Two outstanding female scientists, Whitney Cowell, PhD, MPH, and Angélica Torres-Berrío, PhD, are the recipients of the 2021 Robin Chemers Neustein Postdoctoral Fellowship Award.
Intended to encourage and support female research scientists at the Icahn School of Medicine at Mount Sinai, the fellowship was established in 2010 through a generous gift from Robin Chemers Neustein, JD, MBA, a former member of Mount Sinai’s Boards of Trustees.
Recipients are senior postdoctoral scientists who intend to complete their training within two years, have demonstrated high-impact accomplishments in biomedical sciences, and exhibit the potential for an independent scientific career. Dr. Cowell and Dr. Torres-Berrío are the 21st and 22nd recipients of the award.
Postdoctoral fellowship award recipient Whitney Cowell, PhD, MPH, right, with Rosalind J. Wright, MD, MPH
Dr. Cowell works in the laboratory of Rosalind J. Wright, MD, MPH, in the Department of Environmental Medicine and Public Health. Her research leverages a combination of molecular and epidemiologic tools to investigate subclinical changes at the biological level with the goal of translating these findings to improve population-level health.
“Dr. Cowell is an exemplary transdisciplinary scientist who is able to combine principles of molecular biology, data science, environmental health, and life course theory to identify key social and environmental drivers of health and disease,” explains Dr. Wright. “Her research promises to elucidate modifiable factors that can be intervened upon to reduce persistent disparities in pregnancy and perinatal outcomes in New York City and beyond. I am very proud to see her recognized for her innovative work.”
Postdoctoral fellowship award recipient Angélica Torres-Berrío, PhD, right, and Eric J. Nestler, MD, PhD
Dr. Torres-Berrío works in the laboratory of Eric J. Nestler, MD, PhD, in the Nash Family Department of Neuroscience.
Her research is focused on understanding how stress across the lifespan leads to enduring epigenetic alterations linked to depression. She is also interested in identifying molecular biomarkers that can be used to prevent and treat this psychopathology.
“For over a decade, the Robin Chemers Neustein Postdoctoral Fellowship Award program has been a spectacular feature of Mount Sinai’s postdoctoral community,” says Dr. Nestler. “I am very proud of Dr. Torres-Berrío and her impressive accomplishments. She joins a growing list of star women biomedical researchers who have been recognized by this great honor.”
Immunocompromised people have a reduced ability to fight infections and are more vulnerable to severe COVID-19. That is why the U.S. Centers for Disease Control and Prevention (CDC) is recommending that people with moderately to severely compromised immune systems receive an additional dose of the Pfizer-BioNTech or Moderna vaccine.
In this Q&A, Meenakshi Rana, MD, Associate Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai, and the Director of Transplant Infectious Disease, explains why immunocompromised people, who make up almost three percent of the U.S. population, should get this third vaccine dose and why it is important to take other protective measures.
New Guidance on COVID-19 Vaccines: In April 2023, the Food and Drug Administration and the Centers for Disease Control and Prevention announced some major changes for COVID-19 vaccines. Click here to read more about what you need to know.
What did the CDC recommend?
The CDC and the Advisory Committee on Immunization Practices took an important action to prevent COVID-19 infection in our immunocompromised population and among transplant recipients. They now recommend that people who are moderately to severely immunocompromised receive an additional dose of an mRNA COVID-19 vaccine, either Pfizer or Moderna, at least 28 days after the completion of the initial series. The Food and Drug Administration (FDA) now allows for the additional dose for these people as well.
To be clear, this is not considered a booster dose. A booster dose is given to a patient whose immunity to the vaccine may have waned over time. This is considered an additional dose, given to immunocompromised patients to improve their initial response to the vaccine series. These patients are essentially receiving a three-dose mRNA vaccine series instead of a two-dose series.
Who is considered immunocompromised and should get the third dose?
Meenakshi Rana, MD
Immunocompromised patients are a very large and heterogeneous group. For the purposes of an additional COVID-19 vaccine, the CDC has defined a specific moderately to severely immunocompromised group, which includes:
Patients who have been receiving active cancer treatment for tumors or cancers of the blood
Patients who had a solid organ transplant, such as a heart, lung, liver or a kidney, and currently take immunosuppressive medications
Patients who had a bone marrow transplant within two years or had a bone marrow transplant and are currently taking immunosuppressive therapy, or patients who receive CAR T-cell therapy.
Patients who have advanced or untreated HIV
Patients who have another medical condition that require high-dose steroids or immunosuppressive therapy for that medical condition
If you think you fall within this category, it’s important that you speak to your physician to determine if you are eligible for an additional dose of mRNA COVID-19 vaccine.
Why is the CDC taking this action?
