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1rem

Here is a compilation of the COVID-19 vaccine candidates that have achieved FDA Emergency Use Authorization, other approvals, and are in phases 1-3.

The COVID-19 Live Vaccine Tracker

Why reducing pandemic research and response to yes-or-no outcomes is harming public health.

Coronavirus Science Is Not Binary

MJH Life Sciences is presenting a webinar today on this important topic.

Webinar: Race for a COVID-19 Vaccine 

Dr. Adam Brufsky, an oncologist, compares viral and cancer immunity. Dr. Patrick Soon-Shiong connects the relation to COVID-19 vaccine research.

Connecting COVID-19 to Cancer Research

What should be anticipated in effectiveness and implication for the leading candidates.

Setting Standards for a COVID-19 Vaccine

What happens if we don't get a COVID-19 vaccine? Patrick Soon-Shiong, MD, describes another potential route for research efforts, which could also supplement vaccine development.

Can We Fight Coronavirus Without a Vaccine? Explaining Monoclonal Antibody Research

Dr. Patrick Soon-Shiong and Dr. Adam Brufsky move on from the messenger RNA candidates to the adenovirus vaccines.

Adenovirus COVID-19 Vaccines: Challenges of Prior AD Immunity

Dr. Patrick Soon-Shiong, Chairman and CEO of ImmunityBio, explains why T-cell immunity could be an important metric when evaluating experimental COVID-19 vaccines.

Can Moderna's COVID 19 Vaccine Generate Lasting Immunity?

, where we delve into some of the social factors that create and widen healthcare disparities.

Social determinants, a legacy of distrust, and inequities have all been challenges for people of color in the delivery of health care. And these factors have translated to the administration of 

The university hosts the biggest vaccination site in its county, San Bernadino. However, there is low representation of Black vaccinees. Abdul-Mutakabbir and faculty at Loma Linda worked with leaders from local Black churches to get the word out and communicate about the availability and benefits of the COVID-19 vaccine.

“From February 1 until April 30, 2021, 24,808 individuals were vaccinated in the LLU mass clinic with a first dose (Pfizer or Moderna) or single dose (Janssen) of a COVID-19 vaccine, however, only 908 (3.7%) were Black vaccinees. Contrastingly, the LLU remote site clinics vaccinated 1542 individuals with a first or single dose of a COVID-19 vaccine. Of those vaccinees, 675 (44%) were Black,” Abdul-Mutakabbir and coauthors wrote in their poster.

Along with protection against COVID-19, Abdul-Mutakabbir makes the point that preventative measures such as vaccines can help avoid hospital stays and subsequent health care associated infections and antimicrobial resistance. She believes vaccination goes hand-in-hand with antimicrobial stewardship.

Hear what vaccine equity means to Abdul-Mutakabbir, and the vaccine drive in which she was involved.

Missed Episode 1 of Contagion Community? 

Listen in on the conversation and feel free to offer your feedback on this episode, interest in participating in the podcast, or suggest ideas for future episodes. Please email your correspondence to Nina Cosdon: ncosdon@mjhlifesciences.com

In this latest episode of Contagion Community, we interview Dr. Jacinda Abdul-Mutakabbir about vaccine equality vs vaccine equity as well as her experience on a COVID-19 vaccine drive to increase vaccinations in communities of color.

Vaccine Equality vs Equity with Dr. Jacinda Abdul-Mutakabbir

This interview and episode was recorded and produced prior to the November 16 announcement that 

Moderna's vaccine candidate mRNA-1273 was associated with 94.5% efficacy

 in preventing COVID-19 in preliminary phase 3 COVE trial data. Though the candidate and the mRNA platform is discussed throughout the podcast, more updated coverage of mRNA-1273 will be made available on ContagionLive.com throughout the coming weeks.

In matter of 2 weeks, a series of significant clinical, public health, and otherwise factors greatly influenced the current state of 

From promising preliminary phase 3 data from Pfizer and BioNTech, to record surges in new cases and hospitalizations across the US, and to a Presidential election laden with public health policy implications, the makeup of COVID-19 pandemic response is entirely different from what it was weeks ago.

