Using Flu Research Infrastructure to Understand COVID-19

When I began my career in public health, my focus seemed to be on everything but infectious diseases. I wrote my thesis on cancer, completed my dissertation on violence, and entered the Centers for Disease Control and Prevention’s (CDC) Epidemic Intelligence Service as a fellow in environmental health. It wasn’t until I started working at Abt almost 10 years ago that I found my passion for infectious disease research.

When I joined Abt as a senior epidemiologist in 2012, the company already had a history of studying influenza. The 2009-10 influenza pandemic produced alarmingly high rates of pregnant women who were hospitalized and dying from flu-related complications. Those deaths created an urgent need to conduct influenza research and tailor messaging about the importance of flu vaccination. At that time, Abt joined the research effort as a clinical coordinating center for two studies of high-risk populations. Since then, we have greatly expanded our capabilities and expertise to support:

• Clinical research on international studies of influenza burden and vaccine effectiveness among children, pregnant women, healthcare personnel, and the elderly.
• Internet-based surveillance of flu vaccination coverage among high risk populations, including pregnant women and healthcare personnel.
• Oversight and support of pandemic preparation activities in the U.S.
• Coordination of domestic and international immunogenicity trials comparing various types of influenza vaccines on the market.
• Development and implementation of artificial intelligence methods for systematic processing of large volumes of quantitative and qualitative vaccine data.

While at Abt, I have had the good fortune to lead many of these timely and important projects and collaborate with an impressive group of subject matter experts across the globe. Through many hours of site visits, project meetings, and personal interactions with my colleagues, I understand better the challenges that face infectious diseases researchers and the general population and clinicians who care for them. For example, low- and middle-income countries often need basic influenza burden data to demonstrate the need for influenza vaccine. Without sound data, other health issues may take priority for limited resources. I have also been struck by the many hats my fellow collaborators wear. In addition to public health researchers, many are well-respected physicians, advocates, and politicians, often fighting for the greater good of patients and the community.

I also better understand the struggles that our clients and clinicians face when encouraging vaccination in an increasingly anti-vaccination atmosphere. And I appreciate the difficult task of developing flu vaccination campaigns that result in action. I once worked with a public health director who noted that the best thing to happen for vaccination rates in her area was not the public health-led outreach campaigns but the announcement that a popular rapper was diagnosed with the flu and told his online followers to get vaccinated.

Last year, during the 10th anniversary of the 2009 H1N1 influenza pandemic, I attended many presentations and webinars focused on the progress that has taken place and the preparations needed for the next pandemic – because for influenza researchers it is not a question of if but, rather, when the next influenza pandemic will occur. Now we find ourselves in the midst of a different kind of novel pandemic: COVID-19. Can we apply lessons learned from influenza to the current situation? If a vaccine is developed, will people be more inclined to get it than the influenza vaccine? If so, why? How effective will it be in protecting people against infection? If a second wave/season of COVID-19 takes place, will the first-generation vaccine be effective against it?

While we are not in a position to answer these questions while we await development of a vaccine, Abt can help answer other important questions about COVID-19. Through our partnerships with federal and state agencies and healthcare institutions around the world, we have a strong research infrastructure and in-house subject matter expertise. Specifically, we are working with New York City to rapidly deploy a COVID-19 survey module to collect data from adults and children on at risk conditions, illnesses/symptoms in the past 30 days, and medical care/testing sought, among other things. We have existing internet panels of pregnant women and healthcare personnel who can respond to COVID-19 questions. We are also in the process of adapting influenza protocols and data collection instruments to include COVID-19 questions for future multi-site research projects. And when a vaccine does become available, my colleagues and I stand ready to conduct vaccine effectiveness trials among various populations.

Studies such as these conducted by Abt help us understand the novel virus, and, in turn, position us to answer the question: What did we learn and how can it better prepare us for the next pandemic?

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