Speaker 1: Hi everyone. My name is Ashley Pleasant. I work as
Speaker 1: a paralegal and Tyler, Texas, but I love about an
Speaker 1: hour away in Wood County with my mom and stepdad.
Speaker 1: Tyler is a college town, but the surrounding area, including
Speaker 1: my county, is very rural. I think people have had
Speaker 1: a false sense of security that COVID wouldn't come here,
Speaker 1: but in reality, our low population in city could only
Speaker 1: delay its arrival. My family and I have been taking
Speaker 1: all the precautions we can since the nationwide lockdowns begin
Speaker 1: happening in March and April. We only leave the house
Speaker 1: go to work in the store. We wear multi layer
Speaker 1: cloth masks every time we leave the house, we wash
Speaker 1: our hands, use hand sanitizer frequently, and we stop seeing
Speaker 1: anyone in person. Socially but not At the beginning of October,
Speaker 1: COVID still found us. It started off like a mild cold.
Speaker 1: My mom started experiencing mild fatigue and a cough. We
Speaker 1: were slightly worried, but trying not to read too much
Speaker 1: into it. I mean, we were being careful after all.
Speaker 1: Within three days, though, I started having the same symptoms.
Speaker 1: Stepdad the day after me and my eighty seven year
Speaker 1: old grandmother. The day after him. We were still trying
Speaker 1: to not worry too much. I mean, colds are common
Speaker 1: and still happen even during a pandemic. That all changed, though,
Speaker 1: the night my mom decided to grill hamburgers. I realized
Speaker 1: we had a serious problem when I couldn't smell the charcoal,
Speaker 1: grill or cooking burgers. After that, we couldn't keep telling
Speaker 1: ourselves it was just a cold. Over the course of
Speaker 1: the next week, all four of us were tested, and
Speaker 1: all four of our test came back positive for COVID.
Speaker 1: The second week of symptoms felt more severe, with more
Speaker 1: extreme fatigue and coughing, as well as headaches, body aches,
Speaker 1: and a loss of appetite. None of us really ran fever,
Speaker 1: with the exception of my grandmother for just one morning.
Speaker 1: She was struggling with dementia and wasn't eating or drinking enough.
Speaker 1: My mom and I had to get her to drink
Speaker 1: fluids every hour to keep her hydrated and keep her
Speaker 1: fever down, and we had to make sure she was
Speaker 1: eating so she didn't get too weak. We meddled through
Speaker 1: well enough for a few weeks, feeling pretty crummy but managing.
Speaker 1: Around the end of October, We felt like we'd made
Speaker 1: it through the worst of things and we were starting
Speaker 1: a slow recovery process. My grandmother had even gotten a
Speaker 1: mostly clean bill of health from her doctor and was
Speaker 1: getting up and walking around more. We really thought we
Speaker 1: were in the clear. Then at four o'clock in the
Speaker 1: morning on October twenty fourth, I heard my grandmother call
Speaker 1: out from my mom while I was on my way
Speaker 1: to bring her a drink of water. When I got
Speaker 1: to her, she was having difficulty breathing. She was still
Speaker 1: aware and talking, but she couldn't take air in properly.
Speaker 1: I ran to get my mom called an ambulance, and
Speaker 1: within fifteen minutes she was gone. My mom, stepdad, and
Speaker 1: I are still experiencing mild symptoms from COVID two and
Speaker 1: a half months later. I personally still have shortness of breath, fatigue,
Speaker 1: trouble concentrating, and are destappetite. We're all still struggling with
Speaker 1: the fact my grandmother isn't here this year for the holidays.
Speaker 1: This is something no family should have to go through.
Speaker 1: But this pandemic only ends if we all do our part.
Speaker 1: So please everyone, were your masks, wash your hands, stay safe,
Speaker 1: and save a life.
Speaker 2: Thank you.
Speaker 3: My name is Rhiannon. I live in central Florida.
Speaker 4: I work as a paralegal for a small family law firm,
Speaker 4: and I am a volunteer participant in the Phase three
Speaker 4: trial of the COVID nineteen vaccine produced by Pfizer. Before
Speaker 4: my first visit, I had a pre screening eligibility phone
Speaker 4: call with someone from the study. She mentioned that it
Speaker 4: was one hundred and fifty dollars per visit and I
Speaker 4: was like, ooh, well, I guess it's worth it to
Speaker 4: be able to participate. Then she mentioned that they would
Speaker 4: add the money to a debit card starting at my
Speaker 4: first visit. It took a minute to register that they
Speaker 4: would pay me. In late August, I went to my
Speaker 4: first appointment. They took a blood sample, gave me a
Speaker 4: pregnancy test and a COVID test, had me complete and
Speaker 4: sign an informed Consent form. I gave them my complete
Speaker 4: medical history, and finally they injected me with the vaccine
Speaker 4: or placebo. They sent me home with the thermometer, a
Speaker 4: copy of the informed consent form, an emergency information card
Speaker 4: in case I have to go to the er during
Speaker 4: the study, and a swab test kit that I can
Speaker 4: administer myself and mail in if I develop symptoms and
Speaker 4: can't get tested right away. Three weeks later, at my
Speaker 4: second visit, they gave me another pregnancy test COVID nasal
Speaker 4: swab and a second injection, which was the same as
Speaker 4: the first. They administer either vaccine, vaccine or placebo placebo.
Speaker 4: About a month after that, I returned from my third visit,
Speaker 4: during which they drew blood to check and to body levels.
Speaker 4: My fourth visit will be in March of twenty twenty one,
Speaker 4: and then I'll return for at least a fifth and
Speaker 4: a sixth visit over the next twenty months. This is
Speaker 4: an observer blind study, so they will not tell me
Speaker 4: whether I receive the vaccine or placebo until it's over.
Speaker 4: They also don't share with me the results of my
Speaker 4: blood tests. Once a week, I'm asked to complete an
Speaker 4: illness diary through an app on my phone. I simply
Speaker 4: answer yes or no to the question of whether I
Speaker 4: have developed any symptoms of COVID nineteen. So far, I've
Speaker 4: been able to answer no every week. After my first injection,
Speaker 4: I felt nothing, no pain that the injection site, no
Speaker 4: indication of any side effects at all. After the second injection, though,
Speaker 4: my arm was sore for days, it was itchy, and
Speaker 4: there was a raised bruise of the injection site. I
Speaker 4: was cautiously optimistic that I had received the vaccine. Actually
Speaker 4: I was pretty thrilled. I worked from home most of
Speaker 4: the time, but I had worked in the office one
Speaker 4: Thursday in late October, and by the following Monday, two
Speaker 4: of my four coworkers.
Speaker 3: Had symptoms and tested positive.
Speaker 4: By the next week, a third coworker was also positive
Speaker 4: and symptomatic. Knowing that I had been exposed, I got
Speaker 4: tested and was negative. At that point, I was pretty
Speaker 4: sure that the vaccine had made me well. Immune is
Speaker 4: the right word, but invincible is how I felt. So
Speaker 4: in November I asked my primary care physician for an
Speaker 4: order for an antibody test.
Speaker 3: It came back negative. I was so disappointed.
Speaker 4: I don't know what will happen when the vaccine is
Speaker 4: approved and available. The study doctor said that I would
Speaker 4: not be at a disadvantage for having participated in the tree.
Speaker 4: He sent a letter a couple of weeks ago saying
Speaker 4: that they were quote exploring potential ways to change the
Speaker 4: study to create a process that would allow interested participants
Speaker 4: in the placebo group who meet the eligibility criteria for
Speaker 4: early access in their country to cross over to the
Speaker 4: vaccine group in the study.
Speaker 3: End quote.
Speaker 4: At my first visit, the doctor in charge of the
Speaker 4: research facility asked me why I decided to take part
Speaker 4: in the study. I was speeciless for a moment, thinking, see,
Speaker 4: there's this podcast Aaron and Aaron got me all excited
Speaker 4: about vaccines and medical research even before the pandemic. And
Speaker 4: I was really excited for this opportunity to not only
Speaker 4: take part in an important study, but to see for
Speaker 4: myself how informed consent forms look these days, because you know,
Speaker 4: they haven't always been like this. But before I found words,
Speaker 4: he said that most people tell him they're just so
Speaker 4: tired of all this and want to help things get
Speaker 4: back to normal as fast as possible.
Speaker 3: I nodded and said that yes, I just wanted to help.
Speaker 4: Our converse station was over pretty quickly, so I never
Speaker 4: got to tell them the rest that I don't believe
Speaker 4: things are ever going to get back to normal because
Speaker 4: some things have changed forever. That this could be my
Speaker 4: one chance as a paralegal to help save lives through
Speaker 4: medical science. That I feel like it's my duty to
Speaker 4: do what others can't do, and that I'm incredibly grateful
Speaker 4: to live in twenty twenty when so many medical professionals
Speaker 4: have worked tirelessly so that there is already a vaccine.
Speaker 5: Thank you so much, Ashley Henryannon for sharing your stories
Speaker 5: with us. We really appreciate it. And thank you to
Speaker 5: everyone else who is sent in their first hand accounts
Speaker 5: of how COVID nineteen has impacted their lives. I think
Speaker 5: it's so important that we tell these stories and hear
Speaker 5: these stories to know that we're not in this alone,
Speaker 5: and to remind ourselves of the far reaching effects of
Speaker 5: this pandemic.
Speaker 2: Yeah.
Speaker 6: Absolutely, Hi, I'm erin Welsh and I'm erin alman Updyke
Speaker 6: and this is this podcast will kill you.
Speaker 2: Yeah.
Speaker 6: In this episode of our Anatomy of a Pandemic series
Speaker 6: on COVID nineteen, we're revisiting the topic on everyone's minds vaccines.
Speaker 5: Yes, how do these COVID nineteen vaccines work? How do
Speaker 5: we know that they're safe to take? And when will
Speaker 5: they become widely available?
Speaker 2: Great questions, Aaron, Great questions.
Speaker 5: And these questions are just the tiniest sampling of what
Speaker 5: we covered in this super duper info packed episode.
Speaker 6: Really truly, I don't think we've ever packed more information
Speaker 6: into one.
