White House blocks guidelines that would push vaccine past the election
WASHINGTON — Top White House officials are blocking strict new federal guidelines for the emergency release of a coronavirus vaccine, objecting to a provision that would almost certainly guarantee that no vaccine could be authorized before the election Nov. 3, according to people familiar with the approval process.
Facing a White House blockade, the Food and Drug Administration is seeking other avenues to ensure that vaccines meet the guidelines. That includes sharing the standards with an outside advisory committee of experts — perhaps as soon as this week — that is supposed to meet publicly before any vaccine is authorized for emergency use. The hope is that the committee will enforce the guidelines, regardless of the White House’s reaction.
The struggle over the guidelines is part of a monthslong tug of war between the White House and federal agencies on the front lines of the pandemic response. White House officials have repeatedly intervened to shape decisions and public announcements in ways that paint the administration’s response to the pandemic in a positive light.
That pattern has dismayed a growing number of career officials and political appointees involved in the administration’s fight against a virus that has claimed more than 210,000 lives in the United States.
The vaccine guidelines carry special significance: By refusing to allow the Food and Drug Administration to release them, the White House is undercutting the government’s effort to reassure the public that any vaccine will be safe and effective, health experts fear.
“The public must have full faith in the scientific process and the rigor of FDA’s regulatory oversight if we are to end the pandemic,” the biotech industry’s trade association pleaded Thursday, in a letter to President Donald Trump’s health secretary, Alex Azar, asking for release of the guidelines.
The FDA submitted the guidelines to the Office of Management and Budget for approval more than two weeks ago, but they stalled in the office of Mark Meadows, the White House chief of staff. Their approval is now seen as highly unlikely.
A main sticking point has been the recommendation that volunteers who have participated in vaccine clinical trials be followed for about two months after the final dose before any authorization is granted, according to a senior administration official and others familiar with the situation, who spoke on the condition of anonymity. Given where the clinical trials stand, that two-month follow-up period would all but preclude any emergency clearance before Election Day.
The conflict began almost as soon as the FDA submitted the guidelines to the White House budget office on Monday, Sept. 21.
The next day, Dr. Stephen Hahn, the FDA commissioner, briefed Azar on the matter.
That Wednesday, Meadows raised a series of concerns, an administration official said. He questioned the need for two months of follow-up data, said that stricter recommendations would change the rules in the middle of clinical trials and suggested that Hahn was overly influenced by his agency’s career scientists. The White House on Monday did not respond to a request for comment.
Speaking to reporters Sept. 23, Trump publicly cast doubt on whether the guidance would be approved. “We may or may not approve it,” he said, suggesting that the regulatory action “was a political move more than anything else.”
FDA officials later provided additional justification to the White House, explaining that the twomonth follow-upwas necessary to identify possible side effects and ensure that a vaccine’s protection against COVID-19, the disease caused by the coronavirus, was not short-lived. But they have been unable to break the stalemate.
The testing and release of a vaccine is an issue that has gained wide national attention. Trump has repeatedly misrepresented how quickly a vaccine might be available to most Americans, promising a major breakthrough in vaccine development as early as this month. No clinical trial in the United States has yet advanced far enough to prove that any vaccine is safe and effective, although Pfizer, one vaccine developer, is hoping for interim results soon from its trial.
The FDA’s new guidelines were intended to assure companies developing vaccines that they were being held to a common standard and to reassure the public. Polls suggest that Americans are increasingly wary about taking a coronavirus vaccine: A survey published last month by the Pew Research Center found that 51 percent of Americans would either probably or definitely take one, down from 72 percent in May.
Dr. Peter Marks, the FDA’s top regulator for vaccines, said last week that the government had to be transparent about the standards it was using to evaluate experimental vaccines in order to build public trust. He and other health officials have stressed that the companies developing vaccines are already fully aware of the agency’s expectations for products seeking authorization for emergency use.
Azar on Friday played down the conflict with the White House, telling a House panel that those concerned about its involvement in the guidelines were making “a mountain out of a molehill.”
“What the commissioner is proposing to put out is public emergency use authorization guidance on a vaccine that would be consistent with letters already sent to the manufacturers,” Azar said. “The FDA has already told the manufacturers what they’re going to look for.”
“The FDA has already told the manufacturers what they’re going to look for.”
Alex Azar, secretary of Health and Human Services