It is only bound to change even more greatly in just a couple more weeks. Before the US Food and Drug Administration (FDA) is able to weigh on the potentially first COVID-19 vaccine to submit an Emergency Use Authorization (EUA) and kick off an unprecedented distribution and real-world monitoring process, it’s crucial to assess where things stand now, and what’s coming up.

This week’s Vaccine Race podcast features an interview with William Schaffner, MD, professor of Preventive Medicine and Medicine at the Vanderbilt University Medical Center.

Schaffner discusses his own impression of the new Pfizer preliminary data for candidate BNT162, whether the current US rate of 150,000-plus new daily cases could pressure the FDA to further expedite a vaccine, what vaccine distribution, storage, and immunization will entail, and what a new administration would (or would not) mean for COVID-19 response and vaccine development.

The Vanderbilt Professor of Preventive Medicine shares thoughts on the first potential COVID-19 vaccine, at a time of record new daily cases.

Vaccine Race: The Pfizer Vaccine with William Schaffner, MD

Last Friday, the US Food and Drug Administration (FDA) hosted a Vaccines and Related Biological Products Advisory Committee (VRBPAC) meeting to discuss 

 research, development, and eventual licensing with the Center for Biologics Evaluation and Research (CBER).

Though the live-broadcast meeting did not weigh any regulation decision nor tailor its agenda to any single vaccine candidate or company, it provided the public a glimpse into the mindset of the FDA’s key experts weeks prior to anticipated Emergency Use Authorization (EUA) applications for COVID-19 vaccines.

The advisory committee meeting also allowed for community-based input—of which there was plenty, as advocacy and health organizations alike represented differing patient populations, issues in disparity, and calls for scrutinous, transparent regulation of any possible vaccines.

In this week’s episode of Vaccine Race, Donald Alcendor, PhD, rejoined the limited series to give real-time takeaways from the VRBPAC meeting and what discussion could implicate for COVID-19 vaccine regulation. Among topics, the expert from Maharry Medical College and Vanderbilt University School of Medicine provided perspective on secondary phase 3 assessment endpoints, mandated vaccination groups, pediatric treatment arms, and advocacy representation at the meeting.

for the treatment of adult and children hospitalized with COVID-19 breaking a day prior, Alcendor also discussed what the decision could mean for eventual vaccine authorization.

A glimpse into FDA advisor perspective just weeks before EUAs are anticipated to be sent.

COVID-19 Vaccine Race: FDA Advisory Committee Meeting with Donald Alcendor, PhD

, as the global-scale infectious disease meeting has been forced to resort its comprehensive clinical agenda to a virtual format due to 

As an acknowledgement to the great burden of COVID-19—and in spirit with the meeting’s great collaborative efforts—the first 24 hours of the annual meeting are dedicated to discussions around the pandemic, titled “Chasing the Sun.”

 will provide around-the-clock IDWeek 2020 coverage over the next days, we kick off our content in a similar fashion: the second episode of our limited series podcast Vaccine Race.

In this episode, senior editor John Parkinson sits down with Mei Mei Hu, co-chief executive officer of vaccine development company Covaxx, and honorary member of Time Magazine’s Next 100 List of 2019.

Covaxx’s investigational COVID-19 vaccine, UB-612, is the first multitope peptide-based vaccine capable of activating both B-cells and T-cells.

about her company and its creation of this interesting candidate, and provided some firsthand insights into getting a vaccine through the development process.

Stay tuned for more IDWeek 2020 content, and a new Vaccine Race episode, throughout the week.

ID Week

A vaccine developer joins for a firsthand discussion on the development, research, and distribution process.

Vaccine Race: Mei Mei Hu on Developing, Researching a COVID-19 Vaccine

Few medical advances have progressed with such expediency, scrutiny, and financial backing as the development of 

In just 10 months, drug developers, legislators, and researchers have collaborated on the condensed creation, assessment, and planned distribution of nearly a dozen likely candidates designed to curb coronavirus’ spread. If majority population immunity is the safest, most efficient mean to end the effect of a pandemic that’s already cost 210,000-plus lives, then whatever vaccines reach market could be world-changing.