Speaker 2: Episode, Oh my gosh.
Speaker 6: And we are so excited to share with you all
Speaker 6: of the vaccine info you could ever hope for. But
Speaker 6: first we have some very important business to take care of.
Speaker 6: It's quarantin any time. It is quarantin any time. What
Speaker 6: are we drinking this week?
Speaker 7: Well, of course Quarantiny thirteen naturally, and in the Quarantine
Speaker 7: thirteen is bourbon, ginger ale, rosemary, simple syrup, lime juice,
Speaker 7: and muddled blackberries.
Speaker 5: Delicious, it really really is. And also we want to
Speaker 5: give a shout out to Abby and Jesse, who are
Speaker 5: the daughters of one of our guests for this episode,
Speaker 5: doctor Orin Levine, and who sent along a placeibrita version
Speaker 5: of this recipe which they called the Sweet Lady Levine.
Speaker 6: I love it so much, amazing. Thank you both so
Speaker 6: much for the suggestion. It made our lives easier coming
Speaker 6: up with this quarantine and it's delicious.
Speaker 5: Yeah really, I was like, oh my gosh, a recipe
Speaker 5: just here, just gifted.
Speaker 2: This is amazing.
Speaker 5: We will post the full recipe for the Quarantine E
Speaker 5: thirteen along with the non alcoholic Place Verta on our
Speaker 5: website This Podcast will Kill You dot Com as well
Speaker 5: as on all of our social media channels, so make
Speaker 5: sure you follow us there.
Speaker 2: Okay, what else?
Speaker 6: We are of course still soliciting first hand accounts for
Speaker 6: this COVID nineteen series, so if you haven't yet and
Speaker 6: you'd like to submit your first hand account, you can
Speaker 6: go to our website This Podcast will Kill You dot Com,
Speaker 6: click on the COVID nineteen tab and that'll send you
Speaker 6: to a Google form that you can fill out. And
Speaker 6: thank you again so much to everyone who has submitted
Speaker 6: their first hand account so far.
Speaker 5: Absolutely, and we are also in the process of getting
Speaker 5: transcripts done for all of our episodes and we are
Speaker 5: so excited about this really and we will announce on
Speaker 5: our social media when the transcripts are ready for current
Speaker 5: or past episodes, so make sure that you follow us
Speaker 5: on there, and we'll also be posting links to the
Speaker 5: transcripts on our website under the transcripts tab, so you
Speaker 5: can also check back in there periodically if you are curious.
Speaker 2: Yeah.
Speaker 6: Other than that, we have kind of usual business things
Speaker 6: really quick. We have a good Reads list check that out,
Speaker 6: a bookshop affiliate account really phenomenal and amazing tpwky merch.
Speaker 6: You can find links to all of these on our website,
Speaker 6: This podcast will kill You dot Com.
Speaker 5: Okay, Aaron, I think it's finally time to get to
Speaker 5: the meat of this episode.
Speaker 2: I think so too.
Speaker 5: I mean, this is what everyone has been waiting.
Speaker 2: For, really truly, myself included.
Speaker 5: Oh my gosh. At the time of recording this, which
Speaker 5: is December fifteenth, twenty twenty, according to the New York
Speaker 5: Times Coronavirus Vaccine Tracker, there are currently forty one vaccines
Speaker 5: in phase one trials, sixteen in Phase two, sixteen also
Speaker 5: in phase three, five vaccines approved for early or limited use,
Speaker 5: and two approved for full use.
Speaker 6: That is huge, amazing, truly phenomenal.
Speaker 5: Absolutely like remarkable. I can't stop smiling thinking about it.
Speaker 5: It's amazing. It just feels like such a relief, and
Speaker 5: it's really hard to take in like good news, and
Speaker 5: so it sort of feels like it's true.
Speaker 6: The news that there are multiple vaccines that have been
Speaker 6: shown to be effective against this virus that causes COVID
Speaker 6: nineteen is some of the best news that we've had
Speaker 6: in a very long time, and it really does finally
Speaker 6: feel like the light at the end of that very
Speaker 6: very long pandemic tunnel we're living in is finally visible.
Speaker 5: Yes, it really does feel that way, but there are
Speaker 5: many questions that remain. There has been a lot of
Speaker 5: concern about the safety of these vaccines and possible side effects,
Speaker 5: in addition to questions of access and vaccine distribution. And
Speaker 5: to help us address these concerns, we were fortunate enough
Speaker 5: to talk to two amazing scientists two two two how cool.
Speaker 5: Doctor Maria Sunderram, postdoctoral fellow at the University of Toronto
Speaker 5: Center for Vaccine Preventable Diseases and fellow at ICES, a
Speaker 5: nonprofit health research organization, and also doctor Orin Levine, Director
Speaker 5: of Vaccine Delivery at the Bill and Melinda Gates Foundation.
Speaker 6: Both are phenomenal interviews. We can't wait for you to
Speaker 6: hear them. We're going to start with doctor Sundram, who
Speaker 6: answered are many, many, many questions about the vaccines themselves,
Speaker 6: questions like what are the ingredients and how do they
Speaker 6: actually work. We recorded this interview on December fourteenth, twenty twenty,
Speaker 6: so we'll let her introduce herself right after this break.
Speaker 8: So my name is Maria Sundram. I'm an infectious disease epidemiologist,
Speaker 8: and I'm a postdoctoral fellow at the University of Toronto
Speaker 8: Center for Vaccine Preventable Diseases, and I'm also a fellow
Speaker 8: at ICs, which is a not for profit research institute
Speaker 8: in Toronto.
Speaker 2: Excellent, Thank you.
Speaker 6: We're very excited to have you here. Over the last
Speaker 6: month or so, there have been some very optimistic and
Speaker 6: exciting headlines with the emergence of what appears to be
Speaker 6: at least three potentially successful vaccines for SARS CoV two.
Speaker 6: Could you kind of break down what those vaccines are
Speaker 6: and how maybe each of them work.
Speaker 8: Yes, definitely. So I think the three vaccines that we're
Speaker 8: talking about are this Pfiser Beyond Tech vaccine, the MODERNA vaccine,
Speaker 8: and then this vaccine that's being developed by Oxford and Astrosenica.
Speaker 8: And it's worth noting there's a couple other vaccines that
Speaker 8: have been approved for use in other countries, but I
Speaker 8: can just talk about these three. I think they've been
Speaker 8: at the top of our national conversation at least. So
Speaker 8: the Pfiser Beyond Tech and the MODERNA vaccines are both
Speaker 8: mRNA vaccines and the Oxford Astrosedtica vaccine is a non
Speaker 8: replicating viral factor vaccine. Your listeners may know that when
Speaker 8: we're talking about kind of a traditional vaccine, normal vaccine,
Speaker 8: like your seasonal flu shot. What we're doing, we're showing
Speaker 8: our immune systems a dead virus, a killed virus that
Speaker 8: can't infect us, but it's the whole thing. So our
Speaker 8: immune systems are seeing this complete virus that is dead
Speaker 8: and saying, Okay, this is really helpful. Now I know
Speaker 8: what this looks like. I'm going to be prepared for
Speaker 8: next time when I see this one that looks like this,
Speaker 8: but it's alive. So we're starting at an earlier point
Speaker 8: in the process with the mRNA vaccines, And what we're
Speaker 8: actually doing there is we're giving our cells, like the
Speaker 8: IKEA instructions to make one part of the virus, and
Speaker 8: in this case, it's the spike protein, which is this
Speaker 8: protein on the outside.
Speaker 3: Of the coronavirus.
Speaker 8: So our cells are able to produce this protein only
Speaker 8: not the whole virus, but just this protein, and then
Speaker 8: they say, Okay, we're going to protect specifically against this protein,
Speaker 8: which is the protein that we really need to protect against,
Speaker 8: and then we're prepared when we see the whole virus.
Speaker 8: So that's really helpful because it allows us to understand
Speaker 8: how to protect against virus without the risk of actually
Speaker 8: getting ill. And the non replicating viral vector that's in
Speaker 8: the Oxford astrosetic vaccine works kind of in a similar way,
Speaker 8: but instead of us making that protein, we're asking a
Speaker 8: different virus to make that protein. In this case, it's
Speaker 8: an adnovirus, So this is another resttray virus that in
Speaker 8: this case it's usually among chimpanzees. It doesn't really cause
Speaker 8: us any physical discomfort or anything. We probably don't even
Speaker 8: notice that it's there, but we've given that this ad
Speaker 8: novirus the information to also make this spike protein. So
Speaker 8: it's on its little membrane, it's it's showing all of
Speaker 8: its sort of normal adnovirus stuff, and then it's also
Speaker 8: got the spike protein. So our immune system is like, oh, okay,
Speaker 8: there's that thing that I need to protect against now
Speaker 8: I know. So that's kind of that's kind of how
Speaker 8: those those vaccines work.
Speaker 5: Awesome. So let's start at the very beginning, and this
Speaker 5: might be sort of a more general question, but you know,
Speaker 5: what are in these vaccines, Like what are the ingredients
Speaker 5: and what do they do? What do each of them do?
Speaker 8: Yeah, so I did talk a little bit about this already,
Speaker 8: kind of like how the mRNA vaccines work, and then
Speaker 8: how this adnavirus factor vaccine works. The other things that
Speaker 8: are in these vaccines. So for example, the Pfizer vaccine
Speaker 8: has lipids, salts, and sugar, and this is pretty similar
Speaker 8: to what's in the MODERNA vaccine as well. So the
Speaker 8: lipids are these tiny little fat globules, and they're there
Speaker 8: because we want to be able to protect this mRNA
Speaker 8: before it can be absorbed into our cells. And I
Speaker 8: said before that mRNA is kind of like an Ikea instructions,
Speaker 8: and it very much is, but it's not in the
Speaker 8: like book that you get for Mikia. It's like it's
Speaker 8: like it was written on ticker tape or like a
Speaker 8: super long CBS receipt. So it's kind of like you know,
Speaker 8: flapping of the wind a little bit. It's bopping around,
Speaker 8: and it can be really fragile, and so we want
Speaker 8: to make sure that when it, you know, when we're
Speaker 8: giving it to people, that it really like stays intact
Speaker 8: enough so that when it gets to our cells it
Speaker 8: really has something meaningful to say, and our cells can
Speaker 8: read it instead of being confused. So they've charged these
Speaker 8: little fat globs and the charge allows the m RNA
Speaker 8: to stick inside them, so it's really it's almost like
Speaker 8: a little sphere that surrounds the mRNA and protects it.
