The Starbucks store manager wasn’t sure she was going to take a vaccine for COVID-19. She was skeptical about how quickly the new vaccines had been developed.

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But one of her three children has a compromised immune system due to cerebral palsy and, ultimately, she decided that the vaccine could help protect not only her, but also those around her. She’s fully vaccinated now and said she’d encourage others with questions to do their research.

“I feel like I made the right decision, not only for me but my family,” said Brittani, who lives in Texas.

She shared her story recently with other Starbucks partners during a virtual panel designed to answer questions about the current vaccines available in the United States. The panel featured scientists Drs. Stephaun Wallace and Amitabha Gupta from <a href="https://www.fredhutch.org/en.html">Fred Hutchinson Cancer Research Center</a> in Seattle. The renowned center, based in Seattle, is leading clinical trials for COVID-19 vaccines and treatments.

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Wallace is a director of Fred Hutch’s COVID-19 Prevention Network and the HIV Vaccine Trials Network, as well as a staff scientist of the Vaccine&nbsp;and Infectious Disease Division. Gupta is the scientific content strategist at Fred Hutch and was formerly a researcher in the Basic Sciences division.

The event was moderated by Becky Elias, a public health expert and director of retail food safety and quality assurance at Starbucks. May Jensen, vice president of Starbucks partner resources, also joined.

Read on to learn the answers to questions submitted by Starbucks partners for the panel. (Answers have been edited for length and clarity.)

<a href="#immune">How do our immune systems work and what role do vaccines play?</a>

<a href="#vaccines">These vaccines were developed quickly. Are they safe?</a>

<a href="#booster">Will we need booster shots?</a>

<a href="#variants">Will the vaccines be effective against the variants?</a>

<a href="#covid">If I already had COVID-19, should I still get vaccinated?</a>

<a href="#effects">What can you say about the range of side effects that occur and how that can be different from person to person?</a>

<a href="#trusted">What are some trusted sources of information on COVID-19?</a>

<a href="#report">How can we tell whether a report or article is true or misinformation?</a>

<a href="#inclusive">Some people can’t get vaccinated due to medical or religious reasons; how will we ensure we're being inclusive in the workplace for those who are vaccinated and those who aren’t?</a>

How do our immune systems work and what role do vaccines play?

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Dr. Stephaun Wallace: What we know is that our immune systems are already designed really well to prevent us from acquiring diseases and getting seriously ill from different things, but oftentimes our immune systems aren't quite up to speed on emerging infectious diseases. So, what a vaccine does is, it primes our immune system, or as I like to say, it teaches our immune system to better recognize and fight these invaders.

There are different ways that we also understand that vaccines can work. They can prevent infection, depending on how the vaccine was developed and how the trials were designed to test that particular product, but we also know that there are some vaccines out there that [may not totally prevent infection but can] prevent serious illness, and that is their main function. And then we also understand that there are some vaccines out there that work to prevent disease and delay disease progression.

These vaccines were developed quickly. Are they safe?

Wallace: Yes. It's important that I say that no safety protocols or processes were skipped at all in this process. The (U.S. Food and Drug Administration) was very clear from the very beginning that they needed to see a very specific set of data to come from the trials in order to move things forward.

There was a huge amount of coordination in this process at the federal level and internationally as well. Everyone is working on this, everyone is thinking about how to resolve this, everyone is talking about this. As a result, when you have that much energy and input and attention and focus on a particular thing, it's going to speed the innovation process up a bit.

The other thing I would say is that typically pharmaceutical companies have to go through a funding period between the different phases of clinical research. What the federal government did was take taxpayer dollars and invest billions of dollars in this process. So that means that between the Phase One safety trials, the Phase Two trials looking at potential immune responses and the Phase Three trials primarily looking at [how well the vaccines worked], the pharmaceutical companies did not necessarily have to go back and find/develop the resources needed to move to the next stage of research. That funding came from taxpayer dollars. So that helped to move this process along really quickly as well.

Also, the way that the vaccines have been developed is using technology, or platforms, that they had already for other diseases including Ebola, influenza, and even SARS and MERS. And so these are not necessarily new ways to develop vaccines, rather they're being applied in this particular virus.

Will we need booster shots?

Wallace: There is a high likelihood of needing a booster shot in the future. What we do not know yet is the duration of antibody protection so we have to define that first before we're able to go back and say what the boosters look like. I would tell people to think about it in terms of a potential every year sort of a thing, similar to how people think about the flu shot, but again, what it actually ends up being will be determined by [after we know more].

