Fauci says 20 million Americans could get COVID vaccinations around the end of the year

Dr. Fauci testifying in Congress earlier this yearKevin Dietsch/Associated Press

Dr. Anthony Fauci, the nation’s top infectious disease expert, said Tuesday that as many as 20 million people could get coronavirus vaccinations around the end of the year.

By that time, he said, there could be roughly 25 million doses of vaccine available from Pfizer and 15 million doses available from Moderna. The vaccination takes two shots, so that would mean about 20 million people could get protection — a major step forward, though a small fraction of the US population.

Fauci said it could happen by the end of December, or early January if the timeline slips a bit. “That’s what we’re anticipating and hoping,” he said in an interview at the STAT Summit 2020, a virtual event.

Meanwhile, the chief executive of Pfizer, Albert Bourla, revealed in the same event that the pharmaceutical giant is “very close” to submitting a request to the Food and Drug Administration for authorization to distribute the company’s vaccine to some people on an emergency basis.

Fauci said in an interview with STAT’s Helen Branswell that he hoped that at the beginning of next year the pace of vaccinations would pick up.

“As we get into January, February, and March, there will be more that they will be able to scale up. By February that should be 30 [million doses] of Pfizer, 25 [million of] Moderna. These are numbers that were given to me," he said, noting that he was the “science person” not the “supply people." That amount of doses could get 27.5 million people vaccinated.

“What I would like to see is that the most vulnerable get vaccinated within the first few months of 2021, and then subsequently beyond that we expeditiously vaccinate others,” he said.

“The question we always get asked is, 'When is the 25-year-old, 30-year-old person who has no underlying conditions, who’s perfectly healthy, when can that person wind up getting a vaccine? . . . That likely will start somewhere towards the end of April. So that as you get into May, June, and July, you’ll have people in the second quarter vaccinated who want to get vaccinated," said Fauci, who is director of the National Institute of Allergy and Infectious Diseases.

Fauci also said he hoped that the recent vaccine news from Pfizer and Moderna did not prompt people to let their guards down and stop taking precautions to prevent the spread of the virus, which has killed more than 247,000 people in the United States, according to Johns Hopkins University.

“A vaccine should not be considered as a total substitute at this point for public health measures,'' he said.

People should still take precautions, such as wearing masks and avoiding gatherings. “If we did just that, we know now that that will have an impact on an outbreak, and if we just hang on enough to do that until we get enough people vaccinated to turn around the dynamics of the outbreak, we will be OK,” he said.

In other remarks, Fauci, who is 79, said he had no thoughts of quitting or retiring. “For me to think about quitting is so completely out of the realm of reality — there isn’t a chance in the world that I would do that.” He said he still felt on top of his game and “quitting is not in my DNA.”

Asked what he thought about President-elect Joe Biden’s grasp of, and appreciation for, science, Fauci said it was “considerable, in fact, if not profound, from a number of standpoints.”

Pfizer CEO Bourla said at the summit that the New York-based company had acquired two months of safety data on half of the more than 43,000 trial participants, following the second dose of the vaccine. That enables the company to apply for emergency use.

Pfizer and Moderna are both expected to seek emergency use authorizations to distribute the vaccines to people most at risk for catching the disease or suffering serious complications, including health care workers, the elderly, and people with underlying health problems.

Bourla also said the company felt it had an obligation to provide the vaccine early to people who had participated in clinical trials but received a placebo. “They raised their hands,” he said, referring to their willingness to volunteer for a study.

On Nov. 9, Pfizer reported interim results that suggested the vaccine it had developed with its German partner BioNTech appeared to be more than 90 percent effective at preventing COVID-19. Bourla said the data marked a “glorious” moment for him and his employees.

“When I heard the over-90 percent efficacy, I felt like I was living a dream,” Bourla told STAT.

Moderna reported Monday that its vaccine appeared to be 94.5 percent effective, based on a snapshot of data from its ongoing late-stage trial.

Both the Moderna and Pfizer vaccines rely on synthetic messenger RNA, an ingenious variation on the natural substance that directs protein production in cells throughout the body. The vaccines contain custom-made messenger molecules that instruct cells to create a part of the coronavirus and then stimulate the immune system to make antibodies. If it works, that would protect people if they ever got infected with the actual virus.

There are a dozen coronavirus vaccine candidates in late-stage trials globally, and they employ a variety of approaches, but the Moderna and Pfizer vaccines were the first to report preliminary results from late-stage trials.

Mani Foroohar, an analyst with SVB Leerink, said in a note to investors Tuesday that he expects the FDA will approve emergency use of both the Pfizer and Moderna vaccines for some people by the end of the year. Although both vaccines appeared to be remarkably effective in the early data, he cautioned against reading too much into the numbers.

Like Fauci, Bourla emphasized that the good news about the messenger RNA vaccines shouldn’t lead people to drop their guards against the coronavirus.

“People need to not relax,” he said. “They should keep religiously the instructions they’re receiving from health authorities.”

A number of experts have said Moderna has a big advantage over Pfizer because its vaccine doesn’t need to be stored at the same super-cold temperatures that the Pfizer one does.

Moderna said its vaccine candidate remains stable at standard refrigerator temperatures of 36 degrees to 46 degrees Fahrenheit for 30 days. And it remains stable for up to six months in a freezer set at minus-4 degrees Fahrenheit.

Pfizer’s vaccine must be kept at minus-94 degrees Fahrenheit or lower, which some experts have said could create cold-storage problems, particularly for hospitals in rural areas.

But Bourla minimized those concerns. He said Pfizer engineers have designed special isothermal boxes that can hold 1,000 to 5,000 doses, along with dry ice, and keep the vaccines super-cold. The boxes feature thermometers and global-positioning systems so officials can keep track of them.

Meanwhile, The New York Times reported that Pfizer plans to work with four states — Rhode Island, Texas, New Mexico, and Tennessee — to refine their plans for delivering and administering its vaccine before it receives its expected authorization.

The pilot program, which the company announced on Monday, is aimed at helping the states with their planning, but it will not mean that they receive doses of the vaccine any earlier than other states do.

“We are hopeful that results from this vaccine delivery pilot will serve as the model for other US states and international governments,” Angela Hwang, a Pfizer executive, said in a statement.

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STAT News covers health, medicine, life sciences and the pharmaceutical business. It is part of Boston Globe Media Partners, the parent company of The Boston Globe.