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What are the three phases of vaccine testing?

Substantial research needs to be completed by scientists before any potential vaccine undergoes phased testing. Once it gets to that stage, there are three research phases of trials that take place before the vaccine can be deployed for use. During the first stage (Phase I), the new vaccine is provided to small groups of people—the first time the vaccine is tested in humans. The second stage (Phase II) involves testing the vaccine on people who have similar characteristics (such as age and physical health) to the target population, or the group for which the vaccine is intended. The goal of this stage is to identify the most effective dosages and schedule for Phase III trials. The final stage (Phase III) provides the vaccine to thousands of people from the target population to see how safe and effective it is. Once the vaccine clears this last stage, the manufacturer can apply for a license from regulatory authorities (like the FDA) to market for human use. Sometimes medications that have already been approved by the U.S. Food and Drugs Administration in clinical trials will enter into a Phase IV trial. This phase focuses on potential side effects from the vaccine or medication that were not seen in the first three phases. This phase also helps researchers understand how well a vaccine works over a longer time frame and how safe it is, often with thousands of people over several years. Phase IV is also called a 'post-marketing surveillance' trial.

Can the virus be transmitted through the air?

According to the World Health Organization (WHO), the virus that causes COVID-19 is primarily spread through respiratory droplets (little spit droplets that fly out when a person sneezes, coughs or talks). Respiratory droplets can infect other people who are nearby, or indirectly infect others when they touch a surface contaminated with infected droplets. After an open letter by scientists in July 2020, the WHO now acknowledges the possibility of airborne transmission, which is caused by smaller and lighter 'droplet nuclei' (residuals of respiratory droplets from infected people) that can remain in the air for longer periods of time and remain infectious over long distances. Experts are looking at previous data from China to see whether the virus may spread through the air or through vents via airborne transmission. While a few lab-based studies have found that the virus can be present in the air for up to three hours, these studies did not assess if the virus is viable to infect anyone else. Recently, a research study published in Nature found viral contamination in air samples from patients isolated at a medical center, which supports the use of airborne isolation precautions in caring for COVID-19 cases. A few studies have also looked into how airborne transmission may have played a role in certain outbreaks, such as the one in the Diamond Princess cruise ship. One of these studies in pre-print found that it was likely that a combination of both close-range (respiratory droplet) transmission and long-range (airborne) transmission contributed similarly to disease progression aboard the ship. Thus far, the WHO still claims that evidence points to close person-to-person respiratory droplet transmission as the primary mode of COVID-19 transmission. However, experts warn that there is significant reason to believe airborne transmission is happening. The U.S. Centers for Disease Control and Prevention (CDC) now provides infection control recommendations for airborne transmission as well as respiratory droplet transmission. Definitive studies may take a long time to alter the body of evidence in the coming weeks and months, but proactive prevention measures such as universal use of masks (the U.S. CDC recommends wearing a cloth mask over a surgical mask for increased protection) could save lives in the meantime.

What does the scientific literature say about using hydroxychloroquine to prevent, treat or cure COVID-19?

Hydroxychloroquine is not a recognized prevention, treatment or cure for COVID-19. Earlier in the pandemic, hydroxychloqoruine was proposed as a treatment for COVID-19, on the basis of some preliminary results from small, uncontrolled clinical trials. Since then, more robust randomized controlled trials have been conducted to study hydroxycholoquine as a treatment for hospitalized coronavirus patients. Study results published in November 2020 show that hydroxychloroquine does not benefit adults hospitalized with the coronavirus disease. Another study published in 'The Lancet' in November 2020 reported that hydroxycholoquine does not prevent mortality from COVID-19 even among those who were using it before they got infected with SARS-CoV-2. Around the world, some countries have authorized chloroquine or hydroxychloroquine for the treatment of COVID-19 despite limited clinical evidence supporting its efficacy. This decision follows some preliminary results coming out of China and France in March 2020, where a few small clinical trials showed limited success of the medication. On June 15th 2020, the U.S. FDA revoked the special permission to use chloroquine and hydroxychloroquine in emergency situations for COVID-19, citing that these drugs are unlikely to be effective in treating COVID-19 and highlighting serious cardiac adverse events and other serious side effects reported in studies.

What do we know about the smallpox vaccine?

