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CYNTHIA LEIFER: Good afternoon, everyone. I would like to welcome you all, students, staff, faculty, as well as members of our Ithaca community, to today's panel. This is The Science Behind COVID-19 Vaccines, A Conversation with Cornell Immunology Experts. I'm Cynthia Leifer. I'm a professor in the Department of Microbiology and Immunology. I came to Cornell in 2005. I run an immunology research lab that studies how our immune system detects vaccines and infections and mounts protective immunity.
I also teach immunology here at Cornell. This last year has been challenging for all of us. There have been many struggles but also some amazing opportunities. For this last year, I've been thinking a lot about vaccines and doing a lot of science communication with interviews nationally and internationally on radio and TV. I also host a podcast called Immune.
And when the pandemic hit, I, like many of my colleagues, became much more active in speaking with members of our community and our families. So many people had so many questions. It was a scary time. And I felt both a responsibility and an honor in being able to break down confusing information in a way that allayed people's fears. That's why I'm here today, because I believe in vaccines and the importance of every person in our community who is able to get vaccinated.
And I'll tell you that we heard good news today. I checked 20 minutes ago. We have had 189, 692,045 vaccines that have been administered in the United States. And we broke a record again on Saturday with 4.6 million doses administered. I'm proud to say I was one of those. I got my second dose of the Bio-- Pfizer BioNTech vaccine on Saturday. I'm joined today by three of my world renowned immunology colleagues who also believe in the importance of vaccination and have agreed to help me answer many of your questions.
Professor Deborah Fowell is a professor and chair in the Department of Microbiology and Immunology. She's a member of the Executive Committee of the Cornell Center for Immunology and co-director of the Friedman Center for Nutrition and Inflammation. Professor Fowell does amazing cutting edge research using imaging techniques to study how our immune cells move around and tissues and how they mediate protection against infection.
Avery August is a professor and former chair in the Department of Microbiology and Immunology. He is a Howard Hughes Medical Institute Professor and Vice Provost for Academic Affairs. Professor August is also a powerhouse in the area of T cell biology research. As you'll hear, T-cells are critical players in our immune response to infectious organisms, especially viruses. And you'll hear how they seek out and destroy infected cells in our body.
He's also passionately engaged in science communication and vaccine advocacy. Lastly is Gary Koretzky, a professor of medicine at Weill Cornell Graduate School, adjunct professor in the Department of Microbiology and Immunology here at Ithaca and Director of the Cornell Center for Immunology. He holds both a PhD and an M.D. And prior to assuming his role as Vice Provost for Academic Integration, he was an extremely prolific immunology researcher who defined critical events to activate those T cells that I mentioned and how they initiate protective immune responses.
Also, Dr. Koretzky is the incoming president of the American Association of Immunologists, which is the largest professional society of immunology in the world. And I want to mention that since Professor Koretzky is also a physician, he was instrumental in developing Cornell's highly successful testing and tracing program for COVID-19. And lastly, he's been very busy over the last few weeks vaccinating members of our community.
So you can see we have an extraordinary panel of immunologists to answer your questions about COVID-19 vaccines. We only have one hour to cover this important topic. It's very complicated. And our plan is to give you a very brief introduction to how vaccines work. And then we'll answer some of the questions that were submitted prior to this event by email. And then to end our program, we will answer questions that you're submitting via the Q&A or question and answer here on Zoom.
So please enter those questions at any time during this hour. Although, recognize that this time is going to go quickly. So we may not be able to answer all of your questions. Also, just to let you know, we're not going to be addressing questions about Cornell policies related to the vaccine or COVID-19. Because there will be additional and specific information provided by the administration as those decisions are made.
So at this time, I'd like to turn it over to Professor Fowell who will give us a very brief overview on vaccines and their importance for public health.
DEBORAH FOWELL: Thank you, Cindy. It's a delight to kick off this discussion. I'm really excited about it, excited to show you how passionate we are about the study of the immune system and vaccination. So our human immune system has evolved to respond to an infinite array of pathogens or infectious agents, such as viruses, bacteria, parasites, and fungi.
The key to the success of an immune response is its ability to clear that infection but also to remember the encounter with that pathogen. And this is called immune memory. And it enables the immune response to respond faster the next time around when you see that pathogen again and hence protect you from getting sick a second time around. And vaccination exploits this extraordinary ability of the immune system.
And it does so by safely inducing this memory response without-- in individuals without them ever having to see the pathogen in the first place. So how does this work? For many vaccines, and especially for the vaccines now available for SARS-CoV-2, that's the virus that causes COVID-19 disease, the vaccine does not contain the virus itself. It contains a small portion of the virus or a protein from that virus or the machinery to help make that protein in our own bodies. And that's specific to that virus.
And these proteins are chosen in the vaccine because they're often proteins that are critical for the virus to get into the body's cells. So after you get vaccinated in the muscle, the immune cells carry that vaccine material into the lymph nodes, where they can activate the immune system. And they activate two different arms of the immune response, B cells and T cells And the B cells make antibodies. These are things that you've all heard of I'm sure.
