COVID19 Road to a vaccine episode 15: Professor Lynn Gillam

In episode 15, our host, Associate Professor Nigel Crawford, speaks to Professor Lynn Gillam. Lynn is a clinical ethicist who trained in philosophy and bioethics. She is a Professor in the Centre for Health Equity, in the Melbourne School of Population and Global Health at the University of Melbourne; and the Academic Director of The Children’s Bioethics Centre at the Royal Children’s Hospital in Melbourne, Australia. The Children’s Bioethics Centre provides support including ethical decision making for clinicians in relation to patient care issues. Nigel and Lynn will discuss some of the ethical issues raised in the setting of SARS-CoV-2 vaccines, utilising a framework of points raised by Dr John Lantos from the Children’s Mercy Hospital in Kansas City, USA, at the recent Bioethics E-Conference hosted by The Children’s Bioethics Centre:

  • The importance of realising that not doing something or not conducting research is a decision in itself
  • The notion of “too fast can’t be safe” – some steps need to take the time they have always taken, some things can be done more quickly, recognising that if you do nothing, you are allowing harm to happen
  • The role of ethical boards and the way vaccines are developed, i.e. the use of younger, healthier participants in research, not the individuals who are getting the worst disease
  • The involvement of children and elderly people in clinical trials and the key differences in the ethical considerations of this
  • Global equity of access to SARS-CoV-2 vaccines when they become available, who gets them first and how should these decisions be made?
  • The role of Citizens’ Juries in deciding who has priority of access to vaccines in a pandemic situation
  • Mandatory vaccination
  • The use of foetal embryonic cell lines in vaccine development

Links

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by Alice Black

NEJM: Evaluating and Deploying Covid-19 Vaccines — The Importance of Transparency, Scientific Integrity, and Public Trust

The following article published in the New England Journal of Medicine, discusses the importance of adhering to well-established and transparent regulatory processes when it comes to approving a COVID-19 vaccine. Reassuring the public with robust scientific evaluation from independent bodies, without interference from governments for the purposes of political advantage, is essential to promote public confidence and ensure the success of vaccination programs. 

Read the article in full here:

NEJM: Evaluating and Deploying Covid-19 Vaccines — The Importance of Transparency, Scientific Integrity, and Public Trust

by Alice Black

COVID19 Road to a vaccine episode 14: Dr Bruce Gellin

In episode 14, our host, Associate Professor Nigel Crawford, speaks to Dr Bruce Gellin. Bruce is the President of Global Immunization at the Sabin Vaccine Institute in Washington. The Sabin Vaccine Institute’s mission is to make vaccines more accessible, enable innovation and expand immunisation across the globe. Bruce took up this role in 2017, prior to this serving as the Deputy Assistant Secretary of the National Vaccine Program Office at the US Department of Health and Human Services where he served as technical and policy advisor to the WHO, focusing on influenza vaccines and global issues of vaccine hesitancy. Bruce has also worked at the Centers for Disease Control and Prevention (CDC), consulted for GAVI and is one of America’s principle spokespeople on vaccines and immunisations. He and Nigel discuss the following in the context of vaccine confidence:

  • The recent halting of the Oxford Astrazeneca trial and how the system that is in place did exactly what is supposed to
  • “The Cutter Incident” and the ongoing impact this has had on vaccine safety, particularly from the manufacturing perspective
  • The vast importance of ensuring immunisation providers understand the vaccine development process as if they don’t understand it and are sceptical this can have a huge impact on vaccine uptake 
  • The importance of open disclosure in the vaccine development pathway
  • How the Sabin Vaccine Institute is meeting the challenge of vaccine hesitancy
  • Sabin’s‘Boost’ program for healthcare workers 
  • How vaccines are monitored once they are in use, also called phase IV surveillance

 Links:

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by Alice Black

COVID19 Road to a vaccine episode 13: Professor Kim Mulholland

In episode 13, our host, Associate Professor Nigel Crawford, speaks to Professor Kim Mulholland. Kim is a paediatrician and Professor of Child Health from the Murdoch Children’s Research Institute, the University of Melbourne department of Paediatrics and the London School of Hygiene and Tropical Medicine. With post-graduate training in immunology, respiratory medicine and tropical medicine, his vast experience includes developing a program of research covering all aspects of childhood pneumonia which helped guide WHO policies. He has been involved in the oversight of many vaccine trials and has served on steering committees or DSMBs for a range of vaccines including pneumococcal, dengue, RSV and COVID-19. He and Nigel discuss:

  • global issues brought about by the SARS-CoV-2 pandemic and some of the surprising ways the virus has spread globally
  • what we can learn from seroprevalence in countries such as India
  • vaccine nationalism and the push for global solidarity
  • the role of Australia in the pacific region in regards to vaccine preparedness
  • global, equitable access to COVID-19 vaccines

Links:

Listen here:

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by Alice Black

Halting the Oxford vaccine trial doesn't mean it's not safe- it shows they're following the right process

Due to a single event of an unexplained illness, the AstraZeneca Oxford group have announced a voluntary pause on all vaccinations across all sites of their COVID-19 vaccine candidate clinical trial. This pause will allow an independent committee to review the safety data and investigate the incident. 

