‘I don’t think we’ve done enough to get vaccines overseas’: Doctor
Dr. Arthur Caplan, NYU Langone Health, Division of Medical Ethics at NYU School of Medicine, joins Yahoo Finance to discuss the latest on the coronavirus vaccines and booster shots.
Video Transcript
JOE BIDEN: Those eligible include, in addition to meeting the requirement of six months after the second shot, those people that are 65 years or older, adults 18 and over with certain underlying health conditions like diabetes and obesity, and those who are at increased risk of COVID-19 because of where they work or where they live like health care workers, teachers, grocery store workers. That group makes up 60 million Americans who are now eligible for a booster six months after their second shot.
AKIKO FUJITA: President Biden there speaking earlier at the White House clarifying who is now eligible for the Pfizer-BioNTech booster. Those comments came after the CDC director overturned a recommendation by the agency's panel on distribution for the third shot. For a little more clarity, let's bring in Yahoo Finance's Anjalee Khemlani, who's tracking this story for us, along with a special guest. Anjalee.
ANJALEE KHEMLANI: In Dr. Arthur Caplan, Director of NYU Langone's Division of Medical Ethics and a top bioethicist in the country. Dr. Caplan, thank you so much for joining us today. I want to start off with, as we were just talking before we got on the show, a crazy 24 hours, what with the CDC's advisory committee vote and then the director and her action sort of setting the tone for what the booster conversation will be moving forward. It seems like you had a prediction that it was going to be quite as confusing and as big a mess as it was. So let's hear what your thoughts are on how this has all panned out.
ARTHUR CAPLAN: Well, you know-- and thanks for having me-- it was predictable that it would be a mess. I don't know if you remember, Anjalee, but the president started talking about boosters back in August. I think it was on the 18th. He shifted the date about booster availability three times. We got a lot of chatter coming out of the FDA about what they thought.
Sometimes when the data is poor, not because it's ill collected, it's just that we don't have a lot of experience with boosters, I wish they would have been quiet until they got to the CDC and let the CDC make its position known after all the advice and all the information was swirling around. The way it is now, I'll give you another prediction, there are so many people eligible under the conditions that they laid out that everybody who follows this issue is going to go out and get a booster.
ANJALEE KHEMLANI: Well, that's a good one to hold on to. We'll get back to you when that happens. But we've also seen how prior to the booster of being authorized there were people getting it anyway. So there's also this discussion of really reality being split from what's going on in the government. I just wonder, do you think that it really will have as much of an impact to have the authorization?
ARTHUR CAPLAN: A little bit. But people follow the news. The worried well, the well-informed people are a little better off. They see data coming out of places like Israel, and it looks like third shots help. As you said, people are already out there in pretty big numbers getting boosters. Some drugstore chains are just giving them without any question. They're not asking you to prove you're over 65 or working in some dangerous environment. They're just giving them.
So again, I do think you're going to see tremendous demand right away across the board from all sorts of people. And one other point, you know the biggest threat to us? It's the unvaccinated. So while we're all interested in that booster shot and what's going to happen and when can I get a third shot, and right now we're just talking about Pfizer, we still have to keep our eye on the bigger prize-- get your first shot.
ANJALEE KHEMLANI: Right. And I'm so glad you brought that up, because clearly part of this is because of what we saw with the recent Delta surge and how many of those individuals in the hospitals were unvaccinated. President Joe Biden just earlier today calling out those individuals, saying please get your first shot, or at least those who have gotten a first to follow up for their second. Is this move going to help if we do, in fact, face another surge? Do we anticipate that it's going to be just as bad?
ARTHUR CAPLAN: Well, let me add in one other variable. We all have to go out and get our flu shots. Flu wasn't bad last year. We all stayed home. A lot of people masked. There weren't people running around on subways and buses. Flu took a holiday. Flu is ready to return.
We're really talking about a need to get the unvaccinated their COVID shot and everybody to get their flu shot. Were more people to do both of those things, think we could have a better winter. There are a lot of people vaccinated. That's great.
