Lessons From Past Vaccines

the past. But first, here's what happened in virus news today. Europe, as well as areas reaching from Canada to Hong Kong, suspended travel to the UK as a full lockdown came into force in London and Southeast England to contain a

mutation of the coronavirus. The Europeans Center for Disease Prevention and Control said preliminary analysis in the UK indicates that the coronavirus variant is significantly more transmissible, with an estimated increased transmissibility of up to seventy The new faster spreading mutation of the virus has also been detected in Australia, Denmark and Gibraltar. The European regulator has said it is very likely the FISER and bio en Tech vaccine will

offer protection against the new strain of COVID nineteen. The vaccine just won the backing of a key European review panel, clearing the way for inoculations in the region to start before the end of Marco Cavalery, chair of the European Medicines Agency Pandemic Task Force, said that while more evidence is needed, the antibody response seen from the shot suggests

the new strain shouldn't compromise the vaccines effectiveness. Meanwhile, in South Africa, private hospital operators have warned that they are facing severe capacity constraints due to a resurgence in coronavirus cases. The COVID nineteen pandemic first peaked in South Africa in late July, before infections tailed off in the fall. The country is in the midst of a second wave of the disease that began shortly before the holiday season, when

millions of people traditionally travel. Finally, congressional leaders in the US reached a deal on a roughly nine hundred billion dollar spending package to bolster the US economy amid the continued coronavirus pandemic. This gives lawmakers a short timetable to review and pass the second largest economic rescue measure in the nation's history. Senate Majority Leader Mitch McConnell, Howse Speaker Nancy Pelosi, and Senate Democrat Leader Chuck Schumer announced the

accord on Sunday. The legislative text is still being written, but the House is expected to vote on it Monday, followed by the Senate. And now for today's main story, the US has begun a massive vaccination campaign to fight the coronavirus, but the effort will have plenty of challenges, including convincing people to get immunized. Of course, it's not the first time the country has rolled out this kind

of public health initiative. Bloomberg's John Lawerman spoke with infectious disease specialist William Shaffner of Vanderbilt University to learn more. You've observed, lived through, and participated in some ambitious vaccine campaigns. Is it fair to say that the small pox imnization effort was the biggest and most successful on record? I would think that that's the case that in polio, smallpox of force was eradicated the global campaign against polio. We

now have polio confined really to Afghanistan and Pakistan. They're the last holdouts for the wild poliovirus. Both of those have been extraordinarily comprehensive, and both of them lasted years around the world, but both very very successful public health interventions against two very dreaded diseases. Well, let's talk about smallpox first, because smallpox was effectively eradicated. Is that the only disease that we've been able to eradicate? And if so,

why was that possible? It's the only human disease we've been able to eradicate. Yes, it was possible for or a number of reasons. One, the smallpox virus actually spread relatively slowly. It has this reputation of spreading rapidly, but it actually spreads rather slowly. You need rather close contact for transmission to occur. You knew where every case of smallpox was because we didn't have any asymptomatic or subclinical infection.

Smallpox was a dramatic, serious, easily recognizable disease, so you could find it. And then we had a brilliant strategy of vaccinating. We first tried to just vaccinate everybody, and you know that went halfway there, But the real strategy was to find out where the cases of smallpox were and then to vaccinate everybody around them so the smallpox virus couldn't spread any further and that snuffed out the

transmission and of smallpox. So what about with polio. We've had an excellent polio vaccine for years, I guess almost as long as we've had a small pox vaccine, perhaps even longer. We don't even use smallpox vaccine really anymore because we don't need it. But polio, there's still some pockets of polio, right, what's the obstacle there, Well, there's several obstacles to polio. Polio is a much more subtle

infection because it's an intestinal virus. And for every hundred people who are infected who have this virus in their intestines, usually without symptoms, without symptoms, John there's one case of paralytic polio, so it's much harder to trace. But however, the vaccine was so easy to administer. Remember you could give it on a sugar cube to a child and it would go down into the intestinal tract and then

do it's work, So we could vaccinate. In this case, we had a different strategy to just vaccinate very comprehensively and they're The trick is to be accepted in the population to vaccinate each and every child, and that becomes the great challenge in areas where there is civil unrest, turbulence, and indeed UH guns are blazing, so the last challenges are very severe. So this situation that you mentioned with many many asymptomatic people along with some who actually become symptomatic,

that sounds kind of familiar. So what kind of lessons do you think we can learn from polio that could be applied to, you know, coronavirus to covid vaccines. Yes, it is familiar, isn't it, because we have many people who are without symptoms who can transmit the COVID virus the same. The most important lesson I think has to do with actually the business you're in communication, communication, communication.