And these antibodies are made specific to the viral protein that's in that vaccination. And those antibodies are then released into the bloodstream, where they can circulate and protect all parts of the body. The antibodies work by binding to parts of the virus and blocking that virus from getting inside our own-- the cells of our body. To deal with any of these cells that potentially get virally infected, we have to call on the other half, the second arm of the immune response. And that's the T cell response.
And the vaccine expands particular types of T cells called cytotoxic T cells, or killer T cells. And these T cells are able to move around the body and identify virally infected cells and eliminate them. So the development of these two important arms of the immune response, the B cells and antibody production and the T cells, takes about one to two weeks after-- from the time in which you're vaccinated.
And as I said, these B cells and T cells remember seeing this viral protein and form this basis of immune memory. And they can stick around for months, for years, even decades. So the outcome of a successful vaccine is to provide you with this immune protection, without ever having to encounter the virus itself. The memory response is then quickly able to respond to the virus if, in fact, you do get infected with the virus itself.
Those antibodies bind and help prevent the virus from entering cells of your body. And then the T cells can wipe up and eliminate any of those virally infected cells. So in-- at the end of this successful vaccine, you are protected from the virus. And that really though does two very important things that I think we'll probably talk a lot about today. One, it protects you personally from getting sick. But it also reduces the chances that you'll harbor viruses and pass that virus on to other people in the community.
So that's a very quick description of the immune system. Cindy, I hope that was sufficient for everybody to understand how vaccines work.
CYNTHIA LEIFER: Thank you. That was perfect. You all got Immunology 101. So I want to remind everybody before we switch on to questions that this recording will be available on CornellCast this week sometime. So you can go to Cornell.Edu/Video/, so you should be able to find it there. So with that base introduction, I'd like to switch over to some of the questions we received by email.
And we received lots of questions. And some of these you may hear bits of what you wrote, but we kind of glommed together what multiple people asked. So the first one I'm going to toss over to you Professor August. Can you tell us about these-- how these vaccines were developed, and how years of basic science research in disciplines like immunology and virology helped us get to develop these as quickly as we were able to do that in the last year?
AVERY AUGUST: Thank you, Professor Leifer and Professor Fowell for such a perfect description of the sort of underlying basis for how the immune system works. One of the advantages we've had increasingly over the last few years is the benefit of significant investment in what we call basic or fundamental research that really tells us how the body works, how does the immune system work, what are the cell types involved, what are antibodies do.
So that when a big challenge like SARS-CoV-2 appears, we're much better able to mobilize. And so the fact that we've been able to do this so quickly, unprecedentedly quickly, is because we've had the benefit of having this information that we can very quickly pivot. Much of the work that was done that led to the development of the vaccines that we're using now came from work that researchers were doing in other viruses or in other systems, in some cases just trying to understand how these systems work.
So in this case, there were multiple things that happened. We had a lot of information about using what's called mRNA technology. And this is the technology that underpins the Pfizer and Moderna vaccine. I personally have received the Pfizer vaccine. And we had a really good understanding of how to manipulate and use mRNA technology to develop-- to deliver those proteins that Professor Fowell referred to that the immune system needs to recognize.
And so we were able to very rapidly pivot and use that information to start to develop that technology. Similarly, for the Johnson & Johnson vaccine, which uses a simple cold virus for its delivery system, and it basically delivers the same thing and delivers the same protein that Professor Fowell referred to, that we're trying to train our immune system to recognize with regards to protecting us from COVID-19.
And so having that information allowed us to very quickly turn our attention to developing these delivery strategies, so that we can quickly deliver vaccines that could be tested very quickly. A matter of fact, it was reported that, as soon as we understood what the structure of the virus looks like, over the weekend, we were able to devise an approach. Now it doesn't mean we were able to do the experiments but as an approach.
And so very quickly, we were able to pivot. And so that is how the vaccine was able to be developed so quickly in part. Because we had the benefit of understanding a lot more about the immune system, how it works, understanding how to deliver these proteins so that the immune system can recognize them, both by mRNA technology or by using this cold virus delivery system, and being able to rapidly move into what we call clinical trials to test whether it works.
And as we heard late last year, the clinical trials were successful, really, really more successful than we thought initially. And we were able to then pivot and start to deliver those vaccines increasingly to larger populations.
CYNTHIA LEIFER: So you raised a really interesting question. Because a lot of people were curious about how these were tested. So can you comment on-- not just-- you commented on how we made them so quickly. But can you comment about how they were tested so quickly, and whether they were held to the same standards as other vaccines or other drugs that the FDA approves?
AVERY AUGUST: So one of the fantastic opportunities that we had, if this could be called a fantastic opportunity given where we are, is, again, we had lots of information on how to develop the vaccine strategies. But we also started everything at the same time. So normally what would happen is we would first test the vaccine in small-- in tissue culture and in small animals. And then gradually we would then move into what are called Phase I clinical trials and then Phase II clinical trials.
