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view of government. funded by these companies and more. >> wow, supports c-span, as a public service along with these other television providers. giving you a front row seat to democracy. ntinues. host: our guest is andrew, he is with insider and covers the health care industry and the world of pharmaceutical and biologic companies in here to talk about the role of vaccines with the delta variant. thank you for joining us. andrew: thank you, pedro, for having me. host: our vaccine manufacturers looking at developments with the delta variant? andrew: it's an interesting

picture, we see the vaccines holding up here, they are safe and effective and the main concern i've been tracking closely is around this question of durability protection which we know from the clinical trial last year just how long with protect -- what protection from these vaccines last and do the mutations we have seen in the delta variant that partially degrades the vaccines protection. none of this full degradation of protection but the nomination of having several months out plus the rise in the delta variant does have vaccine manufacturers thinking about booster doses, re-formulations, and so on. host: as far as various companies involved in developing the vaccine what is the line saying and what is -- when it comes of possibility of what the vaccine could do against the delta variant. andrew: pfizer has been the most

vocal or out front. we believe there is a need for booster doses six to 12 months after the second dose, that is going back for a third dose of the pfizer biontech vaccine after completing the first two doses. their partner has presented data where there is a slight drop in antibodies which is the main element of the immune response that protects us from this virus. when you take into consideration all the other factors there is some lab testing -- there is some lab testing that shows a drop in antibodies. the main thing to watch for is data from the real world, people living in the real world and seeing how these vaccines are holding up. these vaccines are still largely protective and there might be a drop from something like 95% effective to 90% effective and over several more months of vaccine manufacturers expect that to continue to gradually decline without a booster shot. 90% to 89%.

the key thing to watch is around severe disease and protecting against hospitalization and death and that is where the most interesting data has come out of israel. there booster dose for people 60 years and older who are five months removed from the second dose, israel has data showing protection against severe disease, hospitalization, deaths peaked at 97% then went down in the last few months to 84%. that is a decent decline, still highly effective. if the booster dose is available perhaps that could literally boost protection against the delta variant. host: is pfizer making a case or an argument for a booster shot? what data do they base that on? andrew: kind of a confluence of data, there is israel data that is showing a modest decline in protections against severe disease. there is data from their own clinical trial has been ongoing

and that enrolled 40,000 people randomized in getting the pfizer vaccine or a placebo. they have been following those people and shown month over month the most recent data that presented a week ago showed six months out effectiveness against symptomatic disease, with any severity of covid that declined from 95% at a peak to 90 or 85%. that shows a modest decline and finally there is research being done which might be the most -- the lease definitive because of the nature of the testing done on test tubes. that research, testing against the delta variant shows the delta variant does partially evade the vaccines respond since the vaccines were formulated around the original strain that came out of the wuhan due to the mutation seen in the delta variant the vaccines seem to be

less effective against this new strain. host: andrew dunn of the insider talking about variants and vaccines when it comes to the delta variant. (202) 748-8000 for eastern and central time zones, (202) 748-8001 for the mountain and pacific time zones. this coming across from cnn, more than 99.9% of people fully vaccinated against covid-19 have not had a breakthrough case resulting in hospitalization or death according to the latest cdc data. andrew: this has been fascinating to watch as far as so many elements of the pandemic it comes down to public health messaging and these are complex and nuanced discussions and finding the right tone and messaging has been a challenge when it comes to the cdc response around mask guidance i think there was trying to find the right doubt -- the right balance between when they said you are in a high transmission area put a mask back on even if

you are indoors and vaccinated simply because they have seen data that shows at the initial level vaccinated people can still get covid and have high viral loads. when you look at the whole of the data this is predominantly still a pandemic of the unvaccinated. when you look at is who in--is in hospital or icu wards it is 95% unvaccinated people. the interesting thing to watch is there is some research showing that for vaccinated people that get these exceedingly rare breakthrough cases, cnn reporting showed the viral load in their body which should suggest how symptomatic or contagious they might be that rapidly declines after a few days. taken altogether, it should be reassuring that these vaccines are holding up and having immense benefits even against the delta variant. host: when it comes to the idea

