Latest / The SHEA Podcast / COVID-19: Perspectives On The Vaccine Trials & Vaccine Rollout, 1/14/21

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COVID-19: Perspectives On The Vaccine Trials & Vaccine Rollout, 1/14/21 · The SHEA Podcast

• 0:08
  SPEAKER_01: Welcome to the Rapid Response Podcast brought to you by Society of Healthcare Epidemiology of America, promoting the prevention of healthcare associated infections and antibiotic resistance and seeking to advance the field of healthcare epidemiology and antibiotic stewardship.
• 0:23
  SPEAKER_01: I'm Dr.
• 0:24
  SPEAKER_01: Wali Javed, hospital epidemiologist at Mount Sinai Downtown, and I'll serve as your moderator.
• 0:31
  SPEAKER_01: Discussion on this podcast does not reflect Shay's perspective but facilitates communication of multiple perspectives and experiences as we go through this challenging time together.
• 0:42
  SPEAKER_01: Shay is excited to launch this episode of podcast COVID-19 updates, What We Know Now.
• 0:48
  SPEAKER_01: Today's discussion will focus on perspectives on vaccine trials and vaccine rollout.
• 0:55
  SPEAKER_01: Our speakers today are Dr.
• 0:57
  SPEAKER_01: Anema Obu Agu, Associate Professor of Medicine at Yale School of Medicine, and Dr.
• 1:03
  SPEAKER_01: Gopi Patel, Medical Director of ND Microbial Stewardship Program and Hospital Epidemiologist at Mount Sinai Hospital.
• 1:11
  SPEAKER_01: Thank you for joining us today.
• 1:13
  SPEAKER_01: Before we start our discussion, I would like to turn it over to Dr.
• 1:17
  SPEAKER_01: Cindy Prince to get us started on brief news and guidance update for this week.
• 1:22
  SPEAKER_00: Thank you, Dr.
• 1:23
  SPEAKER_00: Javed.
• 1:24
  SPEAKER_00: As of today, there have been 90 million cases of COVID-19 and almost 2 million deaths worldwide, with 22.4 million cases in the U.S.
• 1:32
  SPEAKER_00: and 373,000 deaths.
• 1:34
  SPEAKER_00: A study in the New England Journal of Medicine demonstrated the effectiveness of convalescent plasma against article V in older adults when administered within 72 hours after onset of symptoms.
• 1:45
  SPEAKER_00: In its double-blind classical controlled randomized trial conducted in Argentina, non-hospitalized participants who were 75 to older with no preexisting conditions or were 65 to 74 years old with at least one pre-existing condition, and who had a positive RTP-4 test for SARS-CoV-V were eligible.
• 2:03
  SPEAKER_00: The treatment arm received 250 milliliters of convalescent plasma with a SARS-CoV ID tighter of more than 1 to 1,000.
• 2:11
  SPEAKER_00: The primary endpoint of interest was development of severe respiratory disease assessed from 12 hours to day 15 after plasma infusion.
• 2:19
  SPEAKER_00: The trial was terminated early at 76% of enrollment due to a reduction in cases in the area, but results showed a significant difference in the primary outcome with a risk reduction of 48% of the sorts of convalescent plasma compared to both.
• 2:33
  SPEAKER_00: In the landset, a large cohort study by Flynn et al.
• 2:36
  SPEAKER_00: examined long-term outcomes for COVID-19 patients who were discharged from the hospital and move on between January 7th and May 29th.
• 2:43
  SPEAKER_00: The study period was from June 16th to September 30th with a median follow-up time for participants of 186 days.
• 2:51
  SPEAKER_00: The most common long-term symptoms were fatigue and muscle weakness affecting 63% of participants, difficulty sleeping, which affected 26% of participants, and anxiety or depression, which affected 23%.
• 3:04
  SPEAKER_00: Patients who had been more severely ill had increased risk of these symptoms in addition to an increased risk of pulmonary diffusion abnormality.
• 3:11
  SPEAKER_00: The authors also assessed antibody titles of follow-up compared to acute phase titers for 94 participants.
• 3:18
  SPEAKER_00: In this group overall seropositivity, zero positivity of IP antibodies to the N protein and to the receptor binding domain and neutralizing antibodies were all significantly decreased at follow-up compared to a key phase, although heterogeneous individual responses were observed.
• 3:34
  SPEAKER_00: No difference in seropositivity of IP to the spike protein was observed.