Beyond coverage of the spread, prevention, and treatment of coronavirus, 

 recognizes the need to give unique focus to this unparalleled clinical effort. Readers can follow along vaccine research and insights on the COVID-19 Vaccine page, and can catch up on the individual candidates’ progression on the 

And now, they can tune in to the Vaccine Race podcast, a limited series designed to provide everything new to know and learn about the COVID-19 vaccine candidates.

The inaugural episode’s featured guest is Donald J. Alcendor, PhD, Assistant Professor of Cancer Biology at Meharry Medical College and Adjunct Associate Professor of Cancer Biology at Vanderbilt University School of Medicine.

After updates on vaccine developments, new data, FDA guidance, and distribution deals, Alcendor joins to discuss the need for vaccine buy-in from hard-to-reach populations and communities historically at odds with healthcare.

Register for the Contagion daily newsletter to receive COVID-19 updates, research, and perspectives straight to your inbox

The Meharry and Vanderbilt-based expert shares insights into reaching less trustful populations on the first podcast episode.

COVID-19 Vaccine Race: Donald Alcendor, PhD, on Community Buy-In

The week's most-clicked COVID-19 stories included vaccine updates, new variants, and a pivotal FDA advisory committee vote.

The Top 5 COVID-19 Stories This Week

Novavax will update its protein-based COVID-19 vaccine, but maintains the current vaccine is effective against current and future variants.

To Meet Updated FDA Recommendations, Novavax Will Update Protein-Based COVID-19 Vaccine

The FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) voted to move toward a unified strain composition for COVID-19 primary and booster vaccines.

FDA Advisory Committee Votes to Unify the Strain Composition of COVID-19 Primary and Booster Vaccines

In the CDC’s latest Morbidity and Mortality Weekly Report, investigators reported the Moderna and Pfizer-BioNTech updated vaccines helped prevent acute infection from the latest Omicron mutations.

The mRNA COVID-19 Boosters Protect Against XBB and XBB15 

The Pfizer-BioNTech COVID-19 vaccine was associated with rare instances of myo/pericarditis and acute kidney injury, according to a nationwide study in New Zealand that confirmed the safety profile of the vaccine.

Large New Zealand Study Confirms Safety Profile of Pfizer-BioNTech Vaccine


According to the National Institutes of Health, nearly all children become infected with RSV by age five, and approximately 58,000 of them need hospitalization annually. This past fall, RSV cases increased dramatically, and impacted hospital capacity with this patient population.

Although there are RSV vaccines and therapies in clinical trials, there is nothing approved. Both prevention and treatment remain critical, clinical needs, and FDA sees these unmet needs as of significant importance.

In November, clinical-stage biotechnology company, Codagenix, was granted an FDA Fast Track designation for its, an intranasal, live-attenuated vaccine candidate, CodaVax-RSV, for the prevention of respiratory syncytial virus (RSV).

“Though RSV is the leading cause of hospitalization for children below the age of five, there are currently no vaccines approved to protect against this devastating disease. We are encouraged by the Fast Track designation for CodaVax-RSV, which recognizes the vaccine’s unique potential to address this significant unmet need,” Codagenix Cofounder and CEO J. Robert Coleman, PhD, MBA, said in a statement at that time. 
 
The phase 1 dose escalation study of CodaVax-RSV evaluating safety and immune responses in healthy children aged six months to five years is expected to initiate in the early part of this year, immediately after this year’s RSV season. Based on the results of this study, a phase 2 dose confirming study will explore efficacy during the RSV season in 2023-2024.

The company has built its platform around live-attenuated virus vaccines as opposed to viral vector or mRNA-based vaccines using its codon deoptimization platform.

The company also has its COVID-19 intranasal vaccine candidate, which recently entered phase 3 clinical trials as part of the WHO-sponsored studies.

In a wide-ranging interview with 

, Coleman talks about the advantages of traditional live-attenuated virus vaccines as opposed to mRNA-based vaccines as well as updates on their RSV and COVID-19 vaccines.

This live-attenuated investigational vaccine was developed by Codagenix, which uses its codon de-optimization platform for its candidates.

