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Expert Interviews
COVID-19, Respiratory Infections CE/CME accredited

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Experts answer questions with in-depth advice on the current clinical landscape and how new therapies and guidance might impact regional clinical practice. Useful tips below will show how to navigate the activity. Close

The mRNA vaccine platform: A novel tool for the rapid development of vaccines against respiratory viral infections

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Dr Anna Blakney is an assistant professor and Tier 2 Canada Research Chair in the Michael Smith Laboratories and School of Biomedical Engineering at the University of British Columbia (UBC), Vancouver, BC, Canada. read more


Dr Blakney’s research background encompasses the development of molecular and biomaterial engineering strategies for delivery of self-amplifying RNA. Her lab uses bioengineering, molecular biology and immunology approaches to develop the next generation of RNA vaccines and therapies. Her research has been published in a variety of top tier journals including ACS Nano, Nature Communications, Molecular Therapy, Biomaterials, Journal of Controlled Release and Advanced Materials. Dr Blakney has received numerous awards and recognitions in addition to the Tier 2 Canada Research Chair in Nucleic Acid Bioengineering, including the 2022 Gairdner Early Career Investigator Award, the 2021 UBC President’s Award for Public Education Through Media and the 2022 Controlled Release Society Gene Delivery and Editing Focus Group Young Investigator Award.

Dr Anna Blakney discloses: Advisory board or panel fees from GenVax. Grants/research support from Pfizer and Replicate Bioscience. Contractual service fees from Moderna (Relationship Terminated).

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Prof. Dr. med. Oliver Cornely is director and chair of Translational Research at the Cologne Cluster of Excellence on Cellular Stress Responses in Aging-Associated Diseases at the University of Cologne, and scientific director of the Center for Clinical Trials. Clinically, he serves as infectious diseases consultant at the University Hospital of Cologne, Germany. read more


Prof. Dr. med. Cornely is board certified in internal medicine, infectious diseases, haematology, oncology and emergency medicine, and holds degrees in medical mycology and travel medicine. In January 2021, he founded the VACCELERATE platform, which currently includes 23 countries and 29 partner institutions for the European Commission to accelerate vaccine development against COVID-19 and future pandemic pathogens.

Prof. Dr. med. Cornely is immediate-past president of the European Confederation of Medical Mycology (ECMM), the umbrella organization of 28 national mycology societies. He set up the ECMM Global Guideline programme, ECMM Academy (Fellows programme), and ECMM Excellence Center Initiative, designating clinical and microbiological excellence centres after an international audit procedure. He is founder and chair of the Infectious Diseases Scientific Working Group of the European Hematology Association. Prof. Dr. med. Cornely is a member of the Council of the International Society for Human and Animal Mycology and serves as chair of the Infectious Diseases Working Party, a working group of the German Society for Hematology and Oncology. He was recently elected as site spokesman for Bonn/Cologne for the German Center for Infection Research.

Prof. Dr. med. Oliver Cornely discloses: Grant Research and Support from Amplyx, Basilea, BMBF, Cidara, DZIF, Gilead, Matinas, MedPace, MSD, Mundipharma, Pfizer and Scynexis. Consulting fees from Abbvie, Amplyx, Biocon, Biosys, Cidara, Da Volterra, Gilead, IQVIA, Janssen, Matinas, MedPace, Menarini, Molecular Partners, MSG-ERC and Pfizer. Speaker’s Bureau from Abbott, Abbvie, Al-Jazeera Pharmaceuticals, Astellas, Gilead, Grupo Biotoscana, Hikma, MedUpdate, Merck/MSD, Mylan, Noscendo and United Medical/Knight. Expert testimony from Cidara. Data Safety Monitoring Board or Advisory Board from Actelion, Cidara, Entasis, IQVIA, Janssen, Med Pace, Paratek, Pulmocide and Shionogi. Other from DZIF – German Center for Infection Research.

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Prof. Ann R Falsey is a professor of medicine at the University of Rochester School of Medicine, New York, NY, USA. read more


Prof. Falsey is well established in clinical and translational research in the field of respiratory viral infections in adults, including: the epidemiology and impact of respiratory syncytial virus in adult populations, influenza, coronaviruses, parainfluenza viruses and human metapneumovirus. She has conducted numerous adult surveillance and vaccine studies in a variety of settings, including ambulatory older adult clinics, nursing homes and senior daycare centres. She has extensive experience in diagnostic and serologic assay development for respiratory viruses.

