With an exciting change of pace, the Food and Drug Administration has voiced their approval for the Johnson & Johnson COVID-19 vaccine. Once officially in circulation, this product will be the United States’ third vaccine against this ongoing pandemic. This news, combined with the fast rollouts behind the Oxford University and AstraZeneca vaccine, will help boost the diminishing supply in a high-demand environment. Vaccines are just a tip of the iceberg and other factors like seasonality, social patterns, and adapting infrastructures have contributed to the gradual decline of COVID-19 cases. In a weekly update by the World Health Organization, it was noticed that the first week of February 2021 was the fourth week in a row where global cases declined. This report shows a 17% case drop compared to the previous week, which makes it the lowest number of new cases since late October. Though, the public perception towards these new drugs have remained a challenge and 47% of Americans remain hesitant to getting a shot. American citizens are cautious due to the uncanny speed behind the vaccine rollouts and feel that the national health officials have been withholding vital information. During a time where conflicting health opinions fuel ongoing conspiracy theories, how can a normal citizen remain optimistic and educate themselves on the current pandemic. I reached out to Mary Blake, a Medical Laboratory Technician and founder of Blake Incorporated LLC, to discuss issues behind the ongoing vaccine rollout.
American citizens who are resistant to the ongoing rollouts primarily point to the history of vaccine timelines, like the 4 year development of the Mumps vaccine and the 5 year development of the Ebola vaccine. Can you explain why the vaccine for COVID-19 was brought into the market at such a historical speed and are there any additional myths that are created by the general public?
So firstly, what I’d like to do is kind of take a minute to review a little bit about these trials when vaccines are being developed or any type of investigational therapy in general and then address your question a little bit. So when it comes to a research study, whether it’s a vaccine or any type of investigational medicine they normally will enter them into a clinical trial. Clinical trials are basically research studies that are performed. They aimed to evaluate a medical or surgical or some type of behavioral medication that is either going to be more effective than what is already being used conventionally or it’s going to have less side effects symptoms. Normally these trials take between 10 to 15 years and it’s broken up into phases, phase zero through phase four, which is commercial approval and post-market surveillance. That being said a lot of that time in the 10 to 15 year mark is a lot of legislative red tape. So a lot of these are institutions that have to wait on funding, so they have to secure funding and sometimes that means that they have to apply for certain grants. Sometimes that means that they don’t get to escalate to the next phase of a trial until they have proven the first steps. Also, a lot of time there’s prolonged animal testing and as much as we love animals and want to, or don’t want to suggest them to any type of harm, we also don’t want to subject humans to investigational therapies or products that may or may not be harmful. So a lot of those things go into the timeline.
A lot of times too, they like to wait longer to see if there are any symptoms, any safety concerns. They want to make sure that they have enough volunteers for any type of vaccination therapy to adequately represent the population that they would be treating. So there’s a lot of that that goes into it. There has to be consent from all of the volunteers. You have to find a qualified physician to lead those vaccination studies and all of these things take time. And I think that with the COVID trials, there has been a lot of the legislative red tape that they’re able to forego. Number one, they’ve dedicated a lot of time and a lot of funding to these institutions that think that they can make them and that entails a lot of time where they’d be applying for grants and trying to get funding, trying to get loans sometimes they have to co-partner or they have to consult with other entities, other third-party vendors. A lot of that was just cut out with COVID. They were just able to say, here’s the resources that you need, focus on this and also a lot of times these labs are doing several types of testing or they have several different types of vaccines or therapies that they’re trying to figure out, and that also is time, if you’re dividing your time. I think a lot of these institutions were able to just kind of drop those other side projects and just focus totally on the COVID vaccine. But you that being said, in all fair and honesty it’s appropriate for people to have concerns. A lot of the time that it does take that we spoke about within 10 years or so, or however long it normally takes is seeing if they’re going to be symptoms or side effects.
