Anti-Covid-19 Vaccination at UPMC Salvator Mundi International Hospital. Interview with the medical director Prof. Giovanni Vizzini.

On 13 January, the anti-Covid-19 vaccination campaign was launched and in two days the 200 doses provided for the coverage of all medical and health personnel were administered. Yesterday, February 4, the second dose was administered. A very important step both for the operators of the clinic, and for their families, and for the patients of the structure, who can thus be guaranteed even greater safety and always high levels of assistance and care. We ask our Chief Medical Officer and COO and Medical Director of UPMC Italy, Prof. Giovanni Vizzini, for a snapshot of the clinic and global situation.

Professor Vizzini, how necessary do you think the vaccine is to defeat the pandemic? What is the value and coverage it offers?

This is the real and only weapon available to get out of the pandemic (and all its consequences) and resize the Covid-19 infection, bringing it back to a serious clinical condition (sometimes even deadly) but which will have an impact identical or even lower than that of many diseases with which we have been living for centuries. The discovery of the mechanism and protective power of the vaccine, starting from the defeat of smallpox, is probably the greatest achievement in the history of medicine and remains a very powerful weapon in the protection of the human species against dreaded diseases. Just think of measles and polio. Regarding coverage, all the anti-Covid vaccines developed and authorized over the last few months have shown a very high ability to protect against infection (around 90% of people who complete the vaccination cycle of the two injections).

The administration of the second dose of the Covid-19 vaccine at UPMC Salvator Mundi International Hospital represents a decisive phase in such a long period of critical global health, which lasted almost a year. Professor Vizzini, how important is the vaccine within a healthcare facility?

In health facilities is concentrated a population involuntarily selected for its fragility. Both acute diseases, for limited periods, and chronic ones, indefinitely, make patients generally weaker by reducing, among other things, their ability to defend themselves from infections. Furthermore, in hospitals the patient population belongs to the older age groups, and this is, as is now known, the main risk factor for contracting the most serious forms of Covid-19 infection. Vaccinating health personnel therefore aims to reduce and possibly eliminate the risk that patients in health facilities (including nursing homes for the elderly) may be infected by close and repeated contact with health personnel. Secondly, in the context of the pandemic and the enormous demand for assistance in health facilities, the contagion of health personnel (and their consequent isolation in quarantine) has led to enormous organizational difficulties for the reduction of staff, with negative effects on the ability of facilities to accept patients and in the quality of care.

At UPMC Salvator Mundi International Hospital, 99% of healthcare workers have joined the Covid-19 vaccination campaign. A sign of cohesion and strong motivation and a clear message. It would be defined as an act of love but above all of responsibility and also a deontological and social duty, is it correct?

For health personnel, the value of vaccination can be considered multiplied. Not only is a gesture made that protects us (individually), and protects our loved ones and all the people with whom we will have contact from now on. But it has great importance as it constitutes the fundamental weapon to avoid that through our normal activities of care for patients we can unintentionally and unknowingly infect fragile people, such as our patients, and cause even very serious damage to their health (which is exactly the opposite of what we commit ourselves to every day, even with great sacrifices).

As for administrative staff, has vaccination already been scheduled at UPMC Salvator Mundi International Hospital?

The administrative staff of the health facilities has been equated, by the National Technical Scientific Committee for the COVID emergency, to the general population. For this reason, it can be vaccinated, in accordance with the national and regional vaccination plan, based on belonging to the various categories defined by age groups or for the possible presence of comorbidities.

The global impact of the COVID-19 pandemic has led to an unprecedented level of mobilization in the world of scientific research to develop vaccines in a very short time, bringing them into clinical trials and, in some cases, already approval and authorization. Perhaps this speed in processes and the presence of vaccines based on different technologies, in some people, have caused concern and mistrust. What do you feel to say about this?

The only differences that can be detected in the development, experimentation and authorization processes compared to the past are:

1. the massive and contemporary commitment of all laboratories in the world with experience in the field of vaccines;

2. the enormous commitment of States to finance (in a closed box) the pharmaceutical industries for development and experimentation, which has allowed enormous investments in this phase of research, which has never occurred before;

3. reduction (sometimes elimination) of all administrative and "bureaucratic" procedures, unfortunately present in the authorization processes of the Agencies of all countries (in particular FDA in the USA and EMA in Europe). None of the essential and indispensable stages of the experimentation and authorization process has been eliminated or minimized. As with all drugs and vaccines, surveillance (so-called "post-marketing") is continued after authorization for clinical use, so that possible very infrequent side effects can also be identified and their effectiveness (or non-efficacy) in specific and particular conditions can be better understood. For example, we will be able to better understand if a type of vaccine will be more suitable in a particular age group or in particular conditions, such as pregnancy and breastfeeding. As for possible adverse effects, to date more than 107 million doses of vaccines have been administered worldwide, without any side effects having been reported, in type and frequency, compared to the information obtained from clinical trials.

UPMC and the University of Pittsburgh, known for their research, are also studying a new vaccine and a treatment against Covid-19. There is also talk of nasal spray for this purpose. Can you explain, in simple words, what it is? Are the relevant procedures already underway to obtain the experimentation in Italy?

The Covid vaccine developed in the research laboratories of UPMC and the University of Pittsburgh consists of a protein, recreated in the laboratory, identical to one of those present on the surface of the Covid-19 virus and called "Spike". It is one of the most important components for the survival of the virus itself, because through this surface protein the virus penetrates into the cells of our body and inside them finds the material ("food") to replicate. The UPMC vaccine, once injected into the body, stimulates the production of antibodies against the spike protein and leaves the cells of our immune system to remember this contact. If the vaccinated person comes into contact with Covid-19, his immune system will recognize this foreign protein placed on the outer wall of the virus and will be ready to produce specific antibodies, which will be able to block the entry of the virus into the cells of his body and therefore its replication, eliminating it. With this mechanism you will not give time to the virus to multiply, to enter the cells of our body (especially those of our respiratory system) and to cause disease. UPMC's vaccine recently began authorization procedures for testing on volunteers in the United States and Italy.