The first confirmed case of SARS-CoV-2 infection in the United States was reported one year ago today. A year later, 24 million Americans have been infected and 400,000 have died (worldwide, the sums are 95 million and two million, respectively).
This pandemic doesn’t give a damn about partisan politics, presidential or otherwise. It methodically, cruelly rolls on as vaccines slowly, tentatively roll out—and as one administration rolls into another. The new President has promised a herculean and coordinated effort to vaccinate the population, while leaders around the world pledge the same for their countries. The first 100 days of the Joe Biden presidency will be as closely watched as Franklin Delano Roosevelt’s first 100 days in 1933, in the throes of the Great Depression.
Now as then, time is of the essence as a new, more transmissible variant of the virus threatens to spread like California wildfire. Every day counts, every COVID-19 vaccination takes a step forward, every infection prevented is a brick in the wall of a fortress of eventual protection.
The question is: If we build it, will they – the vaccine-hesitant – come?
This week’s edition of The Vaccine Project Newsletter is 2,311 words long and will take you nine minutes to read.
The communications effort
Communication cannot afford to be the weakest link in the chain of disease prevention. Fortunately, lots of capable folks are stepping up to the challenge.
- The Public Health Communications Collaborative has assembled a rich library of resources, including a poll exploring The Language of Vaccine Acceptance, a Vaccine Misinformation Management Guide, a regularly updated set of Answers to Tough Questions and a series of webinars on COVID vaccine communications.
- Changing the COVID Conversation, a study conducted by the de Beaumont Foundation with pollster Frank Luntz, includes a tip sheet on best words to use – and avoid – in talking about vaccines.
- Speaking of words, the Biden administration will be phasing out the much-maligned name of Operation Warp Speed. There’s a new chief of the effort as well: Dr. David Kessler, commissioner of the Food and Drug Administration from 1990 to 1997.
- An action plan on Building Trust in and Access to a COVID-19 Vaccination Among People of Color and Tribal Nations is a collaborative effort of The Trust for America’s Health, National Medical Association and UnidosUS. Key points: include trusted community organizations in vaccination planning, education and delivery; help people make informed decisions and send messages via trusted messengers and pathways; and make it as easy as possible for folks to be vaccinated at sites that are trusted, safe and accessible.
- Kareem Abdul-Jabbar, the NBA’s all-time leading scorer, is urging us all to get vaccinated; he was filmed taking his shot (the best he ever took?) for a PSA that debuted on Martin Luther King Day. Also receiving and endorsing the vaccine: Cynthia Marshall, CEO of the Dallas Mavericks and the NBA’s only Black female team president.
The takeaway: It’s all about trust. And information. And access. And did we mention trust?
History lesson: Polio vaccination was big—and this is bigger
Polio peaked in the U.S. in 1952 with 60,000 cases in children, including 21,000 cases of paralysis. Fear of this crippling illness justifiably gripped the minds of parents, including my own. Circa 1955, in the second grade classroom at Thomas Wharton Elementary, I dutifully lined up for my polio shot (yes, I am that old). Just to put the order of magnitude in perspective, 21,000 cases of paralysis from polio in all the U.S. is less than the number of deaths from COVID-19 (24,000) that have occurred in Florida alone.
After the Salk polio vaccine was developed, the rollout was, in modern parlance, a hot mess, with a bad batch of vaccine packing a gut punch to public trust amid a campaign that ran in fits and starts. Medical experts and public health agencies turned to the Ad Council, which launched an “extended and repetitive” campaign to persuade at least 80% of Americans under age 40 to receive all three shots.
Happy ending department: Herd immunity was eventually achieved, with the arrival of oral as well as injectable vaccine. No cases of polio have originated in the US since 1979 and we are on the doorstep of global eradication.
When things fall apart, the center needs to hold.
- On the one hand, we’ve got long lines, crashing vaccine registration Web sites and pharmacy-hopping in pursuit of elusive vaccines. “I feel like I’m trying to get a Beyonce ticket,” said a woman struggling to line up an appointment for her mom.
