Fauci Warns Vaccine May Only Help Control Coronavirus Pandemic

Dr. Anthony Fauci cautioned about high expectations about the efficacy of a vaccine for the COVID-19 China coronavirus in an interview Friday with the Brown University School of Public Health.

Fauci has served since 1984 as the director of the National Institute of Allergy and Infectious Diseases at the NIH and is a member of the White House Coronavirus Task Force. 

In response to a question from a student about a vaccine, Fauci said:

“…So, when you’re talking about a vaccine, um, if this were measles in which you could guarantee that if you get vaccinated it’s likely you’re 97 to 98 percent uh, uh, protected. Then you don’t have to worry about anything else, but just get yourself vaccinated. When you’re dealing with a vaccine for a disease like coronavirus in which you’re talking about the natural response of immunity, generally it’s finite. In other words we don’t know yet what the efficacy might be. I believe we’ll get an effective vaccine, but we don’t know if it’s gonna be 50 percent, 60 percent, hopefully I’d like to see 75 percent or more. But the chance of it being 98 percent effective is not great. Which means you must never abandon the public health approach. You’ve gotta think of the vaccine is a tool to be able to get the pandemic to no longer be a pandemic but to be something that’s well controlled. And by well controlled is my–I won’t say my vision, that sounds too haughty–but what I’d like to see is that, you know I know you’re learning this in your course because it’s the, one of the tenants of infectious diseases: There’s control, there’s elimination and there’s eradication. We’ve only eradicated one human infection in the history of the planet–and that’s small pox. But what we’ve done very successfully is that we’ve eliminated polio from the United States and a lot of other countries. We’ve eliminated malaria. And then we’ve controlled other diseases to a really good level. So what I’m shooting for is with a vaccine and good public health measures, we could bring it down to somewhere in between really good control and elimination. That’s what a vaccine’s gonna do, but it’s not gonna do it alone.” 

YouTube video cued to question on a vaccine: 

CNBC reported the FDA is shooting for a minimum of 50 percent efficacy:

…The Food and Drug Administration has said it would authorize a coronavirus vaccine so long as it is safe and at least 50% effective. Dr. Stephen Hahn, the FDA’s commissioner, said last month that the vaccine or vaccines that end up getting authorized will prove to be more than 50% effective, but it’s possible the U.S. could end up with a vaccine that, on average, reduces a person’s risk of a Covid-19 infection by just 50%.

“We really felt strongly that that had to be the floor,” Hahn said on July 30, adding that it’s “been batted around among medical groups.”

“But for the most part, I think, infectious disease experts have agreed that that’s a reasonable floor, of course hoping that the actual effectiveness will be higher.” 

A 50% effective vaccine would be roughly on par with those for influenza, but below the effectiveness of one dose of a measles vaccination, which is about 93% effective, according to the Centers for Disease Control and Prevention…

Last month The Atlantic cautioned about getting hopes up too high about what a vaccine can accomplish (excerpt):

…Vaccines are, in essence, a way to activate the immune system without disease. They can be made with weakened viruses, inactivated viruses, the proteins from a virus, a viral protein grafted onto an innocuous virus, or even just the mRNA that encodes a viral protein. Getting exposed to a vaccine is a bit like having survived the disease once, without the drawbacks. A lot remains unknown about the long-term immune response to COVID-19, but, as my colleague Derek Thompson has explained, there are good reasons to believe getting COVID-19 will protect against future infections in some way.

Vaccine-induced immunity, though, tends to be weaker than immunity that arises after an infection. Vaccines are typically given as a shot straight into a muscle. Once your body recognizes the foreign invader, it mounts an immune response by, for example, producing long-lasting antibodies that circulate in the blood. 

But respiratory viruses don’t normally fling themselves into muscle. They infect respiratory systems, after all, and they usually sneak in through the mucous membranes of the nose and throat. Although vaccine shots induce antibodies in the blood, they don’t induce many in the mucous membranes, meaning they’re unlikely to prevent the virus from entering the body. But they could still protect tissues deeper in the body uch as the lungs, thus keeping an infection from getting worse. “The primary benefit of vaccination will be to prevent severe disease,” says Subbarao. A COVID-19 vaccine is unlikely to achieve what scientists call “sterilizing immunity,” which prevents disease altogether.

One way to boost the effectiveness of a respiratory-virus vaccine is to mimic a natural infection, by spraying live but weakened virus into the nose. FluMist, for example, contains weakened flu viruses, and a handful of research groups are looking into the strategy for COVID-19. But live virus vaccines are riskier because, well, the virus is live. “We don’t want to be spraying coronavirus up people’s noses until [we] are absolutely sure that it’s actually a virus that can’t spread from person to person and that it can’t make somebody sick,” says Kathleen Neuzil, the director of the University of Maryland’s Center for Vaccine Development and Global Health. “It will just take time.”

With this first generation of vaccines, though, speed is of the essence. An initial vaccine might limit COVID-19’s severity without entirely stopping its spread. Think flu shot, rather than polio vaccine…

End excerpt. Please read the complete Atlantic article at this link.