New COVID-19 variants will emerge ‘unless we redouble’ global vaccination efforts, doctor says

Dr. Peter Hotez, Co-Director of the Center for Vaccine Development at Texas Children's Hospital, discusses global vaccination efforts, the Omicron wave, high demand for testing, and coronavirus cases.

Video transcript

ALEXIS CHRISTOFOROUS: We are expecting to hear from President Biden this afternoon as the Omicron variant continues to sweep the nation. The US is now averaging nearly half a million new COVID cases each day. Joining us now is Dr. Peter Hotez, Co-Director of the Center for Vaccine Development at Texas Children's Hospital and Dean of the National School of Tropical Medicine at Baylor College of Medicine.

We're also joined by our health reporter, Anjalee Khemlani. Doctor, good to see you again and thanks so much for joining us. I want to ask you about this stat-- the CDC says now about 95% of the cases we're seeing are Omicron. I'm wondering what that means in our fight against COVID. Since Omicron is said to be weaker than the Delta variant, does this actually improve conditions? And are we seeing some light at the end of the tunnel?

PETER HOTEZ: I wish that were the case. I'm not so sure. I mean, first of all, it means that two of the three monoclonal antibodies that we've had are no longer going to be a factor here because they do not work against Omicron. That's the Regeneron and the Lilly monoclonal antibody. Leaves us one left, the one from GSK there that we do not have in quantity in many hospital formularies. So that's an issue.

Also, the fact that Omicron's so highly transmissible, it's knocking out part of the health care workforce. So even though the virus itself has less severity and fewer hospitalizations, there are still a lot of hospitalizations and other fewer health care providers to take care of them. So all those three factors do create a pretty dangerous situation.

So the big picture is that even though the virus itself may cause less severe illness, when you factor in those other issues overall, the epidemic is just as dangerous in many respects. So hospitalizations are going up. We do not have as many health care providers to take care of them. Plus, the additional instability of knocking out our transportation hubs and other essential workers-- all of that combines to create a pretty serious situation for the country in the month of January.

ANJALEE KHEMLANI: Dr. Hotez, I know that you and I have had many discussions about the progress in your vaccine. And we finally see the authorization now in India with Biological E-- really great news and really important point that I know a lot of media have picked up on, and that is that this vaccine doesn't have any strings attached to it. Can you tell us why this is so important and how you came to this decision at a time where we see, really, vaccines and treatments get so much money from this pandemic?

PETER HOTEZ: Yeah. I mean, all of our vaccines have been developed in the non-profit sector or at our Texas Children's Center for Vaccine Development at Baylor. We've been developing parasitic disease vaccines for over 20 years. We adopted a coronavirus vaccine program about 10 years ago and we showed that the spike protein was a target of the virus, how to deliver the spike protein.

And so we adapted that program to COVID-19 early in 2020 and developed a prototype vaccine that was highly effective at inducing virus-neutralizing antibodies and producing durable protection. And so what we've done is license this now to India at Biological E, one of the big vaccine producers in India, to Indonesia with Biopharma, to Bangladesh and Incepta, and to Botswana at Immunity Bio.

And they have the ownership of the vaccine. We helped them at our own expense in the co-development. So these are meant as vaccines for the world. And now what's happened-- Biological E in India is the furthest along. They have 150 million doses ready to go. And now they're producing 100 million doses a month.

So they'll produce a billion doses-- low costs, similar technology used to make the recombinant hepatitis B vaccine. That's why it could be made locally, because they have decades of experience doing it, high levels of virus-neutralizing antibody durable protection, simple refrigeration, and probably one of the best safety profiles of any of the COVID vaccines.

So this meets all the target product profile for the ideal global health vaccine. And so we're excited about doing that. Because right now, most of the pharma companies in the G7 countries just do not have that commitment to the global south, to the southern hemisphere, and in addition to countries like India.

So we're taking that on ourselves. And so far, the emergency use authorization announcement is very exciting. And let's face it, this is what we need to prevent future variants from emerging. This is why we had Delta out of an unvaccinated population in India, Omicron out of an unvaccinated population in Southern Africa.

Unless we can redouble our commitment to vaccinate low and middle income countries, we'll continue to be exposed to serious variants of concern. And we're excited to help fill that gap.

- And, doctor, I want to ask you really quickly-- President Biden said just a few minutes ago that he characterized a testing situation as being frustrating. That seems like a big understatement to me. But nevertheless, his administration is rolling out 500 million free test kits. My question is, is that too little too late when we are at the height of this pandemic, it seems-- more than 100 million daily fresh cases every day in this country?

PETER HOTEZ: Yeah. We needed that commitment a few months ago. And even then, probably wouldn't be adequate. We've just, since the beginning of this pandemic, we've not gotten diagnostic testing up to speed. It's always been problematic.

So hopefully now, we'll start clawing back and helping on that front. But it has been a source of frustration. Remember, for all those lines of people you see around the block, for all those lines of cars, multiply it times three or four, because those are the number of people in cars that looked at that line and said, you know what? I just don't have time to wait four hours in line for a test.

And so this is always going to be problematic. And it hurts our ability to fight this awful pandemic.

ANJALEE KHEMLANI: On that point, Dr. Hotez, looking at not just your vaccine, and really the market that you actually do have, I know we discussed many times, will there actually be a large enough market for you? But this is also true for testing and for pretty much everything else.

It seems like there's been still a reactive sort of strategy to the pandemic, even though we kind of know that this is supposed to be coming and going in waves. How would you characterize what to expect for the remainder of the year?

PETER HOTEZ: For the remainder of the year, I'm hopeful that this current Omicron wave will eventually subside. Some feel it'll be in a couple of weeks, others say it'll be a bit longer. And then the question is, what happens next? Well, what happens next is we know there's still not enough Americans vaccinated.

And if you're infected with Omicron and recovered, you're likely going to be susceptible to reinfection with new variants, and new variants are arising. So we'll have a break for maybe a few months, and then the next variant will come along unless we make that commitment to vaccinate the world and unless we make a commitment to do something about this very aggressive anti-vaccine lobby that seeks to discredit the effectiveness or safety of vaccines. We've got to deal with those two big problems if we're really going to finally get out of this.

ALEXIS CHRISTOFOROUS: Doctor, you know that we have a new mayor here in New York City. And he is vowing to keep the city open. He is imploring businesses to bring workers back he's saying that schools should remain open. And this is a New York state number, not a New York City number-- but the state is reporting over 85,000 positive COVID cases. That's a record for new daily COVID cases among states. Do you think it's the prudent thing to do to push to keep schools open and to get people back in the office?

PETER HOTEZ: Well, what I've said is it's the choice between a bad decision and a bad decision. There's no good decision to make here. And so I have sympathy and empathy for educators and decision makers on either side of this. So the downside, of course, with opening up schools now is the high level of transmission, whether you can sustain school openings when teachers, and staff, and bus drivers are also getting sick, and whether that will knock too much out of the workforce to make it possible.

On the other hand, we know the long-term psychological effects and short-term of not having kids in schools, and their lack of access to mental health counseling, and even school meals and nutrition, and the Surgeon General's report on the damaging effects. So what I've said is, you know, you tell me what the decision is and I'll and I'll tell you the pluses and minuses.

It's tough. It's tough to make a good decision. And so other school districts of large size have made the decision to delay opening with the hope that they can add it on in the summer. And I'm generally supportive of those decisions. But I understand what Mayor Adams is doing. And it's hard to throw darts at it. These are tough decisions to make right now.

ALEXIS CHRISTOFOROUS: Yeah, tough indeed-- an honest answer. Dr. Peter Hotez, we appreciate your time today. Thank you.