Vaccine Awareness by Mediaplanet_USA

A Mediaplanet Science-Based Guide to Vaccines and Immunizations

Vaccine Awareness Learn more about how vaccines are effective, why the COVID-19 vaccine will be safe, and how distribution will work

What comes next after approving a COVID-19 vaccine? The reason why pregnant women should get vaccinated

DECEMBER 2020 | FUTUREOFPERSONALHEALTH.COM

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Flip the Pharmacy is transforming community-based pharmacy practice beyond filling prescriptions to a focus on providing patient care.

ASK THE EXPERTS What do you need to know about the upcoming COVID-19 vaccine? We ask an expert about how we can effectively distribute the essential vaccine.

Why should Americans trust that vaccines are safe and effective? Approved vaccines are transported from the manufacturer to the final distribution point through the cold chain. As part of the pharmaceutical cold chain, the vaccines are constantly monitored with a temperature data logger that ensures that the vaccines stay within their required temperature range. The data is recorded and stored to ensure that every vaccine administered maintains its efficacy to provide the desired immune response for the end patient. How does vaccine hesitancy affect your organization or industry? The CDC has provided specific requirements for the temperature monitoring and storage of vaccines. In the United States, the American Association of Immunization Managers has representatives in every state that ensure that all providers across their state comply with those guidelines to ensure the safety and efficacy of administered vaccines. Jamie Pearce, Vice President and General Manager InTemp, Onset Computer Corporation

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Pharmacists, the Unsung Heroes of the Pandemic During the start of the pandemic in March, pharmacists swung into action, developing plans to keep serving their communities’ evolving needs as safely as possible. Identified as essential health providers, pharmacists promptly adopted curbside pickups, prescription deliveries, and new safety installations like plexiglass barriers. When hand sanitizer was difficult to find, compounding pharmacies began making it. They often donated sanitizer to other health workers and local officials, along with masks and personal protective equipment. We’ve seen pharmacists inspire their communities to come together, creating handmade greeting cards to help show some love to patients, particularly those who are older or had been isolated from friends and family. These are just a few of the remarkable things that pharmacists have done to keep their communities safe. They have been among the most trusted professions for decades and,

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Essential workers But other health concerns haven’t gone away. If anything, it’s more important now to get a handle on existing health issues, which might increase a patient’s risk for COVID-19. For millions of Americans, a pharmacist is the most accessible — if not the only — healthcare provider who can help them be their healthiest. Nearly 95 percent of the population lives within 5 miles of a pharmacy. And for thousands of communities, an independent pharmacy is their only pharmacy. Their pharmacist can help patients manage diabetes, monitor blood pressure, and manage multiple medications.

answering vaccine-related questions, and addressing vaccine hesitancy. This will become critical when we finally have a commercially available COVID-19 vaccine. Millions of Americans will need the vaccine and will turn to their trusted pharmacist for it. In the meantime, everyone must still stay current on their routine vaccines. Doing so can keep patients and their loved ones healthy, especially as we safely reopen schools and businesses. Unfortunately, during the coronavirus pandemic, some vaccination rates have dropped, leaving individuals vulnerable to vaccine-preventable diseases including polio and smallpox. Most pharmacists can help you remain current on routine vaccines safely and conveniently. Whether you visit your neighborhood pharmacy or a different provider, the point is to get immunized. Talk with your pharmacists about which vaccines are right for you and what safety protocols are in place so you can feel comfortable being immunized. Pharmacists are essential healthcare providers. Pharmacies are essential businesses. Getting recommended vaccinations protects yourself and others. n

Keeping a vaccination routine Pharmacists also play an important role in immunizing patients against the flu and other illnesses,

B. Douglas Hoey, Pharmacist, MBA, CEO, National Community Pharmacists Association; Scott J. Knoer, MS, PharmD, FASHP, Executive Vice President and CEO, American Pharmacists Association

to no one’s surprise, when their communities needed them most, they stepped up to the plate.