And then finally, we would then be-- the information would be given to the FDA. And they would approve it. That would take years. What the vaccine industry did is start all of that all at the same time. So we started the animal trials at the same time. We started the clinical trials soon after, as soon as we figured out that this was safe to deliver. And so we were very rapidly able to get, in people, as I talk about it.
I think it was maybe three or four months after the first animal trials were done that we started to use-- to test whether the vaccine would first be safe in people, and then finally, whether it would generate immune protection. And then finally, we started to get a better understanding of whether it would be able to protect against the disease, the symptoms of the disease. So because we started-- we basically threw everything at the vaccine.
We started the animal studies, the human studies. We started even making the vaccines before it was actually approved, anticipating that this would all work. And so that's why we were able to do this so quickly. And the vaccines, all of the steps were followed. The vaccine is made on a good manufacturing protocols, which is the standard of vaccine production for the FDA approval. None of that has changed.
It's just it all started at the same time. And so we were able to do this much more quickly.
CYNTHIA LEIFER: Great. Thank you. That was a lot of really useful information. I think I'll pose the next few questions to Professor Koretzky. So we've heard a lot about efficacy as the different vaccines have become available to the public. So could you discuss what efficacy means and how much it matters?
GARY KORETZKY: Sure, Cindy. And first, I want to just thank all of you for joining us today. This is such an important topic. And we're really pleased to be able to give some information. So one of the most important things to remember about the COVID-19 vaccines is that they were created in the hope that they would prevent serious disease, right. So this is a disease that has now killed more than 560,000 Americans and many, many more people in the hospital, a devastating disease.
So the purpose of the vaccine, first and foremost, was to prevent that serious illness. So when we talk about efficacy, you've heard about efficacy or effectiveness. The numbers that we read about for the different vaccines have come actually from those clinical trials that Avery talked about. Tens of thousands of volunteers received either a vaccine or an inert shot, a placebo. And the volunteers were then followed over time. And they were assessed for evidence of clinically significant COVID-19 disease.
So what was found? It was remarkable. Each of the currently approved vaccines were extremely effective at preventing COVID-19 disease, preventing hospitalizations, and, really, really importantly, preventing death. A vaccine was described as being 90% effective if in a study, 100 patients that were randomly assigned the control, the placebo, might have gotten COVID. And only 10 volunteers would have gotten COVID.
Now this is really important. It doesn't tell you that the vaccine protects completely, but it protects remarkably well. So importantly, though, when we think about the different vaccines, each vaccine was shown to be effective. They can't be compared directly to each other. And the reason for that is that they were studied in different populations, in different times, actually even in different parts of the world.
What we can say, each is incredibly effective and actually much more effective than what the FDA put as the bar to begin. The bar said-- the FDA said they would approve the vaccine if it was 50% protective. These vaccines were much, much more effective than that. So hence, the three vaccines that are now approved in the United States have reached that point.
I do want to make another really critical point. And this is actually from one of the questions also that I noticed that was posed right now. And that is that when the vaccines were first approved, they were approved because they protected from disease. And that's what we absolutely needed to do. We didn't know something else really, really important. And that was, would these vaccines also protect from getting infected, perhaps asymptomatically, and actually being able to transmit to other people?
Well, we're beginning to learn that. And the studies are again really, really remarkable. They're very, very encouraging. And we're learning that as people become vaccinated, not only are they protected from getting disease themselves, but they're also protected from acquiring the virus and then giving it to others. Again, not 100% but really, really well.
So this is a really important point to stress and that is why should you get vaccinated. You get vaccinated, of course, to protect yourself. You don't want to be in the ICU. You don't want to be one of these individuals who is a long-hauler, you know, somebody who's had COVID and has remained sick for a while. But just as importantly and as importantly for the population, as importantly for vulnerable individuals, if you become vaccinated, it's much less likely that you'll become infected and then transmit it to somebody else who might not even be able to be vaccinated, that you'll be able to protect the community. And that's great news.
CYNTHIA LEIFER: Yes, that is great news. So what-- you mentioned about these different types of vaccines. And some get one shot, and some get two shots. I had two shots. I had the Pfizer. Other people have J&J. Can you just quickly talk about why one shot for some and two shots for the other? And do you think we're going to need more shots in the future?
GARY KORETZKY: Sure. And this also relates to how the vaccines were studied. As you heard from Deborah, a great strategy that immunologists use is to give a protein, to give an antigen is what immunologists call that, that primes the immune response. And then you follow with the second dose. We call that a booster. And that elicits this stronger response, this memory response. It reminds the immune system that it's seen a protein and now it's going to respond more effectively and quickly.
So when Moderna and Pfizer did their trials, they did them with this in mind. And they gave two doses. And they work. And that's how the vaccine was approved. And that's why we give two doses. J&J recognize that there would be great advantages to a single dose. As Avery mentioned, we were doing all of this together in real time. They asked the very, very difficult question, will one dose work? And one dose does work for J&J.
