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Vaccinations To Prevent COVID-19 Could Begin Next Month, Fauci Says

Dr. Anthony Fauci
Dr. Anthony Fauci

Dr. Anthony Fauci, the country's foremost infectious disease expert, tells NPR that it's "OK to celebrate" the good news about Moderna's coronavirus vaccine, but warned it's not the time to back off on basic health measures.

The biotechnology Moderna Inc. said Monday that its experimental vaccine was 94.5% effective in preventing the disease, according to data from its clinical trial.

"From a scientific and potential public health standpoint, this is an extraordinarily important advance," Fauci told Rachel Martin on Morning Edition Tuesday.

The Moderna study has 30,000 volunteers who either got a placebo or the vaccine. There have been 95 people who happened to get sick with COVID-19. But 90 of the people who got sick didn't get the vaccine; of people who got vaccinated, only five got sick.

A week earlier, Pfizer said its vaccine was more than 90% effective in its own trial.

The Food and Drug Administration set a minimum effectiveness of 50%. Fauci said a few months ago he would "like [a vaccine] to be 75% or more" effective. So the news of two vaccines showing early results of being 90% or higher "is a very, very important advance in our armamentarium of trying to stop this outbreak," Fauci said Tuesday.

Moderna said it will ask the FDA to approve its vaccine for emergency use "in the coming weeks" while a Pfizer partner said it could apply as early as this week.

The timeline is significantly quicker than the standard drug approval and distribution process. It's helped by the government's Operation Warp Speed, which has already paid companies billions of dollars to start making vaccines before they are approved.

Fauci said that hopefully by the end of the year, two companies' vaccines will have enough doses available for 20 million people.

"At best, what we will see, will that be some people — generally the highest priority, that's determined by an advisory committee and ultimately the CDC — there will likely be some getting vaccinated towards the end of December," he said.

The consensus is that health care workers will be the first ones to get vaccinated.

"As we get into January, February, those doses will increase," Fauci said. At that point, doses will still be limited to certain prioritized groups.

"By the time you get to, let's say, the end of April, the beginning of May, June, July, as we get into the second quarter, it'll be much more likely that you'll have, quote, 'the general population' that's not on the priority list will be able to get vaccinated," he said.

There's also the challenge of convincing people to get vaccinated once they can. In one poll in August, 35% of respondents said they wouldn't get a coronavirus vaccine once it becomes available.

Fauci says he hopes that people "who are hesitant or reluctant" to get vaccinated might be persuaded "when they see the extraordinary efficacy of the vaccine."

Still, that is many months away. In the meantime, the Trump administration has not coordinated with incoming members of President-elect Joe Biden's team on coronavirus response. Biden said on Monday: "More people may die if we don't coordinate."

Fauci, who sits on the current White House coronavirus task force, noted that he's worked with six presidential administrations. He said transitions are "critical."

"I would like to see the interaction with people who might be coming in and be doing the things that are being done now by the task force and by the people in the health system," he said.

Despite lack of coordination with the current White House, the Biden team is already talking with vaccine manufacturers, which Fauci called a "good thing."

The eventual vaccine is "not going to do it alone, though," he said. "That's the important point. This should not be a signal to pull back on the public health measures that we must continue to implement."

As part of that, health experts are warning that traveling for Thanksgiving next week is fraught with risk as coronavirus cases soar nationwide.

"If you have people in the family who are at a higher risk, people that might be elderly with underlying conditions and you want guests to come in that might be going through crowded airports or on airplanes, you really got to think twice," Fauci said. "Is this something that I really want to take a risk for?"

Fauci, who is 79, said his three daughters who live in different parts of the country aren't coming home for Thanksgiving this year. They'll spend some time talking on video calls instead.

"I don't like it that way, but I think they're making a prudent decision and trying to protect their father, and I'm proud of them for that," he said.

Avery Keatley and Arezou Rezvani produced the audio interview.

TRANSCRIPT:

RACHEL MARTIN, HOST:

It is time to recommit, to dig in and resolve again to do what we all can to slow the spread of the coronavirus because it's shaping up to be a tough holiday season. COVID infections and hospitalizations are at an all-time high across this country. States are starting to restrict businesses and social gatherings again. There is a glimmer of hope, though. The pharma company Moderna joined Pfizer yesterday in announcing positive results of its vaccine trial. So that is now two potential candidates for a coronavirus vaccine.

