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We Need To Double Down On Efforts To Stop COVID-19, NIH Chief Says

NOEL KING, HOST:

There are two big questions on COVID-19 at the moment. Where do we stand on a vaccine? Well, advisers from the FDA will meet this week to decide whether there's enough evidence to authorize Pfizer's COVID-19 vaccine. And then, who will get the vaccine first? In an interview yesterday with CNN's "State Of The Union," Dr. Moncef Slaoui, the chief scientific adviser of Operation Warp Speed, said elderly people and the health care workers who take care of them may get vaccinated as early as this month.

(SOUNDBITE OF ARCHIVED RECORDING)

MONCEF SLAOUI: We should be able to have immunized that full population and the health care workers that take care of them by the end of the month of December or by the middle of the month of January. The vaccine efficacy, as we have seen it, actually starts reasonably quickly after the first dose of vaccine and then is further maintained with the second dose. And therefore, I am hopeful that by the end of the month of January, we should already see quite a significant decrease in the mortality and severe morbidity associated in the elderly population.

KING: I'm on the line now with Dr. Francis Collins. He's the director of the National Institutes of Health. Sir, thank you for being with us.

FRANCIS COLLINS: Glad to be with you this morning, Noel.

KING: Let's start by talking about vaccine approval. So the FDA will review Pfizer's vaccine this week and Moderna's vaccine next week. How will the agency determine whether these vaccines should be authorized for use?

COLLINS: Well, the FDA's career scientists have been poring over the details of how these trials have been turning out for both Pfizer and for Moderna with more than 30,000 people involved in each one. And they look at every single record. It's the most detailed analysis you can imagine. Tomorrow night, they're supposed to post the results of their findings for everybody to look at. And then on Thursday, there will be this public meeting of the advisory committee that is going to look at the Pfizer data. And a week later, the same committee will look at the Moderna data. If they vote to approve, which most of us believe they will based on the data we've seen so far, then vaccinations could start quite shortly after that.

So what Dr. Slaoui was saying in the clip you just played does mean that we would expect the highest-risk people, which are going to be those in nursing homes and assisted living facilities, as well as health care providers, will start rolling up their sleeves in the month of December. And we would hope very much to see, then, some benefit from that by January in terms of a reduction in what has been a terrible trajectory of morbidity and mortality in those very high-risk groups.

KING: Interesting that the FDA is going to be making this public so that people can see what they've been looking at. The government, Dr. Collins, says it will decide how many vaccines each state gets based on population, not on the number of people in high-risk groups like elderly, which is what the CDC wanted. What's the disconnect there? And are you concerned about that adjustment?

COLLINS: There was a deep debate about this issue, I imagine (laughter).

KING: OK.

COLLINS: But if you actually look at the difference across the country, while there are some differences in the proportion of high-risk individuals from state to state, it's not a huge effect. It gets really complicated if you try to do this in a very specialized way, making sure you get the census data right. And it seemed more likely to be equitable and less likely to cause a lot of trouble to simply go on a population basis. And that's what was decided.

KING: OK, fair enough. What percentage of the population needs to get vaccinated in order for the threat of COVID to subside?

COLLINS: We really need to get to 80%, 90%...

KING: Eighty, 90...

COLLINS: ...Of individuals being immune before you could really say this virus is done 'cause that's what it takes to achieve the kind of so-called herd immunity. So that's a ways off. We can get started in December and January, but it's unlikely that we'll reach that level of immunization - even with everything that's being done - until the spring or even the early summer, which means we all got to double down on those public health measures that we know can work in order to keep this pandemic, which is running wild across the country right now, from getting even worse. We've got a lot of work to do, every one of us, to try to keep ourselves safe and keep our neighbors and our friends and our grandparents from being at risk.

KING: There is a big concern here regarding the vaccine, which is that a lot of Americans say they will not take it when it's available. According to a recent Pew Research poll, about 60% of Americans say they will definitely or probably take it, but that still leaves 4 in 10 not willing to say yes. With that much - what do you do with that much skepticism? How do you build confidence? What's the plan?

