Joey Wahler (Host): It's a major annual concern, so we're discussing protecting public health during respiratory virus season. Our guest is Thomas Grenier. He's Head of Vaccines for Sanofi North America. Sanofi is one of ACHE's premier corporate partners supporting ACHE'S vision and mission to advance healthcare leadership excellence. For more information on Sanofi, please visit the corporate partner section of ache.org. This is the Healthcare Executive podcast from the American College of Healthcare Executives, providing you with insightful commentary and developments in the world of healthcare leadership. Thanks for joining us. I'm Joey Wahler. Hi there, Thomas. Welcome.

Thomas Grenier, MBA: Hi Joey.

Host: Great to have you aboard. And so first, can you tell us a bit about Sanofi and its mission and vaccine development and commitment to public health?

Thomas Grenier, MBA: Sure. Absolutely. And thanks again for having me today. We are at Sanofi, an R and D driven, AI powered biopharma company, and we have one purpose, which is to chase the miracles of science to improve patients' lives every day. So we are more than 82,000 colleagues worldwide, 13,000 here with me in the US.

And we are on the course to transform practice of medicine through breakthrough science and to make positive impact on the people and the communities we serve. So, of course, patients are at the center of everything we do and our commitment to public health is unwavering. In the vaccines division of Sanofi, we have a long legacy of discovering, developing, manufacturing and distributing vaccines in the US. Actually all started more than 128 years ago on Swift Wire, our main site in Pennsylvania, it's our main US vaccines manufacturing facilities where we do both manufacturing and R and D. In this site and other sites around the world, we've made some significant innovations over the years. We discovered and developed the first vaccine against meningitis. Then we developed our higher efficacy flu vaccines for the older adults. And more recently, together with our partner AstraZeneca, we developed the first RSV infant immunization, just to cite a few examples of the innovation, the science based innovation that is so important for us.

So we are very much committed to high quality scientific evidence to advance protections for vaccination.

Host: So Thomas, what would you say are the biggest challenges this respiratory season as COVID continues to swirl along with RSV and the flu of course.

Thomas Grenier, MBA: Yeah, well, we are not short of challenges these days, I must say, and probably I would see four big buckets that I could describe to you today. I think the first one is about the real public health risks we are facing. Look, the vaccination rates are down. The vaccine hesitancy is rising, and more and more people are being left unprotected from preventable illnesses.

We can talk about flu. I mean, The last flu season was the worst over the past 15 years. We had massive hospitalization. A CDC estimates there were anywhere between 600,000 and 1.3 million people hospitalized because of flu. There were between 27,000 and 130,000 people in the US who died from flu. So flu is a huge disease.

So is COVID as well. I mean, We learned to live with it. But the virus still has profound impact on morbidity and mortality. We see some preliminary data here from CDC, where we have as well, huge level of hospitalization, 380,000 to 540,000 hospitalizations and more than 44,000 deaths. These are huge numbers that I hope you understand the magnitude of these numbers.

And this is the public health challenge we're facing. That's the first one. That's the biggest one. Of course, there's another one that's adding up to this one, which is the inaccurate information and the lack of trust that we can feel in healthcare that we're facing, and that's why it's so important to provide accurate and science-based information to choose on the frontline and to patients so they can make informed decisions about their health. There are a few things we can do together. Make sure that healthcare professionals can engage in this conversation. Really address the questions head on and not be shy to really discuss the topic on the table.

And on this, advocacy groups have amazing resources that can help direct healthcare professionals as well. But clearly there's a big gap in terms of accurate information that we should all tackle together. I see a search challenge as well on vaccines acceptance and vaccines coverage rate. Of course in the US we have strong immunization rates over overall, and surveys show again and again that majority of Americans view longstanding childhood vaccines as safe and essential.

However, we see more and more challenges with vaccines acceptance, and I'm convinced and we are convinced here that science must remain our foundation as we address these challenges. We know that immunizations is one of the most powerful tools to protect individuals and communities from preventable diseases.

 And a very important point is that healthcare providers and professionals are the number one trusted source for medical decisions. Survey after survey, what we observe is that other groups have some impact, but the one group that has the most impact is healthcare providers. And it's a tough job out there because there's a lot on their shoulders, a lot of questions, lot of work.