The following article, published in The Conversation, outlines how this halt doesn't necessarily indicate that the vaccine is not safe, but reflects the robust processes for clinical trials. It is important to recognise that whilst these clinical trials are moving at pandemic speed, safety is not being compromised.

The Conversation: Halting the Oxford vaccine trial doesn't mean it's not safe- it shows they're following the right process

by Alice Black

COVID19 Road to a vaccine episode 12: Professor Heidi Larson

In this episode of COVID19 Road to a vaccine, our host, Associate Professor Nigel Crawford speaks to Professor Heidi Larson. Heidi is an anthropologist and Director of the Vaccine Confidence Project and Professor of Anthropology at the London School of Hygiene and Tropical Medicine. The Vaccine Confidence Project is a WHO centre of excellence on addressing vaccine hesitancy. Heidi is the previous head of Global Immunisation Communication at UNICEF, chaired GAVI’s advocacy taskforce and served on the WHO SAGE working group on vaccine hesitancy. In this episode they discuss:

  • How and why Heidi founded The Vaccine Confidence Project
  • Why vaccine confidence is already proving to be so important in relation to a SARS-CoV-2 vaccine when there is not yet a vaccine that has gone through all the phases of a clinical trial
  • Whether or not vaccine confidence is impacted by the way in which different countries are handling the SARS-CoV-2 pandemic
  • The importance of health care workers modelling vaccine uptake to promote vaccine confidence
  • Positive ways we can use social media to promote vaccine preparedness
  • Resistance to mandatory vaccination and the importance of community vs herd immunity

Links:

Listen to the episode here:

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by Alice Black

New immunisation reference page: Melbourne immunisation drive-through clinics

Staying up to date with scheduled and additional vaccinations, remains essential during the COVID-19 pandemic. Concerning results from the Royal Children’s Hospital (RCH) National Child Health Poll, indicate the impact that the pandemic has had on immunisation, with data showing 1 in 5 children have had those vaccinations delayed since the beginning of the pandemic.

Families are reminded that it is safe and recommended to attend local immunisation providers (GP or local council) for vaccinations, however drive-through clinics are also available at Monash Health in Clayton and the RCH in Parkville. 

For more information please refer to the following:

MVEC: Melbourne immunisation drive-through clinics

by Alice Black

COVID19 Road to a vaccine episode 11: Associate Professor Margie Danchin and Professor Julie Leask

In episode 11 of our COVID19 Road to a vaccine series, our host, Nigel Crawford, speaks to experts in vaccine confidence, Associate Professor Margie Danchin and Professor Julie Leask. Margie is a consultant paediatrician at the Royal Children’s Hospital, an Associate Professor within the University of Melbourne Department of Paediatrics and the Murdoch Children’s Research Institute, where she is the leader of the Vaccine Uptake Group. Julie is a social scientist and professor in the Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney and a visiting Professorial Fellow at NCIRS (the National Centre for Immunisation Research and Surveillance). In this episode they discuss:

  • Responses to vaccine hesitancy and promoting vaccine confidence from an Australian perspective 
  • The importance of language and definitions when it comes to vaccine confidence, hesitancy and uptake 
  • (5) important ways to prepare the public for a SARS-CoV-2 vaccine
  • The role of social media platforms in communicating this information
  • The importance of measuring vaccine confidence in the community
  • Ways of communicating well around adverse events in gaining community trust and maintaining vaccine programs, including utilising expertise from specialist immunisation clinics (SICs)

Links:

Listen to the episode here:

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by Alice Black

The use of foetal tissue in vaccine development

There has been attention in the media recently regarding the use of foetal cell lines by the Oxford Vaccine Group to develop their COVID-19 vaccine candidate. Cell lines are currently used to manufacture many vaccines including varicella, hepatitis A, rabies and MMR vaccines. 

The below information from the Children's Hospital of Philadelphia (CHoP) discusses the background behind using these cell lines in vaccine development as well as any potential ethical or religious concerns surrounding this. 

Vaccine ingredients- Fetal tissues

 

 

by Alice Black

The RCH Immunisation Service: Drive-through clinic is now open

To support families in continuing to receive scheduled vaccinations during the COVID-19 pandemic, the RCH Immunisation Service has just opened its own immunisation drive-through clinic. Additional precautions have been implemented to ensure the safety of all patients, families and staff. Access to medical care remains an essential service during this time and staying up to date with scheduled immunisations is encouraged.

The drive-through clinic will operate on Tuesdays and Wednesdays from 9am - 1pm until September 15. 

Bookings for the drive-through clinic are mandatory and can be made by contacting the immunisation team via this link. 

by Alice Black