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Biden: His Team Has Seen "No Detailed Plan" On COVID-19 Vaccine Distribution; Dr. Fauci On Whether the Public Will Have A Choice Of Which COVID-19 Vaccine They Receive; Dr. Leana Wen On COVID-19 Vaccines For Breastfeeding Mothers. Aired 9-10p ET

Aired December 4, 2020 - 21:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


[21:00:00]

(COMMERCIAL BREAK)

ANDERSON COOPER, CNN HOST: And welcome, I am Anderson Cooper.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: And I'm Dr. Sanjay Gupta.

This is our 23rd CNN Global Town Hall on the Coronavirus, only this time, the title is a hopeful one, "The Vaccines." As always, we're being seen around the world on CNN International, and streamed on CNN.com.

COOPER: As we come to you tonight, two vaccines, right now, one from Pfizer, the other from Moderna, appear to be on the cusp of FDA approval, which of course is only the beginning. It's going to take a massive effort to produce and distribute, store and deliver doses to people.

Yet, according to President-Elect Biden today, he is not satisfied with what he has seen of it.

(BEGIN VIDEO CLIP)

JOE BIDEN (D), PRESIDENT-ELECT OF THE UNITED STATES: There is no detailed plan that we've seen, anyway, as to how you get the vaccine out of a container, into an injection syringe, into somebody's arm. And it's going to be very difficult for that to be done, and it's very expensive proposition.

There's a lot more that has to be done.

(END VIDEO CLIP)

COOPER: I'll just add tonight, we'll ask the nation's preeminent infectious disease expert, Dr. Anthony Fauci about that. He has been tapped, as you know, to serve as the Chief Medical Adviser in the Biden administration.

GUPTA: And we're also going to ask Dr. Fauci about the National Vaccine Advisory Committee's decision today to not recommend an Emergency Use Authorization for a COVID-19 vaccine in children. And, in addition, your many questions for Dr. Fauci, please tweet them to us with the #CNNTownHall. You can leave a comment on the CNN Facebook page as well.

COOPER: And a lot of you have sent them in video form, which we appreciate. You can see some of them up on the screen. And we'll get to as many of those as we can tonight as well.

We'll be joined by a couple who took part in the vaccine testing, who will tell us about their experiences, and the side effects one of them felt.

In addition, we'll talk about the months ahead, and how rough they are going to be, vaccines or no vaccines.

Today, so far, the third worst day ever for new cases, nearly 204,000 new infections, and still climbing. The University of Washington Health Metrics team is now projecting more than a quarter million more lives lost between now and April.

So, there is a lot to get to tonight. First, Sanjay, this is the point in each of our Town Halls, we get a checker from you on where you think things stand. How do you see things right now?

GUPTA: Well, Anderson, since this pandemic began, I've thought a lot about this country as if it were my own patient.

I saw COVID-19 sort of start as this localized disease in just a few places around the country. But the country, the patient, ignored some basic treatment advice that could have been very effective, and as a result, the disease spread.

And now, that localized spread has spread throughout the entire body, this country, leaving no state really untouched, and the patient is more vulnerable than ever, and yet, still in some ways, unwilling to undergo the necessary treatment.

So, as you talk about, Anderson, there is the hope of a vaccine on the horizon. But I can tell you, as a doctor, the medical community doesn't have the luxury of waiting. They are tired. And they are overworked. And they are stressed. And the patient, the country, needs help right now.

The thing is that the treatment plan is not complicated. Masks, they are almost surgical in how quickly they can make a difference. The virus simply won't have anywhere to go if people are masked up. The more people wear them, the more lives can be saved. It's pretty simple.

We also know that 80 percent of the infections in this country are occurring in just a few locations, so we have to be particularly aggressive there. Not shutting down, just, reducing maximum capacity, in places like restaurants, and gyms, and bars. Those treatments alone could make a huge difference.

You add in more testing, you add in contact tracing, and we could be on our way to good health, even before a vaccine arrives. But the question is, the question has been, will my patient, this country, listen this time around?

As you know, Anderson, more than half Americans now say they know someone personally who's been hospitalized or died of this disease. And just this week, more people died of COVID than died of heart disease in an average week, heart disease, which is the leading cause of death in our country.

So, we got a big problem, to your question, Anderson, but also a prescription to help.

COOPER: Yes. When it comes to vaccine distribution, the devil is certainly in the details.

GUPTA: And to get a glimpse of that, to get one of the more complicated parts of the chain, CNN Aviation Correspondent, Pete Muntean is at the airport for us.

COOPER: So, Pete, what kind of preparations--

PETE MUNTEAN, CNN AVIATION CORRESPONDENT: Hi, Sanjay, this is American Airlines.