FDA Fast Tracks Intranasal RSV Vaccine

 its first Vaccines and Related Biological Products Advisory Committee (VRBPAC) meeting for 2023, and the meeting is looking to discuss if the currently available COVID-19 vaccines should be modified and how and whether the composition and schedule for booster doses should be adjusted moving forward.

One important component that has been sorely missed in understanding virus protection is T-cell testing.  The role T-cells have played in understanding COVID-19 immunity and vaccine response has been limited at best. Measuring T-cell response could help provide a more complete picture of protection after vaccination. 

A growing body of evidence indicates T-cells may be an important correlate for protection and should be considered as an endpoint for vaccine clinical trials and in the development of next generation vaccines and boosters

The ability to determine immunity information in individuals may help to bore down on needed protection against viruses.

“As we've seen with the latest outbreak, T-cell testing is very, very important for long-term immunity,” Virax Biolabs Group Chief Scientific Officer Tomasz George, PhD, said. “So in order for you to get a real picture of how your body is adapted to a virus, or whether you're going to fight off a new virus in the future, it's useful to look at your T cells to say actually, will I mount an effective response if I was to get this virus again, or if I was to get new virus in the future that's kind of maybe similar to a virus that I've had in the past?”

United Kingdom-based Virax Biolabs Group is a biotech company that is focused on the detection and diagnosis of viral diseases, with a particular interest in the field of immunology. 

Virax is currently developing

a proprietary T-cell testing platform, Virax Immune, with the intention of providing an immunology profiling platform that assesses each individual’s immune risk profile against major global viral threats.

The goal is to help individuals track their immune status and provide suggestions to guide their health, and the company expects to do this by augmenting the patient/user experience by launching its Virax Immunity mobile application.

In addition to the aforementioned platform, the company has commercially available tests for COVID-19 and introduced monkeypox and varicella-zoster viruses real-time PCR detection kits earlier this year. 

 spoke to George who offered some insights into why T-cell testing has been limited thus far, provided background on their T-cell platform, and how immune-profiling can work on a larger scale.

Virax Biolabs has developed a T-cell testing platform to develop an immune risk profile against viral threats.

Determining Long Term Immunity May Aid in Understanding Vaccine Efficacy 

Wendy Wright, DNP, ANP-BC, FNP-BC, FAANP, FAAN, FNAP:

 In our clinic, we separated the Moderna and Pfizer vaccines and do Moderna Mondays and Pfizer Fridays. Because there are so many idiosyncrasies to the different dosing, our fear is giving the wrong dose to the wrong person. I want to talk to all of our pharmacists here, because in many states, pharmacists can’t vaccinate every age group. A lot of primary care providers are saying, “This is way too much work. We aren’t taking any of these on. You need to go to the pharmacy.” Pharmacists are just as burdened as we are with all the workload, if not more. As a country, it’s most important that we all work within our systems to create novel ways to get these vaccines on board.

 From the pharmacist standpoint, we’re vaccinating most age groups at this point due to special pandemic orders. Over 70% of individuals who have received vaccines have received them from pharmacists. I’m in the community, and I vaccinate. I only vaccinate with Pfizer. When I go into the community, I only take Pfizer with me. Moderna has a ton of doses in the vial, and the climate of uptake is changing, so I don’t feel comfortable wasting the number of doses that I would waste should I take Moderna with me into the community.

I explain this to the community members, and then I offer that information in terms of heterologous vaccination. Can you receive 2 different vaccines? Can you receive a different booster? I consistently have that conversation. I consistently discuss the study in which 400 individuals enrolled. Individuals got Pfizer-Pfizer, or received Moderna, Johnson & Johnson or Pfizer, and they wanted to see their immunogenicity. We saw similar responses with the mRNA vaccines but a lower response with J&J, which is why it’s recommended that those who had J&J get the booster with the mRNA vaccines. That’s the conversation I have with my patients.

We talked about dumbing the science down, but I believe in making them a community stakeholder. I explain, “This is how this goes.” I want them to know the reason I’m not bringing Moderna, but that I’m not compromising their protection. That’s a good point you brought up, Wendy. We have so many different doses. We have so many different caps at this point: 17 different colors. It becomes a matter of, “How can I do this and maximize the vaccinations? How do we keep it safe?” Then I end up in the community, and patients ask me, “Can I get the flu vaccine? Can I get it at the same time as the COVID-19 vaccine?” It becomes that comfortable place when I have only the Pfizer COVID-19 vaccine. If I bring the influenza vaccine with me, it becomes a bit easier to have to manage only those 2 different types of vaccines.

