WEBVTT - COVID-19 Chapter 13: Vaccines, Take 2

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<v Speaker 1>Hi everyone. My name is Ashley Pleasant. I work as

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<v Speaker 1>a paralegal and Tyler, Texas, but I love about an

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<v Speaker 1>hour away in Wood County with my mom and stepdad.

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<v Speaker 1>Tyler is a college town, but the surrounding area, including

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<v Speaker 1>my county, is very rural. I think people have had

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<v Speaker 1>a false sense of security that COVID wouldn't come here,

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<v Speaker 1>but in reality, our low population in city could only

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<v Speaker 1>delay its arrival. My family and I have been taking

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<v Speaker 1>all the precautions we can since the nationwide lockdowns begin

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<v Speaker 1>happening in March and April. We only leave the house

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<v Speaker 1>go to work in the store. We wear multi layer

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<v Speaker 1>cloth masks every time we leave the house, we wash

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<v Speaker 1>our hands, use hand sanitizer frequently, and we stop seeing

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<v Speaker 1>anyone in person. Socially but not At the beginning of October,

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<v Speaker 1>COVID still found us. It started off like a mild cold.

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<v Speaker 1>My mom started experiencing mild fatigue and a cough. We

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<v Speaker 1>were slightly worried, but trying not to read too much

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<v Speaker 1>into it. I mean, we were being careful after all.

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<v Speaker 1>Within three days, though, I started having the same symptoms.

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<v Speaker 1>Stepdad the day after me and my eighty seven year

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<v Speaker 1>old grandmother. The day after him. We were still trying

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<v Speaker 1>to not worry too much. I mean, colds are common

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<v Speaker 1>and still happen even during a pandemic. That all changed, though,

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<v Speaker 1>the night my mom decided to grill hamburgers. I realized

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<v Speaker 1>we had a serious problem when I couldn't smell the charcoal,

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<v Speaker 1>grill or cooking burgers. After that, we couldn't keep telling

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<v Speaker 1>ourselves it was just a cold. Over the course of

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<v Speaker 1>the next week, all four of us were tested, and

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<v Speaker 1>all four of our test came back positive for COVID.

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<v Speaker 1>The second week of symptoms felt more severe, with more

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<v Speaker 1>extreme fatigue and coughing, as well as headaches, body aches,

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<v Speaker 1>and a loss of appetite. None of us really ran fever,

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<v Speaker 1>with the exception of my grandmother for just one morning.

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<v Speaker 1>She was struggling with dementia and wasn't eating or drinking enough.

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<v Speaker 1>My mom and I had to get her to drink

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<v Speaker 1>fluids every hour to keep her hydrated and keep her

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<v Speaker 1>fever down, and we had to make sure she was

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<v Speaker 1>eating so she didn't get too weak. We meddled through

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<v Speaker 1>well enough for a few weeks, feeling pretty crummy but managing.

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<v Speaker 1>Around the end of October, We felt like we'd made

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<v Speaker 1>it through the worst of things and we were starting

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<v Speaker 1>a slow recovery process. My grandmother had even gotten a

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<v Speaker 1>mostly clean bill of health from her doctor and was

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<v Speaker 1>getting up and walking around more. We really thought we

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<v Speaker 1>were in the clear. Then at four o'clock in the

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<v Speaker 1>morning on October twenty fourth, I heard my grandmother call

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<v Speaker 1>out from my mom while I was on my way

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<v Speaker 1>to bring her a drink of water. When I got

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<v Speaker 1>to her, she was having difficulty breathing. She was still

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<v Speaker 1>aware and talking, but she couldn't take air in properly.

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<v Speaker 1>I ran to get my mom called an ambulance, and

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<v Speaker 1>within fifteen minutes she was gone. My mom, stepdad, and

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<v Speaker 1>I are still experiencing mild symptoms from COVID two and

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<v Speaker 1>a half months later. I personally still have shortness of breath, fatigue,

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<v Speaker 1>trouble concentrating, and are destappetite. We're all still struggling with

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<v Speaker 1>the fact my grandmother isn't here this year for the holidays.

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<v Speaker 1>This is something no family should have to go through.

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<v Speaker 1>But this pandemic only ends if we all do our part.

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<v Speaker 1>So please everyone, were your masks, wash your hands, stay safe,

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<v Speaker 1>and save a life.

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<v Speaker 2>Thank you.

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<v Speaker 3>My name is Rhiannon. I live in central Florida.

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<v Speaker 4>I work as a paralegal for a small family law firm,

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<v Speaker 4>and I am a volunteer participant in the Phase three

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<v Speaker 4>trial of the COVID nineteen vaccine produced by Pfizer. Before

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<v Speaker 4>my first visit, I had a pre screening eligibility phone

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<v Speaker 4>call with someone from the study. She mentioned that it

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<v Speaker 4>was one hundred and fifty dollars per visit and I

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<v Speaker 4>was like, ooh, well, I guess it's worth it to

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<v Speaker 4>be able to participate. Then she mentioned that they would

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<v Speaker 4>add the money to a debit card starting at my

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<v Speaker 4>first visit. It took a minute to register that they

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<v Speaker 4>would pay me. In late August, I went to my

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<v Speaker 4>first appointment. They took a blood sample, gave me a

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<v Speaker 4>pregnancy test and a COVID test, had me complete and

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<v Speaker 4>sign an informed Consent form. I gave them my complete

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<v Speaker 4>medical history, and finally they injected me with the vaccine

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<v Speaker 4>or placebo. They sent me home with the thermometer, a

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<v Speaker 4>copy of the informed consent form, an emergency information card

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<v Speaker 4>in case I have to go to the er during

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<v Speaker 4>the study, and a swab test kit that I can

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<v Speaker 4>administer myself and mail in if I develop symptoms and

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<v Speaker 4>can't get tested right away. Three weeks later, at my

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<v Speaker 4>second visit, they gave me another pregnancy test COVID nasal

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<v Speaker 4>swab and a second injection, which was the same as

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<v Speaker 4>the first. They administer either vaccine, vaccine or placebo placebo.

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<v Speaker 4>About a month after that, I returned from my third visit,

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<v Speaker 4>during which they drew blood to check and to body levels.

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<v Speaker 4>My fourth visit will be in March of twenty twenty one,

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<v Speaker 4>and then I'll return for at least a fifth and

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<v Speaker 4>a sixth visit over the next twenty months. This is

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<v Speaker 4>an observer blind study, so they will not tell me

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<v Speaker 4>whether I receive the vaccine or placebo until it's over.

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<v Speaker 4>They also don't share with me the results of my

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<v Speaker 4>blood tests. Once a week, I'm asked to complete an

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<v Speaker 4>illness diary through an app on my phone. I simply

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<v Speaker 4>answer yes or no to the question of whether I

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<v Speaker 4>have developed any symptoms of COVID nineteen. So far, I've

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<v Speaker 4>been able to answer no every week. After my first injection,

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<v Speaker 4>I felt nothing, no pain that the injection site, no

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<v Speaker 4>indication of any side effects at all. After the second injection, though,

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<v Speaker 4>my arm was sore for days, it was itchy, and

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<v Speaker 4>there was a raised bruise of the injection site. I

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<v Speaker 4>was cautiously optimistic that I had received the vaccine. Actually

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<v Speaker 4>I was pretty thrilled. I worked from home most of

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<v Speaker 4>the time, but I had worked in the office one

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<v Speaker 4>Thursday in late October, and by the following Monday, two

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<v Speaker 4>of my four coworkers.

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<v Speaker 3>Had symptoms and tested positive.

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<v Speaker 4>By the next week, a third coworker was also positive

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<v Speaker 4>and symptomatic. Knowing that I had been exposed, I got

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<v Speaker 4>tested and was negative. At that point, I was pretty

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<v Speaker 4>sure that the vaccine had made me well. Immune is

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<v Speaker 4>the right word, but invincible is how I felt. So

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<v Speaker 4>in November I asked my primary care physician for an

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<v Speaker 4>order for an antibody test.

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<v Speaker 3>It came back negative. I was so disappointed.

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<v Speaker 4>I don't know what will happen when the vaccine is

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<v Speaker 4>approved and available. The study doctor said that I would

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<v Speaker 4>not be at a disadvantage for having participated in the tree.

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<v Speaker 4>He sent a letter a couple of weeks ago saying

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<v Speaker 4>that they were quote exploring potential ways to change the

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<v Speaker 4>study to create a process that would allow interested participants

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<v Speaker 4>in the placebo group who meet the eligibility criteria for

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<v Speaker 4>early access in their country to cross over to the

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<v Speaker 4>vaccine group in the study.

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<v Speaker 3>End quote.

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<v Speaker 4>At my first visit, the doctor in charge of the

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<v Speaker 4>research facility asked me why I decided to take part

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<v Speaker 4>in the study. I was speeciless for a moment, thinking, see,

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<v Speaker 4>there's this podcast Aaron and Aaron got me all excited

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<v Speaker 4>about vaccines and medical research even before the pandemic. And

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<v Speaker 4>I was really excited for this opportunity to not only

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<v Speaker 4>take part in an important study, but to see for

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<v Speaker 4>myself how informed consent forms look these days, because you know,

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<v Speaker 4>they haven't always been like this. But before I found words,

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<v Speaker 4>he said that most people tell him they're just so

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<v Speaker 4>tired of all this and want to help things get

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<v Speaker 4>back to normal as fast as possible.

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<v Speaker 3>I nodded and said that yes, I just wanted to help.

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<v Speaker 4>Our converse station was over pretty quickly, so I never

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<v Speaker 4>got to tell them the rest that I don't believe

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<v Speaker 4>things are ever going to get back to normal because

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<v Speaker 4>some things have changed forever. That this could be my

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<v Speaker 4>one chance as a paralegal to help save lives through

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<v Speaker 4>medical science. That I feel like it's my duty to

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<v Speaker 4>do what others can't do, and that I'm incredibly grateful

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<v Speaker 4>to live in twenty twenty when so many medical professionals

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<v Speaker 4>have worked tirelessly so that there is already a vaccine.

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<v Speaker 5>Thank you so much, Ashley Henryannon for sharing your stories

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<v Speaker 5>with us. We really appreciate it. And thank you to

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<v Speaker 5>everyone else who is sent in their first hand accounts

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<v Speaker 5>of how COVID nineteen has impacted their lives. I think

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<v Speaker 5>it's so important that we tell these stories and hear

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<v Speaker 5>these stories to know that we're not in this alone,

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<v Speaker 5>and to remind ourselves of the far reaching effects of

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<v Speaker 5>this pandemic.

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<v Speaker 2>Yeah.

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<v Speaker 6>Absolutely, Hi, I'm erin Welsh and I'm erin alman Updyke

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<v Speaker 6>and this is this podcast will kill you.

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<v Speaker 2>Yeah.

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<v Speaker 6>In this episode of our Anatomy of a Pandemic series

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<v Speaker 6>on COVID nineteen, we're revisiting the topic on everyone's minds vaccines.

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<v Speaker 5>Yes, how do these COVID nineteen vaccines work? How do

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<v Speaker 5>we know that they're safe to take? And when will

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<v Speaker 5>they become widely available?

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<v Speaker 2>Great questions, Aaron, Great questions.

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<v Speaker 5>And these questions are just the tiniest sampling of what

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<v Speaker 5>we covered in this super duper info packed episode.

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<v Speaker 6>Really truly, I don't think we've ever packed more information

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<v Speaker 6>into one.

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<v Speaker 2>Episode, Oh my gosh.

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<v Speaker 6>And we are so excited to share with you all

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<v Speaker 6>of the vaccine info you could ever hope for. But

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<v Speaker 6>first we have some very important business to take care of.

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<v Speaker 6>It's quarantin any time. It is quarantin any time. What

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<v Speaker 6>are we drinking this week?

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<v Speaker 7>Well, of course Quarantiny thirteen naturally, and in the Quarantine

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<v Speaker 7>thirteen is bourbon, ginger ale, rosemary, simple syrup, lime juice,

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<v Speaker 7>and muddled blackberries.

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<v Speaker 5>Delicious, it really really is. And also we want to

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<v Speaker 5>give a shout out to Abby and Jesse, who are

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<v Speaker 5>the daughters of one of our guests for this episode,

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<v Speaker 5>doctor Orin Levine, and who sent along a placeibrita version

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<v Speaker 5>of this recipe which they called the Sweet Lady Levine.

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<v Speaker 6>I love it so much, amazing. Thank you both so

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<v Speaker 6>much for the suggestion. It made our lives easier coming

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<v Speaker 6>up with this quarantine and it's delicious.

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<v Speaker 5>Yeah really, I was like, oh my gosh, a recipe

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<v Speaker 5>just here, just gifted.

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<v Speaker 2>This is amazing.

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<v Speaker 5>We will post the full recipe for the Quarantine E

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<v Speaker 5>thirteen along with the non alcoholic Place Verta on our

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<v Speaker 5>website This Podcast will Kill You dot Com as well

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<v Speaker 5>as on all of our social media channels, so make

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<v Speaker 5>sure you follow us there.

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<v Speaker 2>Okay, what else?

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<v Speaker 6>We are of course still soliciting first hand accounts for

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<v Speaker 6>this COVID nineteen series, so if you haven't yet and

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<v Speaker 6>you'd like to submit your first hand account, you can

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<v Speaker 6>go to our website This Podcast will Kill You dot Com,

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<v Speaker 6>click on the COVID nineteen tab and that'll send you

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<v Speaker 6>to a Google form that you can fill out. And

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<v Speaker 6>thank you again so much to everyone who has submitted

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<v Speaker 6>their first hand account so far.

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<v Speaker 5>Absolutely, and we are also in the process of getting

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<v Speaker 5>transcripts done for all of our episodes and we are

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<v Speaker 5>so excited about this really and we will announce on

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<v Speaker 5>our social media when the transcripts are ready for current

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<v Speaker 5>or past episodes, so make sure that you follow us

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<v Speaker 5>on there, and we'll also be posting links to the

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<v Speaker 5>transcripts on our website under the transcripts tab, so you

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<v Speaker 5>can also check back in there periodically if you are curious.

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<v Speaker 2>Yeah.

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<v Speaker 6>Other than that, we have kind of usual business things

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<v Speaker 6>really quick. We have a good Reads list check that out,

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<v Speaker 6>a bookshop affiliate account really phenomenal and amazing tpwky merch.

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<v Speaker 6>You can find links to all of these on our website,

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<v Speaker 6>This podcast will kill You dot Com.

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<v Speaker 5>Okay, Aaron, I think it's finally time to get to

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<v Speaker 5>the meat of this episode.

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<v Speaker 2>I think so too.

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<v Speaker 5>I mean, this is what everyone has been waiting.

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<v Speaker 2>For, really truly, myself included.

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<v Speaker 5>Oh my gosh. At the time of recording this, which

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<v Speaker 5>is December fifteenth, twenty twenty, according to the New York

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<v Speaker 5>Times Coronavirus Vaccine Tracker, there are currently forty one vaccines

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<v Speaker 5>in phase one trials, sixteen in Phase two, sixteen also

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<v Speaker 5>in phase three, five vaccines approved for early or limited use,

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<v Speaker 5>and two approved for full use.

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<v Speaker 6>That is huge, amazing, truly phenomenal.

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<v Speaker 5>Absolutely like remarkable. I can't stop smiling thinking about it.

0:12:32.600 --> 0:12:35.000
<v Speaker 5>It's amazing. It just feels like such a relief, and

0:12:35.040 --> 0:12:38.440
<v Speaker 5>it's really hard to take in like good news, and

0:12:38.480 --> 0:12:40.959
<v Speaker 5>so it sort of feels like it's true.

0:12:41.240 --> 0:12:44.280
<v Speaker 6>The news that there are multiple vaccines that have been

0:12:44.280 --> 0:12:47.679
<v Speaker 6>shown to be effective against this virus that causes COVID

0:12:47.760 --> 0:12:51.000
<v Speaker 6>nineteen is some of the best news that we've had

0:12:51.360 --> 0:12:55.160
<v Speaker 6>in a very long time, and it really does finally

0:12:55.200 --> 0:12:58.640
<v Speaker 6>feel like the light at the end of that very

0:12:58.920 --> 0:13:03.240
<v Speaker 6>very long pandemic tunnel we're living in is finally visible.

0:13:03.960 --> 0:13:07.480
<v Speaker 5>Yes, it really does feel that way, but there are

0:13:07.720 --> 0:13:10.600
<v Speaker 5>many questions that remain. There has been a lot of

0:13:10.679 --> 0:13:14.400
<v Speaker 5>concern about the safety of these vaccines and possible side effects,

0:13:14.640 --> 0:13:19.079
<v Speaker 5>in addition to questions of access and vaccine distribution. And

0:13:19.160 --> 0:13:22.920
<v Speaker 5>to help us address these concerns, we were fortunate enough

0:13:22.960 --> 0:13:28.720
<v Speaker 5>to talk to two amazing scientists two two two how cool.

0:13:29.160 --> 0:13:33.160
<v Speaker 5>Doctor Maria Sunderram, postdoctoral fellow at the University of Toronto

0:13:33.280 --> 0:13:37.440
<v Speaker 5>Center for Vaccine Preventable Diseases and fellow at ICES, a

0:13:37.520 --> 0:13:43.840
<v Speaker 5>nonprofit health research organization, and also doctor Orin Levine, Director

0:13:43.920 --> 0:13:46.760
<v Speaker 5>of Vaccine Delivery at the Bill and Melinda Gates Foundation.