Smallpox was among the deadliest viral diseases in human history, killing an estimated 30% of the people infected and leaving many survivors with permanent life changes, such as blindness or disfigurement.** ** The smallpox vaccine developed by Edward Jenner in 1796 is considered the first successful vaccine to be created. In the original version, a patient was infected with another disease, cowpox, to induce an immune response that could protect against smallpox. Smallpox vaccines have evolved over time, with some eventually using a different virus called vaccinia (which is similar to cowpox and less harmful than smallpox) to induce a protective immune response. Since smallpox vaccines are considered live virus vaccines, as opposed to weakened (attenuated) or killed (inactivated), more precautions are required when getting this type of vaccine and there are higher risks of severe side effects. Thanks to extensive global vaccination efforts reaching 80% coverage in each country, smallpox was recognized as eradicated in 1980 by the World Health Organization. This means that the smallpox vaccines no longer need to be routinely given, and many people born after this time have not been vaccinated against smallpox.In July 2020, a report was published in Genome Biology about the origins and genetic diversity of some historical smallpox vaccine strains. The authors have stated that "understanding the history, the evolution, and the ways in which these viruses can function as vaccines is hugely important in contemporary times" and that "this work points to the importance of looking at the diversity of these vaccine strains found out in the wild. We don't know how many could provide cross protection from a wide range of viruses, such as flus or coronaviruses."

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In-house scientists provide custom explainers for critical science questions from journalists, fact-checkers and others in need of accessible breakdowns on scientific information. Topics range from reproductive health, infectious disease, climate science, vaccinology or other health areas.

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Our scientists, writers, journalists, and experts do not engage in, advocate for, or publicize their personal views on policy issues that might lead a reasonable member of the public to see our team’s work as biased. If you have concerns or comments about potential bias in our work, please contact our editorial team at health@meedan.com.

Our mission

Health Desk provides on-demand and on-deadline science information to users seeking to quickly communicate complex topics to audiences.

In-house scientists provide custom explainers for critical science questions from journalists, fact-checkers and others in need of accessible breakdowns on scientific information. Topics range from reproductive health, infectious disease, climate science, vaccinology or other health areas.

Meedan's Health-Desk.org makes every effort to provide health- and science-related information that is accurate and reflects the best evidence available at the time of publication. To submit an error or correction request, please email our editorial team at health@meedan.com. All error or correction requests will be reviewed by the Health Desk Editorial and Science Teams. Where there is evidence of a factual error or typo, we will update the explainer with a correction or clarification and follow up with the reader on the status of the request.

Our scientists, writers, journalists, and experts do not engage in, advocate for, or publicize their personal views on policy issues that might lead a reasonable member of the public to see our team’s work as biased. If you have concerns or comments about potential bias in our work, please contact our editorial team at health@meedan.com.

Nat Gyenes

Nat Gyenes, MPH, leads Meedan’s Digital Health Lab, an initiative dedicated to addressing health information equity challenges, with a focus on the role that technology plays in mediating access to health through access to information. She received her masters in public health from the Harvard T. H. Chan School of Public Health, with a focus on equitable access to health information and human rights. As a research affiliate at Harvard’s Berkman Klein Center for Internet & Society, she studies the ways in which health information sources and outputs can impact health outcomes. She lectures at the Harvard T.H. Chan School of Public Health on Health, Media and Human Rights. Before joining Meedan, Nat worked at the MIT Media Lab as a health misinformation researcher.

Megan Marrelli

Megan Marrelli is a Peabody award-winning journalist and the News Lead of Health Desk. She focuses on news innovation in today’s complex information environment. Megan has worked on the digital breaking news desk of the Globe and Mail, Canada’s national newspaper, and on the news production team of the Netflix series Patriot Act with Hasan Minhaj. She was a Canadian Association of Journalists finalist for a team Chronicle Herald investigation into house fires in Halifax, Nova Scotia. On top of her role at Meedan Megan works with the investigative journalism incubator Type Investigations, where she is reporting a data-driven story on fatal patient safety failures in U.S. hospitals. She holds a Master of Science from the Columbia Journalism School and lives in New York.

