He was not seen coming in his years as a medical student at the UBA nor in the residency at the “Ricardo Gutiérrez” Children’s Hospital, when he was flying towards infectious pediatrics under the wing of “teachers like Eduardo López or Daniel Stamboulian”. Alexander Cane possibly he never imagined that in his fifties he would live a pandemic. That I would end up inclined to the communication of health through the giant Pfizer, gathering hard data to build an irrefutable, clear, convincing and (indispensable quality) true discourse about an unpredictable virus. Science and rhetoric would be their weapons. His goal, vaccination against him Covid.
And yet, there he is, comfortable in his role. At there of the computer looks relaxed but corporate. The video interview with Clarion unfolds with Germanic precision. It would be in English, but it turns out that Cané is Argentine. One of those with one leg here and another there because “the family stayed.”
Since 2019, he has led the Scientific and Medical Affairs area for North America of the Pfizer Vaccines Division. Behind her, a poster with the logo of the pharmaceutical company that produces the avant-garde “messenger RNA” is cut out. Those vaccines that in 2021, the more urgent they were, the more they wanted.
“The key is to communicate Covid transparently,” said Alejandro Cané, Pfizer’s vaccine leader.
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But they arrived and are being administered to boys and adolescents from the age of 12. In addition, they are the reinforcement for thousands of adults. And now they arrive for boys aged 5 and up.
In the interview, a proposal flies over that Cané repeats whenever he can: overcome any brand issue. Instead, reporting hard data to encourage pediatric vaccination.
Clarion reminds you that while coverage for boys is good, there are disturbing differences between provinces. While 70% of minors between the ages of 3 and 17 in the Buenos Aires radio have two doses, in Chubut it is 45%. In Misiones, 32%. Cané, methodical, listen.
-There are pediatricians who suggest families “wait” before vaccinating their children. What would you say to those doctors?
-Today there is enough data to indicate that vaccines, all those on the market, are effective: they serve to prevent disease and death from Covid. And they showed security. The adverse effect associated with vaccination is infinitely less than the complexity of the virus per se. In the risk-benefit ratio, vaccinating has a much lower risk against infection. Now if you take this back a year, a lot of this information was not available. You will remember that the SAP (Argentine Society of Pediatrics), lacking the information, did not recommend pediatric vaccines. But when he had the information he released a public document advising children to be vaccinated.
How could this round trip have been avoided?
-The secret is that the information is available. There is also an issue of how we communicate the data we have. If it is done transparently and clearly, people understand and know how to manage the risk-benefit ratio well. Thinking that a child is going to have a mild or asymptomatic disease just because he is a boy is a mistake, even more so having safe vaccines that are going to benefit him and the community in which he lives. Not vaccinating is a very selfish decision.
-In 2020 it was said that boys were only vectors of Covid. How did the management of the pandemic affect that initial conception?
-In fact, it was said that boys were less affected. The issue is that viruses are very democratic: they make no distinction of gender, ethnicity or social status. However, SARS uses a receptor called ACE, which is more expressed in adults, and that’s how it spread. We are already in the fourth wave globally and each one impacted younger groups. In the first wave, it was those over 65. In the second, young adults, who were more mobile and did not take many protective measures. In the third, teenagers. Now, the little ones, although it is not a disease of children, such as influenza.
-But in boys there are also cases of severe disease…
-Yes. 30% of completely healthy boys develop severe Covid disease. Not only in Argentina: worldwide, there are 30% of boys without any risk factor who develop serious illness. “Serious” means hospitalized and can lead to death. In any case, there are no identified risk factors for Multisystem Inflammatory Syndrome, an excessive reaction that can cause kidney, lung or heart damage and is more common in boys; and for the “long Covid”, the symptoms that are sustained over time. Anyone can develop them. The reason not to vaccinate is to take an unnecessary risk.
-At different times during the pandemic there was tension over access to information. How understandable is it that the doctors who had doubts demanded access to the papers and documents that the ANMAT had already reviewed?
-That the information is available is crucial to build trust. Generating clear and transparent information is the only way to avoid fake news or the fear associated with the unknown. The approval of a vaccine by authorities such as the ANMAT, which is tremendously prestigious, is very valuable. I say this with Argentine pride, regardless of the government in office. That medical societies support, is what has always happened. Sometimes there is a question of timing of how it is communicated, but having the information available, for us health professionals, is crucial.
-Speaking of pride, what did you feel when you learned that Argentina approved a vaccine against Covid (Sinopharm’s) for children from the age of 3 almost before anyone else? Did he think “it’s okay”, “it’s risky”, or what?
-I am very confident in the technical capacity of the ANMAT experts. I am part of the different medical societies: pediatrics, infectology, pediatric infectology. I trained with several of the experts who advise on vaccines. Although it is true that the information was not available, Argentina was at the forefront in terms of vaccination. Think that we were (and I say “we were” because I feel part of the decision) who tested Pfizer’s mRNA vaccine in more than 6,000 subjects, which helped make it available throughout the world. It just shows that we have the ability to do good things. For us and globally.
-However, part of the population is not vaccinating their children. Do you think that families who resist immunizing them with Sinopharm will want to vaccinate them with Pfizer? Why?
-I would not enter into the discussion of which vaccine is vaccinated with. I can say, with concrete data, that Pfizer was shown to be effective in a clinical study with more than 2,500 children. We go over eight months of follow-up and it showed 100% efficacy in preventing serious illness and hospitalization from the age of 5, with a greater safety profile than the one it has for adults, which in itself is very good. Risk-benefit studies were done. The one with the most press is the myocarditis. But it was seen that the risk is 30% higher (overwhelmingly higher) in those who suffer from Covid, compared to those who receive the vaccine.
-Continuing with the pediatric segment, did the FDA put “buts” to the development of Pfizer for babies from six months?
-I tell it in the first person because I am responsible for the interaction with the FDA and the CDC in the United States. It was not a hindrance. To obtain FDA authorization, we compared the immune response after two doses in children aged 6 months to 4 years, compared to adults aged 16 to 25 years, who were part of the pivotal clinical study, precisely the one that showed that the vaccine It was effective and safe. The doses had to be as good in babies as in adults, but we saw that with two doses the same level of antibodies was not reached, due to a matter of immunological immaturity. The decision, both by Pfizer and the FDA, was to give a third dose. And so the study was extended. We will have information by the end of March or mid-April. I have no doubt that the vaccine will be authorized.
-How will the vaccination schedule against Covid be from now on?
-I do not know. My personal opinion is that we are headed for an endemic. That is, the virus will live with us, just as it happens with the flu. I think we are going to have annual vaccinations according to the subgroup of viruses that circulate. Now we have Omicron; another variant appears there and the vaccination has to be adjusted. But I would think that it will be an annual vaccination with prioritization of the people most at risk. A approach flu-like.
-As an Argentine who saw these two years from the outside, how could the communication of the pandemic have been improved, for example, that directed at young people?
I give a biased answer. I have three teenage children. I am not the average in the community because they saw me working on vaccines in the last two years, but they wanted to get vaccinated. I think that in recent months, communication has improved a lot, both in terms of vaccination and in terms of protection measures. The information, in general, with ups and downs, has been quite good. There are always things to improve; not only in the communication part but also in the way the information is developed. Today the focus must be placed on the provinces that have delayed vaccination in children. The only real way to resume a normal life is to have as many of the population as possible vaccinated.
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