Speaker 8: The salts are the buffer that's in the Physer Beyon
Speaker 8: Tech and the MODERNA vaccines, respectively, allow all of the
Speaker 8: stuff that's in the vaccine, including the engine and everything else,
Speaker 8: to be the same pH and the same solidity as
Speaker 8: our bodies, and that's really helpful so that we can
Speaker 8: only react to the enigen. And then there's sugar in
Speaker 8: both vaccines as well, and this can help, for example,
Speaker 8: if the vaccine has to be extored at very cold temperatures,
Speaker 8: it can help with the vaccine antigen not being damaged
Speaker 8: that process. And then the Bordertra vaccine also has something
Speaker 8: called sodium acetate, and this can be something that kind
Speaker 8: of holds all of this other stuff together, kind of
Speaker 8: stabilizing everything that's in the vaccine. Because there's there's like
Speaker 8: polar items and then there's non polar items, which would
Speaker 8: be the lipids. It can sort of wind up, you
Speaker 8: know how Salad dressing separates and you've got like the
Speaker 8: oil and the vinegar and you have to like shake
Speaker 8: it up in order to like have it be like palatable.
Speaker 8: So we like obviously don't want our vaccines to be
Speaker 8: like salad dressing that has separated. So so some of
Speaker 8: these things, the sodium acetape for example, can help kind
Speaker 8: of stabilize that, and the buffer can help with that
Speaker 8: as well. And both of those vaccines are preservative free.
Speaker 2: Gotcha.
Speaker 6: So there has been some misunderstanding. I think that we've
Speaker 6: heard a lot that these vaccines have the potential to
Speaker 6: give somebody COVID nineteen And I think you kind of
Speaker 6: touched on this already, but could you kind of explain
Speaker 6: more specifically why that isn't possible in this case?
Speaker 8: Yes, I can, so I understand why this is a concern.
Speaker 8: And there are way in the beginning when we are
Speaker 8: making vaccines, we used attenuated versions of viruses, and that
Speaker 8: means kind of, you know, it was alive, but it
Speaker 8: was you know, kind of limping along, not as effective
Speaker 8: as a sort of natural infection against some of these
Speaker 8: different pathogens. And that's still the case for some of
Speaker 8: the immunizations that we receive today.
Speaker 2: There.
Speaker 8: For example, there's a live attenuated version of the flu
Speaker 8: vaccine that you can get in a nasal spray. So
Speaker 8: this is an example of a virus that really can't
Speaker 8: cause illness, but is still sort of limping along enough
Speaker 8: for our immune system to really take notice. These vaccines
Speaker 8: that I've just mentioned, they don't contain a whole virus,
Speaker 8: much less one that's alive. As I mentioned, they only
Speaker 8: contain one part of the virus, which is the spike protein.
Speaker 8: And so there's really there's no virus in any of
Speaker 8: these vaccines that I've mentioned, and so it's really just
Speaker 8: not possible. It's just not there.
Speaker 5: So that being said, you know, there is this advisory
Speaker 5: that people who receive the vaccine are still told you
Speaker 5: should still wear a mask. So can you explain why
Speaker 5: people should wear a mask even after getting vaccinated.
Speaker 8: This is a great question. Why should you wear a
Speaker 8: mask even after you've been vaccinated. So one really important
Speaker 8: thing to remember is that after you get the first shot,
Speaker 8: you're gonna have to wait three weeks and you're gonna
Speaker 8: have to go back for another shot, and then you're
Speaker 8: gonna have to wait a little bit after that to
Speaker 8: build the maximum amount of antibodies that we would consider
Speaker 8: for you to be fully vaccinated. And this is actually
Speaker 8: the case for a lot of vaccines. For example, when
Speaker 8: you get your flu shot, you're not considered to be
Speaker 8: truly vaccinated until two weeks later, because that's when your
Speaker 8: body has made sort of the maximum amount of antibody
Speaker 8: that's going to really protect you throughout the flu season.
Speaker 8: So first of all, you're not sort of immune like
Speaker 8: superhero style, like right after you get the first shot. Unfortunately,
Speaker 8: it's gonna take a while, at least five weeks, and
Speaker 8: you have to go back for the second shot, which
Speaker 8: just also like gonna be challenging, I know for some people.
Speaker 8: The other thing is that part of this is about
Speaker 8: humoral versus mucosal immunity. So when we get these shots,
Speaker 8: we're going to have these antibodies in our blood, and
Speaker 8: you and I know that's not where COVID nineteen goes first.
Speaker 8: It doesn't sort of like get injected directly into our skin.
Speaker 8: It comes into our body through our restory pathways, and
Speaker 8: so there are these mucosal surfaces in our nose, in
Speaker 8: our nasopharynx, kind of the back of our nose and
Speaker 8: throat area that also have kind of their own sort
Speaker 8: of unique mucosal defense mechanisms, and there can be cells
Speaker 8: waiting at that mucosal surface for different pathogens. It's not
Speaker 8: clear yet exactly what kind of immunity we might be
Speaker 8: developing from the vaccine at those mucosal surfaces, and so
Speaker 8: if that's not as rob as the immunity that's in
Speaker 8: our blood, we could wind up sort of hosting COVID
Speaker 8: nineteen in our nasal mucosa and then inadvertently, you know,
Speaker 8: sort of like wiping our nose and then like sort
Speaker 8: of exposing someone else to that. It's possible that it
Speaker 8: could happen. Even though we wouldn't experience sort of physical
Speaker 8: discomfort from any sort of colonization, it's still possible that
Speaker 8: we could spread that onto someone else. And it's always
Speaker 8: possible for us to sort of touch a surface and
Speaker 8: then touch something else that someone else may touch and
Speaker 8: then touch their face. So it's not as though we're
Speaker 8: completely cutting off all modes of transmission. We're reducing them
Speaker 8: quite a lot, but it's still maybe possible to transmit
Speaker 8: that virus even if you don't feel unwell. So that's
Speaker 8: why it's a really good reason to continue wearing a
Speaker 8: mask and continue taking those other precautions as will, including
Speaker 8: washing your hands.
Speaker 2: That makes so much sense.
Speaker 6: So kind of looking big picture, what does the timeline
Speaker 6: look like for these vaccines until like we you could
Speaker 6: just go to our doctor or the pharmacy and actually
Speaker 6: get one. What kind of steps are still remaining in
Speaker 6: the process.
Speaker 8: So I will start by saying, I wish I could
Speaker 8: give you a date. I wish I could give myself
Speaker 8: a date and be like, oh, on this day, that's
Speaker 8: when I'm going to go and get vaccinated. I don't
Speaker 8: have that date yet because so much of this process
Speaker 8: is moving so fast, and there are so many different
Speaker 8: moving components, and all of those moving components are happening
Speaker 8: sort of simultaneously. So a couple of things that I'm
Speaker 8: keeping in mind. You know, certainly it's going to be
Speaker 8: longer for you and for me than it would be
Speaker 8: for healthcare workers, older adults, and essential workers. Those people
Speaker 8: have the greatest risk and they need to be prioritized.
Speaker 8: We need to protect them. The additional steps include sort
Speaker 8: of the manufacturing, the delivery, rolled out campaigns, and you know,
Speaker 8: establishment of systems that help people remember to come back
Speaker 8: for their second dose. Again, that can be really challenging.
Speaker 8: So those are all of the steps for vaccines that
Speaker 8: have obtained this emergency use authorization. For vaccines that aren't
Speaker 8: quite there yet, that's another step. So it's really hard
Speaker 8: to say exactly what all of that means. I'm hopeful
Speaker 8: for the fall, but I have to be honest and
Speaker 8: tell you I'm not exactly sure what date.
Speaker 5: Yes, fair, So, even before this pandemic, there was a
Speaker 5: great deal of vaccine hesitancy, and now many people are
Speaker 5: expressing concerns about receiving a vaccine that was developed so rapidly,
Speaker 5: And you know, is that actually a valid concern? And
Speaker 5: maybe by way of answering that, could you walk us
Speaker 5: through some of the steps being taken to ensure safety
Speaker 5: and efficacy of a vaccine, and these vaccines in particular.
Speaker 8: Yeah, this is a great question. So I completely understand
Speaker 8: that when you're not part of these steps, and when
Speaker 8: you're not sort of living and breathing them every day,
Speaker 8: this can be incredibly confusing.
Speaker 2: It's how happens so fast, and.
Speaker 8: So many other things have been happening this year that
Speaker 8: it's just really really hard to sort of put all
Speaker 8: of us in context, and even people like myself who
Speaker 8: are infectious disease epidemiologists by training and by trade, we
Speaker 8: often struggle to keep up with the incredible amount of
Speaker 8: information that's being sort of circulated every day. So I'll
Speaker 8: walk you through some of the steps thats that have
Speaker 8: been taken to ensure the safety and the effectiveness of
Speaker 8: these vaccines. So this is why we do phase one,
Speaker 8: in phase two, in phase three studies, different phases of
Speaker 8: clinical trials. So in phase one studies, in preclinical studies,
Speaker 8: what we're trying to do is identify is this something
Speaker 8: that could help people, but more specifically, is this something
Speaker 8: that could potentially be harmful to people? And we're continuing
Speaker 8: to ask that question about safety in each subsequent phase
Speaker 8: of clinical trials, and in each subsequent phase, we're asking
Speaker 8: more and more people, Hey, are you feeling okay? How
Speaker 8: was that for you? Are you feeling discomfort? You know,
Speaker 8: do you have like a mile headache? We want to
Speaker 8: know about that as well. And that doesn't stop after
Speaker 8: the emergency use authorization or even after full approval from FDA.
