Fauci says herd immunity possible by fall, ‘normality’ by end of 2021

“As a public health official … it would be unconscionable to walk away from this or to throw up your hands in frustration,” Fauci said. “It’s not about me and how I feel; it’s about what the problem is. And the problem is enormous. … You just have to suck it up and keep going.”

Fauci was introduced by Chan School Dean Michelle Williams, who said the level of noncompliance with basic and straightforward public health measures makes her think the nation has become numb to COVID-related illness and death. That could be a dangerous thing, she said, if it translates into an unwillingness to take a vaccine. Recent Pew surveys, she said, indicate that Americans who say they would take the vaccine rose to 60 percent in November from 51 percent in September, a figure that’s nonetheless dangerously low if the goal is to reach levels high enough to virtually stop the transmission and end the pandemic.

“Saving lives is now a race against the clock. Let each of us … do the right thing,” Williams said, “because we simply cannot afford to go numb.”

The afternoon event was the second at Harvard on Wednesday focused on COVID vaccines. The first, hosted by the Harvard Medical School-led Massachusetts Consortium on Pathogen Readiness, or MassCPR, featured several experts on various aspects of the pandemic discussing vaccine trials and distribution efforts, as well as health disparities and ways to reach minority communities and encourage vaccine acceptance.“As a public health official … it would be unconscionable to walk away from this or to throw up your hands in frustration. … You just have to suck it up and keep going.”— Anthony Fauci

HMS Dean George Daley, who hosted the MassCPR event, said that successful development and deployment of COVID-19 vaccines show “science, medicine, and public health at its best” but warned that overconfidence about a preventative treatment can be as dangerous as mistrust.

“Vaccine mistrust is dangerous, but so is overconfidence,” Daley said. “We need to be wary of the dangers of magical thinking, of seeing vaccines as a silver bullet. Vaccines will not offer an overnight solution. We have to temper our optimism with a dose of reality and brace ourselves for many more months of infection prevention and distancing measures as the vaccines are rolled out.”

Experts discussed the news of adverse reactions to the Pfizer vaccine that had been thought to be overwhelmingly safe. British authorities on Wednesday recommended that people prone to severe allergic reactions avoid the treatment, which this week became the first approved for distribution after the conclusion of clinical trials in a Western nation. Two British health care workers who were inoculated early developed severe allergic reactions. Also on Wednesday, Canada approved the vaccine for distribution, while on Thursday, a U.S. Food and Drug Administration advisory panel endorsed the Pfizer vaccine for U.S. distribution, with final approval expected soon.

Both Fauci and experts at the MassCPR event said that rare, serious side effects like the allergic reactions sometimes occur once a vaccine is widely distributed because it reaches many more people than a clinical trial, including some with health issues or genetic profiles that make them susceptible to severe reactions. That’s why vaccines are monitored even after they go out to the general population. That’s also partly why the U.S. is backing multiple vaccine efforts, in hopes that rare side effects observed with one vaccine will be absent with another, Fauci said.

“These are the kinds of things that happen when you implement large vaccine programs,” Fauci said. “You’re talking about millions of individuals getting vaccinated, so you may start seeing effects in some that might not have been picked up when you were dealing with thousands.”

The allergic reactions did not prompt a recommendation to halt vaccinations, but rather to heighten vigilance so that people prone to severe allergic reactions not take the vaccine or take it only with medical help nearby in case a severe reaction occurs.

Former Food and Drug Administration Commissioner Margaret Hamburg, who appeared at the MassCPR event, said a key ethical question emerging as the U.S. moves toward vaccine approval will be whether to offer the vaccine to those enrolled in the clinical trials’ placebo group. On one hand, she said, early trial results have shown the vaccine to be more effective than hoped for and vaccination — particularly of those at high risk — might be desired. But on the other hand, important questions about the duration of the vaccine’s protection and about late-emerging side effects might be answered if the trial runs its planned two years. Inoculating those in the placebo arm of the trial would eliminate an unvaccinated population against which to compare the vaccinated participants’ results.

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