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It has now been 6 months since the first wave of Americans received their first shot of a COVID-19 vaccine. Proving just how effective the vaccines are in the U.S., we've seen the virus spread down to levels not seen since the start of the pandemic. But one thing we still don't know: how long immunity will last. As Pfizer and Moderna move forward for full FDA licensure, executives at both companies have cited the need for a likely booster. Pfizer CEO Albert Bourla, DVM, PhD, predicted the need for a booster to be "somewhere between 6 and 12 months" after first being vaccinated. Explaining the key role variants will play in the decision, Moderna CEO Stéphane Bancel predicted it could be as soon as September for those at highest risk of severe infection. NIAID director Anthony Fauci, MD, told a Senate subcommittee that he would expect the need for a booster, but declined to put a timeline on his prediction. "I don't anticipate that the durability of the vaccine protection is going to be infinite," Fauci said. Researchers within his institute at the NIH recently began looking into, not just if boosters are necessary but also how to possibly mix vaccines and the impacts on protection. On this week's episode, William Schaffner, MD, professor of Preventive Medicine and Infectious Diseases at Vanderbilt University Medical Center in Nashville, joins us to help break down what the science tells us now, and what to expect.

The U.S. has hit a new COVID-19 milestone -- not a grim one, but one of hope -- experiencing the lowest case and death counts since early on in the pandemic. Around the world, a different picture is emerging as countries like Brazil, India, and Malaysia are experiencing devastating surges and shortages of critical supplies. India recently reported seeing more COVID deaths in a single day than any other country at any time during the pandemic. Globally, more than 3.5 million people are estimated to have died from COVID-19 -- however, researchers at the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine believe that number is vastly undercounted and the real death toll is likely two to three times higher. Even as 9% of the world's population have gotten vaccinated, half of those manufactured doses have gone to wealthy countries, whose supply is starting to exceed demand. Krutika Kuppalli, MD, vice chair of the global health committee at the Infectious Diseases Society of America and assistant professor of medicine in the division of infectious diseases at the Medical University of South Carolina, joins us in this week's episode to explain why the longer cases spread uncontained in any part of the world, the worse it fares for all of us.

Almost half of all Americans have now received at least one COVID-19 vaccine dose and roughly 40% are fully vaccinated, making mask mandates a thing of the past. Already, more than half a dozen states have vaccinated more than 70% of adults with at least one dose and some counties are hitting vaccine rates as high as 90% for those over 65 years of age. As we've watched deaths from COVID drop across the country, it seems we are getting closer to the goal of the pandemic response: getting a high enough percentage of people with immunity to return to "normal." While all signs seem to point to us being closer to that goal, will it also signal the end of the pandemic? After all, herd immunity is a global effort and dozens of countries haven't even vaccinated 5% of their population. Tom Frieden, MD, MPH, the former CDC Director under President Obama, and current president and CEO of Resolve to Save Lives, joins us on this week's episode to explain if we'll get there or if our goal should be something else completely.

The COVID-19 vaccine rollout has now expanded to include young adolescents among those eligible to receive Pfizer's two-dose shot. This expanded authorization comes as mask mandates across the country are lifting. Adding younger teens means an additional 17-million sleeves can be rolled up to receive a shot as the U.S. pushes forward with the largest mass vaccination program in history. But, even if vaccinations mean life can go 'back to normal,' many parents are concerned over potential side effects and long-term impacts of the vaccine. Others, however, are rushing to vaccinate ahead of summer camps. Every parent wonders: when will a vaccine be available for even younger kids? Some parents have even considered enrolling their young children in clinical trials for an earlier shot at a dose. Joining us this week is Paul A. Offit, MD, director of the Vaccine Education Center and professor of pediatrics in the Division of Infectious Diseases at Children's Hospital of Philadelphia. He's also a member of the FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC), the impartial group of experts that has been responsible for giving the greenlight for emergency use authorization.

Wear your mask. Or, don't wear your mask if you are vaccinated, as long as you are outside. But, keep masking and social distancing inside even if you are vaccinated. It's confusing to many. Vaccines have been proven to prevent serious infection, and studies that show a reduction in transmission are building, but they aren't foolproof. A recent study by Public Health England found that a single dose of either the Pfizer-BioNTech or AstraZeneca vaccine reduced household transmission by up to half. Those both require two doses to be considered "fully vaccinated." The study comes as we hear more about breakthrough COVID cases. In this episode, Colleen Kelley, MD, an associate professor of infectious diseases at Emory University School of Medicine in Atlanta and a principal investigator for the Moderna and Novavax phase III clinical trials at the Ponce de Leon Clinical Research Site, joins us to explain the risk of transmission after vaccination.

