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NIH Director Collins On Why The U.S. Reversed Its Decision On Booster Shots


And now let's go to Dr. Francis Collins, as promised, director of the National Institutes of Health. Dr. Collins, welcome back.

FRANCIS COLLINS: Good morning, Steve. Glad to be with you.

INSKEEP: A couple of weeks ago on the program, you said we don't need boosters right now. What have you learned in the couple of weeks since?

COLLINS: Well, many of us have been studying this data virtually daily - the docs that work at NIH, FDA, CDC, the surgeon general. And the more recent data, which is really coming along in just the last few weeks, are showing this waning of protection over time. It's not dramatic, and it's particularly accentuated by the delta variant, which, as you know, is very contagious, spreading rapidly through the country and for which the vaccines, while they still provide protection today against severe illness - you are seeing some breakthrough infections of people who do get symptoms. They're not bad enough to be in the hospital.

You can see the path that's happening. I'll tell you, Steve, I was one of the skeptics. Two weeks ago, I was saying, yeah, no, I don't see it yet. Let's keep watching this a while longer. CDC published three new papers yesterday. And it's both the U.S. data and some of the data we've seen from other countries, particularly Israel, that makes it pretty clear we're on this path.

Now, could we wait another two or three months and be safe in just holding off? I'm not sure, but I don't think that's a good idea. We need not to be behind this virus but ahead of it. And so let's see what FDA and the CDC advisers do with this data over the course of the next month. But I think it's on the right path now to open up the possibility for boosters by September 20 for the people who got their immunizations the furthest back in January.

INSKEEP: Right. Thanks for the reminder that this is not quite final. There is a little bit of study yet to go.

COLLINS: That's right.

INSKEEP: But I want to ask about something you said. You said the waning of the vaccine's effectiveness is not dramatic. Are you telling me that for me as an individual, if I had the Pfizer or Moderna shot, it doesn't matter that much to me as an individual whether I get this booster, but perhaps it does have a big difference on the community and the overall effectiveness of vaccines?

COLLINS: Well, it may matter some. Again, we are seeing what used to be effectiveness against getting symptomatic illness that was up around 90, 95%. That has definitely waned down - in some studies, like the Mayo Clinic one, as low as in the 40 percentage, which means you could still get a cold but not get seriously ill. In terms of waning of prevention against hospitalization, things are looking good now. But you would, by following the trends, suspect that in a few more months, they wouldn't be.

And you're right, though, Steve. It's not just about the individual, although we care a lot about the individual. We also care about the community. We're trying to see what we can do to deal with what is currently a pretty tough situation now, with close to 200,000 new cases every day, hospitalizations going up. Deaths have doubled in the last two weeks. We got to be doing everything we can to get on top of this.

INSKEEP: Let's hear some more of the criticism that Allison Aubrey mentioned from world organizations worried about the world community, so to speak. The World Health Organization's Mike Ryan, Dr. Mike Ryan, said this booster recommendation is not ethical. That's what he said, because he felt that any shots available should go to unvaccinated people elsewhere in the world before boosters are given out to anybody. Let's listen.


MIKE RYAN: If we think about this in terms of an analogy, we're planning to hand out extra life jackets to people who already have life jackets while we're leaving other people to drown without a single life jacket.

INSKEEP: Dr. Collins, do you accept that analogy? I grant what we heard in Allison's reporting, that the United States is sending millions of doses of vaccine around the world, but still there's only so much vaccine, and there are billions of people who need it. Is that analogy true? Some people are getting a second life jacket while other people have none.

COLLINS: Well, I don't like the analogy. I am somebody who's very devoted also to our responsibility in thinking about not just ourselves but the whole world. So I think this is a really critical issue. The problem is the life jackets that, if you want to use the analogy, the vaccine represents turn out to be perhaps losing some of their flotation ability. So we don't want to let those people drown even though they had a jacket that's not quite working anymore. But that's probably pushing the analogy too far.

I don't accept the idea that we have to do one or the other. We are, after all, sending out more doses to the rest of the world. In all the other countries combined, 115 million doses are already out there. Another 500 million are planned and already approved. We've given $4 billion to COVAX. We're scaling up the manufacturing as fast as we can, so this doesn't have to be a limited number of doses. It'll be more about distribution.

And again, let's be clear, the U.S. - if you look at Louisiana, Florida, Mississippi right now, if they were countries, they would lead the world in the number of per capita cases right now. We've got a big problem on our own hands, so it's not as if we've got it all figured out and everybody's got a life jacket. We're still in trouble.

INSKEEP: Part of the reason that we're still in trouble is that millions of Americans have declined to take their first vaccine shot. And this is a problem that public health authorities have been struggling with for months. Do you feel you're any closer to the answer?

COLLINS: Steve, this is such a frustration. Yeah, 90 million people are sitting ducks right now for this particular very contagious virus. And when you see what's happening in the hospitals, filling up, and the morgues starting to fill up too - these are over 90% unvaccinated people. This was preventable. You know, we have done a lot to try to get the word out to convince people that this is something you want for yourself and your family, that the data is extremely compelling. But we just got to activate every credible voice in the community so that people will see the value of this. And that means their own doctors and their pastors and everybody needs to become an ambassador for the value of vaccinations or this is going to go on and on.

INSKEEP: The Supreme Court, of course, the other day upheld a vaccine mandate at Indiana University. What's the difference between a mandate that works and a mandate that doesn't work, in your view?

COLLINS: Well, they are controversial, of course, in terms of what it says to some people who are offended by the idea that their liberties are being encroached upon. But when it comes to a pandemic, it's long been established that there are times where the government needs to take that kind of action. I'm glad to see more and more businesses mandating vaccines for their employees. I was glad to see that decision about Indiana University and their students. I run an agency, the NIH, that has 45,000 employees and contractors. They're going to be required to be vaccinated or else get tested twice a week. I do think it's time to apply every carrot and every stick we can get our hands on.

INSKEEP: I appreciate hearing you say, Dr. Collins, that your agency is not doing an absolute mandate. You're telling people get vaccinated or you have to get tested. There is an opt-out if there are a few people that just really don't want to do it.

COLLINS: That's right. Our exception, though, is people who have patient care 'cause we run a hospital. Those people are required. That's a mandate to be vaccinated, or you can't come to work.

INSKEEP: Which is now, of course, happening with people in nursing homes - nursing home staff as well. Dr. Collins, thank you so much.

COLLINS: Glad to be with you, Steve.

INSKEEP: Dr. Francis Collins is director of the National Institutes of Health.

(SOUNDBITE OF NORTHCAPE'S "CAPILLARY ACTION") Transcript provided by NPR, Copyright NPR.