But then I get asked, “Do I get the vaccines in the same arm?” I explain to them that this is mRNA technology, and you can definitely receive other vaccines because it’s equivalent to an inactivated vaccine. It isn’t live, so you can receive 2 different inactivated vaccines, or a live and an inactivated vaccine. You just can’t get 2 live ones at the same time. I advise to not get them in the same arm. You guys may have different advice, but I usually say to get them in 2 separate arms. I did it in the same arm last year, and I still regret it. I still have phantom pain.

 There are a couple of things I’d add. Heterologous boosting has become sexy. I love talking about that with people. I say, “In Europe, they’ve been doing this for a long time. Let’s mix it up, and you may have some better protection.” We do give 2 live vaccines on the same day. We do MMR [measles, mumps, and rubella] and varicella. They just have to be separated by a month if they aren’t done on the same day. That doesn’t matter with these. People can get other vaccines, but don’t do them in the same arm. We’re giving the flu vaccine in one arm and the COVID-19 vaccine in the other. We say, “You probably aren’t going to like us tomorrow, but then you’re miserable and your misery is over. Take some acetaminophen if you need it, and you’ll be done with your vaccines.”

That’s a great point. We’re starting to give our flu vaccines where I work, and a lot of people say, “Just give both to me at the same time. If I’m going to feel bad, I want to feel bad only once.” It’s good to remind people that if they feel bad, it isn’t because they developed the infection. I’ve heard the old adage about people getting the flu from the flu shot. It’s hard to dissuade people from believing that. It’s important to reiterate to people that your arm is going to be sore and you may feel fatigued and a little out of it for a day, but that’s just your immune system waking up and figuring out what it’s doing. Don’t worry that you’ve acquired COVID-19 or influenza from the shot that you’ve gotten. I always try to point that out if I’m giving both vaccines at the same time. You’re going to feel kind of bad, but it’s OK. You don’t have the disease.

 Right on. The hashtag here from Wendy is #MixItUp. Let’s start a new campaign.

 Or #HeterologousBoostingIsSexy. That’s the other one.

 That’s a long hashtag. That may not work. It’s interesting. I have a ton of friends who are first responders and firemen. One of the highlights and feel-good moments for me during the past 2½ or 3 years is when people got out there and did their part in helping immunize people. I took my parents to be vaccinated. We drove 60 miles to Brenham, Texas. Both of my parents are immunocompromised. My mom’s a recovering patient with cancer. My dad has some diabetes issues. They’re both older. We drove them into this community, and there were thousands of cars. It was so exciting to see them get their shots. It’s easy to forget that. That wasn’t that long ago. We have to remember how amazing the country responded. We certainly tripped over ourselves sometimes, and we made some mistakes, but overall, we stepped up when we had to.

I’m glad you guys talked about flu and COVID-19. We need to make sure people understand that it’s safe to get both vaccines. I do one in each arm, myself. That helps. Also, if you have issues—I got 4 shots for COVID-19 and had some issues– it’s OK to take a little acetaminophen after you take that vaccine. It might make you feel a little better. Why feel horrible? That’s what medications are for. I tell people all the time, “That’s why you’re taking a vaccine. It’s also why we take medication. You don’t need to suffer. It’s OK if you’re doing it correctly according to the directions, and things will be a little easier for you.” That’s important.

Before I move on, the last point I want to mention and cement what you guys talked about was that mixing and matching became critical, and there are data. With the Johnson & Johnson vaccine, we were desperate to get people vaccinated, so we were looking for a 1-shot option because Moderna and Pfizer were both 2 shots, about 3 to 4 weeks apart. In hindsight, the Johnson & Johnson vaccine should have been a 2- or maybe 3-vaccine series. We learned some lessons, but 1 shot was better than no protection when this thing was raging 2 years ago.

