NMDA Journal Winter 2020-21

10 New Mexico Dental Journal, Winter 2020-21  continued from page 9 The Four Types of Vaccines Currently Used to Protect Against Infection Live Attenuated Vaccines: A weakened form of the germ that causes the disease. They create a strong immune response that can last a lifetime with only one or two doses. They cannot be given to people with weak immune systems, long-lasting health prob- lems, or those with organ transplants. They need to be kept cold, so they don’t travel well. Live vaccines are used for the eradication of Measles, Mumps, Rubella (MMR), Rotavirus, Smallpox, Chickenpox, and Yellow Fever. Inactivated Vaccines: A killed version of the germ. They do not provide as strong protection as the live vaccine, so booster shots are required. This type protects us against Hepatitis A, Flu (shot only), Polio (shot only), and Rabies. Subunit, Recombinant, Polysaccharide, and Conjugated Vaccines: A specific piece of the germ that provides a strong immune response targeted to key parts of the germ. These can be used on almost anybody including people with weakened immune systems. Booster shots are often necessary. These vaccines protect us against Hib (Hae- mophilus influenza type b), Hepatitis B, HPV, Whooping Cough, Pneumococcal Disease, Meningococcal Disease, and Shingles. Toxoid Vaccines: A toxin made by the germ that cause the disease. The immune response is targeted to the toxin and not the germ. For ongoing protection, a booster shot may be required. These vaccines are used to protect against Diphtheria and Tetanus. DNA, mRNA, and Recombinant Vector Vaccines: Are new on the stage, and many of the COVID vaccines are using these tech- nological platforms. Clinical Trial Phases Phase 1: The vaccine is given to a small group of healthy people and are exposed to the disease looking for side effects, efficacy, and figuring out the best doses. Phase 2: The vaccine is given to several hun- dred people checking for viability, efficacy, and side effects. Phase 3: The vaccine is given up to thou- sands of people and a similar group takes a placebo. These randomized trials can take one to four years. For COVID-19, the trials are months long. Phase 4: The vaccine drugs that are approved for use are monitored for long- term side effects. Therapeutics Antiviral drug development usually takes years, so scientists are looking for current medi- cations that keep the virus fromentering the cell, preventing replication of the virus in the cell andminimizing the damage that the virus does to the organs. Thesemedications are likely to be current drugs used for other diseases. They Phase 1 Phase 2 Phase 3 Phase 4 NATIONAL ACADEMY of MEDICINE SCIENCES ENGINEERING MEDICINE The National Academics of Phase 1a "Jumpstart Phase" • High-risk health workers • First responders Phase 1b • People of all ages with comorbid and underlying conditions that put them at significantly higher risk • Older adults living in congregate or overcrowded settings • K-12 teachers and school staff and child care workers • Critical workers in high-risk settings— workers who are in industries essential to the functioning of society and at substantially higher risk of exposure • People of all ages with comorbid and underlying conditions that put them at moderately higher risk • People in homeless shelters or group homes for individuals with disabilities, including serious mental illness, developmental and intellectual disabilities, and physical disabilities or in recovery, and staff who work in such settings • People in prisons, jails, detention centers, and similar facilities, and staff who work in such settings • All older adults not included in Phase 1 • Young adults • Children • Workers in industries and occupations important to the functioning of society and at increased risk of exposure not included in Phase 1 or 2 • Everyone residing in the United States who did not have access to the vaccine in previous phases Equity is a crosscutting consideration: In each population group, vaccine access should be prioritized for geographic areas identified through CDC's Social Vulnerability Index or another more specific index. FIGURE: A Phased Approach to Vaccine Allocation for COVID-19 Framework: The National Academies of Sciences, Engineering, and Medicine released this chart October 2, 2020. Chart made available to NMDA Journal courtesy of NASEM.