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Dr. Paul Offit Gives Updates On The US COVID-19 Vaccine Rollout


So what are the implications of the slow rollout, and what needs to change? Dr. Paul Offit is one of the experts who advised the FDA during the vaccine approval process. He's also the director of the Vaccine Education Center at the Children's Hospital of Philadelphia and joins me now. Dr. Offit, good morning.

PAUL OFFIT: Good morning.

FADEL: So the U.S. has had two vaccines approved for emergency use for two weeks. And as we just heard, the goal was for 20 million people to get their first dose by today. But according to the CDC, we're at about 2.8 million people. So what happens if things continue at this pace?

OFFIT: Right. I mean, first of all, we only have about 12 million doses distributed. It's a two-dose vaccine, which would be, you know, six million people. So we haven't even made enough vaccine to vaccinate 20 million people.

So I think two things need to change. One is we need to really ramp up production, which may mean, you know, sort of commandeering a variety of production sites so that more than one or two sites are making this vaccine. Secondly, I think we need to have a plan for distribution that is - centers on mass distribution - in other words, that we do this in stadiums and auditoriums and churches and synagogues, that we just line up to give vaccines, which is the only way this can happen. You can't just have people sort of walk into the pharmacy and get it at their convenience. This is going to have to be a mass vaccination campaign.

FADEL: So you're saying there's not enough vaccine. We're hearing reports of frontline medical workers, especially in rural areas, who were promised a vaccine and are still waiting for their shots. What does this indicate about obstacles at a state and local level?

OFFIT: Right. It's - what we're asking to have happen here is that we're asking for 70% of the American population to be vaccinated. There's 330 million people in our country. So if you vaccinate, let's say, 240 million people, that's 480 million doses that you have to get out there. It's hard to do that. I mean, our hospital, I think, has done a very good job. At Children's Hospital of Philadelphia, we vaccinate 10 to 12 people every 30 minutes. And so we vaccinate 350 people a day. We've vaccinated 4,500 people in less than two weeks. That's the way to do it. Just, you know, line us up and give us the vaccine. But, again, you can't do that unless there is enough vaccine, and we don't have enough vaccine yet. We - it's not easy to mass-produce vaccines, especially these vaccines, which are in this lipid nanoparticle, which has never been scaled up before. So you can't just snap your fingers and watch it happen. But, hopefully, under the next administration there'll be a real commitment to mass production.

FADEL: How much of this is about a lack of funding, resources?

OFFIT: I think everything is about a lack of funding and resources. I mean, if you look at - we just had this virus in hand - SARS-CoV-2 virus - in January of 2020. That's the first time we knew the sequence of this virus. Within 11 months, we've done two large clinical trials using a novel technology - messenger RNA - that worked extremely well. I mean - and the reason that we were able to do that so quickly is we spent $24 billion to do it. I mean, we made a major Manhattan Project-level commitment to do that. I think we have to do the same thing for vaccination. We did it for vaccine. Now, we have to do it for vaccination. I'm not sure there's - at least not in this administration - the will to do this.

FADEL: On that note, you know, President Trump recently deflected blame, tweeting, now it's up to the states to administer and get moving. How much responsibility for planning and logistics do the states bear, and how much does the federal government bear?

OFFIT: Right. Well, they both bear responsibility. And the finger-pointing doesn't do any good. I mean, we're all in this together. And so let's do what we can do at our best. I mean, we've pulled together in national tragedies before. You know, the - World War II was a national tragedy. 9/11 was a national tragedy. These aren't Republican or Democratic issues, and the finger-pointing doesn't do any good. Let's figure out how to do this and do it and spend the resources we need to do it. It's just wearing, frankly, just always trying to figure out who to blame.

FADEL: You know, you mention that we're only at a point where people have gotten the first vaccine dose, and many people will need their second shots soon. Could this cause even more confusion and further complicate this rollout that's been so slow?

OFFIT: It would be demoralizing. I mean, I'm one of those people who got the first dose and certainly expect the second dose because the way these studies were done, both by Pfizer and Moderna, was they found that one dose was not good enough, that it didn't induce high levels of virus-specific neutralizing antibodies with a single dose, hence the second dose that was given depending on the product three or four weeks later. Then they got an excellent boost response, and then when they did the big Phase 3 trial of tens of thousands of people, they found that it was highly effective. To get one dose is to assume that you have some level of protection and to assume that that level of protection is relatively long-lasting, both of which might not be true.

FADEL: President-elect Joe Biden has vowed to administer 100 million vaccine shots during his first 100 days in office. How realistic is that, given what we know about the current challenges?

OFFIT: Well, given the way that we're mass-producing the vaccine right now, it seems incredibly unrealistic. I mean, what we're talking about, then, is having a million doses a day. Right now, we only have 12 million doses, and it's been several weeks. So we definitely have to change the way that we're mass-producing and distributing this vaccine. I'm glad he said that. I think it's aspirational. It's good to set a high bar. And, hopefully, we'll be able to mass-produce this in the manner that it needs to be mass-produced and then distribute it in the manner it needs to be distributed. But right now, we're doing neither.

FADEL: Now, Dr. Anthony Fauci recently said 90% of Americans will need to be vaccinated or immune to stop the spread of the coronavirus. That means unifying much of the country behind this vaccination campaign during a very polarized time on even whether to get this vaccine. How do we do that in order for things to return to somewhat normal by the spring or summer?

OFFIT: Right. I think 90% might be high. I mean, this is a vaccine that's 95% effective. So there's a formula for this for how - depending on the contagiousness of the virus and the effectiveness of the vaccine. Probably 70% may be close. Also, remember, we have reported that 20 million people in the United States have been infected. That's just the number of people who have been tested to have been infected. If you look at, actually, the antibody studies, which is a more sensitive way of figuring out who actually has been infected, it's probably - that number is probably off by a factor of three. So in truth, about 60 million people in this country have already been infected. That's 20% of the population. Those people, when they're re-exposed to the virus, are going to be very unlikely to be hospitalized or die. So I think that we're dealing with a little bit of a net. We have about 20% of the population that's already probably, at a large level, protected against the severe nature of this virus.

FADEL: In the few seconds that we do have left, the federal government has a distribution partnership with a number of pharmacy chains, including Costco, Walmart and CVS, to administer vaccines in their stores and other sites. But they haven't launched that effort yet. Will that help if they do launch that?

OFFIT: Yes, definitely it'll help. I mean, where it won't help is - I mean, in my state, Pennsylvania, you know, there are those regions in the center of the state that are fairly sparsely populated where there may not be a pharmacy nearby. And I'm actually on this committee with our secretary of health, Rachel Levine. And what she wants to do is set up, you know, vaccination centers in the same way you would have a testing center in those areas. And that's great. It's a good idea. It's doable. But, again, it requires money to do it. So I think this all comes down to the same thing, which is making a financial commitment. In the same way we made a financial commitment to doing the research and development of these vaccines, we need to make a financial commitment to vaccination.

FADEL: Dr. Offit is a member of the FDA vaccine advisory panel. Thank you again for being with us, and Happy New Year.

OFFIT: Thank you. Happy New Year.

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