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All pharmacies are not the same. Most pharmacies are just about convenience. Find a pharmacy that is focused on your health with free hand-delivery to your door at www.cpesn.com/pharmacies.

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COVID-19 Vaccines: Understanding the Process Some people don’t trust the FDA to adequately protect the public when approving COVID-19 vaccines. Sadly, some Americans no longer trust the FDA to protect the public from ineffective COVID-19-related products. At some level, this distrust is understandable. On April 7, the FDA approved the use of hydroxychloroquine for patients with COVID-19. The drug had never been shown to work and, in about 10 percent of recipients, it caused irregular heartbeat. Nonetheless, the drug was quickly approved through Emergency Use Authorization (EUA). When studies subsequently showed that hydroxychloroquine neither treated nor prevented COVID-19, the FDA withdrew its approval. Then, on August 23, the FDA approved the use of convalescent plasma. Once again, no scientific studies had been performed showing that convalescent plasma worked or was safe. Nonetheless both the Secretary of Health and Human Services and the Commissioner of the

FDA declared it to be a major breakthrough in the fight against COVID-19. By the end of August, a lot of people believed that the FDA was serving the current administration rather than protecting the public. Now, using the same EUA mechanism, the FDA is on the verge of approving COVID-19 vaccines. Many are understandably worried that the same low standards may be applied. However, the supervision and approval of vaccines will differ from what happened with COVID-19 treatments. Vaccine approval is different First, unlike hydroxychloroquine and convalescent plasma, vaccines were tested in large, prospective, placebo-controlled trials (called phase 3 studies) to determine their safety and effectiveness prior to authorization through EUA. The group determining whether companies can submit their vaccines for FDA approval is called the Data Safety Monitoring Board, composed of inde-

pendent researchers. It serves as a firewall between the company and phase 3 studies. Second, the FDA also relies on a committee of independent experts called the FDA Vaccine Advisory Committee, to recommend whether COVID-19 vaccines should be approved for use once submitted by companies. Third, after the FDA Vaccine Advisory Committee has made its recommendations, the CDC also reviews the data from the vaccine trials. The CDC process also includes an independent committee of experts, called the Advisory Committee on Immunization Practices, which independently reviews the evidence, reaches its own conclusions, and makes recommendations about who should or shouldn’t get a vaccine. The FDA and CDC advisory meetings are open to the public, and their members feel the awesome responsibility, knowing they and their families may take the vaccine. n Paul A. Offit, M.D., Director, Vaccine Education Center, Children’s Hospital of Philadelphia

ASK THE EXPERTS What do you need to know about the upcoming COVID-19 vaccine? We ask an expert about vaccine timing and acceptance.

Why is now a critical time in the history of vaccines? Facing a once-in-a-century pandemic, no part of the world has been left untouched by COVID-19. At the same time, the world has more innovative tools, expertise, and knowledge than at any other time in history, and other immunization programs — such as the effort of Rotary and its Global Polio Eradication Initiative (GPEI) partners to eradicate polio — can serve as a blueprint. How does vaccine hesitancy affect your organization or industry? Worldwide, the overwhelming majority of parents want their children vaccinated against polio. However, with the advent of social media, the polio eradication program has seen the number of polio vaccine refusals increase since 2019, and vaccine hesitancy has been declared a top global health threat by the WHO. The polio program uses communitytailored strategies to communicate the safety, efficacy, and importance of the polio vaccine, often relying on trusted voices — like local religious leaders and community influencers — to build vaccine acceptance. John Hewko, General Secretary and CEO, Rotary International

Learn how pharmacists keep you healthy—with vaccinations, medication advice and convenient care. pharmacistsforhealthierlives.org MEDIAPLANET

Yes, Vaccines Work Only 58 percent of Americans said that they are getting the soon-to-be COVID-19 vaccine. What can we do to increase this number? Vaccines are one of the greatest public health achievements of the 20th century, saving tens of millions of lives. The science is abundantly clear: vaccines work. It’s easy to forget what it was like before we had vaccines for diseases like polio, measles, rubella, diphtheria, and whooping cough. In the ‘50s, for example, polio caused more than 15,000

cases of paralysis. After the vaccine, cases plummeted. There hasn’t been a single case of polio originating in the United States since 1979.

address head-on. An effective COVID-19 vaccine won’t fulfill its mission without an equally effective vaccine education.

