Narrator  00:00

Be inspired, supported, and empowered. This is the Global Healthy Living Foundation, Podcast Network.

Susan Jara  00:11

Welcome to “Informed Immunity: the Podcast Dedicated to Bringing You the Latest Evidence Based Information on Vaccines, Community Health, and the Fight Against Infectious Diseases.” I’m Susan Jara, Director of Patient Education at the Global Healthy Living Foundation, and your guide on this journey to better health. In this audio guide, we’re tackling some of the most common myths and misconceptions about vaccines. We’ll break down the facts to help you feel confident in making informed decisions about vaccinations. Whether you’re worried about vaccine safety or simply curious about the truth behind the rumors, this audio guide will provide clarity and insight. Today, we’re joined by Samantha Picking, Pharmacist and Director of Immunization at Walgreens. With her extensive experience in developing immunization strategies and ensuring equitable access to life saving vaccines, Samantha will help us debunk these myths and explain how vaccines truly work to protect our health.

Susan Jara  01:12

Before we get to the vaccine myths. Samantha, can you please briefly remind our listeners, what are vaccines and how do they work to protect our health?

Samantha Picking  01:20

Of course. So, what I want to remember is, vaccination is the number one way that someone can protect themselves or their loved ones against serious disease and respiratory illnesses, like flu, COVID and RSV. Getting vaccinated prevents illnesses, medical visits, hospitalization, days away from work, and even death. When it comes to flu, COVID, or other illnesses that we’re preventing through vaccination. There is a chance that some people get vaccinated, still feel sick afterwards, but their symptoms and severity of illness, if they do end up getting those diseases that we’re preventing, are reduced significantly because they got vaccinated. Now, vaccines work by stimulating the body’s immune system to produce antibodies. They do this by limiting an infection; the presence of a disease-causing organism in the body, to engage the body’s natural defenses. Vaccines are usually administered through needle injections. However, there are some that are administered by mouth or sprayed in the nose.

Susan Jara  02:14

Thank you, Samantha, that was a great overview. Now, that we have this basic understanding of how vaccines interact with our immune system. Let’s tackle some of those common myths. Let’s start with, “Is there any evidence that vaccines cause autism?”

Samantha Picking  02:28

This is a big one that’s out there, and there is no credible scientific evidence linking vaccines to autism. There was an original study that suggested there was a link. However, that study was found to be fraudulent and was retracted. Its’ author also lost his medical license, due to these ethical violations in the study. And there have been multiple large scale studies. There are tons of vaccinations that have been done over the years, and these studies included those, by the CDC, the Institute of Medicine, have confirmed that vaccines do not cause autism.

Susan Jara  03:00

Yeah, that is a big one. Thank you so much for clearing up that major concern for, you know, so many listeners out there. What about the claim that, “Vaccines can cause the diseases they’re supposed to prevent?”

Samantha Picking  03:10

Yeah, and sometimes this may feel like it, because you get side effects after you get a vaccine, and again, they’re rare and small, but there is no way vaccines can cause the disease they are meant to prevent. So, some vaccines actually contain an inactivated form of a virus or parts of a germ, which cannot cause disease. The flu vaccine, for example, is manufactured using what’s known as dead or inactivated virus, so it really cannot cause influenza for a person receiving that vaccine. In addition, there are vaccines that are known as live attenuated vaccines, so they have a weakened form of the virus, but they can’t actually cause the illness itself, especially in healthy patients.

Susan Jara  03:51

Thank you. I’m so glad we have that myth debunked, that you can’t get the flu from getting the flu shot. Another common question people have is, “Whether natural immunity is better than vaccine induced immunity?” Can you please explain this for our listeners, Samantha?

Samantha Picking  04:06

Of course. Vaccines provide a safe way to build immunity, without the harmful effects of the disease itself. Now, natural immunity may occur after infection. However, the risks of the disease are far worse than the risk of actually getting a vaccination, because we know those are safer. If you’re actually getting the infection, say flu, you could be suffering from severe complications, severe illness, or even death, if you are choosing to go with natural immunity versus getting a vaccination.

Susan Jara  04:33

Thank you. And you know, I think that’s definitely worth reiterating, that vaccines provide a safe way to develop immunity. And I think there’s a lot of misconceptions about immunity, especially when it comes to COVID-19, for example, if you’ve received your COVID-19 vaccine during the beginning of the pandemic, do you necessarily need to get another one?

Samantha Picking  04:53

Yeah, that’s a great question. And at the start of the pandemic, we really weren’t sure. We didn’t know how COVID would react, as a virus. Now, natural immunity from having COVID-19, may not provide that long term protection and reinfection is possible. Stronger defense against variants; we now know that COVID-19 virus changes, similar to what we see with flu. So, that allows us to change the vaccine and better protect it against the newer variants, that are surfacing for COVID-19. And the vaccines are helped to design to protect against those different variants, as the virus change on us. Now, public health benefit to getting the vaccine; getting vaccinated helps reduce the spread of virus to others. You may not feel like you need it, because you’ve had the infection. However, a major benefit of vaccines is protecting those around you, whether it’s your grandparents, little ones, or just people in the community that you’re interacting with, that you may not realize have weakened immune systems.

Susan Jara  05:49

Yeah, thank you for that. Public health benefit is just so important, especially for so many of our listeners, who are immunocompromised, or who take immunosuppressing medication, or who have loved ones who are also immunosuppressed. And you know, this kind of makes me think of another concern about receiving vaccination. Can receiving too many vaccines overload our immune system. Could you please address that, Samantha?

