The following is a transcript of an interview with Dr. Scott Gottlieb that aired on Sunday, September 12, 2021, on “Face the Nation.”
MARGARET BRENNAN: Well, we want to go now to former FDA commissioner Dr. Scott Gottlieb, who sits on the board of Pfizer. He’s got a new book coming out to you next week, Uncontrolled Spread: Why COVID 19 Crushed Us and How We Can Defeat the Next Pandemic. Scott, it is great to see you again.
DOCTOR SCOTT GOTTLIEB: Good to see you.
MARGARET BRENNAN: Look, states can mandate vaccines. Federal government has never done something like this before, outside of the U.S. military. The Republican governor of Arkansas is on TV today, saying this is going to backfire. He’s trying to convince his constituents to take the vaccine and because the federal government is telling them to, he says it’s going to be even harder. Practically speaking, does this mandate make sense?
DR. GOTTLIEB: I think the downside of this mandate in terms of hardening positions and taking something that was subtly political and making it overtly political could outweigh any of the benefits that we hope to achieve. If you look at where we are right now, right now, 75% of adults over the age of 18 have had at least one dose of the vaccine. Most of them will complete the series. That’s a very high number of people vaccinated owing to the good work of the Biden administration. We’re not going to get above 90%. We don’t even really reach 90% with childhood immunizations, which are mandated. So, we’re going to get somewhere between 80 and 90%. I would state that we would have gotten to 80% just on our current trajectory in short order. Perhaps with a mandate on small businesses, eventually you get to something akin to 85%, but it’s going to be slow because this is going to get litigated. It takes OSHA time to implement regulations. You’ll have to put in place guidance, give businesses a grace period and then figure out what the enforcement mechanism is going to be in. In the near term. A lot of businesses that might have mandated vaccines are now going to sit on their hands and say, I’m going to wait for OSHA to tell me just how to do it and give me more political cover. So, in the near term, you could actually discourage some vaccination.
MARGARET BRENNAN: Right. OSHA, that’s going to come from the Labor Department, and they haven’t filed that yet.
DR. GOTTLIEB: Right.
MARGARET BRENNAN: That’s what you are referring to. But the president, what he said was mandating a vaccine for businesses and if employees at those businesses don’t take it, the alternative is to get weekly testing. Do we have the testing capacity in the country to do that right now?
DR. GOTTLIEB: We would have the testing capacity to do it, but it puts a big burden on businesses to have to operationalize that and determine what they’re going to do with the result. So, I think a lot of businesses are going to opt to try to force workers to get vaccinated if in fact this ever goes into effect. But again,–
MARGARET BRENNAN: Many were.
DR. GOTTLIEB: –we are looking at a very long timeline here. Excuse me.
MARGARET BRENNAN: Many already were.
DR. GOTTLIEB: Many- many were, exactly. Many businesses are, and I think that the federal government’s action to require federal employees to get vaccinated, which is probably well within their purview to do that in a function of federal readiness that gives plenty of political cover for more businesses, more private sector businesses to start to implement their own mandate. So, I don’t think we had to reach down to the level of small businesses with 100 or more employees and put a federal requirement on them. I don’t think the federal government should be dictating this. I also don’t think governors should be preventing small businesses from making these determinations on their own. We should leave these decisions to communities, local communities and businesses to make assessments on what their risk is, what their settings are, how much precautions they can put in,–
MARGARET BRENNAN: Yeah.
DR. GOTTLIEB: –and whether vaccine requirements are an absolute necessary- necessary to- to protect people in those settings.
MARGARET BRENNAN: Well, kids still can’t get a vaccine if they’re between the ages of five and 11. When will it be available to them?
DR. GOTTLIEB Well, I’m more familiar with the process for Pfizer, the company I’m on the board of. Pfizer has said that they’re going to have data before the end of September. They could be ready to file within days of having that data, so they’ll file very quickly with the FDA. FDA has said it’s going to be a matter of weeks, not months, in terms of their evaluation of that clinical data to make a determination whether they’re going to authorize vaccines for kids aged five to 11. I interpret that to mean perhaps four weeks, maybe six weeks. But I think in a best-case scenario, given that timeline they’ve just laid out, you could potentially have a vaccine available to children aged five to 11 by Halloween. If everything goes well, the Pfizer data package is in order, and FDA ultimately makes a positive determination, I have confidence in Pfizer in terms of the data that they’ve collected. But this is really up to the- the Food and Drug Administration to make an objective determination.
MARGARET BRENNAN: Well, then it’s up to parents, whether they want to use a vaccine under emergency use for their children. If you’re a parent, what do you ask your pediatrician and are there options out there?
DR. GOTTLIEB: Yeah, I think parents should look at this as a decision where there is some latitude in terms of what you do with your child, and you really should consult your pediatrician and have a conversation. Parents have understandable concerns about putting any new product, new medical product in a child. It’s not just this vaccine. It’s any vaccine or any therapeutic, and I understand those concerns. This isn’t a binary decision. It’s not a choice of do I vaccinate my child or not? There’s different ways to approach vaccination. You could go with one dose for now. You could potentially wait for the lower dose vaccine to be available, and some pediatricians may make that judgment. If your child’s already had COVID, one dose may be sufficient. You could space the doses out more. So, there’s a lot of discretion that pediatricians can exercise, making largely off label judgements, but exercising discretion within the context of what an individual child’s needs are, their risk is, and what the parents’ concerns are. So, I would urge every parent to have a conversation with their pediatrician. Pediatricians are very good at counseling through these decisions, and I think that they could provide good objective advice to parents.
MARGARET BRENNAN: Well, what about the parents themselves? We’ve seen this Israeli data that shows the vaccine may have some waning impact after six months. When is the FDA going to fully approve boosters and if Pfizer’s first out of the gate, as has been reported, when will we see Johnson & Johnson and Moderna follow?
DR. GOTTLIEB: Well, there’s a meeting this Friday of the FDA’s advisory committee to discuss this very issue. The agency could be in a position to act very quickly, depending on what the outcome of that meeting is. If there is a recommendation from the FDA as external advisors to authorize boosters or licensed boosters, the agency could act very quickly, and then ACIP, the advisory committee to the CDC would meet and make a recommendation about what population should receive boosters. The conventional wisdom is- is that if boosters are approved, it’s probably going to be for people who are more at risk from COVID right now. They’ve already recommended it for those who are immunocompromised, moderately or severely immunocompromised. I think the next tranche would probably be older individuals, particularly individuals who live in congregate settings like nursing homes. And that’s may- that may be what we see next. Pfizer has filed their application with the FDA. I think J&J is going to be in a position also to file a package with the FDA soon as well. They have very good data also looking at boosters. They’ve showed a good response. And I think that vaccine also could be in a position to get authorized by FDA in short order.
MARGARET BRENNAN: Also, very quickly, governors issue mandates for kids to get vaccines. Anyone sending their kid in the classroom has to do that. Do you expect COVID to be any different?
DR. GOTTLEB: In time, no, I think you’re going to see more local school districts and governors make those recommendations. Eventually ACIP is going to make a recommendation about whether this should be included in the childhood immunization schedule. My guess is they’re waiting for more of the vaccines to be fully licensed to make that kind of a recommendation. But I would expect this eventually to be required as part of the childhood immunization schedule.
MARGARET BRENNAN: Well, Dr. Gottlieb, always good to talk to you and FACE THE NATION will be back in one minute. Stay with us.