Fever. Sore arm. Flu-like symptoms. These are the COVID-19 vaccines' side effects, which now also include possible rare blood clots in the brain, and maybe even shingles. But are the side effects worse than getting COVID? For roughly 5 million Americans, they are concerned enough to skip that second dose, according to the CDC. Even as we learn about the possibility of these side effects, others are no longer a concern. Bell's palsy, for example, which was noted during clinical trials and at the FDA meetings as something to watch, has now been determined following an analysis to be no more likely than with other viral vaccines. So which side effects do we need to be on the lookout for, and which ones will pass just as quickly as we felt them? In this episode, Dial Hewlett Jr., MD, medical director for the Westchester County, New York Department of Health and fellow with the Infectious Diseases Society of America, joins us to explain. Dr. Hewlett also previously worked at Pfizer with their global medical product evaluation team.

Across the country, states are moving forward to either require or ban vaccine passports, even as nations move forward with bilateral agreements to allow travel without quarantining if you have one. As more people get vaccinated it will become the travel conundrum. Many cruise lines already say they will require proof of vaccination for crews and passengers. Sports and entertainment venues in certain states also say it will be required for entry. The federal government has maintained they won't be mandating one, but private companies are saying that a "passport" or COVID vaccine card is your ticket in. Would a vaccine passport, called by any other word, be as controversial? To find out how exactly these passports or verification cards would work, and "what's in a name," we spoke with Dakota Gruener, Executive Director for ID2020, a nonprofit group that's working on digital identification and is part of the Good Health Pass Collaborative; and Brian Castrucci, DrPH, MA, an epidemiologist and President & CEO of the de Beaumont Foundation.

The vaccine rollout so far has shown us that the process has been all but equitable for some of the most vulnerable populations. According to newly posted CDC data, more than half of all American adults have now received at least one dose of a COVID vaccine, and a third are fully vaccinated. A disproportionate number of those already vaccinated, however, are white. Black and Hispanic communities received a smaller share of the vaccine. As vaccine eligibility nationwide opens up to all adults, it's worth asking whether that will equate to equitable access. Richard Besser, MD, a pediatrician, former acting CDC Director, and the current President and CEO of the Robert Wood Johnson Foundation, the nation's largest non-profit dedicated to health, joins us on this week's episode to examine how equitable the vaccine distribution has been and where efforts need to be focused.

COVID surges and vaccination rates. Are the two inextricably linked? Vaccination rates continue to increase as many states have opened availability to all adults. But also increasing? COVID-19 surges, apparently resulting from a combination of eager travelers, relaxed distancing and mask mandates, and new variants that are more transmissible and perhaps more dangerous. What does that mean for vaccines and the ability to stop this pandemic? Nahid Bhadelia, MD, MALD, the medical director for Boston Medical Center Special Pathogens Unit and associate professor of infectious diseases at Boston University School of Medicine, joins "Track the Vax" host Serena Marshall on this week's episode to discuss whether we can vaccinate our way out of the pandemic.

It's now 100 days since the first COVID shot was given in the largest mass vaccination campaign in U.S. history. With more than 2 million shots administered daily, more vaccines are going in arms each day in America than in all of the clinical trials combined. Each vaccines clinical trial had 30,000-40,000 participants and was required to produce data for at "least two months after completion of the full vaccination regimen to help provide adequate information to assess a vaccine's benefit-risk profile." Today, that means we are getting more and more real-world data from a larger and more diverse group than any clinical trial could ever hope to produce. And as vaccine makers continue to seek FDA authorization, the real-world data also require intense scrutiny. According to the CDC, the current vaccine safety monitoring program is one of the most intense ever. But how does it work — and is it intense enough? Aaron Kesselheim, MD, JD, MPH, professor of medicine at Harvard Medical School and Brigham and Women's Hospital in Boston, joins us on this week's episode to answer that question and explain the possible shortfalls, as well as what you should know if you need to report something.

It's been one full year into the pandemic and it's clear: women are bearing the brunt of it. And it's not only because women have been forced out of the workplace at disproportionate rates — hitting the lowest level of female participation in the workplace since 1988 — or because more than 75% of those working in the healthcare sector are women. In fact, women appear hardwired to experience COVID-19 and the vaccines differently. Data from the CDC suggests side effects from the vaccines are worse in women; for example, 63 of the total 66 reported cases of anaphylaxis happened in women. Sabra Klein, PhD, a professor at the Johns Hopkins Bloomberg School of Public Health and co-director of the Center for Women's Health, Sex, and Gender Research, joins us on this week's episode to explain the biological reasons behind the data.

Vaccine distribution nationwide continues to ramp up, with nearly 2-million shots being given daily. President Biden has now said that every adult could be vaccinated by the end of May. A big promise that brings with it hope... a light at the end of the COVID-19 tunnel. But when will COVID vaccination be as simple as getting a flu shot? Many of the doses currently being given are at mass-vaccination sites. Will local and national pharmacies be able to simplify the process? The government still controls the supply and distribution of COVID-19 shots. We wanted to understand what that process looks like and when they expect to offer vaccines on-demand. Rina Shah, PharmD, group vice president, for pharmacy operations and services at Walgreens, joins us on this week's episode to answer those questions.