of boosters it was the cdc and the fda putting out a joint statement "americans who have been fully vaccinated don't need a booster shot at the time, fda, cdc, and nih are engaged in a science-based rigorous process to consider whether a booster might be necessary. the process takes into account laboratory data, clinical trial data and cohort data from specific pharmaceutical companies. we continue to review new data that becomes available and we will keep the public informed. we are prepared for booster doses and when the science demonstrates they are needed. was that an expected response or an unusual response? andrew: it felt like there was a bit of daylight between what pfizer has to say forcefully about wanting to see a booster dose six to 12 months after the initial vaccination. this joint statement from the fda and cdc is extraordinarily rare, you don't see many joint statements between the two

agencies that operate on their own for the most part. i think they want to assert their independence, that they will review data on their own terms and look for their own signals of waiving community and the benefit of a booster shot area they've been clear about this and they want to weigh the benefits against the risk and they want clinical data showing a third dose is safe and not just effective but safe to give to people. there is some daylight between what pfizer is saying and what u.s. health authorities are saying and it will be interesting to watch as we go into the fall how this evolves because pfizer is presenting quite a lot of data coming out of their labs and research they are sponsoring suggesting a booster dose would be helpful. there is a financial incentive with pharmaceutical companies behind selling their products here and what u.s. health authorities specifically the cdc is running their own tests monitoring how the vaccine is holding up ineffectiveness. host: andrew joining us for this

conversation, you can call and if we have a question or, you can post on our social media sites and text us at (202) 748-8003. all of that comes in light of reporting in the wall street journal about the fda fully approving these vaccines that have been put out out of the emergency use permit and this says only pfizer has submitted all the necessary information to the fda and analysts expect they will be the first to get the green light, modernity says it is completing rolling data submissions and johnson & johnson saying and stuff i'll approval this year. expand on that. andrew: these are different regulatory pathways. these vaccines have been rolled out through emergency use authorization which is a regulatory pathway the fda can use in times of emergency. they have been granted for the moderna vaccine, pfizer biontech, and the johnson

and johnson vaccine in the u.s.. pfizer as you said has submitted the paperwork and that is going through the process. fda has said the deadline for making a decision of january 4 and fda officials have said publicly in the past few weeks they expect to make a decision on the pfizer vaccine well before january and that deadline. it's a fair question as far as the moderna data. if you look at the timeline they trail pfizer by a couple of weeks. we see mentored up publicly stating that they have finished -- we see my dharna publicly state -- my dharna -- moderna publicly state that dude -- there is a small fraction of the vaccine -- of the population that will see full approval as a full endorsement of the agency.

there are some bioethicists who have tied for approval to vaccine mandates, which has been interesting to see. a lot of movement around vaccine mandates. if there is a bla they can give some employers more comfort in issuing a mandate or saying if you are going to work in our offices you need to be vaccinated. host: will discuss those topics and more with andrew from the insider. ron from new hampshire is up first. go ahead please. caller: andrew, they are trying to blame this recent uptick in cases on the delta variant, but the reason that we had a rise in cases is because they got rid of the masks in may. way back in december of last year we identified the delta variant. we had our first cases of the delta variant in february. in march the cdc announced the

delta variant was more aggressive and would become the dominant variant in the u.s.. in may while we had a death rate of 600 people per day, the cdc said, no more masks. that was an insane decision. i don't know why they did that. they realize they made a mistake and are trying to correct it. they are trying to cover by saying it was the delta variant. the recently had it -- the reason we had an uptick is because they got rid of masks in may. the real story is to investigate how that decision was made and who screwed up in the cdc and made the decision to tell people to stop wearing masks. host: that's ron in new hampshire. andrew: the cdc has been in a hard spot as far as they have to react to all the data coming out and foreign policy decisions across the entire nation.