Speaker 8: So the US, for example, and this is true in
Speaker 8: other countries too, but specifically in the US, there are
Speaker 8: several different mechanisms for the reporting and sort of identification
Speaker 8: of different safety outcomes for vaccines. One of those is
Speaker 8: called the Vaccine Safety Data Link and another one is
Speaker 8: called VEYERS or the Vaccine Adverse Event Reporting System. So
Speaker 8: these are super fast mechanisms where we're constantly looking to see, Hey,
Speaker 8: is there anyone who received this vaccine that maybe a
Speaker 8: week later they had like a headache still, or they
Speaker 8: had some fatigue, or they know they had some other
Speaker 8: sort of safety outcome We want to know about that.
Speaker 8: Even though this vaccine has been approved by FDA, we're
Speaker 8: going to continue to ask these questions and continue to
Speaker 8: make sure that there isn't, for example, some really super rare,
Speaker 8: one in a million type of event that could make
Speaker 8: us reassess the risk benefit ratio of this vaccine.
Speaker 5: And so along these same lines, can you talk about
Speaker 5: what emergency use authorization means and whether we've seen this
Speaker 5: before and if we have under what circumstances.
Speaker 8: Yes, I will say we have seen emergency use authorization before,
Speaker 8: and maybe one of the best examples is during the
Speaker 8: two thousand and nine swine flu pandemic. During that time,
Speaker 8: we had an EUA to use tamiflu, which is a
Speaker 8: flu anti viral for children less than a year old.
Speaker 8: At the time, it was already approved for children over
Speaker 8: a year old. But we knew during that swine flu
Speaker 8: pandemic that very young children were having really severe outcomes,
Speaker 8: and we were really concerned specifically for that age group,
Speaker 8: and so we said, okay, you know, the available safety
Speaker 8: data indicates that this is probably a good risk benefit
Speaker 8: ratio for children under one year old, and then you know,
Speaker 8: that kind of became part of our pandemic response. So
Speaker 8: it's certainly not the first time that we've used this mechanism,
Speaker 8: and I think it's really important that we do use
Speaker 8: it when we really need it, such as during a
Speaker 8: global pandemic. Euas can only be given based on Phase
Speaker 8: three results or interim results from Phase three studies, and
Speaker 8: those interim results are sort of decided upon by this
Speaker 8: independent Data Safety and Monitoring Board. And then there's this
Speaker 8: expectation that those applications for euas that companies have to
Speaker 8: make formally to FDA when they apply for the EUA,
Speaker 8: they include all of the safety information from their Phase
Speaker 8: one and their Phase two studies and then ideally their
Speaker 8: Phase three study with a median of two months of
Speaker 8: follow up. So that means that not only are they
Speaker 8: assessing safety outcomes, but.
Speaker 2: They're making sure that they're.
Speaker 8: Identifying safety outcomes on this kind of time frame that
Speaker 8: we really think is relevant as well. So they're not
Speaker 8: just looking for the day after and then like two
Speaker 8: days after they forget about it. No, they really are
Speaker 8: looking for quite a long time after people do receive
Speaker 8: this shot.
Speaker 2: Yeah, that makes sense.
Speaker 6: So I feel like you've explained a lot about how
Speaker 6: we've tried to make sure that this is a very
Speaker 6: safe vaccine. But for people who are maybe still a
Speaker 6: bit nervous or a bit scared, could you explain why
Speaker 6: someone maybe doesn't need to be any more afraid of
Speaker 6: this vaccine than any of our usual vaccines like MMR
Speaker 6: or even the seasonal influenza vaccine.
Speaker 8: So I do think it's understandable why people might be
Speaker 8: more hesitant or cautious about this vaccine development process because
Speaker 8: the mRNA and the viral vector vaccines are relatively new
Speaker 8: to us and the development process has been really quick,
Speaker 8: so it is definitely understandable. I think the main thing
Speaker 8: to remember is that all of these vaccines have gone
Speaker 8: through the same evaluation process as all of the other
Speaker 8: vaccines that we've had. So we took the same amount
Speaker 8: of steps and asked the same amount of questions that
Speaker 8: we would have if this vaccine development process had taken
Speaker 8: ten to fifteen years. We just did it in a
Speaker 8: much shorter timeframe.
Speaker 2: And that was.
Speaker 8: Possible because we all decided sort of as a society
Speaker 8: that these vaccines would be incredibly important to all of us.
Speaker 8: So there was a great amount of monetary support of
Speaker 8: political will, and then also tens of thousands of people
Speaker 8: agreed to be participants in these studies as well, and
Speaker 8: that you know, we wouldn't have had a vaccine so
Speaker 8: quickly if people were slower to say, oh, okay, I'm
Speaker 8: gonna I'm going to participate in this study. So they've
Speaker 8: all gone through the same evaluation process and they all
Speaker 8: continue to be assessed with the same safety reporting mechanisms.
Speaker 8: So you know, we're not just skipping steps just because
Speaker 8: you know, this one time it's convenient for us. No,
Speaker 8: we're still adhering to all of those rules. We're not
Speaker 8: cutting any corners there. And again I kind of mentioned
Speaker 8: this a little bit earlier, but the vaccines also cannot
Speaker 8: these mRNA vaccines and the viral vector vaccines that can't
Speaker 8: give you COVID nineteen because they don't contain the virus M.
Speaker 5: Yeah. I also keep thinking about how this is just
Speaker 5: such a high stake situ situation for the companies producing
Speaker 5: these vaccines, like if there's a misstep, if they you know,
Speaker 5: if something happens, like there's a lot on the line.
Speaker 5: And not only that, but just like public faith or
Speaker 5: acceptance or you know whatever of vaccines that's also hugely
Speaker 5: on the line at this point. And so it really
Speaker 5: does seem like there's so much to risk, So why
Speaker 5: would there be steps skipped or something like that, Like
Speaker 5: there's just so much on the line.
Speaker 8: Oh, yes, absolutely, And you know, they have to still
Speaker 8: get the go ahead from FDA. So if they were
Speaker 8: to skip steps and then apply for this EUA, if
Speaker 8: they skip the steps, FDA has to say, you know what, sorry,
Speaker 8: we can't award you this emergency use authorization. We can't
Speaker 8: do it. And that really, just like you said, it
Speaker 8: represents a huge loss of investment for those companies. There's
Speaker 8: really no reason for them to skip steps, and there's
Speaker 8: a lot of reasons for them to not skip those steps.
Speaker 2: Right, exactly.
Speaker 5: Yeah, So much of this concern also that I've seen
Speaker 5: around seems to be centered around potential side effects of
Speaker 5: the vaccines. And you know, we expect to see things,
Speaker 5: or it's not unusual to see things like mild side effects,
Speaker 5: you know, like you mentioned, a slight headache or maybe
Speaker 5: some fatigue, And this happens for many vaccines, including potentially
Speaker 5: the vaccines for sar's Kobe two. And these side effects
Speaker 5: are not really something to worry about because they do
Speaker 5: seem to be short and mild. But how likely is
Speaker 5: it that additional side effects severe or not that we
Speaker 5: haven't yet seen, or even long term side effects may
Speaker 5: emerge later on, you know, months from now, as more
Speaker 5: people take the vaccine.
Speaker 8: So some of these outcomes, as you mentioned, kind of
Speaker 8: like headache, fatigue, what my mom calls just feeling junkie,
Speaker 8: feeling creuddy, you know, maybe like feeling tired, maybe even
Speaker 8: having like a low grade fever for a day. Those
Speaker 8: kind of they're unpleasant, but they kind of mean your
Speaker 8: immune system is working, and so that's that's a really
Speaker 8: good sign for us. And you know, it's a possibility,
Speaker 8: however small, that rare side effects that maybe more serious
Speaker 8: could happen, and that's why we continue to monitor vaccines
Speaker 8: for safety well after they're approved. We still are doing
Speaker 8: safety assessments for flu vaccines, for example. So we take
Speaker 8: that so seriously, and especially, you know, you mentioned with
Speaker 8: COVID nineteen vaccines, there's so much on the line with
Speaker 8: keeping people safe and then you know, proving to people
Speaker 8: that we've made sure that these vaccines are safe and
Speaker 8: okay for them to get. We really take that so
Speaker 8: so seriously.
Speaker 2: Yeah, definitely.
Speaker 6: So speaking of kind of long term side effects, there's
Speaker 6: been some discussion lately of a fear of antibody dependent enhancement,
Speaker 6: which is something that we've only touched very briefly on
Speaker 6: on this podcast, I think in.
Speaker 2: Our deng gay episode. So what do we know, maybe
Speaker 2: if you.
Speaker 6: Could explain for people who don't remember kind of what
Speaker 6: antibody dependent enhancement is, and what do we know about
Speaker 6: the risk of vaccine induced ad with this COVID vaccine
Speaker 6: or maybe I don't know with vaccines in general.
Speaker 8: Yeah, this is a great question. So antibody dependent enhancement
Speaker 8: of disease is kind of this phenomenon where, for example,
Speaker 8: a vaccine might not work in the way that you
Speaker 8: intended it to work, and for DENGI, we know that,
Speaker 8: for example, if you get infected with deng ye zero
Speaker 8: type one, you may recover and ideally you know it
Speaker 8: won't be like that bad of an infection, and it's
Speaker 8: going to be uncomfortable but maybe not terrible. But then
Speaker 8: your risk of more severe disease, including like dengie hemorrhatic fever,
Speaker 8: is really increased if you then get infected with a
Speaker 8: different zero type like two through four. And that's because
Speaker 8: your body has created these antibodies, but those antibodies don't
Speaker 8: neutralize the virus, and so unfortunately, one of two things
Speaker 8: can happen. One of those things is that those antibodies
Speaker 8: then promote the uptake of the virus into for example,
Speaker 8: macrophages other cells in your immune system, and instead of
Speaker 8: destroying the virus, the virus then infects the macrophage and
Speaker 8: then produces more copies of itself. So that's one sort
Speaker 8: of way in which that can sort of make the
Speaker 8: disease more severe. And the other way that's kind of
Speaker 8: generally seen is that we're reacting to this infection in
Speaker 8: a much more severe way than we might have during
Speaker 8: the first time around, and so our bodies are forming
Speaker 8: these immune complexes that are kind of viruses plus a
Speaker 8: bunch of antibodies glommed on, and they're promoting these kind
Speaker 8: of really severe inflammatory chains that kind of really cause
Speaker 8: a lot of discomfort and maybe some really bad side effects.
