Nancy Messonnier, MD, director of the National Center for Immunization and Respiratory Diseases at the CDC, was the first public health official to warn the public about the coming impacts of COVID-19 on daily life. In a new interview with WebMD, Messonnier talks about her current work on the rollout of a COVID-19 vaccine, a topic she'll be addressing at the upcoming Health Connect South Conference.
This interview was edited for clarity and length.
WebMD: Do you have any predictions as we move into the fall and winter? What are you expecting?
Messonnier: The concern of course is that co-circulation of flu and COVID-19 will be really difficult. One of the interesting things is that the mitigation measures that we’re all undertaking to respond to COVID -- that is social distancing, washing our hands, wearing masks -- are exactly the same measures that one would expect to have an impact on influenza. And in fact, we’re actually seeing this year in the Southern hemisphere, which they have the flu season before ours, less flu activity, and that really might be on account of these preventive behaviors, which is great.
But the point is that we should certainly hope that it's going to be less disease for the flu this year. But flu is unpredictable, and especially a flu season amid a pandemic, so what I would tell people is while we should definitely hope that mitigation measures are going to decrease the risk of flu, we still believe that people should get vaccinated because vaccination is an important way that they can protect themselves.
WebMD: I want to go back to one of the last press briefings that I heard you on. It was February 25th and your cautions to the public that day turned out to be remarkably prescient. You said disruption to everyday life might be severe. You warned us about the need for long-term teleworking, canceling mass gatherings, delaying elective medical procedures, the possibility of school closures and the impact that those would have on everyday life. And you said these are the things we need to be thinking about right now and that was back in February, and no one else was saying those things at the time. What inspired you to give those warnings and why didn't the country start for preparing for those things back in February?
Messonnier: You know, I think today what I really want to focus on is what we're going to do from now and how we're going to keep moving forward. So I think that's the best strategies for today's conversation to talk about what we all as a community and a country can do today. What I think people can do today is to continue to follow the recommendation to get their flu shots and to get prepared for the hopefully very quick availability of the COVID vaccine.
WebMD: Since you’ve been working on the vaccine, when can we reasonably expect a vaccine to be available?
Messonnier: We are working in partnership with Operation Warp Speed and my colleagues say that there will be vaccine available this fall but that they expect the quantities of vaccine to be limited. By next year, we should have much larger quantities of vaccine available. So, on the delivery side, we’re working to ready the country for the first implementation of vaccine this fall, but then also getting ready for a much larger availability of vaccine next year.
WebMD: So you think we’ll see some sort of emergency use authorization for a vaccine this fall?
Messonnier: Based on the Operation Warp Speed projections, they believe that vaccines will be ready for submission for an EUA (emergency use authorization) this fall. And you know as a country, we certainly don't want to have vaccine available and not be ready to deliver it, and so my focus is on making sure that as soon as that vaccine is ready and available, the country's ready to distribute it and administer it, and that we know who's getting it and make sure as much as possible of that process is seamless.
WebMD: Will the Advisory Committee for Immunization Practices (ACIP) have any role in making recommendations about the COVID-19 vaccine, especially for children? Children aren’t included in the clinical trials, and so I’m wondering if that will fall to ACIP to sort the available science to try to figure out whether or not to vaccinate children.
Messonnier: ACIP certainly will have a role in making recommendations to the CDC director on use of available vaccines.
In terms of kids, I certainly am looking forward to the day when there will be a vaccine available to kids. I have kids myself, and I definitely would like to see them protected as early as possible. I understand that the current clinical trials in the United States are in adults, but there are definitely plans in place to start looking at those vaccines in kids, and I'm hoping that moves as quickly as possible.
WebMD: Have you personally been privy to any of the science or the study results as they come in from the Warp Speed trials?
Messonnier: So the current Phase III studies, I think are what you're talking about. And those are sort of the big clinical trials where people are getting vaccinated either by the study vaccine or a placebo. It's actually the data safety monitoring board (DSMB) that has access to those data. So I certainly have not seen any of that yet.
WebMD: What do you think so far from the Phase I and II?
Messonnier: I think these vaccine candidates look really promising and like everybody else in the country, I expect, I'm waiting to see these larger trials. I'm encouraged. I'm also encouraged by the fact that we have great systems in place to make sure that the results from those studies are thoroughly evaluated by the data safety monitoring board, by the FDA’s advisory committee, and then by the CDC’s ACIP. Those are the systems that we always use to evaluate vaccines and those are the systems that were being used now, and I think that you know, we should feel it's satisfying to know that that that we're going to depend on those regular systems.
WebMD: Are you going to get a vaccine and if so, when will you do it? As soon as one is available?
Messonnier: So I think I definitely trust the systems and as a vaccine is authorized and recommended by CDC. If I'm in one of the groups that identified as being a priority, I would get vaccinated. I think it's going to be hard for people to understand, especially in the fall, that while vaccine may be available, it may not be available yet for everybody.
And like everybody else in the country, I'm going to be following the guidelines and getting the vaccine when it's my turn.
WebMD: The CDC has been in the middle of some very public policy reversals on key safety guidance. All this has left some people feeling like CDC science and reputation has been damaged. How's the morale there and how does the agency plan to repair the damage and rebuild public trust?
Messonnier: I certainly can't speak for all of CDC. But what I can say, and what I would want the public to know, is that I work with great people at CDC and across the country public health professionals are working every day to stop COVID and to keep our communities in Atlanta and the entire United States safe. I know that I and our staff will continue to do that work every day.