one interesting dynamic to keep in mind is we've had these pockets of unvaccinated communities. the variance as far as vaccine uptake rate varies immensely from state to state. if you look at states like mississippi or alabama there is a huge delta between their vaccination rates and some of the highest uptake's in the u.s.. keeping that in mind as far as the cdc crafting guidance that can be applied across the nation -- when you talk to public health experts there was a lot of questions around the cdc guidance of saying no more masks. the american public read that as a return back to normal. i've heard public health experts compare this current moment as far as seeing the cdc guidance now about wearing masks indoors, you can't put the toothpaste back in the tube once it is out and it is going to be a real challenge to communicate what the cdc is trying to accomplish

with this newest guidance. it is trying to slow the spread of the virus and stop what we are seeing as far as the uptick not just in cases but in hospitalizations and increasing deaths. one thing i'm watching for is can the cdc explain the endgame here? there is a general thinking among public health experts that this virus is going to be and do make and will not be eradicated. zero covid is not a feasible goal for the u.s. given how widely this virus has spread around the world. what is the endgame? is there a certain level of hospitalization and deaths that as a society we will find acceptable? is there a way to say that and how do we get to that point and what does life look like as far as are the vaccines alone enough to bring us there or will we have other non-fard -- other nonpharmaceutical interventions like masking and social distancing. it's a really tough situation

and it some of the hardest challenges in public health messaging i've had to cover. host: the cdc reporting when it comes to those fully backslid in the u.s. that is still under 50%. what the likelihood of that number rising from there? andrew: there is some modest reason for optimism as far as we have seen in the last couple of weeks. a slight uptick in the number of daily first dose is being given in the u.s.. that number was declining pretty rapidly over the past few months and plateauing around a pretty low number. if this modest uptick can continue given the urgency we have heard around the need to get vaccinated as the delta variant spreads and a lot of stories coming out about unvaccinated people who ended up in the hospital and regretted not getting the vaccine, hopefully that can encourage more people to get the vaccine because the data shows this is a safe and widely effective rodda that will help bring an end to

this pandemic in the u.s.. host: mark in silver spring, maryland, go ahead. caller: there is a whole literature out there where the government had its anti-smoking campaign that was quite effective. for example, they showed a long ravaged by smoking compared to a healthy lung. has anyone out there seen a long ravaged by covid compared to a healthy lung as part of the messaging? dr. fauci, god bless him, when he asked 99% of those who are dying without the vaccine, what else could we do the answer is there are people who are convinced not by numbers but by pictures. when you show these pictures you

prevent self-efficacy behaviors like take a vaccine, where, etc. , and point out their motivators. the good to yourself, your family, and your community. host: that is mark from silver spring, maryland. andrew: off of that point i would say on almost a personal note it has been really impactful to read some of the stories recently around unvaccinated people in the hospital expressing regret they did not get the vaccine. there was a great story down in alabama about a doctor having to tell patients who are in the icu that it is too late to get the vaccine, the vaccine won't do them any good at this point. which brings that emotional element of these are people and this is still a pandemic that is affecting tens of thousands every day who are getting infected for the first time and thousands of people in the

hospital. i think it's a good point as far as her membrane the human element and emotional aspect. host: this is dr. fauci from yesterday about the covid surge and the impact it is having. >> are we headed towards a period once again where we are going to see lockdowns, businesses shutting down, masks routine for everybody, or is this potentially just a temporary setback? dr. fauci: i don't think we will see lockdowns, i think we have enough of the percentage of people in the country, not enough to crush the outbreak but i think enough to not allow us to get into the situation we were in last winter. things are going to get worse if you look at the acceleration of the number of cases, the seven day average has gone up substantially. what we need to do, we say it over and over, we have 100

million people in this country who are eligible to be vaccinated who are not getting vaccinated. we have seen an outbreak of the unvaccinated, there are some breakthrough infections among the unvaccinated. no vaccine is 100% effective. in the breakthrough infections they are mostly mild and without symptoms whereas the unvaccinated who have a much greater chance of getting infected in the first place are the ones that are vulnerable to getting severe illness that might lead to hospitalization and in some cases death. we are looking not to lockdowns but to some pain and suffering in the future because we are seeing cases go up which is the reason we keep saying the solution to this is get vaccinated and this would not be happening. host: if that's the case, the