Life without a vaccine None of us need a reminder, though. COVID-19 is still surging around the country. However, even if an effective vaccine is debuting soon, only 58 percent of Americans said they would get a COVID19 vaccine, according to a November Gallup poll. Though the figure is up from 50 percent in September, it’s still a serious challenge that we must

Vaccines work Before a vaccine ever makes it to the public, federal science agencies oversee an extensive testing phase to ensure it’s safe and effective. Often, this process can take years; though for COVID19, global mobilization and many years of existing research have helped speed up the process. A new vaccine is first studied in animals and then

in humans in three phases — first in a small number of people before expanding to hundreds and then to thousands. As of mid-November, 12 coronavirus vaccines had begun phase 3 trials. After a vaccine is approved, officials begin monitoring their use and investigating any potential safety concerns. Systems such as the national Vaccine Adverse Event Reporting System are already set up to do this kind of surveillance and are specifically designed to detect safety issues in their earliest stages. These systems have served us well for many

decades, producing safe and effective vaccines that saved millions of American lives. Vaccines are one of the greatest disease-fighting tools ever discovered. Soon, we’ll have a chance to wield one against COVID19, too, but just as its development is a collective effort, so too is the effort to get people to roll up their sleeves and get immunized. For that, we must all come together to spread the word far and wide: vaccines work. n

Georges C. Benjamin, M.D., Executive Director, American Public Health Association

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cation infrastructure — laboratories, millions of health workers, and technology — are already being utilized against COVID-19. For example, the polio surveillance network, which detects poliovirus in humans and the environment, is now also being used to identify suspected COVID-19 cases. The polio program’s cold chain system — made up of freezers, refrigerators, and cold boxes to store the vaccine and keep it cold during transportation — may be useful in the deployment of a COVID-19 vaccine. Ending a disease is a tremendous undertaking. But, when governments, multi-

lateral institutions and nonprofits like Rotary mobilize together, nothing is insurmountable. The remarkable progress made in ending polio provides a blueprint for overcoming COVID-19, especially for the distribution and acceptance of an effective vaccine, to deliver the long-awaited end to this pandemic. n John Hewko, General Secretary and CEO, Rotary International

Rotary is a global network of volunteers dedicated to tackling the world’s most pressing humanitarian challenges, including polio. Learn more at Rotary.org.

Pregnant Women Still Need Routine Vaccines During the Pandemic Pregnant women need to keep up with their recommended vaccinations for the health of their babies.

Despite the pandemic, many people are gathering with loved ones during the holiday season — some of whom are at higher risk of getting seriously sick from COVID-19, flu, and other preventable diseases.

Pregnant women and their babies are at risk Most people associate vaccines with children and older adults. But did you know that vaccines are also an essential part of a healthy pregnancy? Medical experts, including OB-GYNs and nurse-midwives, recommend that all pregnant women get vaccinated against flu and whooping cough during every pregnancy even during the pandemic.

Protect yourself and your baby from flu Flu vaccines are recommended for everyone 6 months and older. Though many dismiss the flu as no big deal, it’s actually a leading cause of death in the United States. Even otherwise healthy people, including pregnant women, get seriously ill with flu each year. In fact, changes to a woman’s body during pregnancy make her more

likely to be hospitalized with flu. Getting the flu during pregnancy also increases the chances of birth defects and premature birth. Fight against whooping cough Anyone can get sick with whooping cough (or pertussis), but the disease is particularly dangerous for babies. Like with flu, babies are at high risk from whooping cough complications. Most