COOPER: --are you seeing?

MUNTEAN: Sorry, I didn't mean to jump the gun there, Anderson.

Yes, this is American Airlines cargo cold storage facility, here in Philadelphia, pharmaceuticals only. Essentially, one big refrigerator here, 25,000 square feet, you can see the cold air blowing in from the fans over there. It's about 40 degrees inside here.

[21:05:00]

The idea is that this temperature will help preserve the specialized containers for the vaccine that need to be super-cold, the Moderna vaccine, negative 4 degrees Fahrenheit, the Pfizer vaccine negative 100 degrees Fahrenheit.

They would sit on the shelves in a place like this, but not for very long. Just a pit stop, Airlines say, albeit a very critical one, on the road, for getting the vaccine administered to you. Airlines say they will be the ones to have the vaccine in their possession the longest.

GUPTA: It's interesting, Pete. I've heard American Airlines also doing these test flights, to make sure they're ready. I mean medical supplies go via plane all the time. Is there something special about these test flights?

MUNTEAN: Well, I just want to show you one more way that Airlines are keeping the vaccine cold while it's in transit, Sanjay.

Out here on the floor is a specialized refrigerated battery-powered shipping container. You can set the temperature on this. I'm just going to punch the screen here. 32 degrees Fahrenheit, alarms go off in this, if the temperature is off by even a quarter of a degree.

Airlines say they already have the infrastructure in place for a mission of a lifetime. American Airlines says it has a plan in place that once the vaccine is FDA-approved, it can begin shipping it within 24 hours.

COOPER: Pete Muntean, appreciate it, thanks.

GUPTA: Thanks, Pete.

COOPER: Joining us now, Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases. He's also soon-to-be Chief Medical Adviser in the incoming Biden administration. He's, of course, still a member of the White House Coronavirus Task Force.

He was last seen in our CNN Global Town Hall, back in July. Needless to say, we are very happy to have him join us tonight.

So, Dr. Fauci, you just saw our Reporter going through some of the distributional logistics at the airports. President-Elect Biden is saying, "There is no detailed plan," from the Trump administration, about distributing a vaccine.

Have you seen a plan? What's going on?

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: Well, there clearly is an organized approach that's right from the military component of Operation Warp Speed, General Gus Perna, who is responsible for the actual transport, the planes, the trucks, the trains, that take the material, in this case, the candidate vaccines, from the storehouses, the warehouses, where they are, after they have been filled and finished, to the local places of distribution, namely the state and the city local areas.

Once it gets there, Anderson, it is up to the state and local authorities, in their individual way, to make the decisions about the distribution as well as the logistics of it. So, it really is going to be at the level of the state.

So, I think that's what is meant by not having a broader global in the sense of the whole country plan, but the individual states and localities will make their decisions, and to give the distribution the way they normally would distribute, something like influenza vaccine.

So, that's really the way it's going to be, very much locally mandated for the actual distribution, from the bottle, into the arm of a person, as opposed to transportation, to the particular site.

GUPTA: Dr. Fauci, good to see you. Thanks for joining us.

I wonder if you could give us a picture of what it's going to look like. I mean, where will most of the vaccines actually be administered, do you think, through doctors' offices, hospitals, CVS- and Walgreens-type locations?

FAUCI: Yes, Sanjay, it's going to be all of the above. So, it's going to be CVS, Walgreens, doctors' offices, clinics and hospitals. I know that because they are already been shipped, ready for distribution.

And, like you would do, Sanjay, I have made a couple of calls around right here, where I live in Washington.

And already, we know there are some hospitals, some clinics that already have material that has been shipped to them. So, the answer to your question, Sanjay, I think, is going to be all of the above.

COOPER: So, when you said hospitals, some hospitals already have it, that means - I mean, when do they get the go-ahead to start inoculating people?

FAUCI: Yes, as soon as the EUA is officially administered by the FDA--

COOPER: The Emergency Use Authorization?

FAUCI: --yes, yes, right, the Emergency Use Authorization, essentially, immediately after that, it likely will be a day or, at the most, a couple of days. But it is essentially right from the time that you get the official authorization by the Emergency Use Authorization, what we refer to as an EUA.

COOPER: You recently apologized for a criticism of the U.K.'s speedy authorization of the Pfizer vaccine. Can you just talk about your initial concerns about that, and the speed at which this is happening?

[21:10:00]

FAUCI: Well we, here in the United States, the Food and Drug Administration, no doubt, really is the gold standard of really careful scrutiny of all of the data, all the minutia, of the data, of the clinical trials. That's just the way our FDA works.

Some may say it's a bit too careful, a bit too slow. But it really isn't. It really makes very much the front-burner, safety and absolute certainty of efficacy.