• 3:38
  SPEAKER_00: And finally, admit concerns that mutations in the receptor binding domain of the spike protein and COVID-19 variant B117 might affect vaccine efficacy.
• 3:50
  SPEAKER_00: The tested the vaccine against the mutation of those concerns, a sperogen 501 keratine or N501Y.
• 3:57
  SPEAKER_00: The author used a clinical strain with the same background as the FIBOccine spike antigen and generated an N501Y substitution.
• 4:05
  SPEAKER_00: Zero from 20 vaccine to all participants drawn between two and four weeks after the second vaccine dose were tested in a 50% plaque reduction neutralization assay.
• 4:14
  SPEAKER_00: Plaque reduction was not lower for the Y501 virus compared to the N501 virus, indicating that the N501 mutation should not affect vaccine efficacy.
• 4:25
  SPEAKER_01: Thank you, Dr.
• 4:26
  SPEAKER_01: Prinz.
• 4:27
  SPEAKER_01: I will now move into discussion with Dr.
• 4:29
  SPEAKER_01: Obuagu and Dr.
• 4:31
  SPEAKER_01: Patel.
• 4:31
  SPEAKER_01: And thank you again for being a part of this podcast.
• 4:34
  SPEAKER_01: Dr.
• 4:34
  SPEAKER_01: Obuagu, you were involved as a side PI at Yale University for the Pfizer vaccine.
• 4:40
  SPEAKER_01: Can you talk about what you did?
• 4:42
  SPEAKER_01: And can you share your experience in this role?
• 4:45
  SPEAKER_02: That's a great question.
• 4:47
  SPEAKER_02: So my primary portfolio at Yale is I'm the director of the HIV Clinical Trials Program, and we mostly focus on HIV therapeutics and prevention.
• 4:57
  SPEAKER_02: And as you can imagine, when COVID-19 hit, having had pre-existing relationships with pharmaceutical industry partners, having research infrastructure, including personal and expertise in virology, you can imagine that was a natural fit for me to pivot, like a lot of other HIV researchers have done around the country and internationally, frankly, to COVID-19 research.
• 5:19
  SPEAKER_02: So where we leveraged some of the expertise and resources and relationships we had to facilitate also working with Pfizer for the vaccine trial.
• 5:29
  SPEAKER_02: And so having run the trial at Yale University, as you can imagine as the principal investigator, the key and roles I played were to, first of all, really organize infrastructure to be able to successfully conduct the trial and keep fidelity to protocol.
• 5:43
  SPEAKER_02: It required having a designated research site for the work, also having to really pull a really requisite number of staff from regulatory staff to data managers to nursing staff because the studies had to have staff who were both blinded to patient assignments and unblinded to patient assignments, pharmacy storage space for the COVID vaccine.
• 6:04
  SPEAKER_02: And so it was really a huge enterprise to be able to really just have the, you know, put together the resources I needed to successfully run the trial.
• 6:13
  SPEAKER_02: You can imagine that all this happened within an accelerated timeline.
• 6:17
  SPEAKER_02: And so, for example, we needed our institutional review board to review protocols in a very rapid timeline, execute contracts, agree on budget.
• 6:25
  SPEAKER_02: And so it really took a lot of the resources and support from Yale University for us to be able to do that.
• 6:31
  SPEAKER_02: Then, of course, the next step was being able to recruit individuals to the study.
• 6:35
  SPEAKER_02: And as you are aware, the timeline for recruitment was also compressed, and there was an interest to make sure that even a recruitment that we recruited individuals with certain characteristics, such as older individuals, which were important to study, but also that we had a good mix of different races and ethnicities and making sure that we had good proportions of racial ethnic groups that were disproportionately impacted by COVID-19, which included blacks or African Americans and Hispanics.
• 7:02
  SPEAKER_02: So it definitely did take a lot of planning, a lot of work, and we're pleased that we were able to contribute significantly to this study as a site.
• 7:10
  SPEAKER_02: And one last thing I would mention was there was a lot of skepticism about mRNA technology for vaccines because, as you can imagine, of all the different COVID-19 vaccine platforms, mRNA technology was new.
• 7:22
  SPEAKER_02: And so part of the challenge was having to convince potential clinical trial participants about the safety.
• 7:28
  SPEAKER_02: We participated in the phase two and phase three trial data, so we at least had the phase one safety data to show that at least the first group of individuals who received the vaccine did find and also set their expectations around what the side effects could be.