But they are the one trusted source that people respect and it's very precious. Malcolm is the fourth challenge I mentioned, and it's along the community vaccination rates. And as you know, vaccine is not just about the individual, it's about the community as well. And the most vulnerable populations depend on the overall population being vaccinated.

I'm thinking of children, I'm thinking of seniors. I'm thinking of people with underlying conditions. And there's quite a lot here where vaccines can help if we get the right coverage rate. People don't pay enough attention to the fact that individuals with multiple underlying medical conditions have a very high risk for acute respiratory illness and influence associated hospitalizations. For certain vulnerable individuals, Flu can even increase the risk of pneumonia, heart attack, and stroke. Again, it's a big deal. There's a lot of overwhelming activities these days in health systems in the US. There's so much to do. So that's why, again, immunization is so important because it can, palliate the toll on health systems. For example, RSV. RSV is the number one cause of infant hospitalization.

The one reason why infant have to go to the hospital, is because of RSV. It takes a huge toll on teams and staffs in health systems. It takes up to 21% of pediatric ICU days. They are due to RSV infections. Again, here, there are immunization solutions to avoid this. Really important to keep developing them and using them.

COVID-19 we've mentioned is as well a big burden. So despite this, the vaccines, COVID vaccines uptake is only half of influenza. All this to say that communities are at risk and immunization is a great solution to try help mitigate that risk.

Host: Well, Thomas, you mentioned there that we're coming off the worst flu season in 15 years. So having said that, how can hospital systems and vaccine manufacturers collaborate to effectively anticipate and mitigate such surges in respiratory illnesses?

Thomas Grenier, MBA: I like your question a lot because it's all about working together. It's not just one part of the ecosystem. It is all parts that have to work together. And the good news is we all have a common goal. The common goal we have between manufacturers, health systems, payers, every part of the chain is to make sure that communities are producted from illnesses that are preventable.

There are a lot of tools existing that, that can help address issues like vaccine hesitancy, fatigue, and support people who are on the front line in health systems to answer questions from people and patients to make sure that we all keep vaccination top of mind. One of the strategy we developed together is around health information technology, HIT. More specifically, automation can take the pressure off on the frontline by providing vaccine information, automatic reminders, eligibility alerts, and even can help schedule vaccine visits. And our company is absolutely committed to be at the forefront of technology where we see health system leading as well with EHR and solution that can help immunization uptake.

So we do provide guidance and publicly available resources that health systems can use again to make the most of their mission to help support reducing these preventable diseases. Quality as well is very important, and that's answer of these goals that unites us. We do support health system who are striving to meet their quality goals.

It's a, an essential part of the vaccines ecosystem. So we have assured interest in increasing vaccination rates for population health altogether in underserved communities as well. And that's where using immunization protocols can help. Even the one that are seen only in ER and then leave, protocols can help and can be extremely productive to help avoid these diseases.

And finally, the other part of the chain relates to patient advocacy. It's so essential to share patient stories, real life story of what happens when they're not vaccinated. And I was in Atland at ID week, couple of weeks ago, I could attend a discussion with John Grimes and Jamie Shambom, who are two survivor from meningitis.

These are amazing character and personalities. They are the face of resilience. Their story is absolutely amazing and they're a very important voice in the fight against meningitis, where again, vaccines is such a great solution to help prevent this disease. We need more of this patient story. We need more of the emotion dimension that goes with this disease,

so we make sure it doesn't just remain a figure on a paper, but it's real life. And again, as a contributor to that ecosystem, our role as manufacturer together with health systems and other parts of the system is to make sure that these stories are known and that the burden of disease is not ignored anymore.

Host: So Thomas, when we talk about this collaboration between hospital systems and vaccine manufacturers, can you give us an example of a success story there?

Thomas Grenier, MBA: Of course. And look, I have quite a few to share. I'm going to focus on the one that I really like. I think that that connection with health systems is really important. We've learned that most of the successes we've had have been with organization that implement multimodal strategies to meet patients where they are and offer multiple pathway for patients to participate in their own respiratory health management.

And I can share some examples there indeed. One is using patient portals to send personalized vaccination reminders based on risk factors. That might seem pretty obvious, but not so many host system do it. And the few one who do it have great returns on that effort in terms of increasing immunization rates.