To help us understand where we are headed, we've got Dr. Anthony Fauci on the line. He is the head of the National Institute of Allergy and Infectious Diseases at the NIH and a member of President Trump's coronavirus task force. Dr. Fauci, thank you so much for being back on the show.

ANTHONY FAUCI: Good to be with you.

MARTIN: We've heard other public health officials praising this news from Moderna about its vaccine. But if I may, you carry a different kind of authority. So I want to hear it from you. Is it OK to celebrate this?

FAUCI: Yes, it is OK to celebrate it because from a scientific and potential public health standpoint, this is an extraordinarily important advance. Both vaccines - both the Pfizer vaccine and, most recently, just yesterday, the announcement of the Moderna vaccine - have a high degree of efficacy.

So just for the numbers, to understand, of the 95 events - events meaning infections that were detected within the context of the trial - five of them were in the vaccine group, and 90 of them were in the placebo group, namely the group that did not receive the vaccine. Of the severe events that were recorded - namely, someone who didn't just get mild to moderate symptoms, but had severe disease - there were 11 in the placebo group and zero in the vaccine group. That gives you a vaccine efficacy of 94.5%. That is extraordinary.

When I spoke to you last time and we were talking about vaccines, I told you that I would feel good if we had a 70% to 75% effective vaccine, which if we combine that with public health measures, we could have an impact on the outbreak. Ninety-four percent for this and more than 90% for the Pfizer candidate, to me, is a very, very important advance in our armamentarium of trying to stop this outbreak. It's not going to do it alone, though, Rachel. That's the important point.

MARTIN: What do you mean?

FAUCI: This should not be a signal to pull back on the public health measures that we must continue to implement.

MARTIN: Right. Because these vaccines and others in the pipeline, I mean, it's going to take a while to get them produced and distributed. But where is that timeline now? I mean, you're saying the efficiency of these vaccines is more promising than you had even anticipated. Does that mean - does it speed up things to some degree?

FAUCI: No, no.

MARTIN: No.

FAUCI: It does not speed up things. The only thing I think it ultimately will do, that I'm hoping - Rachel, I'm hoping that when the people who are hesitant or reluctant to get vaccinated because of a variety of reasons, when they see the extraordinary efficacy of the vaccine, it might make them more amenable to wanting to get vaccinated. But the timeline of getting the doses into the vials and available for vaccination are going to be a graded process. It's not going to happen all at once.

For example, right now, with both of these candidates going to get approval either as an emergency use authorization or an ultimate true approval as a licensure, that's the process that's going on right now. At best, what we will see will that - be some people, generally the highest priority that's determined by an advisory committee and ultimately the CDC, there will likely be some getting vaccinated towards the end of December. But as we then get into...

MARTIN: This December? Next month?

FAUCI: This December. Literally, next month. We hope that we'll be getting vaccine into people. The recommendation of who that will be will be finalized by the CDC - likely will be health care workers, as well as people who are at a high risk for serious disease. We...

MARTIN: Can I ask about that, though, Dr. Fauci?

FAUCI: Yeah.

MARTIN: Because the list of who gets it is going to be a reflection of our own society's values, right?

FAUCI: Right, right.

MARTIN: Teachers. Child care providers.

FAUCI: Yeah.

MARTIN: Are they going to be on that list?

FAUCI: Yeah. Oh, absolutely. It will be a graded list. It will be a list in which you go from people who are either at a highest risk or are important to society. And then as you go down the list, it gets to people who are less at risk for serious disease and then, ultimately, what we call the general population - you know, the 25-, 30-year-old person with no underlying conditions who's otherwise healthy. That likely will be the person towards the end.

As the doses come in, Rachel, they're not going to come in all at once. So, for example, the hope would be and - but not totally guaranteed, but close - is that by the end of the year, you'll be able - one company will have 25 million, the other one will have 15 million. So you'll have about 40 million doses for about 20 million people. As we get into January, February, those doses will increase.

So what the projection is going to be - and remember, these are not guaranteed, but it looks pretty good for this - that the first several months of 2021 will be going through the priority group. By the time you get to, let's say, the end of April, the beginning of May, June, July, as we get into the second quarter, it'd be much more likely that you'll have, quote, "the general population" that's...

MARTIN: OK.

FAUCI: ...Not on the priority list will be able to get vaccinated.

MARTIN: Helpful to have...