0:13:47.320 --> 0:13:49.840
<v Speaker 6>Both are phenomenal interviews. We can't wait for you to

0:13:49.880 --> 0:13:52.440
<v Speaker 6>hear them. We're going to start with doctor Sundram, who

0:13:52.480 --> 0:13:57.720
<v Speaker 6>answered are many, many, many questions about the vaccines themselves,

0:13:58.000 --> 0:14:00.679
<v Speaker 6>questions like what are the ingredients and how do they

0:14:00.679 --> 0:14:05.240
<v Speaker 6>actually work. We recorded this interview on December fourteenth, twenty twenty,

0:14:05.360 --> 0:14:08.280
<v Speaker 6>so we'll let her introduce herself right after this break.

0:14:36.520 --> 0:14:40.160
<v Speaker 8>So my name is Maria Sundram. I'm an infectious disease epidemiologist,

0:14:40.640 --> 0:14:43.440
<v Speaker 8>and I'm a postdoctoral fellow at the University of Toronto

0:14:43.800 --> 0:14:47.640
<v Speaker 8>Center for Vaccine Preventable Diseases, and I'm also a fellow

0:14:47.640 --> 0:14:51.000
<v Speaker 8>at ICs, which is a not for profit research institute

0:14:51.120 --> 0:14:52.320
<v Speaker 8>in Toronto.

0:14:52.560 --> 0:14:53.640
<v Speaker 2>Excellent, Thank you.

0:14:54.200 --> 0:14:57.640
<v Speaker 6>We're very excited to have you here. Over the last

0:14:57.920 --> 0:15:01.400
<v Speaker 6>month or so, there have been some very optimistic and

0:15:01.480 --> 0:15:05.000
<v Speaker 6>exciting headlines with the emergence of what appears to be

0:15:05.080 --> 0:15:09.960
<v Speaker 6>at least three potentially successful vaccines for SARS CoV two.

0:15:10.520 --> 0:15:13.160
<v Speaker 6>Could you kind of break down what those vaccines are

0:15:13.280 --> 0:15:14.880
<v Speaker 6>and how maybe each of them work.

0:15:15.800 --> 0:15:19.800
<v Speaker 8>Yes, definitely. So I think the three vaccines that we're

0:15:19.840 --> 0:15:24.160
<v Speaker 8>talking about are this Pfiser Beyond Tech vaccine, the MODERNA vaccine,

0:15:24.200 --> 0:15:28.600
<v Speaker 8>and then this vaccine that's being developed by Oxford and Astrosenica.

0:15:28.640 --> 0:15:30.800
<v Speaker 8>And it's worth noting there's a couple other vaccines that

0:15:30.840 --> 0:15:33.080
<v Speaker 8>have been approved for use in other countries, but I

0:15:33.080 --> 0:15:35.000
<v Speaker 8>can just talk about these three. I think they've been

0:15:35.440 --> 0:15:40.280
<v Speaker 8>at the top of our national conversation at least. So

0:15:40.400 --> 0:15:43.240
<v Speaker 8>the Pfiser Beyond Tech and the MODERNA vaccines are both

0:15:43.560 --> 0:15:48.320
<v Speaker 8>mRNA vaccines and the Oxford Astrosedtica vaccine is a non

0:15:48.360 --> 0:15:53.160
<v Speaker 8>replicating viral factor vaccine. Your listeners may know that when

0:15:53.160 --> 0:15:57.880
<v Speaker 8>we're talking about kind of a traditional vaccine, normal vaccine,

0:15:57.960 --> 0:16:01.360
<v Speaker 8>like your seasonal flu shot. What we're doing, we're showing

0:16:01.400 --> 0:16:05.320
<v Speaker 8>our immune systems a dead virus, a killed virus that

0:16:05.600 --> 0:16:08.240
<v Speaker 8>can't infect us, but it's the whole thing. So our

0:16:08.280 --> 0:16:11.640
<v Speaker 8>immune systems are seeing this complete virus that is dead

0:16:11.720 --> 0:16:14.760
<v Speaker 8>and saying, Okay, this is really helpful. Now I know

0:16:14.760 --> 0:16:16.600
<v Speaker 8>what this looks like. I'm going to be prepared for

0:16:16.680 --> 0:16:19.960
<v Speaker 8>next time when I see this one that looks like this,

0:16:20.080 --> 0:16:24.200
<v Speaker 8>but it's alive. So we're starting at an earlier point

0:16:24.200 --> 0:16:27.200
<v Speaker 8>in the process with the mRNA vaccines, And what we're

0:16:27.240 --> 0:16:30.440
<v Speaker 8>actually doing there is we're giving our cells, like the

0:16:30.560 --> 0:16:34.960
<v Speaker 8>IKEA instructions to make one part of the virus, and

0:16:35.040 --> 0:16:37.400
<v Speaker 8>in this case, it's the spike protein, which is this

0:16:37.520 --> 0:16:39.120
<v Speaker 8>protein on the outside.

0:16:38.640 --> 0:16:39.600
<v Speaker 3>Of the coronavirus.

0:16:40.000 --> 0:16:44.040
<v Speaker 8>So our cells are able to produce this protein only

0:16:44.120 --> 0:16:46.840
<v Speaker 8>not the whole virus, but just this protein, and then

0:16:46.880 --> 0:16:50.200
<v Speaker 8>they say, Okay, we're going to protect specifically against this protein,

0:16:50.240 --> 0:16:53.360
<v Speaker 8>which is the protein that we really need to protect against,

0:16:54.280 --> 0:16:55.960
<v Speaker 8>and then we're prepared when we see the whole virus.

0:16:56.000 --> 0:16:59.160
<v Speaker 8>So that's really helpful because it allows us to understand

0:16:59.160 --> 0:17:03.480
<v Speaker 8>how to protect against virus without the risk of actually

0:17:03.520 --> 0:17:07.560
<v Speaker 8>getting ill. And the non replicating viral vector that's in

0:17:07.600 --> 0:17:11.440
<v Speaker 8>the Oxford astrosetic vaccine works kind of in a similar way,

0:17:12.359 --> 0:17:15.439
<v Speaker 8>but instead of us making that protein, we're asking a

0:17:15.480 --> 0:17:18.280
<v Speaker 8>different virus to make that protein. In this case, it's

0:17:18.280 --> 0:17:22.840
<v Speaker 8>an adnovirus, So this is another resttray virus that in

0:17:22.840 --> 0:17:26.080
<v Speaker 8>this case it's usually among chimpanzees. It doesn't really cause

0:17:26.160 --> 0:17:29.120
<v Speaker 8>us any physical discomfort or anything. We probably don't even

0:17:29.200 --> 0:17:33.880
<v Speaker 8>notice that it's there, but we've given that this ad

0:17:33.920 --> 0:17:38.439
<v Speaker 8>novirus the information to also make this spike protein. So

0:17:38.760 --> 0:17:41.720
<v Speaker 8>it's on its little membrane, it's it's showing all of

0:17:41.720 --> 0:17:44.320
<v Speaker 8>its sort of normal adnovirus stuff, and then it's also

0:17:44.320 --> 0:17:47.000
<v Speaker 8>got the spike protein. So our immune system is like, oh, okay,

0:17:47.480 --> 0:17:50.720
<v Speaker 8>there's that thing that I need to protect against now

0:17:50.760 --> 0:17:52.880
<v Speaker 8>I know. So that's kind of that's kind of how

0:17:52.920 --> 0:17:54.399
<v Speaker 8>those those vaccines work.

0:17:54.920 --> 0:17:58.960
<v Speaker 5>Awesome. So let's start at the very beginning, and this

0:17:59.080 --> 0:18:02.000
<v Speaker 5>might be sort of a more general question, but you know,

0:18:02.080 --> 0:18:05.320
<v Speaker 5>what are in these vaccines, Like what are the ingredients

0:18:05.400 --> 0:18:07.439
<v Speaker 5>and what do they do? What do each of them do?

0:18:08.240 --> 0:18:10.680
<v Speaker 8>Yeah, so I did talk a little bit about this already,

0:18:10.760 --> 0:18:13.840
<v Speaker 8>kind of like how the mRNA vaccines work, and then

0:18:13.880 --> 0:18:18.080
<v Speaker 8>how this adnavirus factor vaccine works. The other things that

0:18:18.119 --> 0:18:21.480
<v Speaker 8>are in these vaccines. So for example, the Pfizer vaccine

0:18:21.960 --> 0:18:26.000
<v Speaker 8>has lipids, salts, and sugar, and this is pretty similar

0:18:26.000 --> 0:18:28.600
<v Speaker 8>to what's in the MODERNA vaccine as well. So the

0:18:28.680 --> 0:18:34.200
<v Speaker 8>lipids are these tiny little fat globules, and they're there

0:18:34.320 --> 0:18:38.680
<v Speaker 8>because we want to be able to protect this mRNA

0:18:39.800 --> 0:18:43.600
<v Speaker 8>before it can be absorbed into our cells. And I

0:18:43.720 --> 0:18:47.080
<v Speaker 8>said before that mRNA is kind of like an Ikea instructions,

0:18:47.080 --> 0:18:48.840
<v Speaker 8>and it very much is, but it's not in the

0:18:48.880 --> 0:18:52.760
<v Speaker 8>like book that you get for Mikia. It's like it's

0:18:52.800 --> 0:18:54.760
<v Speaker 8>like it was written on ticker tape or like a

0:18:54.800 --> 0:18:57.679
<v Speaker 8>super long CBS receipt. So it's kind of like you know,

0:18:58.160 --> 0:19:00.280
<v Speaker 8>flapping of the wind a little bit. It's bopping around,

0:19:00.400 --> 0:19:03.160
<v Speaker 8>and it can be really fragile, and so we want

0:19:03.200 --> 0:19:05.160
<v Speaker 8>to make sure that when it, you know, when we're

0:19:05.200 --> 0:19:07.920
<v Speaker 8>giving it to people, that it really like stays intact

0:19:08.040 --> 0:19:10.959
<v Speaker 8>enough so that when it gets to our cells it

0:19:11.040 --> 0:19:13.479
<v Speaker 8>really has something meaningful to say, and our cells can

0:19:13.520 --> 0:19:18.160
<v Speaker 8>read it instead of being confused. So they've charged these

0:19:18.160 --> 0:19:22.760
<v Speaker 8>little fat globs and the charge allows the m RNA

0:19:22.840 --> 0:19:25.359
<v Speaker 8>to stick inside them, so it's really it's almost like

0:19:25.400 --> 0:19:27.679
<v Speaker 8>a little sphere that surrounds the mRNA and protects it.

0:19:28.600 --> 0:19:32.280
<v Speaker 8>The salts are the buffer that's in the Physer Beyon

0:19:32.320 --> 0:19:36.679
<v Speaker 8>Tech and the MODERNA vaccines, respectively, allow all of the

0:19:36.720 --> 0:19:39.359
<v Speaker 8>stuff that's in the vaccine, including the engine and everything else,

0:19:40.000 --> 0:19:43.200
<v Speaker 8>to be the same pH and the same solidity as

0:19:43.240 --> 0:19:46.320
<v Speaker 8>our bodies, and that's really helpful so that we can

0:19:46.600 --> 0:19:50.040
<v Speaker 8>only react to the enigen. And then there's sugar in

0:19:50.080 --> 0:19:53.360
<v Speaker 8>both vaccines as well, and this can help, for example,

0:19:53.720 --> 0:19:56.560
<v Speaker 8>if the vaccine has to be extored at very cold temperatures,

0:19:56.920 --> 0:19:59.879
<v Speaker 8>it can help with the vaccine antigen not being damaged

0:20:00.080 --> 0:20:03.440
<v Speaker 8>that process. And then the Bordertra vaccine also has something

0:20:03.440 --> 0:20:06.960
<v Speaker 8>called sodium acetate, and this can be something that kind

0:20:06.960 --> 0:20:09.840
<v Speaker 8>of holds all of this other stuff together, kind of

0:20:09.840 --> 0:20:14.679
<v Speaker 8>stabilizing everything that's in the vaccine. Because there's there's like

0:20:14.760 --> 0:20:17.480
<v Speaker 8>polar items and then there's non polar items, which would

0:20:17.480 --> 0:20:21.199
<v Speaker 8>be the lipids. It can sort of wind up, you

0:20:21.200 --> 0:20:23.879
<v Speaker 8>know how Salad dressing separates and you've got like the

0:20:24.560 --> 0:20:26.800
<v Speaker 8>oil and the vinegar and you have to like shake

0:20:26.840 --> 0:20:29.280
<v Speaker 8>it up in order to like have it be like palatable.

0:20:29.680 --> 0:20:31.760
<v Speaker 8>So we like obviously don't want our vaccines to be

0:20:31.840 --> 0:20:34.600
<v Speaker 8>like salad dressing that has separated. So so some of

0:20:34.640 --> 0:20:38.320
<v Speaker 8>these things, the sodium acetape for example, can help kind

0:20:38.320 --> 0:20:40.119
<v Speaker 8>of stabilize that, and the buffer can help with that

0:20:40.200 --> 0:20:43.280
<v Speaker 8>as well. And both of those vaccines are preservative free.

0:20:44.000 --> 0:20:44.440
<v Speaker 2>Gotcha.

0:20:45.080 --> 0:20:48.240
<v Speaker 6>So there has been some misunderstanding. I think that we've

0:20:48.280 --> 0:20:51.520
<v Speaker 6>heard a lot that these vaccines have the potential to

0:20:51.640 --> 0:20:54.480
<v Speaker 6>give somebody COVID nineteen And I think you kind of

0:20:54.520 --> 0:20:56.680
<v Speaker 6>touched on this already, but could you kind of explain

0:20:56.760 --> 0:20:59.960
<v Speaker 6>more specifically why that isn't possible in this case?

0:21:00.480 --> 0:21:04.120
<v Speaker 8>Yes, I can, so I understand why this is a concern.

0:21:04.359 --> 0:21:07.600
<v Speaker 8>And there are way in the beginning when we are

0:21:07.600 --> 0:21:13.040
<v Speaker 8>making vaccines, we used attenuated versions of viruses, and that

0:21:13.119 --> 0:21:14.959
<v Speaker 8>means kind of, you know, it was alive, but it

0:21:15.040 --> 0:21:18.560
<v Speaker 8>was you know, kind of limping along, not as effective

0:21:18.640 --> 0:21:21.680
<v Speaker 8>as a sort of natural infection against some of these

0:21:21.880 --> 0:21:24.520
<v Speaker 8>different pathogens. And that's still the case for some of

0:21:24.560 --> 0:21:26.560
<v Speaker 8>the immunizations that we receive today.

0:21:26.920 --> 0:21:27.080
<v Speaker 2>There.

0:21:27.119 --> 0:21:29.600
<v Speaker 8>For example, there's a live attenuated version of the flu

0:21:29.720 --> 0:21:32.199
<v Speaker 8>vaccine that you can get in a nasal spray. So

0:21:32.240 --> 0:21:34.359
<v Speaker 8>this is an example of a virus that really can't

0:21:34.400 --> 0:21:37.440
<v Speaker 8>cause illness, but is still sort of limping along enough

0:21:37.480 --> 0:21:40.520
<v Speaker 8>for our immune system to really take notice. These vaccines

0:21:40.560 --> 0:21:43.800
<v Speaker 8>that I've just mentioned, they don't contain a whole virus,

0:21:44.320 --> 0:21:47.639
<v Speaker 8>much less one that's alive. As I mentioned, they only

0:21:47.680 --> 0:21:51.120
<v Speaker 8>contain one part of the virus, which is the spike protein.

0:21:52.040 --> 0:21:54.399
<v Speaker 8>And so there's really there's no virus in any of

0:21:54.440 --> 0:21:56.879
<v Speaker 8>these vaccines that I've mentioned, and so it's really just

0:21:56.920 --> 0:21:58.160
<v Speaker 8>not possible. It's just not there.

0:21:59.320 --> 0:22:02.920
<v Speaker 5>So that being said, you know, there is this advisory

0:22:02.960 --> 0:22:06.000
<v Speaker 5>that people who receive the vaccine are still told you

0:22:06.000 --> 0:22:08.320
<v Speaker 5>should still wear a mask. So can you explain why

0:22:08.359 --> 0:22:11.280
<v Speaker 5>people should wear a mask even after getting vaccinated.

0:22:11.880 --> 0:22:14.320
<v Speaker 8>This is a great question. Why should you wear a

0:22:14.359 --> 0:22:18.240
<v Speaker 8>mask even after you've been vaccinated. So one really important

0:22:18.240 --> 0:22:21.040
<v Speaker 8>thing to remember is that after you get the first shot,

0:22:21.440 --> 0:22:24.040
<v Speaker 8>you're gonna have to wait three weeks and you're gonna

0:22:24.040 --> 0:22:26.120
<v Speaker 8>have to go back for another shot, and then you're

0:22:26.119 --> 0:22:28.240
<v Speaker 8>gonna have to wait a little bit after that to

0:22:28.320 --> 0:22:31.080
<v Speaker 8>build the maximum amount of antibodies that we would consider

0:22:31.480 --> 0:22:34.159
<v Speaker 8>for you to be fully vaccinated. And this is actually

0:22:34.160 --> 0:22:37.000
<v Speaker 8>the case for a lot of vaccines. For example, when

0:22:37.000 --> 0:22:39.600
<v Speaker 8>you get your flu shot, you're not considered to be

0:22:39.680 --> 0:22:44.200
<v Speaker 8>truly vaccinated until two weeks later, because that's when your

0:22:44.240 --> 0:22:46.879
<v Speaker 8>body has made sort of the maximum amount of antibody

0:22:46.880 --> 0:22:48.919
<v Speaker 8>that's going to really protect you throughout the flu season.

