EPISODE 6 – Fighting COVID-19: How Public Health Measures Support Vaccine Research
As the Director of the Canadian Center for Vaccinology and Primary Investigator of the Canadian Immunization Research Network, Dr. Scott Halperin is at the forefront of efforts to provide Canada with the national capacity to undertake vaccine and infectious disease research. In this episode of the Beyond Research podcast, you’ll hear how Scott and his team of over 130 investigators at 50 institutions are working on important COVID-19 research urgently needed by Canadians.
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Rhys Waters 0:03
Welcome to be on research, a podcast brought to you by research Nova Scotia.
Stefan Leslie 0:11
Scott Halperin is the director of the Canadian center for vaccinology and the primary investigator of the Canadian immunization Research Network. As such, he's at the forefront of efforts to provide Canada with the National capacity to undertake vaccine and infectious disease research.
Scott Halperin 0:28
You know, infectious diseases are always there. But we tend to be able to ultimately control them. We've done that great amount of control of infectious disease over the last couple of 100 years, and that infectious diseases are not the number one killer anymore.
Stefan Leslie 0:43
Today, you'll hear how Scott and his team of over 130 investigators at 50 institutions are working on important COVID-19 research urgently needed by Canadians. Morning, Scott, good morning. Can you tell me a bit about how you yourself got into this work? What of it is most interesting to you?
Scott Halperin 1:02
Yes. So I'm an infectious disease specialist. And I've been doing that for a long time. And the thing that excites me about infectious diseases is that it's constantly changing. There are always new infections. You've heard the term the World Health Organization talks about public health emergencies of international concern. Well, there have been six of those, you know, in the past 10 years starting from the pandemic h1 and one things that people that emerged and then people forget about so we had the Zika virus, which was causing damage to you know, fetuses and and then we had SARS, the first SARS Coronavirus back in 2003. So infectious disease is always changing, it means that we there's always going to be interesting work to do. So I got into infectious disease because of that. And I've been doing it for a long time. And I've gone through a lot of new infections. This pandemic is obviously the biggest one globally. And you know, I think it makes for very interesting days.
Stefan Leslie 2:00
We mentioned the Canadian center for vaccinology. And then the Canadian immunization Research Network. Can you describe what each of these two organizations does?
Scott Halperin 2:09
Sure. So the Canadian Immunization Research Network, or we call it CIRN, is a Research Network funded by the Public Health Agency of Canada and the Canadian Institute of Health Research Cir. And it's made up of eight sub networks, each having a specific targeted type of research that it does. And the purpose of it was to establish the infrastructure for Canada to do research that's of importance for public health decision making, and was specifically set up for preparation for a crisis like we're now pandemic. In fact, the network was first set up during the h1 and one influenza pandemic in 2009. And then it's been continuously funded since then to do research in between pandemics, but always to be on guard for a pandemic and to be able to do that type of research.
Stefan Leslie 3:00
So this originated with a twin n one that's going back quite a few years now did that establish us in or did that put us in good stead to prepare for the work that needed to be done in the face of the current pandemic?
Scott Halperin 3:14
It did, it's important to have infrastructure that does the type of research that takes time to establish because, well, people can pivot and change individually in their labs can do work on on a new area, and when in emerging crisis like this. So for example, one of our sub networks is called the Canvas Network, which is a Safety Network. And that network on an annual basis looks at the influenza vaccine as it's rolled out each year, because as you know, the influenza vaccines changed every year. So it's in a sense, almost a new vaccine each year. And that network looks at 40 to 50 60,000 people who had the very beginning of the programs when they get their vaccines, to look at safety to make sure there's no safety signals, that provides reassurance to the rest of Canada, that the vaccine for this year is is safe, that network is going to be pivoting to look at COVID-19 vaccines when they're rolled out. It hasn't done that work yet, because there is no COVID vaccine yet, but once it is, and it's being used in large numbers of people, that networker is there to do that early safety surveillance that Canadians want, which is to make sure the vaccine is safe.
Stefan Leslie 4:31
It's quite remarkable that isn't it that all of these organizations which did exist have have quite impressively, all pivoted to working on this pandemic. The question I've got is when you read about all the development efforts internationally, this is going on in a number of different countries, a number of companies are looking at it there's perhaps dozens at some stage of development is that kind of work company in a positive way, or competitive in a negative way.
Scott Halperin 5:04
Right now, things are competitive in a positive way. There's a lot of data sharing a lot of information there. I mean, right now, there are now over 200 vaccines that are in various stages of development, over 40 that are already in clinical trials. That information is being shared quite extensively. And most of the developing new companies developing it are sharing resources. So you hear of even some of the major competitors, the large multinationals are joining together, where one company has the technology in the antigen and other company has a technology in the admin attributes are things that still help stimulate the immune system. And those companies are working together. So we're seeing a lot more sharing of technology and data now than we do in between, you know, outside of a crisis.