Some people have gotten the disease. That's too bad. Kids may become eligible in the next month or two down to age five. That would be great. Some of us will have boosters, stronger immunity there. I think that I'm going to predict that will make for a better season than we saw last year.
ANJALEE KHEMLANI: Definitely. On the point of the fact that this is all really just a discussion around Pfizer's booster and we still have to have sort of a repeat process for Moderna and Johnson & Johnson, based on when that data comes in, a lot of people have discussed the timing of this.
We now have a booster available, number one, before kids are able to access a dose, but in addition, at a time where maybe some people are already going to go ahead and try to get a dose of that Pfizer even if their initial shot isn't the Pfizer dose and that mixing and matching that hasn't yet been approved but is a practice in Europe. I just wonder your thoughts on that, on just sort of how this is all playing out time-wise?
ARTHUR CAPLAN: I say hold out. If you got Moderna, if you got Johnson & Johnson, the data there that we do have shows pretty good immunity, still strong eight months out. Wait another month or two, figure out, do you need it?
Is the Moderna vaccine a little bit more effective, lasting a little bit longer, or whatever the data is going to show on J&J? Don't panic. Don't try to get in an experiment about switching over to the Pfizer shot as your third shot. I worry about that, not because I think it's going to make people ill or sick, but I worry it won't work.
ANJALEE KHEMLANI: What about the conversation about global supply and just generally global vaccinations? We know that that's been a major concern, especially of critics-- from critics of the booster campaign. Should that really be an issue that we focus on right now? Or is what the supplier's saying true where we do have enough for the US and to share abroad?
ARTHUR CAPLAN: I don't think we've done enough to get vaccines overseas. If you look at vaccine availability in Africa, it's almost nothing. Those countries, those areas do pose threats to us, because as long as COVID is percolating out there, it could mutate again, pose a threat to us. Plus people are dying and getting sick in those places, and we owe it to them, having a vaccine, to get it to them.
All that said, I think we can do both. The effort to get third shots out here, I don't think it's really going to impact the availability of vaccines in other poor countries or middle-income countries. We have enough supply here to do it. You need an international push. And we should be doing it to get vaccines out to the rest of the world.
But you know, they need infrastructure. You could send them vaccines on boats all day long, no roads, no refrigerators, no doctors or nurses, trained personnel to give the shots, no way for the people to get to where the shots might be, that's not going to lead to worldwide vaccination. So it's not vaccines alone. You've got to fill in the infrastructure to make things move to let people really get vaccinated.
ANJALEE KHEMLANI: Certainly part of the conversation we're hearing. I want to bring it back to, you know, what's going on here in the US and a final thought. What we saw happen, the timeline that played out from August when President Joe Biden did announce the boosters to now where we've finally gotten to the point where we have the guidance for at least one vaccine, do you think this debate is over of the consternation, the concerns about whether or not a booster is valid and the data that goes with it? Or have we laid that to rest? So there has been a lot of comparisons to the Trump administration and its top-down approach. Are we in the same position now?
ARTHUR CAPLAN: We have not laid this debate to rest. I'll give you an interesting problem that's still hanging there. I've said many times, it's not a booster. It's a three-shot vaccine to be effective. It's just like HPV vaccine for cervical cancer, hep B vaccines. There are many vaccines that are three shots.
If you say it's a standard need, everybody has to get three shots to get vaccinated, that's different from arguing about, well, do you need a booster? Do you need a little bump? So I think we're going to settle that issue. It's not settled, in my view.
And I think we're going to see debates about, well, how often do we do this not just as to whether an individual would benefit, but how expensive is it every year to roll out a massive third shot redo campaign? We do it with flu. Hasn't proved particularly effective. Most people don't get their flu shots. What would it take to really get this going in a serious way if we have to take this shot every year? Big, big challenge.
ANJALEE KHEMLANI: Definitely. Well, we'll have to leave it there. Dr. Arthur Caplan, Director of NYU Langone's Division of Medical Ethics. Thank you again for joining us. Akiko, back to you.