Samantha Picking  06:13

The one thing to remember is, our immune systems are amazing. They are capable of handling exposure to 1000s of antigens, daily, that we don’t even realize we’re exposing ourselves to. So, no, receiving multiple vaccines at once does not overload our immune system – It’s designed to do that. Vaccines are only a tiny fraction of what the immune system encounters daily. According to the CDC, even side effects of vaccines are generally the same when given with other vaccines. Just on Monday this week, I got both my flu and COVID vaccine, and I’ve had both of them separately, and I’ve seen no difference, in terms of how I feel after those vaccinations. So, they may vary by individual, but it’s important to remember that even if you do experience those common side effects, like headache, fever, pain, swelling, it just means vaccines are working. It’s also shown in studies, that combination of vaccines is safe and effective. According to current CDC guidance, it’s safe to get multiple vaccines at the same time, whether it’s flu, COVID, RSV, pneumonia, or really any vaccine you may be missing at that moment. It’s better to get protected when you’re there, getting vaccines, than allow for any additional gap, until you get that vaccine.

Susan Jara  07:20

Let’s explore the topic of vaccine side effects, which is another area that generates a lot of questions and concerns. Do vaccines cause severe side effects?

Samantha Picking  07:31

What I can tell you, Susan, it’s a great question. Severe side effects from vaccines are extremely rare. The most common side effects are mild, so, soreness of your arm or soreness at the injection site. Maybe a low grade fever, but the benefit of vaccination far outweigh the small risk of any side effect.

Susan Jara  07:47

Speaking of seriousness, let’s touch on whether these vaccine preventable diseases are really as serious as they seem. Is this something that individuals should worry about developing flu, RSV, COVID, pneumonia?

Samantha Picking  08:00

Absolutely! Vaccine preventable diseases can be very serious, and even deadly for people, again, with compromised immune system, taking immunocompromising medications. And while I may be healthy, I may be also exposed to people that are immunocompromised, so I’m protecting them by getting my vaccination. And just as an example of this, flu can cause mild to severe illness, and at times, can lead to life threatening complications. Pregnant women, young children, seniors are really at the highest risk for complications, when they contract flu. In addition, to communities of color; Black, Hispanic, Native American communities tend to experience higher rates of severe illness and hospitalization from the flu. Often due to decreased vaccination rates, but also socioeconomic factors. And then those in rural communities, that may not have access to health care, if they are experiencing a severe reaction to say, or complication from flu. RSV, very similar, can be anywhere from mild to severe, ranging from just a cold, having severe lung infections, like pneumonia or other complications. And again, this is a lot for the younger population, so infants and also older adults. As an example, my kids had RSV when they were little, and from that, ended up with pneumonia, ear infections. I’ve had two kids in the hospital from RSV, and it’s just really something I wish I had a vaccination, at that time, to prevent from having to go through that, with my children. Also, vaccines prevent against severe outcomes and help maintain public health. Getting vaccinated is the most important thing that you can do, to help protect yourself and those around you. In addition, to vaccination, every day preventative actions, helping reduce the spread of flu, COVID, RSV, during respiratory season, we are about to enter respiratory season, and this is so important, so avoiding close contact with people, who may be sick, covering your nose and your mouth when you sneeze, washing your hands often, avoiding touching your eyes, nose, and mouth. All these additional things, in addition to getting vaccinated, is so important this time of year.

Susan Jara  09:51

Thank you. Thank you for putting things in perspective and offering just tangible advice that, you know, our community can use on a daily basis to stay safe. You know, access to vaccines is so important, and I know Global Healthy Living Foundation and Walgreens work together, to really, you know, promote access, which is so important. It’s really important to remember that vaccines are not just about individual protection, but about community health as well. So, thank you so much for joining us today, Samantha. We’ve covered a lot of important information about vaccines, and debunking common myths, and let’s hope we address some common concerns. And you definitely provided evidence based information, to help our listeners make informed decisions about vaccinations.

Samantha Picking  10:31

Susan, thank you so much for having me today. I really enjoyed this conversation – It’s so important!

Susan Jara  10:39

This is “Informed Immunity.” Thank you for joining us on this audio guide. Remember, the fight against infectious diseases is a community effort, and your participation is crucial. For more reliable information on vaccines, and to stay up to date on the latest in public health, visit our website at ghlf.org, or check out the Centers for Disease Control and Prevention, or World Health Organization website. This podcast was made possible with support from GSK. If you enjoyed this episode, please rate our podcast, write a positive review, and share it with your friends and family. It will help more people like you, find us. Until next time, stay informed and stay healthy; together, we can make a difference.

Narrator  11:24

Be inspired, supported, and empowered. This is the Global Healthy Living Foundation, Podcast Network.

Narrator  00:00

Be inspired, supported, and empowered. This is the Global Healthy Living Foundation, Podcast Network.

Susan Jara  00:11

Welcome to “Informed Immunity: the Podcast Dedicated to Bringing You the Latest Evidence Based Information on Vaccines, Community Health, and the Fight Against Infectious Diseases.” I’m Susan Jara, Director of Patient Education at the Global Healthy Living Foundation, and your guide on this journey to better health. In this audio guide, we’ll focus on the challenges of navigating the health care system, particulary, when it comes to getting recommended vaccines. We’ll talk about common barriers to getting vaccination, along with practical solutions to overcome them. So, you can best protect yourself and your loved ones. Whether you’re trying to navigate the health care system, worried about vaccine safety, or just curious about the latest advancements – this podcast is for you. So, let’s take this journey together and take one step closer to building a healthier future for all. Today, we’re joined by Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation, and a leading expert in health care policy and biopharmaceuticals. With extensive experience in health economics and policy, Dr. Popovian will help us navigate the complexities of the health care system, when it comes to vaccination.