Drs Jacinda Abdul-Mutakabbir, Madeline King, Rodney Rohde, and expert nurse practitioner Wendy Wright provide insight on receiving the influenza vaccine concurrently with the SARS-CoV-2 booster shot, and comment on data on immune responses from the Moderna and Pfizer/BioNTech vaccines.

Influenza Vaccination With SARS-CoV-2 mRNA Booster Shots

Experts in the management of SARS-CoV-2 educate on CDC and FDA recommendations for approaching administration of booster vaccines, including those for special patient populations.

CDC and FDA Recommendations for SARS-CoV-2 Booster Shots

Wendy Wright, DNP, ANP-BC, FNP-BC, FAANP, FAAN, FNAP; Jacinda Abdul-Mutakabbir, PharmD; and Rodney E. Rohde, PhD, MS, SM(ASCP)CM, SVCM, MBCM, FACSc; review what encompasses a bivalent vaccine and give their perspective on how to communicate the role of the vaccine in optimizing protection for patients.

Defining SARS-CoV-2 Bivalent Vaccines and Optimizing Protection Through Vaccination

Rodney E. Rohde, PhD, MS, SM(ASCP)CM, SVCM, MBCM, FACSc, leads a discussion on the constant evolution of SARS-CoV-2 variants and the impact on vaccine and booster shot development and administration.

Evolution of SARS-CoV-2 Variants on Booster Shot Development and Formulations

Jacinda Abdul-Mutakabbir, PharmD; Wendy Wright, DNP, ANP-BC, FNP-BC, FAANP, FAAN, FNAP; and Madeline King, PharmD, BCIDP, examine the efficacy and real-world implications of the COVID-19 booster shot in terms of vaccination protection rates.

COVID-19 Booster Vaccination Protection Rates

Rodney Rohde, PhD, MS, SM(ASCP)CM, SVCM, MBCM, FACSc:

 I’m a credentialed specialist in virology and microbiology as well as public health. My background is in testing, including some of the molecular testing that Wendy and Dr JAM were talking about. It’s interesting to hear you talk about it because when I speak to the public, which is what we’re doing now, I can’t overemphasize how critically important it is for good science communication and good health literacy.

To be clear, the CDC and the WHO [World Health Organizations] have these designations of variant of interest. Those are the ones on our radar. We’re watching those. Variant of concern is happening right now: something we’re going to keep our eyes on a little closer. The one we haven’t seen and we don’t want to see is the variant of high consequence. That means we’ve entered the world of vaccines not working, therapies not working, and things spreading out of control. You might have thought about that early on in the pandemic. We never got there, but we probably were close before we had the vaccines roll out.

Thank you for defining those in your patient populations, in your research, and elsewhere. It’s critical that the public continues to understand that as we move forward. Any of you can jump in here: do you think there’s a particular impact of these different variants when you start thinking about the challenges they present to vaccination? Certainly, the public thinks that. Do you have a way to explain that to your populations?

Wendy Wright, DNP, ANP-BC, FNP-BC, FAANP, FAAN, FNAP: 

For me, it has posed a huge challenge. First and foremost, providers are fatigued. We’re vaccined out. I just saw someone who’s on her fifth vaccine, and she said, “When is this going to end?” I wish I had a magic wand, but those variants have made it tough for us to keep pushing people to continue to booster. We made a mistake when this virus came out and we started giving the vaccines. We needed to have a 3-dose primary series and not call these booster shots. Many experts will say that we probably needed to give 1, give another a month later, and give a third 6 months later, as we do with many other vaccines. Because when people hear the term 

For the last 2 years, we’ve been chasing these variants. We’ve got to find a way to get ahead of these variants, which is what we’re trying to do with the more targeted bivalent vaccine that became available in September. It has made it very challenging for all of us clinically but also for patients. They don’t necessarily know what to do. A woman said to me, “I’m going to be very frank with you. I’m taking this vaccine only if you tell me I need it. I’m done with the government. I don’t trust them.” We’re hearing this resounding that people don’t trust science. She said to me, “If you want me to have it, I promise you I’m going to have it.” That’s a nice segue to what we’ll discuss later. But it’s also really hard on people. They don’t always feel well when they get these vaccines.

