Fact Check My Feed: Could A COVID-19 Vaccine Come Out Before Election Day?

IRA FLATOW: This is Science Friday. I’m Ira Flatow. As we await further news about the health of President Trump, the first lady, and possible other staff members testing positive for COVID-19, this week’s presidential debate had coronavirus as a central issue. During the debate, President Trump said we are just weeks away from a COVID-19 vaccine.

This is not the first time Trump has said something along those lines. He’s repeatedly said he wants a vaccine out before Election Day. But is this even possible?

Remaining with us to help us fact-check your coronavirus news feed, election style, here’s Dr. Angela Rasmussen, an Associate Research Scientist in the Columbia University Mailman School of Public Health in New York.

Angela, let’s start with the question of if we can get a vaccine before the election, how realistic is this?

ANGELA RASMUSSEN: I think it’s very unrealistic. I think it’s not impossible, and certainly the CEO of Pfizer, in particular, has made comments to the effect of they believe they may have some efficacy data. The real question for me is whether that efficacy data, if there’s any at all, will be really sufficient for the FDA to say, yes, this vaccine is clearly safe and effective and it works, and it should now be distributed widely to the American public.

I think that the trials for these vaccines all started in late July. Most of these vaccines are a two-shot regimen, meaning they have to get a second shot of the vaccine three to four weeks after receiving the first shot. And in the case of Pfizer, it’s three weeks after. And after that, you’ll still have to wait for people in those experimental groups in the trials receiving the vaccine to actually be exposed to. coronavirus in order to determine whether or not that vaccine works. It’s not impossible, again, but it’s a real stretch to say that we would have enough data from those trials to be confident that these vaccines do, in fact, work.

IRA FLATOW: And even distribution, which is something we’ve talked about last time, even if you have a vaccine getting it out to the public could take a lot longer than people expect.

ANGELA RASMUSSEN: That’s absolutely right. Distribution is going to be a huge challenge for a lot of these vaccines, especially the mRNA vaccines, such as the Pfizer vaccine. Currently, the Pfizer vaccine has to be kept at an extremely cold temperature to the point where you need to have either vapor phase liquid nitrogen storage for it, or you need to have a minus 80 degree Celsius freezer. And most places, most pharmacies, places that you would normally go to to get a vaccine don’t necessarily have that kind of cold chain capability. So it is going to be a real challenge to actually manufacture these vaccines at scale and then distribute them to the American public, much less the global public.

IRA FLATOW: Let’s talk about a move that Secretary of Health and Human Services Alex Azar made recently. He barred agencies, including the FDA, from signing any new rules about vaccines. What does that mean?

ANGELA RASMUSSEN: It’s hard to say. And I will give a disclaimer that I am not a policy expert. But from the folks that I have talked to who are involved more on the policy side of things, it’s really hard to say what this means other than it’s potentially an attempt to run around or circumvent the normal regulatory process for approving things. What this essentially means is that Secretary Azar is going to have really the sole authority to decide whether or not a vaccine could be approved and that the FDA can’t make new, potentially tougher regulations describing what kind of bar would need to be met in order for a vaccine to get an emergency use authorization.

So it’s really very concerning. We won’t really know what it means until we see Secretary Azar really put this into practice. But it’s very concerning to think that the secretary of HHS would effectively undermine the agencies within HHS, including the FDA and its important role in regulating drugs.

IRA FLATOW: So it’s basically seen as a political move?

ANGELA RASMUSSEN: Yes. There have been increased reports over the past month or so that there is a lot of political movements within HHS. There has also been reporting that the CDC’s messages and guidelines have really been influenced by folks on the political side with minimal background in science or evidence-based medicine. So overall, it’s a very concerning trend, and I think this is really contributing to the fact that the American public is feeling that these agencies within HHS, including FDA, CDC, and the National Institutes of Health, are somehow compromised politically.

IRA FLATOW: Let’s move on to what vice presidential nominee Kamala Harris said, that she would be hesitant to trust a vaccine pushed out before the election. And other high-profile politicians and experts have said similar things. Is this a valid concern?

ANGELA RASMUSSEN: I think it’s a very valid concern. Personally, I would be very skeptical of a vaccine that was approved before the election unless there was really, really clear, strong evidence supporting that decision. And right now I just don’t see, as I mentioned earlier, how it’s going to be possible to actually get enough data from these trials within that time frame to be able to make a decision that’s based on evidence. Any time you are talking about approving a drug or a vaccine for the general public that’s really based more on political considerations than evidence that process is suspect.