Susan Jara  01:23

Welcome, Dr. Popovian.

Dr. Robert Popovian  01:25

Thank you for having me.

Susan Jara  01:26

Could you briefly explain, to our listeners, the work you’ve been leading with GHLF in the vaccine space?

Dr. Robert Popovian  01:31

GHLF has had a long history of working in vaccine policy, and advocacy, and education. This is prior to the pandemic, actually, they were very much engaged with adolescent vaccination for meningitis. Obviously, with the pandemic, GHLF took on a larger role in vaccine education and advocacy, and since then has followed through, and has tried to provide education, research, as well as, advocacy in the space, to ensure that patients who are vulnerable, especially patients with chronic diseases or autoimmune disorders, have access to vaccines and are educated about the benefits and the risks.

Susan Jara  02:08

Thank you. I know a lot of the work, that we’ve done, has been surrounding common barriers to adult vaccination. Can you please talk about some of those barriers that you’ve identified, in your own research?

Dr. Robert Popovian  02:19

Let’s start with discussing misinformation. So, that’s the number one thing: there’s a lot of misinformation about vaccines, and their safety and efficacy, and GHLF has taken a leading role in trying to educate patients about the benefits of immunization. But there are other barriers, so we’ve tried to identify, for example, access in low income communities, with regards to a barrier that we’ve identified. We did a research on reimbursement and how that reduces access with physicians, and pharmacists, and immunizing. We’ve tried to look at how pharmacy benefit management companies have tried to manipulate the market. We’ve also lauded and supported things, like zeroing out of pocket costs for vaccinations, especially for Medicare Part D patients, who are extremely vulnerable, since they’re seniors, and we’ve tried our best to also try to identify what are the barriers that patients have, through doing survey research that we’ve published recently.

Susan Jara  03:18

Thank you! Just going back, could you elaborate a little bit about misinformation? What do you think is the top misinformation that patients have regarding vaccination?

Dr. Robert Popovian  03:28

Well, the number one thing is that, unfortunately, during the pandemic, there was a lot of overpromising about what vaccines do. Vaccines, from the minute that they were developed, the intent was to prevent the worst outcome, and in this case, is mortality and morbidity. Unfortunately, there was a lot of enthusiasm when the COVID vaccine came out, that the vaccines were going to help reduce the spread of COVID infections; and that’s not true. Vaccines have always aimed to reduce mortality and morbidity, as I stated, and that’s been the biggest barrier in being able to get over the hump with some patients, to go back to the basics, and explain to them what the value is. So, that’s the misinformation that was out there, about what the intent of immunization is. But also, there’s been, historically, misinformation about the safety of the vaccines, which has been refuted over and over again throughout the years. In fact, one of the original publications that sort of raised concerns about vaccination is no longer even available, publicly, because the journal that published it has withdrawn it, and the individual who published it actually lost their medical license to practice. So again, I think it’s twofold: one is the misinformation that is done intentionally or unintentionally with uninformed patients, but also the overpromising that sort of like what vaccines do, which we need to sort of level set with patients, which is, they are intended to really prevent the worst outcome.

Susan Jara  04:52

Great, thank you. You also kind of touched on financial barriers and used the term “zeroing out of pocket costs.” Could you explain that, for maybe one of our listeners, who doesn’t understand that?

Dr. Robert Popovian  05:02

That’s an interesting thing. So, True Affordable Care Act, passage of the Affordable Care Act, vaccines have had zero out of pocket costs for commercial insurers. Unfortunately, one of the areas that patients still had to pay out of pocket costs to acquire the vaccine, was among seniors in Medicare Part D vaccines. And fortunately, one of the benefits of the Inflation Reduction Act passage was that they zeroed out of pocket. So, now in the United States, unless you’re uninsured and/or you don’t have any government insurance, like Medicaid or Medicare, there is no out of pocket cost for anybody who has some type of an insurance. So, as a patient, when you show up at a pharmacy or a physician’s office and acquire vaccine, out of pocket costs should not be a barrier that you face as a patient. Now, having said that, Susan, there’s a lot of instances that we still see that there has been misinformation, or intentionally or unintentionally, that patients have showed up to a pharmacist or a physician’s office and they were charged in out of pocket costs. Partially, that has to do with the way the benefit design was placed, by either the employer or the insurer that they acquired, where they probably had to pay up front and then get reimbursed. And by the way, that’s not the case. You know, the intention of the law is that patients don’t pay anything out of pocket, when they show up. So, there’s still some barriers with regards to that, but we are trying to, one by one, educate the patients to become better consumers and push back, when they’re asked for any kind of out of pocket and when they show up at a pharmacy or at a physician’s office.

Susan Jara  06:33

Great, thank you so much. You had mentioned, you can go to your pharmacist, you can go to your provider for vaccinations. Could we talk a little bit about the role of pharmacists, in improving vaccination rates?