0:22:49.720 --> 0:22:54.000
<v Speaker 8>So first of all, you're not sort of immune like

0:22:54.200 --> 0:22:58.400
<v Speaker 8>superhero style, like right after you get the first shot. Unfortunately,

0:22:58.640 --> 0:23:01.760
<v Speaker 8>it's gonna take a while, at least five weeks, and

0:23:01.800 --> 0:23:04.080
<v Speaker 8>you have to go back for the second shot, which

0:23:04.160 --> 0:23:06.919
<v Speaker 8>just also like gonna be challenging, I know for some people.

0:23:07.720 --> 0:23:10.040
<v Speaker 8>The other thing is that part of this is about

0:23:10.280 --> 0:23:15.240
<v Speaker 8>humoral versus mucosal immunity. So when we get these shots,

0:23:15.280 --> 0:23:18.840
<v Speaker 8>we're going to have these antibodies in our blood, and

0:23:19.320 --> 0:23:22.280
<v Speaker 8>you and I know that's not where COVID nineteen goes first.

0:23:22.600 --> 0:23:25.520
<v Speaker 8>It doesn't sort of like get injected directly into our skin.

0:23:25.960 --> 0:23:29.280
<v Speaker 8>It comes into our body through our restory pathways, and

0:23:29.320 --> 0:23:32.320
<v Speaker 8>so there are these mucosal surfaces in our nose, in

0:23:32.320 --> 0:23:35.960
<v Speaker 8>our nasopharynx, kind of the back of our nose and

0:23:36.040 --> 0:23:39.960
<v Speaker 8>throat area that also have kind of their own sort

0:23:39.960 --> 0:23:44.679
<v Speaker 8>of unique mucosal defense mechanisms, and there can be cells

0:23:44.960 --> 0:23:50.359
<v Speaker 8>waiting at that mucosal surface for different pathogens. It's not

0:23:50.520 --> 0:23:53.080
<v Speaker 8>clear yet exactly what kind of immunity we might be

0:23:53.119 --> 0:23:57.840
<v Speaker 8>developing from the vaccine at those mucosal surfaces, and so

0:23:58.600 --> 0:24:01.320
<v Speaker 8>if that's not as rob as the immunity that's in

0:24:01.359 --> 0:24:04.960
<v Speaker 8>our blood, we could wind up sort of hosting COVID

0:24:05.040 --> 0:24:10.199
<v Speaker 8>nineteen in our nasal mucosa and then inadvertently, you know,

0:24:10.240 --> 0:24:12.680
<v Speaker 8>sort of like wiping our nose and then like sort

0:24:12.680 --> 0:24:14.920
<v Speaker 8>of exposing someone else to that. It's possible that it

0:24:14.960 --> 0:24:18.520
<v Speaker 8>could happen. Even though we wouldn't experience sort of physical

0:24:18.600 --> 0:24:23.560
<v Speaker 8>discomfort from any sort of colonization, it's still possible that

0:24:23.600 --> 0:24:25.639
<v Speaker 8>we could spread that onto someone else. And it's always

0:24:25.680 --> 0:24:27.720
<v Speaker 8>possible for us to sort of touch a surface and

0:24:27.760 --> 0:24:29.679
<v Speaker 8>then touch something else that someone else may touch and

0:24:29.680 --> 0:24:32.640
<v Speaker 8>then touch their face. So it's not as though we're

0:24:32.680 --> 0:24:37.320
<v Speaker 8>completely cutting off all modes of transmission. We're reducing them

0:24:37.359 --> 0:24:40.480
<v Speaker 8>quite a lot, but it's still maybe possible to transmit

0:24:40.520 --> 0:24:44.639
<v Speaker 8>that virus even if you don't feel unwell. So that's

0:24:44.680 --> 0:24:47.320
<v Speaker 8>why it's a really good reason to continue wearing a

0:24:47.320 --> 0:24:49.879
<v Speaker 8>mask and continue taking those other precautions as will, including

0:24:50.000 --> 0:24:50.719
<v Speaker 8>washing your hands.

0:24:51.400 --> 0:24:52.479
<v Speaker 2>That makes so much sense.

0:24:53.440 --> 0:24:57.199
<v Speaker 6>So kind of looking big picture, what does the timeline

0:24:57.240 --> 0:25:00.360
<v Speaker 6>look like for these vaccines until like we you could

0:25:00.440 --> 0:25:03.399
<v Speaker 6>just go to our doctor or the pharmacy and actually

0:25:03.440 --> 0:25:06.879
<v Speaker 6>get one. What kind of steps are still remaining in

0:25:06.880 --> 0:25:07.480
<v Speaker 6>the process.

0:25:08.280 --> 0:25:10.800
<v Speaker 8>So I will start by saying, I wish I could

0:25:10.880 --> 0:25:15.200
<v Speaker 8>give you a date. I wish I could give myself

0:25:15.240 --> 0:25:17.000
<v Speaker 8>a date and be like, oh, on this day, that's

0:25:17.000 --> 0:25:18.840
<v Speaker 8>when I'm going to go and get vaccinated. I don't

0:25:18.880 --> 0:25:22.560
<v Speaker 8>have that date yet because so much of this process

0:25:22.640 --> 0:25:24.919
<v Speaker 8>is moving so fast, and there are so many different

0:25:25.040 --> 0:25:28.320
<v Speaker 8>moving components, and all of those moving components are happening

0:25:28.359 --> 0:25:32.040
<v Speaker 8>sort of simultaneously. So a couple of things that I'm

0:25:32.119 --> 0:25:34.520
<v Speaker 8>keeping in mind. You know, certainly it's going to be

0:25:34.600 --> 0:25:37.119
<v Speaker 8>longer for you and for me than it would be

0:25:37.160 --> 0:25:40.480
<v Speaker 8>for healthcare workers, older adults, and essential workers. Those people

0:25:40.960 --> 0:25:43.480
<v Speaker 8>have the greatest risk and they need to be prioritized.

0:25:43.520 --> 0:25:46.640
<v Speaker 8>We need to protect them. The additional steps include sort

0:25:46.640 --> 0:25:51.040
<v Speaker 8>of the manufacturing, the delivery, rolled out campaigns, and you know,

0:25:51.119 --> 0:25:54.440
<v Speaker 8>establishment of systems that help people remember to come back

0:25:54.480 --> 0:25:57.600
<v Speaker 8>for their second dose. Again, that can be really challenging.

0:25:58.560 --> 0:26:02.000
<v Speaker 8>So those are all of the steps for vaccines that

0:26:02.040 --> 0:26:06.720
<v Speaker 8>have obtained this emergency use authorization. For vaccines that aren't

0:26:06.800 --> 0:26:09.680
<v Speaker 8>quite there yet, that's another step. So it's really hard

0:26:09.720 --> 0:26:13.480
<v Speaker 8>to say exactly what all of that means. I'm hopeful

0:26:14.200 --> 0:26:17.639
<v Speaker 8>for the fall, but I have to be honest and

0:26:17.680 --> 0:26:19.920
<v Speaker 8>tell you I'm not exactly sure what date.

0:26:22.680 --> 0:26:28.359
<v Speaker 5>Yes, fair, So, even before this pandemic, there was a

0:26:28.640 --> 0:26:32.320
<v Speaker 5>great deal of vaccine hesitancy, and now many people are

0:26:32.400 --> 0:26:36.800
<v Speaker 5>expressing concerns about receiving a vaccine that was developed so rapidly,

0:26:37.359 --> 0:26:40.399
<v Speaker 5>And you know, is that actually a valid concern? And

0:26:40.440 --> 0:26:42.800
<v Speaker 5>maybe by way of answering that, could you walk us

0:26:42.840 --> 0:26:46.480
<v Speaker 5>through some of the steps being taken to ensure safety

0:26:46.520 --> 0:26:49.600
<v Speaker 5>and efficacy of a vaccine, and these vaccines in particular.

0:26:50.040 --> 0:26:53.200
<v Speaker 8>Yeah, this is a great question. So I completely understand

0:26:53.800 --> 0:26:55.640
<v Speaker 8>that when you're not part of these steps, and when

0:26:55.640 --> 0:26:57.840
<v Speaker 8>you're not sort of living and breathing them every day,

0:26:57.920 --> 0:26:59.640
<v Speaker 8>this can be incredibly confusing.

0:26:59.680 --> 0:27:01.680
<v Speaker 2>It's how happens so fast, and.

0:27:01.680 --> 0:27:04.439
<v Speaker 8>So many other things have been happening this year that

0:27:04.520 --> 0:27:07.480
<v Speaker 8>it's just really really hard to sort of put all

0:27:07.480 --> 0:27:10.800
<v Speaker 8>of us in context, and even people like myself who

0:27:11.119 --> 0:27:16.360
<v Speaker 8>are infectious disease epidemiologists by training and by trade, we

0:27:16.440 --> 0:27:19.440
<v Speaker 8>often struggle to keep up with the incredible amount of

0:27:19.480 --> 0:27:23.080
<v Speaker 8>information that's being sort of circulated every day. So I'll

0:27:23.080 --> 0:27:24.879
<v Speaker 8>walk you through some of the steps thats that have

0:27:25.000 --> 0:27:27.840
<v Speaker 8>been taken to ensure the safety and the effectiveness of

0:27:27.920 --> 0:27:31.240
<v Speaker 8>these vaccines. So this is why we do phase one,

0:27:31.359 --> 0:27:34.240
<v Speaker 8>in phase two, in phase three studies, different phases of

0:27:34.240 --> 0:27:38.800
<v Speaker 8>clinical trials. So in phase one studies, in preclinical studies,

0:27:38.840 --> 0:27:41.280
<v Speaker 8>what we're trying to do is identify is this something

0:27:41.320 --> 0:27:44.920
<v Speaker 8>that could help people, but more specifically, is this something

0:27:44.960 --> 0:27:47.600
<v Speaker 8>that could potentially be harmful to people? And we're continuing

0:27:47.640 --> 0:27:51.119
<v Speaker 8>to ask that question about safety in each subsequent phase

0:27:51.119 --> 0:27:54.040
<v Speaker 8>of clinical trials, and in each subsequent phase, we're asking

0:27:54.080 --> 0:27:56.760
<v Speaker 8>more and more people, Hey, are you feeling okay? How

0:27:56.920 --> 0:27:59.159
<v Speaker 8>was that for you? Are you feeling discomfort? You know,

0:27:59.160 --> 0:28:00.720
<v Speaker 8>do you have like a mile headache? We want to

0:28:00.760 --> 0:28:04.480
<v Speaker 8>know about that as well. And that doesn't stop after

0:28:04.640 --> 0:28:08.320
<v Speaker 8>the emergency use authorization or even after full approval from FDA.

0:28:08.880 --> 0:28:11.960
<v Speaker 8>So the US, for example, and this is true in

0:28:11.960 --> 0:28:14.520
<v Speaker 8>other countries too, but specifically in the US, there are

0:28:15.440 --> 0:28:21.159
<v Speaker 8>several different mechanisms for the reporting and sort of identification

0:28:21.920 --> 0:28:25.399
<v Speaker 8>of different safety outcomes for vaccines. One of those is

0:28:25.400 --> 0:28:28.080
<v Speaker 8>called the Vaccine Safety Data Link and another one is

0:28:28.119 --> 0:28:32.000
<v Speaker 8>called VEYERS or the Vaccine Adverse Event Reporting System. So

0:28:32.080 --> 0:28:36.760
<v Speaker 8>these are super fast mechanisms where we're constantly looking to see, Hey,

0:28:37.240 --> 0:28:39.520
<v Speaker 8>is there anyone who received this vaccine that maybe a

0:28:39.560 --> 0:28:42.520
<v Speaker 8>week later they had like a headache still, or they

0:28:42.560 --> 0:28:44.960
<v Speaker 8>had some fatigue, or they know they had some other

0:28:45.000 --> 0:28:46.880
<v Speaker 8>sort of safety outcome We want to know about that.

0:28:47.040 --> 0:28:50.240
<v Speaker 8>Even though this vaccine has been approved by FDA, we're

0:28:50.280 --> 0:28:52.640
<v Speaker 8>going to continue to ask these questions and continue to

0:28:52.680 --> 0:28:56.680
<v Speaker 8>make sure that there isn't, for example, some really super rare,

0:28:57.000 --> 0:29:00.320
<v Speaker 8>one in a million type of event that could make

0:29:00.440 --> 0:29:05.480
<v Speaker 8>us reassess the risk benefit ratio of this vaccine.

0:29:06.080 --> 0:29:09.040
<v Speaker 5>And so along these same lines, can you talk about

0:29:09.080 --> 0:29:12.880
<v Speaker 5>what emergency use authorization means and whether we've seen this

0:29:13.040 --> 0:29:15.920
<v Speaker 5>before and if we have under what circumstances.

0:29:16.880 --> 0:29:20.600
<v Speaker 8>Yes, I will say we have seen emergency use authorization before,

0:29:20.880 --> 0:29:23.680
<v Speaker 8>and maybe one of the best examples is during the

0:29:23.720 --> 0:29:27.240
<v Speaker 8>two thousand and nine swine flu pandemic. During that time,

0:29:27.280 --> 0:29:31.280
<v Speaker 8>we had an EUA to use tamiflu, which is a

0:29:31.280 --> 0:29:34.040
<v Speaker 8>flu anti viral for children less than a year old.

0:29:34.400 --> 0:29:36.560
<v Speaker 8>At the time, it was already approved for children over

0:29:36.600 --> 0:29:39.040
<v Speaker 8>a year old. But we knew during that swine flu

0:29:39.120 --> 0:29:42.600
<v Speaker 8>pandemic that very young children were having really severe outcomes,

0:29:42.920 --> 0:29:45.840
<v Speaker 8>and we were really concerned specifically for that age group,

0:29:45.880 --> 0:29:48.800
<v Speaker 8>and so we said, okay, you know, the available safety

0:29:48.880 --> 0:29:52.720
<v Speaker 8>data indicates that this is probably a good risk benefit

0:29:52.840 --> 0:29:56.440
<v Speaker 8>ratio for children under one year old, and then you know,

0:29:56.480 --> 0:29:59.160
<v Speaker 8>that kind of became part of our pandemic response. So

0:29:59.200 --> 0:30:01.680
<v Speaker 8>it's certainly not the first time that we've used this mechanism,

0:30:01.720 --> 0:30:04.440
<v Speaker 8>and I think it's really important that we do use

0:30:04.480 --> 0:30:06.800
<v Speaker 8>it when we really need it, such as during a

0:30:06.840 --> 0:30:10.760
<v Speaker 8>global pandemic. Euas can only be given based on Phase

0:30:10.760 --> 0:30:14.600
<v Speaker 8>three results or interim results from Phase three studies, and

0:30:14.600 --> 0:30:17.200
<v Speaker 8>those interim results are sort of decided upon by this

0:30:17.480 --> 0:30:21.800
<v Speaker 8>independent Data Safety and Monitoring Board. And then there's this

0:30:21.880 --> 0:30:27.000
<v Speaker 8>expectation that those applications for euas that companies have to

0:30:27.000 --> 0:30:30.360
<v Speaker 8>make formally to FDA when they apply for the EUA,

0:30:30.840 --> 0:30:33.200
<v Speaker 8>they include all of the safety information from their Phase

0:30:33.240 --> 0:30:37.040
<v Speaker 8>one and their Phase two studies and then ideally their

0:30:37.040 --> 0:30:39.680
<v Speaker 8>Phase three study with a median of two months of

0:30:39.760 --> 0:30:43.080
<v Speaker 8>follow up. So that means that not only are they

0:30:43.080 --> 0:30:44.960
<v Speaker 8>assessing safety outcomes, but.

0:30:44.920 --> 0:30:46.480
<v Speaker 2>They're making sure that they're.

0:30:46.440 --> 0:30:49.760
<v Speaker 8>Identifying safety outcomes on this kind of time frame that

0:30:49.800 --> 0:30:51.760
<v Speaker 8>we really think is relevant as well. So they're not

0:30:51.800 --> 0:30:53.520
<v Speaker 8>just looking for the day after and then like two

0:30:53.560 --> 0:30:56.080
<v Speaker 8>days after they forget about it. No, they really are

0:30:56.080 --> 0:30:58.880
<v Speaker 8>looking for quite a long time after people do receive

0:30:58.920 --> 0:30:59.880
<v Speaker 8>this shot.

0:31:01.120 --> 0:31:02.480
<v Speaker 2>Yeah, that makes sense.

0:31:03.520 --> 0:31:06.000
<v Speaker 6>So I feel like you've explained a lot about how

0:31:06.640 --> 0:31:08.760
<v Speaker 6>we've tried to make sure that this is a very

0:31:08.800 --> 0:31:11.800
<v Speaker 6>safe vaccine. But for people who are maybe still a

0:31:11.840 --> 0:31:14.400
<v Speaker 6>bit nervous or a bit scared, could you explain why

0:31:14.520 --> 0:31:17.360
<v Speaker 6>someone maybe doesn't need to be any more afraid of

0:31:17.360 --> 0:31:21.200
<v Speaker 6>this vaccine than any of our usual vaccines like MMR

0:31:21.440 --> 0:31:23.480
<v Speaker 6>or even the seasonal influenza vaccine.

