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Covid 19 vaccine conversations 2021 01-20

Vaccine efforts from three health centers

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Covid 19 vaccine conversations 2021 01-20

  1. 1. Conversations on COVID-19 Vaccine Efforts January 20, 2021
  2. 2. Introducing Joint Accreditation Community Health Center, Inc. (CHC) and its Weitzman Institute have received Joint Accreditation for Interprofessional Continuing Education. This designation confers simultaneous continuing education accreditation across nine national accrediting bodies. This Weitzman ECHO program is now able to award continuing education credit to a wide array of health professionals, including physicians, nurses practitioners, physician assistants, pharmacists, nurses, psychologists, dentists, social workers, and dietitians. If you have not been filling out previous CE evaluation forms because you were not able to use credits through AAFP, we highly encourage you to begin filling them out moving forward so you can receive credits!
  3. 3. Disclosure • With respect to the following presentation, there has been no relevant (direct or indirect) financial relationship between the party listed above (or spouse/partner) and any for-profit company in the past 12 months which would be considered a conflict of interest. • The views expressed in this presentation are those of the presenter and may not reflect official policy of Community Health Center, Inc. and its Weitzman Institute. • We are obligated to disclose any products which are off- label, unlabeled, experimental, and/or under investigation (not FDA approved) and any limitations on the information hat I present, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion.
  4. 4. Conversations on COVID-19 Vaccine Efforts January 20, 2021 www.rand.org/ Stephen Scholand, MD; Infectious Disease Specialist, MidState Medical Center
  5. 5. 24,247,006 cases on 1/19/21 with 401,586 deaths https://coronavirus.jhu.edu/map.html COVID-19 in the United States
  6. 6. https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html Coming off ‘peak’
  7. 7. How many ‘jet liners’? A320 seats 182 passengers
  8. 8. https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html Nursing Homes Cases & Deaths
  9. 9. Pressure on Hospital Systems https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
  10. 10. COVID-19 Vaccinations Across the Nation https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
  11. 11. News Headlines At least 20 States have the U.K. strain • 122 total (B.1.1.7 strain): FL (46), CA (40), CO* (6), MN (5), IN (4), NY (4)… • About 56% more transmissible than earlier versions of the virus • Spread to 50 countries already • As of 1/18, ~11 million given at least one dose of vaccine • Far short of 20 million by 12/31 www.cdc.gov/coronavirus/2019-ncov/transmission/variant-cases.html
  12. 12. Infection and Immunology www.criver.com
  13. 13. www.nature.com/articles/ d41586-020-01221-y
  14. 14. www.nature.com/article s/d41586-020-01221-y
  15. 15. COVID-19 Vaccines • Pfizer mRNA • Moderna mRNA • J&J • Astra Zeneca/University of Oxford – Modified chimp adenovirus vector (ChAdOx1) • Many other candidates…
  16. 16. Pfizer Vaccine • 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 Celsius (112 Fahrenheit)
  17. 17. • mRNA molecule • inactive ingredients (excipients): – Lipids/nanoparticle: • ALC-0315 ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2- hexyldecanoate) • ALC-0159 = 2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide • 1,2-distearoyl-sn-glycero-3-phosphocholine (DSPC) • Cholesterol – Salts: • dibasic sodium phosphate dihydrate • monobasic potassium phosphate • potassium chloride • sodium chloride • sucrose • water for injection Pfizer Vaccine “Comirnaty”
  18. 18. Moderna Vaccine • mRNA vaccine, mRNA-1273 • Lipid nanoparticle dispersion containing mRNA – Encodes for the prefusion SARS-CoV-2 spike protein • 30,000 participants in 89 sites • 2 doses - no trial-limiting safety concerns
  19. 19. • Ingredients: – Lipids: • SM-102 • polyethylene glycol [PEG] 2000-dimyristoyl glycerol [DMG] • Cholesterol, and • 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC]; – Other: • tromethamine; tromethamine hydrochloride; • acetic acid; sodium acetate; and • sucrose