That’s not the process we normally use to regulate drugs and vaccines and make sure that they are safe and effective. So I would share Senator Harris’s concerns about that. And I have to say, I’m a huge vaccine enthusiast personally. If the data is there to suggest that this vaccine, whichever vaccine it is, for COVID is safe and effective, I’ll be first in line. But if it’s not, if that data is not there, then I would be hesitant to take it as well.

IRA FLATOW: This week, more than 60 physicians and experts sent a letter to Pfizer’s CEO asking the company to go through rigorous safety and efficacy measures for their vaccine. With what they’re asking, a vaccine wouldn’t be out before the end of November, like you said before. Do you think this is going to make a difference when the president is persistently saying he wants a vaccine as soon as possible?

ANGELA RASMUSSEN: I really hope that pushback from the scientific and medical communities would have an influence on the vaccine manufacturers. Because ultimately, the FDA or Secretary Azar, they are not going to be able to approve a vaccine that they haven’t gotten an emergency use authorization application for.

So if the manufacturers themselves are going to wait to apply for approval until they have a sufficient body of evidence that suggests that the vaccine is safe and effective, then there won’t be the opportunity to have this political approval for it. I worry that if the vaccine manufacturers don’t and they are racing to see who can get there first, and there is a strong financial incentive for them to do so, then we will see overall a huge loss in confidence in vaccines in general from the public, and that will have repercussions for public health far beyond the COVID pandemic.

IRA FLATOW: And could that not be one of the purposes of having this constant back-and-forth and changing guidelines and expectations about the vaccine to actually increase distrust in the vaccine overall?

ANGELA RASMUSSEN: I mean, I hope that that’s not the intent by people in the federal government, that they are intentionally trying to decrease public confidence in vaccines. But I think that that is certainly a consequence of this. I mean, we’ve already seen a lot of vaccine hesitancy from people who are normally also proponents of vaccines.

I think some of the language around this, the Operation Warp Speed language, for example, sort of implies that corners are being cut already. And so if there was an added political interference, or at least the perception of that interference, that this wasn’t a science-based, evidence-based decision, I think that that will really be catastrophic in terms of the public’s overall confidence that vaccines are, in fact, excellent public health measures that definitively prevent disease.

IRA FLATOW: Parenthetically speaking about vaccines, are we seeing any spillover in to this year’s flu vaccination program about whether the public is actively seeking to get one or to avoid getting a shot?

ANGELA RASMUSSEN: Yeah, so I don’t have actual numbers on that. But there’s always been a problem with people taking the flu vaccine. There are a lot of myths about the flu vaccine that persist, despite the fact that they’ve been debunked many times, for example, that the vaccine can give you the flu itself.

There is also perception that because the flu vaccine isn’t always 100% effective, or it doesn’t provide 100% protection, that it’s completely worthless and it’s pointless to get it. And then there are concerns that the flu vaccine is associated with all these side effects that there’s no evidence that it is, and the flu vaccine has actually been used for decades safely. But people are already hesitant to get the flu vaccine.

And I feel like now a combination of pandemic fatigue, already distrust in flu vaccines coupled with this distrust in the agencies themselves that regulate vaccines, such as the FDA, and these concerns about the COVID vaccine that there will be a lot of people who say, you know what, no, thanks. I’m just going to hold off on flu vaccines, COVID vaccines, any other vaccines for the foreseeable future. I think that that, again, has really serious repercussions for public health, in general.

IRA FLATOW: Let’s talk about something else that came up in the debate. President Trump said that the Obama administration was a, quote, “disaster at handling the H1N1 pandemic. Is this true?

ANGELA RASMUSSEN: Well, I think that it’s hard to say that any administration with any outbreak of a communicable disease ever does a perfect job. I don’t think, however, that the 2009 H1N1 pandemic response was a disaster. And in fact, by all accounts, Joe Biden himself was personally very interested in that from the start. He was very aggressive about pushing for a vaccine.

And there were mistakes that were made. There were some manufacturing problems also that came up with making the 2009 H1N1 vaccine itself. There were some technical difficulties that delayed production. And there were shortages of that vaccine when it came out.