Dr. Anshu Shroff

Anshu holds a Doctor of Public Health (DrPH) from the Harvard T.H. Chan School of Public Health, and a Humanitarian Studies, Ethics, and Human Rights concentrator at the Harvard Humanitarian Initiative. She is a Harvard Voices in Leadership writing fellow and student moderator, Prajna Fellow, and the John C. and Katherine Vogelheim Hansen Fund for Africa Awardee. Anshu’s interests include: systemic issues of emergency management, crisis leadership, intersectoral approaches to climate risk resilience, inclusion and human rights, international development, access and sustainability of global health systems, and socio-economic equity. Anshu has worked at the United Nations, UNDP, UNICEF, Gates Foundation, and the Institute of Healthcare Improvement.

Dr. Christin Gilmer

Dr. Christin Gilmer is a Global Health Scientist with a background in infectious diseases, international health systems, and population health and technology. In the last 15 years, Christin has worked for the WHO, University of Oxford, World Health Partners, USAID, UNFPA, the FXB Center for Health & Human Rights and more, including volunteering for Special Olympics International’s health programs and running health- and technology-based nonprofits across the country. She obtained her Doctor of Public Health Degree at the Harvard T.H. Chan School of Public Health, her MPH at Columbia, and spent time studying at M.I.T., Harvard Kennedy School, and Harvard Business School. Christin has worked in dozens of countries across five continents and loves running programs and research internationally, but she is currently based in Seattle.

Dr. Jessica Huang

Dr. Jessica Huang is currently a COVID-19 Response and Recovery Fellow with the Harvard Kennedy School’s Bloomberg City Leadership Initiative. Previously, she worked and taught with D-Lab at MIT, leading poverty reduction and humanitarian innovation projects with UNICEF, UNHCR, Oxfam, USAID, foreign government ministries and community-based organizations across dozens of countries. She also co-founded a social enterprise that has provided access to safe drinking water to thousands in India, Nepal and Bangladesh. Formerly trained as an environmental engineer, she earned a Doctorate of Public Health from Harvard and a Master’s in Learning, Design and Technology (LDT) from Stanford. Her projects have won multiple awards, including the top prize in A Grand Challenge for Development: Technology to Support Education in Crisis & Conflict Settings, and led to her being recognized for Learning 30 Under 30. She enjoys being an active volunteer, supporting several non-profits in health, education, environmental sustainability and social justice.

Jenna Sherman

Jenna Sherman, MPH, is a Program Manager for Meedan’s Digital Health Lab, an initiative focused on addressing the urgent challenges around health information equity. She has her MPH from the Harvard T.H. Chan School of Public Health in Social and Behavioral Sciences, with a concentration in Maternal and Child Health. Prior to her graduate studies, Jenna served as a Senior Project Coordinator at the Berkman Klein Center for Internet and Society at Harvard Law School, where she worked on tech ethics with an emphasis on mitigating bias and discrimination in AI and health misinformation online. Previous experiences include helping to develop accessible drug pricing policies, researching access to quality information during epidemics, and studying the impact of maternal incarceration on infant health.

Nour Sharara

Nour is a Global Health Strategy consultant based in Dakar (Senegal) and specialized in health system strengthening. Most recently, she worked with Dalberg Advisors focusing on Epidemic Preparedness & Response and Vaccination Coverage and Equity across 15 countries in Sub-Saharan Africa. Her previous work experiences include researching the clinical needs in point-of-care technology in cancer care at the Dana-Farber Cancer Institute in Boston; and coordinating the implementation of a colonoscopy quality assurance initiative for a colorectal cancer screening program at McGill University in Montreal. Nour has a Master of Public Health from the Harvard T.H. Chan School of Public Health, a Master of Arts in Medical Ethics and Law from King’s College London, and a Bachelor of Science from McGill University. She is fluent in French and English.

Shalini Joshi

Shalini Joshi is a Program Lead at Meedan and formerly the Executive Editor and co-founder of Khabar Lahariya - India’s only independent, digital news network available to viewers in remote rural areas and small towns. Shalini transformed Khabar Lahariya from one edition of a printed newspaper to an award-winning digital news agency available to over ten million viewers. She has a sophisticated understanding of local media and gender, and the ways in which they can inhibit women from participating in the public sphere in South Asia. Shalini was a TruthBuzz Partner & Fellow with the International Center for Journalists (ICFJ). She is a trainer in journalism, verification and fact-checking. She has designed, implemented and strengthened news reporting & editorial policies and practices in newsrooms and fact-checking organisations. Shalini set up and managed the tipline used to collect WhatsApp-based rumors for Checkpoint, a research project to study misinformation at scale during the 2019 Indian general elections.

