Watch the AMA's daily COVID-19 update, with insights from AMA leaders and experts about the pandemic.
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AMA Chief Experience Officer Todd Unger speaks with physician and adjunct associate professor at Emory School of Medicine Sandra Fryhofer, MD, chief strategy officer of the Immunization Action Coalition L.J. Tan, PhD, MS, and infectious diseases specialist at the University of Maryland Medical Center James Campbell, MD, MS, on updates regarding COVID-19 including the impact COVID-19 will have on immunizations for other infections disease and what to expect in the fall, in part two of a two-part series.
Learn more at the AMA COVID-19 resource center.
Unger: Hello, this is the American Medical Association's COVID-19 update. Today we continue with part two of our two-part series on the impact of COVID-19 on routine immunizations. I'm joined today by Dr. Sandra Fryhofer, an internal medicine physician, adjunct associate professor of medicine at Emory University School of Medicine, and an AMA trustee in Atlanta. Dr. Fryhofer is the AMA liaison to the CDC's advisory committee on immunization practices. Dr. L.J. Tan, chief strategy officer of the Immunization Action Coalition in Chicago. He also co-founded and co-chairs the National Adult and Influenza Immunization Summit. And Dr. Jim Campbell, professor of pediatrics and an infectious disease specialist with the University of Maryland Medical Center in Baltimore, Maryland. I'm Todd Unger, AMA's chief experience officer in Chicago.
Dr. Tan, you talked about measles. What about other important vaccinations, such as the flu? What do physicians need to know about this for the coming fall?
Dr. Tan: I think that's a great question. I think what we're going to end up seeing this fall, for flu vaccine, is a major push to try to take flu off the table. So why do we want to take flu off the table? If you think about COVID-19 and the fact that we're likely going to have a resurgence of COVID-19 disease, and you think about the symptoms of COVID-19 versus the symptoms of flu, there's a lot of overlap. And if you think about the populations that are vulnerable to the COVID-19, there's also a lot of overlap with the flu population that are vulnerable to flu. And so I think what we really want to do is take flu off the table as much as we can this fall. So what do we mean by that? Take it off the table in terms of the health care systems. When we have our resurgence of COVID-19 disease, we do not want to be also having to deal with influenza at the same time.
So the more people we can get vaccinated and protected and get them out of that system, wonderful. And then, obviously, with the overlap of populations and symptoms, in terms of the two diseases, if we can have people vaccinated, that's one less diagnostic criteria that we can look at as people come in with respiratory illness. So getting flu off the table this fall is a high priority for, not just the summit that I co-chair, but also for the CDC. The CDC will be launching some initiatives this fall to help the public understand, even as COVID-19 disease resurges, even as the pandemic continues, getting protected against flu, for example, this fall will be very important. And I would argue not just flu, anything that we can do to take diseases off the table so that people aren't going to the health care system would be fantastic. So pneumococcal vaccine, shingles vaccine, all those things are things that we need to be looking for in the fall to take it off the table. So I think that's a great point. Thank you so much there, Todd.
Unger: Well, last time we talked a little bit about COVID-19 and the vaccine in development. What are you hearing and what do think the timing is for a COVID-19 vaccine?
Dr. Tan: I'm happy to jump in first and just mention, I'm happy to send this link to everybody via the summit that I co-chair with the CDC and with the Office of Infectious Disease Policy at AHS. We held a meeting on May 12. We were specifically on COVID-19 vaccine development and we had six of the innovators representing five different vaccine platforms present on the clinical trials that are ongoing right now. And so I think with that in the background, what I can say is that I'm fairly confident with the number of irons we have in the fire, something will strike. And if everything goes well, I think we can be entering phase three trials, probably at the end of this year, if everything goes well. With the way manufacturers have committed to repurposing their capacity, their facilities towards a COVID-19 vaccine, if everything goes well, I think we can see potentially 100-200 million doses of a COVID-19 vaccine in the spring of 2021.
That, again, subject to everything going well, subject to obviously FDA regulatory approval, in this case under emergency use authorization. After having heard some of our innovators, I'm a little more optimistic than I was earlier. So I'll speak to that part. And I think, obviously, I leave it Dr. Campbell, Dr. Fryhofer, because I think there are also going to be concerns about when we "rush a vaccine," what does that mean?
Dr. Campbell: Yeah, maybe I can jump in next. Thanks, Dr. Tan. We are involved in some of those vaccine trials and in developing next phase trials and particularly what do we do as we gather more and more information on the safety immune response and efficacy in adults? When's the right time to trigger, that we start moving down into children, into the elderly, into those who are at high risk? So we're involved in trying to help people to make those decisions. I am also very optimistic, especially because so many people have turned their attention to this and are using every type of platform, as we say, meaning various scientific approaches to vaccines. Some of which, that platform has not had licensed vaccine before.
But in terms of safety, that of course, is the number one thing when you're talking about vaccines because they don't go, typically, to a small group of people. They go to large population, sometimes the entire population. So the bar for safety is very high, we have to keep that very high. We need to move quickly and, at the same time, not cut corners. There are ways of doing that and that is when everyone's on board. The manufacturers, the investigators, the regulators, everyone is thinking the same way because many of the delays, not delays, but the longer time that it takes to move things through is because there's just processes. If you do the same work, but in a shorter amount of time, you can still show all the important things about safety. That's the way I feel, is no cutting corners but just move a lot faster and work late into the night.
Dr. Tan: Absolutely.
Unger: Dr. Fryhofer, any thoughts on that?
Dr. Fryhofer: Well, I think it's great to hear that update, how we're coming along with this COVID vaccine, but there's several months before that will happen. As Dr. Tan and Dr. Campbell alluded to, many experts do predict a second surge of COVID in the fall, right as flu season begins. That's another reason why flu vaccination, especially this year, is so important. And reminder, everyone six months and older needs flu vaccination every year, including this year.
Now we all know that many routine visits are going virtual, and although we can do a lot in a telehealth visit, immunization still requires an in-person encounter. But during these telehealth visits, there's much we can do. We can reinforce the importance of vaccination and review which vaccinations a patient needs and come up with a plan, be creative, be efficient. Remember that physician recommendation is a great motivator for vaccination. You can administer vaccination during an in-person visit for another reason. You can give more than one vaccination at a time. Dr. Tan mentioned the many vaccines that some patients may need. I think we will expect more drive-thru flu vaccination clinics in the fall and remind your patients to dress appropriately for the occasion. If they wear a sleeveless shirt, it's going to be much easier to administer that vaccine.
Unger: That is great advice. Thank you very much. That completes our two-part series on immunizations and COVID-19. Thank you very much, Dr. Fryhofer, Dr. Campbell and Dr. Tan for being here today and sharing your perspectives.
If you missed part one, you can find it on the AMA's YouTube channel. We'll be back tomorrow with another COVID-19 update. For updated resources on COVID-19, visit ama-assn.org/COVID-19. Thanks for joining us and take care.