Q&A with Dr. Anthony Fauci, this year’s Luminary Award winner

February 12, 2021

Providence Health Team

Photo credit: National Institute of Allergy and Infectious Disease

Recently Dr. Lee Hood, co-founder of the Institute for Systems Biology and Chief Science Officer at Providence, presented the 2021 PMWC Luminary Award to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, for his work fighting against some of humanity’s most virulent medical threats. The Luminary Award was presented on behalf of Precision Medicine World Conference and recognizes contributions of prominent figures who have accelerated personal medicine.

Hood spoke with Fauci about the importance of basic research, the extraordinary speed of COVID-19 research, the efficacy of mRNA vaccines on COVID-19 and lessons learned from the pandemic.

"We should have a vaccine, as well as universally applicable antivirals, that we could use for the next outbreak," Fauci said. "I would be really disappointed if when this is over, we don't put together a commission and codify what we need to do as opposed to saying, ‘Well, we got through that, now let’s worry about the next problem.'"

You can watch the full 60-minute conversation directly below or scroll down to read the Q&A highlights from the discussion.

Hood: What benefits to 21^st century medicine do you see coming out of the COVID-19 pandemic?

Fauci: When it comes to infectious diseases, we showed the investment in vaccine platform technologies together with prototype pathogen studies — where you can extrapolate within families of microbes — how we did something within the context of a horrible pandemic of historic proportions. To go from the availability of a sequence in a database of a new virus to having phased clinical trials and a vaccine that’s highly efficacious going into the arms of individuals in about 11 months. When we were at the NIH together, doing this would have been unimaginable.

I think the world needs to appreciate the fundamental and the concept of mRNA vaccines that people were playing around with and how it might be the solution to the perfusion confirmation that has led to a highly immunogenic spike protein for a vaccine that’s now 95% effective. To me, that’s how this year has done something about bridging the gap between fundamental research and applied research.

Hood: Do you see a path forward to prevent a pandemic like this again?

Fauci: You’ll never prevent the emergence of a new microbe, but you can prevent that emergence from becoming a pandemic. This is the third pandemic of a coronavirus. Prior to SARS-CoV in 2002, coronaviruses were insignificant common cold viruses that accounted for 15-30% of all the common colds we would get. The time has come to develop a universal coronavirus vaccine. That’s not going to be very difficult given our technologies. Even now, we have a very efficacious vaccine at 94-95%.

But that pressure of the immune system on circulating isolates has diminished some of the efficacy of the vaccines. With our technologies we should not have to worry about that. We should have a vaccine as well as universally applicable antivirals that we could use for the next outbreak. I would be really disappointed if when this is over, we don’t put together a commission and codify what we need to do as opposed to saying ‘well, we got through that, now let’s worry about the next problem.’

Hood: Can you explain the difference between the classic vaccine and the mRNA approach?

Fauci: There are three platforms that are now being pursued for COVID-19. One is mRNA in which you can easily pull out a sequence and stick it into your mRNA. If you need to change it, it’s really simple — like a plug and play. With the standard way, you develop the protein and give it together with an antigen, and you would have to develop a new protein to be your immunogen. Here you just need to switch sequences. It's good for flexibility with COVID-19, and it also will help us go back and look at the vaccines that have been very problematic in the past — HIV, tuberculosis, and even some of the cancer vaccines.

Hood: With cancer, people have long sought vaccines that could provide protection. What about the possibility of making an mRNA vaccine for that?

Fauci: I see them as exciting possibilities, and a lot of other people do too.

Hood: If you just have one dose of the COVID-19 vaccine, how good is that protection going to be?

Fauci: The Moderna and Pfizer studies that were done with a lot of people show the optimum response if you give a prime [vaccine] is around days 10-27 and you get about 50% protection with a durability that is modest to minimum. When you boost on day 21 with Pfizer and day 28 with Moderna, right around 10-14 days later, you get a ten-fold increase in neutralizing antibodies that’s durable for at least six months, and maybe a few years.

Hood: How long is the immunity going to last?

Fauci: To be honest, I really don’t know. If you look at the common cold coronaviruses, there are four of them that account for about 15-30% of all the viruses we get every year. The immunity does not last very long because people get reinfected with the same genetic material. That may be because it’s upper respiratory and isn’t systemic. When you get vaccinated, you get a system response. We will follow the studies over two years, but right now, we don’t know what the duration [of immunity] is. I suspect it’s going to be a longer duration than with the common cold virus.

Hood: What is the possibility we could eliminate this virus?

Fauci: I think it depends on getting a substantial proportion of the world vaccinated. We estimated that if we get 70-85% of the country vaccinated, we will develop a degree of herd immunity that the virus won’t have any place to go and there will be very few susceptible hosts. And those people who are susceptible would be protected by the herd effect. We’re not going to crush it unless we get a multi-year global vaccination program going.

Learn more about Providence’s vaccine efforts.