Year Of The Vaccine – Global Connections with Robert Siegel

This monthly Zoom Leadership Forum series captures unfiltered conversations moderated by preeminent host Robert Siegel with an august group of guest speakers.

January’s Global Connections Forum spotlighted issues related to the COVID-19 vaccination. The conversation highlighted four prominent speakers who each discussed their own perspective about the current state of, and future for, the U.S. vaccination program and distribution process. The panelists include, Dr. Peter Hotez of Baylor College of Medicine, Dr. Ofer Levy of Harvard Medical School, Dr. Irwin Redlener of Columbia University, and Dr. Jason Schwartz of Yale Public School of Health. Additionally, Dr. Michael Drescher of the Rabin Medical Center provided an update as to the Covid-19 pandemic in Israel.

Robert Siegel begins by asking if the vaccine prevents outright infection of the coronavirus or reduces the severity, or both? This question was directed to the efficacy of the two M-RNA vaccines, Pfizer and Moderna.

Dr. Levy stated that both vaccines have a very high degree of efficacy and are very safe, at this point proven to be approximately 95% effective against the disease. However, he adds that disease and infection are two separate issues, as one can be infected and asymptomatic. Dr. Drescher then interjected to discuss data coming from Israel, which demonstrates a reduction in infection and transmission due to the Pfizer vaccine.

Robert Siegel then questions whether a patient of a concierge practice would have better access to a vaccine than others in the general public.

Dr. Schwartz weighed in by explaining that given the magnitude of the roll-out of vaccines, there will always be isolated incidents of favoritism and manipulation of the system; however, these incidents will be anomalies. Dr. Redlener then addressed the complicated political dynamic in New York between Governor Cuomo and Mayor De Blasio, which was exacerbated by the lack of leadership on the federal level and an absence of both a uniform federal program and guidelines for the vaccine roll-out. This confusion has filtered down to the state level and significantly delayed distribution of the vaccine.

The next question was bipartite: Why is there a supply backlog and if Moderna does not require the same levels of refrigeration as Pfizer, why are we not prioritizing the Moderna vaccine?

Dr. Levy imparted that the analysis is context-driven. Given the history of vaccination, which generally has taken years from development to usage, the fact the Covid-19 vaccine has gone from development to approval to use within months is incredible. He explained that at every step there are challenges related to the scale of the endeavor. Given that both vaccines are similar in their effectiveness and safety, he recommends taking whichever one is available. Dr. Hotez then states that these two vaccines are not meant to be the workhorses of the global vaccine program, but given the fact that M-RNA vaccines can be produced rapidly, they are readily available in the USA. However, with respect to lower and middle income countries, other vaccines, which are presently being developed and which are more practicable, will have to be produced and approved for the global public at large. Dr. Levy explains that COVD-19 is a global problem that will have to be addressed multi-laterally from that perspective.

Robert Siegel then asks if any genetic markers been identified that would corelate to the severity of the illness?

Dr. Hotez explains that there have been certain studies that have demonstrated that certain genetic defects related to the inability to produce interferon may contribute to the severity of the infection. Dr. Levy expands on this idea by citing his own program in Boston, which centers on the idea that there is no “one size fits all” vaccination, and that vaccines can be targeted precisely for individuals.

The last part of the conversation dealt with Biden’s goal of administering 100,000,000 million vaccines in 100 hundred days.

This experts panel provided a substantial insight into both the efficacy and relevant factors underlying the Covid-19 vaccination program, interposed with a dose of realism about the domestic and international distribution process. Given that President Biden’s ambitious plans have yielded 50,000,000 million vaccinations to date, there remains optimism that we are steadily nearing the goal of herd immunity.

Article by Jonas Plaut, Columbia University

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