The Lancet, a peer-reviewed general medical journal, released a study that demonstrated a single shot of the Pfizer vaccine being tied to an 85% decline in symptomatic disease. This has created critics who echo that the White House needs to change its strategy, where distribution prioritizes getting the first shot to as many people as possible. What does the second dose of the vaccine provide and why is the strategy prioritizing giving two shots to emergency groups?
The idea for the second dose is that it’s going to be more effective when we have that boost, that multiple dosage and I think for the optimum utilization, the thought process behind what the white house and the country has decided to do is that they effectively want to cure the world. For that to be done, you effectively want to completely protect your people for life, if that makes sense. So it’s my opinion that what their hope is to, I think by 2023 was the last report that I read, the hope is to basically eradicate COVID. They want to just you know, smallpox, polio, you don’t hear about them very much, and in fact, I think smallpox is completely eradicated, but the thought behind the multiple dosing is just to completely eradicate COVID. Sometimes if you just have that single dose while I think that, yes, I agree, you could probably reach more people faster, it may or may not have a permanent protection for them. So, I think the thought process behind the second dosing is to effectively protect as many people as possible for the rest of their lives. So they’re saying that they’re creating that final approval, but technically it hasn’t rolled out yet. There could be logistical issues that could delay it. I think that since we have a vaccine on the market, we’ve got a product that we can give to people, they’re just trying to get it out as fast as possible since we’ve got something. I think once the Johnson and Johnson vaccine does become available and they’re able to kind of see how stable it is in the temperatures how effective if it continues to have the same amount of efficacy, if it continues to be just as safe or safer, then there’s a possibility that they might change strategy and prefer that one over, but technically it’s not here yet, and we can only kind of hypothesize as to how good it’s going to be once it actually hits the market, once it’s commercially available and then kind of go from there. I think a lot of the strategy with COVID is kind of fluid, right? I mean, there’s a lot of rules and regulations and policies and suggestions that were made and then changed. Things that they’ll say, okay, well now… I know initially it was a 14 day quarantining and then it went down to 7 or 10. So I think as more information is found, then, yeah, they could change, they could update, they could prefer or suggest one vaccine over the other. I think that just remains to be foreseen.
I can understand how someone who is skeptic or someone who’s just kind of concerned about the change of information. I think that it shows the level of adaptability that we have because as human beings, no entity and no industry is perfect. I think that the ability to have that fluidity and have the ability to adapt to the new circumstances actually is a strength because if you keep doing the same thing over and over, and it’s not working anyway, then why would you keep doing it? Why would you just stay the course if you know something is not working? People change, people are different, times change, technology changes. The technology that we have today is so much more advanced than what we had even 5 or 10 years ago. And so, yeah, that’s going to drastically change the speed at which vaccines are able to come to market. It’s going to change marketing strategies, it’s going to change just how public health in general is addressed. So I would just challenge someone who is concerned or has some skepticism to just get some more information from those professionals, from the doctor, from scientists. It’s their right. I think that it is fair to ask questions. You don’t want to just blindly follow as well. So I think that it’s perfectly appropriate to have questions, to have concerns, but I would challenge someone who has those concerns to ask an appropriate professional in that field, why they’re happening? Why are we doing this? Why this vaccine over the other? Why are these policies changing? And then truly be receptive to the information that that industry professional is saying. So yeah, I hear you and I hear people who, friends and family who have questions all the time. So I think that it’s going to keep our industry accountable and as new information comes out, it’s going to be available in real time.
Target stated in early February that hourly employees receiving coronavirus shots will get up to four hours of pay. This was on top of the 200 million dollar investment that Target put towards its employee recognition program for 2021. With the large percentage of Americans who are hesitant to receive the coronavirus shot, do you think company mandates will occur or be needed to achieve herd immunity?
