Scientists from Fred Hutchinson Cancer Research Center and thousands of Starbucks partners joined for a virtual “Conversation with Leaders on the Frontlines of COVID-19” to talk variants, vaccines and the path forward.

About a year ago, Dr. Tom Lynch had just started his new job as president and director of the Fred Hutchinson Cancer Research Center in Seattle when two scientists asked to meet with him.

“Tom, we’ve got a problem,” they told him. The researchers were Dr. Trevor Bedford and Dr. Steve Pergam, both associate professors at Fred Hutch’s Vaccine and Infectious Disease Division who had been monitoring reports of COVID-19 cases, which had been newly identified in the United States. A computational biologist, Bedford had developed a model that showed that the novel virus was not only in the area but had been silently spreading for weeks.

Fast forward to today and Fred Hutch is now at the heart of research into COVID-19. Long known for developing groundbreaking treatments and cures for cancer, it’s also renowned for its work on viruses and is the home of the world’s largest HIV vaccine trials network. As part of Operation Warp Speed, Fred Hutch is also leading clinical trials for promising experimental COVID-19 vaccines and treatments.

Research Scientist Adam Dingens performs ELISAs with serum samples from individuals who had COVID-19 in the Bloom Lab at the Fred Hutchinson Cancer Research Center in Seattle, Washington. The lab has pivoted to Covid-19 since the pandemic swept into Washington State three months ago.

On Thursday, Lynch and Bedford, along with Fred Hutch’s Dr. Michele Andrasik and Dr. Catherine Liu, spoke to thousands of Starbucks partners from stores and company headquarters during a video panel about COVID-19. It’s part of an occasional series of conversations held by Starbucks for partners about large societal issues. During the hour-long panel, Fred Hutch researchers helped separate fact from fiction on what’s known about the virus, the vaccines and how long antibodies last, and discussed racial health disparities.

“Fred Hutch researchers are on the frontlines of the COVID pandemic tracking the virus and working on some of the significant phase three (vaccine trial) tasks,” said Starbucks chief executive officer Kevin Johnson, introducing the members of the panel.

President and Director Dr. Thomas Lynch Jr., Fred Hutchinson Cancer Research Center
Dr. Trevor Bedford
Dr. Michele Andrasik
Dr. Catherine Liu

In addition to Johnson, they were joined on screen by Shannon Garcia, Starbucks senior vice president of operations, and Becky Elias, director of global retail quality assurance for Starbucks.

Last month, Starbucks began working with Washington State Gov. Jay Inslee and others to support accelerated, safe and equitable vaccine distribution and administration, applying its knowledge about serving 100 million customers a week through 30,000 stores around the world to streamlining vaccination centers.

“We want to help get more people vaccinated and share the best practices with other states across the country,” Johnson said.

Will vaccines protect against COVID-19 variants?

As of this week, more than 27 million people in the United States had tested positive for COVID-19 and more than 475,000 have died.

Bedford’s early modeling of the spread of the virus made him a trusted source for many around the world. His Twitter followers, which shot to more than 300,000 in the wake of the pandemic, include renowned researchers, laypeople and celebrities. Now he’s looking at how the new COVID variants in the UK, South Africa and Brazil affect what happens next and what they mean for the current vaccines.

Scientist in lab looking through microscope — Graduate Research Assistant Kate Crawford views cells infected with pseudotyped lentivirus with a microscope in the Bloom Lab at the Fred Hutchinson Cancer Research Center.

Research shows the UK variant is more transmissible, contains higher viral loads and results in as many as 30 percent more hospitalizations and deaths, said Bedford. He expects that by the end of March, it may account for 50 percent of the cases in the United States. The variant was detected recently in a University of Washington student.

The good news is that the Pfizer and Moderna vaccines, which use genetic molecules called mRNA to trigger an immune response, seem to be effective so far against the variants from the UK, Brazil and South Africa, he added. And even those vaccines that are less effective are still protective against the severe forms of the disease. The changing landscape does mean that some vaccines will probably need to be reformatted at a global scale, he said. And in the future, people may need to get an annual COVID shot to protect against new variants, just as we do with the flu.

“It’s going to be a battle between how quickly we can vaccinate people and seasonality and the divergent spread (of this variant),” he said.

Now that the vaccines exist, they could be changed seasonally and targeted geographically.

What we can learn from Rita Hanks’ antibodies

There’s been a lot of confusion about what kind of protection those who have recovered from COVID will have. Lynch, the Fred Hutch president, confessed to the panel that “not everything I read is the New England Journal of Medicine” and said he’d recently read in People magazine that actor Rita Hanks who, along with her husband, Tom, were among the earliest patients to have COVID-19, no longer has detectable antibodies to protect against the virus. What can we learn from that, he asked Bedford?

There’s a really important distinction between antibodies from “natural infection” from those who have had the virus and those who have antibodies resulting from a vaccine, said Bedford. Those who are asymptomatic or had a mild case often have a lower amount of antibodies that wane significantly over time. That’s why vaccination is key, even for those who have already had the virus. The data on those who’ve been vaccinated with the Pfizer or Moderna shots show a “really nice high level of antibodies,” he said. “That’s why, even if someone has had COVID … getting vaccinated will bring them up to a level that is protective and there hasn’t been as much waning with that.”

Fears about vaccines

While vaccines are still in short supply and many who want them can’t get them, others remain skeptical about them, especially in Black, indigenous and people of color (BIPOC) communities. Those are also the communities who are disproportionately affected with higher rates of infections and deaths. Rates of hospitalization in some BIPOC communities are up to five times higher than in people who are white, according to the Centers for Disease Control and Prevention.

