“Pfizer has a particular onus to help intervene globally as one of the largest and most profitable pharmaceutical companies in the world. With its immense capital power, Pfizer should shift some of their spending from national ads promoting their vaccine product in a country that has large booster vaccine availability to sharing the technology that can help countries self-produce and vaccinate their citizens much faster.

Even if new production facilities had delays from receiving the mRNA technology protocol to production, the months spent toward self-producing could be expediting vaccine receipt for countries otherwise waiting until the end of 2022 for donated vaccines.

In a pandemic that is approaching six million global deaths, time is the most valuable resource in fulfilling vaccine equity. Countries cannot wait to save lives while wealthy pharmaceutical companies gatekeep vital technology.”

Amber Gipson-Fine is a project manager.

She shares her story and discusses her KevinMD article, “People over profit: Pfizer and Moderna must share vaccine technology.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show at KevinMD.com/rate. Subscribe at KevinMD.com/follow. Today on the show, we have Amber Gipson-Fine. She’s a project manager, and she wrote the KevinMD article “People over profit: Pfizer and Moderna must share vaccine technology.” Amber, welcome to the show.

Amber Gipson-Fine: Thank you for having me.

Kevin Pho: We’ll get to your article in a little bit, but first off, can you share your story and journey to where you are today?

Amber Gipson-Fine: Absolutely. Thanks again for having me on. I am a trained epidemiologist, so I practice public health. During the beginning of the pandemic, I was working in New York City, in the Bronx, doing chronic disease and psychosocial oncology program coordination. Then I transitioned. I was going to move to Chicago, as my partner, now husband, is located here, and since the pandemic was brought on, I made the switch from chronic disease to infectious disease with COVID.

A lot of COVID clinical trials were coming out in the race to find the vaccine, and I had the privilege to get hired by Rush and start working under the infectious disease team under Dr. Beverly Sha. We were able to work on the AstraZeneca clinical trial, and then, as other vaccines came on the market after clinical trial approval and then FDA approval, we moved forward in implementing those into the community, making sure that everybody was educated on the side effects that we knew of at the time about vaccines, the importance of getting vaccinated, and really the life-changing technology that came about.

So the clinical trials that I was working on weren’t necessarily the mRNA vaccines that came on the market during that race, but everybody had to become quick experts on everything available to protect communities and make sure that fewer deaths from COVID happened. So I’m an epidemiologist by training, but currently a project manager within clinical trials at Rush. It’s originally an HIV unit.

Kevin Pho: So from your perspective as an epidemiologist and a clinical trial expert during the COVID pandemic, what were some of the biggest things that surprised you through that lens?

Amber Gipson-Fine: One of the biggest things that surprised me was when I was reading news articles, because when you’re talking to the community, I think it’s important to understand what’s out there and what people are reading, not just from a scientific lens, because I’m also heavily biased. I know how to read science, and it was important that I was seeing what was out there. Originally, I thought everybody was going to be most fearful of vaccine side effects, or thinking that this had a direct relation to some other misinformation, and the misinformation that came about was a different manifestation. It became heavily politicized in a way that I wasn’t necessarily anticipating. I wasn’t anticipating some people denying COVID as a phenomenon, especially when some families were being directly impacted by it or, even worse, had deaths in the family as a result of it.

So my lens in community education really had to change. It involved a lot of listening to what people were actually afraid of and going more individualized than public health trains you to do, because I was finding that, in general, when news sources came out with information, yes, millions of people read it, and some people were convinced by that scientific literature, but oftentimes so many individuals were still afraid. I think that natural, innate fear of the unknown, including when a new technology comes out, is really understandable. So what is most effective is individual by individual, but of course the consequence of that is time, and you can’t reach as many people when people don’t trust a unified news source.

Kevin Pho: Now, can you give an example of how you individualize that messaging that was a little bit different from your traditional public health training?

Amber Gipson-Fine: Absolutely. I remember once adults became sort of unified, at least in what they had to do. Again, I practiced in Chicago, and sooner rather than later, Chicago started implementing mandatory masking, and a lot of employers began requiring the vaccine, so choice was limited in those specific contexts. But right when children were able to get the vaccine, so many parents, some of whom got the vaccine immediately, or delayed and eventually got it, said, “You know, this is my life, and I did what I had to do because of either regulations or what I believed in science. But now I’m talking about my six-year-old child, and that is a scary decision. So what do you have to say about that, Amber? Should I be putting my child at potential risk when I don’t know all of these effects that could potentially be impacting my child’s life?”

