Judy Martin, MD, Professor of Pediatrics at University of Pittsburgh School of Medicine, talks about the potential of booster shots in regard to COVID-19.
What are you and your colleagues looking for in the booster shot trial?
MARTIN: This particular study is looking at the safety of being able to provide booster vaccines as well as the immunogenicity, or the immune response that happens. Specifically, we’re looking at the different combinations of vaccines to determine which might be better. Would it be better, if you initially got an mRNA vaccine, to boost that with another mRNA vaccine? Or would it be better to do something different and perhaps boost with an adenoviral vector vaccine? We are studying all the different combinations in order to answer that question. The Moderna and Pfizer vaccines are mRNA based and the Johnson and Johnson is an adenovirus vector vaccine.
Can you tell me how the study is being conducted?
MARTIN: We’re looking for two groups of individuals. We would get people who have already received a COVID vaccine and then boost them with one of the options that we have as part of the study. The second group of individuals we’re looking for are individuals who have not received any COVID vaccines to date. The reason they’re so important is because we have a unique opportunity to get blood samples prior to the first dose, , after the second dose, and after the third dose to really give us better insight into the immune responses and the changes that occur between each dose.
How long is this going to run and when do you and other researchers anticipate results?
MARTIN: The study itself will last about a year. We’ll be following individuals and getting blood specimens in order to assess that immune response over time. We are hopeful to have some initial safety information quickly because most of the side effects after a vaccine happen in the first week or two or up to a month after.
Have you begun giving any of these shots or testing anything at this point?
MARTIN: The study is already enrolling. The first cohort is well underway. We’re still actively looking for individuals who have not yet been immunized. That’s a little bit of a harder group to find because most people who wanted a vaccine have already gotten it. It’s an adaptive study design. So, we will continue to add new groups to the study along the way.
What’s the benefit of having this information, especially in the next six months, year, two years?
MARTIN: We don’t know yet if we’re going to need booster doses. That’s the big question. Does immunity from your initial series of vaccines go down and not protect you any longer? We also need to determine how much of an impact the SARS-CoV-2 variants are going to have. With the fluvaccine, you get a dose each year because the variants or the types of influenza change. The concern is, at some point, our current vaccinations might not protect us as well as they are doing right now for the variants. We want to be prepared with the information, so if a time comes where we do think we need booster doses, that we know what the best response is going to be in terms of which vaccines in what combinations and what timing.
Is there anything you want to make sure people know about vaccines or boosters?
MARTIN: Thereare some people already asking, should they go get another shot because they’re concerned? We don’t have enough information at this time to answer that question. There’s one study that was conducted in the UK that combined AstraZeneca vaccine with Pfizer vaccine. But here in the U.S., for these combinations that we have available, we don’t have that information. So, it’s really important that we get the data so we can make informed decisions and informed recommendations.
I did read that people who got the J&J vaccine are concerned because it was just one shot as opposed to two.
MARTIN: It’s still too early to tell. The biggest concern right now are those individuals who are getting infections and are hospitalized, in the United States, for the most part, are those who are unimmunized. If we’re going to focus our efforts on anything right now, we need to focus on getting more people immunized in order to reduce the spread of infection.
Should you have a title or bullet here since you are changing from booster doses to pediatrics?
How important is it to have something we can offer parents for kids that are 12 and under?
MARTIN: We’re still learning a lot about how infection is spread and who is spreading infection. Up until now, we really haven’t focused on the pediatric group as being a large group that is spreading infection.. The biggest concern and reason to consider vaccination in children are there are serious illnesses in children. There are children who are being hospitalized. There are children who have died of SARS-CoV-2. So, certainly we can help to protect against those issues by vaccinating the children. There are also other complications of having a COVID infection such as the multi-system inflammatory syndrome (MISC), and that’s a big concern. But, perhaps by immunizing individuals, we can protect them from getting an infection and protect them from getting that complication. Another reason to immunize children is to help protect the adults too. We know that not all adults mount an immune response, specifically individuals who’ve had organ transplants or who’ve had an immune-suppressive agents because of treatments for other diseases. Many of those individuals have not mounted an immune response and may still be vulnerable to infection. So, the more people around them who are protected is how we can protect those individuals.
Is there anything else you want people to know about either the research that’s being done, or long-term implications of this kind of research?
MARTIN: A lot of people have interest, and more people are better informed about the research process now than ever before. Certainly participating in a research study is a very individual decision. We engage with the adults and with the families that are interested in the research to ensure they understand what it means to be in a research study, to understand the risks and the benefits that are potentially going to happen with the research study, and to make sure that it’s a good fit for them. There are many people that we speak to who, after our discussion, decide that it’s not for them, and that’s ok. We want to ensure that everyone has adequate information to make the decision for themselves.
You mentioned you had a lot of telephone calls on this particular study. Why do you think there’s such a high interest and people are willing to step up and see if this might be the right fit?
MARTIN: It’s somewhat changed over time. When we did the initial adult studies, what I heard a lot were that people didn’t want to sit at home and just not do anything and they wanted to take part in the science, and they knew that these research studies were potentially a way out of the pandemic. They were really motivated to help other people. We still hear that a lot. But what I’m hearing more is that individuals want to help their family members. They want to ease the anxiety. Because a lot of people are worried now about going out and they want to do whatever they can to protect themselves and to protect their loved ones.
Do you think there will come a point where this is behind us, or is this going to take more than 18 months, two years, five years?
MARTIN: I think it’ll get behind us because it’s got to get better. We have tools to be able to deal with this, whether it’s the vaccine or masks or social distancing, or all of these things.. It’s going to take a while. There’s so much that’s unknown right now because we don’t know what’s going to happen with these variants, and that’s our biggest concern right now.
Interview conducted by Ivanhoe Broadcast News.
END OF INTERVIEW
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