deaths from whooping cough are among infants younger than 2 months. Getting flu and third-trimester Tdap vaccines during every pregnancy — as opposed to before or after — allows a woman to pass on some protective antibodies (immunity) to her baby. On their own, babies can’t get vaccinated until 2 months old for whooping cough and until 6 months old for the flu. Flu and Tdap vaccines are safe and effective for pregnant women and their babies. Medical and public health experts agree that the benefits of vaccines during pregnancy outweigh any potential risks to moms and babies. Visit Vaccinateyourfamily. org for more information about vaccines during all stages of life. n Jennifer Zavolinsky, MHS, CHES, Director of Outreach Initiatives, Vaccinate Your Family

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Vaccines: The Secret Weapon Though vaccines have successfully minimized risk, a lot of vaccine-preventable diseases are still infecting people today. What are VPDs? Vaccines prevent 2-3 million deaths per year globally. However, vaccine-preventable diseases (VPDs) still cause 1.5 million deaths worldwide. Many parents think diseases like chickenpox or polio are things of the past. We only think that way because vaccines have been so effective in preventing these terrible diseases. Here’s a rundown of some of the most common vaccine-preventable diseases. Chickenpox Though seen as a mild disease, chickenpox can result in bleeding disorders, brain swelling, and pneumonia. It’s transmitted over the air and through direct contact. The varicella vaccine offers robust protection. Measles A potentially fatal disease, measles causes rash, fever, brain swelling, and pneumonia. In 2018 alone, more than 140,000 people died from measles — primarily children under 5 years old. Diphtheria Beginning with a mild fever, diphtheria can eventually lead to heart failure, coma, and death. Hepatitis (A & B). Both forms of hepatitis attack the liver, leading to liver failure, liver cancer, and associated disorders. They often show no symptoms until the disease is quite advanced, but well-established vaccines protect against them both. Rabies According to the CDC, someone is treated for rabies exposure every 10 minutes. It can be contracted from almost-invisible scratches and bites from wildlife, but it’s easily preventable via vaccination. Pertussis Known as whooping cough, this disease appears as severe cough and apnea. In 2017, there were nearly 19,000 cases of whooping cough. Polio Despite having one of the most successful vaccines, the disease remains a threat. Victims may show no symptoms at all, but eventually it leads to paralysis and death. Tetanus Contracted through cuts and open wounds, this terrible disease can cause muscle stiffness that affects the ability to swallow and breathe. Meningitis A bacterial infection of the brain and spinal cord, it progresses rapidly, and immediate treatment is necessary. Mumps Once thought eradicated via an aggressive vaccination program, there have been thousands of new cases since 2006. Jeff Somers

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Call Your Pediatrician: Catch Up on Visits and Immunizations Now

Jennifer Shu, M.D., FAAP American Academy of Pediatrics Because of the pandemic, a lot of parents postponed pediatrician visits for their children. Now is the perfect time to catch up. Children and teens need regular checkups to make sure their development is on track, to talk about nutrition and behavior, and to get the vaccines they need. It’s safe and necessary; plus, your pediatrician wants to see your child. Pediatricians have seen a huge drop in patient visits because of the pandemic. Lots of children are missing vaccinations, physical exams, and screenings. Now that influenza and COVID-19 are circulating, it’s important that you stay connected with your pediatrician. Pediatricians are taking extra steps to protect against COVID-19. If you have any concerns, you can call your pediatrician. They can tell you about safety precautions in place at the office.

If your child hasn’t been vaccinated for influenza yet, it’s not too late. Your child should get a flu vaccine as soon as possible. Getting an influenza vaccine can both prevent flu and lessen the risk of severe symptoms if they do get sick. It’s as important as wearing a face covering, washing hands, and staying 6 feet apart. Other reasons Besides the influenza vaccine, your child also needs their recommended childhood immunizations. We wouldn’t want an outbreak of another potentially deadly, yet entirely preventable disease, such as measles. Other reasons to schedule a visit with your pediatrician include newborn visits after having a baby; adolescent health concerns, such as menstrual care and depression screening; routine lead, anemia, and cholesterol screening; hearing and vision screenings; monitoring growth, blood pressure, and other vital signs; preparticipation physical examinations before returning to sports or other activities; assessing developmental milestones; and treating infections or injuries.