Will the vaccines be effective against the variants?

Wallace: Yes. Pfizer, Moderna and J&amp;J actually are really good again at preventing people from getting seriously sick and being hospitalized. Now, [trials of] Pfizer and Moderna were not being conducted during the time when we were identifying these various variants. So, I think that there's some consideration there around less efficacy, specifically for mild or moderate disease.

But when we think about severe illness, all of them, again, worked really well to respond to that, and these vaccines are actively being tested against variants as we continue to identify them.

If I already had COVID-19, should I still get vaccinated?

Wallace: Yes. If you have had COVID-19 disease, you should still get vaccinated. The recommendations are still 90 days after symptoms have subsided, and you should still get both doses of Pfizer/Moderna or the one-dose J&amp;J vaccine.

Our antibody response from natural infection doesn't last very long, we've observed. And another thing is that you may actually encounter a variant. So it would be good to make sure that we are protecting people against that, and the vaccination process will ensure a more robust immune response should you encounter the virus again in the natural environment.

What can you say about the range of side effects that occur and how that can be different from person to person? &nbsp;

Dr. Amitabha Gupta: There are a range of side effects that occur with these vaccines and basically, they range from a sore arm to a little bit of a headache to a little bit of a fever. I know my wife got her second dose of Pfizer last week, and she described it as having a mild hangover, if you will.

There’s a range of side effects including chills and fevers, and it varies from person to person. Everybody's immune system is different, and there are different stages. And it's not to say that if you don't suffer a reaction your immune system isn't working. Your immune system is still working, and your body is still building protection to the different vaccines.

There are some side effects that people were seeing early on. There was the talk of anaphylaxis in some of the mRNA vaccines [Pfizer and Moderna]. Those are being considered very carefully, and it's important to know that these [side effects] exist and to understand who they're affecting, and whether there needs to be an update to the guideline. This is where this Johnson &amp; Johnson and AstraZeneca piece fits in. The pause [on the J&amp;J vaccines to investigate reports of rare blood clots] was exactly what science meant to happen when you do a trial for 30,000 people [while the vaccines were being tested].

Thirty thousand is not a million people, it's not 10 million people. As we start getting into 10 million people [vaccinated] we will encounter people whose immune systems are different than the people who are tested in the 30,000. It's important at that point to pause and really understand the underpinning of that.

There are systems in place to help monitor and track people who may experience reactions to the vaccine so that we're able to then go back and say, OK, well, we're seeing this number of people that have this kind of reaction and it wasn't expected, we may need to pause this particular vaccine in order to look closely at whether or not there is causation versus correlation – whether this vaccine is actually causing the reaction versus just being sort of part of the story.

There is a lot of information about COVID-19 -- both accurate information and misinformation. It can be hard to tell if the information is from a reputable source. What are some trusted sources that people could go?

Wallace: Some of the top sources are the <a href="https://covid19.nih.gov/">National Institutes of Health</a>, pharmaceutical companies who are doing the trials, the <a href="https://www.cdc.gov/coronavirus/2019-ncov/index.html">Centers for Disease Control and Prevention,</a> <a href="https://www.fredhutch.org/en/research/diseases/coronavirus.html">Fred Hutch’s COVID-19 page</a>, the <a href="https://coronaviruspreventionnetwork.org/">COVID-19 Prevention Network</a> and <a href="https://preventcovidwa.org/">PreventCovidWA.org</a>.

How can we tell whether a report or article is true or misinformation?

Wallace: When I'm working with people around how to distinguish between misinformation and accurate information, I look to see if there are links to reference articles and whether it was published in a peer-reviewed journal. I also look to see if there a date on the article and is it from some anonymous person or do they actually have a name of the author of the article. I see a massive amount of information from anonymous sources who [claim to be] a nurse or a doctor but they never say what their affiliation is and they never say their name. I think it's really important that we arm ourselves to better distill this information and to be able to navigate it effectively.

Gupta: I want to add that when people [show me these articles] I always ask them what the sources of where they got them. I might say “What is it that is leading you to trust this piece of information?” I have a lot of friends who are still hesitant [about getting a vaccine], educated friends with advanced degrees but they still have questions. Understanding their motivation or their distrust is something I really try to get to with all my friends and family as well.

