Thursday, September 30, 2021

Dr. Michael Osterholm on boosters


I think Michael Osterholm is caught between a rock and a hard place. On the one hand he cannot disagree too much with the FDA and CDC on boosters, but his experience  and the data on boosters  from Israel tells him otherwise.  (Note: The official transcript comes out on Mondays. This is my on the fly version) 


21:27 - But I believe that time will show that this is a three-dose prime vaccine. I know that there are some of you out there who are my friends who will disagree strongly with me on this, but I think it is. And I think that there were two elements about what happened with these vaccines over the course of recent months. One was Delta, of course, the second one is the fact of just the time period from when someone was vaccinated and the potential waning of immunity. As I have said before on this podcast, there are two different kinds of buckets. One for safety and one on how best to use this vaccine. We’ve answered the safety bucket, that is not the question. The issue is how best to use these vaccines in terms of dose and dose pacing and what does it do in terms of the human immune response, and I think one day it will be shown that this is going to be a three- dose prime vaccine, and you know, maybe there will be an annual booster, I hope not, but maybe the data will show that too.

And so, I think the challenge we have was we don’t really have compelling data showing from many, many people that in fact over time this waning immunity would resolve in not just mild illness but potentially an increase of severe illness, and some would say let’s wait and get that date first. And I am saying well, you know, that means other people are gonna get sick and some people will die, and if we basically are in a position of doing something now, why would we let that happen? And the appropriate response is, well you don’t know it is going to happen. I don’t. I don’t.  Nor does anybody. We have data from Israel which supports basically that might be the case. So, I think the right answer is right now, that number one, we want to prevent severe illness, but you know I categorically reject this sense that we’ve always said that the vaccine just prevents severe illness, hospitalizations and deaths. I don’t know where anybody wrote that down and said that a year ago. We want to prevent all infections and when we got that first data on mRNA vaccines that’s  what people believed this vaccine would do! That was the accepted position. And so, I think it is still a very important measure to vaccinate people even against mild or breakthrough illnesses, if for example it is resulting in major shortage of health care workers, because they are now out with this infection, people who are essential workers. I think it is fair to keep them out.

Now the flip side of that is, of course, that we do not have the vaccine for the rest of the world. Well, I understand that, and I do believe this is a critical issue and I have been a strongest supporter of global vaccine access. Our country continues to lead the way, we have donated more vaccines to other countries all the other countries than every other country in the world combined. We are a bit hard on ourselves that way and I believe that one day this vaccine will be a three prime dose vaccine for the entire world.