March 03, 2021
By Douglas L. Jennings, PharmD, FACC, FAHA, FCCP, FHFSA, BCPS
Volume 1, Issue 1
“Brevity is the soul of wit.”
Welcome to the first installment of “Talking Therapeutics!” Each week we’re going to tackle a timely therapeutic topic by breaking it down into bite-sized talking points. The goal is to convey high-impact clinical material in a quick, fun, easy-to-read article. That said this week’s column is a little longer as we’re tackling a very important topic: COVID-19 vaccines.
Point 1: All of the COVID-19 Vaccines Are Highly Effective
This one is really important for us to break down for our patients, because definition of “effective” in the clinical trials for Moderna and Pfizer was overall infection (including mild disease), whereas for Johnson & Johnson it was defined only as moderate to severe disease (excluding mild). This is a critical distinction, as a patient who sees in the lay press that the Moderna and Pfizer vaccines are “more effective” in preventing disease than the Johnson & Johnson and AstraZeneca counterparts, they may decline the latter vaccinations when offered and instead either wait for one of the “more effective” vaccines or attempt vaccine tourism to get the dose that they want. This critical nuance—that differences in the rates of overall infection in the trials were driven by mild cases—makes the following sentence all the more important. Severe cases resulting in hospitalization were drastically reduced and deaths were nearly eliminated in all of the COVID-19 vaccine clinical trials. The bottom-line message that we need to communicate to our patients is that for the endpoints that matter (like death and hospitalization) each of the available vaccines are highly effective, and they basically turn COVID-19 into a common cold for the vast majority of recipients.
Point 2: Vaccines Work in the Real World Too
An Israeli study recently published in the New England Journal of Medicine included over 1 million recipients, and found that the Pfizer vaccine reduced symptomatic cases by 94% a week after the second dose and reduced severe disease by 92%. In this study, only 3.5 of out every 100,000 vaccine recipients were hospitalized with COVID-19; compare this to a normal winter in the United States, where roughly 150 of out every 100,000 people are hospitalized each year with the flu, and these data are even more compelling. Importantly, real world trials like these also confirm the widespread safety of vaccines, a point that we as pharmacists really need to drive home for our patients.
Point 3: Vaccines Appear to Be Effective Against New Variants
The Israeli study mentioned above reported that the Pfizer vaccine the vaccine appears to work against the UK variant B.1.1.7, which started to circulate in that country during the study period. Similarly, the Johnson & Johnson vaccine—which included patients from South Africa, where 95% of strains were of the B.1.351 lineage—demonstrated complete protection against COVID-19-related hospitalization and death. The bottom-line is the variants exist because of widespread disease, and so the quickest way to halt the genesis of new variants is to vaccinate as many people as quickly as possible and slow disease spread.
In closing, we as pharmacists need to advocate the importance of vaccination to all of our patients. It’s the only way out of this pandemic and we won’t get back to “normal” until a substantial number of Americans are vaccinated. I hope that you all enjoyed reading the first installment of Talking Therapeutics! In next week’s column, we’ll discuss some exciting news regarding a novel heart failure treatment. In the meantime, please feel free to suggest future topics for this column in the space below.
Dr Jennings is currently an Associate Professor of Pharmacy at Long Island University and the clinical pharmacist for the Heart Transplant and LVAD teams at NewYork- Presbyterian Hospital Columbia University Irving Medical Center. He is an active researcher in his field, and he has published over 120 peer-reviewed abstracts and manuscripts, primarily focusing on the pharmacotherapy of patients under mechanical circulatory support. As a recognized expert in this area, he has been invited to speak at numerous national and international venues, including meetings in France, Saudia Arabia, India. Finally, Dr. Jennings has been active in professional organizations throughout his career. He is a fellow of the American College of Clinical Pharmacy, the American College of Cardiology, the Heart Failure Society of America, and the American Heart Association.
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