How will we ensure we're being inclusive in the workplace, with our guidance for vaccinated and unvaccinated Starbucks partners, as many partners can't get vaccinated due to medical, personal or religious reasons? How will we make sure our store leaders are doing what's right through the lens of inclusion?

May Jensen: We all have the lens of Our Mission and Values as leaders and partners at Starbucks, which is around creating a culture of warmth and belonging for everyone. And, as we know, there are so many different nuances to making the decision to get vaccinated or not. And we need to be respectful of those decisions and be inclusive of our partners.

And so a couple of things that we can just make sure we recommend is that how are we leaning in and creating a support system as leaders and partners for each other, asking questions about like “How are you doing today? How are you feeling, given the current environment? What do you need from me as a partner or leader to help you through this time?” Rather than asking “Have you been vaccinated yet?” because that obviously implies a bias.

So we're actually putting together a lot of tools and resources for our leaders in the stores, to be able to engage in these conversations appropriately and supportively with our partners.

Dr. Stephaun Wallace and Dr. Amitabha Gupta from Fred Hutchinson Cancer Research Center answered Starbucks partners questions about COVID-19 vaccines during a virtual open forum.

9 things to know about COVID-19 vaccines: Starbucks, Fred Hutch host panel

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Scientists from Fred Hutchinson Cancer Research Center and thousands of Starbucks partners joined for a virtual “Conversation with Leaders on the Frontlines of COVID-19” to talk variants, vaccines and the path forward.

About a year ago, Dr. Tom Lynch had just started his new job as president and director of the Fred Hutchinson Cancer Research Center in Seattle when two scientists asked to meet with him.

“Tom, we’ve got a problem,” they told him. The researchers were Dr. Trevor Bedford and Dr. Steve Pergam, both associate professors at Fred Hutch’s Vaccine and Infectious Disease Division who had been monitoring reports of COVID-19 cases, which had been newly identified in the United States. A computational biologist, Bedford had <a href="https://nextstrain.org/">developed a model</a> that showed that the novel virus was not only in the area but had been silently spreading for weeks.

Fast forward to today and <a href="https://www.fredhutch.org/en.html">Fred Hutch</a> is now at the heart of research into COVID-19. Long&nbsp; known for developing groundbreaking treatments and cures for cancer, it’s also renowned for its work on viruses and is the home of the world’s largest HIV vaccine trials network. As part of Operation Warp Speed, Fred Hutch is also leading clinical trials for promising experimental COVID-19 <a href="/Users/landerso/AppData/Local/Microsoft/Windows/INetCache/Content.Outlook/2E16FXW6/preventcovid.org">vaccines and treatments</a>.&nbsp;

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On Thursday, Lynch and Bedford, along with Fred Hutch’s Dr. Michele Andrasik and Dr. Catherine Liu, spoke to thousands of Starbucks partners from stores and company headquarters during a video panel about COVID-19. It’s part of an occasional series of conversations held by Starbucks for partners about large societal issues. During the hour-long panel, Fred Hutch researchers helped separate fact from fiction on what’s known about the virus, the vaccines and how long antibodies last, and discussed racial health disparities.

“Fred Hutch researchers are on the frontlines of the COVID pandemic tracking the virus and working on some of the significant phase three (vaccine trial) tasks,” said Starbucks chief executive officer Kevin Johnson, introducing the members of the panel.

In addition to Johnson, they were joined on screen by Shannon Garcia, Starbucks senior vice president of operations, and Becky Elias, director of global retail quality assurance for Starbucks.

Last month, Starbucks began working with Washington State Gov. Jay Inslee and others <a href="https://stories.starbucks.com/stories/2021/offering-to-serve-starbucks-joins-effort-to-help-speed-covid-19-vaccination-delivery/">to support accelerated, safe and equitable vaccine distribution and administration</a>, applying its knowledge about serving 100 million customers a week through 30,000 stores around the world to streamlining vaccination centers.

“We want to help get more people vaccinated and share the best practices with other states across the country,” Johnson said.

Will vaccines protect against COVID-19 variants?

As of this week, more than 27 million people in the United States had tested positive for COVID-19 and more than 475,000 &nbsp;have died.

Bedford’s <a href="https://www.fredhutch.org/en/news/center-news/2020/03/tracking-covid-19-trevor-bedford.html">early modeling of the spread of the virus</a> made him a trusted source for many around the world. His Twitter followers, which shot to more than 300,000 in the wake of the pandemic, include renowned researchers, laypeople and celebrities. Now he’s looking at how the new COVID variants in the UK, South Africa and Brazil affect what happens next and what they mean for the current vaccines.