• 7:41
  SPEAKER_02: So I think all in all, it's been a great experience.
• 7:44
  SPEAKER_02: The study is still ongoing.
• 7:45
  SPEAKER_02: We just completed enrollment of individuals age 12 to 15 in the study, so expanded eligibility to include younger individuals.
• 7:54
  SPEAKER_02: And it's been great to see how we now have a vaccine that's been shown to be highly effective and safe.
• 8:00
  SPEAKER_01: What did you learn?
• 8:01
  SPEAKER_01: And is there any data or other information that came from the trials that you were able to provide to our listeners, especially as it pertains to vaccine safety and effectiveness?
• 8:14
  SPEAKER_02: Yeah, so I think that we learned through the study about what to expect in terms of safety, that majority of the adverse events or side effects that would occur tend to happen early, typically within the first six weeks of receiving the vaccine.
• 8:28
  SPEAKER_02: We learned that older individuals tended to have less of those events than younger individuals, and maybe that had something to do with immune responses to the vaccine, which is not unexpected for differential responses to vaccines.
• 8:42
  SPEAKER_02: But we also learned that individuals over time, at least in the Pfizer study, tended to do better.
• 8:47
  SPEAKER_02: So we had less adverse events with people who got the second vaccine as compared to the first, unlike the moderner study where it was the reverse.
• 8:55
  SPEAKER_02: So, you know, we were very happy with the overall safety.
• 8:59
  SPEAKER_02: And I think now that the vaccine has been rolled out to the general public, it's nice to see that there are really no surprises and the real world experience seems to be mirroring the experience that we had conducting the trial.
• 9:11
  SPEAKER_02: The effectiveness as well, we do know that there's a time component to it, that individuals between the first and second vaccine could still be vulnerable to the infection.
• 9:20
  SPEAKER_02: And so, you know, part of the message we always want to get out is that a single dose would not lead to achieving the optimal effectiveness of the vaccine, that a second dose is critically important to optimizing the effectiveness of the vaccine.
• 9:33
  SPEAKER_02: The other thing that's important to mention is that the safety and efficacy also were similar between individuals of different races and ethnicities, which is critically important, and also individuals with high burden comorbidities.
• 9:47
  SPEAKER_02: Again, so you know, one of the questions we frequently ask are Are there any subgroups for which there are concerns about the safety and effectiveness?
• 9:54
  SPEAKER_02: And the good news is that we haven't identified any.
• 9:57
  SPEAKER_02: And I think the fact that we are now expanding the vaccine protocol to include now younger children and hopefully in the future, including pregnant women, we will continue to learn so much more about the safety and effectiveness in even much more broader populations.
• 10:12
  SPEAKER_01: Thank you.
• 10:13
  SPEAKER_01: And you have also done a lot of media work on the vaccine.
• 10:16
  SPEAKER_01: What messages are you trying to convey and would like our audience to know?
• 10:22
  SPEAKER_02: Yeah, so the critical information to really get out there, and I think that has been amplified and echoed by leaders in the field and public health experts, which I think are critically important.
• 10:32
  SPEAKER_02: You know, one of the things that are driving vaccine skepticism, hesitancy, that a lot of terms on that spectrum describing either delayed desire to receive the vaccine or desired not to receive the vaccine at all, is the accelerated pace of vaccine development that occurred, concerns about side effects either in the short term or long term, and concerned about equitable representation within the clinical trials, concerned about politicalization and how that impacts approval of vaccines, for example.
• 11:02
  SPEAKER_02: And so it's been very important to really, as I interact with the media, feed print media or on television, to really emphasize that the accelerated pace of clinical trials was really a testament to how well things can work when everyone works together.
• 11:18
  SPEAKER_02: You know, pharmaceutical industry, academic centers, and research programs and clinical research.
• 11:23
  SPEAKER_02: People like myself and my institution, as well as so many others around the world, public health experts, when there is funding for research and collaborations, these are how well and how fast things can happen or evolve when all stakeholders are working together to achieve a common goal.
• 11:41
  SPEAKER_02: And also that, you know, there were no shortcuts involved in the vaccine and they went through the typical phases of vaccine development where safety was assessed in genisticity or new responses were assessed prior to rolling it out to a much larger group of individuals, and that even while those large studies were conducted, that there was a careful eye for safety signals as the studies went along.