  20. 20. Resources • Nuvance health 2000+ articles reviewed: https://spark.adobe.com/page/nM7AVuPoJ2SN0/ • 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/
  21. 21. Conversations on COVID-19 Vaccine Efforts Mike Renaud; Vice President of Quality and Patient Engagement, Presbyterian Medical Services Kenneth Tai, MD; Chief Health Officer, North East Medical Services Mary Blankson, DNP, APRN, FNP-C; Chief Nursing Officer, CHC Inc.
  22. 22. Presbyterian Medical Services • Location: New Mexico, Statewide • Number of Patients Served: 90,000 • Stage in Vaccine Rollout: Actively administering vaccinations to patients and community members • Number of Vaccines Distributed: 3,500 • Current Success: Transitioning into patient administration of vaccine • Current Challenge: Administrative burden and state bureaucracy
  23. 23. North East Medical Services • Location: San Francisco Bay Area, California • Number of Patients Served: 70,000 • Stage in Vaccine Rollout: Healthcare workers; starting patients ages 75+ this week in San Jose • Number of Vaccines Distributed: 1,800 • Current Success: Can administer 60 vaccines in 3 hours with a team of 2 nursing staff per site; 75% of staff have been vaccinated • Current Challenge: Pre-registration and scheduling, charting, getting 10 doses per vial, short half life of vaccines (6 hours), limited supplies from counties & state, getting the word out to community
  24. 24. Community Health Center, Inc. • Location: Connecticut, Statewide • Number of Patients Served: 150,000 • Stage in Vaccine Rollout: Phase 1B – Individuals 75 and older • Number of Vaccines Distributed: 8,283 • Current Success: Standing up mass vaccine clinics and taking on Pfizer vaccines • Current Challenge: Staffing
  25. 25. Vaccine Questions • How is your health center navigating and alerting your provider and patient networks regarding vaccine updates? • How are people learning that the vaccine is available to them in different groups of need? • How are you operationalizing vaccine clinics? • How are you addressing vaccine hesitancy amongst your staff and patients? • How are you partnering with local community organizations to promote trust around the vaccine and address misinformation?
  26. 26. Participant Q&A
  27. 27. Thank You! To learn more about The Path Forward series WeitzmanLearning.org/the-path-forward To view previous COVID-19 sessions: WeitzmanLearning.org/coronavirus
  28. 28. Additional COVID-19 Vaccine Information January 20, 2021 Stephen Scholand, MD; Infectious Disease Specialist, MidState Medical Center
  29. 29. Blood Types Zietz, M., Zucker, J. & Tatonetti, N.P. Associations between blood type and COVID-19 infection, intubation, and death. Nat Commun 11, 5761 (2020). https://doi.org/10.1038/s41467-020-19623-x
  30. 30. Bell’s Palsy • CDC: – Were reported in participants in the mRNA COVID-19 vaccine clinical trials – Pfizer-BioNTech trial, 4 cases (0.0091% of participants). Days 3, 9, 37, and 48 days after vaccination. No cases in the placebo group – Moderna trial, 3 cases (0.099% of participants). One case in the placebo group. Occurred days 32, 28, and 22 after vaccination – FDA does not consider these to be above the rate expected in the general population • Not concluded these cases were caused by vaccination – Therefore, persons who have previously had Bell’s Palsy may receive an mRNA COVID-19 vaccine
  31. 31. Autoimmunity and GBS • No data are currently available on the safety of mRNA COVID-19 vaccines for autoimmune • Persons who have previously had GBS may receive an mRNA COVID-19 vaccine
  32. 32. Pregnancy • Pregnant women with COVID-19 are at increased risk for severe illness – ICU admission, mechanical ventilation, and death – Adverse pregnancy outcomes, i.e. preterm birth – No safety concerns were demonstrated in rats that received Moderna vaccine – No data on the safety of COVID-19 vaccines in lactating women • Not thought to be a risk to the breastfeeding infant
  33. 33. Allergy - Anaphylaxis • CDC guidance: Talk with HCP if history of severe allergic reaction (e.g., anaphylaxis) to any other vaccine or injectable therapy (e.g., intramuscular, intravenous, or subcutaneous) – Unknown risks of developing a severe allergic reaction vs. the benefits of vaccination

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