CHARLESTON — As COVID-19 case numbers keep surging, a team of local doctors and researchers is running West Virginia’s only COVID-19 vaccine trial.
Led by Dr. Suzanne Gharib in her private South Charleston practice, the team is taking patients for AstraZeneca COVID-19 vaccine trials, among a few around the world.
“I think, on some level, a lot of people are feeling kind of hopeless right now and looking for a way to help,” Gharib said. “We’re all kind of burned out and tired. Pandemic fatigue has set in, but this is something that looks towards the future.”
For every two people injected with the vaccine, one is given a saline placebo. Participants receive two doses about a month apart. The study is double-blind, meaning not even Gharib knows which injection volunteers receive. So far, Gharib said, about 70 people from as far as Beckley and Morgantown have participated in the trial, and the team is looking for more to take part.
“The more people you have participate in a trial, especially those disproportionately affected (by COVID-19) in this case, the better your data will be,” Gharib said. “The more young people, old people, minorities, women — the more people we get, the more you can ensure (the vaccine) works with different genetic makeups, different populations.”
Unlike vaccines being developed by Pfizer and Moderna, the AstraZeneca version is not an mRNA, which is a vaccine based on synthetic genetic material (messenger RNA) that, once injected, creates a virus antigen inside a person’s body that can help the immune system fight the virus.
MRNA vaccines are a relatively new technology, Gharib said, while AstraZeneca’s vaccine — which injects the host with protein from the virus to train the immune system to fight it — is a more traditional approach.
“This is more practiced, more tried-and-true technology that we’ve been studying and working with for some years,” Gharib said.
Also unlike its competitors, the AstraZeneca vaccine could be a simpler option when it comes to distribution, especially for more rural or cash-strapped areas, Gharib said.
Because of their makeup, mRNA vaccines must be stored at extremely low temperatures, often requiring specialized freezers equipped with dry ice. With more traditional vaccines, the necessary equipment is similar to what’s needed for flu shots and other common vaccinations, Gharib said.
“There’s no big to-do with this,” Gharib said. “That could be easier when it comes to asking pharmacies, maybe in the middle of nowhere, to store this and keep it on hand. Most probably are equipped already to do so.”
Gharib said she doesn’t prefer one vaccine over the other and it’s difficult to tell which will be the first approved by the federal Food and Drug Administration.
But as the number of COVID-19 cases and deaths grows, the day for an approved vaccine cannot come soon enough. Like all states, West Virginia last month submitted a vaccine distribution plan for federal Centers for Disease Control and Prevention approval.
The state plan relies on a three-phase system for distribution, where each phase would see more people receive the vaccine.
The first phase of vaccines in West Virginia will go to health care personnel (anyone at risk of exposure to COVID-19 who is paid to work in a “health care setting” and who cannot work from home) and the “non-health care critical workforce,” defined in the plan as those “necessary to maintaining the essential functions of society.”
“Our grocery workers, people who are having consistent contact with people — they are our most exposed,” Gharib said. “They’re also the people that keep things going, that we need for daily life.”
Phase two of the state’s plan would make the vaccine available to the public in a limited capacity. Sites to distribute the vaccine will be carefully selected to ensure “critical populations” are accessed.
Phase three would see widespread public distribution of the vaccine. Gov. Jim Justice has said the West Virginia National Guard will head vaccine distribution efforts just as it has testing.
Gharib is working on a two-year trial. Some of the most important work comes in the later months.
“Follow-through and continued research are what’s really important in vaccine trials,” Gharib said. “It’s how we’ll learn the true efficacy of this vaccine. Does it only last six months? Is it going to be an annual immunization? What are the potential side effects for different populations? These are important questions that only get answered with time.”
At Gharib’s office, vaccine work happens on weekends, when medical professionals from Morgantown and Beckley drive to Charleston and volunteer their time for the trial. During the week, Gharib sees patients from her private practice. Some, she said, still are suffering some of the less obvious side effects of the pandemic.
Some haven’t kept up with preventative care practices. Many are immunocompromised and hesitant to take their medications. Older patients are lonely. All, she said, are counting the days till the pandemic ends and they’re given back their peace of mind.
“When this is over, I think we’re going to be in another health care crisis, and it’s going to evolve and unfold for years to come,” Gharib said. “The amount of mental suffering this has caused, the loneliness, the unknowns — it’s going to be huge.”