Columbia’s COVID-19 Vaccine Symposium Was Years in the Making

Starting on Feb. 22,  global health experts including Anthony Fauci of the National Institute for Allergy and Infectious Diseases, Tedros Ghebreyesus of the World Health Organization, and philanthropist Melinda Gates will gather at a week-long virtual symposium at Columbia University to discuss scientific, public health, economic, and societal issues relating to COVID-19 vaccines. The vaccines will be the most critical element in ending the pandemic that has killed 2.3 million people around the world. 

Though the symposium, organized by experts at Columbia, is focused on COVID-19, planning for the event began months before the global health community was aware of SARS-CoV-2. 

“After the Zika outbreak, we put together a working group at Columbia around global health security,” says Lawrence Stanberry, MD, PhD, a pediatrician, vaccinologist, and virologist at Columbia University Vagelos College of Physicians and Surgeons and co-convenor of the symposium. 

“Our view was that vaccines were going to be critical against dangerous new pathogens, and we needed to educate people in health care, government, social sciences, journalism, and the general public about new vaccine developments.”

Stanberry and a group of fellow experts in global health, infectious diseases, policy and governance, and vaccine development—including Philip LaRussa, MD, Marc Grodman, MD, and Wilmot James, PhD—began laying the groundwork for the symposium in 2016.

The CUIMC Newsroom spoke with Stanberry to learn more. 

What led to the initial idea for a vaccine symposium?

We’ve seen a series of significant epidemics and outbreaks in recent years. In 2009, there was the H1N1 influenza outbreak. Then, in 2014 we had Ebola introductions in the United States coming out of West Africa. Not long after that, we saw the 2015-2016 Zika outbreak. We were experiencing Zika firsthand in New York and we became increasingly concerned about pandemic preparedness. 

We organized a day-long symposium in 2017 at Columbia to discuss the lessons being learned from the Zika epidemic. With funding from ELMA Philanthropies, we began a project to assess the preparedness of children’s hospitals in Africa to respond to disasters including epidemics and pandemics.

Our work on pandemic preparedness coincided with the efforts of organizations such as the Coalition for Epidemic Preparedness (CEPI) and the Biomedical Advanced Research and Development Authority (BARDA), which began laying the groundwork for rapid vaccine development and distribution in the event of a pandemic. 

Recognizing that vaccines were going to be critical for pandemic preparedness and response, we obtained funding in 2019 that allowed us to organize an educational symposium on vaccines and global health. 

What was the original goal of the symposium?

Our main goal was to provide a platform to discuss the importance of vaccines in global health security. We knew important issues will include challenges surrounding vaccine development, manufacturing and immunizations during a major outbreak or pandemic. What do you do around global distribution? What about vaccine hesitancy and confidence? 

In December 2019, we began planning a symposium.

What changed?

By January 2020, we knew there was a problem brewing; by March, we were on lockdown in New York. With the seriousness of the pandemic now apparent, we reorganized the symposium with a focus on COVID-19 vaccines.

With a pathogen like SARS-CoV-2 that’s circulating worldwide, mutating as predicted, we’re not going to make the world safe until we can get everyone immunized. It’s becoming clear that herd immunity from natural infection is not going to bring the pandemic to an end. 

The plan for the symposium is to look at all of the topical issues that relate to rapid development, distribution, and uptake of the COVID-19 vaccines. We want to know what is going right and what is going wrong. 

Why do we need a vaccine to defeat COVID-19?

It’s estimated that each year there are around 200 infectious disease outbreaks worldwide. Outbreaks can often be contained by public health measures such as use of personal protective equipment and placing infected individuals in isolation or quarantine. This strategy worked well for the SARS outbreak that occurred in 2002-2003 because infected individuals did not become contagious until they were very sick. COVID-19 (SARS-CoV-2 infection) is a very different story. 

We now know that infected individuals are contagious before they get sick and, in many cases, never show any signs of illness. This situation makes the use of public health measures less effective and makes the development and use of safe and effective COVID-19 vaccines even more important. 

Some have suggested that herd immunity could be achieved by allowing large segments of the population to become infected with the virus. Such an approach would come at great cost, including loss of life. There is also growing evidence that immunity resulting from natural infection may not protect against reinfection. This pandemic is not going to burn itself out. The only way we are going to end this pandemic is by widespread global uptake of COVID-19 vaccines. 

What has made rapid vaccine development possible now?

Three factors have contributed to the rapid development of the COVID-19 vaccines. First, efforts by organizations like CEPI and BARDA facilitated the development of vaccine platforms that could be used to rapidly develop vaccines. 

Second, plans for manufacturing vaccines prior to their approval allowed for the rapid distribution of vaccines following emergency use authorization. 

Third, to show that a vaccine is efficacious, a proportion of the volunteers in the study must become infected. With COVID-19, thousands of people were being infected daily, making it possible to demonstrate efficacy in a remarkably short period of time. It is important to recognize that all of the steps required to prove that the vaccine is safe and efficacious have been taken with the vaccines that have received emergency use authorization. 

There is hope in the United States that things will be getting back to normal by this summer or fall, but it will not be normal for much of the rest of the world. The important question is, how long is that going to take and how do we manufacture, distribute, and pay for enough vaccine to immunize 6 billion adults worldwide?

This is a global problem, and we need global solutions.