Patients who are considered moderately to severely immunocompromised are more vulnerable to COVID-19. They are more likely to have severe disease, and more likely to be hospitalized with COVID-19. In addition, there has been data suggesting that moderately to severely immunocompromised patients may not have as strong an immune response to the initial COVID-19 vaccine series, and we have seen breakthrough infections in vaccinated immunocompromised patients, occasionally requiring hospitalization. The CDC also now has data suggesting that a third vaccine would be safe.
What should I do if I think I am affected by this action by the CDC?
If you think you are considered moderately to severely immunocompromised, talk to your doctor to see if you are eligible for an additional dose of COVID-19 vaccine. The CDC recommends that you receive a third dose with the same mRNA vaccine. For example, if you received an initial Moderna vaccine series, then you should complete your series with an additional third dose of the Moderna vaccine.
What if I am immunocompromised and I received the Johnson & Johnson vaccine?
When the CDC made this recommendation, they did not have enough data on whether immunocompromised patients who received the J&J vaccine would have an improved response after receiving an additional dose of the same vaccine. For this reason, we are currently awaiting more guidance from the CDC on what to recommend for these patients.
If I am immunocompromised, what else should I do to protect myself?
In addition to receiving an additional dose of an mRNA vaccine, you should continue to practice all those protective precautions that we’ve been discussing: social distancing, hand hygiene, and masking. It’s also very important that all of those around you, your family and your friends, are all vaccinated.
The FDA has also authorized the use of a medication, known as a monoclonal antibody, for what is termed “post- exposure prophylaxis.” That means, if you are exposed to a loved one or family member with COVID-19, this medication can be given to you to prevent COVID-19 and progression to severe disease or hospitalization with COVID-19. You should call your physician to see if you are eligible.
Should I get an antibody test to see if I am eligible for the third dose?
We are not recommending that you get an antibody test for this purpose, because we don’t know what level of antibodies is considered protective. We recommend that if you are considered immunocompromised, you should receive an additional vaccine dose, regardless of antibody response.
On the evening of Tuesday, September 11, 2001—with fires burning at the site of where the twin towers had stood that morning and several thousand people still unaccounted for—a group of physicians from the Mount Sinai Selikoff Centers for Occupational Health met to discuss a plan of action for treating survivors and first responders who had rushed in to help.
Protégés of the late Irving Selikoff, MD—a pioneering researcher who was the first to definitively link asbestos exposure to lung cancer—these physicians knew how dangerous the air was at the site of the attack, which had been reduced to 1.8 million tons of burning rubble. The toxic stew of chemicals would later be found to include major hazards to human health, such as lead and other heavy metals, benzene, dioxin, and asbestos. The physicians also knew that serious illnesses could develop decades after an individual’s initial exposure, lessons they had learned from Dr. Selikoff and his groundbreaking research in the 1960s.
Over the course of their first meeting and several subsequent ones that included colleagues such as David Prezant, MD, Chief Medical Officer of the Fire Department of the City of New York (FDNY), the Mount Sinai physicians established a blueprint for what is now the World Trade Center (WTC) Health Program.
Today, 20 years later, the WTC program continues to receive new patients. It consists of six New York City-area medical centers, including Mount Sinai, and a separate treatment center exclusively for FDNY members. Together, the centers treat more than 80,000 emergency responders—firefighters, police, recovery and cleanup workers—as well as 30,000 people who worked, lived, or went to school near the disaster zone in lower Manhattan. Their medical care will be funded through 2090, under the federal James Zadrogra 9/11 Health and Compensation Act, which was signed into law in 2011.
“The Selikoff Centers had exceptional doctors and they worked their fingers to the bone getting this program off the ground,” says Michael Crane, MD, MPH, who joined Mount Sinai in 2006 as Director of the World Trade Center Health Program Clinical Center at Mount Sinai. “Their incredible dedication got this going. It was hardscrabble, making phone calls and asking people to speak out about the program. They were helped by community and civic leaders and members of Congress who got behind this. Their story is really an inspiration.”
Dr. Crane, whose program at Mount Sinai cares for roughly 23,000 responders, was medical director of Con Edison’s health program on 9/11. Immediately following the attacks, he was down at the site making sure Con Edison’s recovery workers had proper masks and breathing protection. But that was not the case for many other responders. The filters on their masks clogged up after an hour and workers were either too busy to replace them or could not find extra masks.
Sandra Lowe, MD, talks about what we’ve learned about trauma and resilience from treating responders. Her answers have implications for COVID-19 and beyond. Dr. Lowe is Medical Director at the World Trade Center Mental Health Program Clinical Center of Excellence at Mount Sinai.
“You’d see the masks hanging off their faces,” says Dr. Crane. “They were running in to save people’s lives. They ran in without appropriate equipment and suffered the consequences.”