FAUCI: Because if you want to get - yeah, if you want to get the epidemic under control, you have to have a substantial proportion of the population vaccinated. You know, the two ingredients of that are, A, a very effective vaccine and, B, a lot of people taking the vaccine.

MARTIN: So...

FAUCI: So we have at least two vaccines, and there are more in the pipeline, Rachel. There are a few others that are a bit behind, in essence, in the schedule. That doesn't mean they're any - going to be any less effective or not.

MARTIN: Right.

FAUCI: We don't know that yet because they haven't been fully tested.

MARTIN: So it's...

FAUCI: But there are going to be other candidates that are going to be essential if we want to get enough vaccine to give to everyone who would need it or want it in the country.

MARTIN: There are several months between now and when a general population vaccine will be available. And part of making that work is going to be coordination between the incoming Biden administration and the outgoing Trump administration. Joe Biden said yesterday more people may die if President Trump doesn't coordinate on COVID, which he has yet to do. Do you agree with Joe Biden's statement that more people may die if coordination doesn't happen?

FAUCI: You know, obviously, transitions are going to be very important. As I've said a few times now over the last few days, that I have been involved with now six administrations and multiple transitions. And they are critical for the smooth - going from one to the other. I made the metaphor - it's like you're in a relay race and you're passing the baton to someone. You don't want to stop and then pass it and have the person be stopped. You want to have a smooth - going from both of them moving at the same time. So, obviously, it would be preferable to have a transition interaction with an incoming group.

MARTIN: You were on a call, as I understand it, with the coronavirus task force, 2-hour call with governors to review distribution plans of the vaccine. Vice President Mike Pence chaired that. Was there anyone from the Biden transition team on that call?

FAUCI: No, there was not, to my knowledge.

MARTIN: Do you find that to be a problem?

FAUCI: Well, I mean, I would like to see the interaction with people who might be coming in and be doing the things that are being done now by the task force and by the people in the health system. Obviously, there's no doubt that it is better to have a smooth transition.

MARTIN: What are the costs of not having that transition?

FAUCI: Well, it depends...

MARTIN: Again, I know you're in a tough spot.

FAUCI: Yeah, I...

MARTIN: But lay out - what are the costs?

FAUCI: Well, you know, it depends. I think with regard to the vaccine itself, the interaction with the company, that's going along right now. I understand - though I don't know, and I'm not in a position to make any comment about this - that the Biden people are already talking to the companies, which is a good thing. So they're going to have an interaction with them, which they're doing right now.

What we're doing now in our interaction is getting the prioritization correct. The CDC will ultimately make that decision. The transportation from the production of the vaccine to the places where it needs to be distributed is already right now in the planning and in the implementation stage. You know, with Operation Warp Speed, General Gus Perna is the person involved with the logistics of that. And that's something that I think is going along pretty smoothly right now.

MARTIN: Dr. Fauci, have you been asked to stay on in the Biden administration?

FAUCI: I have not been in contact with the Biden administration at this point.

MARTIN: Lastly, I need to ask about Thanksgiving. We know it needs to be different - stay at home, keep it small. How is your Thanksgiving going to change this year?

FAUCI: Oh, it's going to change significantly. And that's one of the things that I tell the American people when I get asked, as you're asking me, Rachel, is that we've got to make risk assessment and risk benefit discussions within the family. If you have people in the family who are at a higher risk - people that might be elderly, with underlying conditions - and you want guests to come in that might be going through crowded airports or on airplanes, you really got to think twice. Is this something that I really want to take a risk for?

I can't speak, obviously, for every family, but I can tell you what I'm doing in my own family. I have three adult professional daughters in three separate parts of the country that would require flying for two of them and driving for another. They got together, my daughters, and said they do not want to put me, since I am, as tough as it is to sometimes admit it, an elderly person - I'm 79 years old - they are very sensitive about the idea that getting tested or getting quarantined in the couple of days to Thanksgiving.

What we're going to do is we're going to have a meal with my wife and I, and we're going to Zoom in and spend some time back and forth with the girls. I don't like it that way, but I think they're making a prudent decision in trying to protect their father, and I'm proud of them for that.

MARTIN: Dr. Anthony Fauci, head of infectious diseases at the National Institutes of Health. Dr. Fauci, thank you, as always, for your time.

FAUCI: Good to be with you. Thank you for having me, Rachel.