COVID-19 Vaccines Crucial to Protect Vulnerable Populations During Holiday Season


A Q&A with Robert Walker, MD, senior vice president and chief medical officer at Novavax.

Earlier this year, the FDA approved updated COVID-19 vaccines from Pfizer, Moderna, and Novavax that protect against currently circulating variants. Getting these updated vaccines is important to protect vulnerable populations, especially during the holiday season when people tend to meet more frequently indoors.

However, a survey from the Kaiser Family Foundation found that half of adults in the United States said they do not plan on getting the updated COVID-19 vaccines.1 The top reasons given for not getting the vaccines include a lack of worry about the virus, being too busy, and having bad side effects from the previous vaccines.

Drug Topics sat down with Robert Walker, MD, senior vice president and chief medical officer at Novavax, to discuss factors contributing to poor COVID-19 vaccine uptake, how to improve vaccine rates, why it’s important to get vaccinated, and the benefits of having 2 different COVID-19 vaccine platforms.

Drug Topics: Despite recommendations from health authorities, a considerable portion of the population in the US has not received updated COVID-19 vaccines. What are some of the key factors that are contributing to this?

Robert Walker, MD: I think there's two major factors. One is what's commonly called vaccine fatigue, which is [when] people want to just turn the page on COVID, despite the fact that the virus doesn't want to turn its page on us. I think that's a main driver. The other is the misinformation and disinformation that we're all sort of inundated with every day. I think those are the main drivers and are the ones that I think we're trying to address as best we can, so that people have the information they need to make good decisions.

Drug Topics: What strategies or initiatives do you think could help bridge this immunization gap and improve overall vaccine coverage?

Walker: I think that it's education in all its forms. I think we just have to customize the way we give information and message information to the audience that we're trying to reach. We just have to inform people about the burden of disease, about the groups that are at risk, about the safety of the vaccines, and the effectiveness of the vaccines. We just have to keep pounding away at those messages.

I think the other is that we [need to] recognize that there are hard to reach communities. They tend to be populations of color or other disenfranchised groups within our country. We have to make special efforts to reach those groups. Oftentimes, that means partnering with leaders in the community, people who have trust. I think that we can only push our messages so far. We need some help.

Drug Topics: According to recent data from the CDC, COVID-19 has led to more hospitalizations than the flu. Why is this comparison significant and how do you think this information could influence public perception and behavior during the holiday season?

Walker: We think of influenza as a seasonal respiratory illness. We associate it with the holidays because that's when we're all gathering indoors. The weather's getting colder, there's more transmission of the virus. I think the analogy between influenza and COVID is, in some ways, trying to help people use a paradigm [or] a framework for thinking about this, with which they're already familiar, and applying it to this relatively new virus.

I think that helps because they're both respiratory viruses, they both can cause severe illness, hospitalizations, and deaths. We have vaccines for both of them. That sort of associating is probably a reasonable thing to do and helps people get over some of the inertia or some of the obstacles they might otherwise feel with respect to getting vaccinated against COVID, because they're very much familiar and feel more comfortable with the flu.

Drug Topics: Low vaccination rates can impact vulnerable populations, such as the elderly and immunocompromised. Why is it crucial to focus on their protection during the respiratory virus season?

Walker: The elderly and other vulnerable populations, like the immunocompromised for example, these folks account for 80% of the hospitalizations in this country. In order to have the biggest impact on quelling the severe aspects of this disease, those are the populations that are most important from the perspective of reducing hospitalizations and deaths. That's why it's important.

Why is it important for the rest of us to get vaccinated? First of all, we want to protect our own families, our own loved ones, and ourselves to the best that we can. But we also want to play our part in protecting our communities, and protecting the most vulnerable people in our community. The more that all of us can get vaccinated and be protected, the less opportunity the virus has to infect these more vulnerable population groups.

Drug Topics: People now have 2 options when it comes to COVID-19 vaccines. Can you briefly explain the difference between mRNA and protein-based vaccines, such as the vaccine from Novavax?

Walker: Both vaccines are given by injection, typically into the arm muscle. The Novavax [vaccine] uses a protein based technology. This involves giving fragments of the major protein, called the spike protein on the virus. By giving these pieces of Spike, combined with an adjuvant, which is a substance that magnifies the immune response, we essentially teach the immune system to respond with a protective response when the body encounters the actual virus sometime in the future.

mRNA uses a different technology. It's really a genetic material that provides the instructions to the cells, after its introduction, for the cells to make their own version of the spike protein. That in turn then teaches the immune system to make a response. They're both geared towards the same goal, but it's the way they do it, the method by which they teach the immune system, that's different.

Drug Topics: What are the benefits of having different COVID-19 vaccine platform options?

Walker: We've done our own survey. We've learned that 85% of people say that it's important to them, and to their families, to have options. Options, choices, people recognize that that's important. The more options, I think, the more likely people are to select something with which to get vaccinated. In terms of our public health mission, which is getting the most people possible vaccinated and protected, options kind of help to drive that. The other is that just from a vaccine supply, public health perspective, it's important to have more than 1 vaccine supply, more than 1 platform, to preserve the vaccine supply chain. You never want to be dependent on only 1 technology or only 1 buyer.

Drug Topics: Is there anything else that you wanted to touch upon that we didn't talk about?

Walker: Your audience is pharmacists and pharmacists are so critical. It appears that more people interact with a pharmacist than interact with physicians or other health care professionals in the course of a week, a month, or a season. I just think that we need to recognize the pivotal role [pharmacists] play, just in terms of the contact and the trust that people in the community have with them. It’s important to do everything possible to make sure the pharmacists understand the data and the options, so they in turn can present that to the communities.

1. Sparks G, Kirzinger A, Kearney A, et al. KFF COVID-19 Vaccine Monitor November 2023: With COVID Concerns Lagging, Most People Have Not Gotten Latest Vaccine And Half Say They Are Not Taking Precautions This Holiday Season. News Release. November 17, 2023. Accessed December 12, 2023.
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