Prof. Falsey is a member of the steering committee for the Global Influenza Initiative, the Infectious Diseases Society of America and the American Virology Society. She has published over 200 peer-reviewed articles, reviews, book chapters and abstracts. She currently serves as the co-director for the National Institute of Allergy and Infectious Diseases Respiratory Pathogens Research Center recently awarded to the University of Rochester. 

Prof. Ann R Falsey discloses: Advisory board or panel fees from Sanofi. Consultancy fees from Gilead. Grants/research support from BioFire Diagnostics, CyanVac, Janssen, Merck, Moderna and Pfizer.

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  • Select in the video player controls bar to choose subtitle language. Subtitles available in English, French, German, Italian, Spanish.
  • Downloads including slides are available for this activity in the Toolkit
Learning Objectives

After watching this activity, participants should be better able to:

  • Recognize the rationale for mRNA-based vaccines and considerations for their design
  • Discuss the effectiveness of mRNA-based vaccines to manage respiratory viral diseases based on clinical and real-world experiences with COVID-19 vaccines
  • Discuss recent developments in the use of the mRNA platform to develop prophylactic and therapeutic vaccines for respiratory diseases
Overview

Leading experts explore mRNA vaccine platforms for respiratory viruses, including their design, clinical application and future prospects.

This activity is jointly provided by USF Health and touchIME. read more

Target Audience

Infectious disease specialists, pulmonologists, pharmacists, primary care physicians and primary care nurses involved in the delivery of vaccines for respiratory diseases.

Disclosures

USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity.  The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

Faculty

Dr Anna Blakney discloses: Advisory board or panel fees from GenVax. Grants/research support from Pfizer and Replicate Bioscience. Contractual service fees from Moderna (Relationship Terminated).

Prof. Dr. med. Oliver Cornely discloses: Grant Research and Support from Amplyx, Basilea, BMBF, Cidara, DZIF, Gilead, Matinas, MedPace, MSD, Mundipharma, Pfizer and Scynexis. Consulting fees from Abbvie, Amplyx, Biocon, Biosys, Cidara, Da Volterra, Gilead, IQVIA, Janssen, Matinas, MedPace, Menarini, Molecular Partners, MSG-ERC and Pfizer. Speaker’s Bureau from Abbott, Abbvie, Al-Jazeera Pharmaceuticals, Astellas, Gilead, Grupo Biotoscana, Hikma, MedUpdate, Merck/MSD, Mylan, Noscendo and United Medical/Knight. Expert testimony from Cidara. Data Safety Monitoring Board or Advisory Board from Actelion, Cidara, Entasis, IQVIA, Janssen, Med Pace, Paratek, Pulmocide and Shionogi. Other from DZIF – German Center for Infection Research.

Prof. Ann R Falsey discloses: Advisory board or panel fees from Sanofi. Consultancy fees from Gilead. Grants/research support from BioFire Diagnostics, CyanVac, Janssen, Merck, Moderna and Pfizer.

Content reviewer

Sally F Alrabaa, MD, has no relevant financial relationships to disclose.

Touch Medical Contributors

Adriano Boasso has no financial interests/relationships or affiliations in relation to this activity.

USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

If you have questions regarding credit please contact cpdsupport@usf.edu.

Accreditations

Physicians

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (www.uems.eu).

Advanced Practice Providers

Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

Date of original release: 21 September 2023. Date credits expire: 21 September 2024.

If you have any questions regarding credit please contact cpdsupport@usf.edu.

This activity is CE/CME accredited

To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

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Topics covered in this activity

COVID-19 / Respiratory Infections
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touchEXPERT OPINIONS
The mRNA vaccine platform: A novel tool for the rapid development of vaccines against respiratory viral infections
0.75 CE/CME credit

Question 1/5
Which of the following statements best describes the mechanism of action of mRNA-based vaccines?

IFN, interferon; mRNA, messenger RNA.

mRNA vaccines mobilize innate and adaptive immunity, eliciting both cellular and humoral responses. Following uptake into the cell via endocytosis, the mRNA activates type I IFN-mediated innate immunity via TLR-signalling, a mechanism referred to as the ‘self-adjuvant’ effect. After endosomal release, the mRNA is translated into proteins that are processed into antigens and are presented by MHC molecules to activate T-cell-mediated immunity. Cytotoxic CD8+ T cells kill infected cells, and CD4+ T cells secrete cytokines and co-activate B cells to promote humoral (antibody-mediated) immunity.

Abbreviations

CD, cluster of differentiation; IFN, interferon; MHC, major histocompatibility complex; mRNA, messenger RNA; TLR, toll-like receptor.