“We are being decimated,” said Dr. Michele Andrasik, director of community engagement for the COVID-19 Prevention Network and senior staff scientist with Fred Hutch’s Vaccine and Infectious Disease Division. “In many situations across our indigenous communities and in rural Black communities, the rates of hospitalization and deaths are just staggering.”

While the Pfizer and Moderna vaccines have efficacy rates of around 95 percent – notably high compared to other vaccines, such as flu shots which are around 60 percent, she said – some people question whether they can trust the vaccines and the speed at which they were developed.

“Many communities have a long and sordid history with medicine, with research,” Andrasik said. “I think it’s incredibly important to acknowledge that and to address some of that and discuss how those past indiscretions and unethical instances have really led to a more ethically focused science in BIPOC communities.

“Personally, I would be shocked if people of color, BIPOC, people were not skeptical. I think it’s a healthy coping mechanism to question.”

Andrasik said it’s important for those in the medical community to listen and validate those concerns. She tries to make sure people are getting their information from reputable places. “I ask my cousins, for example, where exactly did you get that information and can you trust that information to be true?”

While some are hesitant about the vaccines, believing they were developed so fast that they shouldn’t be trusted, Andrasik is quick to point out that the foundational work of the mRNA vaccines has actually been going on for several decades. One of the key scientists who developed the Moderna vaccine is Dr. Kizzmekia Corbett, a Black woman, who, “along with the vaccine research center team of National Institutes of Health, have been working on this for 17 plus years, so this is not new,” Andrasik said. “I think that’s critical.”

What is the risk of vaccine side effects or reaction?

As vaccines are rolling out to larger groups of people, Dr. Catherine Liu, a physician and professor in Fred Hutch’s Clinical Research and Vaccine and Infectious Disease divisions, said she gets a lot of questions about side effects and what’s normal.

The most common vaccine side effect, she said, is soreness at the injection site. Some people may also experience fatigue, headaches, body aches or low-grade fevers. Most of the side effects go away after a day or two, she said.

Two people unpacking boxes of Pfizer vaccine — Pharmacy Director Dr. Rick LeFrance and Pharmacy Technician Michelle Vincent receive and unpack the first Pfizer vaccine package delivered to the Seattle Cancer Care Alliance in December 2020.

While it might be tempting to try to curb side effects right before getting the vaccine by taking Tylenol or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, the current recommendation is to avoid it, Liu said. “There’s not really a lot of data about whether this could impact vaccine-induced immune response, so, in the absence of data, the guidance is to avoid pre-medication,” she said.

While reports of people having an anaphylactic reaction to the vaccine have made headlines, Andrasik stressed that it’s important to look at those in the context of how many vaccines were given out. As of early January, out of 4 million people vaccinated with Moderna, 10 people had an anaphylactic reaction, she said, and out of 2 million doses of Pfizer, 21 cases were reported.

“It’s incredibly rare,” she said, “but all of the vaccination sites have an integral protocol they follow so you will stay and be monitored after your vaccination.”

Staying safe: ‘The three Ws’ and double masks

With new COVID variants circulating and a long waiting list to get a vaccine, it’s more important than ever to take precautions, said Lui.

The core safety measures are ‘the three Ws’: wear a mask, watch your distance between others and wash your hands. It’s also important to avoid non-essential travel and crowds. “Those are key strategies to prevent transmission in the face of these new variants,” she said. “And when it does become your turn and we have vaccine available, please go get vaccinated.”

Earlier this month, the CDC also recommended that people wear a multi-ply mask, which could be a mask with two or more layers, or to “double mask”, practices that are now also Starbucks policy, based on guidance from the Centers for Disease Control and Prevention earlier this month.

The CDC recommendation was based on data that suggested wearing a mask correctly can reduce exposure by about 95 percent compared to not wearing a mask, she said. The key is to make sure it really fits well. That means using one with a wire that can be bent to fit around your nose and that fits snugly against your face without any gaps.

A Starbucks partner asked Liu, a physician who specializes in the prevention and treatment of infectious diseases, whether wearing a mask can decrease a person’s oxygen saturation. Several studies have looked at that, she said, and didn’t find any evidence that wearing a mask reduces the ability to breathe in oxygen and eliminate carbon dioxide.

Liu said that pandemic fatigue is very real and that it can be hard to keep up all the safety measures but that the new variants may be able to take advantage of lapses in protection. “It’s just very important for us to not let our guard down as we get really close to protecting the larger community with the vaccine ramp up.”

Moving forward

As the panel wound down, Lynch, the president of Fred Hutch, said he’s convinced that cancer will be cured at some point, maybe not in our lifetimes, but in those of our children. But “viruses are going to be with the world for the rest of humanity,” he said. “They’re not going anywhere.”

Just as with COVID’s emergence, the threat of new viruses will always be real. One of the things COVID has exposed is the need for more infectious disease resources.

“By having a combination of epidemiologists like Trevor, the therapeutic people like Catherine, the vaccine developers like Michele, and the clinical trial structure to be able to try new things, that’s kind of one of the things [Fred Hutch] is committed to doing even after COVID is dissolved.”

For more information on Fred Hutch and how to support research on cancer and COVID-19 or to get research updates, click here. You can also support Indigenous communities hard hit by the pandemic by donating personal protective equipment through Fred Hutch’s Amazon wish list.

Header image: Healthcare workers at SCCA get vaccinated with the Pfizer COVID-19 vaccine, December 18, 2020 at the Seattle Cancer Care Alliance in Seattle, Washington. Photo by Robert Hood, Fred Hutch

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