Speaker 8: So that's kind of like the two main avenues where
Speaker 8: this could happen and where we've seen it potentially happen
Speaker 8: for stuff like Denky. I will say for sarscov two.
Speaker 8: The studies that have been done in animals, the results
Speaker 8: are really variable about which, if any of these things
Speaker 8: could be happening. But what does seem to be consistent
Speaker 8: is that neutralizing antibodies, so anybody that can sort of
Speaker 8: take out the virus, those do protect animals from subsequent challenge,
Speaker 8: so subsequent exposure to that virus on purpose. And we
Speaker 8: do see neutralizing antibodies for these vaccines, the Pfizer and
Speaker 8: Moderna vaccines that have been reported, because that's a really
Speaker 8: good sign that this is not sort of a major
Speaker 8: concern for these vaccines. And I will say as well,
Speaker 8: this hasn't been sort of a focus of the primary
Speaker 8: sort of efficacy or safety outcomes of the vaccines. But
Speaker 8: it's certainly the case that people in both the Pfizer
Speaker 8: and the Moderna clinical trials will have been zero positive
Speaker 8: at baseline. So that means some people, whether they know
Speaker 8: it or not, will have had a Saruscobe two infection
Speaker 8: before they get vaccinated. And we see very favorable safety
Speaker 8: profiles for both of these vaccines, and so we really
Speaker 8: do sort of that's an additional sort of uh, you know,
Speaker 8: notch that can help us feel comfortable about this, but
Speaker 8: we're obviously going to sort of still be assessing that
Speaker 8: particular question.
Speaker 9: M hm.
Speaker 5: Okay, that is good good news, though we haven't seen
Speaker 5: anything yet that's pretty promising. So, speaking of efficacy, what
Speaker 5: do we know so far about the efficacy of these vaccines?
Speaker 5: Can you walk us through also what efficacy versus effectiveness
Speaker 5: means in terms of vaccines and how that translates into
Speaker 5: protection under real world conditions.
Speaker 8: Yeah, So efficacy versus effectiveness this is something that like
Speaker 8: is totally inside baseball. I think emologists and other epidemiologists
Speaker 8: they're very similar actually. So efficacy really refers to how
Speaker 8: something works, either a drug or a vaccine or something
Speaker 8: else in a clinical trial set under ideal conditions where
Speaker 8: we're asking people to keep a diary and like set
Speaker 8: a remind or seven pm, think about if you have
Speaker 8: a headache, and you know, if you do, like write
Speaker 8: that down. So we're like really like very closely following
Speaker 8: everyone that are in these clinical trials. Now, in the
Speaker 8: real world, you can, I'm sure you can imagine a
Speaker 8: lot of differences. For example, I don't check a time
Speaker 8: or at seven pm every night to see if I
Speaker 8: have a headache. So there is like, you know, the
Speaker 8: real world is a little bit messier, and you know,
Speaker 8: things might sort of float away from us. We might forget,
Speaker 8: for example, that we're feeling just a little junkie today
Speaker 8: if something really good is on TV or something. So
Speaker 8: there's a little bit of a difference in terms of
Speaker 8: like how well we know it works in the ideal scenario,
Speaker 8: where like we're absolutely like assessing every possible thing we
Speaker 8: can assess, and we're making sure everyone's coming back for
Speaker 8: their second dose at the right time. In the real world,
Speaker 8: you know, maybe it doesn't happen exactly that way, and
Speaker 8: so we want to make sure that it's also as
Speaker 8: effective and as safe in the real world setting. And
Speaker 8: so that's what effectiveness is. So when we say the
Speaker 8: Pfizer A modern vaccines are about ninety five percent effective,
Speaker 8: that means we're saying, okay, you know, we gave people
Speaker 8: these shots. We try to get them in at the
Speaker 8: time that they were supposed to do for their second shot,
Speaker 8: but you know, they weren't living in a lab. They
Speaker 8: were also kind of at home, like living their own
Speaker 8: normal lives. So when we say that they're about ninety
Speaker 8: five percent effective, that kind of relates to this understanding
Speaker 8: that this is. We think that this is more mirroring
Speaker 8: like a real world scenario than like a you know,
Speaker 8: a very regimented clinical trial. Of course, they're still in
Speaker 8: a clinical trial. So we do after vaccines become available
Speaker 8: for use by like, for example, you and me, we
Speaker 8: do something called a phase four steady And that's kind
Speaker 8: of to assess, like in truly real world conditions where
Speaker 8: people are not participants in a clinical trial, how well
Speaker 8: is this vaccine working. So we're going to continue to
Speaker 8: update that number.
Speaker 6: What do we know at least so far about how
Speaker 6: long in community is expected to last from the various
Speaker 6: vaccines that we have.
Speaker 8: I will say that the existing evidence sort of suggests
Speaker 8: that immunity is what we call durable up until a
Speaker 8: certain point. So we have this kind of durable immune
Speaker 8: response that seems to last for at least a few months.
Speaker 8: And of course we know exactly how long it lasts,
Speaker 8: because we would need a crystal ball into the future
Speaker 8: to know that for sure. The existing evidence, based on
Speaker 8: the follow up that we've been able to have so far,
Speaker 8: suggests that it does last for at least a few months,
Speaker 8: and that is really great news.
Speaker 5: So what are some of the issues with clinical trials
Speaker 5: and vaccine development in terms of getting you know, like
Speaker 5: a representative subsection of the population. And what does this
Speaker 5: mean for who may be able to get a vaccine once,
Speaker 5: you know, once they're ready or once they're all available,
Speaker 5: particularly in terms of like age group or immune status.
Speaker 8: So yeah, so I already mentioned a little bit how
Speaker 8: you know, clinical trials are like not quite like real life,
Speaker 8: and you've touched on something that I think is so
Speaker 8: important that people who are willing to participate in clinical
Speaker 8: trials are often a little bit different than the people
Speaker 8: who are just in our population in general, So they
Speaker 8: represent a sub section of the general for example, the
Speaker 8: general US population. But maybe not every single person. For example,
Speaker 8: frequently clinical trials for vaccines don't include pregnant women, and
Speaker 8: they don't include people with underlying immunosuppressive conditions, like people
Speaker 8: that have MS or my senia gravis. And that's because
Speaker 8: we want to know is this vaccine going to work
Speaker 8: in people that it absolutely definitely should work in people
Speaker 8: whose immune systems are functioning in the way that we
Speaker 8: kind of expect, and unfortunately this can exclude people who
Speaker 8: are at really high risk sometimes, and so this is
Speaker 8: a really challenging sort of push and pull with vaccine development.
Speaker 8: And the other really important component here I think a
Speaker 8: lot of the clinical trials have really tried to address this,
Speaker 8: but it's still very challenging is that there's probably not
Speaker 8: enough outreach to folks who are not white in clinical trials,
Speaker 8: and so that makes it hard to understand exactly is
Speaker 8: this vaccine going to be, for example, better in this community,
Speaker 8: or is it going to be exactly the same, or
Speaker 8: is it going to underperform, you know, so we need
Speaker 8: to make sure that we're getting a really representative sample.
Speaker 8: And then sometimes age too. I mentioned earlier the EUA
Speaker 8: for Tama flu was sort of then applied to children
Speaker 8: under one year of age. A lot of things are
Speaker 8: not tested for children unless the disease is specifically like
Speaker 8: mostly in children, because we have this different sort of
Speaker 8: you know, risk benefit calculus for children. We really want
Speaker 8: to keep them safe from any possible thing that they
Speaker 8: could experience.
Speaker 2: It's unpleasant.
Speaker 8: So what this all means is that we have a vaccine,
Speaker 8: for example, the Pfizer Beyond Tech vaccine that we feel
Speaker 8: really confident about for adults, and there's some inclusion in
Speaker 8: in their clinical trials of children a little bit younger,
Speaker 8: and we need to follow that data a little bit
Speaker 8: more before we can expand those recommendations to children who are, like,
Speaker 8: for example, younger than sixteen. And we'll probably have to
Speaker 8: do separate studies about the safety and effectiveness of these vaccines,
Speaker 8: for example, in pregnant women or people with underlying immunosuppressive conditions.
Speaker 6: Interesting, I've seen a misconception kind of floating around that
Speaker 6: if you've already had COVID nineteen, you don't have to
Speaker 6: get vaccinated, this like immunity passport kind of idea. Can
Speaker 6: you explain please why that is not the case.
Speaker 8: Yes, So I will say for many folks who do
Speaker 8: have an actual COVID nineteen infection, it does appear that
Speaker 8: they're neutralizing anybody does last again at least a few months,
Speaker 8: So that's a good sort of first step. But I
Speaker 8: will say again, it's not clear that between humoral antibody
Speaker 8: and ucoastal antibody. That's kind of this thing that I
Speaker 8: was talking about earlier, where those cells in your nasofarings
Speaker 8: or your nasal mucos are kind of you know, lying
Speaker 8: in wait for that virus at that sort of respiratory
Speaker 8: epithelial interface. It's also not clear, for example, if you
Speaker 8: actually truly have a COVID nineteen infection, how long you
Speaker 8: may shed that virus. So that's another really important difference
Speaker 8: between COVID nineteen infection and receiving a vaccine against COVID nineteen.
Speaker 8: There are reports of people shedding virus for quite a
Speaker 8: long time. You know, even if you were recovered sort
Speaker 8: of physically and you are feeling great and you have antibodies,
Speaker 8: you could still be exposing other people and that's certainly
Speaker 8: not something that you want to do. And then finally,
Speaker 8: it's not really clear from the available data exactly how
Speaker 8: long you're neutralizing anybody's going to last, and so it's
Speaker 8: really tough to say, oh, you know, I was I
Speaker 8: had a COVID nineteen infection in March, so I'm good,
Speaker 8: I'm superman.
Speaker 2: I can do it.