various companies involved whether producing vaccines or tests or the like, how prepared are they for this long haul dr. fauci talks about? andrew: they are prepared, they are doing proactive studies against different variants. the ramp-up in manufacturing has been extraordinary as far as pfizer beyond tech and maternal have produced billions of doses in the next years and will continue to ramp up production for the world. the significance and the severity of the pandemic is not lost on them, which has been reassuring to see around some of the variance being able to use the new vaccine technology around messenger rna and that has allowed for more rapid development of new constructs of the vaccine. we have seen this from moderna and pfizer, it neutralizes a strain close to the delta virus and pfizer i believe sometime

this month will enter human testing for essentially a booster shot of its current vaccine that is tailored against the delta variant. when you look at that work as far as proactive research being done to tractor ability protection and develop potential weapons if needed to further combat the spread of the pandemic it is reassuring on that front. >> there was a viewer on our twitter feed asking if someone got a pfizer vaccine and if they decided to go to the booster route does it have to be a pfizer booster? andrew: it's a great question and we are watching for more definitive data to answer that. this is something the cdc's independent advisory committee will weigh on when this conversation does come up in the next few months. there is research that will answer that question definitively. i look specifically to the u.k. who is running a mix and match study mixing different covid

vaccines with different combinations for boosters. you have the astrazeneca shot or the johnson & johnson shot, would it be safe and effective to get a pfizer or moderna or novavax whenever that comes online as a booster shot. stay tuned, there will be more data there. there is preliminary data that suggests it is safe and likely effective but there should be a more definitive answer. host: we have a viewer on twitter asking, what happened to the inexpensive rapid tests that were promised. i can't be vaccinated and rapid test should be one of the tools we are using. andrew: that's a great question. the response to the pandemic should not just be vaccines, it should be billing diagnostic vaccines and therapeutics. it's been surprising to see the lack of uptake among that and at home quick, easy, and cheap come of the diagnostic tests to tell if you have covid can help

identify and isolate cases on the mild side among the vaccinated who might not be as inclined to go to a mass testing site. if they are vaccinated it's not likely to be a severe illness at the end of the day. if there was a cheap at-home test that would be helpful and i'm not totally clear about why that has not been developed and scaled up and prioritized. my report focuses more on vaccines and therapeutics. therapeutics are incredibly important to pay attention to. there are a few treatments out there particularly for people who are at -- in the hospital with a risk of serious disease. we should be data from merck and pfizer that have an oral antiviral. the tamiflu type option where if you get covid and the symptoms have not developed yet or are still mild or moderate you take this oral drug and pick it up at the pharmacy and that can

prevent you from getting severe oral or critical disease down the line. watching for the development and the uptake of diagnostics and therapeutics is going to be critically important to see this pandemic out. caller: good morning, thanks for taking my call. i'm not sure if this question has been answered, as a nurse i'm well aware of the critical process to get a drug approved. my question is the fda with much pushback approved the new alzheimer's drug that the efficacy was poor and it was very costly. if they can ram that through quickly, how come we can't get the covid vaccine approved? the government can move forward and demand that the military kids get the vaccine.

i don't understand why we can't. with all the statistics and the reporting they can't get this approved until january. andrew: that's an interesting question. you're talking about the bio gender drug approved may be about a month ago as one of the first treatments from alzheimer's disease. that was a controversial approval decision. the independent advisory committee that weighed in on that, several of those experts who sat on this committee and made the decision recommending against the approval ended up resigning over the approval decision -- approval decision. there was a mixed bag of evidence supporting if the drug worked and it will help to benefit alzheimer's patients. that is interesting to keep in mind and they are having people who have raised the idea that the credibility of the agency is

at risk when they make approval decisions without clear evidence of benefit like in that case. they did approve that under the accelerated approval pathway which is not full approval. that pathway is based upon if there is a saray get endpoint which is a different measure that suggests that there likely will be clinical benefits down the line, and this case that is a protein, removing that from blaine -- from brain plaques they think that is a decent predictor that could help alzheimer's patients. they will have to run a confirmatory study to confirm the benefit of this drug. the fda has the option to pull it from market. one last point on the timeline of that, that took several months to go through that approval process. when you look at the timeline around the work for the

