Panel Discussion on the COVID Vaccine: Operational and Clinical Preparedness as presented at the Weitzman ECHO on October 21, 2020

1. Panel Discussion on the COVID Vaccine:
Operational and Clinical Preparedness
October 21, 2020

2. CME Credit
• Bridgeport Hospital Yale New Haven Health is accredited by the Connecticut State
Medical Society to sponsor continuing medical education for physicians. The
Bridgeport Hospital Yale New Haven Health designates this live activity for a
maximum of one (1) AMA PRA Category 1 CreditsTM. Physicians should claim only
credits commensurate with the extent of their participation in the various
activities.
• This activity has been planned and implemented in accordance with the Essential
Areas and policies of the Accreditation Council for Continuing Medical Education
through the joint sponsorship of Bridgeport Hospital Yale New Haven Health and
the Weitzman Institute. Bridgeport Hospital Yale New Haven Health is accredited
by the Connecticut State Medical Society to provide continuing medical education
for physicians.
• The content of this activity is not related to products or services of an ACCME-
defined commercial interest; therefore, no one in control of content has a relevant
financial relationship to disclose and there is no potential for conflicts of interest.

3. www.criver.com
Panel Discussion on the COVID Vaccine:
Operational and Clinical Preparedness

4. COVID-19 in the United States
8,272,427 cases on 10/21/20 up from 7,856,321 cases on 10/13/20 220,992 deaths
https://coronavirus.jhu.edu/map.html

5. Increasing

6. Viral Transmission - Updates
• ‘Expect numbers to continue to increase’
– Dr. Hoetz
• Main transmission: coughs, droplets >> surfaces
– Air-conditioning?
• Dr. Nardell - Hot weather -> seek air conditioning -> not
socially distancing; rebreathing the air that people have
just exhaled
– Sewage – Virus can be found in feces
• Not Polio! No infections documented (CDC)

7. Co-infections? (SARS-CoV-2 + ???)
• Rare to have co-infections
• 3% viral coinfection
• RSV, Influenza A
• (less than flu!)
• GET A FLU SHOT!
Co-infections in people with COVID-19: a systematic review and meta-analysis
Lansbury L, Lim B, Baskaran V, Lim WS. J Infect. 2020 Aug; 81(2): 266–275.

8. Virus
• SARS-CoV-2 has a ‘proofreading’ enzyme
– Corrects potentially fatal copying mistakes
– Mutates 2 to 6x SLOWER than influenza
• What is known about mutations so far?
– 6 major strains (L– original strain, S -first new
strain, V, G/GR/GH- most widespread)
• GH most widespread in USA
https://www.sciencedaily.com/releases/2020/08/200803105246.htm

9. Vaccines
• Different technologies (Sept 30th ECHO)
• One shot/two shots
– Viral mutations – more shots required?
Multivalent vaccine?
• Safety
– Those with underlying disease

10. COVID-19 Vaccine Overview
* https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines
# https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-
vaccines
• 169 COVID-19 vaccine candidates
under development*, #
– 44 of these in human trials
– 10 are in Phase 3
• Different platforms:
– Inactivated, non-replicating viral vector, protein
subunit, RNA, DNA, VLP, replicating viral vector…

11. What are the lead vaccine candidate(s)
• Pfizer mRNA
• Moderna mRNA
• J&J
– Recombinant, replication-incompetent adenovirus
type 26 (Ad26) vector, constructed to encode
(SARS-CoV-2) spike (S) protein
• Astra Zeneca/University of Oxford
– Modified chimp adenovirus vector (ChAdOx1

12. Dr. Scholand’s best guess
• mRNA vaccine, BNT162b2
– Lipid nanoparticles mRNA encoding spike glycoprotein (S)
• The target of virus neutralizing antibodies
• 43,000 participants; including children aged 12
• 2 doses: mild to moderate side effects
– Minus 80 Celcius (112 Fahrenheit)
• Pfizer CEO: Results by ‘end of November’
• Emergency Use Authorization: + 2 months

15. Dr. Fauci
• In the news again
– He is right, we should listen to him!
• Wear a mask
• Social distance
• Wash hands
• Avoid large groups
• Still try to do things OUTSIDE, rather than IN

16. Resources
• Nuvance health 1400+ articles reviewed:
https://spark.adobe.com/page/fwhfDctGtttlw/
• CDC:
https://www.cdc.gov/coronavirus/2019-ncov/index.html
https://emergency.cdc.gov/coca/calls/2020/
• WHO:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
• Johns Hopkins:
https://coronavirus.jhu.edu/map.html
• Others
https://www.thelancet.com/coronavirus
https://covidactnow.org/

17. REMINDER
Next Session is November 4th
Future Sessions: 1st and 3rd Wednesdays

18. Thank You!
To learn more about The Path Forward series
WeitzmanLearning.org/the-path-forward
To view previous COVID-19 sessions:
WeitzmanLearning.org/coronavirus