Dr. Robert Popovian  06:44

Yeah, absolutely. And we did a specific study, and I’ll mention the study in the context that we’re going to be discussing. So, pharmacists are one of the most, if not the most accessible health care professional, in the United States. About 90% of individuals, living in United States, live within five miles of a pharmacy. And pharmacists have taken the lead pre-COVID, but especially post-COVID. With regards to adult immunization, we did a study with IQVIA, that demonstrated that about 80% of adult immunization, post-COVID, is now being administered in a pharmacy, by a pharmacist or a pharmacy technician, and that’s impressive. Obviously, a lot of it was the COVID vaccine, but since then, the majority of the flu vaccine, majority of the pneumococcal vaccine, and shingles, and now RSV are being administered in pharmacy, in the 80%+ rate. So, pharmacists play a huge role in this, and we did a specific study looking at low income communities; we wanted to see what is the accessibility of low income communities, by the way, Susan, that are over represented by minorities. And what we found is that, in low income communities, there’s better access for pharmacies than physician offices, who immunize. And why is this important? Is because one: not only there’s physical access, but remember, pharmacies also have longer hours of operation, and they are open seven days a week, instead of five day, usually. So, when you add up those things, it becomes not only the physical location, but the hours of operation and everything else makes it even much more accessible. And remember, low income patients, generally, are hourly wage earners. So, as an hourly wage earner, if you don’t show up to work; you don’t get paid. So, you require access to health care professionals, who are available after hours of work. And this is why also a pharmacy and a pharmacist plays a larger role in immunization, in these type of communities. And as I mentioned in the beginning, these communities are overrepresented by minorities, both racial and ethnic minorities. Therefore, it becomes a DEI (diversity, equity, and inclusion) issue, frankly, with regards to, how we should, basically, champion and make it easier for patients to acquire their vaccines at pharmacies.

Susan Jara  08:52

Great, thank you. Can you please discuss the findings from your paper relative to vaccine access and supply, especially for high risk chronic disease adults?

Dr. Robert Popovian  09:01

Yes, so, you know, we did a paper, specifically about that. Obviously, these papers are available publicly for anybody can read. We specifically looked at how pharmacies play a large role in administration, like, for example, with the low income communities, how they’re accessible in physical locations, and how they were doing significant number of the adult immunizations, but one of the things that we’ve found is that there’s an appetite by the pharmacy benefit management (PBM) companies and insurers to now get involved. Traditionally, vaccines have been an area where PBMs and the insurers have not played a role, because there’s no out of pocket costs, so there’s no benefit for the insurer to do anything, other than just administer and process the prescription, basically, or process the vaccine payment. But what we’ve learned is that they are trying to get involved in it, and the reason being, for a variety of reasons, partially has to do because they see it as a profit center, that’s been untapped, and they’re trying to basically manipulate the market to be able to garner more benefits from the pharma companies, and that has disrupted the market, and it’s going to disrupt the market, especially for patients with chronic diseases, because remember, again, going back Susan, who’s going to benefit the most from vaccines, it’s elderly, patients with chronic diseases, or patients with autoimmune disorders, who their immunity is at risk. So, because of those reasons, we need to make sure that PBMs stay out of the vaccine market and that they don’t start messing around, like, they’ve done with the traditional biopharmaceutical market, where the access has been restricted for patients and because of that, patients suffer.

Dr. Robert Popovian  09:34

And so, what steps can a patient take, to be involved in this greater access and to prohibit PBMs and insurance companies from interfering?

Dr. Robert Popovian  10:42

They need to be educated, number one; they need to know what their rights are; they need to know that, if they show up to a pharmacy, or a physician’s office, and somebody requires them to pay out of pocket, they need to question that, because by law, no one, that has any type of government or private insurance, should be paying anything out of pocket to acquire that vaccine. So, they need to become better advocates, push back, if they’re asked to do so, and also, one of the things, I always talk about, is that they need to get educated about what are the requirements for them to acquire this vaccine. So, Center for Disease Control provides recommendations about who should acquire certain vaccines, and sometimes those are not in alignment with the Food and Drug Administration label. In fact, they’re contradictory at times. And what we need to do is do a better job, and this is where GHLF comes into play; Global Healthy Living Foundation and all the patient organizations, about educating patients about, if CDC is saying this is the recommendation, and you show up at a pharmacy and the pharmacist says, or a physician’s office then says, “You don’t really fit the bill, with regards to the recommendation,” you should be asking ‘Why?,’ and push back, and then try to acquire the vaccine based on your needs, and have that discussion with the pharmacist or physician. Now, fortunately, CDC, they’re trying to do much more clear recommendations for these vaccines, about the risk of the patients, but unfortunately, this is raising other set of issues, that we’re now working on, because it’s making it far more complicated for pharmacists and physicians to identify these risks, within their office environments or in their pharmacies.

10:42

Great, thank you. That’s really important for our patients to advocate for themselves, and as you said, push back, and know guidelines, and what vaccinations they need, and work with our provider to make sure that they’re staying on schedule. A lot of education at GHLF is also surrounded about COVID-19, and we had talked about a lot of miscommunication around vaccination, due to COVID-19. Can you talk about how the COVID-19 pandemic influenced adult vaccination rates and also public perception of vaccine?

