Weitzman ECHO on COVID-19 Recorded on October 20, 2021

1. Continuing Education Credits
In support of improving patient care, Community
Health Center, Inc. / Weitzman Institute is jointly
accredited by the Accreditation Council for
Continuing Medical Education (ACCME), the
Accreditation Council for Pharmacy Education
(ACPE), and the American Nurses Credentialing
Center (ANCC), to provide continuing education for
the healthcare team.
A comprehensive certificate will be sent after the
end of the series, December 2021.

2. Disclosures & Disclaimers
With respect to the following presentation, there has been no relevant (direct or indirect)
financial relationship between the faculty listed above or other activity planners (or spouse/partner)
and any for-profit company in the past 12 months which would be considered a conflict of interest.
The views expressed in this presentation are those of the faculty and may not reflect official
policy of Community Health Center, Inc. and its Weitzman Institute.
We are obligated to disclose any products which are off-label, unlabeled, experimental, and/or
under investigation (not FDA approved) and any limitations on the information that are presented,
such as data that are preliminary or that represent ongoing research, interim analyses, and/or
unsupported opinion.
This project is supported by the Health Resources and Services Administration (HRSA) of the
U.S. Department of Health and Human Services (HHS) as part of an award totaling $137,500 with 0%
financed with non-governmental sources. The contents are those of the author(s) and do not
necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S.
Government. For more information, please visit HRSA.gov.

3. At the Weitzman Institute, we
value a culture of equity,
inclusiveness, diversity, and mutually
respectful dialogue. We want to
ensure that all feel welcome. If there
is anything said in our program that
makes you feel uncomfortable,
please let us know.

4. 20 Oct 2021

5. 44,937,514 cases on 10/18/21 with 724,417 deaths
https://coronavirus.jhu.edu/us-map
COVID-19 in the United States: TOTAL

6. COVID-19 Hot Spots
https://www.nytimes.com/interactive/2021/us/covid-cases.html

7. https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
Summer
Surge

8. https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html

9. Delta Variant – “like COVID on steroids”
• It is a variant of concern! (VOC)
• One of the most transmissible viruses known
– (Up there with chickenpox, varicella)
• Contains at least 13 mutations from the original strain
– 4 of these are of particular concern affecting the Spike protein
• Higher transmissibility, more amounts of virus (1200x)
• Stronger attachment to ACE-2 receptor
• Decreased recognition by the immune system
• Increased cell to cell infectivity (?)
• Delta itself is mutating further: DELTA VARIANTS
– AY.1 to AY.38
– ‘Delta plus’ AY.1 and AY.2

10. ‘Bully in the Playground’

11. Groups at Higher Risk for Infection
Risk Factor
Asthma Serious Heart Disease
Chronic Lung Disease Hemoglobin Disorders
Diabetes Nursing home residents/LTC
Chronic Kidney Disease - Dialysis Aged 65 and older
Liver Disease Immunocompromised
Morbid Obesity
https://www.cdc.gov/coronavirus/2019-ncov/need-extra-
precautions/groups-at-higher-risk.html

12. The Amazing Immune System
Working ‘Behind the Scenes’

13. Immunity 101
• Receive the vaccine, immunity starts to go up
• Get a second shot – and immunity increases nicely

14. Do we need boosters?
What might happen
immunologically after a booster?

15. Immunity 201
• Receive the primary series, immunity very good after 2nd shot
Get a booster shot ….
Get a booster shot expect immunity to explode upwards!

16. Booster Immunizations
“It's very, very clear that
there's waning immunity,
and we need to boost
individuals who have
received any of the three
products that we've been
dealing with right now”
– Dr. Anthony Fauci

17. Boosters
• Pfizer vaccine approved 3rd shot 6 months out
• Moderna, J&J - could get approval as booster
shots this week - by Wednesday evening?
– Up to the full FDA and CDC to give the green light
– 15 million Americans got Johnson & Johnson
• “Mix and match” study showed increased
immunity:
– J&J vaccines given another J&J booster = 4x
– J&J vaccines given Moderna = 76x increase

18. “Mixing and Matching”
• The immune system will respond to what it
‘sees’
– NIH study: Atma RL et al. Heterologous SARS-CoV-
2 Booster Vaccinations – Preliminary Report
• COVID-19 vaccines are robust!
• Analogy:
– Pfizer vaccine: Left hook
– Moderna vaccine: Right jab
– J&J: Big punch
www.animatedimages.org

19. Moderna or Pfizer Boosters for Johnson &
Johnson Recipients?
• Providers should be given a measure of
discretion as the campaign ramps up
– Dr. Paul A. Offit, FDA and Children’s Hospital of
Philadelphia, noted “we should move quickly on
this, because it’s already happening.”
• Operationally: try to make it easy…

20. COVID-19 Vaccinations Across the Nation
https://covid.cdc.gov/covid-data-tracker/#vaccinations

21. COVID-19 Boosters Across the Nation
https://covid.cdc.gov/covid-data-tracker/#vaccinations

22. https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-people-fully-percent-total
Percent Fully Vaccinated by State for the
Total Population

23. Trusted Resources
• Johns Hopkins
https://coronavirus.jhu.edu/map.html
• CDC
https://www.cdc.gov/coronavirus/2019-ncov/index.html
https://emergency.cdc.gov/coca/calls/2020/
• WHO:
https://www.who.int/emergencies/diseases/novel-coronavirus-
2019
• Others
https://www.nytimes.com/interactive/2021/us/covid-cases.html
https://www.thelancet.com/coronavirus
https://covidactnow.org/