I’m really sensitive to that. I’m not a parent, but I can imagine making a decision for yourself is very different than making a health decision for others. Whether we could provide future data wasn’t really relevant in that moment. The question was, do I get my child vaccinated right now? Do I wait three months? Am I going to blame myself if something else comes out in the news the next day? That’s a heavy decision. So we worked through those, and I would say that normally the counseling process involved what they perceived as risk and what was important to them.

In a specific example, a family was traveling to South Carolina. They were going to get on a flight, and they were seeing family, and some of the family members were not vaccinated. So the question became, what is the best way to optimize protection and safety for what this family views those principles as? The child did end up getting vaccinated, but that conversation could have gone a different way, and some have. I’m not here to convince or force anybody to do anything that they otherwise wouldn’t do, because that is removing autonomy. I obviously want people to get vaccinated and protect themselves, but individual health contexts are different, and I don’t think we’re getting anywhere by shaming people. I don’t think anybody who doesn’t immediately take a new vaccine is stupid. It’s quite the opposite. So public health definitely taught me that people are motivated by different health inspirations and outcomes, but when it became about really individualized fears, I think that was a context I wasn’t expecting.

Kevin Pho: All right, let’s transition into the KevinMD article that you wrote. It’s titled “People over profit: Pfizer and Moderna must share vaccine technology.” Now, for those of you who get a chance to read your article, can you just walk my audience through it and share the story of why you decided to write it?

Amber Gipson-Fine: Absolutely, thank you. Pfizer and Moderna are the two pharmaceutical companies that developed mRNA vaccines to prevent disease of COVID-19, the spread of it, and severe symptoms. Both of these technologies were very effective, way more effective than we could have anticipated. The original goals for vaccines were to reduce infection by 50, sometimes even 40 percent, and the numbers from Pfizer and Moderna were incredible. These mRNA vaccines prevented disease in over 90 percent of the people that were originally taking them, and of course we’re talking about the original variant. More have come since then.

These companies, I argue in my piece, are responsible for making sure that we achieve some global equity. I’m based in the United States, in Chicago, Illinois, specifically. I have been extremely privileged in the sense that I have not only a choice of vaccine, so I was able to get Pfizer through Rush University, but I’m able to get boosters as they come out at my discretion. In the United States right now, we’re suddenly being faced with whether or not to get a second booster, for those of us who are fully vaccinated with one or two doses and then kind of a booster after that. A lot of countries are still struggling to even get inoculated at all, to get one dose of the vaccine. My public health background tells me that this is a human rights crisis. People are dying unnecessarily because we’re waiting on donations to be shipped out.

One of the major arguments that Pfizer, Moderna, and some other larger organizations could make is, “Well, these are corporations. They’re here to make money.” I understand that they are pharmaceutical companies, but we can’t wait for donations. There’s such a global health bonus in protecting lives. One of the major arguments, too, is, “Look, the United States is donating vaccines to other countries,” and that’s absolutely true. I addressed this in my article, but it’s timely, and the United States has to pay for those vaccines. Doctors Without Borders has actually identified over a hundred different facilities abroad that are capable of making mRNA vaccines in-house, so to speak, and that would speed up the rate at which we can vaccinate the global population.

Kevin Pho: In terms of the specific reasons Pfizer and Moderna say they won’t share vaccine technology, is it primarily a money issue?

Amber Gipson-Fine: It’s primarily a money issue. I’m also sensitive to the argument that it’s really just about patent technology. They created a brand-new, innovative technology that has not worked in other contexts. With mRNA vaccines, this is the first time that they’re really being used in a very efficacious setting, and they are really, again, saving lives. But yes, I think it’s really a money and legal issue as to why they wouldn’t readily give up the technology to other sites, even under maybe strict legal contracts.

Kevin Pho: Now, in terms of sharing vaccine technology, is there a solution that threads the needle between the patents and sharing the vaccine widely to other countries?

Amber Gipson-Fine: Yes, I think there are definitely compromises that can be made. Doctors Without Borders identified over a hundred sites. A hundred sites might not need the technology to do this in the best way. I am not a shipping or travel expert. These vaccines need to be transported to the people who need them most. It’s a problem that is organic to the United States as well. A lot of hospitals were able to get this technology, but in more rural areas, or areas that don’t have concentrated populations, getting vaccine rollout was difficult. So this is just a larger-scale problem. I do think that donations could also be extremely effective, but they’re not being done in an extremely timely, sensitive manner right now. There are many sites in the U.S. that have supplies of vaccines that aren’t being used, and we’re not shipping them.

Again, the United States, under federal programming, has donated many doses. One billion was promised abroad, but we have to wait for the payment to be processed, and then for these companies that are limited in their own capacity. I want to be sensitive to that, too. Pfizer and Moderna can’t readily produce half a million doses in one day and ship them to the exact location they need to be. It makes logical sense to me, but I do think that there are compromises in between. I don’t think it has to go to every single site.