Mohit Nair

Mohit Nair currently serves as Partnerships Director at FairVote Washington, a non-profit organisation based in Seattle, WA. Previously, he worked with the Medecins Sans Frontieres (MSF) Vienna Evaluation Unit and with MSF Operational Centre Barcelona in India. He has conducted research studies on diverse topics, including the drivers of antibiotic resistance in West Bengal and perceptions of palliative care in Bihar. Mohit has also worked as a research consultant with Save the Children in Laos to identify gaps in the primary health system and develop a district-wide action plan for children with disabilities. He holds a Master of Public Health from the Harvard University T.H. Chan School of Public Health and a Bachelor of Science from Cornell University.

Dr. Seema Yasmin

Seema Yasmin is an Emmy Award-winning medical journalist, poet, physican and author. Yasmin served as an officer in the Epidemic Intelligence Service at the U.S. Centers for Disease Control and Prevention where she investigated disease outbreaks. She trained in journalism at the University of Toronto and in medicine at the University of Cambridge. Yasmin was a finalist for the Pulitzer Prize in breaking news in 2017 with a team from The Dallas Morning News and received an Emmy Award for her reporting on neglected diseases. She received two grants from the Pulitzer Center on Crisis Reporting and was selected as a John S. Knight Fellow in Journalism at Stanford University iin 2017 where she investigated the spread of health misinformation and disinformation during epidemics.

Dr. Saskia Popescu

Dr. Saskia Popescu is an infectious disease epidemiologist and infection preventionist with a focus on hospital biopreparedness and the role of infection prevention in health security efforts. She is an expert in healthcare biopreparedness and is nationally recognized for her work in infection prevention and enhancing hospital response to infectious diseases events. Currently, Dr. Popescu is an Adjunct Professor with the University of Arizona, and an Affiliate Faculty with George Mason University, while serving on the Coronavirus Task Force within the Federation of American Scientists, and on a data collection subcommittee for SARS-CoV-2 response with the National Academies of Science, Engineering, and Medicine. She holds a PhD in Biodefense from George Mason University, a Masters in Public Health with a focus on infectious diseases, and a Masters of Arts in International Security Studies, from the University of Arizona. Dr. Popescu is an Alumni Fellow of the Emerging Leaders in Biosecurity Initiative (ELBI) at the Johns Hopkins Bloomberg School of Public Health, Center for Health Security. She is also an external expert for the European Centre for Disease Control (ECDC), and a recipient of the Presidential Scholarship at George Mason University. In 2010, she was a recipient of the Frontier Interdisciplinary eXperience (FIX) HS-STEM Career Development Grant in Food Defense through the National Center for Food Protection and Defense. During her work as an infection preventionist, she managed Ebola response, a 300+ measles exposure resulting in an MMWR article, and bioterrorism preparedness in the hospital system. More recently, she created and disseminated a gap analysis for a 6-hospital system to establish vulnerabilities for high-consequence diseases, helping to guide the creation of a high-consequence disease initiative to enhance readiness at the healthcare level.

Ben Kertman

Ben Kertman is a behavior change scientist and public health specialist who became a user research consultant to help organizations design experiences that change behaviors and improve human well-being. Impatient with the tendency of behavior change companies to use a single discipline approach (e.g. behavioral economics) and guard their methods behind paywalls, Ben spent the last 7 years developing an open-source, multi-discipline, behavior change framework for researchers and designers to apply to UX. Ben is an in-house SME at Fidelity Investments and consults for non-profits on the side. Ben holds a masters in Social and Behavior Science and Public Health from Harvard.

Dr. Emily LaRose

Emily LaRose is a Registered Dietitian and Nutrition and Global Health Consultant who, in addition to her work with Meedan, currently works as a Technical Advisor for Nutrition for Operation Smile. She has been a dietitian for more than 18 years and, over the past 10 years, she has worked for the World Bank, Global Alliance for Improved Nutrition (GAIN), Médecins Sans Frontières (MSF), PATH, Johnson & Wales University, and Children’s Hospital Los Angeles. In her work, she has conducted analytical research and written specialty reports on infant and young child malnutrition, health misinformation, global human milk banking practices, and innovative food system programs; developed tools and protocols for clinical nutrition care delivery in humanitarian hospitals; taught university-level nutrition courses; and provided nutritional care for critically ill hospitalized patients. Emily earned her Doctor of Public Health (DrPH) degree with a Nutrition and Global Health Concentration at the Harvard T.H. Chan School of Public Health, her Master of Science in Dietetics at Kansas State University, and her Bachelor of Science in Culinary Arts Nutrition at Johnson & Wales University.