So future studies are going to give us more insight into these vaccines. We'll learn about better ways to use them. But for now, we know that they work really well with these schedules of dosing. So will there be a need for boosters in the future? Well, time's going to tell. There are certain vaccines that require boosters, right. If you've got a tetanus shot a long time ago and you step on a rusty nail, you're going to get a booster, right. It really matters.
There are other vaccines that last for longer periods of times, other that lasts for shorter periods of times. When these vaccines were first approved, we said immunity for 90 days. Well, the reason for that is they were only around for 90 days. Now, it's been 180 days. And we know the immunity lasts that long. So we're going to learn more about this. We're going to learn about the need for boosters. But right now, we know that they're effective in the ways that they're given.
CYNTHIA LEIFER: That's great. So all of this sounds so positive. Are there any limitations to these vaccines? One of the things we're hearing about is variants. And some people who emailed us asked about variants.
GARY KORETZKY: Sure. So there are two big limitations. One is the vaccines are not 100% effective. So that even if you've been vaccinated, you should be aware. You should realize it's possible to become infected. If you're symptomatic, if you're at Cornell, do the daily check even after you've been vaccinated. But so one of the limitations is that they're not 100% effective. But they're better than not having the vaccine.
It's also possible that the COVID virus is going to change over time. We know that variants exist. One of the ways that these variants come about is that the virus circulates in people. It changes when it's in people. So another big, big advantage of vaccination is that you decrease the number of people who can become infected. You decrease the rate at which the virus can then mutate.
But the variants exist. And we have to be aware of it. We study them. There might be a need to change the vaccines as a booster to respond to different variants. And, again, we're going to be learning about that as time goes by. The pandemic isn't quite over yet. We've got great tools now. And it's really important to use them.
CYNTHIA LEIFER: You make some really great points. And I know that I get asked very frequently, do I still need to wear a mask after I get the vaccine? Can I go out and socialize with my friends? And I think you make the good point as we just don't know yet. Because there aren't enough people in our community who have gotten the vaccine and who are protected. And there are these variants that could potentially arise.
So for now, we still need to do all the distancing measures, wash hands, wear a mask, stay six feet apart for the time being. So that's great. So I'm going to let you out of the hot seat now. And I'm going to put Professor August in the hot seat and ask you a question. So we had a lot of questions about vaccine reactions. I certainly was tired yesterday and had some fever and aches from my shot on Saturday.
So we were specifically got some questions about the fact that some people get fatigue, aches, pains, fever. And some people have just a sore arm or no reaction at all. Does it correlate? So if someone, for example, only gets a sore arm or has no response, should they be concerned that they're not protected?
AVERY AUGUST: Thank you. Thank you, Cindy. That's a fantastic question. I personally had the same experience, where in my first shot I had very mild symptoms. And my second shot was definitely more serious. And I will say that those symptoms that most people report is part of the normal process. I mean, if you think about it, when you have an infection, your body is sort of going through the process of responding to what it thinks is an infection. Because that's what we're trying to do with the vaccines.
And that's part of the normal process. And it shouldn't last for very long. But it will certainly be part in varying degrees, depending on-- there's a number of factors that determine how we respond to immune challenge in terms of infections, genetics, environment, et cetera. And so there's going to be a range of responses.
With regards to the more serious concerns, which are some of the allergic type responses, certainly if you have allergies that you know if, if you have autoimmune status, if you have some compromised immune state, then you should definitely consult with your physician. So that you can get better guidance as to your particular situation and how you should approach getting vaccinated.
But for most of us, we will have varying degrees of symptoms that come from either the primary and/or the secondary time we get vaccinated that might vary with regards to the symptoms.
CYNTHIA LEIFER: That's great. So this is interesting. Because you're raising the question here or the point of, should you consult your physician or what? And what about if you're young and healthy and health and wellness focused, how do you make these choices? Can lifestyle protect you? I think it's important to know also if you've had COVID that the recommendations are that you should get the vaccine. And that there's no reason to wait to get the vaccine if you've had COVID. Because it's basically just like getting a booster vaccine if you've had a vaccine. So that's not a big deal.
They do-- I do know that if you have had COVID and you had severe disease and you had some of those more novel immunotherapies, you should consult your physician. Because there are some instances if you've had some monoclonal antibody therapy or whatever, they do recommend that you wait. But in general, there's no reason to wait. But what about these people who are young and healthy? Can maybe-- Professor Fowell, can you comment on that?
DEBORAH FOWELL: Yes, thanks Cindy. Yeah, I think we all have to weigh up the sort of pros and cons of . Vaccination I know everybody's thought about that as they enter this important decision. But there are already two things to bear in mind. Is that you're making a personal choice, but you're also making a choice that affects your community. And I think Dr. Koretzky brought that up. And I think it's something that we have to be really cognizant of as we're doing this.