I think that the intention of a lot of these large companies like Target Amazon, a lot of these huge fortune 500, I think the intention is admirable. However, when you start demanding or making something mandatory, I would want to say that you just want to be a little careful. A lot of the problems that we already have is that people are afraid of quote unquote, big brother and if big brothers tell you, well, you have to do this a lot of times people are just going to push back even more. So at this point, I don’t think the answer lies in making it mandatory. However, we do have to come up with a good strategy of achieving herd immunity in an appropriate time. I think that we’ve got to really get out into the communities that have that hesitancy because I think that everyone kind of noticed certain trends within certain communities that are hesitant. There’s a reason that they’re hesitant. We spoke earlier on the speed at which the vaccines were coming into fruition and if that’s the question, then we tackle that problem. There’s also some hesitancy against the different racial groups and you tackle it, you just tackle the issue head on. What are their concerns? There’s hesitancy across party lines. You address those issues, tackle them, and I think that over time when those individuals are seeing that the vaccine is safe, that the concerns that they had are no longer valid, then they’ll come around. We’re hoping obviously sooner, rather than later. To achieve that herd immunity in an appropriate amount of time, we need it to be sooner rather than later, but you got to keep in mind, some people were already anti-vaxxers.
Some people already were not believing in the necessity of vaccines. So how do you talk to those people? There’s just a lot more to unpack to just say, let’s make them mandatory. Some people have different religious affiliations. Some people have very sensitive immune systems and allergies, so all of those things have to be addressed before you just make something mandatory, tell them that they have to do it because they end up pushing back and that’s not what we want.
Snow and freezing temperatures during early February placed a three-day delay on interstate trucking, creating a backlog of 6 million COVID-19 vaccine doses. What are the primary contributors to a vaccine bottleneck and are there any potential logistical issues you could foresee?
I remember that speech that you were addressing. Well, we have to keep in mind that there’s 15,000 flights with 15 million approximately cooling boxes and this is a report that I actually took from DHL, who is one of the largest distributors for the vaccine, but at any time there’s 250 types of vaccines that are in the stage of development and they have to be transported. They have to be distributed, there’s got to be the procurement. I do think that now the reason that the current administration is a lot more confident is because a lot of these companies…. So you’ve seen Moderna for instance they have factories all over the world. And I think kind of when we were talking earlier about a lot of these big pharma companies dropping some of their side projects to focus solely on COVID vaccination and production and procurement. So they’ve got centers worldwide, several in the US several internationally, and I think that that confidence with having the amount of vaccines to be available is because, like you said, behind the scenes, they’re seeing mass production at several sites but that being said also as well. There’s so many other logistical things that go into making sure that the vaccine gets from bench to your arm. They talked about earlier, making sure that it arrives at a set temperature. Some vaccines can be transported between two to eight degrees Celsius and some have to travel as low as negative 80 degrees Celsius. Now, what that means is for companies like DHL or whoever is going to be distributing them, has to have these freezers on board of their planes essentially or their trucks or however they’re going and also means that the distribution and I think there was some problems with that, that we saw in New York and several other States where there was some gap or some misinformation where either there were no supplies or there were too many supplies and they end up going dead unfortunately, because there was a break in that communication chain. I think that something like this has not been done before to this large scale at least not in many years and not in the way that we’re currently rolling it out.
So I think that’s why there was such a large bottleneck initially, because it’s easy to have these ambitious ideas on how you’re planning to execute a strategy, but once it actually gets going, once it’s actually rolling things and challenges come up that were unforeseeable at the time of the planning stage. So I think that that was a big issue however they’ve been learning and watching all of this since the time that the pandemic started, because initially we had a shortage on PPE. If you remember back in the spring of 2020, we had this issue with PBE. So I think that they took that information that we really saw the breakdown and we really had the problems with trying to get masks and gloves and sanitizer around the country, and they’re able to plan and foresee how they’re going to get the vaccines. Another big issue is countries that have very rural areas. So we talked about South America, African countries, Indian countries, places like that, that do have rural populations. They’re going to need to come up with a strategy to number one, just get an idea of how many people are in these villages. They’re not big cities, so some people may be unaccounted for. Number two, you got to make sure you have the means of transportation if they’re in a jungle, or if they’re in a desert. What’s the best mode to get these vaccines to those people, or do you try and bring them into a larger city that’s almost like a vaccination hub? And then you want to make sure that it’s at the appropriate temperature. It’s got to be kept very cold and you’ve got to travel very far for some of these places.