Research shows the UK variant is more transmissible, contains higher viral loads and results in as many as 30 percent more hospitalizations and deaths, said Bedford. He expects that by the end of March, it may account for 50 percent of the cases in the United States. The variant was detected recently <a href="https://www.washington.edu/coronavirus/2021/02/09/uk-coronavirus-variant-detected-at-the-uw-message-to-seattle-campus-students-and-employees/">in a University of Washington student</a>.

The good news is that the Pfizer and Moderna vaccines, which use genetic molecules called &nbsp;mRNA to trigger an immune response, seem to be effective so far against the variants from the UK, Brazil and South Africa, he added. And even those vaccines that are less effective are still protective against the severe forms of the disease. The changing landscape does mean that some vaccines will probably need to be reformatted at a global scale, he said. And in the future, people may need to get an annual COVID shot to protect against new variants, just as we do with the flu.

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“It’s going to be a battle between how quickly we can vaccinate people and seasonality and the divergent spread (of this variant),” he said.

Now that the vaccines exist, they could be changed seasonally and targeted geographically.

What we can learn from Rita Hanks’ antibodies

There’s been a lot of confusion about what kind of protection those who have recovered from COVID will have. Lynch, the Fred Hutch president, confessed to the panel that “not everything I read is the New England Journal of Medicine” and said he’d recently read in People magazine that actor Rita Hanks who, along with her husband, Tom, were among the earliest patients to have COVID-19, no longer has detectable antibodies to protect against the virus. What can we learn from that, he asked Bedford?

There’s a really important distinction between antibodies from “natural infection” from those who have had the virus and those who have antibodies resulting from a vaccine, said Bedford. Those who are asymptomatic or had a mild case often have a lower amount of antibodies that wane significantly over time. That’s why vaccination is key, even for those who have already had the virus. The data on those who’ve been vaccinated with the Pfizer or Moderna shots show a “really nice high level of antibodies,” he said. “That’s why, even if someone has had COVID … getting vaccinated will bring them up to a level that is protective and there hasn’t been as much waning with that.”

While vaccines are still in short supply and many who want them can’t get them,<a href="https://www.fredhutch.org/en/news/center-news/2021/01/covid-19-vaccine-safety.html"> others remain skeptical about them</a>, especially in Black, indigenous and people of color (BIPOC) communities. Those are also the communities who are disproportionately affected with higher rates of infections and deaths. Rates of hospitalization in some BIPOC communities are up to <a href="https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/coronavirus-infection-by-race/faq-20488802">five times higher</a> than in people who are white, according to the Centers for Disease Control and Prevention.

“We are being decimated,” said Dr. Michele Andrasik, director of community engagement for the COVID-19 Prevention Network and senior staff scientist with Fred Hutch’s Vaccine and Infectious Disease Division. “In many situations across our indigenous communities and in rural Black communities, the rates of hospitalization and deaths are just staggering.”

While the Pfizer and Moderna vaccines have efficacy rates of around 95 percent – notably high compared to other vaccines, such as flu shots which are around 60 percent, she said – some people question whether they can trust the vaccines and the speed at which they were developed.

“Many communities have a long and sordid history with medicine, with research,” Andrasik said. “I think it’s incredibly important to acknowledge that and to address some of that and discuss how those past indiscretions and unethical instances have really led to a more ethically focused science in BIPOC communities.

“Personally, I would be shocked if people of color, BIPOC, people were not skeptical. I think it’s a healthy coping mechanism to question.”

Andrasik said it’s important for those in the medical community to listen and validate those concerns. She tries to make sure people are getting their information from reputable places. “I ask my cousins, for example, where exactly did you get that information and can you trust that information to be true?”

While some are hesitant about the vaccines, believing they were developed so fast that they shouldn’t be trusted, Andrasik is quick to point out that the foundational work of the mRNA vaccines has actually been going on for several decades. One of the key scientists who developed the Moderna vaccine is Dr. Kizzmekia Corbett, a Black woman, who, “along with the vaccine research center team of National Institutes of Health, have been working on this for 17 plus years, so this is not new,” Andrasik said. “I think that’s critical.”

What is the risk of vaccine side effects or reaction?