Dr. Robert Popovian  12:40

So, obviously, there was a lot of enthusiasm, when the vaccines were being developed. If you recall, Susan, we were all locked up and we were all looking forward to a vaccine that will help us get out, and being able to live our lives in a normal way. So, the enthusiasm was there. Unfortunately, what happened is that there were some legitimate questions by patients and even health care professionals, who wanted to know, ‘How did we develop a vaccine so quickly, and effectively, and whether or not the vaccine was safe?’ Unfortunately, those individuals were sidelined, and the questions were not answered. And these were legitimate questions; even I, as a pharmacist, as a healthcare professional, I wanted to know, ‘How did we get to a point, that we were able to develop a vaccine within six months, when we traditionally developed a pharmaceutical over 10 year period, right?’ So, there were some legitimate questions that needed to be answered. The other thing, like, I touched in the beginning, is the overpromising of the vaccines, by certain health care officials, both on the federal and the state level. They should have been honest about it. Look the vaccines, as I said from the beginning, they’re intended to prevent the worst outcome, which is mortality and morbidity. They’re not there to basically reduce communicable diseases, that we’re still going to get COVID, we’re still going to get the flu, but when you have the vaccine, it’s going to reduce the burden of illness, and it’s going to reduce the potential morbidity and mortality. So, I think that also was a problem that we need to get over. And then, frankly, the mandate issue, was a problem, because it was the first time that people, whether employers or government, was mandating people to get the vaccine. And again, instead of having a discussion with patients and answering their questions, they were just telling them “Be quiet, you don’t know any better. Just get the vaccine and everything will be fine.” And then, when you see these things, like in the social media, where patients got the COVID vaccine, but still got COVID, instead of saying, “Yes, you got COVID, but guess what? You’re not dead, or you’re going to be fine, because it’s going to be a less severe infection.” Or there was a lot of misinformation about natural immunity, right? People were saying, “Well, I got the COVID infection, why don’t I just get it and develop natural immunity, and then, instead of getting the vaccine.” Well, what officials should have said is that, “Yes, that is true, you can get the infection and get natural immunity, and you don’t need the vaccine, but you’re also taking a risk of dying, if you get the infection.” Versus if you got the vaccine, and even if you got COVID, the burden of illness would have been significantly lower. And that’s why I think, Susan, vaccines are the most cost beneficial intervention ever developed by the medical community, by researchers, by biopharmaceutical industry. And what we need to do is to go back to the basics of why they’re necessary and who is the vulnerable population that would benefit the most. And it’s sad to see now that we’re two, three years past the height of the pandemic, that we have become complacent about vaccination, and in fact, only about 30% of seniors, I think, last year, got the new version of the COVID vaccine, with the new entity, and this is scary, and we’ve seen also a drop in other adult immunizations, over time, and pediatric immunizations. These are scary times. We need to go back to the basics, and, what I say to people is that, we need to start treating patients as adults and having a conversation with them, and not wag our finger and say, “You just have to get it and be quiet.”

Susan Jara  16:00

I love that! To start treating patients like adults, and make them feel empowered and educated.

Dr. Robert Popovian  16:05

Absolutely.

Susan Jara  16:06

Looking forward, what policy changes, or initiatives, do you think are necessary to really sustain and improve adult vaccination rates?

Dr. Robert Popovian  16:14

Number one, as we started to discuss, we need to ensure that state laws, that prohibit pharmacists from immunizing, are streamlined and expanded. Because pharmacists are the most accessible health care professional, as we’ve said before, and especially in the low income communities. If we want to get low income patients, at better access, we need to have the pharmacist involved. Okay, that’s the number one thing. So, state laws need to be streamlined/expanded. What I say is that, pharmacists should have the same authority as a physician, in administering the vaccine. Vaccine is not a diagnosis. There’s a FDA label, and as health care professionals, pharmacists can’t follow those directions. So, that’s the number one thing. Number two thing is that we need to guard against insurers or PBMs trying to manipulate the model, for their profitability. Remember, as I mentioned, no one pays out of pocket for anything. So, what is the benefit that we’re getting here, for the PBM involvement? Traditional PBMs and insurers have been involved because there’s a benefit to the patient, right? They’re gonna lower the out of pocket costs or cover something, but right now, nobody pays anything out of pocket, so there is no patient benefit for their involvement. So, we need to guard against that. Number three, I would say, we need to do a better job of educating and advocating for vaccines, and need to go back to the basics. As we said, we need to treat patients as adults, and encouraging to get the vaccine, not mandating the vaccines, because that will help. So, that will come with ongoing public health type of endeavors that we need to do, and reducing the misinformation and everything else. But again, as I said from the beginning, since I’ve been involved in the health care policy space, health care in general, I’ve always said vaccines are the most cost beneficial intervention that has ever been developed in the health care system, and we need to become better advocates for these important medicines. Because at the end of the day, what we know about the vaccines is that they’re going to reduce mortality and morbidity, and that’s the key.

Susan Jara  18:04

Thank you so much, Robert, for joining us today and talking about misinformation, and vaccine access, and really the importance of educating our patient community on vaccination, to protect themselves and their loved ones.

Dr. Robert Popovian  18:17

I appreciate it. Thank you for having me.

Susan Jara  18:22

This is “Informed Immunity.” Thank you for joining us on this audio guide. Remember, the fight against infectious diseases is a community effort, and your participation is crucial. For more reliable information on vaccines, and to stay up to date on the latest in public health, visit our website at ghlf.org, or check out the Centers for Disease Control and Prevention, or World Health Organization website. This podcast was made possible with support from GSK. If you enjoyed this episode, please rate our podcast, write a positive review. and share it with your friends and family – It will help more people like you, find us. Until next time, stay informed and stay healthy. Together, we can make a difference.

Narrator  19:07

Be inspired, supported, and empowered. This is the Global Healthy Living Foundation Podcast Network.

Narrator  00:00

Be inspired, supported, and empowered. This is the Global Healthy Living Foundation, Podcast Network.

Susan Jara  00:11

Welcome to “Informed Immunity: the Podcast Dedicated to Bringing you the Latest Evidence-Based Information on Vaccines, Community Health, and the Fight Against Infectious Diseases.” I’m Susan Jara, Director of Patient Education at the Global Healthy Living Foundation, and your guide on this journey to better health. In this audio guide, we explore the future of vaccine research, focusing on advancements that could impact chronic conditions. Today, we are joined by two experts: Dr. Philip Dormitzer, Senior Vice President, and Global Head Vaccines R&D, and Infectious Disease Research at GSK; and Dr. Jamila Louahed, who leads the Global R&D for Therapeutic Vaccines, and is the Belgium R&D Site Head, at GSK Vaccines.

Susan Jara  00:59

Hi, Jamila and Phil. Thank you so much for joining us today.

