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■ COVID‐19 Report

■ COVID‐19 Report

Do Vaccines Under Development Have a Shot at Preventing COVID‐19 Infections ?

Creating a safe , effective vaccine for COVID‐19 is complicated , and the time to market is uncertain .
By Francis Collins , M . D ., Director , National Institutes of Health

Here are excerpts

from a conversation between National Institutes of Health ( NIH ) Director Francis Collins , M . D ., and Anthony S . Fauci , M . D ., director of NIH ' s National Institute of Allergy and Infectious Disease ( NIAID )— one of the leading figures in the nation ’ s response to the COVID‐19 pandemic .
Dr . Fauci was appointed director of NIAID in 1984 . He oversees an extensive portfolio of basic and applied research to prevent , diagnose and treat established infectious diseases such as HIV / AIDS , respiratory infections , diarrheal diseases , tuberculosis and malaria , as well as emerging diseases such as Ebola and Zika . NIAID also supports research on transplantation and immune-related illnesses , including autoimmune disorders , asthma and allergies . The NIAID budget for fiscal year 2020 is an estimated $ 5.9 billion .
Dr . Fauci has advised six presidents on HIV / AIDS and many other domestic and global health issues . He was one of the principal architects of the President ’ s Emergency Plan for AIDS Relief ( PEPFAR ), a program that has saved millions of lives throughout the developing world .
Now , he is a leader in the worldwide battle against COVID‐19 and in the race for a vaccine . Here are his thoughts on the days ahead and the healthcare crisis we are all facing .
Dr . Francis Collins : Where are we with the COVID‐19 vaccine efforts that have been moving forward at unprecedented speeds ? Dr . Anthony Fauci : Although timetables are given , whenever you ’ re dealing with a vaccine ’ s development , there ’ s never a guarantee that your candidate will be both safe and effective . So , there ' s always the big question mark . However , assuming that there will be one , and maybe more , safe and effective vaccines , here ' s where we are with the timeline . There are multiple candidates using different platforms — several of which the United States government and the NIH are involved in , helping to facilitate the development — either directly or indirectly — with our sites .
If things go the way it looks like they ’ re going , one of these candidates will enter phase 3 trials . Other candidates will sequentially come in . We hope as we go along that by the end of this year , or the beginning of 2021 , we will at least have an answer whether the vaccine , or vaccines , are safe and effective . If so , we are now working with the companies to start making doses before we even know whether it works or not . So when we get to the winter in the early part of 2021 , we will start to have a large number of doses that people will be able to use if it turns out to be safe and effective .
“ We will get a vaccine ,” says Dr . Fauci . “ We will get therapies for early disease and for late disease . We will get through this .”
Dr . Francis Collins : Does that mean if one of those vaccines doesn ' t turn out to be safe and effective , you just have to throw out all of those doses that were made ? Dr . Anthony Fauci : Unfortunately , yes . But that is a financial risk . That is not a risk for safety , nor is it a risk for scientific integrity . And I think that ’ s what the general public needs to understand . The risk we ’ re taking is to gain months so that we will be able to have it ready . And , if we lose , we ’ re only losing money .
Dr . Francis Collins : Suppose this all looks really good and you have a vaccine that ’ s safe and effective , and we start immunizing people . How long will that protection last when you ’ ve got a vaccine ? Are you going need to take it again ? Dr . Anthony Fauci : We do not know the answer to that . You can assume that you ’ re going to get protection at least to take us through this cycle . When you look at natural infection , it ’ s anywhere between six months to a year . We ’ re going to assume that there ’ s a degree of protection , but we have to assume that it ’ s going to be finite . It ’ s not going to be like a measles vaccine . So , there ’ s going to be follow-up in those cases to see if we need a boost . We may need a boost to continue the protection . But right now , we do not know how long it lasts .
Dr . Francis Collins : And do we know whether people who got natural infection with this virus SARS-CoV-2 can get re-infected ? Are there cases where people really got better and then got sick again ? Dr . Anthony Fauci : There are no documented cases where people got better and actually got sick again in the sense of virus replicating . They were able to do PCR ( a test to detect the virus ’ s genetic material ) of what was likely viral fragments that showed up on PCR . The idea of relapses , I wouldn ’ t be surprised if there ’ s a rare
Continued On Page 18 Leading the charge against a pandemic , Anthony S . Fauci , M . D ., is director of NIH ’ s National Institute of Allergy and Infectious Disease .
Photo Courtesy of NIH
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