Fauci to Montana: Return to almost normal by fall if Americans get vaccinated

The COVID-19 virus has plagued the world for about a year. But now that vaccines are being distributed, things could return to near normal by mid-fall, according to President Joe Biden’s chief medical advisor.

“If we could get past this issue of vaccine hesitancy, where a significant number of people may not want to get vaccinated, if we could convince them to get vaccinated and get to that 70% to 85% of the population vaccinated, I believe that, by next fall, we could begin to approach a significant degree of normality,” said Dr. Anthony Fauci.

On Wednesday, Fauci took an hour out of his busy schedule overseeing the nation’s COVID-19 response to headline the 2021 Mansfield Lecture sponsored by the University of Montana. More than 6,000 people attended via Zoom to hear political science professor Robert Saldin and a few preselected Montanans question Fauci about the pandemic and vaccines.

Fauci said Americans should trust the scientific process that produced the handful of vaccines being used or considered. He knows some are worried about how quickly the vaccines were produced, but the speed of the process was only possible because of all the groundbreaking research that’s been conducted over the past decade or so.

Scientists had already figured out how to make messenger-RNA vaccines a few years earlier. So once the Chinese recognized the danger in December 2019 and then published the genetic sequence of the coronavirus on Jan. 10, 2020, scientists – including those at the Rocky Mountain Laboratory in Hamilton – immediately got to work developing an mRNA vaccine.

“Eleven months later, we were putting the first doses of a highly successful and highly efficacious vaccines that had a good safety profile into the arms of individuals,” Fauci said. “This is beyond unprecedented. It’s something that if anyone (asked) any of us with experience in vaccinology ‘Could this be possible,’ we would have all said ‘Absolutely not.’ But it’s the extraordinary advances in science that anteceded this that allowed us to do that.”

Fauci added the speed didn’t compromise safety. Both the Pfizer and Moderna vaccines still went through clinical trials that included 44,000 and 30,000 volunteers respectively. Then the Data Safety Monitoring Board, a group of scientists independent of the federal government, reviewed the data and agreed the vaccines were about 95% effective when people were given both the primer and boost shots. Then the Food and Drug Administration went through its own review before giving its authorization.

“So for people who have skepticism, they need to understand that the entire process was both transparent and independent,” Fauci said.

Fauci said he disagreed with scientists, such as epidemiologist Mike Osterholm, who have suggested that, with limited amounts of vaccine, it might be better to give more people the first shot, which would be at least 65% effective, rather than giving two shots to some people.

Fauci said the clinical trials didn’t study what happens with just one shot. Having people protected by only one shot might allow the virus to mutate into something stronger, kind of like disease bacteria can get stronger if people don’t take their full course of antibiotics.

Osterholm has said the National Institute of Health should study what would happen. But Fauci said another clinical trial to study that would take months, and in the meantime, more vaccines are being manufactured. By the time we had the results, enough vaccine will be available so we wouldn’t have to worry about it anymore. So we might as well stay the course, Fauci said.

Some of those vaccines being produced include the Johnson & Johnson vaccine, which is less effective – 72% - than the Pfizer and Moderna vaccines. Fauci said those other vaccines are still useful because they prevent the severe symptoms associated with COVID-19 and are easier to distribute. They don’t have to be kept as cold and only one shot is required.

But the key is getting people to accept the vaccine in the first place. Fauci said returning society to close to normal depended on 70 to 85% of the population getting immunized to create herd immunity.

A number of people asked Fauci how to overcome skepticism. University of Montana human biology student Kaylee Kronsperger said she’s seen so many parents who are unwilling to vaccinate their children for diseases like measles so she didn’t think they’d do it for COVID-19. Chairwoman Shelly Fyant of the Confederated Salish and Kootenai Tribes asked why indigenous people should trust the vaccine after all the betrayals of the federal government.

Fauci said people have to respect the skepticism of others and not be hypercritical. The only way to overcome the skepticism is to explain step-by-step how the vaccines were developed and how they work. Not everyone will buy in, but a proportion will, Fauci said.

Fauci told Fyant he hopes people of color will overcome their skepticism because they face higher risks due to more health concerns. And while the federal government committed heinous acts in the past, ethical guidelines and review boards prevent such things from happening now, Fauci said.

“In my mind, as a physician, it would be doubly tragic if, on the one hand, you suffer disproportionately from the outbreak, but on the other hand, you do not allow yourself the advantage of the one intervention that we know absolutely is life-saving. That would be doubly tragic for Native Americans,” Fauci said.

Missoula nurse Lisa Beard and her son Hudson worried that too many people think children are immune. But three months after catching the coronavirus, Hudson still suffers debilitating symptoms such as migraine headaches, dizziness and an enlarged heart artery. He asked if Fauci could help him.

Fauci told Hudson he’s one of the kinds of people whose bodies end up overreacting to the virus even though it’s no longer present.

Fauci said physicians don’t know enough about the inflammatory response for him to help Hudson, but the hope is that eventually his body will right itself.

“I can’t promise you that but I’m hoping that for you, for other children like you, that will be the case,” Fauci said. “We’re trying to figure out what this Post-Acute COVID Syndrome is.”

While scientists still have much to learn about this coronavirus, Fauci said three lessons should have already been learned during this past year.

First, never underestimate the dangers of an emerging pathogen. Fauci said that, even after all the outbreaks he’s seen, COVID-19 surprised him.

“With over 480,000 deaths so far with 27 million infections, we are living through the worst example of a respiratory-borne pandemic in over 100 years,” Fauci said. “This is beyond what I imagined.”

Second, the U.S. was not prepared to deal with the COVID-19 pandemic, although it should have been. Marshall Bloom, Rocky Mountain Laboratories associate director for Science Management, said Fauci has worked for every president since Ronald Reagan and every one had to deal with a pandemic, from AIDS to Ebola.

But the Trump administration cut programs in the Center for Disease Control and Prevention and the National Institute of Health that left the nation vulnerable.

To improve communication regarding pandemics, nations are developing a global health security network.

Finally, Fauci emphasized the importance of supporting scientific research.

“If we did not have the years of investment in biomedical research, we would never have come up with a vaccine in such an unprecedented period of time,” Fauci said.

Contact reporter Laura Lundquist at lundquist@missoulacurrent.com.