Dr. Anthony Fauci may be the only immunologist in the world who needs no introduction. He’s dealt with numerous infectious disease outbreaks—and the political turmoil that often surrounds them. As a member of the Coronavirus Task Force, he’s taken heat from White House aides and others who chafe at his frank opinions about the pandemic response. Lately, he’s been contending with President Trump’s apparent wish to release an expedited COVID-19 vaccine before the election on November 3.
Now Fauci is drawing a line on vaccines. A presidential edict to force the Food and Drug Administration, already criticized as politically compliant, to approve a COVID-19 vaccine before election day “will be blown out of the water publicly by the people who understand what it takes to declare a vaccine safe and effective,” says Fauci. “It would be a public embarrassment.”
Newsweek spoke with Fauci Friday about political pressure to release a vaccine, the latest data on the Moderna vaccine that the U.S. government is paying for, and the recent revelation that the president intentionally understated the severity of the pandemic in February and March. Here are excerpts:
Newsweek: Do you worry that political pressure to release a vaccine early is hurting the effort?
Fauci: The honest answer is, no. There are a number of checkpoints in that process that would make it very difficult for politics to have an influence on whether a vaccine is approved for use before it was shown truly to be safe and effective. The accumulation of data and the analysis of data is unbiased. An independent group called a Data and Safety Monitoring Board is associated with every clinical trial that has NIH [National Institutes of Health] fingerprints on it.
Let’s get down to the imaginary scenario where, all of a sudden, somebody from the White House calls up the FDA commissioner and says, we want this vaccine out there now: Do it, or I’ll fire you. If that happens, it will be so publicly blasted. It seems inconceivable. In addition to the Data and Safety Monitoring Board is an advisory committee to the [Food and Drug Administration]. And then you have the scientific community, like me and Francis Collins, who’s the director of NIH. We have not been shy about being vocal concerning prematurely doing an Emergency Use Authorization.
Do you worry that the politics of vaccines will give momentum to anti-vaxxers?
Oh, yes. Obviously, the statements that have come out of the White House about the FDA being a Deep State, the FDA giving an emergency-use authorization to hydroxychloroquine and then withdrawing it, the president being obviously very favorably disposed to hydroxychloroquine and me being publicly against it. All of that stuff clearly feeds into people having an issue [with vaccines].
How do you counter that?
We try to get people who are trusted by the community to go out there and explain about the vaccine process and be very transparent. You have a lot of people like myself—literally two or three times a day, I’m out there talking about the importance of safe and effective vaccines—who think the most effective way to get to the community to realize that the process is trustworthy is get people who are actually community people out there, particularly among the African-American and Latinx communities.
Is there any preliminary data from the Moderna vaccine trial?
Nothing right now. The first look by the DSMB has not occurred yet because they’re still enrolling volunteers, and most of them have not yet even received the second dose. By the end of September, we would probably get a feel for where we are.
So you have no way of knowing how long the trial will last?
Exactly. If you asked me to put down my 10 cent bet on that, I would say it likely would be November or December.
What’s your 10-cent bet on how effective the Moderna vaccine will be?
You really can never tell. If you look at the phase one study, which was only a small study of 45 people, [the vaccine] induced neutralizing antibodies and at a robust level, equivalent to or better than what you see with natural infection. Historically, that is a good sign. That means that you can likely predict that it is going to be effective. I would guess that it’s going to be somewhere around 70 to 75 percent effective, but that’s purely a guess. I mean, that’s not based on anything. I would be more certain that it is going to be effective and that it is going to be helpful and going to be utilizable.
The FDA is targeting a 50-percent effectiveness rate for new vaccines. What do you say to people who say that since a vaccine might work only half the time, there’s no point in getting it?
Any degree of protection is better than no degree of protection. You need to make sure that people understand that you will not 100 percent protected. Therefore, you need to continue to wear a mask, you need to continue to be physically distant, and you need to continue to avoid crowds. Having the vaccine on board is just an extra, added level of protection.
What’s your best guess about how 2021 will go? Will we still be taking precautions?
It’s always dangerous to make these kinds of predictions, but I would say at a minimum, we’re going to be doing this well into 2021, certainly through the winter. No doubt. By June or July of 2021, you may have most of the population vaccinated. As we turn the corner halfway through 2021, getting into the summer and fall, I would predict that we’re going to be approaching a certain degree of normality—not completely, because we’re still going to have some coronavirus circulating around, but it’s not going to be something that’s a immobilizing society the way it currently is.
What would you expect to change in a Biden administration?
If you go into January with a new administration, I think it will be fortunate because I believe quite frankly that we’ll have a vaccine by then.
Some people think the COVID-19 death toll is only 6 percent of what’s been reported, a view that’s being pushed by QAnon. Others think it’s higher than the official toll. What do you think?
I don’t waste a lot of time trying to figure out if it’s 185,000 or 191,000 [deaths]. It’s almost certainly in that ballpark. And all of the other crazy theories, particularly the QAnon theory that it’s only 6 percent, is total nonsense.
What do you make of Bob Woodward’s report that the president intentionally understated the severity of the pandemic in the spring?
While that was going on, I and my colleagues were saying what it really was like. I was sounding the alarm about community spread, about all kinds of things. To the extent that people have trusted me and listened to me, there was no doubt that we were saying it was serious.
But Trump has a bigger bully pulpit than you do.
Yes, right. That’s unfortunate that that happened.