Stefan Leslie 5:51
Is this the kind of crisis that requires multiple vaccines? Or is this the kind of pandemic which could result in a single vaccine that's effective across the board is? In other words, do we need to develop these vaccines in parallel, because they may be more effective in different circumstances, one from it from each other?
Scott Halperin 6:13
It will be a real failure if we only have one vaccine that's successful. And the reason for that is that there is going to be a huge demand for this vaccine. So it's, typically we talk in millions of doses, we need billions of doses. And there is absolutely no company that can scale up to that degree. So we need multiple successful vaccines in order to meet the need across the world, there are probably about six different types of vaccines we call platforms of vaccines. And the hope is that we'll get successful vaccines from multiple platforms. And because just as you said, we may find out that, you know, one platform works better in the elderly, another platform works better in children and other platform doesn't work better in some specialty populations, but but does reasonably well for relatively healthy people. If we have multiple vaccines, we can target different vaccines, different products for to the different populations, and thereby be more efficient in how many vaccine doses we can get out there. So you do meet that global need.
Stefan Leslie 7:22
When you read about the development of vaccine. Commonly you hear that until we have something that's effective, and available to the majority of the population, that we are going to continue to be in this world of other public health measures, quarantine restrictions on travel, wearing of masks, many of which presumably ought to continue because they represent good, ordinary health, like preventing the flu. washing their hands, I think has been a pretty good idea for many decades. We've understood that. But can you talk a little bit about your research as it relates to the efficacy of these public health measures, and the impact that those have on on a variety of populations?
Scott Halperin 8:03
Yeah, so one needs to be able to do things immediately. Well, one allows technology to catch up technology being vaccines, and we need to do things, simple things, public health measures, very early on, because those can be done immediately. And those are things that have been done for 100 years, things like isolation, quarantine, distancing, washing, hands, masks, those are things we know that can slow down or prevent the spread of infection. And we know they work. the Maritimes is a excellent example of how things can work. Some other jurisdictions around the world are excellent examples how if you don't do those things, they don't work. And we need to be able to allow the technology allow the number of vaccine doses to catch up. And in the meantime, still not put people at risk. So these public health measures are going to be with us for quite a while. And people do need to get used to them and learn how to live with them, despite the restrictions continue on. Having said that, there are a lot of policies, a lot of public health policies that are put into place there, they affect people differently, different people, you know, if you if you're told to stay in your home and stay home, that's great if you have a home, if you you know aren't able to socially distance within a home in your own home with multiple different people who are unrelated. That's a problem with these policies. But policies at the higher level are implemented very broadly and at the local level need to be interpreted and need to be implemented. And some of the research we're doing is looking at how policies are interpreted from the central level down to the local level down to the community level down to the individual. And what we're trying to do is to see how these policies affect different people. differentially, and whether that information can be fed back to policymakers in such a way that policies can be nuanced, and what level that's best to be fed back at whether it's at the central level or whether it's more at the community level.
Stefan Leslie 10:13
Why is it important for public health policy officials to understand the impact of the varying impact of those decisions on different communities?
Scott Halperin 10:24
Policies are only effective if they're followed. And understanding how policies are affecting different communities differentially allows you to nuance the policies to make sure that the effect that you want, by implementing those policies is achieved. So different people in the communities may interpret those policies differently, they may feel that how they affect them is different, and therefore they don't apply to them. So understanding their perceptions of the policies, and how they are actually carrying them out. For example, if you tell someone to wear a mask, but they take their mask off, you know, in order to talk to somebody, it's not achieving the goal. We heard the mass policies in schools, where kids were coming home with different masks, and they say, Oh, yeah, we all change masks. And then the older kids because they're smarter, and more educated before they get on the bus, they all get their own mask back so that their parents don't know that they changed them. So even going down to the children to understand how they understand the policy is important, because you're not achieving your means everybody might be wearing a mask. But keeping the same mask is very important.
Stefan Leslie 11:35
Are there particularly vulnerable parts of the population that are of special concern to you?
Scott Halperin 11:42
The populations that don't have access to all facilities and services are a particular concern. And we know the pandemic is is asymmetrically affecting different populations of racialized communities, as well as communities that are, for example, having issues with homelessness or under housing, food insecurity, the pandemic is absolutely affecting these groups differently. And one of the groups that we're looking at with our research grant, is NGOs are not for profit organizations that serve populations that are at risk. And we want to look at on an organizational level, how do the NGOs interpret these policies? And how do they have to pivot to serve the particular populations that they do? And then also try to look at how those populations feel about these policies and how they're affected by them, and how that differs from populations that are not at risk. So I mentioned homeless, this is a one that we're particularly concerned about, also looking at NGOs, that serves populations who women who are suffering domestic violence, but there's so many different communities that can be adversely affected, we'll probably just be looking at a select few as an example of how there is a differential effect of the pandemic on different communities.