Dr. Phil Dormitzer  01:02

It’s a pleasure to be here. Thanks for having us.

Jamila Louahed  01:04

It’s a pleasure to be with you, Susan.

Susan Jara  01:06

Thank you! Phil, do you want to please start, and maybe just tell us a little bit about yourself, and how you’ve come to be on this podcast with us?

Dr. Phil Dormitzer  01:14

My name is Phil Dormitzer, and I lead Vaccines, Research and Development, and Infectious Disease Research at GSK. So, our basic job is to develop new vaccines, to maintain the vaccines that are out there, and the goal is, ultimately, to improve the health of people who receive our vaccines.

Susan Jara  01:32

Great, thank you! Jamila, would you like to introduce yourself to the audience, as well?

Jamila Louahed  01:36

My name is Jamila Louahed, and I’m working with Phil as a Global Head for therapeutic vaccines, and I’ve been passionate to really understand how immunology and immune system can really play a role to prevent diseases. So, I’m really happy about the success that has been done in vaccine and more to come in the future.

Susan Jara  01:52

Great, thank you so much! Let’s just jump right in. Phil, do you mind telling us a little bit about the current state of vaccine research?

Dr. Phil Dormitzer  02:00

So, it’s a very exciting time in vaccine research, because we have a number of platforms or technologies to make vaccines, that are really coming together. We have the new vaccines, like RNA vaccines, which played such an important role in the COVID-19 pandemic. We also have, for example, the RSV vaccine, which involves the new ability to structurally understand and engineer antigens. There are also new technologies for vaccines against the sugars on the bacteria (the carbohydrates), with a new platform technology we called MAPS. So, across of a variety of technologies target different kinds of pathogens. We have new technologies now being deployed for vaccines.

Dr. Phil Dormitzer  02:01

Great, thank you. Jamila, would you like to add anything?

Dr. Phil Dormitzer  02:07

Maybe just to add that many very true new vaccine has been done, thank to new technology, and as mentioned by Phil,many new technology to better understand the pathogen, together with new platform, technology has really helped to have vaccine for more have to treat diseases, like the RSV, who took 60 years to be able to have the first vaccine again,the RSV.

Susan Jara  03:04

Wow, 60 years. It’s really amazing just hearing about this research and just really helps reassure us that better solutions are on the way for our patient community. So, it’s really exciting. Let’s talk a little bit about some of the innovative approaches, that GSK is specifically using in vaccine development.

Dr. Phil Dormitzer  03:22

So, maybe I’ll mention specifically a couple of things. One is, you mentioned the RSV vaccine, you know the RSV vaccine, people struggled for years, really, since the 1960s to make an RSV vaccine. And it was a scientific, really breakthrough, that was made initially at NIH, when they found out that the antigen people used to combat RSV, the spike protein on the virus, changes shape, and they actually have to determine the shape of the molecule that elicited the most efficient immunity, and then, how to stabilize it in that shape. And then that really set off a new era in RSV vaccines, where attempts that hadn’t worked in the past, now, with this new knowledge, started working, and that led to the RSV vaccine. So, it was a clear example of a scientific breakthrough, that led to a technological breakthrough, that meant a vaccine target that people had struggled with for many, many years, now became a tractable target, and today we have effective RSV vaccines.

Susan Jara  04:15

And, Jamila, would you like to add to that?

Jamila Louahed  04:17

Again, I think if you look about the amount of data that now we can really capture a new technology. We have a better tool to understand how the pathogen really play a role, and together with this knowledge, we can transform this knowledge into something that can be used in the vaccine compositions. And the best example was mentioned for RSV; The same finding was used for the COVID-19 in the future, and we know now that many new technology is really unlocking new fields, like the carbohydrates. How can we overcome the number of serotypes that are associated with pathogen? There is now new technology that can overcome some of the hurdles we had in the past.

Susan Jara  04:56

Thank you. And can you explain a little more how targeting carbohydrates, specifically strengthens the immune response in new vaccine technologies?

Jamila Louahed  05:05

If you think about a virus, usually you need to unlock the key that the virus will use to enter into human cells, because it needs all the machinery of the human cells. So, if you find a key, you are in a good track to be able to have something that can really neutralize the virus. A bacteria; It’s a different animal; It’s bigger than a virus, and usually it has carbohydrates at the external level of the bacteria, and this is what you need to target; To be able to neutralize the bacteria. And the tools that you use for virus are different than the tool that you might use for attacking a bacteria, so having good technology that can induce an immune response against those carbohydrates will be very important.

Susan Jara  05:45

Great, thank you – That was a really perfect explanation, I appreciate it. Can we talk about some of the potential vaccines that are being developed for individuals who are living with chronic conditions?

Jamila Louahed  05:56

I think there is one area, where today, people does not value existing vaccines for chronic conditions. And I’m always very surprised to see that patient with heart disease, pulmonary diseases, or people that has some immunocompromise, they are usually much more at risk to develop a disease than a healthy adult, and they usually doesn’t think about having preventative vaccine that could help them to not work on their comorbidity status. So, I would say, first of all, I would really encourage that people that have some weakened immunity or have strong undermined disease to be able to use vaccine, like vaccine against the flu, vaccine against the pneumococcal bacteria, because if they get infected, usually they are much more at risk to have a severe diseases. That’s, I would say, the first chapter, which is making sure that adults, that has comorbidity, really ensure that they can prevent the disease.

