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As COVID-19 cases surge to record highs nearly every day in the U.S., the possibility of a COVID-19 vaccine that would be available at the end of the year has sparked hope and concern. To answer questions and address concerns of union members surrounding the development of a vaccine, three of the nation’s leading experts on vaccines took part in a virtual town hall on Dec. 2, sponsored by the AFT, the American Federation of State, County, and Municipal Employees and the Service Employees International Union.
“The COVID-19 crisis is the greatest public health challenge this country has faced in many decades,” said David Michaels, epidemiologist and professor at the George Washington University School of Public Health, who moderated the town hall. Michaels noted that it’s an exciting time in the development of the corporate vaccine: “It's an important time not just for the development, but also for transparency and for understanding the safety, efficacy and equitable distribution that has to occur when this vaccine is available.”
Vaccines can play a very important role in preventing COVID-19 and making this country’s economy work again, said Michaels. “If workers are not safe, we won't be able to get the economy working for everyone, which is the goal of the incoming administration and the goal of everyone at this town hall meeting today.”
In October, the AFT passed a resolution, “Essential Principles for a COVID-19 Vaccine,” that expressed support for a COVID-19 vaccine that has been proven to be both safe and effective by science. The resolution also called for an effective communication and education strategy about the vaccine. The town hall panelist gave listeners a chance to learn more about the vaccine and the distribution process.
The panel included Dr. Peter Marks, Dr. Nancy Messonnier, and Dr. Patricia Whitley-Williams. Marks is director of the Center for Biologics Evaluation and Research at the Food and Drug Administration. The center is responsible for ensuring the safety and effectiveness of biological products, including vaccines. Messonnier is the director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention. Messonnier’s agency is involved in efforts to prioritize which groups should receive the COVID-19 vaccine, and coordinating with state and local public health authorities on vaccine distribution and administration plans. Whitley-Williams is professor and chair of the Department of Pediatrics at Rutgers University, Robert Wood Johnson Medical School, where she is an infectious disease specialist and a leading voice on healthcare equity issues.
The discussion began with Marks addressing concerns about the safety and effectiveness of the vaccines given how quickly they were developed. Marks said the FDA has a review process in place to ensure that any vaccine that is made available will be safe and effective. Although the process normally takes several years, in this case the process was condensed because manufacturers of the vaccines—Pfizer and Moderna—submitted an emergency use authorization request. The emergency authorization standard was put in place after the terrorist attacks of 9/11 to allow the government to deploy drugs or biologics, or to use devices in the event of a natural disaster or a human-made disaster.
When asked about the possibility that corners were cut in the development of the vaccine, Marks said the vaccine has been studied in tens of thousands of people. “That gives us a fair amount of reassurance that when we see the results of these trials, they will be believable. And so I think we're feeling that there's a reasonable degree of confidence now. Our job at FDA is to make sure that if they don't measure up, they don't get approved,” he added. “If there's one message I would love for everyone listening to understand is how seriously we take the task at hand—which is ensuring that a vaccine is going to be safe and effective before it's rolled out to the American people.”
Messonnier explained that initial doses of the vaccine are expected to be available this month but cautioned that there will be a limited supply for several months.
“We're recommending for the first 30 days—when there is a very limited supply of vaccine—that the first doses go to healthcare personnel and residents of long-term care facilities. The idea is that we'll have consistent allocation nationwide with the focus on healthcare personnel and long-term care facilities as a way to ensure a smooth launch and subsequent distribution and administration.”
Messonnier encouraged anyone who is concerned about where they might fit on the vaccine priority list to check with their local health department, which “should have the most precise information specifically about where you fit.”
Though many healthcare workers are split on their own feelings about a vaccine, they should be prepared to talk with their health systems about the vaccination process. “If you haven't heard anything and you’re a long-term care facility worker or healthcare worker, you should be getting in touch with your employer and making sure that you understand what their plans are,” said Messonnier.
The next phase of vaccine distribution would go to essential workers, those with high-risk medical conditions and older adults, said Messonnier. “We really think it's critical that jurisdictions start planning beyond these groups to make sure that they can ensure easy access to vaccine in, for example, those with limited access to vaccination, like rural populations and communities of color and tribal nations,” she said.
Whitley-Williams discussed the importance of educating the public and healthcare providers about the vaccine. The COVID-19 pandemic has shed new light on long-standing disparities in health outcomes among African Americans and other communities of color; she also underscored the need to examine and address systemic concerns and hesitancies about vaccines.
“Communities of color have been disproportionately affected [by COVID-19], and many persons from communities of color make up the essential workforce. So it is important not only to protect these communities, but also to engage them,” she said.
Communication will be important, said Whitley-Williams. “Studies have shown that patients will ask their providers whether they should take a certain medication or whether they should take the vaccine.”
Healthcare providers should be ready and able to address any concerns. In addition, they will have to stay abreast of what's going on with the vaccine supply. “It will be important to empower all families so that they understand what's going on,” said Whitley-Williams, “and that they become part of this process, and making sure that people who are at risk are protected and that eventually anybody who wants the COVID-19 vaccine will have access.
“A vaccine is no good if it's going to sit on the shelf,” she said. “It has to go into the arm of the patient. We want to make sure that this conversation continues and it's not just doctors and parents, but it also includes nurses, pharmacists and others who are going to be engaged in administering the COVID-19 vaccine.”
When the experts were asked if they would take the vaccine when the time comes, all three said they would. “I can assure you that we have a very large contingent of people working through looking at these vaccines to make sure that they are safe and effective,” said Marks, “and they do so with the standard in mind that they want them to be safe and effective for themselves and for their families and for all of us.”
[Adrienne Coles]