Keeping your child safe To make visits safe, some offices have separated “sick” and “well” areas of their clinic or are having newborns come in before other patients. Phone ahead, so your pediatrician can advise you on the best way to come in. For other kinds of appointments, pediatricians may offer video visits. Call your pediatrician’s office to find out if this is available and appropriate for the needs of your child or teen. If you feel you need to call 911, trust your instincts and call. Otherwise, it’s generally a good idea to check in with your pediatrician first. Sometimes they can help over the phone or will help coordinate other kinds of care for your child without a trip to the hospital. Most of all, do not avoid seeing your pediatrician or going to the clinic or hospital if your child needs necessary medical care. If your child is sick or injured, or struggling emotionally, pick up the phone and call your pediatrician. We are working hard to make sure we can care for your child, while keeping everyone safe. n MEDIAPLANET

What You Need to Know About Rabies Rabies is a deadly and terrifying disease — but with basic knowledge and precautions, it doesn’t have to be. Rabies, a dangerous virus that attacks the nervous system, is more common than you may think. The Centers for Disease Control estimates someone in the United States is treated for rabies exposure every 10 minutes. Here’s how to keep your family safe.

THE RISK

PREVENTION

TREATMENT

• A ny mammal can carry rabies including bats, skunks, raccoons, foxes, and mongoose, but infected bats are the leading cause in the United States

Rabies is scary, but can be easily prevented:

Don’t panic! Even if you suspect you’ve been exposed, rabies is 100% preventable: • Wash all bites and scratches with soap and water

• E ven a tiny scratch from an infected animal can transmit rabies

• Seek medical attention immediately. Your doctor may prescribe postexposure prophylaxis (PEP), including a vaccine and possibly other medications

• I nfected animals can make their way into backyards and parks • Risk increases with outdoor activity and certain travel outside the United States, especially away from urban areas •G et health recommendations for your

• PEP is 100% effective if received before rabies symptoms begin • A bout 55,000 Americans receive PEP each year to prevent rabies infection

destination: www.cdc.gov/travel

• Avoid contact with wildlife • Talk to your children about not touching injured animals they might encounter • M ake sure your kids know to report any bites or scratches • I f traveling to an area where there is an increased risk of rabies, talk to your healthcare provider about pre-exposure vaccination “Rabies: A Forgotten Killer,” Centers for Disease Control and Prevention, 12-Jun-2019. [Online]. Available: https://www.cdc.gov/vitalsigns/rabies/index.html. [Accessed: 17-Nov-2020]. “Centers for Disease Control. “Travelers’ Health.” Retrieved November 19, 2020, from http://www.cdc.gov/travel” “Center for Disease Control. “Rabies.” Retrieved November 19, 2020, from https://wwwnc.cdc.gov/travel/diseases/rabies” SPONSORED BY

As the world prepares for another wave, what is the current assessment of progress toward vaccines to bring COVID19 under control? “They fancied themselves free,” quoted vaccine expert Greg Poland, M.D., director of the Mayo Clinic’s Vaccine Research Group, from Albert Camus’ The Plague, “and no one will ever be free so long as there are pestilences.” Poland addressed hundreds of scientists during the American Association of Pharmaceutical Scientists’ PharmSci 360 conference. Calling fear and ignorance the most highly transmissible diseases in humans, Poland said that common human reactions of denial and overpromis-