- On the other hand, some pharmacies, supermarkets and hospitals are giving unscheduled vaccinations at the end of the day so that thawed doses don’t have to be tossed. You might get lucky.
- The head of the nation’s largest nursing home association hopes to see COVID-19 vaccinations completed for residents and staff by March 1, Danielle Brown reports in McKnight’s Long-Term Care News. Residents are cooperating (90% acceptance), staff not so much (40%-50%, hoping for 65% to 70%.)
- The low rate of vaccination among long-term care employees is, frankly, embarrassing, McKnight’s James M. Berklan notes: “The world is watching. It’s no time to look the vaccine gift horse in the mouth, lest it soon be seen galloping toward more accepting groups.”
- Steven Littlehale, a gerontological clinical nurse specialist and chief innovation officer for Zimmet Healthcare Services Group, explores why some caregivers are resisting vaccination in a McKnight’s Long-Term Care News guest column.
- In Missouri, the Visiting Nurse Association is working on a plan to get home care and hospice workers—“a subset of healthcare workers that seem to have been left out”—vaccinated sooner rather than later.
The takeaway: It’s a logistical seesaw, an ethical teeter-totter. Somewhere in the middle is a place called balance, a space known as equity.
We’re thinking on a grand scale. Now we need to walk the walk.
- By turning to community pharmacies to speed its rollout, “little old West Virginia” has achieved the highest per capita COVID-19 immunization rate in the country. In McKnight’s Long-Term Care News, Danielle Brown explains how local and state leaders felt they could be “more nimble” by stepping outside the federally prescribed program.
- West Virginia is one of only a few states that has administered more than half of the doses received. West Virginia and North Dakota are at 65% while Alabama and Georgia are at 23%. In Colorado, all vaccine providers must administer doses within 72 hours of receipt; otherwise the state steps in and moves the doses elsewhere.
- Arizona has opened a 24/7 vaccination megasite at State Farm Stadium in Glendale, with the help of a $1 million grant from the Ben and Catherine Ivy Foundation. The foundation, whose primary goal is to find a cure for brain cancer, donated $5 million last year to help purchase PPE for frontline workers. Bravo and thank you.
- Across the country, empty baseball and football stadiums, convention centers, and state fairgrounds, are opening up as mass vaccination sites – or, as they are called in Orange County, California, Super PODS (Points of Dispensing). Disneyland is one of five; county officials have dubbed the effort Operation Independence.
- Armories are being turned into armeries. NewYork Presbyterian has opened a site with 70 vaccination stations at The Armory in New York City, which otherwise would have been planning for the world’s premier indoor track meet, the Millrose Games, in February. The 114th running of that event, dating to 1908, has been scratched.
- You can ask the people to come to the vaccine, but you can also bring the vaccine to the people. The Biden plan (see this fact sheet) includes sending mobile vaccination teams into underserved areas.
- How effectively is the rollout reaching the communities bearing the brunt of the pandemic and that historically have been underserved by the healthcare system—Black, Latino, Native American, rural? A panel of public health officials explores these issues in a webinar presented by Politico and sponsored by ConsejoSano, a California-based company that specializes in linguistically and culturally aligned patient outreach.
- To energize the rollout in the UK, primary care networks have been offered bonuses of up to £30 for each dose of vaccine administered in older adult care homes, Nick Bostock reports in GP.
- A “no jab, no job” policy is in effect at London’s Pimlico Plumbers, Stephen Jones reports in Management Today. The company says its employees provide more than 100,000 “COVID-safe” jobs a year. Chairman Charlie Mullins is prepared to pay for private immunizations for his workers if vaccine is not readily available through regular channels.
- In Supply Management, Charlie Hart takes a look behind the scenes at the complexity and challenges of the COVID-19 supply chain. Strong global demand for vaccines “may present similar supply problems to those encountered around PPE in 2020.”