0:31:24.080 --> 0:31:27.360
<v Speaker 8>So I do think it's understandable why people might be

0:31:27.400 --> 0:31:31.920
<v Speaker 8>more hesitant or cautious about this vaccine development process because

0:31:32.040 --> 0:31:35.120
<v Speaker 8>the mRNA and the viral vector vaccines are relatively new

0:31:35.160 --> 0:31:38.640
<v Speaker 8>to us and the development process has been really quick,

0:31:39.000 --> 0:31:41.760
<v Speaker 8>so it is definitely understandable. I think the main thing

0:31:41.800 --> 0:31:44.480
<v Speaker 8>to remember is that all of these vaccines have gone

0:31:44.520 --> 0:31:47.520
<v Speaker 8>through the same evaluation process as all of the other

0:31:47.600 --> 0:31:50.440
<v Speaker 8>vaccines that we've had. So we took the same amount

0:31:50.480 --> 0:31:52.720
<v Speaker 8>of steps and asked the same amount of questions that

0:31:52.800 --> 0:31:56.480
<v Speaker 8>we would have if this vaccine development process had taken

0:31:56.640 --> 0:31:58.880
<v Speaker 8>ten to fifteen years. We just did it in a

0:31:58.960 --> 0:31:59.960
<v Speaker 8>much shorter timeframe.

0:32:00.440 --> 0:32:00.920
<v Speaker 2>And that was.

0:32:00.920 --> 0:32:03.960
<v Speaker 8>Possible because we all decided sort of as a society

0:32:04.640 --> 0:32:07.640
<v Speaker 8>that these vaccines would be incredibly important to all of us.

0:32:08.640 --> 0:32:11.320
<v Speaker 8>So there was a great amount of monetary support of

0:32:11.400 --> 0:32:14.280
<v Speaker 8>political will, and then also tens of thousands of people

0:32:14.360 --> 0:32:16.920
<v Speaker 8>agreed to be participants in these studies as well, and

0:32:17.040 --> 0:32:18.960
<v Speaker 8>that you know, we wouldn't have had a vaccine so

0:32:19.040 --> 0:32:21.680
<v Speaker 8>quickly if people were slower to say, oh, okay, I'm

0:32:21.720 --> 0:32:25.320
<v Speaker 8>gonna I'm going to participate in this study. So they've

0:32:25.440 --> 0:32:28.080
<v Speaker 8>all gone through the same evaluation process and they all

0:32:28.120 --> 0:32:32.400
<v Speaker 8>continue to be assessed with the same safety reporting mechanisms.

0:32:32.720 --> 0:32:35.520
<v Speaker 8>So you know, we're not just skipping steps just because

0:32:35.560 --> 0:32:38.120
<v Speaker 8>you know, this one time it's convenient for us. No,

0:32:38.600 --> 0:32:40.720
<v Speaker 8>we're still adhering to all of those rules. We're not

0:32:40.760 --> 0:32:44.000
<v Speaker 8>cutting any corners there. And again I kind of mentioned

0:32:44.000 --> 0:32:46.560
<v Speaker 8>this a little bit earlier, but the vaccines also cannot

0:32:46.840 --> 0:32:50.320
<v Speaker 8>these mRNA vaccines and the viral vector vaccines that can't

0:32:50.680 --> 0:32:54.920
<v Speaker 8>give you COVID nineteen because they don't contain the virus M.

0:32:55.760 --> 0:32:58.760
<v Speaker 5>Yeah. I also keep thinking about how this is just

0:32:58.800 --> 0:33:02.400
<v Speaker 5>such a high stake situ situation for the companies producing

0:33:02.480 --> 0:33:05.400
<v Speaker 5>these vaccines, like if there's a misstep, if they you know,

0:33:05.440 --> 0:33:08.080
<v Speaker 5>if something happens, like there's a lot on the line.

0:33:08.120 --> 0:33:11.120
<v Speaker 5>And not only that, but just like public faith or

0:33:12.240 --> 0:33:17.840
<v Speaker 5>acceptance or you know whatever of vaccines that's also hugely

0:33:17.880 --> 0:33:19.720
<v Speaker 5>on the line at this point. And so it really

0:33:19.760 --> 0:33:22.440
<v Speaker 5>does seem like there's so much to risk, So why

0:33:22.440 --> 0:33:25.440
<v Speaker 5>would there be steps skipped or something like that, Like

0:33:25.480 --> 0:33:26.800
<v Speaker 5>there's just so much on the line.

0:33:26.960 --> 0:33:29.760
<v Speaker 8>Oh, yes, absolutely, And you know, they have to still

0:33:30.760 --> 0:33:33.520
<v Speaker 8>get the go ahead from FDA. So if they were

0:33:33.520 --> 0:33:36.600
<v Speaker 8>to skip steps and then apply for this EUA, if

0:33:36.600 --> 0:33:39.600
<v Speaker 8>they skip the steps, FDA has to say, you know what, sorry,

0:33:39.640 --> 0:33:43.080
<v Speaker 8>we can't award you this emergency use authorization. We can't

0:33:43.120 --> 0:33:45.800
<v Speaker 8>do it. And that really, just like you said, it

0:33:45.840 --> 0:33:50.360
<v Speaker 8>represents a huge loss of investment for those companies. There's

0:33:50.440 --> 0:33:52.920
<v Speaker 8>really no reason for them to skip steps, and there's

0:33:52.920 --> 0:33:55.880
<v Speaker 8>a lot of reasons for them to not skip those steps.

0:33:56.360 --> 0:33:57.360
<v Speaker 2>Right, exactly.

0:33:57.640 --> 0:34:02.080
<v Speaker 5>Yeah, So much of this concern also that I've seen

0:34:02.440 --> 0:34:06.200
<v Speaker 5>around seems to be centered around potential side effects of

0:34:06.320 --> 0:34:09.760
<v Speaker 5>the vaccines. And you know, we expect to see things,

0:34:10.239 --> 0:34:13.280
<v Speaker 5>or it's not unusual to see things like mild side effects,

0:34:13.320 --> 0:34:15.600
<v Speaker 5>you know, like you mentioned, a slight headache or maybe

0:34:15.640 --> 0:34:19.960
<v Speaker 5>some fatigue, And this happens for many vaccines, including potentially

0:34:19.960 --> 0:34:24.320
<v Speaker 5>the vaccines for sar's Kobe two. And these side effects

0:34:24.400 --> 0:34:27.279
<v Speaker 5>are not really something to worry about because they do

0:34:27.320 --> 0:34:30.759
<v Speaker 5>seem to be short and mild. But how likely is

0:34:30.800 --> 0:34:34.799
<v Speaker 5>it that additional side effects severe or not that we

0:34:34.880 --> 0:34:38.520
<v Speaker 5>haven't yet seen, or even long term side effects may

0:34:38.600 --> 0:34:41.680
<v Speaker 5>emerge later on, you know, months from now, as more

0:34:41.680 --> 0:34:42.920
<v Speaker 5>people take the vaccine.

0:34:43.600 --> 0:34:46.120
<v Speaker 8>So some of these outcomes, as you mentioned, kind of

0:34:46.160 --> 0:34:49.360
<v Speaker 8>like headache, fatigue, what my mom calls just feeling junkie,

0:34:49.480 --> 0:34:53.080
<v Speaker 8>feeling creuddy, you know, maybe like feeling tired, maybe even

0:34:53.160 --> 0:34:56.520
<v Speaker 8>having like a low grade fever for a day. Those

0:34:56.680 --> 0:34:58.759
<v Speaker 8>kind of they're unpleasant, but they kind of mean your

0:34:58.800 --> 0:35:02.400
<v Speaker 8>immune system is working, and so that's that's a really

0:35:02.440 --> 0:35:05.760
<v Speaker 8>good sign for us. And you know, it's a possibility,

0:35:06.760 --> 0:35:11.560
<v Speaker 8>however small, that rare side effects that maybe more serious

0:35:11.840 --> 0:35:14.960
<v Speaker 8>could happen, and that's why we continue to monitor vaccines

0:35:15.000 --> 0:35:18.439
<v Speaker 8>for safety well after they're approved. We still are doing

0:35:18.440 --> 0:35:21.879
<v Speaker 8>safety assessments for flu vaccines, for example. So we take

0:35:21.960 --> 0:35:25.200
<v Speaker 8>that so seriously, and especially, you know, you mentioned with

0:35:25.239 --> 0:35:28.440
<v Speaker 8>COVID nineteen vaccines, there's so much on the line with

0:35:28.719 --> 0:35:31.640
<v Speaker 8>keeping people safe and then you know, proving to people

0:35:32.160 --> 0:35:35.160
<v Speaker 8>that we've made sure that these vaccines are safe and

0:35:35.200 --> 0:35:37.879
<v Speaker 8>okay for them to get. We really take that so

0:35:37.880 --> 0:35:38.719
<v Speaker 8>so seriously.

0:35:39.719 --> 0:35:40.560
<v Speaker 2>Yeah, definitely.

0:35:41.280 --> 0:35:44.399
<v Speaker 6>So speaking of kind of long term side effects, there's

0:35:44.440 --> 0:35:49.520
<v Speaker 6>been some discussion lately of a fear of antibody dependent enhancement,

0:35:50.160 --> 0:35:53.120
<v Speaker 6>which is something that we've only touched very briefly on

0:35:53.120 --> 0:35:54.399
<v Speaker 6>on this podcast, I think in.

0:35:54.360 --> 0:35:58.879
<v Speaker 2>Our deng gay episode. So what do we know, maybe

0:35:58.920 --> 0:35:59.200
<v Speaker 2>if you.

0:35:59.120 --> 0:36:01.560
<v Speaker 6>Could explain for people who don't remember kind of what

0:36:01.640 --> 0:36:04.520
<v Speaker 6>antibody dependent enhancement is, and what do we know about

0:36:04.560 --> 0:36:09.960
<v Speaker 6>the risk of vaccine induced ad with this COVID vaccine

0:36:10.080 --> 0:36:12.200
<v Speaker 6>or maybe I don't know with vaccines in general.

0:36:12.880 --> 0:36:17.080
<v Speaker 8>Yeah, this is a great question. So antibody dependent enhancement

0:36:17.440 --> 0:36:20.759
<v Speaker 8>of disease is kind of this phenomenon where, for example,

0:36:21.400 --> 0:36:23.759
<v Speaker 8>a vaccine might not work in the way that you

0:36:23.800 --> 0:36:26.680
<v Speaker 8>intended it to work, and for DENGI, we know that,

0:36:26.760 --> 0:36:29.000
<v Speaker 8>for example, if you get infected with deng ye zero

0:36:29.040 --> 0:36:32.960
<v Speaker 8>type one, you may recover and ideally you know it

0:36:33.000 --> 0:36:34.719
<v Speaker 8>won't be like that bad of an infection, and it's

0:36:34.719 --> 0:36:37.400
<v Speaker 8>going to be uncomfortable but maybe not terrible. But then

0:36:37.440 --> 0:36:41.000
<v Speaker 8>your risk of more severe disease, including like dengie hemorrhatic fever,

0:36:41.200 --> 0:36:44.120
<v Speaker 8>is really increased if you then get infected with a

0:36:44.160 --> 0:36:48.280
<v Speaker 8>different zero type like two through four. And that's because

0:36:48.360 --> 0:36:52.680
<v Speaker 8>your body has created these antibodies, but those antibodies don't

0:36:52.680 --> 0:36:56.840
<v Speaker 8>neutralize the virus, and so unfortunately, one of two things

0:36:56.880 --> 0:37:00.000
<v Speaker 8>can happen. One of those things is that those antibodies

0:37:00.040 --> 0:37:04.040
<v Speaker 8>then promote the uptake of the virus into for example,

0:37:04.080 --> 0:37:08.080
<v Speaker 8>macrophages other cells in your immune system, and instead of

0:37:08.120 --> 0:37:12.080
<v Speaker 8>destroying the virus, the virus then infects the macrophage and

0:37:12.120 --> 0:37:15.640
<v Speaker 8>then produces more copies of itself. So that's one sort

0:37:15.680 --> 0:37:17.880
<v Speaker 8>of way in which that can sort of make the

0:37:17.960 --> 0:37:20.600
<v Speaker 8>disease more severe. And the other way that's kind of

0:37:20.640 --> 0:37:25.880
<v Speaker 8>generally seen is that we're reacting to this infection in

0:37:25.920 --> 0:37:28.239
<v Speaker 8>a much more severe way than we might have during

0:37:28.280 --> 0:37:31.040
<v Speaker 8>the first time around, and so our bodies are forming

0:37:31.080 --> 0:37:34.759
<v Speaker 8>these immune complexes that are kind of viruses plus a

0:37:34.760 --> 0:37:39.440
<v Speaker 8>bunch of antibodies glommed on, and they're promoting these kind

0:37:39.520 --> 0:37:45.120
<v Speaker 8>of really severe inflammatory chains that kind of really cause

0:37:45.160 --> 0:37:48.640
<v Speaker 8>a lot of discomfort and maybe some really bad side effects.

0:37:49.560 --> 0:37:51.640
<v Speaker 8>So that's kind of like the two main avenues where

0:37:51.640 --> 0:37:55.840
<v Speaker 8>this could happen and where we've seen it potentially happen

0:37:55.880 --> 0:37:59.840
<v Speaker 8>for stuff like Denky. I will say for sarscov two.

0:38:00.200 --> 0:38:03.120
<v Speaker 8>The studies that have been done in animals, the results

0:38:03.120 --> 0:38:07.120
<v Speaker 8>are really variable about which, if any of these things

0:38:07.160 --> 0:38:10.200
<v Speaker 8>could be happening. But what does seem to be consistent

0:38:10.280 --> 0:38:13.400
<v Speaker 8>is that neutralizing antibodies, so anybody that can sort of

0:38:13.840 --> 0:38:18.920
<v Speaker 8>take out the virus, those do protect animals from subsequent challenge,

0:38:18.960 --> 0:38:22.359
<v Speaker 8>so subsequent exposure to that virus on purpose. And we

0:38:22.400 --> 0:38:26.040
<v Speaker 8>do see neutralizing antibodies for these vaccines, the Pfizer and

0:38:26.080 --> 0:38:28.640
<v Speaker 8>Moderna vaccines that have been reported, because that's a really

0:38:28.719 --> 0:38:32.320
<v Speaker 8>good sign that this is not sort of a major

0:38:32.360 --> 0:38:34.920
<v Speaker 8>concern for these vaccines. And I will say as well,

0:38:35.520 --> 0:38:38.680
<v Speaker 8>this hasn't been sort of a focus of the primary

0:38:38.880 --> 0:38:44.000
<v Speaker 8>sort of efficacy or safety outcomes of the vaccines. But

0:38:44.400 --> 0:38:47.800
<v Speaker 8>it's certainly the case that people in both the Pfizer

0:38:47.960 --> 0:38:51.200
<v Speaker 8>and the Moderna clinical trials will have been zero positive

0:38:51.200 --> 0:38:54.200
<v Speaker 8>at baseline. So that means some people, whether they know

0:38:54.280 --> 0:38:57.080
<v Speaker 8>it or not, will have had a Saruscobe two infection

0:38:57.560 --> 0:39:02.080
<v Speaker 8>before they get vaccinated. And we see very favorable safety

0:39:02.080 --> 0:39:05.120
<v Speaker 8>profiles for both of these vaccines, and so we really

0:39:05.160 --> 0:39:07.960
<v Speaker 8>do sort of that's an additional sort of uh, you know,

0:39:08.080 --> 0:39:11.719
<v Speaker 8>notch that can help us feel comfortable about this, but

0:39:11.800 --> 0:39:14.759
<v Speaker 8>we're obviously going to sort of still be assessing that

0:39:14.800 --> 0:39:15.720
<v Speaker 8>particular question.

0:39:16.520 --> 0:39:16.880
<v Speaker 9>M hm.

0:39:17.320 --> 0:39:20.359
<v Speaker 5>Okay, that is good good news, though we haven't seen

0:39:20.400 --> 0:39:26.319
<v Speaker 5>anything yet that's pretty promising. So, speaking of efficacy, what

0:39:26.400 --> 0:39:29.759
<v Speaker 5>do we know so far about the efficacy of these vaccines?

0:39:29.960 --> 0:39:34.120
<v Speaker 5>Can you walk us through also what efficacy versus effectiveness

0:39:34.400 --> 0:39:38.120
<v Speaker 5>means in terms of vaccines and how that translates into

0:39:38.200 --> 0:39:40.480
<v Speaker 5>protection under real world conditions.