The dedication of the recovery workers was inspiring, says Dr. Crane. “So many of them had friends or relatives or people they knew or had trained with down there. Guys who ran down there had built the towers. So it was a tremendous emotional shock. They were energized by this passion to do something about it. So many of them said the same thing: ‘It’s family. I want to find them.’ It was deep and personal and real.”
Michael Crane, MD, MPH, left, and Julia Nicolaou Burns, Administrative Director, Selikoff Centers for Occupational Health
On 9/11, Craig L. Katz, MD, was the newly appointed Director of The Mount Sinai Hospital’s Psychiatry Emergency Room. But it was his leadership of the nonprofit organization, Disaster Psychiatry Outreach, which he had founded during his medical residency, which led to his direct involvement with the families of the victims, survivors, and responders. Almost immediately, Dr. Katz helped organize volunteer psychiatrists who met informally with these groups down at Ground Zero or at the Family Assistance Center that New York City had established downtown.
At the time, lung screenings for responders were being funded by the National Institute for Occupational Safety and Health (NIOSH), but no federal funding had been allocated for mental health. Yet the psychological effects of the troubling rescue and recovery mission were beginning to show.
A few months after the attacks, Dr. Katz says Mount Sinai’s Psychiatry Department received a phone call from the late Stephen Levin, MD, then Medical Director of the Mount Sinai Selikoff Centers for Occupational Health, who said, “ ‘I have all these rescue and recovery workers coming into my office and they’re crying. I don’t know what to do with them. I’m looking at lung exposures and they’re crying.’”
Craig L. Katz, MD
Looking to assist the workers, Dr. Katz, currently a Clinical Professor in the departments of Psychiatry, Medical Education, and System Design and Global Health, at the Icahn School of Medicine at Mount Sinai, wrote a three-page grant proposal to the private Robin Hood Foundation requesting funding for mental health. “That was the birth of the mental health program for recovery workers,” he says.
The Robin Hood Foundation would go on to provide the program with more than $6 million until 2011, when the Zadroga Bill was enacted, according to Dr. Katz. “Robin Hood typically funds underserved populations,” he says. “They agreed the rescue and recovery workers were an underserved population. They were largely men who don’t readily seek help for mental health issues. These blue collar guys were not our usual customers.”
Today, Mount Sinai’s World Trade Center (WTC) Mental Health Program actively treats close to 700 individuals under the leadership of Sandra M. Lowe, MD, Medical Director. “The people involved in the recovery and restoration operations were exposed to so much trauma,” says Dr. Lowe. “Some individuals developed post-traumatic stress disorder (PTSD), major depressive disorder, all kinds of anxiety disorders, and some developed substance misuse problems because that was one of the ways they tried to manage the symptoms they had.”
These mental health conditions, combined with the aero-digestive disorders, lymphoma, or lung cancer, which also stem from their work at Ground Zero, have created a complicated set of issues for this aging cohort of responders, many of whom are now in their 50s.
Sandra M. Lowe, MD
“Some members of the public may question the relevance of the WTC Health Center 20 years later,” says Dr. Lowe. “It is very relevant and needed. People are not aware of the ongoing physical or psychological struggles. We see an increased number of patients coming in for help. They have developed worsening physical conditions or now they’re retiring from the New York City Police Department. They may have been suffering PTSD for 20 years, but now they’re no longer afraid of the stigma associated with seeking help. They’ll say, ‘Doc, this is the first time I’ve told anyone about my nightmares.’ We hear the appreciation from the patients and their families.”
As time goes on, Mount Sinai’s clinical team also sees new health issues arising among responders, including the possibility of early cognitive decline. NIOSH is funding studies to determine whether exposure to toxins at Ground Zero is actually associated with this decline and whether there is a need for an early intervention program.
Kathryn Marrone, LCSW, Director of Social Work for the World Trade Center Mental Health Program, joined Mount Sinai in the summer of 2002 for what she was told at the time would be a one-year job monitoring and assessing the needs of responders. Almost two decades later, she is still working with these men and women. Only now, she says, they are aging and require a shift in services.
The responders “recovered bodies, saw people jumping from buildings, and watched the buildings collapse,” she says. “The level of trauma these individuals experienced was quite severe. They were completely confused about how to manage that emotionally.” But over the years, in their dealings with social workers, doctors, and other colleagues in the program, “Mount Sinai has become a lifeline for so many individuals. It is a place where they can turn because no one else quite gets what they’re experiencing.”
Staff from Mount Sinai Morningside, from left: Ruby Guzman, Maytal Rand, and Amy Bush
Mount Sinai Morningside, in collaboration with Mount Sinai South Nassau, participated in Harlem Week’s “A Great Day in Harlem” event on Sunday, August 8, at the Ulysses S. Grant National Memorial.
In partnership with One Hundred Black Men, Mount Sinai premiered a series of videos featuring members of the community and local celebrities encouraging people to protect themselves and their loved ones against COVID-19 by getting vaccinated.