Kevin Pho: Now, who are the groups that are putting pressure on Pfizer and Moderna to share vaccine technology, and are any of those groups within the United States, for example?

Amber Gipson-Fine: Doctors Without Borders has a lot of different sites, so that’s a big pressure. They put out a formal statement saying that this is their position and urging the United States government, actually, to put more pressure on Pfizer and Moderna. It wasn’t an open letter to the pharmaceutical companies themselves. I think that strategy also makes more sense because, with Pfizer and Moderna, I think many of these organizations, and me as an individual, understand that they do not have to do anything. They are their own private corporations, and that is why the United States government, I think, the federal government, had then promised to purchase, and then send off and donate, these doses, because that was the agreement that they could come to, versus putting pressure on two corporations to donate these for free.

So there are a lot of community health advocacy groups in the United States. There are a number of physicians who have written op-eds on this as well, and there is a phenomenal one from a participant who was actually in the Moderna clinical trial. He removed himself from follow-up because he just felt an ethical collision with being involved in this trial. He was promised and told, “Well, this is to help people not die from this terrible disease,” in an awful pandemic that has plagued the globe for over two years now, and this company basically is prioritizing U.S. lives. So that’s why he chose to remove himself.

Kevin Pho: So what do you expect the next six to 12 months to bring? Do you anticipate any organization or any sort of pressure to really move the needle in terms of convincing Pfizer or Moderna to share vaccine technology across the globe?

Amber Gipson-Fine: What I’m hoping happens is federal expansion might feel some more pressure if groups continue to do so. One billion doses is a huge promise, so I’m being realistic here, as much as my public health brain tells me that with enough pressure, maybe we could do some other negotiating. I also do want to say that Pfizer and Moderna sort of do have these ongoing conversations about what makes the most sense. They are very well aware that not only the U.S. public but the global public really wants this technology and to be able to vaccinate as many people as possible.

So it’s very possible the needle gets moved. I don’t think in a time-efficient manner, unfortunately. I think in order to do this, we really have to keep the pressure up and say it’s not acceptable that the federal government buying these vaccines and waiting for donation is the main mechanism to get there. Pfizer and Moderna have also paired with some other smaller organizations, and those contracts are very close to the chest, so I don’t have that data, but it’s very possible in the next few months that other promises could be made, and I really hope that they are.

Kevin Pho: We’re talking to Amber Gipson-Fine. She’s an epidemiologist and project manager. She wrote the KevinMD article “People over profit: Pfizer and Moderna must share vaccine technology.” Amber, for those clinicians who may be listening to this podcast and who this message resonates with, what are some things that they can do on an individual basis?

Amber Gipson-Fine: Absolutely. On an individual basis, I will say I’m privileged to work with so many talented clinicians, so I don’t want to make an accusation here, but I do think, understandably, a lot of health care workers are frustrated right now. There has been direct abuse. We’re tired. A lot of people are not getting time off, or are under chronic stress and are burned out. But even amid all of that, we made a commitment to make sure that patients feel heard, and my only request is that shaming is reduced. So when someone says, “Absolutely not, I don’t want to get vaccinated,” or, “You don’t know what you’re talking about,” the response there just shouldn’t be a threat to that person’s intelligence or that person’s being. It’s frustrating to hear, and I definitely want to lose patience myself. So I think that’s one lesson.

The second lesson is, I have learned so much from all colleagues across health care: physicians, medical assistants, research coordinators. So we are a team, and I think it’s beautiful when you’re able to rely on team members for expertise that you might not have, even if it’s not just in patient communication. I am a white woman, and some of my colleagues who are people of color say, “You know what? I think this is actually a misnuance in the news right now, and this is a myth that’s circulating.” Maybe that’s something that, if it gets brought up, could at least be validated. I think those micro lessons are really important, not only now but for future care.

Kevin Pho: And my final question: What are some of your take-home messages that you want to leave with the KevinMD audience?

Amber Gipson-Fine: Absolutely. It’s frustrating out here. There’s a lot of polarization, politically and also scientifically. It’s hard to take care of ourselves, so prioritizing mental health in any capacity possible. It’s way easier said than done. We have to be able to take care of our teams and ourselves, and for those of us who have children or family members that we’re caregiving for, that’s also another chronic stress. So prioritizing mental health and well-being as much as possible, but also, in the effort to educate people, being as aware of the latest technology and global implementation as we can, basically gaining as much information as we can at different points, and being compassionate with that knowledge.

Kevin Pho: Amber, thank you so much for sharing your time and insight, and thanks again for being on the show.

Amber Gipson-Fine: Thank you again.