key: cord-0705802-260jelj6
authors: Offit, Paul
title: Immunization Symposium
date: 2020-10-31
journal: Journal of the National Medical Association
DOI: 10.1016/j.jnma.2020.09.164
sha: 61bd9cff6d7eddc81f93ddb7db61c97769291ef7
doc_id: 705802
cord_uid: 260jelj6

nan

Paul Offit, MD. The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine There is only one way to stop the relentless pandemic caused by SARS-CoV-2: a vaccine. Although vaccines typically take 15-20 years to develop, this vaccine will likely be developed in 12-18 months. The timeline to develop a SARS-CoV-2 vaccine has been shortened and researchers are closely monitoring towards vaccine approval. The biology of the variety of coronaviruses and specifically SARS-CoV-2 were discussed. Seven categories of the strategy to develop a vaccine were explained: whole killed virus, live attenuated virus, purified viral protein, replicating viral vectors, replication defective viral vectors, mRNA, and DNA. It is important to understand the current state of the development of a vaccine to prevent SARS-CoV, and equally important to understand possible pitfalls when a vaccine is developed at "Warp Speed." Safety of vaccine development was described through the FDA, CDC, and three other programs involved with monitoring and reporting adverse events. The importance of diverse participants in vaccine trials was emphasized, particularly acknowledging the hesitancy in underrepresented minority populations who may refuse to accept the vaccine. Nevertheless, it is imperative that because COVID-19 already disproportionately affects these same populations, continuing to build trust between healthcare providers and patients on what is known about this coronavirus and the necessity of a vaccine cannot stop. The symposium focused on barriers and novel paradigms and interventions in the global effort to care for children and adolescents living with HIV. Dr. Ahonkhai opened the session by focusing on HIV in adolescents and young adults in Africa (specifically, Nigeria). Highlighted was the importance of implementation science methods that address barriers about the effective delivery of antiretroviral therapy (ART), which may differ substantially across different communities and sociocultural contexts. Additionally, the potential for mobile health technology to improve HIV testing and ART adherence among infected individuals was discussed. Dr. Fields reviewed the challenges for HIV prevention and treatment among sexual and gender minority youth in the United States, emphasizing the social disadvantages and disparities experienced by African American adolescent and young adult gay, bisexual and other men who have sex with men living with HIVor at risk for HIVacquisition. The problems facing young men in Baltimore (for example) and other urban settings across the country was highlighted. Dr. Secord provided important guidelines to attendees on promoting HIV testing and pre-exposure prophylaxis (PrEP) among youth. Indications, safety, and benefits of initiating PrEP in at-risk patients were clarified. Dr. Golden reviewed data over the past twenty years demonstrating a decreased risk of HIVacquisition in neonates breastfed by HIV-positive mothers with low viral loads and on ART. Additionally, the benefits, complications and risks associated with adoption of this practice in resource-rich countries, including the United States, were illustrated. Dr. Collins-Ogle closed the symposium by discussing regional differences in HIV acquisition and cultural/social factors that affect access to care by adolescents living with HIV. The overall symposium provided attendees with a plethora of information about HIV care across the pediatric continuum, aspiring to improve clinicians' ability to effectively care for their infants, children, and adolescents. 

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