applications they are aiming to shorten that quite dramatically and typically the agency takes 10 to 12 months to review full approval, and they are looking to do that quicker. host: you had a chance to go inside the lab at madura where they produce vaccines for covid-19. talk about what got you in there and what you were trying to find out. andrew: i was at the moderna main facility in norwood, massachusetts that is producing tremendous amounts of the raw material that goes into the covid vaccine. it's been an interesting business story for me to cover up. i've been talking to modernity since the pandemic begun and it's a company that has transformed from a market capitalization of $7 billion and 100 30 billion or $140 billion which is a remarkable growth over the past year or so. seeing the expansion of the norwood facility to produce as much vaccine as they can has

been incredible. month irna has a relatively new biotech -- it was never -- it has never produced a approved medicine. it was developing new technology with plans several dears -- several years down the line to bring the first medicine to market. this allowed them to accelerate that process and it's amazing to see them expand that site from when i visited last march and now they have it up and running in a second building there and are working on a third building to make this campus of research and manufacturing. it's incredible to see and you talk to the scientists about how they hope to apply the research and the progress they have made on mrna vaccines on covid to other diseases. they are looking at making a high effectiveness flu vaccine. the epstein-barr virus which is

responsible for mononucleosis, they are working on a vaccine for that disease. host: as far as in a generic sense how much profit have the pharmaceutical companies made because of the vaccine? and does that become a concern particularly for those here in washington, d.c., that oversee those kind of things? guest: drug pricing will i think always be a concern. in d.c. and for patients. rightly so. health care affordability has been such a pain point for both the industry and patients alike. the revenue estimates are quite extraordinary. pfizer just upped its guidance a few weeks ago to expect about $33 billion in annual revenue in 2020. which would make the vaccine the best-selling pharmaceutical product in history. moderna, i think their last 12i789 was about $18 billion in sales in 2020. it will be interesting going forward as far as 2021 and beyond if their sales will plateau at a high level or see a

bull this year of everyone getting vaccine and the next few years those numbers settling back down. this is a really significant market. these companies are making billions of dollars off their work. mass producing these vaccines. i'm sure it's going to catch lawmakers' attention increasingly so in the months and years. you see the patent waiver fight the biden administration has set with the world trade organization to waive patents around this technology to allow global manufacturers to start producing this without running into issues. that's been an issue the drug industry has taken concern with. host: from becky in cambridge springs, pennsylvania, for our guest, andrew dunn. good morning. go ahead. caller: good morning, gentlemen. i just have a simple comment. i think that the p.r. on the vaccine has been very poor from

its conception. because it keeps showing people having needles rammed into their arms. there are a lot of folks out here that have an aversion to shots. i don't, but as i have watched these needles in the arms over an over, i'm developing one. and i think that there might be a better approach to getting people interested in having the vaccination other than showing them being stabbed with a needle. i guess that's it. host: thank you. mr. dunn, go ahead. guest: it's a fair point. i think it gets into that public messaging campaign. you are exactly right. there is a chunk of the population that does have some level of fear around needles. and then i think there is a balancing act for when i think about coverage and choosing how to present the vaccine, being up front about that as far as it is

given two injections. i think there is a similar contrast around what to do around the side effect profile around the shots. which are these expected, self-resolving side effects that a lot of people experience after the second dose of either the pfizer or moderna vaccine. you want to be up front with people about the numbers we were seeing there was more significant than the flu shot as far as the severity and frequency of some of the side effects. even though they are self-resolving and not a big deal. you want people to know what they are getting into and know the process of it is injections, and after the second dose you might feel tired and fatigued and that will go away. it's worth leveling with people and being up front. guest: because of what she said, what is the likelihood that future vaccines might not be delivered by a needle but a pill? guest: that's something some pharmaceuticalhave been looking into. the preliminary human results this year have not been that

encouraging on one company was developing an oral pill that could be a covid-19 vaccine. the immune responses they saw in the first chunk of a few dozen human volunteers in that study, they weren't great. it seemed safe, but the effectiveness is still to be determined. there is also some work being done on an intranasal vaccine. that could interestingly be perhaps closer to something like sterilizing immunity because it's given through the nose. that's where you see a lot of virus man fest and build up when you think of contagiousness and early stages of infections around the nose. some of the early data there has not been encouraging on the intranasal front. there are different delivery mcnisms for vaccines beyond needles. companies are looking at that and working on it. it's still early. host: john in elwood, illinois, good morning. caller: how you doing. host: you're on, go ahead. caller: ok. i'll tell you something.