0:39:41.320 --> 0:39:45.160
<v Speaker 8>Yeah, So efficacy versus effectiveness this is something that like

0:39:45.280 --> 0:39:50.080
<v Speaker 8>is totally inside baseball. I think emologists and other epidemiologists

0:39:51.040 --> 0:39:55.919
<v Speaker 8>they're very similar actually. So efficacy really refers to how

0:39:55.960 --> 0:39:58.279
<v Speaker 8>something works, either a drug or a vaccine or something

0:39:58.280 --> 0:40:01.879
<v Speaker 8>else in a clinical trial set under ideal conditions where

0:40:01.880 --> 0:40:04.160
<v Speaker 8>we're asking people to keep a diary and like set

0:40:04.200 --> 0:40:06.560
<v Speaker 8>a remind or seven pm, think about if you have

0:40:06.600 --> 0:40:08.560
<v Speaker 8>a headache, and you know, if you do, like write

0:40:08.600 --> 0:40:12.760
<v Speaker 8>that down. So we're like really like very closely following

0:40:12.800 --> 0:40:15.920
<v Speaker 8>everyone that are in these clinical trials. Now, in the

0:40:15.920 --> 0:40:18.400
<v Speaker 8>real world, you can, I'm sure you can imagine a

0:40:18.440 --> 0:40:20.759
<v Speaker 8>lot of differences. For example, I don't check a time

0:40:20.840 --> 0:40:22.520
<v Speaker 8>or at seven pm every night to see if I

0:40:22.560 --> 0:40:26.520
<v Speaker 8>have a headache. So there is like, you know, the

0:40:26.520 --> 0:40:29.359
<v Speaker 8>real world is a little bit messier, and you know,

0:40:29.719 --> 0:40:32.000
<v Speaker 8>things might sort of float away from us. We might forget,

0:40:32.040 --> 0:40:34.200
<v Speaker 8>for example, that we're feeling just a little junkie today

0:40:35.000 --> 0:40:37.040
<v Speaker 8>if something really good is on TV or something. So

0:40:37.400 --> 0:40:39.560
<v Speaker 8>there's a little bit of a difference in terms of

0:40:39.600 --> 0:40:42.320
<v Speaker 8>like how well we know it works in the ideal scenario,

0:40:42.440 --> 0:40:45.840
<v Speaker 8>where like we're absolutely like assessing every possible thing we

0:40:45.880 --> 0:40:48.200
<v Speaker 8>can assess, and we're making sure everyone's coming back for

0:40:48.239 --> 0:40:51.360
<v Speaker 8>their second dose at the right time. In the real world,

0:40:51.480 --> 0:40:53.960
<v Speaker 8>you know, maybe it doesn't happen exactly that way, and

0:40:54.040 --> 0:40:57.239
<v Speaker 8>so we want to make sure that it's also as

0:40:57.280 --> 0:41:00.799
<v Speaker 8>effective and as safe in the real world setting. And

0:41:00.840 --> 0:41:04.560
<v Speaker 8>so that's what effectiveness is. So when we say the

0:41:04.600 --> 0:41:07.320
<v Speaker 8>Pfizer A modern vaccines are about ninety five percent effective,

0:41:08.160 --> 0:41:10.520
<v Speaker 8>that means we're saying, okay, you know, we gave people

0:41:10.560 --> 0:41:13.160
<v Speaker 8>these shots. We try to get them in at the

0:41:13.200 --> 0:41:15.320
<v Speaker 8>time that they were supposed to do for their second shot,

0:41:16.040 --> 0:41:17.880
<v Speaker 8>but you know, they weren't living in a lab. They

0:41:17.880 --> 0:41:20.480
<v Speaker 8>were also kind of at home, like living their own

0:41:20.640 --> 0:41:23.759
<v Speaker 8>normal lives. So when we say that they're about ninety

0:41:23.760 --> 0:41:27.040
<v Speaker 8>five percent effective, that kind of relates to this understanding

0:41:27.080 --> 0:41:30.719
<v Speaker 8>that this is. We think that this is more mirroring

0:41:30.840 --> 0:41:33.520
<v Speaker 8>like a real world scenario than like a you know,

0:41:33.760 --> 0:41:36.600
<v Speaker 8>a very regimented clinical trial. Of course, they're still in

0:41:36.640 --> 0:41:40.800
<v Speaker 8>a clinical trial. So we do after vaccines become available

0:41:40.840 --> 0:41:44.080
<v Speaker 8>for use by like, for example, you and me, we

0:41:44.120 --> 0:41:46.560
<v Speaker 8>do something called a phase four steady And that's kind

0:41:46.600 --> 0:41:49.839
<v Speaker 8>of to assess, like in truly real world conditions where

0:41:49.840 --> 0:41:52.759
<v Speaker 8>people are not participants in a clinical trial, how well

0:41:52.840 --> 0:41:55.200
<v Speaker 8>is this vaccine working. So we're going to continue to

0:41:55.280 --> 0:41:56.120
<v Speaker 8>update that number.

0:41:56.719 --> 0:41:59.359
<v Speaker 6>What do we know at least so far about how

0:41:59.440 --> 0:42:02.600
<v Speaker 6>long in community is expected to last from the various

0:42:02.680 --> 0:42:03.920
<v Speaker 6>vaccines that we have.

0:42:04.840 --> 0:42:07.799
<v Speaker 8>I will say that the existing evidence sort of suggests

0:42:07.880 --> 0:42:12.200
<v Speaker 8>that immunity is what we call durable up until a

0:42:12.239 --> 0:42:14.640
<v Speaker 8>certain point. So we have this kind of durable immune

0:42:14.680 --> 0:42:18.360
<v Speaker 8>response that seems to last for at least a few months.

0:42:18.680 --> 0:42:21.759
<v Speaker 8>And of course we know exactly how long it lasts,

0:42:21.800 --> 0:42:23.840
<v Speaker 8>because we would need a crystal ball into the future

0:42:23.880 --> 0:42:27.759
<v Speaker 8>to know that for sure. The existing evidence, based on

0:42:27.800 --> 0:42:30.080
<v Speaker 8>the follow up that we've been able to have so far,

0:42:30.440 --> 0:42:33.959
<v Speaker 8>suggests that it does last for at least a few months,

0:42:33.960 --> 0:42:35.560
<v Speaker 8>and that is really great news.

0:42:37.880 --> 0:42:40.960
<v Speaker 5>So what are some of the issues with clinical trials

0:42:40.960 --> 0:42:43.920
<v Speaker 5>and vaccine development in terms of getting you know, like

0:42:43.960 --> 0:42:47.440
<v Speaker 5>a representative subsection of the population. And what does this

0:42:47.560 --> 0:42:50.120
<v Speaker 5>mean for who may be able to get a vaccine once,

0:42:50.280 --> 0:42:52.960
<v Speaker 5>you know, once they're ready or once they're all available,

0:42:53.440 --> 0:42:56.280
<v Speaker 5>particularly in terms of like age group or immune status.

0:42:57.120 --> 0:42:59.600
<v Speaker 8>So yeah, so I already mentioned a little bit how

0:42:59.680 --> 0:43:02.640
<v Speaker 8>you know, clinical trials are like not quite like real life,

0:43:03.080 --> 0:43:05.080
<v Speaker 8>and you've touched on something that I think is so

0:43:05.160 --> 0:43:08.120
<v Speaker 8>important that people who are willing to participate in clinical

0:43:08.120 --> 0:43:10.880
<v Speaker 8>trials are often a little bit different than the people

0:43:11.000 --> 0:43:14.160
<v Speaker 8>who are just in our population in general, So they

0:43:14.200 --> 0:43:16.960
<v Speaker 8>represent a sub section of the general for example, the

0:43:16.960 --> 0:43:21.360
<v Speaker 8>general US population. But maybe not every single person. For example,

0:43:21.680 --> 0:43:25.960
<v Speaker 8>frequently clinical trials for vaccines don't include pregnant women, and

0:43:26.040 --> 0:43:30.240
<v Speaker 8>they don't include people with underlying immunosuppressive conditions, like people

0:43:30.320 --> 0:43:34.040
<v Speaker 8>that have MS or my senia gravis. And that's because

0:43:34.080 --> 0:43:36.480
<v Speaker 8>we want to know is this vaccine going to work

0:43:36.480 --> 0:43:39.719
<v Speaker 8>in people that it absolutely definitely should work in people

0:43:39.719 --> 0:43:41.640
<v Speaker 8>whose immune systems are functioning in the way that we

0:43:41.760 --> 0:43:45.120
<v Speaker 8>kind of expect, and unfortunately this can exclude people who

0:43:45.160 --> 0:43:48.040
<v Speaker 8>are at really high risk sometimes, and so this is

0:43:48.239 --> 0:43:52.000
<v Speaker 8>a really challenging sort of push and pull with vaccine development.

0:43:52.600 --> 0:43:56.480
<v Speaker 8>And the other really important component here I think a

0:43:56.480 --> 0:43:58.600
<v Speaker 8>lot of the clinical trials have really tried to address this,

0:43:58.680 --> 0:44:01.719
<v Speaker 8>but it's still very challenging is that there's probably not

0:44:01.840 --> 0:44:06.240
<v Speaker 8>enough outreach to folks who are not white in clinical trials,

0:44:06.320 --> 0:44:09.680
<v Speaker 8>and so that makes it hard to understand exactly is

0:44:09.719 --> 0:44:13.880
<v Speaker 8>this vaccine going to be, for example, better in this community,

0:44:14.000 --> 0:44:16.279
<v Speaker 8>or is it going to be exactly the same, or

0:44:16.320 --> 0:44:19.080
<v Speaker 8>is it going to underperform, you know, so we need

0:44:19.120 --> 0:44:21.720
<v Speaker 8>to make sure that we're getting a really representative sample.

0:44:22.120 --> 0:44:25.200
<v Speaker 8>And then sometimes age too. I mentioned earlier the EUA

0:44:25.400 --> 0:44:28.640
<v Speaker 8>for Tama flu was sort of then applied to children

0:44:28.760 --> 0:44:30.680
<v Speaker 8>under one year of age. A lot of things are

0:44:30.680 --> 0:44:33.560
<v Speaker 8>not tested for children unless the disease is specifically like

0:44:33.719 --> 0:44:37.440
<v Speaker 8>mostly in children, because we have this different sort of

0:44:37.560 --> 0:44:40.120
<v Speaker 8>you know, risk benefit calculus for children. We really want

0:44:40.160 --> 0:44:44.440
<v Speaker 8>to keep them safe from any possible thing that they

0:44:44.480 --> 0:44:45.160
<v Speaker 8>could experience.

0:44:45.200 --> 0:44:45.880
<v Speaker 2>It's unpleasant.

0:44:46.440 --> 0:44:50.800
<v Speaker 8>So what this all means is that we have a vaccine,

0:44:50.800 --> 0:44:54.320
<v Speaker 8>for example, the Pfizer Beyond Tech vaccine that we feel

0:44:54.360 --> 0:45:00.120
<v Speaker 8>really confident about for adults, and there's some inclusion in

0:45:00.000 --> 0:45:03.040
<v Speaker 8>in their clinical trials of children a little bit younger,

0:45:03.600 --> 0:45:06.520
<v Speaker 8>and we need to follow that data a little bit

0:45:06.560 --> 0:45:10.080
<v Speaker 8>more before we can expand those recommendations to children who are, like,

0:45:10.120 --> 0:45:13.000
<v Speaker 8>for example, younger than sixteen. And we'll probably have to

0:45:13.040 --> 0:45:17.160
<v Speaker 8>do separate studies about the safety and effectiveness of these vaccines,

0:45:17.160 --> 0:45:21.680
<v Speaker 8>for example, in pregnant women or people with underlying immunosuppressive conditions.

0:45:21.680 --> 0:45:26.799
<v Speaker 6>Interesting, I've seen a misconception kind of floating around that

0:45:27.000 --> 0:45:31.000
<v Speaker 6>if you've already had COVID nineteen, you don't have to

0:45:31.040 --> 0:45:35.960
<v Speaker 6>get vaccinated, this like immunity passport kind of idea. Can

0:45:36.000 --> 0:45:39.680
<v Speaker 6>you explain please why that is not the case.

0:45:40.600 --> 0:45:45.400
<v Speaker 8>Yes, So I will say for many folks who do

0:45:45.480 --> 0:45:48.919
<v Speaker 8>have an actual COVID nineteen infection, it does appear that

0:45:48.960 --> 0:45:54.120
<v Speaker 8>they're neutralizing anybody does last again at least a few months,

0:45:54.840 --> 0:45:56.960
<v Speaker 8>So that's a good sort of first step. But I

0:45:57.000 --> 0:46:01.560
<v Speaker 8>will say again, it's not clear that between humoral antibody

0:46:01.600 --> 0:46:03.840
<v Speaker 8>and ucoastal antibody. That's kind of this thing that I

0:46:03.840 --> 0:46:06.960
<v Speaker 8>was talking about earlier, where those cells in your nasofarings

0:46:07.040 --> 0:46:09.520
<v Speaker 8>or your nasal mucos are kind of you know, lying

0:46:09.560 --> 0:46:12.920
<v Speaker 8>in wait for that virus at that sort of respiratory

0:46:12.960 --> 0:46:17.480
<v Speaker 8>epithelial interface. It's also not clear, for example, if you

0:46:17.520 --> 0:46:20.560
<v Speaker 8>actually truly have a COVID nineteen infection, how long you

0:46:20.600 --> 0:46:24.400
<v Speaker 8>may shed that virus. So that's another really important difference

0:46:24.920 --> 0:46:29.680
<v Speaker 8>between COVID nineteen infection and receiving a vaccine against COVID nineteen.

0:46:30.280 --> 0:46:32.640
<v Speaker 8>There are reports of people shedding virus for quite a

0:46:32.640 --> 0:46:35.799
<v Speaker 8>long time. You know, even if you were recovered sort

0:46:35.800 --> 0:46:39.120
<v Speaker 8>of physically and you are feeling great and you have antibodies,

0:46:39.800 --> 0:46:42.800
<v Speaker 8>you could still be exposing other people and that's certainly

0:46:42.840 --> 0:46:45.320
<v Speaker 8>not something that you want to do. And then finally,

0:46:45.320 --> 0:46:48.879
<v Speaker 8>it's not really clear from the available data exactly how

0:46:48.960 --> 0:46:52.520
<v Speaker 8>long you're neutralizing anybody's going to last, and so it's

0:46:52.600 --> 0:46:54.799
<v Speaker 8>really tough to say, oh, you know, I was I

0:46:54.800 --> 0:46:58.120
<v Speaker 8>had a COVID nineteen infection in March, so I'm good,

0:46:58.320 --> 0:46:59.360
<v Speaker 8>I'm superman.

0:46:59.440 --> 0:46:59.840
<v Speaker 2>I can do it.

0:47:00.040 --> 0:47:03.799
<v Speaker 8>Where it's really hard to know based on the epidemiological data,

0:47:04.280 --> 0:47:07.680
<v Speaker 8>what's your antibody level, how much of that antibody is

0:47:07.719 --> 0:47:10.640
<v Speaker 8>neutralizing antibody. Are you going to be able to protect

0:47:10.680 --> 0:47:13.120
<v Speaker 8>other people as well from transmission?

0:47:13.160 --> 0:47:14.080
<v Speaker 3>All of that is unclear.

0:47:14.640 --> 0:47:18.000
<v Speaker 8>So I think maybe the last and possibly the most

0:47:18.040 --> 0:47:21.680
<v Speaker 8>obvious thing to mention here is that it's better to

0:47:21.680 --> 0:47:25.120
<v Speaker 8>get vaccinated. It's not as uncomfortable as getting the actual illness,

0:47:25.320 --> 0:47:27.239
<v Speaker 8>and that's why we have vaccines.

0:47:27.480 --> 0:47:31.720
<v Speaker 2>They're much safer. Absolutely, yes.

0:47:32.680 --> 0:47:35.400
<v Speaker 5>So for our listeners who may know someone who is

0:47:35.480 --> 0:47:40.279
<v Speaker 5>hesitant to receive this vaccine, what advice or reassurance can

0:47:40.320 --> 0:47:42.400
<v Speaker 5>you give them that choosing to get one of these

0:47:42.480 --> 0:47:45.640
<v Speaker 5>vaccines is a better option than taking your chances with

0:47:45.719 --> 0:47:46.520
<v Speaker 5>COVID nineteen.

0:47:48.000 --> 0:47:50.439
<v Speaker 8>I think it's important to consider your kind of risk

0:47:50.480 --> 0:47:53.719
<v Speaker 8>benefit measurement. And I'll tell you guys what I'm thinking

0:47:53.760 --> 0:47:56.400
<v Speaker 8>about when I think about my risk benefit measurement. So

0:47:56.480 --> 0:47:59.400
<v Speaker 8>my risk as cases rise in the US and in

0:47:59.400 --> 0:48:02.880
<v Speaker 8>Canada where I am, my personal risk for infection is

0:48:02.920 --> 0:48:07.000
<v Speaker 8>increasing every day. And it's not the risk doesn't just

0:48:07.080 --> 0:48:09.880
<v Speaker 8>represent like a restory illness of like a common cold.

0:48:09.960 --> 0:48:13.200
<v Speaker 8>It's it's a restory illness that could be quite severe

0:48:13.239 --> 0:48:17.239
<v Speaker 8>for me and could give me really unpleasant long term effects.