Reference

Fang E, et al. Signal Transduct Target Ther. 2022;7:94.

Question 2/5
Which of the following statements best summarizes the key properties of LNPs that make them amenable to clinical application in mRNA vaccines?

IFN, interferon; LNP, lipid nanoparticle; mRNA, messenger RNA; TLR, toll-like receptor.

LNPs simulate the cell membrane phospholipid bilayer to aid stable delivery and uptake of the mRNA vaccine complex. Due to its large molecular weight, negative charge and susceptibility to nuclease degradation, mRNA cannot easily pass through the cell membrane. To overcome these challenges, mRNA encapsulation technologies—including LNPs—were developed.

Abbreviations

LNP, lipid nanoparticle; mRNA, messenger RNA.

Reference

Fang E, et al. Signal Transduct Target Ther. 2022;7:94.

Question 3/5
How would you advise your patients regarding risk of myocarditis following COVID-19 mRNA vaccination?

mRNA, messenger RNA.

Prescribing information for approved mRNA-based COVID-19 vaccinations states there is an increased risk of myocarditis and pericarditis following vaccination.1,2 These conditions can develop within just a few days after vaccination and have primarily occurred within 14 days.1,2 They have been observed more often after the second dose compared with the first dose, and more often in younger males.1,2 Surveillance data show incidence of myocarditis/pericarditis to be low: 132 and 107 per 1,000,000-person years (RR 1.18; 95% CI 0.79–1.79), at Days 1–21 and Days 22–42 post-vaccination, respectively.3 Meta-analyses indicate mRNA COVID-19 vaccines are associated with a short-term greater risk of myocarditis, but the absolute risk appears to be low.4

Abbreviations

CI, confidence interval; mRNA, messenger RNA; RR, rate ratio.

References

  1. EMA. Elosmeran SmPC. Available at: www.ema.europa.eu/en/medicines/human (accessed 11 July 2023).
  2. EMA. Tozinameran SmPC. Available at: www.ema.europa.eu/en/medicines/human (accessed 11 July 2023).
  3. Klein NP, et al. JAMA. 2021;326:1390–99.
  4. Alami A, et al. BMJ Open. 2023;13:e065687.
Question 4/5
Your patient is a healthy woman who is 11 weeks pregnant. She had her last COVID-19 vaccination 5 months ago. She asks whether she is eligible for another booster whilst pregnant. Based on WHO guidelines (as of March 2023), what do you recommend in terms of COVID-19 booster for this patient?

WHO, World Health Organization.

According to WHO guidance updated in March 2023, the recommendation for pregnant adults and adolescents is to receive the primary series and booster vaccination as soon as possible. An additional booster dose should be given during pregnancy if the last dose was administered more than 6 months ago. For this additional booster dose, vaccination in the mid-second trimester is preferred to optimize protection of the pregnant person, the foetus and the infant. However, the vaccine can be safely given at any time during pregnancy to avoid missing opportunities to vaccinate.

Abbreviation

WHO, World Health Organization.

References

WHO. 2023. Available at: www.who.int/publications/i/item/WHO-2019-nCoV-Vaccines-SAGE-Roadmap (accessed 28 July 2023).

Question 5/5
Your patient is an 87-year-old female with COPD who is currently living in a residential care home. Last winter, she was hospitalized with pneumonia. She expresses concerns about needing to go to hospital again this winter if she has ‘another chest infection’. How would you manage this patient?

COPD, chronic obstructive pulmonary disorder; RSV, respiratory syncytial virus.

RSV can cause significant morbidity in older adults, and in those who are immunocompromised or have cardiopulmonary comorbidities.1 Underlying COPD and residency in a long-term care facility are factors associated with increased risk of severe RSV disease.2 Vaccines are available for active immunization for the prevention of lower respiratory tract disease caused by respiratory syncytial virus in individuals 60 years of age and older.3,4

Abbreviations

COPD, chronic obstructive pulmonary disorder; RSV, respiratory syncytial virus.

References

  1. Hill-Ricciuti A, et al. Infect Control Hosp Epidemiol. 2023;44:433–9.
  2. Melgar M, et al. Morb Mortal Wkly Rep. 2023;72:793–801.
  3. FDA. Respiratory Syncytial Virus. Vaccine, Adjuvanted. Prescribing information. Revised: 5/2023. Available at: www.fda.gov/media/167805/download (accessed 28 July 2023).
  4. FDA. Respiratory Syncytial Virus. Vaccine. Prescribing information. Revised: 8/2023. Available at: www.fda.gov/media/168889/download (accessed 28 July 2023).
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