Speaker 8: Where it's really hard to know based on the epidemiological data,
Speaker 8: what's your antibody level, how much of that antibody is
Speaker 8: neutralizing antibody. Are you going to be able to protect
Speaker 8: other people as well from transmission?
Speaker 3: All of that is unclear.
Speaker 8: So I think maybe the last and possibly the most
Speaker 8: obvious thing to mention here is that it's better to
Speaker 8: get vaccinated. It's not as uncomfortable as getting the actual illness,
Speaker 8: and that's why we have vaccines.
Speaker 2: They're much safer. Absolutely, yes.
Speaker 5: So for our listeners who may know someone who is
Speaker 5: hesitant to receive this vaccine, what advice or reassurance can
Speaker 5: you give them that choosing to get one of these
Speaker 5: vaccines is a better option than taking your chances with
Speaker 5: COVID nineteen.
Speaker 8: I think it's important to consider your kind of risk
Speaker 8: benefit measurement. And I'll tell you guys what I'm thinking
Speaker 8: about when I think about my risk benefit measurement. So
Speaker 8: my risk as cases rise in the US and in
Speaker 8: Canada where I am, my personal risk for infection is
Speaker 8: increasing every day. And it's not the risk doesn't just
Speaker 8: represent like a restory illness of like a common cold.
Speaker 8: It's it's a restory illness that could be quite severe
Speaker 8: for me and could give me really unpleasant long term effects.
Speaker 8: And it's also about the risk of me spreading it
Speaker 8: to others that I really love and care about. And
Speaker 8: on the flip side, I the benefit from this potential
Speaker 8: vaccine is that I could be protected against an illness
Speaker 8: that could cause very severe and or long term illness,
Speaker 8: but it would also give me peace of mind. And
Speaker 8: it wouldn't just benefit me, it would likely also benefit
Speaker 8: my community. So for me, that's more than enough to say,
Speaker 8: you know, this is this is a really good thing
Speaker 8: that I'm doing for myself and also for all of
Speaker 8: the people that I care about around me. If you're
Speaker 8: embarking on a convers you know, on a conversation with
Speaker 8: someone you maybe don't see eye to eye with in
Speaker 8: terms of your risk benefit, or maybe they just have
Speaker 8: questions and they're not totally sure. I think it's really
Speaker 8: important to start for a place of common ground and
Speaker 8: kind of lead with empathy. I know that can be
Speaker 8: challenging sometimes, especially if you don't see eye to eye,
Speaker 8: but if you can see kind of common ground in
Speaker 8: terms of like, you know, you care about the people
Speaker 8: around you, or you don't want to be out of
Speaker 8: work for two or three weeks or potentially longer, you know,
Speaker 8: or thinking about like what is important to them, I
Speaker 8: think that's that is really important. And then as much
Speaker 8: as you can sort of just being patient and empathetic
Speaker 8: with the reasons that they might be concerned or the
Speaker 8: way that they're thinking about risk benefit, I think is
Speaker 8: also really important. It can be challenging sometimes, and so
Speaker 8: I also recommend that you take breaks if you get
Speaker 8: really frustrated and be like, you know what, I'm so sorry,
Speaker 8: I have to go right now. I got to go
Speaker 8: to the bathroom, or like I'm just sitting down to dinner,
Speaker 8: or oh, someone just called me, can I call you back.
Speaker 8: I think it's really helpful and important, like take breaks
Speaker 8: and then maybe revisit it when you're feeling like you
Speaker 8: have more, you know, emotional equipment to have that conversation.
Speaker 8: I've been thinking about this a lot, and how great
Speaker 8: it is that we have a vaccine that can be
Speaker 8: delivered to people in the US now. And I was
Speaker 8: really thinking about my mom, who was born before the
Speaker 8: polio vaccine existed, so she was six when the polio
Speaker 8: vaccine became a thing, and at the time, there was
Speaker 8: just huge amounts of celebration. There were literal ticker tape
Speaker 8: parades for this vaccine because it was just this terrifying
Speaker 8: childhood illness that could just be so challenging and so
Speaker 8: terrible for so many people, and it was a huge
Speaker 8: relief to know that we would be able to protect
Speaker 8: children against that. And I have been thinking about, like, man,
Speaker 8: it's kind of a shame that we can't have a
Speaker 8: ticker tape parade for these vaccines, because they represent an
Speaker 8: incredible amount of effort and sacrifice and hard work on
Speaker 8: so many people, including the trial participants, who have given
Speaker 8: their time and their energy for us to know that
Speaker 8: these vaccines are safe and effective. And I really hope,
Speaker 8: as silly as it might seem, I hope that everyone
Speaker 8: gets a chance to set aside some time and truly
Speaker 8: celebrate the fact that this work has been done and
Speaker 8: it continues to happen, and that people are working so
Speaker 8: so hard to help us bring an end to this pandemic.
Speaker 8: It is truly amazing and just a feat I specifically
Speaker 8: the contributions of the people who have been study participants,
Speaker 8: I think is so amazing, and when I think about it,
Speaker 8: it really it kind of gets me choked up because
Speaker 8: it is literally these people are heroes for us. They
Speaker 8: have helped save so many lives and we're very lucky,
Speaker 8: I think, to live in a world where people are
Speaker 8: going to work this hard to keep us safe.
Speaker 5: Thank you so so very much, doctor Sunderum. That was
Speaker 5: such a great interview. It was so fun too. I
Speaker 5: learned so much, so much good information there and I
Speaker 5: feel like, yeah, I feel just a lot more knowledgeable
Speaker 5: about Yeah, the COVID nineteen vaccines. It's been so hard
Speaker 5: to keep up with all of this news, so exactly,
Speaker 5: it was great to have it into like a digestible
Speaker 5: here you go.
Speaker 2: What exactly?
Speaker 6: I agree, it's been even as someone who's like into
Speaker 6: this kind of thing, right, it's really hard to keep up.
Speaker 5: So but Aaron, we're not done yet. No, we're not.
Speaker 6: We're never done. Just kidding, bevery We also wanted to
Speaker 6: learn more about the logistical challenges that we know are
Speaker 6: huge in trying to get this vaccine distributed, both in
Speaker 6: the US and across the globe. And luckily we were
Speaker 6: able to chat with someone whose actual job title has
Speaker 6: vaccine delivery in the name doctor Orrin Levine. This interview
Speaker 6: was recorded on November twenty fourth, twenty twenty, so we'll
Speaker 6: let him introduce himself right after this break.
Speaker 10: I am orn Levine. I'm the Director of the Global
Speaker 10: Delivery Programs at the Bill Winegates Foundation. In this role
Speaker 10: at the Foundation, I lead a series of teams that
Speaker 10: help to both introduce and scale new life saving vaccines
Speaker 10: and improve primary healthcare systems around the world. One of
Speaker 10: the roles that I play externally for the Foundation is
Speaker 10: that I sit on the board of GAVIY, the Vaccine Alliance,
Speaker 10: which is one of the central players in global organizations
Speaker 10: and more recently in KOVACS, the international collaborative effort to
Speaker 10: vaccinate everybody around the world.
Speaker 5: Awesome. Great. So that first question has to do with
Speaker 5: some of the biggest hurdles to vaccine distribution here in
Speaker 5: the US, and just like big picture, what are the
Speaker 5: kind of things that we might see at a national
Speaker 5: level that might make vaccine deployment a little bit more challenging.
Speaker 10: So preparing for the rollout of vaccines in the US
Speaker 10: or anywhere is going to be an effort of unprecedented scale.
Speaker 10: The number of people that we want to try and vaccinate,
Speaker 10: the speed with which we want to vaccinate them, and
Speaker 10: the fact that we need to vaccinate them with not one,
Speaker 10: but two doses of vaccines make the rollout of COVID
Speaker 10: nineteen vaccines kind of scale and complexity that's really going
Speaker 10: to challenge every system around the world. And the challenges
Speaker 10: can be bucketed if you will, into both supply challenges, right,
Speaker 10: So there's a volume of materials logistics that need to
Speaker 10: be sorted out to make sure that the right vaccines
Speaker 10: end up in the right place, with the right supplies
Speaker 10: and the right people to deliver them at the right time.
Speaker 10: And demand issues, and we're seeing the emergence of demand
Speaker 10: issues around the world in the US and elsewhere. Ironically,
Speaker 10: COVID vaccines had an anti vaccine movement even before they
Speaker 10: had vaccines, and that complicates things in terms of the
Speaker 10: acceptance and demand for the vaccine. So I think one
Speaker 10: of the things I worry about in the usnswhere is
Speaker 10: we can't take for grantedvaccine demand. We're really going to
Speaker 10: have to engage with people and listen to them and
Speaker 10: then answer their questions so that they can feel the
Speaker 10: confidence they need to accept the vaccine and get the
Speaker 10: immunity and protection that comes from those and help us
Speaker 10: all to get back to an increased comfort of interacting
Speaker 10: with each other.
Speaker 6: Are there any hurdles that might be different in terms
Speaker 6: of global distribution of the vaccine compared to the hurdles
Speaker 6: in distribution in the US.
Speaker 10: There are some challenges obviously for different places that differ.
Speaker 10: I tend to focus on what brings us together and
Speaker 10: what's more common, but there are some unique characteristics. One
Speaker 10: is access to the supply. As you may know, there's
Speaker 10: a global effort called covax, which is trying to bring
Speaker 10: together high income countries and low income countries to jointly
Speaker 10: fund a portfolio of vaccines that could then help to
Speaker 10: kind of vaccinate the world evenly. That is operating in
Speaker 10: an environment where there's been a lot of bilateral deals
Speaker 10: individual countries kind of locking out vaccines supply for themselves.
Speaker 10: So one of the things that is different is a
Speaker 10: kind of power dynamic and who's laying claim to different
Speaker 10: doses at different points in time.
Speaker 9: There's a financing element to that as well.
Speaker 10: Wealthier countries are typically able to pay more, and that
Speaker 10: sometimes puts them at the front of the line in
Speaker 10: those negotiations. A big reason why covax was created because
Speaker 10: it's I think a shared value of many of us
Speaker 10: that in the middle of a pandemic, vaccine allocation should
Speaker 10: be equitable, not just driven by the lottery of whether
Speaker 10: you happen to live in a country that's wealthier than
Speaker 10: another one.