- There are rollouts and then there are rollouts. The world’s biggest is just getting under way in India (population 1.4 billion), where the immediate goal is to vaccinate 300 million people—30 million healthcare and other frontline workers and 270 million people 50 and older with high-risk medical conditions.
- How did Israel get off to such a fast start in its vaccination effort, and why has the U.S. faltered? Medical and policy experts from both countries weighed in on Day 4 of the JPMorgan Healthcare Conference. Lecia Bushak reports in MM+M.
The takeaway: As of January 19, the U.S. count stood at 31 million doses sent to fridges and freezers and 15.7 million doses put in arms (including 2 million second doses). We’re proving that you crawl before you walk.
There’s lots to learn in the continuing education course known as COVID Prevention 101.
- The New England Journal of Medicine has assembled a COVID-19 Vaccine Resource Center that includes frequently asked questions, research and review articles, clinical reports, management guidelines, commentary and podcasts.
- Within the NEJM library, see an article by the leadership of Dallas’s Parkland Health & Hospital System on “Delivering Covid-19 Vaccines by Building Community Trust.” Among other recommendations, the simple “ask your doctor” is as valid as ever.
- CNN’s website includes links to the central vaccination hubs in each of the 50 states.
- v-safe is a smartphone tool from the Centers for Disease Control and Prevention that allows users to report side effects from the COVID-19 vaccine and sends reminders about the second dose.
- A dozen industry leaders in health and technology—including Microsoft, Oracle, The Commons Project, Mayo Clinic and Salesforce—have formed a coalition called the Vaccination Credential Initiative. Its goal: to give people digital access to their vaccination and health records “so they can use tools like CommonPass to safely return to travel, work, school and life, while protecting their data privacy.”
The vaccine dashboard
- Encouraging results for a single-dose regimen of Johnson & Johnson’s COVID-19 vaccine candidate have just been published. The company hopes to share Phase 3 results this month and, if the data are promising, will quickly apply to the Food and Drug Administration for emergency use authorization.
- The Sanofi/GSK vaccine is being reformulated based on early trial results and new trials will begin in February. Don’t expect any regulatory submissions or approvals until much later in the year.
- CureVac, a German company whose tagline is “the RNA people,” is teaming up with Bayer on the development of an mRNA COVID-19 vaccine. BioNTech, Pfizer’s partner on the world’s first approved COVID-19 vaccine, is also based in Germany. Danke schoen.
- Novavax has finalized an advance agreement to provide 51 million doses of its vaccine, currently in Phase 3 trials, to the government of Australia.
- The variant strain of coronavirus that is now highly prevalent in London and southeast England (known as B.1.1.7) could become the dominant strain in the U.S. by March, the CDC forecasts. As of Monday, there were just 122 documented cases in the U.S.
- The Google News Initiative is giving $3 million to news and fact-checking organizations to combat vaccine myths and misinformation, adding to the $8 million it provided in 2020. Google notes that vaccine misinformation predates and will no doubt outlast the pandemic.
- Don’t call us, we’ll call you. Overwhelmed by a “massive spike in demand” for vaccination appointments, a medical group in New Jersey is pleading with patients to cease and desist. Don’t call … don’t walk into the office or urgent care center … don’t send a message through your portal. In other words, dear patients, please be patient.
- It’s not the first pandemic and it won’t be the last: The COVID-19 pandemic now rates as one of the 10 worst in human history.
- Want to get away from it all? Take to the skies and follow the progress of Perseverance, a NASA mission launched last July 30 to search for signs of ancient microbial life on Mars. The ETA is February 18. Also on NASA’s list: sending a woman to the moon by 2024. Mission name: Artemis, twin sister of Apollo. Jeopardy question! Or answer.
… and some songs
Keep Music in Mind, Samantics (This is a pandemic survival ditty written for the good folks at MerckManuals.com. Thanks to Dave Santoriello for sharing.)
Thanks so much for joining us. Be sure to come back tomorrow for our regular weekly edition of the Haymarket Media Coronavirus Briefing. And, as always, please be safe.