21012020 Vaccination Myth Busting Session for Care Staff

21/01/2020 Vaccination Myth Busting Session for Care Staff The webinar will begin shortly

Agenda 1. How do I get vaccinated? 2. Introduction to the Covid-19 Vaccines 3. Q&A

Routes of SARS-Co. V-2 Transmission Aerosols < 5 µm diameter Suspended in air Airborne (? ) > 1 meter distance Points of entry: Eyes, nose, or mouth Contact/Droplet > 5 µm diameter Direct contact or < 1 meter distance Urine/feces: RNA found in both; live virus cultivated from few specimens Fomites (? ) SARS-Co. V-2– Infected Host Public Health Covid Briefings Galbadage. Front Public Health. 2020; 8: 163. WHO. Scientific Brief. July 9, 2020. Environmental Stability Susceptible Host

Public Health Covid Briefings

WHO Stages Public Health Covid Briefings

Public Health Covid Briefings

Public Health Covid Briefings

The Herd Effect 65% Amount of Immunity Needed Public Health Covid Briefings Natural 15% Vaccine Induced 50% Vaccine Effectiveness X Vaccine Coverage 70% Herd Effect Threshold Vaccine Effectiveness 70% (and how to get there)

Put crudely, vaccines make your body think it has been infected, or present an infections agent to it so your body recognises it when it comes back Public Health Covid Briefings There are multiple types….

SARS-Co. V-2 Public Health Covid Briefings

Today we will just focus on m. RNA and Adenoviral Public Health Covid Briefings

Adenoviral vaccines (Oxford) • • Public Health Covid Briefings Weakened or inactivated human or primate adenoviruses. shuttle a gene from SARS-Co. V-2, into our bodies our cells will read it and make coronavirus spike proteins. PROS • easy and relatively cheap to make. • More “tried and tested” • resembles a natural infection, which provokes a robust innate immune response, triggering inflammation and mustering B and T cells. • CONS • human adenoviruses circulate widely, EG causing the common cold, and some people have antibodies that MAY target the vaccine, POTENTIALLY making it ineffective.

Public Health Covid Briefings

m. RNA Vaccines (Pfizer) • • Whole new type of vaccine While most vaccines work by training the body to recognise and respond to infectious proteins from outside or from weakened viruses, m. RNA vaccines work by getting the body to produce an actual viral protein for the body to recognise and respond to They use m. RNA, or messenger RNA, which is the molecule that essentially puts DNA instructions into action. Solitary proteins (eg a spike protein) so they DON’T PRODUCE WHOLE VIRUS Inside a cell, m. RNA is used as a template to build a protein. • PROS • Potentially more potent and straightforward, Faster to produce and scale up production • Lots of research into how these could work in cancer • No actual virus released into body • resembles a natural infection, which provokes a robust innate immune response, triggering inflammation and mustering B and T cells. • CONS • “envelope” of proteins/fats needed to stop body destroying it • That needs cold storage Public Health Covid Briefings

Public Health Covid Briefings

Vaccine Candidates in Development for SARS-Cov-2 Vaccine Platforms DNA Coronavirus spike gene Virus genes (some inactive) RNA (+ LNPs) Coronavirus spike gene Vaccine Candidates Viral vector (nonreplicating) Viral vector (replicating) 12 20 16 3 8 44 Virus (attenuated) Public Health Covid Briefings 10 14 Virus (inactivated) Protein based (eg, spike) RNA Viral vector (replicating) Viral vector (nonreplicating) Virus genes (some inactive) DNA Other Funk. Frontiers in Pharmacology. 2020; 11: 937. Protein based SARS-Co. V-2 live attenuated SARS-Co. V-2 inactivated

Dose and Age Considerations § Many phase III vaccine studies fail because the dose chosen did not best balance safety and efficacy[1] § Immune function declines with age and this decline is likely partially responsible for the greater risk of severe COVID-19 in older adults may lead to poor vaccine responses and the need for higher vaccine doses in older adults[2, 3] Public Health Covid Briefings 1. Musuamba. CPT Pharmacometrix Syst Pharmacol. 2017; 6: 418. 2. Heaton. NEJM. 2020; [Epub]. 3. Zhu. Lancet. 2020; 395: 1845.

Public Health Covid Briefings

Public Health Covid Briefings

Single Dose is NOT single dose Public Health Covid Briefings

Keep going with prevention & control till Spring Public Health Covid Briefings

Q&A Provider Hub Call 01707 708 108 (9 am – 5 pm | Mon – Fri) Emailassistance@hcpa. info Visit- www. hcpa. info/covid-19 Sign up for the Daily HCPA newsletters

• If I was to decide against having the vaccine now, would we be able to change our mind in the future and have the vaccine and if so can I schedule with a GP? • Is there a possibility of choosing which vaccine you receive if you are worried about a specific one? • If there a possibility that having an MRNA vaccine could affect fertility for males or females? • Have MRNA vaccines all failed animal testing in the past, and not been allowed to be given to humans? If so, why are these vaccines different? • I am hesitant to have the Vaccine, due to there being advisories not to have it if you are breast feeding or trying to conceive – is there a period of time after the vaccination when it is safe to conceive? • Have the vaccines been tested in the BAME communities? • I have some allergies and am worried about an allergic reaction to the vaccines – are they safe? What if my close family member has allergies and I have the vaccination – could it affect them? • Are there resuscitation facilities when vaccinations are being given? Will hospitals cope if the person requires hospitalisation? • Why is it being called a “vaccine” when it neither stops you getting Covid or spreading it? Why is it not being called a “medical intervention”? • Is there currently accessible a full list of all the components of each of the vaccines types that are being used?

• What is currently being done about work on immunity and genetics etc to see who wouldn’t necessarily need to have a vaccine? • Will there be proper monitoring of people such as in the point above when they have the vaccine to ensure they are not reacting? • Has the vaccine been tested on animals? • I’ve had the virus – why do I need the vaccine? I’m not in an ‘at risk’ group – why do I need the vaccine? • The vaccines have been developed very quickly – are they safe? How do we know they are safe in the longer term? Dr Anthony Fauci said the UK had rushed approval, so can we be sure this drug won’t hurt us? • Is there any guidance for anybody who has a needle phobia? • Will the vaccinations give me COVID? • When will the vaccine start to make some effect in preventing or minimising the symptoms of covid? • If you worked in care - as a care assistant, and you do not want to have this vaccine, are there any repercussions? It works for 95%. What if I’m in the other 5%?

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