Vaccines and Antivirals to Beat COVID-19: Where Are We Now? ing — and a limited ability to take a long-term view — have hampered an effective and collective response to public health crises. “We’re in for a long and deadly winter because of our irrationality,” Poland said. “This is all part of a cycle that should surprise no one. It always goes this way.” Poland acknowledged the immense pressure for the pharmaceutical industry to produce treatments and vaccines at unprecedented

speed. As Tufts Center for the Study of Drug Development reported earlier this fall, it normally takes seven years for anti-infective drugs to hurdle clinical trials and win approval from the Food and Drug Administration. Poland warned that there is no substitute for careful clinical trials. He said there is an “irresolvable tension between speed and what we know about safety” for vaccines: though efficacy is generally easily determined, safety is

significantly more difficult to establish, as it requires data points established by time, dosing frequency, population analysis, the effect of other vaccines or medicines, and preexisting conditions. Rolf Hilgenfeld, Ph.D., joined Poland in lamenting the missed opportunities to stifle the pandemic, despite the lessons of history. Hilgenfeld is one of the leading structural biologists working on efforts to decode the coronavirus molecular machine

and design drugs that will be effective blockers to its relentless propagation cycle. An expert in antivirals, he is optimistic that effective therapies are possible for COVID-19. But he bemoaned the fact that the initial SARS outbreaks in the early 2000s did not lead to sustained antiviral drug development programs that could have better prepared the world for its current predicament. Treatment for an infection must begin within a matter of days, he said. We need faster testing methods and wider testing to diagnose and treat people. COVID-19 will likely always be with us, but it could be less dangerous if we can do so. n Tina S. Morris, Ph.D., Executive Director, American Association of Pharmaceutical Scientists

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STChealth launched MyIR Mobile in partnership with local state health departments to allow consumers to review their immunization history, get reminders for future immunizations, and print their own official records to prove vaccinations for travel, work, or to enroll in school. Hesitancy However, consumers are hesitant of a new vaccine. A poll of over 1,500 U.S. adults ages 50 to 80, shows 20 percent

would get a COVID-19 vaccine as soon as possible; 46 percent would like to get it, after waiting for others to receive it; 20 percent are unsure; and 14 percent don’t want it. But clinical trials show no major adverse reactions. The vaccines will be free and available at major pharmacies. Dr. Freese says researchers were able to quickly develop a vaccine based on preclinical research they’ve done in past years with SARS and MERS, both coronaviruses like SARS-

CoV-2. They’re using the same fundamental vaccine development protocols, focusing on safety and efficacy. “The research findings are very promising,” says Dr. Freese. “This is what’s going to help us get back to some semblance of normal.” n Kristen Castillo

STChealth To sign up for MyIR Mobile or get more information: https://myirmobile.com/

Ensuring Access to a Safe and Effective COVID-19 Vaccine As the fight against COVID-19 reaches a climax, health insurance providers are working with everyone to ensure the best vaccine distribution. Every American deserves affordable, comprehensive coverage that provides them access to safe and convenient care, especially as the nation fights the COVID-19 crisis. Health insurance providers have been heavily engaged in the fight, taking decisive actions from waiving cost-sharing payments for COVID-19 treatment to expanding telehealth services. As several COVID-19 vaccines move closer to approval, health insurance providers are already working to ensure that all Amer-

icans have easy access to authorized vaccines. Ensuring the right distribution Health insurance providers will cover the COVID-19 vaccine with no cost to patients. We are also working closely with federal, state, and local leaders to provide the necessary support to ensure that these vaccines get to the people who want and need them. We have worked closely with Operation Warp Speed, a public-private partnership dedicated to developing and distributing a vaccine, to understand the pipeline for the vaccine. Also, we have worked closely with the National Academies to review the framework for determining the vac-

cine’s equitable allocation and distribution. Finally, we are closely tracking the Advisory Committee on Immunization Practices that will recommend who should receive the vaccine. According to current consensus, frontline health workers and longterm care facility residents will get the vaccine first. After this initial phase, the vaccine will go to the highest risk groups and to essential workers. Committed to health Health insurance providers have always played an important role in vaccinations. For childhood vaccines, we conduct outreach and education programs; assess and help overcome the barriers to vaccination; and partner with hospitals, doctors, pharma-

cists, schools, and local communities. Health insurance providers also have expertise in delivering culturally and linguistically appropriate messaging to diverse populations. Our role will be similar when COVID-19 vaccines are ready. Our work does not stop after a vaccination. Following the release of a COVID-19 vaccine, health insurance providers will support post-market safety surveillance, analyzing the vaccine’s safety and efficacy over time. The experience of our members will be aggregated for reporting to the FDA, the CDC, and other authorities, strengthening the nation’s future response even more. n Matt Eyles, President and CEO, America’s Health Insurance Plans (AHIP)

