On this last episode, we look back on 23 years of joyous, difficult and always informative conversation.
This week, Pfizer announced its COVID-19 vaccine may be 90% effective. These results are promising — Dr. Anthony Fauci said this was “just extraordinary.”
In the meantime, states nationwide are preparing for the moment they receive their first vaccine doses, and are already making distribution plans as outlined by the CDC. We hear what those plans look like in our region and what challenges may be ahead.
Produced by Inés Rénique
- Dr. Leana Wen Emergency Physician, Washington Post Columnist, Visiting Professor, George Washington School of Public Health; @DrLeanaWen
- Kurt Seetoo Program Manager, Maryland’s Department of Health Center for Immunization
KOJO NNAMDIYou're tuned in to The Kojo Nnamdi Show' on WAMU 88.5, welcome. Later in the broadcast we talk COVID long-haulers, the term coined for those suffering from long-term symptoms. But first it's the news of the week. Pfizer is on the brink of success in developing a COVID-19 vaccine. The vaccine could be 90 percent effective. It's great progress, but now comes the question of how fast it can be produced and distributed, and how safe it's likely to be. Our region is already preparing. Joining us to discuss this is Dr. Leana Wen, Emergency Physician, Contributing Columnist to The Washington Post and Visiting Professor at George Washington University. Dr. Wen, thank you for joining us.
DR. LEANA WENAlways glad to be with you, Kojo.
NNAMDIAnd I'd love to have you join the conversation too. Give us a call at 800-433-8850. Are you hopeful that we'll have access to a vaccine soon? You can send us a tweet @kojoshow, email to firstname.lastname@example.org or go to our website kojoshow.org join the conversation there. Dr. Wen, 90 percent effective sound really promising, but what do we know about what comes next in the vaccine development and distribution process?
WENWell, I am very optimistic about this Pfizer vaccine and the news that we have so far. Although we do need to take a step back and talk about what we don't know. So what we do know is based on a press release. None of us have seen the data from the company. But based on the press release we understand that in the preliminary studies so far that this vaccine prevents over 90 percent of COVID-19 infections.
WENBut what we don't know is whether that then translates to preventing severe illness, hospitalization and death, which are the endpoints that I think we really care about. We don't just care if somebody gets a sniffle or tests positive. We care about whether it prevents this kind of severe illness. Also we don't yet know about safety. That's going to take time and this is the reason why there will be a delay between when emergency use authorization for this Pfizer vaccine is given, because we have to wait for that safety data to come back.
WENAnd I think it's important for all of us to keep in mind to look there is light at the end of the tunnel, but that hope that's on the horizon is not going to be here for several months at the very earliest. And that means that we really have to get through this winter. And this winter, the way that we're going now looks extremely bleak. We are breaking every record today and we're going to be breaking them again tomorrow. We're on track to seeing a horrific 300,000 new daily infections in the U.S. More than 2,000 people die in the U.S. every year, by the end of this winter, and there need to be steps that we can be taking right now. Even though a vaccine is on the horizon, we need to get through this winter first.
NNAMDIJoining us now is Kurt Seetoo, the Program Manager from Maryland's Department of Health Center for Immunization. Kurt Seetoo, thank you for joining us.
KURT SEETOOThank you for having me.
NNAMDITell us a little bit about the Center for Immunization and what role it plays in vaccine distribution.
SEETOOSure. The Center for Immunization here at the Maryland Department of Health, we're responsible for -- one of our main programs is the vaccines for children programs were we deliver vaccines out to providers offices in the state that are able to vaccinate those children that are deemed eligible with the vaccines for children's program. And those children will get vaccines free of cost to the children. And we are able to hopefully get rid of any kind of discrepancies or disparities that may prevent those children from getting vaccinated.
SEETOOWe have also been in the process of developing our plan in terms of distributing the COVID vaccine. We've been working on a plan since April and we are looking forward to seeing when the vaccine does come out so that we can put our plan in place and get vaccine distributed.
NNAMDIWell, let's talk about what date that will be. A couple of weeks ago, the CDC told states to prepare to receive and possibly even distribute coronavirus vaccines by November 15th. That is very soon, just a few days away. Will a vaccine actually be ready to distribute by then?
SEETOOYou know, at this point it's unknown. We do not know when the vaccine manufacturers will be applying for their EUA or their emergency use authorization. So at this point, November 15th will be kind of a long shot to be ready by then, because as far as we know, those vaccine manufacturers have not submitted an EUA application yet. So that has not been approved.
NNAMDIBut I imagine there has to be a lot in place for when the vaccine is ready. What is your office doing -- or what needs to happen now? You did talk a little bit about that before.
SEETOOSure. So we do have a plan in place and we have gotten our systems ready. The main way the vaccine will be distributed is through the CDC's vaccines for children program system that they have already. And we distribute millions of doses each year through this system. So we are pretty confident that we'd be able to get the vaccine out to the provider's offices as needed. What we will be doing is that we will be asking providers that are interested in being COVID vaccinators to register with our system so that we know that they're interested in getting vaccine.