• 12:03
  SPEAKER_02: So the message to get out there is that the vaccines are as effective as they've been shown to be, that the vaccines are as safe as they're shown to be, and that really we all need to be open-minded and receptive to the vaccine.
• 12:18
  SPEAKER_02: Because, you know, we all think that the way to work ourselves out of this pandemic, you know, yes, the other public health measures, mask wearing, social distancing, or physical distancing, all are not congregating, all work well, but we think that a vaccine would be that critical public health tool that would get us to the end of this.
• 12:36
  SPEAKER_02: And for us to achieve herd immunity, we need everyone to be on board.
• 12:40
  SPEAKER_02: One more thing to add is I've also had a strong message for ethnic racial minorities, especially because studies have shown that the people who are disproportionately impacted by disease, namely black African Americans and Hispanics, tend to also express higher levels of vaccine hesitancy.
• 12:56
  SPEAKER_02: And again, there's so many reasons that I think are pretty well known as to why those communities are more hesitant than other racial ethnic groups for receiving the vaccine.
• 13:06
  SPEAKER_02: And so we really need to do a lot more messaging that's culturally appropriate, that addresses the primary concerns that people have.
• 13:14
  SPEAKER_02: There's no one message that will work for everyone.
• 13:17
  SPEAKER_02: I think those messages have to be tailored to different people groups, and I think that that would go a long way in improving vaccine acceptance.
• 13:25
  SPEAKER_01: That is very, very helpful.
• 13:27
  SPEAKER_01: Thank you.
• 13:28
  SPEAKER_01: Dr.
• 13:28
  SPEAKER_01: Bertel, you are and will continue to assist in vaccination planning for the healthcare system.
• 13:35
  SPEAKER_01: I know you've been very critical in leading the efforts.
• 13:38
  SPEAKER_01: So, how many hospitals are included and how many hospital employees have been offered the vaccination so far?
• 13:44
  SPEAKER_03: Thanks for asking.
• 13:46
  SPEAKER_03: So the Mount Sinai Health System is an eight-hospital health system located throughout New York City, including the boroughs of Queens and Brooklyn.
• 13:54
  SPEAKER_03: And we also have a hospital in Nassau County in Long Island.
• 13:58
  SPEAKER_03: We have about 42,000 employees, if not more, across the health system.
• 14:03
  SPEAKER_03: And at this point, we are at week five, almost six, into our vaccination rollout.
• 14:09
  SPEAKER_03: We have offered vaccination to all on-site employees, including those who are patient-facing, which is the group that we started with.
• 14:18
  SPEAKER_03: And we have gotten to where we're offering vaccination to those individuals who are vital to continue the infrastructure of healthcare in the setting of a continued COVID-19 pandemic.
• 14:29
  SPEAKER_03: So those individuals who've been on-site helping with anything and everything that we need to combat what we are seeing in New York City as the second surge of COVID-19.
• 14:40
  SPEAKER_01: So how is it all going so far?
• 14:42
  SPEAKER_01: And what are the best practices you can share with others who are also in charge of vaccination planning for the employees?
• 14:49
  SPEAKER_03: I think communication.
• 14:51
  SPEAKER_03: It is very different doing a mass vaccination campaign in the setting of a global pandemic and in the setting of social media and email.
• 15:01
  SPEAKER_03: I think many of us who are involved in this vaccination campaign have been involved in flu vaccination campaigns annually, or maybe have been involved in the H1N1 vaccination campaign about a decade ago.
• 15:14
  SPEAKER_03: It is a very different type of campaign in this pandemic, one trying to reach all staff and then trying to staff or provide the infrastructure for offering vaccination to employees, but also with many of the regulatory components that have been put in place, making sure that we are reporting appropriately, making sure we're gathering demographic information about our employees, including where they work and what they do.
• 15:40
  SPEAKER_03: So it's been challenging, but having an appropriate infrastructure put in place with buy-in from leaders, operational individuals, we've been very reliant on our pharmacy colleagues who've been integral to our efforts at offering vaccination, not just to our frontline healthcare workers, but the community of the Mount Santa Health System at large.
• 16:02
  SPEAKER_01: Thank you.
• 16:03
  SPEAKER_01: So another question for you would be, Dr.
• 16:06
  SPEAKER_01: Patel, any thoughts on vaccine rollout and the lessons learned?
• 16:10
  SPEAKER_01: What do you think you'll change or any advice you have you can share with others?