0:48:17.760 --> 0:48:20.000
<v Speaker 8>And it's also about the risk of me spreading it

0:48:20.040 --> 0:48:23.000
<v Speaker 8>to others that I really love and care about. And

0:48:23.040 --> 0:48:25.920
<v Speaker 8>on the flip side, I the benefit from this potential

0:48:26.000 --> 0:48:28.520
<v Speaker 8>vaccine is that I could be protected against an illness

0:48:28.680 --> 0:48:31.960
<v Speaker 8>that could cause very severe and or long term illness,

0:48:32.200 --> 0:48:34.560
<v Speaker 8>but it would also give me peace of mind. And

0:48:34.600 --> 0:48:36.920
<v Speaker 8>it wouldn't just benefit me, it would likely also benefit

0:48:36.960 --> 0:48:41.759
<v Speaker 8>my community. So for me, that's more than enough to say,

0:48:41.760 --> 0:48:43.200
<v Speaker 8>you know, this is this is a really good thing

0:48:43.239 --> 0:48:45.480
<v Speaker 8>that I'm doing for myself and also for all of

0:48:45.520 --> 0:48:48.279
<v Speaker 8>the people that I care about around me. If you're

0:48:48.280 --> 0:48:50.799
<v Speaker 8>embarking on a convers you know, on a conversation with

0:48:50.840 --> 0:48:53.680
<v Speaker 8>someone you maybe don't see eye to eye with in

0:48:53.760 --> 0:48:56.319
<v Speaker 8>terms of your risk benefit, or maybe they just have

0:48:56.440 --> 0:48:59.239
<v Speaker 8>questions and they're not totally sure. I think it's really

0:48:59.239 --> 0:49:01.719
<v Speaker 8>important to start for a place of common ground and

0:49:01.840 --> 0:49:03.520
<v Speaker 8>kind of lead with empathy. I know that can be

0:49:03.640 --> 0:49:06.040
<v Speaker 8>challenging sometimes, especially if you don't see eye to eye,

0:49:06.760 --> 0:49:09.000
<v Speaker 8>but if you can see kind of common ground in

0:49:09.080 --> 0:49:11.040
<v Speaker 8>terms of like, you know, you care about the people

0:49:11.080 --> 0:49:13.719
<v Speaker 8>around you, or you don't want to be out of

0:49:13.760 --> 0:49:17.880
<v Speaker 8>work for two or three weeks or potentially longer, you know,

0:49:18.120 --> 0:49:20.440
<v Speaker 8>or thinking about like what is important to them, I

0:49:20.440 --> 0:49:23.200
<v Speaker 8>think that's that is really important. And then as much

0:49:23.239 --> 0:49:26.480
<v Speaker 8>as you can sort of just being patient and empathetic

0:49:26.600 --> 0:49:29.320
<v Speaker 8>with the reasons that they might be concerned or the

0:49:30.080 --> 0:49:32.040
<v Speaker 8>way that they're thinking about risk benefit, I think is

0:49:32.040 --> 0:49:36.080
<v Speaker 8>also really important. It can be challenging sometimes, and so

0:49:36.560 --> 0:49:38.879
<v Speaker 8>I also recommend that you take breaks if you get

0:49:38.880 --> 0:49:41.160
<v Speaker 8>really frustrated and be like, you know what, I'm so sorry,

0:49:41.280 --> 0:49:43.040
<v Speaker 8>I have to go right now. I got to go

0:49:43.080 --> 0:49:45.400
<v Speaker 8>to the bathroom, or like I'm just sitting down to dinner,

0:49:45.520 --> 0:49:47.520
<v Speaker 8>or oh, someone just called me, can I call you back.

0:49:47.719 --> 0:49:49.880
<v Speaker 8>I think it's really helpful and important, like take breaks

0:49:49.880 --> 0:49:52.319
<v Speaker 8>and then maybe revisit it when you're feeling like you

0:49:52.400 --> 0:49:56.000
<v Speaker 8>have more, you know, emotional equipment to have that conversation.

0:49:56.880 --> 0:49:59.160
<v Speaker 8>I've been thinking about this a lot, and how great

0:49:59.239 --> 0:50:01.160
<v Speaker 8>it is that we have a vaccine that can be

0:50:01.200 --> 0:50:04.120
<v Speaker 8>delivered to people in the US now. And I was

0:50:04.160 --> 0:50:07.920
<v Speaker 8>really thinking about my mom, who was born before the

0:50:07.960 --> 0:50:11.600
<v Speaker 8>polio vaccine existed, so she was six when the polio

0:50:11.680 --> 0:50:16.000
<v Speaker 8>vaccine became a thing, and at the time, there was

0:50:16.120 --> 0:50:19.319
<v Speaker 8>just huge amounts of celebration. There were literal ticker tape

0:50:19.320 --> 0:50:23.480
<v Speaker 8>parades for this vaccine because it was just this terrifying

0:50:23.840 --> 0:50:27.759
<v Speaker 8>childhood illness that could just be so challenging and so

0:50:27.920 --> 0:50:31.800
<v Speaker 8>terrible for so many people, and it was a huge

0:50:31.840 --> 0:50:34.880
<v Speaker 8>relief to know that we would be able to protect

0:50:35.040 --> 0:50:39.359
<v Speaker 8>children against that. And I have been thinking about, like, man,

0:50:39.400 --> 0:50:41.360
<v Speaker 8>it's kind of a shame that we can't have a

0:50:41.400 --> 0:50:46.160
<v Speaker 8>ticker tape parade for these vaccines, because they represent an

0:50:46.239 --> 0:50:49.799
<v Speaker 8>incredible amount of effort and sacrifice and hard work on

0:50:50.000 --> 0:50:54.080
<v Speaker 8>so many people, including the trial participants, who have given

0:50:54.120 --> 0:50:56.640
<v Speaker 8>their time and their energy for us to know that

0:50:56.680 --> 0:50:59.280
<v Speaker 8>these vaccines are safe and effective. And I really hope,

0:51:00.120 --> 0:51:01.920
<v Speaker 8>as silly as it might seem, I hope that everyone

0:51:01.960 --> 0:51:04.960
<v Speaker 8>gets a chance to set aside some time and truly

0:51:05.640 --> 0:51:08.359
<v Speaker 8>celebrate the fact that this work has been done and

0:51:08.440 --> 0:51:11.120
<v Speaker 8>it continues to happen, and that people are working so

0:51:11.120 --> 0:51:14.240
<v Speaker 8>so hard to help us bring an end to this pandemic.

0:51:14.280 --> 0:51:18.640
<v Speaker 8>It is truly amazing and just a feat I specifically

0:51:18.840 --> 0:51:22.959
<v Speaker 8>the contributions of the people who have been study participants,

0:51:23.040 --> 0:51:26.720
<v Speaker 8>I think is so amazing, and when I think about it,

0:51:26.719 --> 0:51:28.520
<v Speaker 8>it really it kind of gets me choked up because

0:51:28.560 --> 0:51:31.799
<v Speaker 8>it is literally these people are heroes for us. They

0:51:31.840 --> 0:51:36.240
<v Speaker 8>have helped save so many lives and we're very lucky,

0:51:36.280 --> 0:51:38.839
<v Speaker 8>I think, to live in a world where people are

0:51:38.880 --> 0:52:06.600
<v Speaker 8>going to work this hard to keep us safe.

0:52:07.000 --> 0:52:10.560
<v Speaker 5>Thank you so so very much, doctor Sunderum. That was

0:52:10.719 --> 0:52:14.200
<v Speaker 5>such a great interview. It was so fun too. I

0:52:14.320 --> 0:52:17.759
<v Speaker 5>learned so much, so much good information there and I

0:52:17.800 --> 0:52:20.640
<v Speaker 5>feel like, yeah, I feel just a lot more knowledgeable

0:52:20.760 --> 0:52:23.239
<v Speaker 5>about Yeah, the COVID nineteen vaccines. It's been so hard

0:52:23.239 --> 0:52:25.920
<v Speaker 5>to keep up with all of this news, so exactly,

0:52:25.960 --> 0:52:28.160
<v Speaker 5>it was great to have it into like a digestible

0:52:28.320 --> 0:52:29.040
<v Speaker 5>here you go.

0:52:29.160 --> 0:52:29.880
<v Speaker 2>What exactly?

0:52:30.040 --> 0:52:32.760
<v Speaker 6>I agree, it's been even as someone who's like into

0:52:32.800 --> 0:52:36.000
<v Speaker 6>this kind of thing, right, it's really hard to keep up.

0:52:36.120 --> 0:52:39.600
<v Speaker 5>So but Aaron, we're not done yet. No, we're not.

0:52:40.719 --> 0:52:44.040
<v Speaker 6>We're never done. Just kidding, bevery We also wanted to

0:52:44.120 --> 0:52:48.120
<v Speaker 6>learn more about the logistical challenges that we know are

0:52:48.280 --> 0:52:51.279
<v Speaker 6>huge in trying to get this vaccine distributed, both in

0:52:51.360 --> 0:52:54.680
<v Speaker 6>the US and across the globe. And luckily we were

0:52:54.719 --> 0:52:57.839
<v Speaker 6>able to chat with someone whose actual job title has

0:52:58.120 --> 0:53:03.160
<v Speaker 6>vaccine delivery in the name doctor Orrin Levine. This interview

0:53:03.239 --> 0:53:06.440
<v Speaker 6>was recorded on November twenty fourth, twenty twenty, so we'll

0:53:06.520 --> 0:53:09.360
<v Speaker 6>let him introduce himself right after this break.

0:53:41.160 --> 0:53:43.360
<v Speaker 10>I am orn Levine. I'm the Director of the Global

0:53:43.360 --> 0:53:47.000
<v Speaker 10>Delivery Programs at the Bill Winegates Foundation. In this role

0:53:47.040 --> 0:53:51.239
<v Speaker 10>at the Foundation, I lead a series of teams that

0:53:51.520 --> 0:53:56.960
<v Speaker 10>help to both introduce and scale new life saving vaccines

0:53:56.960 --> 0:54:01.680
<v Speaker 10>and improve primary healthcare systems around the world. One of

0:54:01.719 --> 0:54:04.880
<v Speaker 10>the roles that I play externally for the Foundation is

0:54:04.880 --> 0:54:08.280
<v Speaker 10>that I sit on the board of GAVIY, the Vaccine Alliance,

0:54:08.320 --> 0:54:11.120
<v Speaker 10>which is one of the central players in global organizations

0:54:11.280 --> 0:54:15.880
<v Speaker 10>and more recently in KOVACS, the international collaborative effort to

0:54:15.960 --> 0:54:17.400
<v Speaker 10>vaccinate everybody around the world.

0:54:18.840 --> 0:54:23.319
<v Speaker 5>Awesome. Great. So that first question has to do with

0:54:23.360 --> 0:54:26.719
<v Speaker 5>some of the biggest hurdles to vaccine distribution here in

0:54:26.760 --> 0:54:29.279
<v Speaker 5>the US, and just like big picture, what are the

0:54:29.360 --> 0:54:31.800
<v Speaker 5>kind of things that we might see at a national

0:54:31.880 --> 0:54:35.560
<v Speaker 5>level that might make vaccine deployment a little bit more challenging.

0:54:36.239 --> 0:54:41.919
<v Speaker 10>So preparing for the rollout of vaccines in the US

0:54:42.000 --> 0:54:47.800
<v Speaker 10>or anywhere is going to be an effort of unprecedented scale.

0:54:48.400 --> 0:54:51.279
<v Speaker 10>The number of people that we want to try and vaccinate,

0:54:51.560 --> 0:54:54.440
<v Speaker 10>the speed with which we want to vaccinate them, and

0:54:54.960 --> 0:54:57.080
<v Speaker 10>the fact that we need to vaccinate them with not one,

0:54:57.120 --> 0:55:01.400
<v Speaker 10>but two doses of vaccines make the rollout of COVID

0:55:02.000 --> 0:55:07.239
<v Speaker 10>nineteen vaccines kind of scale and complexity that's really going

0:55:07.280 --> 0:55:10.280
<v Speaker 10>to challenge every system around the world. And the challenges

0:55:10.560 --> 0:55:14.600
<v Speaker 10>can be bucketed if you will, into both supply challenges, right,

0:55:14.640 --> 0:55:21.480
<v Speaker 10>So there's a volume of materials logistics that need to

0:55:21.520 --> 0:55:24.400
<v Speaker 10>be sorted out to make sure that the right vaccines

0:55:24.600 --> 0:55:27.600
<v Speaker 10>end up in the right place, with the right supplies

0:55:27.600 --> 0:55:29.799
<v Speaker 10>and the right people to deliver them at the right time.

0:55:31.040 --> 0:55:35.480
<v Speaker 10>And demand issues, and we're seeing the emergence of demand

0:55:35.520 --> 0:55:39.600
<v Speaker 10>issues around the world in the US and elsewhere. Ironically,

0:55:41.120 --> 0:55:44.200
<v Speaker 10>COVID vaccines had an anti vaccine movement even before they

0:55:44.200 --> 0:55:50.799
<v Speaker 10>had vaccines, and that complicates things in terms of the

0:55:50.920 --> 0:55:53.960
<v Speaker 10>acceptance and demand for the vaccine. So I think one

0:55:54.000 --> 0:55:56.799
<v Speaker 10>of the things I worry about in the usnswhere is

0:55:57.680 --> 0:56:01.759
<v Speaker 10>we can't take for grantedvaccine demand. We're really going to

0:56:01.840 --> 0:56:05.080
<v Speaker 10>have to engage with people and listen to them and

0:56:05.160 --> 0:56:08.080
<v Speaker 10>then answer their questions so that they can feel the

0:56:08.080 --> 0:56:12.520
<v Speaker 10>confidence they need to accept the vaccine and get the

0:56:12.560 --> 0:56:15.000
<v Speaker 10>immunity and protection that comes from those and help us

0:56:15.000 --> 0:56:19.480
<v Speaker 10>all to get back to an increased comfort of interacting

0:56:19.520 --> 0:56:20.080
<v Speaker 10>with each other.

0:56:20.920 --> 0:56:24.320
<v Speaker 6>Are there any hurdles that might be different in terms

0:56:24.400 --> 0:56:28.480
<v Speaker 6>of global distribution of the vaccine compared to the hurdles

0:56:28.600 --> 0:56:30.400
<v Speaker 6>in distribution in the US.

0:56:31.160 --> 0:56:35.960
<v Speaker 10>There are some challenges obviously for different places that differ.

0:56:37.239 --> 0:56:39.880
<v Speaker 10>I tend to focus on what brings us together and

0:56:39.920 --> 0:56:44.160
<v Speaker 10>what's more common, but there are some unique characteristics. One

0:56:44.280 --> 0:56:47.040
<v Speaker 10>is access to the supply. As you may know, there's

0:56:47.040 --> 0:56:50.840
<v Speaker 10>a global effort called covax, which is trying to bring

0:56:50.880 --> 0:56:54.240
<v Speaker 10>together high income countries and low income countries to jointly

0:56:54.280 --> 0:56:57.120
<v Speaker 10>fund a portfolio of vaccines that could then help to

0:56:57.200 --> 0:57:01.840
<v Speaker 10>kind of vaccinate the world evenly. That is operating in

0:57:01.880 --> 0:57:04.480
<v Speaker 10>an environment where there's been a lot of bilateral deals

0:57:04.640 --> 0:57:08.560
<v Speaker 10>individual countries kind of locking out vaccines supply for themselves.

0:57:09.040 --> 0:57:12.480
<v Speaker 10>So one of the things that is different is a

0:57:12.560 --> 0:57:15.760
<v Speaker 10>kind of power dynamic and who's laying claim to different

0:57:15.800 --> 0:57:17.479
<v Speaker 10>doses at different points in time.

0:57:18.760 --> 0:57:21.080
<v Speaker 9>There's a financing element to that as well.

0:57:21.840 --> 0:57:24.840
<v Speaker 10>Wealthier countries are typically able to pay more, and that

0:57:25.040 --> 0:57:27.320
<v Speaker 10>sometimes puts them at the front of the line in

0:57:27.360 --> 0:57:31.560
<v Speaker 10>those negotiations. A big reason why covax was created because

0:57:31.680 --> 0:57:35.959
<v Speaker 10>it's I think a shared value of many of us

0:57:36.160 --> 0:57:39.480
<v Speaker 10>that in the middle of a pandemic, vaccine allocation should

0:57:39.480 --> 0:57:42.760
<v Speaker 10>be equitable, not just driven by the lottery of whether

0:57:42.840 --> 0:57:44.720
<v Speaker 10>you happen to live in a country that's wealthier than

0:57:44.760 --> 0:57:45.440
<v Speaker 10>another one.

0:57:45.840 --> 0:57:46.320
<v Speaker 1>Yeah.

0:57:46.360 --> 0:57:50.400
<v Speaker 5>Absolutely, We've heard a lot about different countries pre purchasing,

0:57:50.480 --> 0:57:53.800
<v Speaker 5>as you mentioned, these large stocks of vaccines, and so

0:57:54.080 --> 0:57:58.080
<v Speaker 5>in effect, though we might have several different vaccines available,

0:57:58.280 --> 0:58:01.200
<v Speaker 5>which vaccine will a different country choose and will that

0:58:01.240 --> 0:58:04.200
<v Speaker 5>be determined by what might be available in terms of

0:58:04.240 --> 0:58:08.320
<v Speaker 5>like just the sheer number of vaccine stocks that are

0:58:08.320 --> 0:58:09.640
<v Speaker 5>already pre purchased.

0:58:10.360 --> 0:58:13.120
<v Speaker 10>Yeah, I think Aaron that that's going to be one

0:58:13.120 --> 0:58:13.400
<v Speaker 10>of the.

0:58:13.480 --> 0:58:16.080
<v Speaker 9>Complex parts of this of this rollout.

0:58:16.480 --> 0:58:23.000
<v Speaker 10>As different vaccines emerged with different characteristics and different efficacy

0:58:23.320 --> 0:58:28.160
<v Speaker 10>and different price, you'll have preferences by different countries for

0:58:28.200 --> 0:58:32.880
<v Speaker 10>these pieces. So, for example, many of us will probably

0:58:33.120 --> 0:58:35.640
<v Speaker 10>remember where we were when we first heard that there

0:58:35.680 --> 0:58:38.400
<v Speaker 10>was a COVID vaccine that worked. The first one that

0:58:38.440 --> 0:58:42.720
<v Speaker 10>we heard about was the Pfizer vaccine, and that vaccine

0:58:43.160 --> 0:58:48.440
<v Speaker 10>reportedly has over ninety percent efficacy, which is really really good.

0:58:48.920 --> 0:58:52.320
<v Speaker 10>It's also a complicated vaccine to deliver in terms of

0:58:52.360 --> 0:58:57.560
<v Speaker 10>some of its characteristics. It requires what's called ultra low temperatures.