Millions of Americans are in line to get one of now three vaccines approved by the FDA for emergency use. The latest — Johnson & Johnson's one-dose adenovirus vector - can be stored for up to three months in a fridge and is easier to transport. Johnson & Johnson is no stranger to the technology, having used it in its Ebola vaccine. Despite its rollout goals of 100 million doses by June, Rick Nettles, MD, vice president of medical affairs at J&J's Janssen division, says researchers are already looking ahead to expanding its use for children and pregnant women. He joins this week's episode.

As the U.S. hits the half-million death mark from COVID-19 -- a grim milestone that is equal to roughly the entire population of Atlanta and more than that of Miami -- a new weapon is being added to the COVID-19 vaccine arsenal. Johnson & Johnson is seeking emergency use authorization for what would become the U.S.'s first one-dose and non-mRNA COVID vaccine. It employs adenovirus vectors, a technology that has been used in labs for decades and was approved for the Ebola vaccine by the FDA in December 2019. It's the same technology that AstraZeneca/Oxford and Sputnik V use. Still, questions remain on how these vaccines may be different than mRNA or similar enough to other existing shots to encourage vaccine uptake. To explain how adenovirus vectors work and what to expect from the new products, Daniel Griffin, MD, PhD, chief of infectious disease at ProHEALTH Care, an Optum unit, joins us on this week's episode.

As many as a dozen COVID-19 variants are knowingly circulating worldwide. Among them, B.1.1.7 and B.1.351, the highly transmissible strains that originated in the U.K. and South Africa, respectively. As more vaccines continue to push forward for emergency approval worldwide, we're still learning the effectiveness of the current vaccines against the new strains; and how the new mutations mean even those who have already had COVID-19 may not be immune from reinfection. To explore the new strains and what it means for vaccination efforts, future mutations, and herd immunity, Angela Rasmussen, PhD, a virologist with Georgetown University's Center for Global Health Science and Security, joins us on this week's episode.

Nearly 1.5 million Americans are being vaccinated every day against COVID-19. Allergic reactions have led some to question if they should get the vaccine; and scant data from clinical trials for the currently approved vaccines in vulnerable populations means we don't fully know how those with certain conditions will react. Does that mean those with certain allergies or conditions like HIV, multiple sclerosis, or cancer should pass on the shot? What about those who are pregnant? Barbara Alexander, MD, infectious disease specialist at Duke University and current president of the Infectious Diseases Society of America, joins us to explore who should get the shot. Later in the podcast, Mark Turrentine, MD, a professor at the Baylor College of Medicine and co-chair of the American College of Obstetricians and Gynecologists (ACOG) COVID-19 OB Expert Work Group, also joins to explain whether the vaccine is safe for pregnant and nursing women.

New viral strains continue to spread across the country, which has added to the urgency of getting as many people vaccinated as possible. With supplies of the two vaccines currently available in the U.S. falling well short of demand, mandating vaccination is likely not a realistic scenario now. But it could be in the coming months. Is it legal for states, private employers, and even airlines, to mandate a vaccine that has only been approved for emergency use? Who could be held responsible if something goes wrong after getting the shot? Carmel Shachar, MD, executive director of The Petrie-Flom Center for Health Law Policy at Harvard Law School, joins us to explore those legal questions, and more.

A new week, and a new administration that has taken over the pandemic response. Now that 1 million vaccine doses are administered almost daily, President Joe Biden has increased the daily vaccination goal to 1.5 million Americans. What will the COVID national strategy actually look like under a new administration, and is Biden's goal achievable? To explore those questions, and what the future of collaboration in science looks like, we chat with NIH Director Francis Collins, MD, PhD.

Eight COVID-19 vaccines have been approved somewhere in the world, at least for emergency use. In the U.S., only Moderna and Pfizer's two-dose mRNA vaccines are now available for distribution. But as the COVID pandemic continues to run rampant, vaccine supply everywhere remains limited. How did different countries decide who gets it and who doesn't? And what happens to the dozens of phase III clinical trials and their placebo participants who possibly qualify for vaccination with a different shot? To explore these and more ethical questions related to the COVID-19 vaccines, in this episode we speak with Arthur Caplan, PhD, director of the Division of Medical Ethics at NYU Grossman School of Medicine in New York City.

Vaccine distribution — it's been a rocky road. While millions of doses have been shipped, only about one-third have been administered. The federal government has said a lag in reporting as well as the holiday season are partly to blame. But as long lines were seen across the country and in some states a bit of chaos, what happened? Was Operation Warp Speed more about vaccine development than distribution? To examine the issues of what went wrong and what can be done to fix it, in this episode we speak with emergency physician and former Baltimore Health Commissioner Leana Wen, MD, as well as Mike Alkire, president of Premier, the giant medical supply and healthcare technology firm, and host of the "Inside Out" podcast.