As vaccines are rolling out to larger groups of people, Dr. Catherine Liu, a physician and professor in Fred Hutch’s Clinical Research and Vaccine and Infectious Disease divisions, said she gets a lot of questions about side effects and what’s normal.

The most common vaccine side effect, she said, is soreness at the injection site. Some people may also experience fatigue, headaches, body aches or low-grade fevers. Most of the side effects go away after a day or two, she said.

While it might be tempting to try to curb side effects right before getting the vaccine by taking Tylenol or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, the current recommendation is to avoid it, Liu said. “There’s not really a lot of data about whether this could impact vaccine-induced immune response, so, in the absence of data, the guidance is to avoid pre-medication,” she said.

While reports of people having an anaphylactic reaction to the vaccine have made headlines, Andrasik stressed that it’s important to look at those in the context of how many vaccines were given out. As of early January, out of 4 million people vaccinated with Moderna, 10 people had an anaphylactic reaction, she said, and out of 2 million doses of Pfizer, 21 cases were reported.

“It’s incredibly rare,” she said, “but all of the vaccination sites have an integral protocol they follow so you will stay and be monitored after your vaccination.”

Staying safe: ‘The three Ws’ and double masks

With new COVID variants circulating and a long waiting list to get a vaccine, it’s more important than ever to take precautions, said Lui.

The core safety measures &nbsp;are ‘the three Ws’: wear a mask, watch your distance between others and wash your hands. It’s also important to avoid non-essential travel and crowds. “Those are key strategies to prevent transmission in the face of these new variants,” she said. “And when it does become your turn and we have vaccine available, please go get vaccinated.”&nbsp;

Earlier this month, the CDC also recommended that people wear a multi-ply mask, which could be a mask with two or more layers, or to “double mask”, practices that are <a href="https://stories.starbucks.com/press/2020/what-customers-need-to-know-about-starbucks-response-to-covid-19/">now also Starbucks policy</a>, based on guidance from the Centers for Disease Control and Prevention earlier this month.

The CDC recommendation was based on data that suggested wearing a mask correctly can reduce exposure by about 95 percent compared to not wearing a mask, she said. The key is to make sure it really fits well. That means using one with a wire that can be bent to fit around your nose and that fits snugly against your face without any gaps.&nbsp;&nbsp;

A Starbucks partner asked Liu, a physician who specializes in the prevention and treatment of infectious diseases, whether wearing a mask can decrease a person’s oxygen saturation. Several studies have looked at that, she said, and didn’t find any evidence that wearing a mask reduces the ability to breathe in oxygen and eliminate carbon dioxide.

Liu said that pandemic fatigue is very real and that it can be hard to keep up all the safety measures but that the new variants may be able to take advantage of lapses in protection. “It’s just very important for us to not let our guard down as we get really close to protecting the larger community with the vaccine ramp up.”

As the panel wound down, Lynch, the president of Fred Hutch, said he’s convinced that cancer will be cured at some point, maybe not in our lifetimes, but in those of our children. But “viruses are going to be with the world for the rest of humanity,” he said. “They’re not going anywhere.”

Just as with COVID’s emergence, the threat of new viruses will always be real. One of the things COVID has exposed is the need for more infectious disease resources.

“By having a combination of epidemiologists like Trevor, the therapeutic people like Catherine, the vaccine developers like Michele, and the clinical trial structure to be able to try new things, that's kind of one of the things [Fred Hutch] is committed to doing even after COVID is dissolved.”

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For more information on Fred Hutch and how to support research on cancer and COVID-19 or to get research updates, click <a href="http://fredhutch.org/starbucks">here</a>. You can also support Indigenous communities hard hit by the pandemic by donating personal protective equipment through <a href="https://www.amazon.com/hz/wishlist/genericItemsPage/1T2BK2H85VGKB?sort=default">Fred Hutch’s Amazon wish list.</a>

Header image: Healthcare workers at SCCA get vaccinated with the Pfizer&nbsp;COVID-19 vaccine, December 18, 2020 at the Seattle Cancer Care Alliance in Seattle, Washington. Photo by Robert Hood, Fred Hutch

Female nurse getting vaccine needle ready

On Thursday, a team of researchers from Fred Hutch spoke to thousands of Starbucks partners (employees) during a video panel about COVID-19.

What you need to know about COVID-19: Fred Hutch scientists, Starbucks join for panel

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