Dr. Bhargav Krishna

Bhargav Krishna is a Fellow at the Centre for Policy Research in Delhi, and adjunct faculty at the Public Health Foundation of India and Azim Premji University. He previously managed the Centre for Environmental Health at the Public Health Foundation of India, leading research and teaching on environmental health at the Foundation. He has been a member of Government of India expert committees on air pollution and biomedical waste, and has led work with Union and State governments on air pollution, climate change, and health systems. His work has been funded by the World Health Organization, Rockefeller Foundation, Packard Foundation, Environmental Defense Fund, and others. He holds bachelors and masters degrees in Biotechnology and Environmental Science respectively, and graduated recently from the Doctor of Public Health program at the Harvard T. H. Chan School of Public Health. Bhargav also co-founded Care for Air, a non-profit working on raising awareness related to air pollution with school children in Delhi.

Dr. Christine Mutaganzwa

Dr. Christine Mutaganzwa is a medical doctor pursuing a Ph.D. program at the Université de Montréal in Biomedical Sciences. She holds a Master of Medical Sciences in Global Health Delivery (MMSc-GHD) from Harvard Medical School, Boston, MA, and a Master of Sciences (MSc) in Epidemiology and Biostatistics from the University of Witwatersrand, Johannesburg, South Africa. She graduated from the University of Rwanda with a degree in General Medicine and Surgery. Christine has worked with referral hospitals in Kigali, the capital city of Rwanda, during her medical training and after graduation. In addition, she has extensive experience working with rural communities in the Eastern province of Rwanda, where she organized clinical and research activities in active collaboration with colleagues within and outside Rwanda. Her research portfolio cuts across maternal and child health to infectious and chronic diseases. Christine is an advocate for children's healthcare services, especially for underserved populations. She is part of a community of scientists translating scientific findings into understandable and accessible information for the general population. Christine is an avid reader and a lover of classical/contemporary music.

Dr. Ahmad Hegazi

Ahmad is an experienced physician, who earned his medical degree from Cairo University, Faculty of Medicine, in Egypt. He practiced medicine between 2012 and 2017 as a general practitioner where he was involved in primary care, health quarantine services, and radiology. He then taught medicine in Cairo for two years prior to starting his MPH program, at the Harvard T.H. Chan School of Public Health, where he supplemented his experience with knowledge on epidemiology, health systems and global health issues. Additionally, Ahmad has an interest in nutrition, which started as a personal curiosity to how he can improve his own health, then quickly saw the potential for public health nutrition in the prevention and management of multiple, lifelong diseases. His enrollment at Harvard started his transition towards learning about food, and public health nutrition. Ahmad now combines the knowledge and experience of his medical career, with the learnings of his degree to navigate public health topics in his writing and his career. He is a life-long learner and continues to gather knowledge and experience, and works towards maximizing his impact through combatting misinformation through his work with Meedan.

Dr. Uzma Alam

Dr. Uzma Alam is a global health professional working at the intersection of infectious diseases and healthcare delivery in the international development and humanitarian contexts. She focuses on the use of evidence and innovation to inform strategies and policies. Her work has appeared globally across print and media outlets.She has international experience with roles of increasing responsibility across the science value chain having served with academic, non-profit, corporate, and governmental agencies, including advisory commissions and corporate counsel. Uzma is the former secretary of the Association of Women in Science and editor of the Yale Journal of Health Policy, Law, and Ethics. Currently she serves on the Board of the Geneva Foundation. She also leads the Biomedical and Health Sciences Portfolio of the Developing Excellence, Leadership and Training in Science in Africa program (DELTAS-Africa). A US$100 million programme supporting development of world-class scientific leaders on the continent. Plus heading the African Science, Technology, and Innovation (STI) Priorities Programme. A programme that engages Africa’s science and political leaders to identify the top STI priorities for the continent that if addressed, offer the highest return on investment for Africa’s sustainable development.

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