 That’s a great point, Wendy. In speaking about that, you made me think about our messaging when we talk about the flu vaccine as well. I’m afraid that people are going to hear about this booster shot with new variants and think, “I have to get a flu shot every year. I’m going to have to get a COVID-19 vaccine every year.” A lot of people don’t get their flu shot anymore because they think it isn’t effective. People still get the flu. A lot of that messaging is going to be crossed. I fear that people are going to get the same impressions with these COVID-19 vaccines going forward.

You’re right. But the best thing that’s happened from COVID-19 is we’re changing the way we’re communicating about vaccines. We aren’t saying that it’s going to protect you from the disease. We’re saying that the efficacy of these vaccines is around hospitalizations and moderate to severe disease. That’s how we need to change our flu messaging as well. Maybe COVID-19 has set the stage for that.

 Dr JAM, do you have any comments on this?

 I do have comments on this, and it may interface into what we’ll talk about moving forward. Madeline and Wendy were spot on. It’s communication strategy. Rodney, you said it in a previous topic. At the end of the day, we have to be intentional about how we communicate with the public on what these vaccinations are for, what these variants are, and why increased vaccinations are necessary. We have to position scientists as the experts. We can’t have anyone other than trusted scientists. We have Dr Walensky and Dr Fauci, who have been at the macro level. It’s so important for our communication strategies and increasing vaccine uptake.

Part of the question that you asked was so important: how does vaccination efficacy differ for these boosters or the bivalent or the subvariants? What do we notice with the vaccine efficacy as we saw these variants come to be? That’s what’s most interesting, and that’s what I continue to explain to patients when they ask, “Do I have to get these additional boosters?” I say that we originally had a ton of protection. We saw ridiculous efficacy rates when we looked at the Moderna and Pfizer mRNA vaccines that we could have never imagined to see in this lifetime. But when the Alpha variant came along, we didn’t see as much efficacy. Then we saw the Beta and Delta variants, which we remember being such a barrier to care.

As these subvariants occur, we need to have more protection and we need to make sure that we do what we can to build those antibodies back up. It’s the conversation and the messaging. It’s how we package why these boosters are necessary. It’s bold to say, “I know that we originally said you needed 2 doses, or 1 if you want to do Johnson & Johnson, but guess what? Now we want you to get 2 additional boosters on top of that. And now we have the bivalent booster.” It’s important that we educate alongside these rollouts.

 Those are all great points. The common theme [in this conversation] will be science communication. It’s something I’ve been focused on for the last 2½ to 3 years, and really for my whole career in talking about infectious diseases. There’s 1 comment that I’ll add. As someone who works in this realm of virology, 1 thing I talk about with the public, meeting where they are with respect to knowing what a virus really is, is that it’s a diabolical creature that’s always ahead of us, to Wendy’s point. I don’t know if we’ll get ahead of it, but we’re definitely light years ahead of where we were a decade ago.

The mRNA technology allows us to adjust and pivot. There’s still some vagueness and misunderstanding around mRNA technology. It has been around for over 20 years. It’s a fantastic technology that’s going to allow us to probably stay ahead of that. In a new 

 publication, over 1.5 million patient data points in that study show that those vaccines absolutely have kept hospitalizations, severe COVID-19, and deaths down if you were vaccinated. We know all about some of the issues around vaccination and some of the hurdles people have to get them, but it shows that it’s critical to have them moving forward.

Wendy Wright, DNP, ANP-BC, FNP-BC, FAANP, FAAN, FNAP, leads a discussion on the challenges subvariants of SARS-CoV-2 present in terms of vaccination and approaching optimal communication to the public surrounding vaccination.

Impact of SARS-CoV-2 Subvariants on Vaccination

 Madeline, in your work, do you talk about the differences between variants of concern and variants of interest, or that type of information around these strains?

 That’s a great question. In the clinical setting, if I’m talking to patients, I’m not going to talk about the scientific names of anything. I might mention that the current circulating variant is Omicron or Delta, because people hear those names in the news. In the United States, we’re seeing a lot of the BA.5 variant. There’s a new one that’s starting to stick out its ugly head: the BA.4.6 variant. Based on what I’ve seen, it seems that the current vaccine, the new booster, is going to have some coverage. But we don’t typically use the scientific names in clinical practice. We use them in the science and laboratory areas. But of the variants of interest now, BA.5 is the most prevalent in the United States.

