Dr. Anthony Fauci On U.S Efforts To Develop A Coronavirus Vaccine
NOEL KING, HOST:
Health officials say if we want our lives to go back to the way they were before the pandemic, we will need a coronavirus vaccine. To that end, a massive effort is underway. The National Institute of Allergy and Infectious Diseases is funding research. It's working with academic institutions and private companies to help develop a vaccine. And then this week, the biotech company Moderna announced some early positive results from a Phase 1 trial. Eight participants developed antibodies against COVID-19. But the study was small, and it is in the early stages. So how close are we?
Dr. Anthony Fauci is the country's top infectious disease expert. He's a member of the White House Coronavirus Task Force and the director of NIAID. Good morning, Dr. Fauci.
ANTHONY FAUCI: Good morning.
KING: I want to start with this announcement from Moderna because there was so much excitement. But it is worth noting that there also weren't many details. Earlier this week, I talked to Dr. Tim Lahey. He's a vaccine researcher at the University of Vermont Medical Center, and he told me that he is worried about the quality of the science. Here's what he said.
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TIM LAHEY: So typically, if you really want to have trustable science, you release the full information in a published article that's reviewed by peers and has gone through careful safeguards against problems. Here, this is just a press release from the company without enough detail to really dig your teeth into it.
KING: Does he have a point? Are you excited about Moderna's announcement?
FAUCI: You know, yes, I am. And I think the issue that he brings up is a reasonable issue and understandable. What had happened is that the company reviews their data intermittently. And at the last data review, they saw something that was really quite promising. And as a company, they made an announcement that this in fact were the data - it was partial data. It wasn't the entire story, but they felt they needed to make it public. What happened then is that the actual details of the data are now being put together and compiled by my team at NIAID who are the scientists involved in that. That will be - as appropriately - submitted to a peer-reviewed journal so that everyone can see the total data.
But having looked at the data myself, it is really quite promising in the sense of that in the Phase 1 study, which is the first step towards the development of a vaccine through its multiple phases, the vaccine induced what we call neutralizing antibodies as opposed to just binding antibodies. And neutralizing antibodies are antibodies that actually can block the virus. And they did it at a relatively high titer - I mean, even better than we thought. And they did it at a moderate dose of the vaccine. So that's the reason why we thought it would be good news. But the gentleman who had the concern is understandable. And the full data will be coming out in a peer-reviewed journal.
KING: Do you know when?
FAUCI: You know, right now - there were three doses that were used in the Phase 1 trial. There were 45 people in it - 15 persons per dose. They are compiling the data in all of the doses now. They had the data for the first two doses, the low and intermediate dose. As soon as the full data comes out with regard to the higher dose, they'll submit it. I would imagine we're talking in a matter of a couple of weeks for submission. It generally gets reviewed expeditiously, so it should come out within a very reasonable period of time.
KING: And then when might - let's say everything goes according to plan, what happens next? When might we be looking at a vaccine? Or is it just too early to ask you that?
FAUCI: Well, you know, you can make a projection. When you're dealing with vaccines and the vicissitudes associated with vaccines, there are always landmines and hiccups that come along. But the projection now - it's on a - an accelerated pace. Now when I say that, I want to underscore that's not compromising in any way the safety or the scientific integrity. What we're doing is something that's called at-risk. In other words, if we were developing a vaccine in a nonemergent situation, you would go from one step to the next step to the next, and you wouldn't proceed to the next step or make an investment in preparing, for example, clinical sites to test the thousands and thousands of individuals that you would need to test until you were certain that you did have the phase that you were in completed and analyzed. You would then go ahead to the next phase.
What we're doing right now - and this is something that I think is going to be characteristic of multiple of the candidates that are being tested for a coronavirus vaccine - is that you even start investing and even making doses of the vaccine before you are completely sure that it works. So the risk is not to the patients because the safety and the scientific integrity is intact. The risk is to the investment. And we feel that it's important enough to make those investments in order to save months.