SEETOOAnd then once vaccine is available to send out to these different providers we will be able to use our current system to get that vaccine distributed out to all the interested providers.
NNAMDIKurt, this has been a matter of debate for a while now. Who will be getting the vaccine first and who decides that?
SEETOOSure. That's a great question. So when vaccine first comes out, there will be a very limited supply. So with this limited supply we'll be vaccinating those that are probably at the highest risk of being exposed to COVID disease. So your healthcare workers, your first responders and those at highest risk for complications if they were to get COVID. So those are the assumptions that we're working off of right now.
SEETOOBut we are awaiting the official recommendations to come out from the advisory committee on immunization practices or ACIP. They will be meeting once there are some vaccines that have submitted their EUA application. And then they will go ahead and make their official recommendations on who should be in those high priority groups. And from there we'll go ahead and focus on those groups and get the vaccine out to them.
NNAMDIDr. Wen, before I go to the phones, as a medical doctor, what are your thoughts on who gets priority when a vaccine is ready? And how are doctors involved in those decisions?
WENYeah. It's a great question. We do need to have a framework setup in advance. And there will be frameworks for who should get the vaccine first. And that does include people on the frontlines, people who are the most vulnerable including communities of color that have suffered disproportionately from coronavirus. But we all know that it's not enough for us to just have the policies in place unless we also have the mechanisms to literally deliver on these policies. And so I am certain that all of our colleagues around the country who are in public health will be in involved in establishing these frameworks so that it's a combination of public education combined then with the actual mechanisms of delivering the vaccine to those who are the most vulnerable.
NNAMDIKathy in Orlando, Florida. Kathy, you're on the air. Go ahead, please.
KATHYOh, hi. I just wanted to call and let you know that I participated in the Moderna NIH study here through a lab here in Orlando, and it's going well. I had my two vaccines and we do follow-up and it's great. And we're excited.
NNAMDIWhen did you get the vaccine?
KATHYSeptember and October, I had, it's a two doses. One dose each -- it's a double blind study. So nobody really knows, but I kind of felt -- yeah, that I did.
NNAMDISure. Okay. And that was back in September?
KATHYIt was. The first dose was September 2nd. The second dose October 2nd.
NNAMDIOkay. And you're feeling fine?
KATHYYes. Feeling fine. So it's going great. We're excited. We're getting there. It's close, right?
NNAMDIWhat made you decide to volunteer for the trial?
KATHYSeveral things. I'm older. I'm 60 years old. So I figured they would need people my age that were in good health. And I work for one of the larger parks here in the area. And we felt that (unintelligible) shutdowns and layoffs --
NNAMDIUh, oh, we're losing you, but thank you very much for sharing that with us, Kathy. Kurt, what are the logistical issues you're facing when it comes to getting so many people vaccinated?
SEETOOSo I think that one of the logistical issues is making sure that we have enough places for people to go ahead and get vaccinated. So we're looking to enroll as many providers as possible whether they're pharmacies or doctors' offices or urgent cares. Long-term care facilities will also be in our plan as well as our local health departments will be conducting a number of kind of large scale clinics where we'll be able to offer vaccine. But I think making sure that we have enough locations throughout the state where people can get vaccinated is part of our challenge right now. And we just want to make sure that we are able to provide enough opportunities.
NNAMDIHere is David in Annapolis, Maryland. David, you're on the air. Go ahead, please.
DAVIDYeah. I was calling to say (unintelligible) I would not take the vaccine until we have more information. So when you look at what Pfizer has published, they looked at the first 94 patients, who showed COVID symptoms. And the other 906 patients of the first batch (unintelligible) they are not allowed to look at those 906 patients to examine for asymptomatic carriers. So if you were to take the same trial protocols or the standards for the trial and tie that to a placebo group, the only conclusion is the placebo was 95 percent effective. So, you know, there is a lot of missing information and a lot of questions that need to be answered.
NNAMDIDr. Wen, care to respond to that?
WENYeah. I mean, I agree with you. I think that there is a lot of information that we don't yet have. I hope that at the point that emergency use authorization is applied for by the company that Pfizer will make -- or the FDA will also make all the data transparent and available for everyone to see because you can't just have a data point that's presented via press release. We need to a lot more information. Also we need to see information about safety, which we don't yet have, because we are waiting for at least 60 days after the second dose of the vaccine for those safety data.
WENAnd I think we have to take into account that right now we may not in the first -- with the first results we may not yet know the effect for certain populations, for example, the elderly. We are just starting the studies on children and so I think there are a lot of caveats that we have to take into consideration too.
NNAMDIGot to take a short break. When we come back, we will be talking about lingering effects some survivors of COVID can experience. We still have a lot of people who want to know more about the vaccine. So thank you, Dr. Wen for sticking around to help us answer those questions. And, Kurt Seetoo, thank you so much for joining us. I'm Kojo Nnamdi.
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