listeners how to get in touch with you and the Pegalis Law Group again?

Robert - Sure. Uh, where obviously online at pegalislawgroup.com. Our local phone number is 5166842900. You can email us, we have a 24 hour reception service so that we can get the message to us. And if there's any questions you have about, the care for a loved one, not just COVID related, but any kind of issue that you feel. Okay. Something was done wrong. And then God forbid there has been a catastrophe in your family that you want to just get the answers to, you know, you can give us a call.

Hilary - Awesome. Thank you so much. I really appreciate your time today. And. I also want to thank our sponsors. The Pegalis Law Group. Thank you. The Profit Express, Russo Law Group, Pop International Galleries and Gold Benes LLP. And last but not least, I want to thank you. Our listeners for tuning in. If you want more information on this show or any other show you could visit our website hilarytopperonair.com or you can find us on Spotify, iTunes, Google play, Apple podcasts, you name it. We're out there. Have a great week and we'll see you next time.