In a live video update on February 3, 2021, Dr. Anthony Fauci, Director of NIAID, spoke with Dr. Howard Bauchner, editor and chief from the JAMA Network, about the status of the coronavirus pandemic in the U.S.
Dr. Fauci started off by explaining that our current challenge with regard to vaccines is the issue of variants. While the overall efficacy of the vaccine is diminished with variants, it can still reduce severe cases of COVID-19. This is good news; however, we do still have to pay attention when it comes to the spread of variants. When variants have the ability to spread more easily, they become dominant. You can dampen that potential negative effect by vaccinating as much of the population as possible. If you can prevent them from replicating then you’ll diminish the potential of them mutating.
Dr. Bauchner asked if the coronavirus will, at some point, turn into a flu situation with yearly vaccinations. Dr. Fauci responded that it is “too early to say but it’s conceivable that some version of that would occur.” It is important to get the level so low that the virus doesn’t have the ability to replicate. The one barrier is that we need to look at this globally, and figure out how to get vaccines to the developing world. “If you can crush this virus throughout the world, you really won’t give it any chance to evolve season by season with different mutations,” he stated.
Dr. Fauci has run through the calculations of how many vaccines are on order from the various companies, and at this point we have sufficient quantities and access. There’s not really a need to “go beyond the contractual arrangement we’ve already made” in the U.S. and look at the vaccine options being developed in other places like Russia.
There are a number of treatments being used for severe COVID-19 cases, such as corticosteroids, vitamin D, convalescent plasma, and interferon. Dethamexazone has also been very successful. But what about preventing disease? Dr. Fauci stated that we don’t currently have “knockout punches.” We have things like monoclonal antibodies, but you have to administer them very early and as well as be in the hospital to get it. And convalescent plasma doesn’t work as well when people’s bodies start making too many of their own antibodies. “We need a concerted effort for the development… of effective direct antiviral agents…” similar to what we’ve done with HIV. This could mean something like a Z-pack for COVID that you can take right away, the minute you start to experience symptoms.
“The science is very clear that in the trials we did with Moderna and Pfizer.. the data is showing 94-95% efficacy,” said Dr. Fauci. It is important to note there is some “wiggle room” for the period of time between taking the two doses of the vaccine, but you cannot wait for months in between
There have been many questions about vaccine safety in “protected groups” like pregnant women, children, and adolescents. In most vaccine trials – including Pfizer’s and Moderna’s – pregnant women are initially excluded. But due to the recent issue of the Emergency Use Authorization (EUA), there have now been over 10,000 pregnant women involved in the vaccine trials. The FDA… has found, thus far,…no red flags…about pregnant women.” Many of them were healthcare providers who would rather take their chances with a vaccine than get infected with the coronavirus while pregnant. For children, they’re currently doing age de-escalation studies. Over the next few months they’ll collect data from these studies to understand the vaccine’s efficacy and safety for children.
Regarding the various types of vaccines (mRNA, adenovirus vector-based, or protein subunit), Dr. Fauci stated: “I feel that it is extremely likely that each of these platforms that are used will be faced with variants that don’t get completely suppressed with the vaccine-induced antibodies… and the reason for that is common sense… because when you make a vaccine, most of them are directed at that spike protein…Sooner or later, the virus, which is replicating and mutating out there, is gonna evade that… You still have a fixed immunogen and a virus that’s changing.”
Dr. Fauci hopes that by the summer, we have enough people vaccinated in the country to open up baseball stadiums and other similar venues for (masked up and socially distanced) use.
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