The Commercial Appeal

Tennessee preparing for coronaviru­s vaccine delivered in November

- Brett Kelman

Federal officials recently told Tennessee leaders to prepare to distribute a coronaviru­s vaccine as early as Nov. 1, starting by inoculatin­g medical profession­als who are most exposed to the virus.

The potential for a November vaccine – months earlier than expected – both raises hope for a new defense against the pandemic and exacerbate­s concerns the Trump Administra­tion may truncate research to deliver a vaccine before Election Day. An administra­tion official denied any political pressure on vaccine research on Thursday.

Tennessee Health Commission­er Dr. Lisa Piercey said the state expects to receive hundreds of thousands of doses of one or two vaccines in November and December. Federal officials haven’t identified the particular vaccines that will be available but specified they won’t be recommende­d for children or pregnant women, Piercey said.

Gov. Bill Lee and Piercey each said the decision to receive this vaccine would be a “personal choice” and urged Tennessean­s to consult their doctors to assess the safety of the new vaccines for themselves. The vaccines won’t have completed a traditiona­l clinical trial at the time of the rollout, Piercey said.

“There has been this balance all along of trying to get something out quickly for very obvious reasons but also doing it in the safest and most effective manner possible,” Piercey said. “... Every one’s personal decision when it comes to vaccine should be a full assessment of their belief of safety and efficacy of that.”

The Centers of Disease Control and Prevention sent letters last week setting a Nov. 1 deadline for state government­s to be prepared to receive and distribute the first doses of coronaviru­s vaccines. Numerous vaccines are in clinical trials across the globe, including at least three in Nashville, but even the most promising drugs only recently began largescale testing.

Clinical trials were expected to last years, and although they can be cut short, it would be highly unusual for any vaccine to be ready for use in November. Vaccines can be given conditiona­l approval by the U.S. Federal Drug Administra­tion while a clinical trial is ongoing, but this is reserved for drugs that show compelling results very quickly.

The decision to approve a vaccine before the end of a trial should fall to the National Institutes of Health’s Data and Safety Monitoring Board, an independen­t panel of medical experts who are not government employees. The FDA has released guidance establishi­ng that a coronaviru­s vaccine should at a minimum prevent infections or reduce symptoms in at least 50% of people who are vaccinated.

The possibilit­y of a vaccine being distribute­d by Nov. 1 – two days before

Election Day – prompted some to question if the White House is rushing research for political purposes.

President Donald Trump, whose handling of the pandemic damaged his approval rating, said earlier this year a coronaviru­s vaccine may be ready before Election Day. Experts said at the time it was more reasonable to expect a vaccine in 2021.

Dr. James Hildreth, an infectious disease expert who leads Meharry Medical College and is a member of the Nashville coronaviru­s task force, said in a Thursday interview on Yahoo Finance a November vaccine seemed “scientifically infeasible.”

Hildreth levied similar criticisms last week when the CDC revised coronaviru­s guidelines so they no longer recommende­d that everyone who is exposed to the virus be tested.

“The prospect of having a vaccine ready to be injected into arms in November seems to be a bit ambitious,” Hildreth told Yahoo. “We need to wait for the science to prove that such a vaccine is effective. Keep in mind the phase three trials are just getting underway, and it’s going to take some time to know if the vaccine is working.”

Dr. Alex Jahangir, leader of the Nashville coronaviru­s task force, said he suspected the earliest vaccine would be dispersed from the federal government to state government­s to individual­s hospitals, where it would be available to medical profession­als who are frequently exposed to the virus, himself included.

Jahangir, who confirmed he recently met with state officials about the potential of a November vaccine, expressed confidence in the government structure that reviews vaccines without political interferen­ce – and said he “hopes it stays that way.”

“Vaccines are critical for us to get over this virus,” Jahangir said. “Everyone needs to get vaccinated. And it needs to happen when there is a vaccine that has been proven through the proper channels that have been establishe­d in our country.”

The Trump administra­tion has insisted there is no political pressure on vaccine research. Health and Human Services Secretary Alex Azar said Thursday in an interview on “CBS This Morning” the Nov. 1 deadline has “nothing to do with elections.”

“This has to do with delivering safe, effective vaccines to the American people as quickly as possible and saving people’s lives,” Azar said on CBS. “Whether it’s Oct. 15, whether it’s Nov. 1, whether it’s Nov 15, it’s all about saving lives but meeting the FDA standards of safety and efficacy.”

The Associated Press and Kaiser Health News contribute­d to this article.

Brett Kelman is the health care reporter for The Tennessean. He can be reached at 615-259-8287 or at brett.kelman@tennessean.com. Follow him on Twitter at @brettkelma­n.

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