So the projection that we've made - and I actually, you might recall, back in January of this year when we started the Phase 1 trial, I said it would likely be between a year and 18 months before we would have the vaccine. I think that schedule is still intact. I think it is conceivable if we don't run into things that are, as they say, unanticipated setbacks, that we could have a vaccine that we could be beginning to deploy at the end of this calendar year - December 2020 or into January 2021. That's never a promise because when you're dealing with vaccines, there could be so many things that get in the way. Like, it might not be entirely effective, and you wouldn't want to deploy a vaccine that's not effective and certainly not one that's not safe. So the projection of the timeline I think is reasonable. But you always have to do that with some caution and I would say some cautious optimism.
KING: You are speaking optimistically. And I imagine that many people will be relieved to hear what you've had to say. Let me ask you about some mistakes that we know have been made so far. In the time in which we don't have a vaccine, we really need as a country to look at what we are doing. Yesterday, we and others reported on a Columbia University study that found this country could have prevented as many as 36,000 deaths if the government had acted just a week sooner to do - to put social distancing measures in place. What is the takeaway for you there?
FAUCI: You know, there are a number of takeaways. The one is you could always look back retrospectively and say what you could have or should have done.
FAUCI: And you always come up with a situation where you could have done better. There's no doubt about that. I mean, you have to have a certain degree of realism and humility about it. I mean, you know now when you look back that the deployment of mitigation, things like shutting down, getting people to be physically distant, what we've done now throughout the country - you look back and you see that actually has prevented infections. So you make a reasonable assumption. Well, you know if we had done that sooner, we would have prevented more infections, and we would have prevented more deaths. That is true.
But at the time it was not clear that was the case. So of course, we always could have done better, particularly when you look in the rearview mirror and do a retrospectoscope and say, wow, you know, we could have saved a lot of disease if we had done it much earlier. And that's true.
KING: You make a fair point about looking back. Let's look forward. OK? You've said a second wave of the coronavirus is, quote, "inevitable" in the fall. Can you tell us what you think a second wave will look like? Is it just a lot of us getting sick again? What are we going to see?
FAUCI: OK. I'm glad you asked the question because I do believe it needs some clarification. When we say - myself and my colleagues - that there could be a second wave, it would be inevitable if we don't respond. And let me explain what I mean.
FAUCI: The fact that we are going to be pulling back a bit on the mitigation in the attempt to try and get to some degree of normality - and I've always been one, as you well know, to emphasize we've got to do that very carefully and prudently. But as you pull back, if there are infections anywhere in the community or even in the world, inevitably as you pull back on your mitigation, you're going to see blips of cases. If we are not prepared, which I hope and believe we will be, to respond to those blips in cases with identification, isolation and contact tracing, those blips can become outbreaks, and those outbreaks could become real rebounds of infection.
So the one thing I am sure of is that there will be infections around in the fall and in the winter because it's not going to disappear from the planet. Our success or failure in how we deal with that is going to depend on whether or not we could efficiently and adequately respond by not allowing those blips of cases to become resurgences of cases. So it isn't inevitable that we're going to have a massive rebound. What is inevitable is that we will see cases. It's how we deal with it that's going to be the end game.
KING: You're saying we need to stay on our toes. Earlier this...
KING: ...Month, Harvard conducted an analysis for NPR. It found that only nine states were doing the bare minimum amount of testing that they needed to safely reopen. Do we have enough testing capacity right now in this country?
FAUCI: You know, that's a good question because there's always the perception - and perhaps in some cases the reality - that we don't. But right now, when you talk to the people in the group - in other words, in the government both federally and locally, what is happening with testing? It's getting better and better literally as the weeks go by. And we would hope - and I think it's going to turn out this way - I hope so, although I'm not directly responsible for the testing component, looking and hearing what I see from my colleagues - that the ramping up of testing over the next weeks to months should be that by the time we get in the next couple of months and approach the fall - early fall and late fall - we should have enough tests to do what we need to do.
KING: Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. He's also a member of the White House Coronavirus Task Force.
Sir, thank you so much for your time this morning. We appreciate it.
FAUCI: It's always a pleasure to be with you. Thank you for having me.
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