Administering Programs to Fund Vaccines • Increased vaccine access • Stabilized funding source • Lowered healthcare costs Learn how to create a universal vaccine purchase program in your state: www.kidsvax.org/create.

www.kidsvax.org/create | 1.855.KidsVax (543.7829) MEDIAPLANET

A Global Solution to a Global Pandemic A COVID-19 vaccine is only the start to beating the pandemic. The world has to think about production and distribution all over the world. Despite being an important turning point, a COVID19 vaccine does not signal the beginning of the end of this crisis. Only when people all across the globe are protected will we be able to resume our normal lives, trade, travel, and commerce. Given huge demand and limited supply of vaccines, how can we return to normality as quickly as possible? If left to market dynamics, we could repeat the results of the last pandemic: 2009’s swine flu. Back then, vaccines were developed and countries began a bidding war to reserve doses. Very quickly, the wealthiest countries bought up the entire global supply before any vaccine had even been produced, leaving the rest of the world waiting. Times are changing This time, things will be different. For the first time in history, we have a truly global solution to a global pandemic. COVAX, a new global effort, is planning to roll out 2 billion doses of the new vaccines by the end of 2021, making sure no country is left at the back of the queue. Led by Gavi, the Vaccine Alliance, COVAX has created one of the largest coalitions of countries the world has seen: 189 countries in total. Two challenges We now have two challenges ahead of us. The first is quickly securing the doses needed to vaccinate the most vulnerable in every country. We already have hundreds of millions of doses of the vaccine candidates secured. Secondly, we need to secure funds to help countries that can’t afford these vaccines. This should not be seen as handouts for poorer countries. We already have hundreds of millions of doses secured, but need manufacturers to step up. Global collaboration is our best and only path to defeat the pandemic. A successful COVAX effort could mark the beginning of its end. Dr. Seth Berkley, CEO, Gavi, the Vaccine Alliance

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Understanding the Vaccine Cold Chain To transport vaccine vials from the factory to the doctor’s office, they need to go through a process called the cold chain. “In order to maintain stability, they have to be maintained in a cold environment,” says Dr. Bill Williams III. Moderna’s vaccine, which is reportedly 94.5 percent effective, must be kept at minus 4, comparable to a typical freezer. Meanwhile, Pfizer’s vaccine, which is reportedly 95 percent effective, must be kept at an even colder temperature: minus 94. This ultra-low cold chain is known as “the deep freeze.” Pfizer will ship thermal boxes of the vaccine vials packed with dry ice. Challenges One of the major challenges is ensuring freezers are accessible across the country. In the United States, it will be most challenging in rural areas. “They have to be shipped and maintained under cold

chain storage from manufacturing to injection,” says Williams III. Cold storage can be tough to maintain, he says, estimating that 80 percent of the cost of these vaccines is tied to storing them properly. At the point of administration, the healthcare provider will thaw the vaccine. “And then, the clock starts ticking because these are both mRNA-based vaccines,” he says. “They degrade and lose their vaccination power quickly.” When COVID-19 started, Williams’ research lab started

focusing on the cold chain. Along with TFF Pharmaceuticals, they’re working on a new freezing technology, turning the liquid vaccine into a powder. Though he can’t name names, Williams says his lab is working with all the big pharmaceutical companies. Currently, the goal is to make the powder more shelf-stable so a technician can mix a safe liquid before vaccination. A second-generation type of application, it won’t require a cold chain, making it cheaper. n Kristen Castillo

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