How a molecule gets to the masses

Good afternoon, readers.

Have you heard the good news about COVID vaccines?

That’s right. In the span of mere days between the Food and Drug Administration’s (FDA) emergency authorization of Pfizer and BioNTech’s coronavirus shot last Friday to the initial rollout of said vaccine earlier this week, some Americans are beginning to get their first COVID vaccine doses. In a separate vote on Thursday, FDA advisers also voted to recommend Moderna’s vaccine, clearing the way for emergency authorization as early as Friday.

The priority, of course, is for the health care workers on the front lines and the most vulnerable Americans, such as long-term care facility and nursing home residents. But the real marvel to me is the very process of how a vaccine travels from the minds of scientists to the arms of the populace.

It’s worth taking time to marvel at exactly how fast this process has gone—and the myriad challenges which remain.

When companies develop a drug or a vaccine, what they’re really looking to do is suss out a pathogen or biological target’s weak spots. That can take place via, say, throwing a random assortment of molecules and disease-fighters at a specific target in the body. And it’s a process which can often be informed by decoding a biological foe’s genetic code to maximize your chances of a successful biopharmaceutical.

That’s how the R&D part of the COVID vaccine effort went down. Now, it’s all up to a motley crew of players to plan out how to actually get these things to people like doctors and nurses in the safest way possible. And that includes prioritizing exactly who, within a hospital, should be prioritized for getting the first doses.

Dr. Melanie Swift of the famed Mayo Clinic health system is helping lead such efforts on the ground for her own hospital system. It’s an approach that requires keeping tabs on just how close contact nurses, physicians, and their support staff (like those who may have to clean up an ICU) have with COVID patients and their corresponding risk.

“We’ve provided a grid of different tasks and places where our people might work” in order to prioritize how the vaccine doses are doled out, she tells Fortune. “So the COVID-specific unit, for example, emergency departments, a COVID outpatient vaccine infusion center, etc” would be among the first to get vaccine doses once they reach Mayo’s various affiliate hospitals.

“There’s about 10 or 11 of these different risks and settings for our various employees. And it goes all the way down to outpatient clinics, non-direct patient contact staff, and teleworkers. So we’ve got this grid. We actually sent these lists out to the appropriate level supervisor,” says Swift. Those supervisors then check off columns for those they oversee to help Swift and her team determine this vaccine resource allocation.

For more on that conversation, and chats with informatics experts faced with this logistics challenge, head on over here.

We’ll be offline next Thursday (and the Thursday after that) due to the upcoming holidays. Read on for the day’s news, and we’ll see you again in the New Year on January 7. And as a personal request to readers: Let me know what mattered to you most in the health care world this year. And no, it doesn’t have to be related to COVID.

Happy holidays to all.

Sy Mukherjee


Behind ZocDoc's personalized COVID vaccine platform. I spoke with ZocDoc CEO Oliver Kharraz about the company's new efforts to serve as an information hub about the local availability of COVID vaccines. There's a twist to what ZocDoc is doing: The service is free, and you don't have to be a member. It pools in state and local health data in order to provide personalized advice on what steps someone may be able to take in order to get vaccinated. “We understand ourselves really as sort of a marketplace, where consumers can find what’s available to them,” Kharraz says. “And we are, in some ways, a neutral entity. So in that respect there’s a broad spectrum of services Zocdoc users can benefit from. We don’t have a horse in this race. We can just try and put forward what you think is objectively the best information for patients and give them the ability to act on this.”(Fortune)

FDA approves pioneering implant for repairing torn ACLs. The FDA has approved the first-ever implant to help repair torn ACLs, among the most common and debilitating injuries faced by athletes. The BEAR implant from Miach Orthopaedics essentially allows ACL injury patients to avoid expensive and intrusive reconstructive surgery by slowly releasing a flow of collagen back into the injured area, facilitating growth and healing. And it supports the theory that future of medicine is all about being as non-invasive as possible. Just look at the roster of robotic surgeons out there these days. (FierceBiotech)


It's Moderna's turn at the FDA. Just a week after an committee of expert advisers recommended Pfizer/BioNTech's COVID vaccine for emergency authorization (advice which the FDA heeded just a day later), the same committee decided to endorse giving Moderna's own mRNA-based COVID vaccine the same treatment, setting up a speedy emergency authorization. While Moderna's vaccine uses similar technology to Pfizer's, it has different storage requirements, including a less extreme cooling threshold, which could significantly expand the pool of vaccine doses which are out there.


The scale of the pandemic just keeps surging. I'm tired of using the phrase "grim milestone" at this point, but unfortunately we just seem to keep reaching grim milestones. Early Thursday morning, we found out that more than 3,600 Americans had died of COVID in a single day. In addition, there are more than 113,000 active COVID-related hospitalizations, per data from Johns Hopkins. Of course, this is why the vaccine campaign is so critical as we head into what could be a very dark winter when everyone may not have the option to keep gatherings outdoors or socially distant. Vigilance and collective responsibility remains as important as ever. (NPR)


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