You have to provide a goal, you have to enlist the population to achieve that goal, and then you have to tell them very explicitly, very honestly, and very repeatedly, how we're going to get from here to the goal. What about the vaccine, who will get it, when will it be available, how many side effects will it have? And then you have to put down all the rumors that come up, all those falsehoods uh related to the vaccine that people out there managed to conjure up all

the time. I chuckle, But it's very serious business because it can have a very dampening influence on the acceptance of the vaccine. Over the years, you've seen various campaigns, for example, just the annual effort to try to get people to take flu vaccine. I know you're a huge supporter of flu vaccine, right. What can we do to actually make the messaging better and overcome these obstacles that

we've seen in the past. Well, if we're speaking about COVID, and this is a public health statement, not a political statement, but there's been so much mixed messaging about COVID and we have not had, at least to date, a single national campaign. We haven't had a single national coherent response. It's been left to the states, and now we have a crazy quilt, if you will, of different approaches in different states. Is it any wonder that people are confused?

What I would like to see as regards the COVID vaccine is the public health people and the clinici and such as myself out in front, with our political friends behind us. Supporting us, but let us do the messaging, take the politics out of it as much as possible, and let us do our job in a coherent, straightforward fashion with their support, making sure that we are all part of a national effort to dampen the spread of COVID.

And we can do that with a combination of masking, social distancing, avoiding large groups, and now adding the vaccine. We'll have to do all of those together for a period of yet many months, but next year in the holiday season could be back to normal or close to it if we could do all those things together. The vaccine alan won't be enough, not for a long time.

We'll have to do all those things together. Can you can you think of any times in the past US when we've had that kind of messaging, very direct messaging about vaccines. One of the one of the things that I recall, and I'm sure you recall very vividly, was back in two thousand four when the US was trying to roll out smallpox vaccine and I think to a

degree anthrax vaccine for certain populations healthcare workers. And that was very difficult, and I think there were some issues with messaging there, right, and some issues also with with side effects. Do you remember that as a particular episode. Oh, yes, I remember both of those. And we had vaccines, both of them, the smallpox vaccine and the anthrax vaccine that had substantial side effects associated with them, and as a consequence,

acceptance was kind of dicey. And that also had political overtones because there were concerns that particularly the smallpox vacs a nation campaign was perhaps was perhaps more politically motivated than scientifically motivated. So that complicated both of those campaigns. I'm in mind of another one, John, Back in two thousand and nine, we had the pandemic swine flu come

upon the scene. It affected principally children as opposed to adults, and there I think we made one blunder, uh in that we overpromised when the vaccine would be ready, and for a number of technical reasons, it took longer to make the vaccine and get it out and when it was finally ready. Instead of the public health messages being oh, we've got a vaccine here it is, here's who should get it, and here's where you where you should go to get it, the message was in the news media

the vaccines here and it's late. Look at that, huh, and so we stepped on our own message. We've done a little bit of that this time too, and it's made me grumpy because I always prefer to under promise and then over deliver. Then everyone's happy and enthusiastic. There's

been too much over promising here. Any other cases in the past that sort of offer object lessons for how to move forward in this case, well, I can think of a couple of other vaccines that have been introduced into routine practice that were so good that either pediatricians or in my in another case, internists and family doctors accepted the vaccines immediately, and we're very enthusiastic about them and got the moms who brought in the children and

older persons to really accept the vaccine. One had to do with a vaccine again, a bacteria called the new Macoccus. We had a really great new macoco vaccine that eliminated bloodstream infections and meningitis and children. It was so good that the pediatricians all wanted to give it immediately and there were shortages. The same thing happened with the newest version of the shingles vaccine. It's also a spectacularly good vaccine, and among people who knew about shingles, they all went

out and wanted to get it right away. And once again the company was in the public health community were surprised at the demand. Uh. And it took a while to catch up, but we had two brilliant vaccines, and the messages were clear. These are great vaccines. No wonder then that people lined up wanting them. When you look forward to this effort, are you excited about it? I mean, this is this is going to be the most massive I suppose you know, on a timescale, this really dwarfs

the smallpox, any other vaccination effort we've ever had. I think that that's right, John. And if I'm not excited, there's something wrong with me. Covid is a really nasty virus. It does awful things. And here we have what we think are going to be two vaccines, extraordinarily effective, really quite safe. Yes they hurt, but no serious adverse reactions. UH. And the opportunity to provide this prevention to our entire population and reduce COVID to very, very very low levels,

that's an extraordinary opportunity. We don't get a chance to do that in medicine very often that was John Lowerman, and that's it for our show today. For coverage of the outbreak from one hundred and twenty bureaus around the world, visit bloomberg dot com slash Coronavirus and if you like the show, please leave us a review and a rating on Apple Podcasts or Spotify. It's the best way to

help more listeners find our global reporting. The Prognosis Daily edition is produced by top foreheads Jordan Gaspoure, Magnus Henrickson and me Laura Carlson. Today's main story was reported by John Lowerman. Original music by Leo Citrin. Our editors are Rick Shine and Francesco Levi. Francesco Levi is Bloomberg's head of podcasts. Thanks for listening.