TRACK THE VAX

As the U.S. hits the half-million death mark from COVID-19 -- a grim milestone that is equal to roughly the entire population of Atlanta and more than that of Miami -- a new weapon is being added to the COVID-19 vaccine arsenal. Johnson & Johnson is seeking emergency use authorization for what would become the U.S.'s first one-dose and non-mRNA COVID vaccine. It employs adenovirus vectors, a technology that has been used in labs for decades and was approved for the Ebola vaccine by the FDA in December 2019. It's the same technology that AstraZeneca/Oxford and Sputnik V use. Still, questions remain on how these vaccines may be different than mRNA or similar enough to other existing shots to encourage vaccine uptake. To explain how adenovirus vectors work and what to expect from the new products, Daniel Griffin, MD, PhD, chief of infectious disease at ProHEALTH Care, an Optum unit, joins us on this week's episode.

As many as a dozen COVID-19 variants are knowingly circulating worldwide. Among them, B.1.1.7 and B.1.351, the highly transmissible strains that originated in the U.K. and South Africa, respectively. As more vaccines continue to push forward for emergency approval worldwide, we're still learning the effectiveness of the current vaccines against the new strains; and how the new mutations mean even those who have already had COVID-19 may not be immune from reinfection. To explore the new strains and what it means for vaccination efforts, future mutations, and herd immunity, Angela Rasmussen, PhD, a virologist with Georgetown University's Center for Global Health Science and Security, joins us on this week's episode.

Nearly 1.5 million Americans are being vaccinated every day against COVID-19. Allergic reactions have led some to question if they should get the vaccine; and scant data from clinical trials for the currently approved vaccines in vulnerable populations means we don't fully know how those with certain conditions will react. Does that mean those with certain allergies or conditions like HIV, multiple sclerosis, or cancer should pass on the shot? What about those who are pregnant? Barbara Alexander, MD, infectious disease specialist at Duke University and current president of the Infectious Diseases Society of America, joins us to explore who should get the shot. Later in the podcast, Mark Turrentine, MD, a professor at the Baylor College of Medicine and co-chair of the American College of Obstetricians and Gynecologists (ACOG) COVID-19 OB Expert Work Group, also joins to explain whether the vaccine is safe for pregnant and nursing women.

New viral strains continue to spread across the country, which has added to the urgency of getting as many people vaccinated as possible. With supplies of the two vaccines currently available in the U.S. falling well short of demand, mandating vaccination is likely not a realistic scenario now. But it could be in the coming months. Is it legal for states, private employers, and even airlines, to mandate a vaccine that has only been approved for emergency use? Who could be held responsible if something goes wrong after getting the shot? Carmel Shachar, JD, executive director of The Petrie-Flom Center for Health Law Policy at Harvard Law School, joins us to explore those legal questions, and more.

A new week, and a new administration that has taken over the pandemic response. Now that 1 million vaccine doses are administered almost daily, President Joe Biden has increased the daily vaccination goal to 1.5 million Americans. What will the COVID national strategy actually look like under a new administration, and is Biden's goal achievable? To explore those questions, and what the future of collaboration in science looks like, we chat with NIH Director Francis Collins, MD, PhD.

Eight COVID-19 vaccines have been approved somewhere in the world, at least for emergency use. In the U.S., only Moderna and Pfizer's two-dose mRNA vaccines are now available for distribution. But as the COVID pandemic continues to run rampant, vaccine supply everywhere remains limited. How did different countries decide who gets it and who doesn't? And what happens to the dozens of phase III clinical trials and their placebo participants who possibly qualify for vaccination with a different shot? To explore these and more ethical questions related to the COVID-19 vaccines, in this episode we speak with Arthur Caplan, PhD, director of the Division of Medical Ethics at NYU Grossman School of Medicine in New York City.

Vaccine distribution — it's been a rocky road. While millions of doses have been shipped, only about one-third have been administered. The federal government has said a lag in reporting as well as the holiday season are partly to blame. But as long lines were seen across the country and in some states a bit of chaos, what happened? Was Operation Warp Speed more about vaccine development than distribution? To examine the issues of what went wrong and what can be done to fix it, in this episode we speak with emergency physician and former Baltimore Health Commissioner Leana Wen, MD, as well as Mike Alkire, president of Premier, the giant medical supply and healthcare technology firm, and host of the "Inside Out" podcast.

As vaccine distribution ramps up across the U.S., and globally, skepticism remains. Many cite the speed at which vaccines have rolled out as one of their main concerns. In this episode we explore how we got here, how the biopharmaceutical industry readied for this very moment that allowed them to move at warp speed. The vice president for science and regulatory advocacy at PhRMA, Jim Mayne, PhD, joins us to explain how the science-based, public-private partnerships aided in the momentum, how the R&D ecosystem has evolved and why he believes the bio-pharmaceutical industry was not caught off guard by the pandemic.

Vaccination across the nation is now underway, with healthcare workers and those living and working in long-term care facilities among the first to receive the vaccines. Long-term and nursing home residents make up about 1% of the U.S. population, but have accounted for roughly 40% of all COVID-19 deaths, while those older than 50 are more likely to die from COVID-19 than younger age groups. However, they've accounted for less than a quarter of total COVID-19 vaccine clinical trial participants. Why are they so scarcely represented in trials? To learn more, we chatted with Sharon Inouye, MD, MPH, a professor of medicine at Harvard Medical School and geriatrician at Hebrew Senior Life. She is also director of the Aging Brain Center at the Hinda and Arthur Marcus Institute for Aging Research. The episode kicks off with a discussion with 60-year old clinical trial participant Kelley Pick, to hear about her experience in a trial.

With a 'return to normal' from the pandemic practically hinging on COVID-19 vaccines, how do you overcome those who are vaccine hesitant? How does vaccination history impact perception and what role do medical professionals have in explaining the science? To learn more we chatted with MedPage Today Editorial Board member Peter Hotez, MD, PhD, Co-Director of the Center for Vaccine Development at Texas Children's Hospital and Dean of the National School of Tropical Medicine at Baylor College of Medicine.