Another example I want to share with you is, when we develop and we see health system developing peer advocate programs where patients share their experiences with respiratory illness prevention, that works very well. For example, at the Cleveland Clinic we saw relevant percent improvement in influenza immunization rate for patients 18 plus and seven points improvement for patients 65 plus using health information technology to identify patients who were not up to date with their vaccines. So the clinic sent a questionnaire through MyChart, which pretty much all patients in the US have, many of them have, and then they reached these patients to schedule a vaccination from their digital device. This is technology in action to really increase immunization rate with tangible outcome.

Again, these are just a few examples we have. There are many more, but I am convinced partnership and technology is the way to increase immunization rate for the long term.

Host: Absolutely. Couple of other things for you, Thomas. First, how are manufacturers working to ensure equitable access to vaccines? Especially of course, in underserved communities.

Thomas Grenier, MBA: Well, I like that question because access is so important. Vaccines is all about population health. It's about protecting everybody, including the underserved community. It's not the individual, it's the communities, it's everybody. So access is externally important for us. Access takes quite a lot, including partnerships. One of the example of the partnership we developed is the Drive Vaccines program that we developed since 2018 with the National Minority Quality Forum, whose goal is to educate underserved communities of color on immunization and preventions. It's been a great success. That program has been expanded in more than 20 states with more than 25 health systems.

And even better, that program has had real impact on people's life. We can increase with the program flu vaccination by five to 25% each year in underserved communities. And if we step back after all these years working with this program, we've engaged more than 500 providers in the program to get close to 200,000 patients vaccinated against influenza last season, this is a great outcome because this is how we can help protect life and people from hospitalization and all the burden of influenza. All these programs include complex community trusted partnerships. It's about working with grassroots organization like the National Association of Community Health Workers to raise the trusted voices of physicians. Physicians, we mentioned before, community centers, barbershops, faith leaders, people who are trusted in their communities to make sure that they can convey and educate the impact that vaccination can have to help protect lives. It's a big part of what we do. It's a big part of the vaccine's promise, which is protecting everybody, including underserved community, to have the maximum impact we can have together.

Host: And in summary, Thomas, if you could give one best piece of advice to hospital leaders preparing for this respiratory season, what would it be?

Thomas Grenier, MBA: Well, the first one I would say is please get your flu shot. It's essential. You might, well have your COVID shot as well and make sure that you're up to date with your vaccination schedule. Joke apart. It's very important because you are leading by example. People are looking at what you do, and the fact that you take care of your own health is so important for the community around you.

Now, beyond that, one thing you can do is to make sure that you, and that we together, prioritize the role of the teams as key words of accurate and timely information on immunization. Make sure that this is a priority for you and for your teams. Make sure that you implement a systematic organization-wide vaccination protocol to make sure to protect patients through the entire respiratory season and the season doesn't stop at Thanksgiving, the season continues. For example, RSV season doesn't end before the last day of March. So that consistent effort, based on protocols that extend over the season is essential to make sure we can have the impact we want to have. I think you are the backbone of the communities and in terms of prevention, treating respiratory viruses, the role you have as leaders, the role you have with your team is absolutely unique. Nobody else can do it as well as you can do. So I think leading by example and delivering this message of making immunization the top priority is absolutely essential and can be so impactful.

Host: Indeed. In fact I went for my annual checkup just recently. My general practitioner while I was there, offered me a flu shot. I said, why not? Let's get it out of the way early. Done, Thomas.

Thomas Grenier, MBA: That's great. That's excellent to hear and I'm very happy for you because this is going to help you stay out of the hospital, which is what we all want.

Host: For sure. Well, folks, we trust you are now more familiar with protecting public health during respiratory virus season. Thomas Grenier of Sanofi, keep up all your great work. Stay safe, you and yours during this very delicate season, if you will, and thanks so much again.

Thomas Grenier, MBA: Thank you.

Host: And a reminder, Sanofi is one of ACHE'S Premier corporate partners supporting ACHE'S vision and mission to advance healthcare leadership excellence. For more information on Sanofi, please visit the corporate partner section of ache.org. I'm Joey Wahler. Thanks so much again for being part of the Healthcare Executive podcast from the American College of Healthcare Executives.