So the risks of not getting a vaccine is that, yes, you could get mild disease. You could get severe disease. And you can die. And it's not simply an age or lifestyle component that will dictate how you respond on that spectrum. And once you recover from the virus, there are discussions now of many people experiencing long-term damage to their lung tissue, to their heart, to their brain.
And so the opportunity to get the vaccine and to prevent these complications due to the actual infection I think is incredibly important. And we do know that the vaccine is very effective, nearly 100% effective, in certainly preventing death from the virus and the severe complications from having the virus itself. So that's a personal pros and cons that you have to weigh up.
But again at the community level, I think it's really important that, even if you get infected with the virus and are asymptomatic, you can be a carrier. You can transmit that virus to others in the community. So getting vaccinated up front, prior to becoming infected, will provide that level of immune protection that I talked about. That will mean that you are less likely to be able to, once you do get-- if you do encounter the virus after vaccination, you're less likely to harbor that virus and pass it on to other people.
And so I think it's incredibly important that this both personal and community responsibilities are brought into play as you weigh up those options. And I would again reiterate something that Dr. Koretzky said, is that if we get people vaccinated, we will be preventing the transmission of the virus and hence preventing the opportunity for the virus to mutate and create these viral variants.
And so you're also limiting the possible further outbreaks through this limiting the opportunity for viral variants to occur.
CYNTHIA LEIFER: So one of the things that people asked about as well was herd immunity. And you're basically getting that when you're saying protecting other members of our community. Although, we got several emails asking us what exactly is herd immunity. And I, like you, like to call it community immunity. Because I feel like we're protecting each other when we use that term.
But basically the idea is, if we have 100 people in the room and one of them sneezes and releases this, and everyone in the room is susceptible, they could all get this. And then they could spread it to others. Whereas, if we have 80% of those people, so we have 80 out of the 100 individuals have already had it and recovered or have had the vaccine, so either one would provide you with that level of protection, and now there's a sneeze, there's much less likely for people to get infected. And it's much less likely for them to then spread it.
And so it is that idea of we're reducing the number of vulnerable people who could become infected and reducing the chance of spread in the community. We're reducing the development of variants. And lastly, and most-- one of the more important ones, is not everyone can get a vaccine, right. Some people are allergic. Some people have immunocompromised diseases or are undergoing chemotherapy or whatever, and they can't get the vaccine.
And so if we get the vaccine, we can protect those individuals indirectly. And so that's really that idea of herd immunity. So those were the main questions that we had that had come in via email ahead of time. And so I was hoping that right now we could kind of switch to the multitude of questions that are coming in by the Q&A. This is fantastic. I'm so pleased to see that people from our community are so very engaged.
And so let's see. The first question we have here maybe-- maybe Deborah, I can go back to you, is, why get the vaccine if somebody has already had COVID? So if they're protected, why do they need to get this again?
DEBORAH FOWELL: Well, the vaccine will boost that protective immunity that has been provided by getting the virus and recovering. And also, we don't know enough yet about the protection afforded by getting the virus and recovering. So viruses have a whole arsenal of effects that they utilize to try and suppress the immune system in order to evade immune attack and live longer in the host, in the individual.
And so we don't know the interplay between the virus and how much it suppresses the immune system. Obviously, if you've recovered from the virus, you've generated an immune response that at least could get rid of that initial viral infection for sure. But the virus will help boost that immunity and potentially provide longer lasting immunity than maybe you will get from recovering from the virus itself.
CYNTHIA LEIFER: So that raises a good point about how long does immunity last when we get infected or if we have the vaccine. Maybe Professor August, can you kind of give us a little answer to that one?
AVERY AUGUST: Yeah, that's a great question, Cindy. So as Professor Koretzky said, we know what we know because we've been doing-- people have been vaccinated over the last, I guess, nine months or so. And so what we do know is for those who got vaccinated earlier on in the vaccine rollout is that they're still being protected. So we know that at least six months has passed and those individuals still have a high level of protection.
So it could be that the vaccine lasts for a much longer time. It could be that there's a significant drop off after six months. We just don't know because we haven't had the data, the studies to be able to do that. As time goes by and as we analyze more of the vaccine studies, we will have a lot more information about how long it lasts, whether it's six months or nine months.
I will say that one of the individuals who was involved in developing different Moderna vaccine recently announced that they're still analyzing the studies. They're still analyzing the serum. And so as soon as they have the data, they'll release it. And we push it out a few more months as to how long the vaccine lasts. So as we get the data, we can be more confident in saying that it lasts this much longer. But for right now, six plus months is what the studies show.
CYNTHIA LEIFER: Fair enough. And based on other vaccines, other than the flu vaccine where the flu virus actually changes each year, for these other types of vaccines that we have, the indications are that the protection lasts quite a long time. So the expectation is we'll gain more information. And it will last longer. So--
AVERY AUGUST: Yes.
CYNTHIA LEIFER: Thank you for that.
AVERY AUGUST: And actually, just to add to that, one can try to predict based on the protection that's happened now. And certainly, we can project that it will last longer than six months. But the studies confirm that that's what-- that's the data that we have.
