Infectious Disease

Accelerating the gradual adoption of COVID-19 vaccines

January 06, 2021

4 min read

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Healio interviews.

Disclosure:
Keren and Offit do not report any relevant financial information.

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More than 17.2 million doses of COVID-19 vaccine have been distributed in the US, and around 5.3 million people have received one dose, according to the CDC.

As the US nears 22 million cases of COVID-19, some criticize the vaccine’s roll-out as slow, according to Johns Hopkins University.

Philadelphia Children’s Hospital (CHOP) currently has three sites that deliver COVID-19 vaccines. According to the doctor treating the CHOP and the Chief Medical Officer, two more locations are to be added in the coming weeks Ron Keren, MD, MPHThe facility is working with the Philadelphia Department of Health and the Pennsylvania and New Jersey Health Departments to vaccinate 20,000 CHOP employees under the CDC Management Plan.

Ron Keren

“We vaccinated 300 to 500 people a day,” Keren told Healio. “We’re on the move non-stop and we have probably vaccinated around 6,000 people by this point. We hope to be able to offer the vaccine to all of our employees … by the end of this month.”

According to Keren, CHOP geocoded each employee’s address to create heat maps to show where higher concentrations of people live.

While CHOP’s program has had some success in the first few weeks of vaccine delivery, other places have not. Healio spoke to Paul A. Offit, MD, Director of the Vaccine Education Center at CHOP, on the national rollout.

Question: Is there a problem with the rollout? If yes, what IDoes it cause?

Paul A. Offit

Reply: Yes, there is a problem with the rollout. I think it’s a lot slower than you would expect and that has three components. One is mass production, the second is mass distribution, and the third is mass management.

To do this, we need to put in place a public health structure that does not currently exist. In retrospect, I think it should have happened that months before these vaccines were ready to be sold we should have provided the money to create this infrastructure. And we didn’t. Most recently, Congress approved $ 9 billion for this, but it should have come sooner.

We’re not used to that. We have never done that before. I think we need to have mass vaccinations. It’s not just about going to the pharmacy and getting the vaccine at will. We have to line up people and dispense these vaccines in stadiums, synagogues, churches, or wherever people come together in large numbers, one at a time. That takes planning and thought.

Q: Are you in favor of delaying the second vaccine dose as recommended in? a recently Washington Post ÖPinion piece ?

A: No I’m not. If you look at the Phase 3 study for the Pfizer or Moderna vaccine, you will get the first dose. Depending on whether it is Pfizer or Moderna, you will be given the second dose 3 or 4 weeks later. There is a period when you were only given one dose. At Pfizer, there was evidence that around 50% of people who received the vaccine were protected, and for the Moderna study, it was 80% and 90%, depending on when you looked.

One could only say that for a few weeks people were protected from what something is. But if you’re going to say, “OK, let’s just give everyone a first dose and then we’ll get them a second dose if we can,” that second dose will boost your immune response dramatically. You need this second dose.

So if you interfere with the program [and] A week or two goes by, it’s no big deal. But when a few months go by, that’s a big deal because by now you may have figured out that yours was a dose that you knew worked, or [to an] Extent effective for a few weeks, was ineffective for a few months, and you only have a population that is not protected now. I think you shook an already fragile vaccine [mentality] in this country.

Q: What is your opinion on the halving of the doses?

A: Pretty much the same. This is the result of a phase 2 study with a Moderna product in which the immune response to 50 µg mRNA was compared to 100 µg. In total, 100 µg is the dose we’re moving forward with and the immune response was found to be similar. They thought, “Okay, if the immune response was similar, the protective effect is probably similar too.” You do not know that. That is why you do phase 3 attempts. It is for this reason that you are conducting experiments to see if these vaccines actually help prevent disease, as we do not have an immunological core for many of the vaccines currently on the market. That said, you can tell when I have a certain level of neutralizing antibodies to this virus, I know I am being protected. We don’t have that for this vaccine yet. We could, but we don’t have it yet. That puts a lot of faith in that immune response to say that this is a protective immune response too, if you don’t already know. I think it’s a terrible idea. It’s even worse than the other idea [of delaying second doses].

Q: Do you feel that this rollout issue was inevitable?

A: To a certain degree. It’s hard to do. We don’t have any infrastructure. I think the current administration hasn’t paid much attention to that. I think they thought after they made the vaccine they were doing their job. I think they realized how difficult it is to mass-produce, distribute and mass-administer a vaccine. You are learning this, and it is to be hoped that the next government will devote more time to it. But we need a plan. We expect plans from our managers, not hints. And right now we’re just getting a lot of clues.

Q: how is it? the chop Vaccination rollout walk?

A: We vaccinate 12 people in different locations every 30 minutes. We vaccinate hundreds of people a week. We’re going to have thousands of people in a couple of weeks so I think we’re pretty efficient at that.

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