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Every major news outlet, med student, and smartphone-possessing parent has been sharing the exciting prospect of two(!!) potentially efficacious COVID-19 vaccines, but we, as members of privileged societies, are already getting ready to repeat the mistakes of the past. 1/ https://twitter.com/TheAtlantic/status/1327637189954596865
"If the United States exercises its purchase option, a handful of rich nations will have reserved roughly 85 percent of the Pfizer-BioNTech vaccine doses available through the end of 2021, leaving the rest of the world with enough for only 100 million people.)" Is this fair? 2/
I rarely write original posts since there are so many professionals in all domains with more knowledge, experience, and eloquence than I. However, the best part about being a med student is the public assumption that I don't know anything anyway, which makes sharing easier. 3/
Disparities in "health, equity, access, and trust" have already defined testing and infection rates nationally and globally, with the earliest tests flouted by celebrities and influencers as essential workers were left to flounder. 4/
These inequities will only persist and continue to widen in every aspect of society in the recovery period to come and will be further demarcated by the lines along which vaccine access are drawn. 5/
States like MA have already announced plans to prioritize HCWs both directly and indirectly (!) involved in patient care, followed by those at increased medical risk and those 65 yrs+. However, disproportionately-affected communities of color remain un-prioritized. 6/
As the case has always been, health and disease do not exist in a bubble. While current COVID-19 vaccine trials are including more POC than in decades past, many barriers remain. https://www.bostonglobe.com/2020/11/13/opinion/covid-19-vaccine-studies-point-way-clinical-trial-diversity/?event=event25 via @BostonGlobe 7/
There are shining examples of success from the HIV/AIDS epidemic in strengthening social systems to foster awareness and keep patients connected to care. Inherent to this is medicine's legacy of harm upon vulnerable communities and the trust that must be re-EARNED, not gained. 8/
The tensions between Yale, medicine/biopharma, and the city of New Haven that we as @YaleMed students see and learn from firsthand continue to shape health disparities and outcomes, with the @pfizer Clin Research Unit in our backyard. Is enough being done to mend these ties? 9/
“Is it your bishop? Your minister? Your local Dr. Anthony Fauci? Curry said. “A lot of children educate parents in first-generation immigrant families. We should be educating those children on the vaccines.” https://www.bostonglobe.com/2020/11/15/nation/determining-who-gets-first-covid-19-vaccines-while-swaying-minds-those-who-decline/?event=event25 via @BostonGlobe 10/
Community engagement & education through the involvement of local stakeholders and institutions, transparency, and receptiveness and responsiveness to community input are critical to building trust. None of this is new, but can be overlooked at "warp speed." 11/
Furthermore, supply chain hurdles will limit vaccine deployment to some of the hardest-hit regions of the country, particularly low-income communities in rural America. https://www.statnews.com/2020/11/11/rural-hospitals-cant-afford-freezers-to-store-pfizer-covid19-vaccine/ via @statnews 12/
This disadvantage is 2/2 to the costly freezer requirements (-70 C) of the Pfizer/BioNTech vaccine, with a much narrower period of use with dry ice/refrigeration. Urban and academic centers will undoubtedly win out. 13/
Aside: I recognize my own privilege in belonging to a large urban research institution, through which I have regular access to insanely cold freezers for my mouse fracture projects (thanks @OrthoAtYale), and am eternally grateful for the opportunities I am privy to. 14/
The early pandemic days demonstrated the unequal purchasing power of hospitals, cities, & nations in securing PPE/ventilators as supply chains faltered. Will we continue this into the winter and if/as vaccines roll out? How does this speak to the lives we prioritize? 15/
Not everything I have to say is grim though, as the J&J and Moderna vaccines appear to have more favorable storage conditions and global supply chains are being levied for research and distribution. It will be a team effort. https://www.fiercepharma.com/manufacturing/j-j-touts-covid-vaccine-supply-chain-stability-eyes-plans-for-2022 16/