Jamila Louahed  06:52

The second piece, which is more, how can we eventually, in the future, tackle chronic diseases through an active immunizations. I’d like to use one example that people will understand easily, is if you think about the breakthrough innovation that helped protect, again, Hepatitis B, very good preventative vaccines, which has been worldwide distributed. You are protected against developing a chronic disease. Unfortunately, many people have not been vaccinated, and they have encountered a virus and developed what we call a chronic Hepatitis B. Those patients developed this disease, because they have not been able to mount a good immune response, to be able to be protected. So, what we are really developing, usually, all our expertise, is to see how, eventually, can we intervene in those patients that has developed the disease, how can we reset the immune response, to be able to have a new treatment, to really have those patients to live better, because unfortunately, today, nothing really has worked to treat those patients. That’s chronic infectious disease.

Jamila Louahed  07:53

The other one, which I really like, and people tend to forget it, one of the best vaccines that prevent cancer, is the vaccine against papillomavirus, HPV. What if, tomorrow, we have more of those vaccines? That can eventually prevent cancer, which can eventually prevent some of the chronic diseases that are associated with those infections. And this is an area where we are actively looking for, because we have some successes that has shown that we are able to modify the course of the disease, and we really want to make sure that eventually we can really leverage the tool. There has been some recent findings, that suggest that by vaccinating adult, with a vaccine that prevents shingle disease, we might, eventually, delay some neurogenetic diseases, like dementia. If this turned out to be proven in prospective study, this is a tremendous opportunity to be able to tackle the disease, where today, there is not much it is working. So, if tomorrow, we can have appropriate treatment, we call therapeutic vaccine that can delay the disease, this would be very transformative, in the field of prevention.

Susan Jara  08:58

Wow, yeah. I mean, most people think of vaccines as protection, not prevention. So, it’s really interesting to hear them in this light and how vaccines, especially for people living with chronic conditions, can help with comorbidities and wow, I mean, if we could possibly reduce dementia risk with a shingles vaccine, you know that definitely makes the future feel brighter. Phil, did you want to comment on this at all?

Dr. Phil Dormitzer  09:21

So, there have been now a number of observational studies, that have seen an association between immunization against the virus, that causes both chicken pox and shingles, varicella-zoster virus, specifically shingles vaccination, and lower rates of dementia. What we don’t know, is if that’s a causal association or not a sympathetic association, they could be both caused by the same thing. So, what we need to know, now, is to figure out, is it a causal association or not? That’s going to take a lot more study. So, at this point, the reason to take a shingles vaccine is to prevent shingles. We will determine, through additional study, whether the association that has been observed, between taking a shingles vaccine and a lower risk, or delayed, dementia is causal or not.

09:21

Thank you so much for clarifying that. I know that there’s been a shift in public perception about vaccination with, you know, the COVID pandemic, and it certainly has influenced vaccine research as well. Jamila or Phil, will one of you want to kind of talk about this, how the COVID pandemic played a role in vaccine research and public perception of vaccine?

Dr. Phil Dormitzer  10:23

Sure, and maybe I’d mention maybe three brief things. First, one thing that the COVID-19 pandemic response with vaccines really taught us, is how, when everybody cooperates, how fast things can go. Wasn’t just industry; it was industry, it was regulators, it was physicians. Everybody was really on the same page, and we accomplished the development of that vaccine, as an industry, faster than anybody thought was possible. Second thing we learned, was a new technology. It was the first time a new technology, mRNA vaccines, which are very good at adapting quickly and being changed quickly when you need to, for example, when a new pathogen, like SARS-CoV-2 comes out, how quickly that can be deployed. The third thing we learned, it was a little more sobering, is that when you introduce new technology, it takes people a little bit to adjust to it. So, we also saw, although many people were very glad to get the vaccine, also vaccine hesitancy. And so it’s important to not only bring new technologies forward, but also to make sure that we provide people the information they need to feel comfortable, with those new technologies as well.

Jamila Louahed  11:24

I would add also: trusted information is key. I think people need to make sure that the information they get from a clinical study, but also from other key stakeholders, in the healthcare are important. And usually people doesn’t start by not thinking about vaccine is worse, it’s sometimes something that has been prone. So, making sure that the right information is shared, is really important.

Susan Jara  11:47

Yeah, I agree. I mean, that’s why we’re coming together today, you know, to make sure our patient community has trusted information from experts like you. So, I really do appreciate you breaking things down. Let’s jump to our next question: What role do chronic condition vaccines play in improving patient outcomes?

Dr. Phil Dormitzer  12:04

Really, one vaccine really comes to mind, that addresses a chronic condition, and that is the shingrix; the shingles vaccine. When you get infected with varicella-zoster virus, as a child, you get chickenpox. But the virus doesn’t go away; it goes latent in your cells, and it stays there, really the rest of your life, and can come back later in life as shingles; a painful condition with a rash that spreads along the root of a nerve. Now, you would think you got infected with this virus when you’re a child, you still have it, what good would immunization do? You’re already immune. But in fact, when you immunize, even people, who’ve already been infected, are now chronically infected with varicella-zoster virus, you greatly reduce the likelihood that they get shingles. And one of the complications that people really don’t like from shingles is postherpetic neuralgia, when the pain lasts even after the rash goes away. So, it’s an example of something quite surprising, that immunizing someone who’s chronically infected with the virus, has an immune response against this virus, by improving the response against that virus, you can actually prevent some of the long term consequences of that infection.

Susan Jara  13:07

Great, yes, a lot of people in our community talk about shingles and how painful it is, and it’s really important for them to get vaccinated.

Jamila Louahed  13:14

Shingles is a great example, where you are infected and this virus is part of your body, and if you think about many other viruses, can also be associated with the same chronic condition, herpes simplex virus, which is causing either Sol course or genital fpase. Those are important viruses to be tackled in the future, if you want to prevent the disease associated with those viruses in patients.