In my patient population, we talk a lot about the different variants, at least in primary care. Patients are coming in and saying, “Is this the new bivalent vaccine? Is it the one targeting Omicron and its variants?” We talk about it, at least in my practice, because people want to know if they’re getting the vaccine targeting those circulating strains.

We also use the variants to talk about is how genetically different COVID-19 is today from what it was 2½ years ago, making it a little less recognizable by those native vaccines that we gave, which is why it’s so important that our patients get the booster shots that are targeted toward what we’re seeing today. The other thing I love to talk about with them is that they have this impression that Omicron is a mild illness. It may be for some, but it’s so contagious that hospitalization rates are up. Particularly if you’re 0 to 4 years old, your risk of being hospitalized from it is 5 times greater. I want to take that clinical piece from my end back and say that we use this to have a conversation about what we’re seeing so that I can push people to get a vaccine, particularly the boosters that are out.

 I’m definitely in agreement with Wendy. We talk about variants of concern and variants of interest. I try to make people stakeholders of these terms because, at the end of the day, they impact all of us. It’s a matter of explaining exactly what they are. But as Wendy stated, it’s important that we reinforce just how serious these variants are and teach the community that a variant of interest is when we see a bit more mutations than we saw previously. It’s something that we aren’t really worried about in terms of COVID-19. At the end of the day, we expect viruses to change a bit.

But when we get to the variants of interest, we’re interested and looking at it. I tell them that this is something they’re going to look for more in laboratory testing. Are they going to continue to see these strains with these same types of mutations? Then I explain that we’re at that point with Omicron. This is a variant of concern because it’s changing how easy the virus can go from person to person. As Wendy and Madeline stated, this is why we have to have these bivalent vaccines, because we’ve gone from a variant of interest to a variant of concern. This is a problem we have to deal with. It’s important that we continue to use these terms and that that we make the folks we talk with stakeholders of what these terms mean and how serious they can be in terms of COVID-19 and how it’s changing.

Expert health professionals share their thoughts on variants of concern vs variants of interest of the SARS-CoV-2 strains as they relate to clinical practice.

Defining Variants of Interest vs Variants of Concern


In communities of color, health inequities remain a challenge within health care. Certainly the COVID-19 pandemic exacerbated this issues, especially as they pertain to vaccine and therapy access, explains Jacinda C. Abdul-Mutakabbir, PharmD, MPH, AAHIVP.  

Abdul-Mutakabbir is a pharmacist trained in infectious diseases who practices in the intensive care unit of the Loma Linda University (LLU) Medical Center-East Campus in California, pointed out in an interview with 

 during the recent ID Week. 

In Abdul-Mutakabbir’s state of California, Black people represent over 20% of the infections. And in looking at her area of Loma Linda in Southern California, only 30% of Black individuals are fully vaccinated. 

She points out the reasons for this inequities are multi-faceted and acknowledges there are internal individual issues such as vaccine hesitancy as well not trusting the conflicting messages on vaccines, but she also points out external access issues. “It’s a lack of accessibility; it’s not easy to receive vaccines,” Abdul-Mutakabbir said. 

She points out the inability for some individuals to get to vaccine centers. For those who might be reliant on public transportation, it may be impossible for people to get to vaccine centers if buses or trains do now travel to these places. This is something people with cars do not need to consider. Although the COVID-19 vaccines have been free, some individuals may not have known that.

And although one side of this is to identify these issues, Abdul-Mutakabbir points out this can be fixed. “Health inequities are preventable.”



 spoke with Abdul-Mutakabbir about vaccine and therapy utilization issues as well as specific strategies to address these problems.

Earlier this year, Abdul-Mutakabbir discussed this very issue of vaccine equality vs vaccine equity as well as her experience on a COVID-19 vaccine drive to increase vaccinations in communities of color during our 

In communities of color, hesitancy, mistrust, and access issues all drove low COVID-19  vaccination rates during the pandemic.  

Covid Vaccine Race

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