0:58:57.720 --> 0:59:02.760
<v Speaker 10>It's required to be stored at negative seventy celsius. Most

0:59:02.840 --> 0:59:06.520
<v Speaker 10>vaccines are stored between two and eight degrees celsius, which

0:59:06.560 --> 0:59:10.800
<v Speaker 10>is like your kitchen refrigerator. Some vaccines are stored at

0:59:10.800 --> 0:59:14.600
<v Speaker 10>negative twenty celsius, which is more like your freezer of

0:59:14.680 --> 0:59:19.600
<v Speaker 10>your kitchen refrigerator or your or your downstairs freezer. Negative

0:59:19.640 --> 0:59:22.720
<v Speaker 10>seventy is dry ice. You got to wear of admits

0:59:22.760 --> 0:59:24.800
<v Speaker 10>when you handle it. You got to have a special

0:59:24.920 --> 0:59:28.480
<v Speaker 10>supply chain for it. It also is administered in a

0:59:28.880 --> 0:59:33.840
<v Speaker 10>point three mL dose. Every other vaccine is administered as

0:59:33.960 --> 0:59:36.760
<v Speaker 10>zero point five mL dose, and so it requires a

0:59:36.760 --> 0:59:39.480
<v Speaker 10>little bit of special training, a little bit of special handling,

0:59:40.160 --> 0:59:44.160
<v Speaker 10>an ultra cold chain delivery system. It's going to be

0:59:44.200 --> 0:59:47.320
<v Speaker 10>more complicated. On the other hand, it's going to deliver

0:59:47.440 --> 0:59:51.880
<v Speaker 10>ninety five percent efficacy and have a differential price point

0:59:51.880 --> 0:59:56.720
<v Speaker 10>from other vaccines, So that complex mixture of can I

0:59:56.760 --> 0:59:58.120
<v Speaker 10>afford it, can I get it?

0:59:58.360 --> 1:00:00.320
<v Speaker 9>When can I get it? How much can I get it?

1:00:00.480 --> 1:00:04.040
<v Speaker 10>Can I manage the complexity of the ultra cold chain pieces.

1:00:04.560 --> 1:00:07.520
<v Speaker 10>Those are all going to figure into the decisions that

1:00:07.560 --> 1:00:11.240
<v Speaker 10>countries make and the plans that countries make in order

1:00:11.280 --> 1:00:15.320
<v Speaker 10>to roll those vaccines out to everyone. If we think

1:00:15.360 --> 1:00:18.400
<v Speaker 10>about low and low middle income countries, ironically, they have

1:00:18.480 --> 1:00:22.280
<v Speaker 10>some of the most experienced working with ultra cold chain vaccines.

1:00:22.600 --> 1:00:26.760
<v Speaker 10>The early Ebola vaccines required negative seventy as well, and

1:00:26.880 --> 1:00:33.120
<v Speaker 10>so countries like the Democratic Republic of Congo and Rwanda, Uganda, Guinea,

1:00:33.240 --> 1:00:36.840
<v Speaker 10>Sierra Leone, Liberia, these are actually countries that have experienced

1:00:37.000 --> 1:00:41.400
<v Speaker 10>using in small volumes ultra cold chain requiring vaccines. But

1:00:42.160 --> 1:00:45.200
<v Speaker 10>that complex set of factors is what I think we'll

1:00:45.240 --> 1:00:48.400
<v Speaker 10>go into the decisions that countries make and the rollout

1:00:48.440 --> 1:00:50.160
<v Speaker 10>plans that they make with the vaccines.

1:00:50.600 --> 1:00:51.040
<v Speaker 3>M hmm.

1:00:51.200 --> 1:00:53.600
<v Speaker 5>That's interesting. That hadn't really occurred to me before, but

1:00:53.640 --> 1:00:57.520
<v Speaker 5>that completely makes sense. And so it seems like on

1:00:57.560 --> 1:01:00.600
<v Speaker 5>the surface, it's great to have different options for a

1:01:00.640 --> 1:01:03.520
<v Speaker 5>successful COVID nineteen vaccine, But then you start to think

1:01:03.520 --> 1:01:07.240
<v Speaker 5>about the logistics and how if the vaccine requirements are different,

1:01:07.280 --> 1:01:09.640
<v Speaker 5>both in terms of the number of doses required or

1:01:09.720 --> 1:01:13.280
<v Speaker 5>storage requirements, then you have to just, like you know,

1:01:13.640 --> 1:01:17.160
<v Speaker 5>bulldoze forward with one of those options. Is that what

1:01:17.320 --> 1:01:19.800
<v Speaker 5>we might end up seeing for some of these countries

1:01:20.000 --> 1:01:21.640
<v Speaker 5>or do you think it might be Oh well, we'll

1:01:21.640 --> 1:01:23.920
<v Speaker 5>have to just kind of create a different supply chain

1:01:24.000 --> 1:01:26.600
<v Speaker 5>or a different deployment chain for each one of these

1:01:27.240 --> 1:01:29.800
<v Speaker 5>in case one ends up working better than the others,

1:01:29.960 --> 1:01:31.800
<v Speaker 5>or one is cheaper than the others, or one is

1:01:31.840 --> 1:01:33.520
<v Speaker 5>going to be more available than the others.

1:01:34.160 --> 1:01:36.480
<v Speaker 10>I think early on Aaron, there's probably going to be

1:01:36.720 --> 1:01:44.480
<v Speaker 10>a intention wherever possible to supply a country with a vaccine,

1:01:44.920 --> 1:01:48.440
<v Speaker 10>rather than to have multiple vaccines flowing through countries. Now,

1:01:48.480 --> 1:01:51.920
<v Speaker 10>if it's a big enough country and each sub geography

1:01:52.040 --> 1:01:55.960
<v Speaker 10>is large enough, you might think about that. But ideally,

1:01:56.040 --> 1:01:59.200
<v Speaker 10>because these vaccines aren't going to be interchangeable with one another,

1:01:59.360 --> 1:02:01.480
<v Speaker 10>you're going to want to simplify I think that part

1:02:01.640 --> 1:02:06.320
<v Speaker 10>of the supply chain, and then from thereforward, say everybody

1:02:06.320 --> 1:02:10.000
<v Speaker 10>in this country is getting either this mRNA vaccine or

1:02:10.040 --> 1:02:14.400
<v Speaker 10>this live vaccine or this inactivated vaccine. Those decisions to

1:02:14.520 --> 1:02:19.120
<v Speaker 10>kind of supply a country with a single vaccine simplify

1:02:19.280 --> 1:02:22.680
<v Speaker 10>some of the logistics that would become way more complex

1:02:22.720 --> 1:02:26.120
<v Speaker 10>if there are multiple vaccines flowing around at a subnational level.

1:02:27.000 --> 1:02:30.600
<v Speaker 5>Yeah, so earlier you touched on how there was an

1:02:30.640 --> 1:02:34.320
<v Speaker 5>anti vaccine movement or an anti covid vaccine movement even

1:02:34.360 --> 1:02:40.120
<v Speaker 5>before there was a COVID vaccine. And of course a

1:02:40.160 --> 1:02:44.280
<v Speaker 5>lot of this mistrust or skepticism that surrounds vaccines has

1:02:44.360 --> 1:02:48.360
<v Speaker 5>been growing in general in the past few decades, and

1:02:48.520 --> 1:02:53.000
<v Speaker 5>especially from some communities that might already be rightly distrustful

1:02:53.320 --> 1:02:56.200
<v Speaker 5>or mistrustful of the medical system. So could you talk

1:02:56.240 --> 1:03:00.800
<v Speaker 5>about how that plays into not only vaccine development, administration,

1:03:01.200 --> 1:03:03.320
<v Speaker 5>and also what are some of things that could be

1:03:03.440 --> 1:03:06.080
<v Speaker 5>done to rebuild trust in those communities.

1:03:06.680 --> 1:03:08.480
<v Speaker 10>Honestly, one of the things that keeps me up at

1:03:08.560 --> 1:03:13.720
<v Speaker 10>night is the demand side of this. As a personal

1:03:13.720 --> 1:03:17.240
<v Speaker 10>who spent my career working in vaccines, I literally think

1:03:17.320 --> 1:03:19.400
<v Speaker 10>vaccines have an opportunity to save the world.

1:03:19.480 --> 1:03:20.000
<v Speaker 9>Right, Like, the.

1:03:20.920 --> 1:03:25.480
<v Speaker 10>Thing that is keeping us from interacting is that we

1:03:25.560 --> 1:03:29.080
<v Speaker 10>have a virus for which all of humanity lacks immunity,

1:03:30.160 --> 1:03:36.400
<v Speaker 10>and vaccines have the potential to confer that immunity to

1:03:36.480 --> 1:03:39.280
<v Speaker 10>all of humanity, but only if people are willing to

1:03:39.360 --> 1:03:42.640
<v Speaker 10>accept them, only if people are are ready to be immunized.

1:03:42.800 --> 1:03:46.840
<v Speaker 10>And to do that, people have to trust their health system,

1:03:46.960 --> 1:03:50.840
<v Speaker 10>They have to trust their medical providers, they have to

1:03:50.880 --> 1:03:56.640
<v Speaker 10>trust the process by which the vaccines were carefully manufactured,

1:03:56.720 --> 1:04:00.600
<v Speaker 10>carefully regulated to make sure that they're safe potent when

1:04:00.600 --> 1:04:03.760
<v Speaker 10>they come out. And any of us who's a human

1:04:03.840 --> 1:04:07.280
<v Speaker 10>knows that that trust is slow to build and quick

1:04:07.320 --> 1:04:12.400
<v Speaker 10>to erode. And in the most recent era, we've had

1:04:12.400 --> 1:04:15.440
<v Speaker 10>an erosion of trust on many levels, some of it

1:04:15.480 --> 1:04:18.760
<v Speaker 10>related to vaccines specifically, and some of it more generally

1:04:19.080 --> 1:04:23.480
<v Speaker 10>in institutions, in science and many other things. So I

1:04:23.520 --> 1:04:27.320
<v Speaker 10>hope we can use vaccines actually as an opportunity to

1:04:27.960 --> 1:04:32.800
<v Speaker 10>restore trust. And that restoration probably starts with listening to people.

1:04:33.440 --> 1:04:36.720
<v Speaker 10>There's been too much, in my view, polarizing yelling at

1:04:36.760 --> 1:04:39.440
<v Speaker 10>each other, and other enough listening to one another. So

1:04:39.520 --> 1:04:41.120
<v Speaker 10>I'm really hopeful that one of the things.

1:04:41.000 --> 1:04:44.280
<v Speaker 9>That will a side effect, if you will, of a

1:04:44.360 --> 1:04:47.000
<v Speaker 9>COVID vaccine will be forget people to listen to one another.

1:04:47.480 --> 1:04:52.640
<v Speaker 2>Yeah, that'd be the dream, that would be fantastic.

1:04:54.400 --> 1:04:58.760
<v Speaker 5>In terms of vaccine specifically, and maybe vaccine deployment or

1:04:59.200 --> 1:05:01.800
<v Speaker 5>administration on global scale. You know, what do you think

1:05:01.880 --> 1:05:05.080
<v Speaker 5>are the major lessons we've learned or how will this

1:05:05.360 --> 1:05:09.040
<v Speaker 5>have changed the way that we view either emerging infectious

1:05:09.080 --> 1:05:11.640
<v Speaker 5>diseases or vaccines in the future.

1:05:12.120 --> 1:05:14.400
<v Speaker 9>I think there's a lot of opportunity.

1:05:14.440 --> 1:05:16.800
<v Speaker 10>I keep trying to look for silver linings in all

1:05:16.840 --> 1:05:21.200
<v Speaker 10>of this, and I think there is some opportunity going forward.

1:05:21.600 --> 1:05:24.280
<v Speaker 10>Let me give you one of the examples of the opportunity.

1:05:24.320 --> 1:05:30.040
<v Speaker 10>I think the rollout of COVID vaccines offers us. In

1:05:30.160 --> 1:05:34.960
<v Speaker 10>many communities where we work, young adults may not be

1:05:35.400 --> 1:05:37.840
<v Speaker 10>very engaged in their health system. They may not be

1:05:38.000 --> 1:05:42.120
<v Speaker 10>regularly getting preventive care. They may not be getting screened

1:05:42.240 --> 1:05:46.280
<v Speaker 10>for some of the concerns that they have, or getting

1:05:46.320 --> 1:05:52.960
<v Speaker 10>access to family planning or other preventive services. I wonder if,

1:05:53.160 --> 1:05:58.520
<v Speaker 10>in the execution of our rollout of COVID vaccines, if

1:05:58.520 --> 1:06:02.800
<v Speaker 10>we integrate COVID vaccination with a package of services that

1:06:02.840 --> 1:06:04.200
<v Speaker 10>they want and value.

1:06:04.600 --> 1:06:05.840
<v Speaker 9>If we won't, if.

1:06:05.680 --> 1:06:10.600
<v Speaker 10>You will draw into the health system a large set

1:06:10.720 --> 1:06:16.959
<v Speaker 10>of people who've been needing or potentially benefiting from health interventions,

1:06:16.960 --> 1:06:20.120
<v Speaker 10>but who've been not accessing the system in the future

1:06:20.400 --> 1:06:23.800
<v Speaker 10>in the past, and so if we can use the

1:06:24.160 --> 1:06:29.080
<v Speaker 10>act of engaging with them around COVID vaccination to engage

1:06:29.080 --> 1:06:32.600
<v Speaker 10>with them around a broader set of health prevention and

1:06:32.680 --> 1:06:36.680
<v Speaker 10>health conditions, it could be that the rollout of COVID

1:06:36.800 --> 1:06:41.880
<v Speaker 10>vaccines helps impact people's health well beyond conferring immunity.

1:06:42.720 --> 1:06:43.880
<v Speaker 9>I personally can't.

1:06:43.680 --> 1:06:46.360
<v Speaker 10>Wait for us to get to the point where we're

1:06:46.400 --> 1:06:48.840
<v Speaker 10>successful rolling out vaccines. I haven't seen my mom and

1:06:48.920 --> 1:06:50.760
<v Speaker 10>dad in nearly a year, and I want to be

1:06:50.800 --> 1:06:53.440
<v Speaker 10>able to hug my mom and dad without worrying about

1:06:54.680 --> 1:06:56.320
<v Speaker 10>sharing a deadly virus with them.

1:06:56.680 --> 1:06:59.960
<v Speaker 9>So my interests are both global.

1:06:59.680 --> 1:07:03.760
<v Speaker 10>And and equity, and you know, partly deeply personal as well.

1:07:03.800 --> 1:07:08.480
<v Speaker 10>And thanks for you know, sharing these kinds of stories

1:07:08.480 --> 1:07:11.360
<v Speaker 10>and this information with with your listeners, because I think

1:07:11.360 --> 1:07:13.200
<v Speaker 10>they're a big part of making this a success.

1:07:45.960 --> 1:07:49.920
<v Speaker 5>Thank you so so much again, doctor Sundram and doctor Levine.

1:07:50.120 --> 1:07:52.400
<v Speaker 5>It was so great to talk with you, and we

1:07:52.480 --> 1:07:55.360
<v Speaker 5>really appreciate you taking the time out of your incredibly

1:07:55.360 --> 1:07:58.760
<v Speaker 5>busy schedules to help us all get some more info

1:07:58.920 --> 1:08:00.200
<v Speaker 5>about vaccines.

1:08:00.320 --> 1:08:05.959
<v Speaker 6>Yes, we learned so much, so As always in these

1:08:06.000 --> 1:08:10.080
<v Speaker 6>COVID nineteen episodes, we want to summarize with five key

1:08:10.400 --> 1:08:14.720
<v Speaker 6>points that we want you to take away from this episode.

1:08:15.040 --> 1:08:19.479
<v Speaker 6>So number one, we learned that there are at least

1:08:19.760 --> 1:08:23.800
<v Speaker 6>three different vaccines that are very close to approval or

1:08:23.960 --> 1:08:27.559
<v Speaker 6>in some cases have been approved already in the US

1:08:27.760 --> 1:08:30.400
<v Speaker 6>and the UK and a few other countries. So these

1:08:30.439 --> 1:08:32.520
<v Speaker 6>are the ones that we focused on for this episode.

1:08:33.120 --> 1:08:36.640
<v Speaker 6>These are the Peiser vaccine, the Moderna vaccine, and the

1:08:36.680 --> 1:08:42.760
<v Speaker 6>Astrozenica vaccine. And importantly, none of these vaccines contain the

1:08:43.000 --> 1:08:47.880
<v Speaker 6>entire SARS covy two virus. They all contain what are

1:08:48.000 --> 1:08:52.120
<v Speaker 6>essentially instructions of one kind or another to make one

1:08:52.280 --> 1:08:56.760
<v Speaker 6>protein or antigen that is specific to SARS CoV two

1:08:57.240 --> 1:09:00.519
<v Speaker 6>that our body can then recognize and respond to in

1:09:00.560 --> 1:09:04.519
<v Speaker 6>the case of a future exposure or infection. So what

1:09:04.560 --> 1:09:09.599
<v Speaker 6>that means is that none, I'll repeat none of these

1:09:09.680 --> 1:09:13.800
<v Speaker 6>vaccines is capable of giving somebody COVID nineteen, which I

1:09:13.840 --> 1:09:17.960
<v Speaker 6>think is so important. While it is normal to have

1:09:18.040 --> 1:09:21.400
<v Speaker 6>some mild side effects after a vaccine, like a headache

1:09:21.520 --> 1:09:25.240
<v Speaker 6>or maybe pain where you got the vaccine shot, or

1:09:25.320 --> 1:09:28.480
<v Speaker 6>even a mild fever or just feeling kind of cruddy.