CYNTHIA LEIFER: Right. So we can only say based on the data we have. Right. OK. So this next question, I'll take this. So is there any truth to the claim that the vaccine could potentially affect fertility? So are there data on pregnant women? Are we worried about giving it to young people? What we can say is-- I don't know for those of you who have had the vaccine if you did the vaccine registry.
So there's this V-safe. You use the little QR code. You put your phone on it. And I get a notification each day that I put in whether I have any side effects that day, how I'm feeling. They do ask, if you're a woman, if you are pregnant or if you have become pregnant. And so they've been following that. And we only have data as of February. Because, again, that's where they've collected the data.
But they've followed at least 1,815 pregnant women that either got the vaccine after they got pregnant or got the vaccine and then became pregnant. And they've followed 275 births as of then so. And basically what they've looked at is whether any of the outcomes in birth or complications are any different than what happens in the normal population. And the answer is no.
So as far as the data show right now, there's no indication that there's any issue with becoming pregnant or maintaining pregnancy or any adverse outcomes based on the data that are available. So that's what we have right now. So I personally don't have any worry about that at this time. So let's see. I'm trying to-- as a moderator, it's hard for me to kind of monitor the chat, look at the Q&A, and interact with all of my people. But I'm doing the best I can here.
So let's look. The next question, let's see, we can give this to you Professor Koretzky. Can you speak to the lack of knowledge about the long-term effects of these new vaccines, simply because they've only been around for a year, right? And your thoughts on risk long-term or lack thereof.
GARY KORETZKY: Thanks, Cindy. And you're a great moderator. So I think-- so I think the questioner answered their own question. And that is, we just don't know yet, right. But boy, I'll tell you that so far it's been a great experience. I think nationally, I think Cindy said there were 189 million doses given. It's now, I'm sure, more than 190 million. And the safety profile is excellent.
Is there absolute 100% certainty that there won't be an unexpected long-term risk? Well, the answer is no. I mean, I've been a physician for, well, too many years. And there's like no certainty. But we can be really, really sure. We can be really confident. And these vaccines work like other vaccines. You put the protein into the body. You make an immune response. And it has been done now for decades.
We have tremendous experience. The consequence of not doing this, we know what that is. And that is hundreds of thousands or millions of people will die. The consequences of doing this we think are that-- we know will save those lives. And also there's just no evidence yet of long-term risk.
CYNTHIA LEIFER: Thank you. I think that's about the best we can possibly say. Risk is always a hard thing to understand. But there's risks with drinking too much water or taking aspirin. There's risks to everything we do every day. And the risks of these vaccines and the safety profiles are just very, very-- the risks are low and the safety profiles are high. And so we just go with that.
Actually, you know what? There's one here specifically for you. It says, Professor Koretzky has used the word approved several times. But the FDA has only granted emergency use authorization. Can you-- can you kind of address, what is the difference? So what does it mean that we don't have approval yet? And is that-- does that change how we should think about safety?
GARY KORETZKY: Yes. And I would say we do have approval. We have approval under emergency use authorization, right. And the FDA does this in public health emergencies. If there is an urgency for a new therapeutic, for a preventive measure that has been tested, that has been demonstrated to be safe and effective, the FDA will say, boy, we do a lot more typically. But we're convinced. And the convincing came from those tens of thousands of people that were studied and now the millions of people that have been inoculated with these vaccines.
There will be formal approval. I don't think that's high on the radar right now for the FDA. Because they're busy. There are other vaccines that are being studied. But it's really, really important to emphasize that the emergency use authorization is not a shortcut. It's exactly the same questions. It's exactly the same rigor of analysis. And it's saying that, in the setting of this public health emergency, we're going to do this now.
A vaccine might typically take years to go through all the approval processes. And that's OK when there's not a public health emergency. So this time is different. And I hope that everybody will be confident that the FDA has put this at the highest level of their workforce or their workflow and have done it with the rigor. There's a lot of information exactly about this on the FDA website.
CYNTHIA LEIFER: Great. There is a lot of information on the FDA website. I encourage people to go there if they want to learn more information. The CDC website as well has a lot of really useful information. There's one question here about my friend or a family member avoids medications and immunizations. They don't even get flu shots. How do I talk to them about these vaccines?
I can take this one. There's a lot of vaccine hesitancy out there. And understandably, people are nervous about these new things. A lot of people don't like new things. They don't like change, whatever. So we have to understand that. And I think the first thing that I usually ask people when they say they don't want to get the vaccine, I ask them why and try to get at the root and really listen to what they have to say, and then try to answer the questions that they have.
Because if you try to talk to them first and tell them all this information, and here's why it works, here is the immune system response, all of that, they kind of tune out. Because they haven't been heard yet. And I think we really have to recognize that some people have fears or have hesitancy or have worries. And so listen to them, but then also be able to point them to resources where they can get the information that they need.