• 16:15
  SPEAKER_03: I think one great thing about being in New York is that we are all very interconnected.
• 16:20
  SPEAKER_03: And I think we became closer as a New York healthcare community during this pandemic.
• 16:25
  SPEAKER_03: So as a community, all of the health systems sort of banded together to make sure that we were all on the same page.
• 16:31
  SPEAKER_03: We realized us during the pandemic when it came to what PPE you were offering and how were you isolating patients.
• 16:38
  SPEAKER_03: And you know, New York was hit very hard in the spring of 2020.
• 16:42
  SPEAKER_03: And I think we leveraged those relationships and made sure that we were sort of approaching vaccination of our employees the same way.
• 16:49
  SPEAKER_03: And if you are in a situation or a place where you can work together as a healthcare community to offer vaccination and to make sure messaging is the same, I think that's always very helpful.
• 17:03
  SPEAKER_03: I think again, as I said, leveraging every type of communication platform that you have, whether it be Instagram or Facebook or your website, I think that's really important as well.
• 17:14
  SPEAKER_03: And constant communication.
• 17:16
  SPEAKER_03: Many states were very different and how they initially rolled this out.
• 17:19
  SPEAKER_03: And we will see if we can align across the country, especially up here in the Northeast, where many of our staff actually reside in other neighboring states and not necessarily in New York State.
• 17:31
  SPEAKER_03: So those different phasing out of vaccination priorities has been challenging.
• 17:38
  SPEAKER_03: And making sure every employee is accounted for and noting who's been on site, who's been patient-facing, those are often things that you can't glean from human resources records and really trying to figure out who's here, who's seeing the patients.
• 17:52
  SPEAKER_03: In New York State, when we first rolled out vaccine, the supply did not meet the demand, and we were very refreshed by the demand, but there were some concerns about what do you do, how do you make appointments for individuals, employees who really want vaccination, but you may not have the vaccine available at that time.
• 18:11
  SPEAKER_03: And the supply has increased over time.
• 18:14
  SPEAKER_03: So that is not necessarily an issue for our employees today.
• 18:18
  SPEAKER_03: I think the things that were very surprising, and Dr.
• 18:21
  SPEAKER_03: Obuagu touched on it, was communicating and a lack of confidence in the vaccine.
• 18:27
  SPEAKER_03: And I think that we noted many of our frontline providers were very interested in being vaccinated.
• 18:34
  SPEAKER_03: And then we noticed there was this lack of confidence in the vaccine for all the things that Dr.
• 18:38
  SPEAKER_03: Obuagu mentioned amongst support staff and even our nursing staff.
• 18:43
  SPEAKER_03: And that contributed to some difficulty in rolling out to our employees initially.
• 18:48
  SPEAKER_03: And it's really hard for us to quantify what that exactly was.
• 18:52
  SPEAKER_03: I do think once you start vaccinating, and once you see those messages out there of staff being vaccinated and, you know, that message of hope, I think what Dr.
• 19:01
  SPEAKER_03: Obuagu spoke about, the peer-to-peer communication and communicating at different levels to address that lack of confidence is really, really important.
• 19:09
  SPEAKER_03: And I think that's very important for our employees because they're also the ones who are going to get that message to the community at large.
• 19:16
  SPEAKER_01: Dr.
• 19:16
  SPEAKER_01: Obuagu, what are your thoughts on the vaccine rollout and lessons learned?
• 19:21
  SPEAKER_02: Yeah, so I think overall COVID-19 has been a stress test for the US healthcare system, frankly, at all levels, from both from testing to treatment, staffing, and now what will be a vaccination rollout like no other, just given the scale and scope of vaccinations that need to occur in a short period to get us to the end of the pandemic.
• 19:42
  SPEAKER_02: And so that we really have to learn a lot of lessons about how ready we are, pandemic preparedness, if you will.
• 19:49
  SPEAKER_02: And hopefully we can take some of the lessons with the failures we've had with the COVID-19 response and build on that.
• 19:54
  SPEAKER_02: I have very specific ideas around the vaccination rollout.
• 19:58
  SPEAKER_02: For now, like Dr.
• 19:59
  SPEAKER_02: Patel mentioned, there's still a supply issue to meet the demand.
• 20:03
  SPEAKER_02: But I think ultimately when we're thinking about just having to vaccinate literally almost every American, there are things we have to do differently.