COLLINS: Yeah, I'm very worried about this, Noel. Although it will be pointed out that the polls suggest that maybe things are starting to trend in a more positive direction compared to polls that were taken a couple of months ago...

KING: OK.

COLLINS: ...When there was much less information available. Now we know there are vaccines that look extremely promising, and we'll know more about that this week and next week. My hope is that that kind of data - because Americans do tend to make decisions based on data most of the time (laughter) - will convince some of the skeptics that this is something they would not want to miss out on. This is a way to save lives. And when we look around us and see somebody's dying every minute now from COVID-19, how could you walk away from something that might put an end to that?

Surely, you ought to be looking at the data to decide whether you believe it's safe for yourself and your family. And I think if people do that, they will be fairly convinced that this is something they want to take part in. But we got a lot of work to do 'cause, boy, there's so many false stories out there - conspiracies, ideas about this is going to make you sterile or it has Bill Gates'...

KING: Yeah, yeah.

COLLINS: ...Chip in it or God knows. Where do these ideas come from? People just need to sort of take a breath, hit the reset button, look at the data. And I think they'll be pretty convinced this is not something you want to pass up.

KING: So if you do manage to get the message across and a vast majority of options do take - a vast majority of Americans - excuse me - do opt to take the vaccine, how quickly will we be able to return to normal social interactions as the population of vaccinated people grows? Do you have...

COLLINS: That's...

KING: ...Like, a month in mind that you could tell us?

COLLINS: (Laughter) You know, there's a lot of uncertainties here, Noel, so...

KING: Yeah.

COLLINS: ...Let me not tell you that my crystal ball is any clearer than anybody else's. But I think there's a reason to be optimistic that by the summer, we may get to the point where regular social gatherings can happen. I'm hoping to go to a baseball game this summer (laughter).

KING: OK.

COLLINS: That would be a really good indication that we got there - or go to a concert, my gosh. I'm a person who loves music, and I have really missed that. But right now, it's not the time, and it won't be until we get to that very high level of immunization so that it's safe again.

KING: Let me ask you a question that I know many parents are curious about. We know how adults responded to the vaccines in these trials, but what about kids? Have kids been part of the vaccine trials?

COLLINS: They have not. The Pfizer trial is now looking at children down to age 12. But no vaccination trials have been done - had kids younger than that. Those will get underway in the very near future. But this is the way we always do things with a new treatment, whether it's a drug or a vaccine. First, you want to find out, is it safe and effective in adults before you try this on children, recognizing that they may be more vulnerable. There's every reason to think this vaccine is going to work in kids, but we will need to get that data and make sure that's true. So kids will be coming late in the schedule of those who get immunized.

KING: And do you have any idea when that might be?

COLLINS: I think that will very much be in the spring or maybe even the beginning of the summer.

KING: OK. OK. We talked to you in October about mixed messages coming from the White House. And I know that you prefer to stay out of the politics, which is fair. You are a doctor. But what do you think about the messages we're hearing now about the vaccine, both from President Trump and from President-elect Joe Biden?

COLLINS: Well, we seem to have some agreement here that the vaccine's development is a really good thing and that people should sign up and get it themselves. So for once, (laughter) maybe we have an area of bipartisan agreement between administrations and across the Congress - with some exceptions, of course. But I think everybody now looking at the data and recognizing that this is our pathway out of this terrible year, 2020, with all of its consequences for the people whose lives have been horribly affected both in health and the economy. This is the way we're going to get through it. How could you basically not be in favor of seeing this go forward when it looks so good?

KING: Dr. Francis Collins, director of the National Institutes of Health. Thank you so much for your time this morning. We really appreciate it.

COLLINS: Always glad to talk to you, Noel. Thanks for everything you do to get the word out there about what's happening. This is a big week.

KING: Sure is. Transcript provided by NPR, Copyright NPR.