A light at the end of the tunnel? First round of COVID-19 vaccine to be administered at MUSC

The world is breathing a collective sigh of relief – albeit still from behind masks – that a coronavirus vaccine might finally bring things back to “normal.”

With Pfizer, a multinational pharmaceutical behemoth, and Moderna, a small national biotechnology company, producing trials that showed well over 90% efficacy, emergency-use authorization by the FDA is expected to be granted for Pfizer on Dec. 11 and Moderna next week. U.S. government officials believe that the two companies combined will provide 40 million doses by the end of the year. That will be enough for 20 million people, as a second dose is administered three weeks after the first, part of a two-step process.

At MUSC, leaders expect to get 4,875 doses by as early as Dec. 14. Pfizer plans to ship within 24 hours of authorization, which is shaping up to be Dec. 12. Because of the sensitivity of the vaccine – it has to be kept at -94 Fahrenheit – delivery should be rapid. 

Danielle Scheurer, M.D., MUSC Health System chief quality officer, who is leading the vaccine rollout logistics, said implementation will be immediate. The decision as to which employees receive the vaccine first was based on risk of infection.

“We really tried to make it simple. People who work at MUSC and physically touch patients get the vaccine first,” Scheurer said. That group will include MUSC students working on rotations. “The next phase will be those who are within six feet of patients.”

The hospital currently has one ultra-cold freezer specifically designed to keep the vaccine viable for up to six months, though Scheurer said that it probably won’t matter for a while. 

“I expect that our stock of vaccines is going to go into people as fast as we get it in at first,” she said. “We just wanted to be prepared for down the road.”

"People who work at MUSC and physically touch patients get the vaccine first.”

 

Dr. Danielle Scheurer, MUSC Health System chief quality officer

The vaccine will be available to employees on all MUSC campuses – including Chester, Lancaster, Florence and Marion – and sign-up will be available on the MUSC intranet on Dec. 13.

Scheurer noted that team members are not mandated to get vaccinated against the novel coronavirus, though she suspects they will be lining up immediately. According to Pfizer, people who receive the first dose are 52% less likely to develop symptoms of COVID-19, and that number jumps to 95% after the second dose. 

Though this is all exciting news, MUSC infectious disease expert Krutika Kuppalli, M.D., warned the public not to become complacent. “We still need to adhere to public health measures,” she said. “Still wear a face mask when you’re out in public, keep your distance from others and avoid crowds. We still don’t know if this vaccine prevents transmission.”

Scheurer is hopeful that people will remain vigilant and patient. “It’s very important that we have a rigorous process in place because we have to register every single person who gets this. It’s not going to be as easy at the flu shot, which doesn’t really require federal tracking or multiple doses. This vaccine requires a lot more tracking of subjects, so it will take more time per patient to be successful,” she said.

As for other trials leading to potential vaccines, Scheurer said that there are several still ongoing globally. At MUSC, one of those trials, which is being conducted by AstraZeneca – a trial that was briefly put on hold in September due to a health scare – is back up and running, and two more are slated to begin very soon. The reason these other trials are still important, AZ study leader and MUSC emergency medicine physician Gary Headden, M.D., said, has a lot to do with logistics. One company can’t possibly serve the world, he explained, and every company’s vaccine is different.

“Ninety percent effectiveness is great, but you have to understand that this is measured in the short term after vaccination, and so we don’t really know about efficacy down the road. I’m rooting for all horses here; they’re all important.”

Another reason other trials are still critical is due to the means by which the vaccine is delivered. AZ’s just needs regular refrigeration. Pfizer’s vaccine, on the other hand, must be kept at ultra-cold temperatures, something that would present a challenge in third-world countries. 

“Those freezers are expensive. Who can afford that? I worry about places like Bangladesh and Africa,” Headden said. “You need to give places different options.”

Though the initial success of all of these vaccines is exciting, Headden, too, warned about relaxing too quickly. 

“Time will tell. Let’s put it this way. The type of people who enroll in these trials – the ones that are contributing to all these great numbers – aren’t the kinds of people who are hanging out at bars. They’re wearing masks everywhere,” Headden said. 

“Remember we’re only as good as our weakest link here. We’re hoping we can knock this thing back enough that it will stop spreading. Then – and that’s going to take time – things might start to look a little more like we’re used to.”