• 20:11
  SPEAKER_02: I think the last time I checked, it was about still 7 million vaccinations on the CDC tracker and well short of the 20 million or so that we hope to occur by the end of December.
• 20:21
  SPEAKER_02: And yes, some states, like my state in Connecticut, have done better than others, but I think we've all fallen short of what aspirational cardinals we should have.
• 20:29
  SPEAKER_02: So I want to approach it from a who, where, when, why approach.
• 20:32
  SPEAKER_02: So for the who, I think that we need a core of vaccinators.
• 20:36
  SPEAKER_02: I think that to be able to really scale up vaccination, we need a lot more people engaged in offering vaccinations.
• 20:43
  SPEAKER_02: So my institution, for example, has opened up time schedules and asked for volunteers among the healthcare staff, including physicians like myself, to volunteer to offer to give vaccinations to others, especially as we start to roll out beyond healthcare workers and offer the vaccine to those in community, like the elderly and first responders.
• 21:02
  SPEAKER_02: We need more people to vaccinate.
• 21:03
  SPEAKER_02: And then there's the where.
• 21:05
  SPEAKER_02: I think we need to get vaccines out of the hospital systems and get them out into the community so that they're more accessible to members of the public.
• 21:14
  SPEAKER_02: And I think we need to be also offering all kinds of available times, weekends like Saturdays, Sundays, early morning hours, late hours, so that people who are brought down by their jobs and availability can definitely get vaccinated.
• 21:27
  SPEAKER_02: But then there's the also a big elephant in the room, which is again vaccine hesitancy.
• 21:31
  SPEAKER_02: And intentionally choosing a play on words, I think that especially with the initial rollout to healthcare workers, healthcare workers are not immune.
• 21:38
  SPEAKER_02: We have so much work to do with increasing the public's confidence in the safety and efficacy of the available vaccines to maximize uptake.
• 21:47
  SPEAKER_01: That's very nicely stated.
• 21:49
  SPEAKER_01: I'll just summarize what I have learned from this conversation about the vaccine rollout: that collaboration even beyond the healthcare system is important.
• 21:58
  SPEAKER_01: Communication is Critical, and I think knowing and trying to address all the concerns of our own staff is also very, very critical.
• 22:07
  SPEAKER_01: And increasing the capacity to vaccinate is important, recognizing who will vaccinate, who will be assigned, and trying to participate in the vaccination planning before it gets busy is going to be very, very important.
• 22:20
  SPEAKER_01: And lastly, as you mentioned, the vaccine hesitancy is a big problem, and we do need to address that as more of a global issue throughout the healthcare systems.
• 22:30
  SPEAKER_01: As healthcare workers are leaders in their community, and if they are hesitant, it's hard for the community to get vaccinated.
• 22:37
  SPEAKER_01: It's an important thing that we all need to get everybody the right information, the critical information, and address everybody's concerns and also plan as quickly as possible.
• 22:48
  SPEAKER_01: So, Dr.
• 22:48
  SPEAKER_01: Obuagu, have you been vaccinated?
• 22:51
  SPEAKER_01: And if so, can you share your experience?
• 22:53
  SPEAKER_01: Any side effects or complications?
• 22:55
  SPEAKER_02: Thanks for that question.
• 22:56
  SPEAKER_02: I have been vaccinated.
• 22:58
  SPEAKER_02: I received the Pfizer vaccine.
• 23:00
  SPEAKER_02: In fact, I had the privilege, given that I also have been on the front lines of patient care as an ID physician.
• 23:07
  SPEAKER_02: I was one of the first five individuals to receive the vaccine at Leon Newton Hospital.
• 23:12
  SPEAKER_02: I received the second dose of my vaccine just over a week ago, and the only side effect I had was a little bit of discomfort in the arm that occurred a couple of hours after the shots I had and lasted for about two days and went away.
• 23:27
  SPEAKER_02: I noticed that my reaction to the second vaccine was a little less than the first vaccine, and I had no systemic side effects.
• 23:34
  SPEAKER_02: So I had a great experience with the vaccine, like so many others are reporting.
• 23:39
  SPEAKER_02: And I think it's given me a little bit of a boost in my confidence that as I continue to engage in frontline patient care, that I am protected against the virus.
• 23:50
  SPEAKER_02: And I think it's a great feeling to do that.
• 23:52
  SPEAKER_02: And on a personal note, I've never been a direct beneficiary of any research I've done because my research has focused on HIV medicine.