1:09:28.600 --> 1:09:31.639
<v Speaker 6>These kind of symptoms don't mean that you have COVID nineteen,

1:09:31.760 --> 1:09:34.479
<v Speaker 6>and they don't mean that you're infectious to others either.

1:09:35.000 --> 1:09:37.559
<v Speaker 6>They just mean that your immune system is doing its

1:09:37.680 --> 1:09:41.240
<v Speaker 6>job and responding to the vaccine, which is awesome and

1:09:41.240 --> 1:09:42.840
<v Speaker 6>what we want your immune system to do.

1:09:43.400 --> 1:09:48.960
<v Speaker 5>Yes number two. These vaccines have gone through the same

1:09:49.120 --> 1:09:53.080
<v Speaker 5>exact safety and evaluation steps that other vaccines, like the

1:09:53.080 --> 1:09:57.000
<v Speaker 5>seasonal influenza vaccine or the musles, mumps and rubella vaccines

1:09:57.040 --> 1:10:00.920
<v Speaker 5>also had to go through. All of the same regulatory

1:10:01.000 --> 1:10:04.520
<v Speaker 5>and safety questions were asked about the COVID nineteen vaccines

1:10:05.000 --> 1:10:07.439
<v Speaker 5>as they were for these other vaccines that were more

1:10:07.479 --> 1:10:11.360
<v Speaker 5>familiar with the difference is that with these COVID nineteen

1:10:11.439 --> 1:10:15.040
<v Speaker 5>vaccines we were able to ask and answer these questions

1:10:15.080 --> 1:10:18.280
<v Speaker 5>in a much shorter timeframe, which was made possible by

1:10:18.280 --> 1:10:22.040
<v Speaker 5>the sheer amount of people and resources committed to this project.

1:10:22.720 --> 1:10:25.639
<v Speaker 5>And like those other vaccines, we will continue to monitor

1:10:25.680 --> 1:10:28.640
<v Speaker 5>the safety of these COVID nineteen vaccines, both in the

1:10:28.680 --> 1:10:31.639
<v Speaker 5>people who were involved in the clinical trials as well

1:10:31.680 --> 1:10:35.720
<v Speaker 5>as everyone else who takes them. Tens of thousands of

1:10:35.800 --> 1:10:39.479
<v Speaker 5>people were involved in these COVID nineteen vaccine clinical trials,

1:10:39.920 --> 1:10:43.320
<v Speaker 5>and the results have been very encouraging, not just in

1:10:43.400 --> 1:10:47.800
<v Speaker 5>terms of efficacy, but also in terms of safety. Some

1:10:47.880 --> 1:10:50.960
<v Speaker 5>mild side effects such as headache or fatigue might be expected,

1:10:51.000 --> 1:10:53.760
<v Speaker 5>as you mentioned in point one erin, but so far

1:10:53.920 --> 1:10:57.400
<v Speaker 5>it doesn't appear that there are major adverse events associated

1:10:57.439 --> 1:11:01.360
<v Speaker 5>with the vaccine, and are incredibly robust vaccine adverse event

1:11:01.439 --> 1:11:05.120
<v Speaker 5>reporting system means that any and all side effects of

1:11:05.160 --> 1:11:08.840
<v Speaker 5>these vaccines will be cataloged and closely examined, and if

1:11:08.840 --> 1:11:12.360
<v Speaker 5>there do emerge more severe side effects later on, we

1:11:12.439 --> 1:11:13.439
<v Speaker 5>will catch them.

1:11:13.400 --> 1:11:16.320
<v Speaker 2>Like very early immediately.

1:11:17.280 --> 1:11:20.280
<v Speaker 5>And one thing I keep coming back to is just

1:11:20.520 --> 1:11:24.240
<v Speaker 5>how much is at stake with these vaccines. Yeah, the

1:11:24.320 --> 1:11:27.360
<v Speaker 5>companies and the governments that have invested so much time

1:11:27.400 --> 1:11:32.479
<v Speaker 5>and resources into vaccine development, public support for vaccines. There's

1:11:32.760 --> 1:11:36.519
<v Speaker 5>a lot to lose here and so very very much

1:11:36.560 --> 1:11:40.719
<v Speaker 5>to gain. A misstep could be incredibly costly in many ways.

1:11:40.840 --> 1:11:43.960
<v Speaker 5>And for that reason, there are many, many, many people

1:11:44.120 --> 1:11:47.320
<v Speaker 5>ensuring the safety and efficacy of these vaccines.

1:11:47.760 --> 1:11:53.759
<v Speaker 6>Absolutely, and speaking of efficacy, point number three, just how

1:11:53.920 --> 1:11:59.320
<v Speaker 6>effective are these vaccines? It turns out very so. We

1:11:59.479 --> 1:12:03.760
<v Speaker 6>learned from Maria that effectiveness is looking at how much

1:12:03.840 --> 1:12:07.719
<v Speaker 6>protection these vaccines are going to provide in the real world,

1:12:08.160 --> 1:12:11.439
<v Speaker 6>not just in a clinical trial or a very controlled setting.

1:12:11.920 --> 1:12:13.920
<v Speaker 6>And in the case of these trials that have been

1:12:13.960 --> 1:12:17.400
<v Speaker 6>conducted already, it seems like the vaccine candidates we have

1:12:17.479 --> 1:12:21.960
<v Speaker 6>appear to be ninety or ninety five percent effective, which

1:12:22.000 --> 1:12:24.160
<v Speaker 6>is amazing.

1:12:23.920 --> 1:12:25.080
<v Speaker 2>Truly amazing.

1:12:25.520 --> 1:12:29.040
<v Speaker 6>Really, we also know from these studies that immunity seems

1:12:29.080 --> 1:12:32.120
<v Speaker 6>to be durable at least for a few months, which

1:12:32.160 --> 1:12:34.120
<v Speaker 6>is great that we know that it lasts for at

1:12:34.200 --> 1:12:37.320
<v Speaker 6>least a little while, although we still don't know exactly

1:12:37.360 --> 1:12:41.120
<v Speaker 6>how long immunity will last, and this is also true

1:12:41.160 --> 1:12:44.920
<v Speaker 6>for infection. We know that immunity after infection lasts for

1:12:44.960 --> 1:12:48.360
<v Speaker 6>at least a few months as well. But especially in

1:12:48.400 --> 1:12:53.400
<v Speaker 6>the case of these vaccines, immunity isn't immediate. Because all

1:12:53.400 --> 1:12:55.759
<v Speaker 6>the vaccines that we have that are close to approval

1:12:55.800 --> 1:12:58.880
<v Speaker 6>are two dose series, meaning you have to get one

1:12:58.920 --> 1:13:02.599
<v Speaker 6>dose and then another three weeks later. Full immunity isn't

1:13:02.600 --> 1:13:05.880
<v Speaker 6>expected until at least five weeks or longer after the

1:13:05.920 --> 1:13:08.880
<v Speaker 6>first vaccine, or two weeks after you get that second dose.

1:13:09.640 --> 1:13:13.800
<v Speaker 6>And because these are not live virus vaccines and they're

1:13:13.840 --> 1:13:16.439
<v Speaker 6>given in our arms rather than through like our nose,

1:13:16.600 --> 1:13:20.559
<v Speaker 6>like some of the live flu vaccine nasal sprays. We're

1:13:20.600 --> 1:13:25.200
<v Speaker 6>not positive about the amount of mucosal immunity that they provide,

1:13:25.520 --> 1:13:29.480
<v Speaker 6>so it's at least theoretically possible that even after vaccination,

1:13:29.800 --> 1:13:33.840
<v Speaker 6>somebody could harbor the SARS covy too virus in their

1:13:33.960 --> 1:13:38.080
<v Speaker 6>mucous membranes. And even after a real infection with SARS

1:13:38.120 --> 1:13:41.360
<v Speaker 6>covy two, people can shed virus for a really long

1:13:41.400 --> 1:13:45.080
<v Speaker 6>time after infection, and that is why it's so important

1:13:45.120 --> 1:13:49.759
<v Speaker 6>that even after vaccination or infection, we continue to practice

1:13:49.840 --> 1:13:52.840
<v Speaker 6>all the same control strategies we've discussed at length, like

1:13:53.160 --> 1:13:55.960
<v Speaker 6>wearing a mask, social distancing, etc.

1:13:56.720 --> 1:14:00.600
<v Speaker 5>Yeah, it's just one more layer of that Swiss cheese situation.

1:14:03.200 --> 1:14:07.639
<v Speaker 5>Point four. Developing effective vaccines against the virus that causes

1:14:07.680 --> 1:14:12.559
<v Speaker 5>COVID nineteen was just the first necessary step. It was

1:14:12.720 --> 1:14:16.559
<v Speaker 5>hugely important, but it's still just the first step because

1:14:16.560 --> 1:14:19.120
<v Speaker 5>we still need to get these vaccines to the people

1:14:19.120 --> 1:14:20.320
<v Speaker 5>who need them.

1:14:20.640 --> 1:14:21.200
<v Speaker 2>If you've been.

1:14:21.160 --> 1:14:23.719
<v Speaker 5>Keeping up with the news, we've already started the rollout

1:14:23.720 --> 1:14:25.840
<v Speaker 5>of vaccines here in the US and in the UK,

1:14:26.360 --> 1:14:29.040
<v Speaker 5>as well as some other places to the highest priority

1:14:29.080 --> 1:14:32.439
<v Speaker 5>recipients like frontline healthcare workers and those residing in long

1:14:32.520 --> 1:14:36.599
<v Speaker 5>term care facilities. But the logistics of vaccine rollout are

1:14:36.800 --> 1:14:40.160
<v Speaker 5>enormously complex and will require the construction of a lot

1:14:40.280 --> 1:14:44.120
<v Speaker 5>of different moving parts. For instance, all of these vaccines

1:14:44.120 --> 1:14:46.920
<v Speaker 5>that are close to approval or have been approved are

1:14:47.000 --> 1:14:49.920
<v Speaker 5>two dough series, which does make their rollout a bit

1:14:49.960 --> 1:14:53.000
<v Speaker 5>more challenging to make sure everyone gets both doses in

1:14:53.040 --> 1:14:57.479
<v Speaker 5>the proper timeframe. Fortunately, some countries have the supply and

1:14:57.520 --> 1:15:01.480
<v Speaker 5>deployment change already in working order from past vaccine campaigns,

1:15:02.160 --> 1:15:05.080
<v Speaker 5>but the existence of three different vaccines that may vary

1:15:05.120 --> 1:15:08.679
<v Speaker 5>in their storage and administration requirements could lead some countries

1:15:08.720 --> 1:15:10.840
<v Speaker 5>to build up a system around one of the types

1:15:10.880 --> 1:15:13.960
<v Speaker 5>of vaccines. And I mean, all in all, it's kind

1:15:14.000 --> 1:15:16.000
<v Speaker 5>of a good problem to have, like we'd rather be

1:15:16.120 --> 1:15:19.160
<v Speaker 5>choosing among several effective vaccines rather than none at all,

1:15:19.600 --> 1:15:21.880
<v Speaker 5>But it does mean that some places will have to

1:15:21.920 --> 1:15:25.160
<v Speaker 5>put their resources towards one of these vaccines over the other.

1:15:27.080 --> 1:15:29.760
<v Speaker 6>And finally, point number five, which I think is one

1:15:29.800 --> 1:15:34.160
<v Speaker 6>of the biggest take home points for me, especially vaccine

1:15:34.200 --> 1:15:39.280
<v Speaker 6>hesitancy is an important issue, especially for these new COVID vaccines,

1:15:40.040 --> 1:15:43.800
<v Speaker 6>but hesitancy in the face of something as new as

1:15:43.880 --> 1:15:48.960
<v Speaker 6>this vaccine. It's really understandable, and it's important for us,

1:15:49.320 --> 1:15:52.200
<v Speaker 6>you know, as educators or even if you're just talking

1:15:52.240 --> 1:15:55.519
<v Speaker 6>with friends and family, to address people who may be

1:15:55.680 --> 1:16:00.240
<v Speaker 6>hesitant or have questions about this new vaccine.

1:16:00.320 --> 1:16:00.840
<v Speaker 2>Empathy.

1:16:02.160 --> 1:16:05.519
<v Speaker 6>Maria Sundram had I think some really good advice, which

1:16:05.600 --> 1:16:08.599
<v Speaker 6>was to start any conversation by trying to find a

1:16:08.680 --> 1:16:12.439
<v Speaker 6>place of common ground, whether that be concerns about getting

1:16:12.479 --> 1:16:16.160
<v Speaker 6>sick yourself or concerns about spreading disease to loved ones,

1:16:16.200 --> 1:16:19.080
<v Speaker 6>whatever it might be. But by starting from a place

1:16:19.120 --> 1:16:22.280
<v Speaker 6>of common ground, it's at least possible to have a conversation,

1:16:22.520 --> 1:16:25.200
<v Speaker 6>whether about vaccines or honestly.

1:16:24.840 --> 1:16:27.800
<v Speaker 2>This is just good advice for life.

1:16:29.040 --> 1:16:32.160
<v Speaker 6>And from Orn's interview, and this is important especially on

1:16:32.200 --> 1:16:35.519
<v Speaker 6>a community and kind of larger scale. We can't just

1:16:35.720 --> 1:16:38.360
<v Speaker 6>assume that there's going to be a demand for this

1:16:38.479 --> 1:16:43.400
<v Speaker 6>vaccine or any of these vaccines. We have to have good, honest,

1:16:43.760 --> 1:16:48.439
<v Speaker 6>open communications surrounding these vaccines and the development process and

1:16:48.600 --> 1:16:52.320
<v Speaker 6>everything surrounding them, and encourage that people get it and

1:16:52.360 --> 1:16:56.479
<v Speaker 6>make it really easily available, rather than just assuming that

1:16:56.520 --> 1:16:58.880
<v Speaker 6>people are going to want a vaccine or will seek

1:16:58.880 --> 1:16:59.679
<v Speaker 6>it out on their own.

1:17:00.200 --> 1:17:03.960
<v Speaker 5>Yeah, that's definitely true. I feel like now it's more

1:17:04.000 --> 1:17:08.760
<v Speaker 5>important than ever to maybe have these conversations and you know,

1:17:09.240 --> 1:17:12.920
<v Speaker 5>practice this empathy. It's crucial right.

1:17:12.800 --> 1:17:13.599
<v Speaker 2>Now to do that.

1:17:14.120 --> 1:17:14.599
<v Speaker 3>Yeah.

1:17:15.000 --> 1:17:18.240
<v Speaker 5>A huge thank you again to doctor Sundram and doctor

1:17:18.320 --> 1:17:21.040
<v Speaker 5>Levine for taking the time to chat with us about

1:17:21.080 --> 1:17:23.800
<v Speaker 5>these amazing COVID nineteen vaccines.

1:17:24.280 --> 1:17:28.400
<v Speaker 2>We learned so much we did. Also a huge thank you.

1:17:28.320 --> 1:17:31.200
<v Speaker 6>To Diane Scott and Ambersetti's for helping to set us

1:17:31.280 --> 1:17:32.599
<v Speaker 6>up to chat with doctor Levine.

1:17:32.880 --> 1:17:35.920
<v Speaker 5>Yes, and if you want to learn even more about

1:17:35.920 --> 1:17:39.439
<v Speaker 5>these COVID nineteen vaccines and other vaccines in development against

1:17:39.479 --> 1:17:43.799
<v Speaker 5>the SARS coby two virus, there's an amazing, amazing vaccine

1:17:43.840 --> 1:17:47.160
<v Speaker 5>tracker that was developed by a huge team of brilliant people,

1:17:47.479 --> 1:17:51.560
<v Speaker 5>including doctor Sundram at McGill University and also at the

1:17:51.680 --> 1:17:56.160
<v Speaker 5>University of Minnesota, among other places. It's an incredible resource

1:17:56.200 --> 1:17:59.080
<v Speaker 5>with tons of great information and you can find it

1:17:59.200 --> 1:18:03.840
<v Speaker 5>at COVID nineteen dot track, vaccines dot org and we

1:18:03.880 --> 1:18:05.840
<v Speaker 5>will also post a link to it in our show

1:18:05.880 --> 1:18:07.720
<v Speaker 5>notes as well as on our website.

1:18:07.960 --> 1:18:08.200
<v Speaker 2>Yeah.

1:18:08.240 --> 1:18:10.599
<v Speaker 6>I think this is a great resource either for you,

1:18:10.880 --> 1:18:12.880
<v Speaker 6>or maybe to send to friends and family that might

1:18:12.920 --> 1:18:17.679
<v Speaker 6>be asking questions. It's just a really comprehensive resource. Thank

1:18:17.720 --> 1:18:20.640
<v Speaker 6>you so much to Bloodmobile, who provides the music for

1:18:20.680 --> 1:18:22.960
<v Speaker 6>this episode and all of our episodes.

1:18:23.320 --> 1:18:27.040
<v Speaker 5>And thank you to the Exactly Right Network, which we

1:18:27.120 --> 1:18:30.600
<v Speaker 5>are a very proud member of and without whom this

1:18:30.720 --> 1:18:32.560
<v Speaker 5>podcast would not be possible.

1:18:33.040 --> 1:18:36.680
<v Speaker 6>This podcast would also not be possible without you, dear listeners,

1:18:36.680 --> 1:18:40.080
<v Speaker 6>so thank you so much for listening to it all.

1:18:40.439 --> 1:18:44.519
<v Speaker 5>Thank you, thank you, thank you. Until next time, wash

1:18:44.560 --> 1:18:45.520
<v Speaker 5>your hands.

1:18:45.400 --> 1:19:05.960
<v Speaker 11>You filthy animals. Um um