Fauci Cautiously Optimistic for End-of-Year COVID-19 Vaccine

Andrew D. Bowser and MDedge News

October 19, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

A COVID-19 vaccine could be proven effective within the last months of 2020, with distribution of first doses possible before the end of the year, according to Anthony S. Fauci, MD, director, National Institute of Allergy and Infectious Diseases, Bethesda, Md.

"Given the rate of infection that's going on in this country, and the distribution of the clinical trial sites involving tens of thousands of volunteers, we project that we will have an answer as to whether or not we have a safe and effective vaccine by November or December," Fauci said today in his virtual keynote address during the annual meeting of the American College of Chest Physicians.

"It may come earlier — this month, in October," he added in his remarks. "That is unlikely — it is more likely that we'll have an answer in November and December."

If that timing does come to pass, Fauci said, it's possible that distribution of doses could start at the end of the year, continuing throughout the beginning and middle of 2021.

Although there are no guarantees, Fauci said he is "cautiously optimistic" regarding the timeline.

He said that his optimism is based in part on animal studies and phase 1 data that demonstrate robust neutralizing antibody responses to a vaccine that are equivalent to, if not greater than, natural infection with the SARS-CoV-2 virus that causes COVID-19.

Rapid Development Gives Reason for Hope

Ryan C. Maves, MD, FCCP, a critical care and infectious disease specialist at Naval Medical Center San Diego, said there is reason to be hopeful that a vaccine will be available by the end of the calendar year. He cautioned, however, that this timing is based on the assumption that one of the vaccines will be proven safe and effective very soon.

"We're lucky to have multiple phase 3 trials using multiple vaccine technologies in different platforms," Maves said in a panel discussion following  Fauci's remarks. "I think the odds are very high that one of them will be effective."

"I'm hoping that multiple vaccines will be effective," Maves added. "Then we'll be in a good position of determining which is the best of several good options, as a society and as a world."

COVID-19 vaccine development over the past year has been remarkably fast, especially given the previous record set by the mumps vaccine, which took about four years to go from initial steps to rollout, Maves noted.

Fauci said the federal government has taken a "strategic approach" to the COVID-19 vaccine that includes direct involvement in the research and development of six different vaccine candidates, five of which are now in phase 3 trials.

As part of that strategic approach, the study protocols are harmonized to have a common data and safety monitoring board, common primary and secondary endpoints, and an independent statistical group to determine correlates of protection, Fauci said.

Prioritizing COVID-19 Vaccine Distribution

Who gets COVID-19 vaccine first will be a challenge for governmental organizations as well as bioethicists, who have proposed different strategies for fairly prioritizing different groups for access.

Reaching communities of color will be an important consideration for prioritization, according to Maves, given the disproportionate burden of disease on Black and Hispanic individuals, among other such populations.

COVID-19-related hospitalization rates have been substantially higher in communities of color, Fauci said in his keynote address. Age-adjusted hospitalization rates for Hispanic/Latinx and Black populations are 375 to 368 per 100,000, respectively, compared with just 82 per 100,000 for White non-Hispanics, according to data from the Centers for Disease Control and Prevention.

Outreach to those communities should include building trust in those populations that they will benefit from a safe and effective vaccine, and making sure that the vaccine is available to those communities as quickly as possible, Maves said.

Fauci and Maves provided no disclosures related to their presentations.

CHEST 2020: American College of Chest Physicians Annual Meeting. Presented October 18, 2020.

This article originally appeared on MDEdge.com.

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