• 24:01
  SPEAKER_02: So this kind of a little bit of a personal satisfaction with being on the receiving end of a vaccine that I participated in advancing.
• 24:09
  SPEAKER_01: That's very well said.
• 24:10
  SPEAKER_01: Dr.
• 24:10
  SPEAKER_01: Batell, have you been vaccinated?
• 24:13
  SPEAKER_01: And if so, can you share your experience and any side effects or complications?
• 24:18
  SPEAKER_03: Sure.
• 24:18
  SPEAKER_03: I also benefited from the research that you have been involved in, Dr.
• 24:22
  SPEAKER_03: Obuagu.
• 24:23
  SPEAKER_03: I actually was a trial participant in the Pfizer vaccine trial.
• 24:27
  SPEAKER_03: And on the first day on December 15th, where my hospital, the Mount Sunday hospital, was offering vaccine to our frontline providers, I was told I received placebo.
• 24:38
  SPEAKER_03: So I had the privilege of being one of the first individuals unblinded by Pfizer as a healthcare worker.
• 24:46
  SPEAKER_03: And I also received my vaccine and I've received dose too.
• 24:50
  SPEAKER_03: My side effect, I had a headache and a little bit of arm pain, different headache than my normal migraine that I get periodically and definitely probably got with increased frequency during this pandemic.
• 25:00
  SPEAKER_03: Went away with Tylenol or acetametophen, and the arm pain persisted, or the localized tenderness of the injection site persisted for about 24 to 48 hours.
• 25:11
  SPEAKER_03: I also, with my second dose, had less severe localized tenderness and no headache.
• 25:17
  SPEAKER_03: And it's been about a week and I feel awesome.
• 25:19
  SPEAKER_03: The only thing is I sort of privately got my vaccines in the research setting and not with the Instagram and the sticker and all of the fanfare.
• 25:28
  SPEAKER_03: But I do think, again, it brings me a lot of hope, not just for our staff that have been through so much, but just for our community as a whole.
• 25:37
  SPEAKER_03: So look forward to continuing to work with individuals like Dr.
• 25:41
  SPEAKER_03: Obuagu and all of you and trying to get to the place where we can offer vaccination to all Americans in a timely fashion.
• 25:50
  SPEAKER_01: So since I asked you the question, I'll also tell you I did get vaccinated too.
• 25:54
  SPEAKER_01: I received my second dose a couple of days back.
• 25:57
  SPEAKER_01: So everything is fresh.
• 25:58
  SPEAKER_01: First dose, just a little bit of arm pain, I went away within 24 hours.
• 26:02
  SPEAKER_01: Second dose, I did have body aches and a Tylenol and Motrin kind of combination did help me yesterday.
• 26:09
  SPEAKER_01: And today I feel like a million bucks right now.
• 26:11
  SPEAKER_01: So I think there are side effects, but I also think that they're really very well manageable.
• 26:17
  SPEAKER_01: So for both of you, what would you say to individuals who are hesitant about getting the vaccine?
• 26:22
  SPEAKER_03: I think it's really important to meet people where they are.
• 26:25
  SPEAKER_03: You know, you might not be able to change someone's mind in a moment in time, but I think you have to hear why they're not confident.
• 26:33
  SPEAKER_03: Is it because they think it happened too fast?
• 26:35
  SPEAKER_03: Is it because they want to know how many individuals were included in the trial that look like them or are like them in any other way?
• 26:45
  SPEAKER_03: Many individuals want to see their colleagues get vaccinated first and see how they tolerate it.
• 26:50
  SPEAKER_03: They want to hear what were the side effects.
• 26:53
  SPEAKER_03: I think one of the biggest issues is we really need individuals out there that are skilled at this type of messaging.
• 27:00
  SPEAKER_03: It is not something that you learn very quickly.
• 27:03
  SPEAKER_03: You can't learn it from reading a website.
• 27:05
  SPEAKER_03: You actually have to see how individuals respond to their peers.
• 27:09
  SPEAKER_03: And I really think that's where we're going to the community and out there, because that's it in terms of healthcare worker hesitancy with vaccination, it's not just in the workplace.
• 27:18
  SPEAKER_03: It actually happens in their communities as well.
• 27:20
  SPEAKER_03: And it's really hard to get to those communities during a pandemic, right?
• 27:24
  SPEAKER_03: The places we would go to have these conversations, whether it be churches or community boards, those are all happening in different forums.