24 hours a day, seven days a week that's all i see on tv is about this covid testing, about how they are going to try to force these schools to give the tests and stuff. please explain to me very carefully how come none of these people aren't bringing up the solution for these migrants that come across and bring all this covid in here and they don't even care. biden says we are going to ship them off to all these different states. we don't care where the covid goes. and wonder why the covid is going up again because they don't care. shipping these people in our motels, hotels. they are just spreading it around. i don't see any conversations at all whatsoever on tv for a long period of time of what they are going to do with these people. host: ok. john, you got your point out. mr. dunn to the idea of the vaccine availability. where are we in the united states and particularly can you trace that to the argument that some make as far as sharing vaccine with poor nations and if we have the ability to do that?

guest: yeah. in the united states this has been up there. there's been inequities as far as the vaccine distribution and access to it. in the u.s. this is widely available. the white house has staff as far as i think most of the vast majority of americans within a few miles of their house they can get a free covid vaccine readily available. you look at other countries, canada is now i believe leading the world as far as vaccine uptake. they have procured quite a lot of doses in the future as well. so rich nations, they have been able to reach these purchasing agreements well ahead of time and really plan out their vac -- vaccine bows doses and thinking about boosters now. it's starting to think about and disconcerting when you think rich nations are thinking about booster doses and giving third doses. while when you look at the continent of africa it's about 1% fully vaccinated. it's just stunning to think of

just the disparities of where the vaccine is going. there are groups working on trying to remedy that. when you look at could he vax -- covax, a nonprofit working on health issues. those efforts have largely fallen short. in part they really were betting on the astrazeneca vaccine and that's had manufacturing issues. here and there where the deliveries have been a little more limited than they expected. when you put that all together it is a concerning picture to think about. public health experts tell me around the world you want to see high vaccine uptick to quell this pandemic and bring it to an end. we are just not seeing that right now. host: jerry in chester, virginia, go ahead. caller: i got a question. these breakthrough infections that you hear about.

recently in massachusetts. has the c.d.c. collected any data of what percentage of those breakthrough infections were immune compromised people? have any of those immune, what percentage of those breakthrough infections have the immune compromise people died from the delta variant. thanks. guest: that's a great question. because we have seen data, the c.d.c. committee really debated this vigorously a few weeks ago around immunocompromise not mounting a sufficient immune response after two doses. and weighed the question should we give a third dose. to answer your question specifically around that massachusetts outbreak around provincetown, the c.d.c. did issue an mmwr report. i didn't see that detailed as far as the stratification of immunocompromised as far as

other people. what drew headlines around that was the amount of breakthrough infections. i think that's an important point. if we do sedatea that shows immunocompromised are not mounting immune responses at the same rate as other people, is that a good population to target as far as getting another dose to and seeing if that helps. something to watch going forward. i think right there as far as -- you couple that with the severity of those cases is more intense and more are landing in the hospital, that only raises the urgency if something should be done on that front. host: our guest covers the pharmaceutical and biotechnology industries. see the work at business insider dot-com. andrew covers the industry. announcer: c-span's washington journal, taking your calls on the news of the day discussing policy issues that impact you. coming up tuesday morning, the

director of the group adult stands on efforts to monitor what they call the right wing movement. then the executive director of heritage action for america, jessica anderson, talks about the upcoming midterms and campaign 2024. watch c-span's washing turned in a live at 7:00 eastern tuesday morning. be sure to join the discussion with your phone calls, facebook comments, text messages, and tweets. ♪ announcer: c-span is your unfiltered view of government, funded by these television companies and more, including buckeye broadband. ♪ buckeye broadband supports c-span as a public service, along with these other television providers, giving you a front row seat to democracy. ♪