Variants of SARS-CoV-2 discovered in England, South Africa and Brazil should not diminish COVID-19 vaccine efficacy to the point where it would be concerning, said NIAID Director Anthony Fauci, MD, at his first press briefing with the Biden administration on Thursday.
However, he acknowledged officials are “paying very careful attention” to these variants and take them “very seriously,” because while they do not appear to be more virulent, they are more transmissible.
“We shouldn’t be lured into complacency about that, because if you have a virus that’s more transmissible, you’re going to get more cases. When you get more cases, you’re going to get more hospitalizations. And when you get more hospitalizations, you’re ultimately going to get more deaths,” Fauci said.
Fauci was given about 15 minutes at the start of the briefing, after which time White House Press Secretary Jen Psaki said she was going to be the “bad cop” and let Fauci get back to work.
He stressed that SARS-CoV-2 variants may cause “diminution” in the “efficacy of vaccine-induced antibodies,” but that does not mean vaccines won’t be effective against the virus, due to a “cushion effect.”
For example, if the Moderna and Pfizer vaccines “can suppress the virus at a dilution of 1:1,000,” the variant could bring that number down to 1:800, which “does not mean the vaccine will not be effective,” he said.
In fact, these new variants make vaccination more urgent than ever.
“As long as the virus is out there replicating, viruses don’t mutate unless they replicate. If you suppress that with a very good vaccination campaign, then you can actually avoid the deleterious effect you get from mutations,” Fauci added.
And given the current COVID-19 vaccine platforms, it would not be difficult to modify the vaccine, were that necessary, he said.
Where the problems may arise are with monoclonal antibody treatment, particularly with the so-called South African variant.
“Since monoclonal antibodies bind to a very specific part of the virus, when there is a mutation there, it has a much greater chance of obliterating the effectiveness,” he explained. Fauci pointed to preprint manuscripts indicating that the South African variant can resist monoclonal antibodies.
He said the main question about the variants, especially the U.K. strain, isn’t about vaccines or therapies, but whether or not it will become the dominant strain or whether “strains already here will prevent it from flourishing and being dominant.” CDC recently published a modeling study estimating the B.1.1.7. variant will predominate in the U.S. by March.
Fauci then elaborated on the general state of COVID-19 in the U.S., pointing to glimmers of hope even amidst 400,000 COVID-19 deaths.
“When looking at the 7-day average” of cases, it “looks like it may be plateauing in the sense of turning it around.” Yet, Fauci warned these numbers may simply be an “artifact” of slowing down during the holidays, and that hospitalizations and deaths lag behind case numbers, so they may yet increase even as cases continue to fall.
He stressed the importance of vaccination in ending the pandemic, saying that if, and only if, 75% to 80% of Americans would be vaccinated against COVID-19 by the summer, we could begin to “approach a degree of normality” in the fall.
When discussing his role at briefings, Fauci said President Biden made it very clear their goal was to be “completely transparent, open and honest.”
“If things go wrong” they will not “point fingers, but correct them” and “make everything we do based on science and evidence.”
When a reporter asked about his experience under the previous administration, Fauci was characteristically reluctant to be openly critical, though he acknowledged that President Trump’s and others’ cheerleading for hydroxychloroquine, for example, made him uncomfortable.
“I can tell you I take no pleasure at all in being in a situation of contradicting the president, so it was really something that you didn’t feel that you could actually say something and there wouldn’t be any repercussions about it,” he said.
Then he added, “The idea you can get up here and talk about what you know and what the science is and that’s it, let the science speak, it’s somewhat of a liberating feeling.”