And at least for me, I usually say this isn't the flu. You know, this is not the flu. We introduced-- this virus came into the human population with not one single person on this Earth being protected. And it has just spread like wildfire. And until we get a certain level of protection, it's going to continue that way. Why isn't that the case for the flu? Most of us have had the flu at one point or other in our lives. And yes, the flu changes from year to year.
But there's a base level of protection in the population. And there's also vaccination against that. And so it doesn't spread like this disease spreads. And furthermore, this is affecting more people more seriously than the flu. And it's killing more people than the flu. And so it's not the flu. We do need to get the vaccine. And really, the only way we're going to get back to what our-- whatever our new normal will be is to get as many people immunized as possible.
OK. So I'm trying to read and talk at the same time here. So ah-ha, here's one about do the vaccines help so-called long-haulers? That is something that we've heard some about. So maybe Dr. Koretzky, can you comment on that?
GARY KORETZKY: Yeah, so this is fascinating. And hopefully, this will really bear out. So very often when there are new diseases, we learn about them. When there over-- over time, when there are therapeutic interventions, we learn about that over time. And this was almost an anecdotal report. That individuals who have had COVID, some of them have symptoms for long periods of time. And some of those individuals would become vaccinated. And they feel better.
And that happens once. And you say, boy, that's great. It happens a few times, and you say, that's curious. It happens a lot of times, you say, we need to study this and really understand it. And we need to know whether that is something we can count on. And that's where we are right now. This is being actively studied. And the hope is-- and there's some biology that might be able to explain why this would be the case.
But the hope is that this might be a great way to help these individuals who are really suffering considerably from having had COVID. So the jury's still out. That would be a great benefit of these vaccines.
CYNTHIA LEIFER: Thank you. I think it's definitely a concern for people who have had family members who had it and are some of these long-haulers. It's a real problem. If we can compare really quickly to the vaccine, when you have that crappy day or two, that's better than months of feeling like that. So the vaccine is protective that way. Anyway, so we don't have a lot of time left.
Let me give the next question to Professor August. And then we'll see where we are. So, insofar as the flu vaccine changes annually for particular strains, would additional coronavirus vaccinations be similar? Or would they more closely resemble other periodic booster shots?
AVERY AUGUST: That's a great question, Cindy. So a few things before I get to the answer, one is the flu vaccines are based on the changing strains that occur periodically every year or two. So each time, we have to predict what strains will circulate. And we have to generate a vaccine that matches that strain. And that's why that requires annual changes.
With regards to booster shots, on the other hand, that's usually used to boost immunity that's waning. So, for example, if we discovered that the current vaccines only protect for six months, just on the short side, then we would want booster shots of the same vaccine to be able to boost your immunity to be further protected. So those are the two differences.
Now one of the things that the questioner perhaps is asking is we have these strains that are now circulating, these variants that are circulating. And that could be the reason for potentially likening it to the flu situation. One of the things that both Professor Koretzky and Professor Fowell talked about is this-- and Professor Leifer is this community protection. As we get more individuals vaccinated, we reduce the circulation of the virus. We reduce the rate of generating new variants. We reduce the need for new vaccines that have to address those variants.
And then the second point is that the current vaccines are protective for most of the variants that are circulating. And so we would only need to have booster shots if immunity wanes, that is immunity doesn't last as long as we think it does, or there are variants that now breakthrough that are not protected by the vaccines that we're currently used right now. So that's sort of our understanding of whether we will need booster shots. Again, the answer is the data will tell us as we hear, as we know more.
CYNTHIA LEIFER: Thanks. And one thing that I wanted to follow up on that, if you don't mind commenting on it quickly, or maybe Dr. Koretzky can, mixing vaccine types. So people have asked, if I got one shot of J&J, can I just go get a Moderna? Or if you've got a Moderna, could you switch to Pfizer? Could you just comment on that quickly?
GARY KORETZKY: So maybe Avery, I'll take that. And then you can add if you like. Because it also brings up something else very important. And that is, when are you fully vaccinated, right? So I'll ask-- I'll address that first, Cindy. And then I'll talk about mixing and matching. So fully vaccinated by definition by the CDC is two weeks after your ultimate dose. So if you got Moderna or Pfizer, it's after two doses. If you've gotten Johnson & Johnson, it's after your single dose.
And two weeks after that is when you're considered fully vaccinated. And that becomes really important. Because the health department will not ask you to quarantine if you've come into contact with somebody with COVID if you are fully vaccinated. But that is the definition. And unfortunately, again, because of how we've studied the vaccines, we are just not comfortable saying, if you got Moderna and then followed it with Pfizer, that that is a way to become fully vaccinated.
So when you get vaccinated, you get your first dose. You get an appointment for the second dose. It's with the same vendor. It's with, if it was Pfizer to start, it's Pfizer for your second dose. We may learn more in the future. We may figure out that it's better to get one Pfizer and then one Moderna. But we're just not there yet. So that won't give you the opportunity to be considered fully vaccinated if there's mixing and matching.