“Thanks to Mount Sinai South Nassau’s vaccination mobile unit—the Vaxmobile—and the incredible staff from Mount Sinai Morningside, we were able to engage residents of Harlem in conversations about the vaccine, and we even provided the vaccine onsite to those ready to roll up their sleeves,” said Amy Bush, Director, Volunteer Services, Mount Sinai Morningside. “In line with the mission of the event, we were honored to have the opportunity to educate attendees, and also give hope to Harlem by spreading immunity in the community.”
Mount Sinai’s Anti-Racist Transformation (ART) in Medical Education leaders: top row, from left, Leona Hess, PhD; and David Muller, MD; and bottom row, medical student Jennifer Dias.
Four years ago, the Icahn School of Medicine at Mount Sinai launched a culture transformation initiative to eliminate racism and bias from its medical education program. Now, Mount Sinai is looking to share its Racism and Bias Initiative, which includes a virtual leaning platform, with eight to ten other medical schools, with the support of a new grant from the Josiah Macy Jr. Foundation.
Icahn Mount Sinai recently sent a Request for Proposal (RFP) to medical schools throughout North America and expects to choose eight to ten that will participate in this community of practice, which offers training modules and tools that lead to cultural change. The project is called Anti-Racist Transformation (ART) in Medical Education.
“Many medical schools are interested in the approach we have taken here at Mount Sinai,” says David Muller, MD, Dean for Medical Education, and Marietta and Charles C. Morchand Chair in Medical Education, at Icahn Mount Sinai, who is one of the grant’s principal investigators. “We have been invited to present at a number of institutions around the country—from grand rounds to seminars and workshops. The support we received from the Macy Foundation, combined with all of the work we’ve been doing, made us feel we could bring eight to ten schools into the fold, share with them the process that is working for us, and evolve together as a community.” Eventually, Mount Sinai will open its program to all medical schools wishing to participate.
Mount Sinai began implementing its change management strategy in earnest in 2018. In December 2020, Dr. Muller and two Mount Sinai colleagues—Leona Hess, PhD, Director of Strategy and Equity Education Programs; and Ann-Gel S. Palermo, DrPH, MPH, Senior Associate Dean for Diversity, Equity, and Inclusion—co authored a paper about their work that appeared in Academic Medicine. Their paper, “Addressing and Undoing Racism and Bias in the Medical School Learning and Work Environment,” sparked interest from other medical schools.
“It’s not enough just to have good intentions,” says Dr. Hess, who is leading Mount Sinai’s current change-management platform and is a co-principal investigator on the grant. “Through this process we’ve really grown to respect what it takes, what are some of the structures, mindsets, and values that we have to instill to get us to a place that’s free of racism and bias, which is our vision. ART in Med Ed is an answer to how we can get there collectively.”
Jennifer Dias, a leader in anti-racism activism, is a third member of the grant’s leadership team and a rising third-year medical student who will be devoting a scholarly year to the initiative.
In July, Mount Sinai Health System’s leadership offered staff the opportunity to receive a Commemorative COVID-19 Challenge Coin to recognize their selfless dedication and commitment during the height of the COVID-19 pandemic in 2020 and 2021.
Challenge Coins, as they have become known, are an important tradition, particularly within the crisis-response community, symbolizing a catastrophic event and recognizing the teamwork and individual sacrifice needed to overcome such events. In the past, they have been given to front-line workers after historical events of importance, such as 9/11 and Hurricane Maria relief efforts in Puerto Rico.
Click here to see three Mount Sinai employees reflecting on challenge coins they received for crisis responses.
In that tradition, this coin is designed to recognize the teamwork and partnership that characterized Mount Sinai’s response to the COVID-19 pandemic. Inscribed on one side of the coin are those exact two words. The opposing side bears a representation of how Mount Sinai’s eight hospitals (marked by eight stars) and hundreds of ambulatory sites—bolstered by clinical, ambulatory, administrative, and operations staff, trainees, and students—united as a system that, together in service, gave and continues to give everything to those who need us most.
Many sites across Mount Sinai hosted events or had managers make rounds to distribute the coins with letters of gratitude. Many other sites are still distributing the coins.
“We offer this small but meaningful token of our deep appreciation. We hope that it will serve as one way to memorialize the remarkable efforts you have made as individuals and as members of a team that met and countered this disastrous pandemic” says Kenneth L. Davis, MD, President and Chief Executive Officer of Mount Sinai Health System.
Immunocompromised people have a reduced ability to fight infections and are more vulnerable to severe COVID-19. That is why the U.S. Centers for Disease Control and Prevention (CDC) is recommending that people with moderately to severely compromised immune systems receive an additional dose of the Pfizer-BioNTech or Moderna vaccine.