Speaker 1: Yeah.
Speaker 5: Absolutely, We've heard a lot about different countries pre purchasing,
Speaker 5: as you mentioned, these large stocks of vaccines, and so
Speaker 5: in effect, though we might have several different vaccines available,
Speaker 5: which vaccine will a different country choose and will that
Speaker 5: be determined by what might be available in terms of
Speaker 5: like just the sheer number of vaccine stocks that are
Speaker 5: already pre purchased.
Speaker 10: Yeah, I think Aaron that that's going to be one
Speaker 10: of the.
Speaker 9: Complex parts of this of this rollout.
Speaker 10: As different vaccines emerged with different characteristics and different efficacy
Speaker 10: and different price, you'll have preferences by different countries for
Speaker 10: these pieces. So, for example, many of us will probably
Speaker 10: remember where we were when we first heard that there
Speaker 10: was a COVID vaccine that worked. The first one that
Speaker 10: we heard about was the Pfizer vaccine, and that vaccine
Speaker 10: reportedly has over ninety percent efficacy, which is really really good.
Speaker 10: It's also a complicated vaccine to deliver in terms of
Speaker 10: some of its characteristics. It requires what's called ultra low temperatures.
Speaker 10: It's required to be stored at negative seventy celsius. Most
Speaker 10: vaccines are stored between two and eight degrees celsius, which
Speaker 10: is like your kitchen refrigerator. Some vaccines are stored at
Speaker 10: negative twenty celsius, which is more like your freezer of
Speaker 10: your kitchen refrigerator or your or your downstairs freezer. Negative
Speaker 10: seventy is dry ice. You got to wear of admits
Speaker 10: when you handle it. You got to have a special
Speaker 10: supply chain for it. It also is administered in a
Speaker 10: point three mL dose. Every other vaccine is administered as
Speaker 10: zero point five mL dose, and so it requires a
Speaker 10: little bit of special training, a little bit of special handling,
Speaker 10: an ultra cold chain delivery system. It's going to be
Speaker 10: more complicated. On the other hand, it's going to deliver
Speaker 10: ninety five percent efficacy and have a differential price point
Speaker 10: from other vaccines, So that complex mixture of can I
Speaker 10: afford it, can I get it?
Speaker 9: When can I get it? How much can I get it?
Speaker 10: Can I manage the complexity of the ultra cold chain pieces.
Speaker 10: Those are all going to figure into the decisions that
Speaker 10: countries make and the plans that countries make in order
Speaker 10: to roll those vaccines out to everyone. If we think
Speaker 10: about low and low middle income countries, ironically, they have
Speaker 10: some of the most experienced working with ultra cold chain vaccines.
Speaker 10: The early Ebola vaccines required negative seventy as well, and
Speaker 10: so countries like the Democratic Republic of Congo and Rwanda, Uganda, Guinea,
Speaker 10: Sierra Leone, Liberia, these are actually countries that have experienced
Speaker 10: using in small volumes ultra cold chain requiring vaccines. But
Speaker 10: that complex set of factors is what I think we'll
Speaker 10: go into the decisions that countries make and the rollout
Speaker 10: plans that they make with the vaccines.
Speaker 3: M hmm.
Speaker 5: That's interesting. That hadn't really occurred to me before, but
Speaker 5: that completely makes sense. And so it seems like on
Speaker 5: the surface, it's great to have different options for a
Speaker 5: successful COVID nineteen vaccine, But then you start to think
Speaker 5: about the logistics and how if the vaccine requirements are different,
Speaker 5: both in terms of the number of doses required or
Speaker 5: storage requirements, then you have to just, like you know,
Speaker 5: bulldoze forward with one of those options. Is that what
Speaker 5: we might end up seeing for some of these countries
Speaker 5: or do you think it might be Oh well, we'll
Speaker 5: have to just kind of create a different supply chain
Speaker 5: or a different deployment chain for each one of these
Speaker 5: in case one ends up working better than the others,
Speaker 5: or one is cheaper than the others, or one is
Speaker 5: going to be more available than the others.
Speaker 10: I think early on Aaron, there's probably going to be
Speaker 10: a intention wherever possible to supply a country with a vaccine,
Speaker 10: rather than to have multiple vaccines flowing through countries. Now,
Speaker 10: if it's a big enough country and each sub geography
Speaker 10: is large enough, you might think about that. But ideally,
Speaker 10: because these vaccines aren't going to be interchangeable with one another,
Speaker 10: you're going to want to simplify I think that part
Speaker 10: of the supply chain, and then from thereforward, say everybody
Speaker 10: in this country is getting either this mRNA vaccine or
Speaker 10: this live vaccine or this inactivated vaccine. Those decisions to
Speaker 10: kind of supply a country with a single vaccine simplify
Speaker 10: some of the logistics that would become way more complex
Speaker 10: if there are multiple vaccines flowing around at a subnational level.
Speaker 5: Yeah, so earlier you touched on how there was an
Speaker 5: anti vaccine movement or an anti covid vaccine movement even
Speaker 5: before there was a COVID vaccine. And of course a
Speaker 5: lot of this mistrust or skepticism that surrounds vaccines has
Speaker 5: been growing in general in the past few decades, and
Speaker 5: especially from some communities that might already be rightly distrustful
Speaker 5: or mistrustful of the medical system. So could you talk
Speaker 5: about how that plays into not only vaccine development, administration,
Speaker 5: and also what are some of things that could be
Speaker 5: done to rebuild trust in those communities.
Speaker 10: Honestly, one of the things that keeps me up at
Speaker 10: night is the demand side of this. As a personal
Speaker 10: who spent my career working in vaccines, I literally think
Speaker 10: vaccines have an opportunity to save the world.
Speaker 9: Right, Like, the.
Speaker 10: Thing that is keeping us from interacting is that we
Speaker 10: have a virus for which all of humanity lacks immunity,
Speaker 10: and vaccines have the potential to confer that immunity to
Speaker 10: all of humanity, but only if people are willing to
Speaker 10: accept them, only if people are are ready to be immunized.
Speaker 10: And to do that, people have to trust their health system,
Speaker 10: They have to trust their medical providers, they have to
Speaker 10: trust the process by which the vaccines were carefully manufactured,
Speaker 10: carefully regulated to make sure that they're safe potent when
Speaker 10: they come out. And any of us who's a human
Speaker 10: knows that that trust is slow to build and quick
Speaker 10: to erode. And in the most recent era, we've had
Speaker 10: an erosion of trust on many levels, some of it
Speaker 10: related to vaccines specifically, and some of it more generally
Speaker 10: in institutions, in science and many other things. So I
Speaker 10: hope we can use vaccines actually as an opportunity to
Speaker 10: restore trust. And that restoration probably starts with listening to people.
Speaker 10: There's been too much, in my view, polarizing yelling at
Speaker 10: each other, and other enough listening to one another. So
Speaker 10: I'm really hopeful that one of the things.
Speaker 9: That will a side effect, if you will, of a
Speaker 9: COVID vaccine will be forget people to listen to one another.
Speaker 2: Yeah, that'd be the dream, that would be fantastic.
Speaker 5: In terms of vaccine specifically, and maybe vaccine deployment or
Speaker 5: administration on global scale. You know, what do you think
Speaker 5: are the major lessons we've learned or how will this
Speaker 5: have changed the way that we view either emerging infectious
Speaker 5: diseases or vaccines in the future.
Speaker 9: I think there's a lot of opportunity.
Speaker 10: I keep trying to look for silver linings in all
Speaker 10: of this, and I think there is some opportunity going forward.
Speaker 10: Let me give you one of the examples of the opportunity.
Speaker 10: I think the rollout of COVID vaccines offers us. In
Speaker 10: many communities where we work, young adults may not be
Speaker 10: very engaged in their health system. They may not be
Speaker 10: regularly getting preventive care. They may not be getting screened
Speaker 10: for some of the concerns that they have, or getting
Speaker 10: access to family planning or other preventive services. I wonder if,
Speaker 10: in the execution of our rollout of COVID vaccines, if
Speaker 10: we integrate COVID vaccination with a package of services that
Speaker 10: they want and value.
Speaker 9: If we won't, if.
Speaker 10: You will draw into the health system a large set
Speaker 10: of people who've been needing or potentially benefiting from health interventions,
Speaker 10: but who've been not accessing the system in the future
Speaker 10: in the past, and so if we can use the
Speaker 10: act of engaging with them around COVID vaccination to engage
Speaker 10: with them around a broader set of health prevention and
Speaker 10: health conditions, it could be that the rollout of COVID
Speaker 10: vaccines helps impact people's health well beyond conferring immunity.
Speaker 9: I personally can't.
Speaker 10: Wait for us to get to the point where we're
Speaker 10: successful rolling out vaccines. I haven't seen my mom and
Speaker 10: dad in nearly a year, and I want to be
Speaker 10: able to hug my mom and dad without worrying about
Speaker 10: sharing a deadly virus with them.
Speaker 9: So my interests are both global.
Speaker 10: And and equity, and you know, partly deeply personal as well.
Speaker 10: And thanks for you know, sharing these kinds of stories
Speaker 10: and this information with with your listeners, because I think
Speaker 10: they're a big part of making this a success.
Speaker 5: Thank you so so much again, doctor Sundram and doctor Levine.
Speaker 5: It was so great to talk with you, and we
Speaker 5: really appreciate you taking the time out of your incredibly
Speaker 5: busy schedules to help us all get some more info
Speaker 5: about vaccines.
Speaker 6: Yes, we learned so much, so As always in these
Speaker 6: COVID nineteen episodes, we want to summarize with five key
Speaker 6: points that we want you to take away from this episode.
Speaker 6: So number one, we learned that there are at least
Speaker 6: three different vaccines that are very close to approval or
Speaker 6: in some cases have been approved already in the US
Speaker 6: and the UK and a few other countries. So these
Speaker 6: are the ones that we focused on for this episode.