A KHN report demonstrates that there is potentially ongoing inequities within vaccination rates between white Americans and black Americans. A key example is the dramatic case behind Pennsylvania, were 1.2% of white citizens were vaccinated compared to 0.3% of black citizens. Is there any key factors contributing to these inequities amongst different demographics?
That topic has been largely discussed since the pandemic started especially since information came out that lower socioeconomic black and brown communities were more affected and more seriously affected by the virus. So historically a lot of black Americans have had a very ingrained distrust into medical and pharmaceutical companies and the industry at large. From when I personally will go out and, when we’re registering people to get the vaccine we hear all the time of the Tuskegee experiments. And if you’re not familiar with the Tuskegee experiments, they were experiments conducted on poor black men that they basically were giving them syphilis and even when the cure came out, which is essentially just penicillin, they chose not to give it to them, and they just watched these men persist with syphilis the rest of their life. And if you know anything about the disease sometimes it can make you go crazy. You can spread it to kids, it can spread to your partner and essentially it just creates a real painful existence. And because that was such a large scale experiment, because it directly targeted poor black men and because it was a clinical trial that was carried out by pharmaceutical companies and information was withheld from these individuals a lot of black individuals they have a lot of hesitancy when it comes to vaccines and when it comes to medicine now. And it still affected the community that it’s still a topic, people still talk about it. And I myself didn’t realize just the severity of what that single event, just how much it’s still persistent until I started talking to people and I was like, wow, people are still talking about this.
It’s very relevant because that means that we still got some things to address, obviously, because of that because of you hear of the Nuremberg trials where the Nazis were testing on Jews and other people who were at disadvantages. People do have a very ingrained fear when it comes to this type of therapy and medicines. When you hear of vaccines or clinical trials you automatically think of some institutions where they’ve got you strapped down to a gurney and they’re poking you and you have no idea what’s their dosing you with. So, you asked earlier why some of these numbers are looking where there’s a large gap. A lot of it just has to do with misinformation or just not being informed over time. There is a lot of increase, I will say, in popping up these grass roots, little pop-ups in communities that normally, they may not see doctors all the time. And there has been a concentrated effort to just get the word out, get information out. I, myself, I was actually in South Dallas yesterday doing some volunteering, and a lot of the time we’re just giving information. We are of course registering people, but we’re also answering questions. I think that it’s helpful when they see people that look like them or can identify with them, can understand the concerns that they have, the hesitancy that they have and are able to provide some solutions, provide some answers to those questions.
So I definitely think that those percentages, as far as black communities not being vaccinated, I think that’s going to change because there has been a big push in churches. There’s been a big push in community centers. There’s been a big push in local grocery stores to get these people vaccinated and to get more information out than what’s previously been done over the years. So, yes, I do think that’s going to change over time and it’s going to change pretty rapidly in those populations. There’s also a hesitancy, if you will in getting vaccines across party lines unfortunately this topic has become pretty politicized as we touched on earlier and there’s some individuals that believe that it’s a hoax they believe that it was used to win or to swing an election. They believe that there’s poison inside of it, not really understanding what the ingredients are for and because of that, they are selectively choosing not to partake in the vaccine either. So, there’s also a percentage of the group who doesn’t believe in it and who chooses not to because of political affiliation, which is unfortunate. But again, it’s an issue that requires we tackle head on, that means that we’ve got to address, we’ve got to acknowledge that people are concerned or angry or upset, and really just get information out there, continue to show that it’s safe, continue to show that it’s effective. Some people don’t even think it’s real.