• 27:32
  SPEAKER_03: And they do want to hear from people that they have trust in.
• 27:37
  SPEAKER_03: So that could be a physician, that could be their peer, that could be a patient actually telling them I got vaccinated and this is what it means to me.
• 27:46
  SPEAKER_03: So I think we have a lot of work to do.
• 27:48
  SPEAKER_03: I think we can all get there and we have to find those ambassadors, but you answer their questions.
• 27:54
  SPEAKER_03: And I think, you know, there's a lot of things we don't know, but there's a lot of things we do know and acknowledge that we have to meet them where they are.
• 28:01
  unknown: Dr.
• 28:02
  SPEAKER_01: Abuagu, what are your thoughts?
• 28:04
  SPEAKER_02: I couldn't agree anymore with Dr.
• 28:06
  SPEAKER_02: Patel.
• 28:07
  SPEAKER_02: I think she responded in the same way I would have.
• 28:10
  SPEAKER_02: If I just wanted to just sound a note of optimism, it appears that the more recent polls, as compared to those who are two, three months older, seem to show an uptick in willingness to receive the vaccine across the board, still with differences across race ethnicity, but show that in general people are warming up to the cold vaccines.
• 28:30
  SPEAKER_02: I think that part of it may be driven, just again, anecdotally, by people being more comfortable seeing a lot more people receive the vaccines and people that look like them.
• 28:40
  SPEAKER_02: There's been a public display of key figures like Dr.
• 28:43
  SPEAKER_02: Patel mentioned, trusted figures in politics.
• 28:46
  SPEAKER_02: You know, Dr.
• 28:47
  SPEAKER_02: Fauci also did his publicly, and also even at the local and the state levels, these have been done openly.
• 28:53
  SPEAKER_02: And also just the sheer volume of people who've gotten vaccinated in the recent weeks, and more and more people knowing someone who's received the vaccine and done fine.
• 29:04
  SPEAKER_02: So I think that may continue to track in the right direction, I hope.
• 29:08
  SPEAKER_02: But one last thing I really want to mention, again, thinking about the lessons learned from COVID-19 in general, is that there's a trust deficit between health systems, the medical community, and the communities that we serve, especially certain communities.
• 29:22
  SPEAKER_02: And that trust deficit has to be addressed.
• 29:25
  SPEAKER_02: As some of that trust deficit is driven by structural issues where people can be perceived to be treated differently within health systems.
• 29:34
  SPEAKER_02: And so I think that during this pandemic and after this pandemic is over, we need to explore ways to engage our communities in a stronger fashion, maintain, grow those relationships, to build what really everyone knows is the true currency, which is trust between the communities that we serve and academic centers, research centers, and just the medical system in general.
• 29:56
  SPEAKER_02: That would definitely go a long way to having people believe what we say, listen to what we say, and hopefully do what we say.
• 30:05
  SPEAKER_01: Thank you, Dr.
• 30:06
  SPEAKER_01: Patil and Dr.
• 30:07
  SPEAKER_01: Abuago.
• 30:08
  SPEAKER_01: I think both your points about hesitancy are so very well said.
• 30:12
  SPEAKER_01: Both, as Dr.
• 30:12
  SPEAKER_01: Batil said, that we need to meet people where they are.
• 30:16
  SPEAKER_01: And as you were mentioning, Dr.
• 30:17
  SPEAKER_01: Abuago, about really addressing the hesitancy and where we can meet them, how we can communicate, and how we can improve our communication.
• 30:25
  SPEAKER_01: I think we are all learning together as to how to address these issues as much as possible and really address it where people are at a given time.
• 30:35
  SPEAKER_01: So I would thank you very much to both of our speakers for sharing your perspectives and experiences.
• 30:42
  SPEAKER_02: Thank you for having us.
• 30:44
  SPEAKER_02: Thank you.
• 30:45
  SPEAKER_01: This podcast can be accessed on Shay's online education center, Learning CE, under the Rapid Response Program.
• 30:53
  SPEAKER_01: You will also find resources such as recorded webinars, healthcare facility, outbreak preparedness, and SHA COVID-19 town hall.
• 31:03
  SPEAKER_01: New members can now receive 50% off 2021 SHA membership by using the coupon code WELCOME2021 until March 31st.
• 31:13
  SPEAKER_01: This concludes this episode of Rapid Response Podcast.
• 31:17
  SPEAKER_01: Thank you for tuning in.