And I will just make another statement about non-US vaccines. They are not approved in New York State as counting for full vaccination. So if you have been vaccinated by a Sinovac by Sputnik V, the immunity may be just as good. But we haven't studied that. We don't have the data. That's probably going to be forthcoming. So if there are individuals who have been vaccinated abroad, they are eligible to be revaccinated in New York.
And that is really recommended because then you are able to then be designated as fully vaccinated. And if there are contact events or whatever, the health department would be very comfortable then saying that, again, you don't have to quarantine.
CYNTHIA LEIFER: And you raise a good point that I wanted to say is that we-- we're not getting into policy. But just to remind everybody that they can register their vaccination status. How do you do that? Can you remind everyone?
GARY KORETZKY: I can. So it's easy. So far 7,000 people have done it, as of about 4 o'clock today. And this is for the Cornell community. Through the daily check, you go to the bottom of the daily check. There's a button. And it says something about register my vaccination. I don't remember exactly what we've called it. And you go to an app. Very simple, you indicate when you were vaccinated, where, meaning which state in the country or outside of the US, who the vendor was, and the dates.
And then you're asked to take a picture of your vaccine card and upload it. So it probably takes about two minutes. A great time to do it is while you're waiting at the time of your second vaccine. You have to wait for 15 minutes. So if you're sitting there, it's a great thing to do on your phone. We have a group that verifies it. It will probably be verified within 24 hours. You'll get an email saying that now you've been uploaded into the system as fully vaccinated.
And this is so critical because of what Cindy was talking about. And that's herd immunity. If we want to have a normal semester in the fall, we need to have herd immunity. The only way we're going to know is if by knowing who's been vaccinated. So the more information we can get, the more we'll learn about how we're doing, and the more we'll learn about what we can do and what sort of restrictions we'll be able to relax as the summer and then the fall begin.
CYNTHIA LEIFER: Thank you for that. I know that was just a little bit of policy. But I think it's an important thing. Because we're all now getting vaccinated. We need to register that. So I'm just being cognizant of the time. We're coming up to the end of our time. And I just wanted to give our panelists an opportunity to respond to anything they've heard or raise any additional issues that they have, questions that they've heard from family members or their community members that they think are important to answer.
I think we've covered a lot of ground today. So any of the three of you want to make final comments?
GARY KORETZKY: Cindy, I'll just say that there are more than 1,000 people listening. And that's phenomenal. And thank you so much for taking the time. You know, this is in probably all of our lifetimes, this is unprecedented what we're going through. There is light at the end of the tunnel. But it's only if we can get past this. And the only way to get past this is by having people vaccinated so that the potential, the risk of COVID diminishes. So I just want to thank everybody out there for taking the time and listening and making good decisions.
CYNTHIA LEIFER: Thank you. I also wanted to say that thank you for listening to immunologists. We all are-- we spend our entire lives thinking about these little cells that circulate around our body looking for infections and killing them and killing cells that are infected. And to be able to share that passion with the community and on such an important topic at such a critical time, I think we're all thrilled to be here.
So are there any other things that you guys would like to say before we close out?
DEBORAH FOWELL: I can mention a personal interaction I've had with my son who is a senior in high school and has been saying, I don't need to get vaccinated. I'm just fine. I'm not going to get sick from this. And so I have, as you can probably tell from my comments throughout this session today, I have constantly said, you do it for your fellow man and woman, the community.
And it's really important right now that we all step up and get vaccinated and prevent the transmission and hence the time which it might take for that virus to mutate and generate new variants. I think it's incredibly important. And I really appreciate all of you coming and listening to us. We're clearly very, very passionate about what we do. And I appreciate you listening.
AVERY AUGUST: And I would also like to add my thanks to all of you who are listening and joining for this webinar. And finally, just adding, any of the three vaccines that you get, take it, because all of the things we're talking about apply. You will be protected. And you will reduce the spread of the virus.
CYNTHIA LEIFER: Great. I want to remind everybody that the video of today's discussion will be available on CornellCast later this week. And we are coming up on exactly one hour. So I want to thank everyone, thank you everyone in the community, everyone in the Cornell community, as well as the extended community and Ithaca, for joining us and listening to this. I hope that-- my hope is that you not only have learned something today, but you've learned something today that you can take away and share.
Because we're here in the spirit of educating. And so I hope that we've given you information that you can now help educate more individuals and spread the knowledge so that we can get past this pandemic. So, again, thank you. And we will see you later. Bye-bye.
Vaccines are changing the course of the COVID-19 pandemic, but many people are left wondering how they work, whether they’re safe and effective, and how vaccination can protect public health. In this virtual question and answer session, a panel of Cornell vaccine and immunology experts answer audience questions about the science behind the vaccines and share answers to some common concerns.
Please note: Two COVID-19 vaccines – Pfizer-BioNTech and Moderna – are currently being distributed in the U.S. The day after this webinar with faculty experts, distribution of a third vaccine, Johnson & Johnson, was paused while the U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) investigate a few reported cases in which recipients experienced a rare form of blood clots.