Stefan Leslie 13:07
In your work looking at the impact and the value of different public health measures. Does that also include the interest in vaccine uptake? Or put the other way? Was it potential resistance to vaccine uptake?
Scott Halperin 13:22
Absolutely. And that's one of the highest priorities of the Public Health Agency of Canada, in terms of preparing for when vaccines are available, to understand whether Canadians are going to want the vaccine and whether they will take, take it. We've heard surveys that say that as many as 30, or 40% of Canadians don't want the vaccines and right now, there's a wide divergence in the public's perceptions and desires. When we announced that we will be doing some of the vaccine trials in Halifax, we've already received over 500 people who want to be part of these vaccine trials to test the vaccines. So there is a certain proportion of the population that can't wait for it to come. On the other hand, there are people who say No, I'd rather wait a couple of years until I see that it's really safe. So trying to understand how people think about vaccines, what goes into their decision making process is very important. And that's one of the priority areas of research for the Canadian immunization research network.
Stefan Leslie 14:30
So you are on the vaccine development side. And of course, there's other parts of the system that work on the approvals process and the testing. Should we be fully confident that when a candidate vaccine has completed the trials process and has been approved for use that it is that it will be safe for the population.
Scott Halperin 14:52
The Canadian regulatory system is a incredibly well developed system that that is purpose is the primary purpose is to make sure your product is safe. And then also that it's effective. And well, the Health Canada, which is the regulator is accelerating the process by making some of the steps more efficient and overlapping, they are doing nothing that compromises the safety, the safety is still the number one priority. And the Canadian regulators, unfortunately, not receiving any and is well positioned to resist any political pressure, which in we know from the US, that's a concern. The Canadian regulator will not allow political pressure to interfere with its regulatory process. And they've demonstrated that, that while some vaccines have moved forward very quickly, others are requiring more data before they can get into clinical trials.
Stefan Leslie 15:55
So no steps are being skipped. Science is being able to proceed as it should, and then the regulatory process does ensure the safety security and efficacy of the of the process.
Scott Halperin 16:05
That's right. That's right, I have no concern that a vaccine that is released before use in the public will be safe.
Stefan Leslie 16:13
I recognize of course, that research is underway. And it can be very unpredictable how long things take, but do you have an understanding of what a likely timeframe, I'm not going to ask you when a vaccine is going to be available? Because that that implies that we understand the production and distribution. But just to the point where we've gone through the various stages of evaluation, on the scientific side? What's the timeframe that we're looking at for some of the more advanced I think you mentioned, there's 30, or 40, that are in some stage of testing of the 200 or so candidates? How far along are those?
Scott Halperin 16:48
Yeah, so, you know, back in February, when the COVID-19 was first declared a pandemic, the estimate was, well, we could have a vaccine in 12 to 18 months. So that would be February to August of 2021. Things are still on target for that prediction, probably not enough vaccine for the whole world. But at least a couple of vaccines may well be there we we have about 11 vaccines are now in phase three studies. And phase three studies are the type of studies where one looks, they've already gone through the early phases to test a safety test with the immune responses, and now they're being looked at to see do they work, we should get some reports of efficacy from those very first vaccines, possibly even by the end of this calendar year. Which means that we could have doses ready for some populations by even January. So that you know that that 12 months, the early part, that doesn't mean we need to stop, because so there are, there are a number of vaccines that are just about to get into phase one studies. Now, we need to continue to pursue those because those will be the vaccines that fill in the market need if they're successful. So it's a sprint, but it's also a bit of a marathon. We need to and those are going on in parallel.
Stefan Leslie 18:11
Is that are there any messages that you'd like to convey as a scientist directly to the population?
Scott Halperin 18:17
There is a trend around the world event sort of an anti science trend, which to me is very worrisome, because it gets the idea? Well, all ideas are of equal importance. It You know, I've got my data. And you know, my data is what I think as opposed to empiric data. So I guess my advice to public is to be critical and to critically think, but to make sure that that reliable sources are the ones that they use most in helping to form their decisions. That's great.
Stefan Leslie 18:52
Thank you very much, Scott. Well, it's been a pleasure. Thank you.
Scott Halperin 18:53
Rhys Waters 18:55
To find out more about this podcast and the research featured in this episode, visit research Nova scotia.ca. My name is Rhys Walters, and we will see you next time
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