Dr. Anthony Fauci on COVID-19 Vaccines

Excerpts from NIH Director Dr. Francis Collins' conversation with Dr. Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Disease.

Collins: Let’s talk about vaccines. The world is abuzz about vaccines as the way in which we might ultimately get past this [pandemic] and have a chance to go back to something approaching normal life. …Where are we … with the vaccine efforts that have been moving forward at unprecedented speeds?

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 itself, we 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 trial for efficacy at the end of July. Other candidates will sequentially come in. Another one at the end of August, one in September, and one in October….

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 plural, 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 that 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. The big if.

Collins: So 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 because it wanted to be ready, but it isn’t always going to work?

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 that, we’re only losing money.

Collins: Okay, so 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?

Fauci: We do not know the answer to that. I mean, 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.

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?

Fauci: There are no documented cases where people got better and actually got sick again in the sense of virus replicating (multiplying). 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 case of an individual who went into remission and relapse.…But, … I could say with confidence that it is very unlikely….

Collins: So you’re saying this is a pretty good virus for a vaccine to work. It has the ability where natural infection does seem to be protective. It doesn't seem to mutate too rapidly compared to some others, is that fair?

Fauci: That is fair. It’s an RNA virus. And, as we know, RNA viruses mutate but the functional consequence of that mutation so far doesn't look to be impressive.

Collins: People are feeling like this is never going to come to an end. The uncertainty and the anxiety is weighing on people. And many people have seen loved ones fall ill, or even die. So this has been a really rough period these months for our country. And some people are wondering: Are we going to get through this? So what would you say to those folks who are just trying to get through each day and wondering: Is there ever going be a better time for us?

Fauci: I could say… as a public health person, as a scientist, it will end. We will get through this for absolutely certain. We’ve already suffered through a lot of pain—a lot of economic and personal pain and inconvenience. But it will end. It will end because the public health efforts will succeed ultimately. And science will get us through this. We will get a vaccine. We will get therapies for early disease and for late disease. So the only message that I think we can jointly tell the American public and the global public is that we will get through this. Hang in there. It will end, we promise you.

Watch the full interview to learn more about COVID-19, vaccines, testing, and more.