But overall, if you just want to look at the total numbers for the 2009 H1N1 pandemic, 14,000 people in the US died. And that’s not a small amount, but that was over the course of about a year. In the case of COVID, 200,000 people have died within nine months, or 10 months, effectively, since it’s made its way to the US and began circulating here. So I would say that while the 2009 pandemic response may not have been perfect and there were some mistakes made, it certainly was very different from the Trump administration’s response to the COVID-19 pandemic.

IRA FLATOW: Let’s move on to something that happened last week . During a Senate hearing on coronavirus, Senator Rand Paul claimed that New York had reached herd immunity and that’s why cases had gone down there. And surprisingly, Dr. Anthony Fauci pushed back strongly. It’s something that we had not seen him do before. Has New York reached herd immunity?

ANGELA RASMUSSEN: So no, New York has not reached herd immunity. And let me back up really quick and just give everybody an explanation of what herd immunity actually means. Herd immunity is the concept that enough people in the population are resistant to the virus that a virus will no longer be able to spread within that population and will eventually die out or be eliminated from that population.

So if everybody’s totally susceptible, the virus can spread at will. If some people are vaccinated or have acquired immunity through natural infection, then the virus will have a much harder time finding a host. And viruses have to find hosts because they can’t reproduce without them. So the idea that we would have herd immunity with only 22%, which is the average seroprevalence, meaning the number of people in New York City who have antibodies to the coronavirus, is really ridiculous, because that suggests that basically 80% of the people, the majority of the population, are still susceptible.

Now, Senator Paul has also brought up the idea that people have T cells and this might also be contributing to herd immunity. So there have been studies that have shown that some people have T cells, which is another kind of immune cell that is involved in antiviral responses, they don’t produce antibodies, but they kill infected cells and they make antibody responses better, they have T cells that cross-react with SARS-CoronaVirus-2, and these are T cells that they probably got from other common cold coronavirus infections. So while we do know that there are some people out there who have these T cells, we don’t know anything about what these T cells do.

And there are not people who have been recorded who have cross-reactive antibodies from these common cold coronavirus infections. So we know if 20% of people have antibodies to SARS-CoronaVirus-2, maybe another 20% have T cells that we don’t even know what they do, that’s still only 40% of the population that has any kind of protective immunity. So the general accepted threshold, and it varies from virus to virus, for herd immunity is about 60% to 70% of people.

It’s still well below that, even if you believe without evidence that those T cells are actually doing something and that people who have been infected before and have any antibodies have complete protection against the virus. So we just really don’t know enough to say that. But I will make one more point, and that is that we’ve never achieved herd immunity through natural infection.

There are some viruses that have gone out of populations, such as Zika, because there is herd immunity for natural infection, but that doesn’t mean the virus is gone, and it doesn’t mean it couldn’t come back. The only way that we’ve ever really achieved long-lasting effective herd immunity is through vaccination, and that’s how we’re going to do it for this virus too.

IRA FLATOW: I’m Ira Flatow, and this is Science Friday from WNYC Studios. In case you’re just joining us, we’re fact-checking your feed with Dr. Angela Rasmussen, Associate Research Scientist at Columbia University, who is always here to help us fact-check our feeds. One last thing before we run out of time.

A new survey from the Kaiser Family Foundations finds public trust in the CDC is dropping fast. This is especially true among Republicans. Is the CDC still a credible source of COVID-19 guidance?

ANGELA RASMUSSEN: So this is what really breaks my heart about how politicized this response has been, partly due to some of Secretary Azar’s actions that have been reported in the past few weeks. The CDC, for decades, has been a reliable place that we could turn to to respond to these epidemics, and the CDC still has tremendous public health experts, excellent scientists working there. The problem is that the policies that have come out of the CDC have been meddled with and that does, overall, reduce public confidence in that agency, including mine.

I have no doubt that the people who are working at the CDC on the ground who are doing the lab work, who are doing the epidemiology work, who are making the recommendations about policy are excellent scientists and public health experts. I think what’s happened, though, is that the way the agency has been interacting with the American public has been compromised, and that does reduce public trust. It’s a real shame. And honestly, I don’t know how we’re going to repair this.

IRA FLATOW: Well, we hope that we can because, as a journalist, we’ve relied on CDC news releases for decades. Thank you very much, Angela, for taking time to be with us today.

ANGELA RASMUSSEN: It’s always a pleasure, Ira. Thanks.

IRA FLATOW: You’re Welcome. Dr. Angela Rasmussen, an Associate Research Scientist in the Columbia University Mailman School of Public Health in New York.

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