Susan Jara  13:38

Yes, thank you. It is, it’s not only preventing the disease, but improving quality of life as well, right? So, let’s talk a little bit about what patients can possibly expect from the future vaccine developments.

Dr. Phil Dormitzer  13:51

Maybe, I can mention a couple of things. Having seen the example of what RNA could do during the pandemic, it might be useful against other pathogens, that change a lot. Influenza comes to mind, where, although it’s not brand new, a new pathogen, every year, you need to update the flu vaccine to match new flu strains. So, that RNA technology that allowed us to respond quickly to the pandemic, may allow us to respond more quickly to changes in, for example, the flu virus. Another thing that might come along is, and this is just slightly off of vaccines, and that is advances in diagnostics. One thing we saw during COVID is the use of home diagnostic kits. Diagnostics are getting better, again, easier to use, so maybe not always for vaccines, but sometimes for anti infective drugs. The ability to test, even at home, for what you’ve got, may help you know what you should take. It can also affect immunization in other ways, as the ability to not only determine what people are ill with at home, but what they’re immune to at home, starts to advance.

Jamila Louahed  14:46

I think there is a lot of effort to make sure that we continue to innovate, to improve our vaccines, to have a better coverage, when it comes to protections. We are also looking to approach that can eventually provide more compliance and coverage for patients, who have vaccine that has a long lasting protection, is definitely an area that we are working on. Combination of vaccines is also something that can be of use for the patients, but also can help to be protected for broader pathogens. So, the other piece that we believe that can be also expected in the future is to have new technology that can have not only a long lasting protections, but better schedule. One can imagine that eventually, having schedules that are much more convenient for patients, might also have more coverage in the future.

Susan Jara  15:36

Yeah, long lasting protection, prevention. We talked about a lot of simple reasons to get vaccinated, and we also know it’s important for patients to stay up to date, in order to make better health decisions. It can help patients really learn about new or improved vaccines, that may offer better protection. With that in mind, can you please talk a little bit about where patients really should be going for vaccine research information?

Dr. Phil Dormitzer  16:00

Always good to be an informed consumer. And there’s a lot of information out there, some of it is good, but some of it is a little questionable. I think consulting your doctor is very important and making sure that you have a solid relationship with the primary care provider, because there’s a lot to know out there. So, sometimes it’s very helpful to have a reliable guide to work with. So, by staying up on the latest research from reputable sources, one can help sort truth from fiction out there, which is very important when you’re trying to make decisions about your own health.

Susan Jara  16:30

Yeah, absolutely. Sorting truth from fiction is key, right? And we talked a lot about vaccine myths in a previous episode of the audio guide. So, if you haven’t already, please go back and have a listen. Jamila, did you want to add any points?

Jamila Louahed  16:44

I think there is a lot of information that can be available from trusted sources. I think the WHO, the CDC, they areinformed scientific community, as well as journal, that can really be used. There is also patient advocacy, where people can also rely, so they usually are quite vocal, but this is where, for me, the more informed you are, the better you can make your own judgments, to be able to be efficacious.

Susan Jara  17:08

Absolutely. Maybe we can just wrap up: Is there a final statement or a few words, you think that patients should really keep in mind when thinking about vaccine and vaccine research?

Susan Jara  17:19

Great. And Jamila, can I turn to you at the same question? Any last parting words about vaccination research for our community?

Dr. Phil Dormitzer  17:19

Maybe a couple really simple things. First, ounce of prevention is worth a pound of cure. Human vaccines have really transformed the health of the world. There are many vaccines that we now take for granted; The childhood vaccines, they’ve been around for a long, long time, they remain important. When you take away vaccine coverage, these things, with rare exceptions, like smallpox, are really not gone forever, they’re still out there. So, it is very important to maintain current vaccines. And today, vaccines aren’t just for children anymore. We now see increasing importance of adult vaccination. We’ve had flu for quite some time, shingles, a little bit less long, pneumococcal vaccines also informed for adults, and now we have the RSV vaccines as well. So, the number of vaccines that can help prevent us through a life cycle, not just when we’re children, but when we’re adults as well, is increasing, and they make a difference.

Jamila Louahed  18:14

Maybe a provocative one. I want to say that, unfortunately, vaccine are a victim of their success; because many diseases have disappeared, and people tend to forget the benefits, that of the immunizations. So, it might be provocative, but this is really what has happened, unfortunately, sometime in patients, that people have forgotten, devastating disease that now we don’t see anymore. And the last maybe conclusion, I would say, there is no greater return on investment, that’s stopping disease before it’s start, which is what you do with a vaccination.

Susan Jara  18:43

Absolutely, thank you so much! And thank you, I really appreciate you sharing your research and breaking everything down for our community. Thank you for all the incredible work you’re doing to advance vaccine research. It’s really been a pleasure having you both with us today.

Dr. Phil Dormitzer  18:58

Oh, thank you.

Jamila Louahed  18:59

Thank you.

Dr. Phil Dormitzer  18:59

It’s a fun time to be in vaccine research.

Susan Jara  19:05

This is “Informed Immunity.” Thank you for joining us on this audio guide. Remember, the fight against infectious diseases is a community effort, and your participation is crucial. For more reliable information on vaccines and to stay up to date on the latest in public health, visit our website at ghlf org, or check out the Centers for Disease Control and Prevention or World Health Organization website. This podcast was made possible with support from GSK. If you enjoyed this episode, please rate our podcast, write a positive review, and share it with your friends and family. It will help more people like you, find us. Until next time, stay informed and stay healthy. Together, we can make a difference!

Narrator  19:49

Be inspired, supported, and empowered. This is the Global Healthy Living Foundation, Podcast Network.