Speaker 6: These are the Peiser vaccine, the Moderna vaccine, and the
Speaker 6: Astrozenica vaccine. And importantly, none of these vaccines contain the
Speaker 6: entire SARS covy two virus. They all contain what are
Speaker 6: essentially instructions of one kind or another to make one
Speaker 6: protein or antigen that is specific to SARS CoV two
Speaker 6: that our body can then recognize and respond to in
Speaker 6: the case of a future exposure or infection. So what
Speaker 6: that means is that none, I'll repeat none of these
Speaker 6: vaccines is capable of giving somebody COVID nineteen, which I
Speaker 6: think is so important. While it is normal to have
Speaker 6: some mild side effects after a vaccine, like a headache
Speaker 6: or maybe pain where you got the vaccine shot, or
Speaker 6: even a mild fever or just feeling kind of cruddy.
Speaker 6: These kind of symptoms don't mean that you have COVID nineteen,
Speaker 6: and they don't mean that you're infectious to others either.
Speaker 6: They just mean that your immune system is doing its
Speaker 6: job and responding to the vaccine, which is awesome and
Speaker 6: what we want your immune system to do.
Speaker 5: Yes number two. These vaccines have gone through the same
Speaker 5: exact safety and evaluation steps that other vaccines, like the
Speaker 5: seasonal influenza vaccine or the musles, mumps and rubella vaccines
Speaker 5: also had to go through. All of the same regulatory
Speaker 5: and safety questions were asked about the COVID nineteen vaccines
Speaker 5: as they were for these other vaccines that were more
Speaker 5: familiar with the difference is that with these COVID nineteen
Speaker 5: vaccines we were able to ask and answer these questions
Speaker 5: in a much shorter timeframe, which was made possible by
Speaker 5: the sheer amount of people and resources committed to this project.
Speaker 5: And like those other vaccines, we will continue to monitor
Speaker 5: the safety of these COVID nineteen vaccines, both in the
Speaker 5: people who were involved in the clinical trials as well
Speaker 5: as everyone else who takes them. Tens of thousands of
Speaker 5: people were involved in these COVID nineteen vaccine clinical trials,
Speaker 5: and the results have been very encouraging, not just in
Speaker 5: terms of efficacy, but also in terms of safety. Some
Speaker 5: mild side effects such as headache or fatigue might be expected,
Speaker 5: as you mentioned in point one erin, but so far
Speaker 5: it doesn't appear that there are major adverse events associated
Speaker 5: with the vaccine, and are incredibly robust vaccine adverse event
Speaker 5: reporting system means that any and all side effects of
Speaker 5: these vaccines will be cataloged and closely examined, and if
Speaker 5: there do emerge more severe side effects later on, we
Speaker 5: will catch them.
Speaker 2: Like very early immediately.
Speaker 5: And one thing I keep coming back to is just
Speaker 5: how much is at stake with these vaccines. Yeah, the
Speaker 5: companies and the governments that have invested so much time
Speaker 5: and resources into vaccine development, public support for vaccines. There's
Speaker 5: a lot to lose here and so very very much
Speaker 5: to gain. A misstep could be incredibly costly in many ways.
Speaker 5: And for that reason, there are many, many, many people
Speaker 5: ensuring the safety and efficacy of these vaccines.
Speaker 6: Absolutely, and speaking of efficacy, point number three, just how
Speaker 6: effective are these vaccines? It turns out very so. We
Speaker 6: learned from Maria that effectiveness is looking at how much
Speaker 6: protection these vaccines are going to provide in the real world,
Speaker 6: not just in a clinical trial or a very controlled setting.
Speaker 6: And in the case of these trials that have been
Speaker 6: conducted already, it seems like the vaccine candidates we have
Speaker 6: appear to be ninety or ninety five percent effective, which
Speaker 6: is amazing.
Speaker 2: Truly amazing.
Speaker 6: Really, we also know from these studies that immunity seems
Speaker 6: to be durable at least for a few months, which
Speaker 6: is great that we know that it lasts for at
Speaker 6: least a little while, although we still don't know exactly
Speaker 6: how long immunity will last, and this is also true
Speaker 6: for infection. We know that immunity after infection lasts for
Speaker 6: at least a few months as well. But especially in
Speaker 6: the case of these vaccines, immunity isn't immediate. Because all
Speaker 6: the vaccines that we have that are close to approval
Speaker 6: are two dose series, meaning you have to get one
Speaker 6: dose and then another three weeks later. Full immunity isn't
Speaker 6: expected until at least five weeks or longer after the
Speaker 6: first vaccine, or two weeks after you get that second dose.
Speaker 6: And because these are not live virus vaccines and they're
Speaker 6: given in our arms rather than through like our nose,
Speaker 6: like some of the live flu vaccine nasal sprays. We're
Speaker 6: not positive about the amount of mucosal immunity that they provide,
Speaker 6: so it's at least theoretically possible that even after vaccination,
Speaker 6: somebody could harbor the SARS covy too virus in their
Speaker 6: mucous membranes. And even after a real infection with SARS
Speaker 6: covy two, people can shed virus for a really long
Speaker 6: time after infection, and that is why it's so important
Speaker 6: that even after vaccination or infection, we continue to practice
Speaker 6: all the same control strategies we've discussed at length, like
Speaker 6: wearing a mask, social distancing, etc.
Speaker 5: Yeah, it's just one more layer of that Swiss cheese situation.
Speaker 5: Point four. Developing effective vaccines against the virus that causes
Speaker 5: COVID nineteen was just the first necessary step. It was
Speaker 5: hugely important, but it's still just the first step because
Speaker 5: we still need to get these vaccines to the people
Speaker 5: who need them.
Speaker 2: If you've been.
Speaker 5: Keeping up with the news, we've already started the rollout
Speaker 5: of vaccines here in the US and in the UK,
Speaker 5: as well as some other places to the highest priority
Speaker 5: recipients like frontline healthcare workers and those residing in long
Speaker 5: term care facilities. But the logistics of vaccine rollout are
Speaker 5: enormously complex and will require the construction of a lot
Speaker 5: of different moving parts. For instance, all of these vaccines
Speaker 5: that are close to approval or have been approved are
Speaker 5: two dough series, which does make their rollout a bit
Speaker 5: more challenging to make sure everyone gets both doses in
Speaker 5: the proper timeframe. Fortunately, some countries have the supply and
Speaker 5: deployment change already in working order from past vaccine campaigns,
Speaker 5: but the existence of three different vaccines that may vary
Speaker 5: in their storage and administration requirements could lead some countries
Speaker 5: to build up a system around one of the types
Speaker 5: of vaccines. And I mean, all in all, it's kind
Speaker 5: of a good problem to have, like we'd rather be
Speaker 5: choosing among several effective vaccines rather than none at all,
Speaker 5: But it does mean that some places will have to
Speaker 5: put their resources towards one of these vaccines over the other.
Speaker 6: And finally, point number five, which I think is one
Speaker 6: of the biggest take home points for me, especially vaccine
Speaker 6: hesitancy is an important issue, especially for these new COVID vaccines,
Speaker 6: but hesitancy in the face of something as new as
Speaker 6: this vaccine. It's really understandable, and it's important for us,
Speaker 6: you know, as educators or even if you're just talking
Speaker 6: with friends and family, to address people who may be
Speaker 6: hesitant or have questions about this new vaccine.
Speaker 2: Empathy.
Speaker 6: Maria Sundram had I think some really good advice, which
Speaker 6: was to start any conversation by trying to find a
Speaker 6: place of common ground, whether that be concerns about getting
Speaker 6: sick yourself or concerns about spreading disease to loved ones,
Speaker 6: whatever it might be. But by starting from a place
Speaker 6: of common ground, it's at least possible to have a conversation,
Speaker 6: whether about vaccines or honestly.
Speaker 2: This is just good advice for life.
Speaker 6: And from Orn's interview, and this is important especially on
Speaker 6: a community and kind of larger scale. We can't just
Speaker 6: assume that there's going to be a demand for this
Speaker 6: vaccine or any of these vaccines. We have to have good, honest,
Speaker 6: open communications surrounding these vaccines and the development process and
Speaker 6: everything surrounding them, and encourage that people get it and
Speaker 6: make it really easily available, rather than just assuming that
Speaker 6: people are going to want a vaccine or will seek
Speaker 6: it out on their own.
Speaker 5: Yeah, that's definitely true. I feel like now it's more
Speaker 5: important than ever to maybe have these conversations and you know,
Speaker 5: practice this empathy. It's crucial right.
Speaker 2: Now to do that.
Speaker 3: Yeah.
Speaker 5: A huge thank you again to doctor Sundram and doctor
Speaker 5: Levine for taking the time to chat with us about
Speaker 5: these amazing COVID nineteen vaccines.
Speaker 2: We learned so much we did. Also a huge thank you.
Speaker 6: To Diane Scott and Ambersetti's for helping to set us
Speaker 6: up to chat with doctor Levine.
Speaker 5: Yes, and if you want to learn even more about
Speaker 5: these COVID nineteen vaccines and other vaccines in development against
Speaker 5: the SARS coby two virus, there's an amazing, amazing vaccine
Speaker 5: tracker that was developed by a huge team of brilliant people,
Speaker 5: including doctor Sundram at McGill University and also at the
Speaker 5: University of Minnesota, among other places. It's an incredible resource
Speaker 5: with tons of great information and you can find it
Speaker 5: at COVID nineteen dot track, vaccines dot org and we
Speaker 5: will also post a link to it in our show
Speaker 5: notes as well as on our website.
Speaker 2: Yeah.
Speaker 6: I think this is a great resource either for you,
Speaker 6: or maybe to send to friends and family that might
Speaker 6: be asking questions. It's just a really comprehensive resource. Thank
Speaker 6: you so much to Bloodmobile, who provides the music for
Speaker 6: this episode and all of our episodes.
Speaker 5: And thank you to the Exactly Right Network, which we
Speaker 5: are a very proud member of and without whom this
Speaker 5: podcast would not be possible.
Speaker 6: This podcast would also not be possible without you, dear listeners,
Speaker 6: so thank you so much for listening to it all.
Speaker 5: Thank you, thank you, thank you. Until next time, wash
Speaker 5: your hands.
Speaker 11: You filthy animals. Um um