Other regulatory agencies, in Europe, in the U.K, may do it a little bit differently, you know? Not necessarily better or worse but just a little bit differently. We do it in a way that may seem to be very careful and very, very slow. But it really isn't.

The career scientists at the FDA, they know what they're doing. They do this for a living. They do it all the time. They're doing it as quickly as they possibly can. But for sure, it's going to be done very carefully, and with a great deal of scrutiny for the data.

GUPTA: Dr. Fauci, last hour, Jason Carroll had this great piece about vaccine hesitancy, a topic you know well, particularly among Black and Brown communities.

You know that these communities have been disproportionately hit by this virus, and they have higher rates of vaccine hesitancy as well. This seems like a major issue to address.

I am just wondering, as you're going to be part of the Biden team now, what tangible steps will you take to sort of build that trust?

FAUCI: Yes. Well, we will be taking steps, Sanjay, and we are currently taking those steps, and that is by really rather - I would say active community outreach, which we've already done.

We do it by PSAs. We do it by engaging through our community groups that are associated with our clinical trial apparatus.

And we do it by engaging leaders in the community. There already is a plan to get people who are respected by the community, athletes, faith-based organizations, personalities, celebrities, to get out there, and get people to be vaccinated.

It would be a really terrible shame if we have the African-American and Latinx community, who, you're absolutely correct, are disproportionately suffering more, from this outbreak, if they did not take a vaccine, which we know to be extraordinarily efficacious, in preventing clinical COVID-19 disease, it would be paradoxical and very, very much of a shame.

So, we really have a responsibility to very actively get out there and get the African American community to appreciate that everything that has been done with these vaccines has been transparent and independent.

And although it's understandable, given the history of how African- Americans have been treated by the medical community, in this country, over the years, historically, it's something that we certainly are not proud of, we've got to turn that around, because we don't want to have the people who need it the most, not have it because of hesitancy to get vaccinated. That would be a terrible shame.

COOPER: We spoke to Dr. Chris Murray with the IHME last hour. Their latest model projects almost 539,000 U.S. COVID deaths by April. CDC's Director Redfield also warned the next three months will be, quote, "The most difficult" time "in the public health history of this nation."

How bad do you think it's going to get?

FAUCI: Anderson, it could get as bad as you just heard the numbers of the model predicting. And the reason for that is we have a number of conflating events occurring that are going to essentially almost synergize in making things problematic.

First of all, we have the surge that we already know has gone on even before the Thanksgiving holiday, that very steep inflection of cases that has led to the record numbers that you and Sanjay just mentioned. That's the first thing.

Secondly, you have the Thanksgiving holiday, and we have not yet seen the full effect of a potential surge upon a surge of what happened last week, because the event usually is followed by two weeks to three weeks later, you see the increase in cases, the travel associated with Thanksgiving, the congregating at family and social gatherings with people indoors, sometimes without masks. So that may peak two weeks to three weeks from now, which puts it right at the cusp, before the Christmas holiday, where you're going to have more travel, and more congregating in a way that's natural and understandable, families and friends getting together.

[21:15:00]

So, we're really very concerned, if you take the Thanksgiving surge, the Christmas surge, by the time you get to the end of December, and the beginning of the January, we very well could see the numbers that you just mentioned about the predictions of what these surges may mean.

But we can do something about it. I think that's the important point. We give the numbers. We talk about how problematic it can be. But in the same breath, we've got to say, if we, as a country, uniformly, do the things that we know can mitigate against spread.

The simple things, the universal wearing of masks, the keeping of distance, to avoiding crowds in congregate settings, particularly indoors, wearing your masks at all time, and washing your hands, as frequently as you possibly can, those simple things alone, despite the enormity of the problem, can make a difference, because it has been proven that it does make a difference.

So, we all need to pull together to do that, because, as I've said so many times, help is on the way.

Vaccines are imminent. We'll be starting to get vaccine doses, in people's arms, by the middle and end of December, and then more in January, more in February, and as we get into the late winter and early spring, a lot more.

So, we need to hang in there, and do that, while we are waiting to get the vaccine to as many people as possible.

GUPTA: Dr. Fauci, I'm curious about the healthcare systems, overall, in the interim. I mean, I know you talk to lots of clinicians around the country. I do as well.

Where do you think things stand? Can the healthcare systems and the hospitals handle this surge? And would you encourage people to do things like postpone elective procedures and things like that, at this point?

FAUCI: Sanjay, we are almost there. I hate to say it. We are really in some areas, not all, some areas are fine. They got a lot of backup. They're in good shape.

But I get on the phone to my colleagues, just most recently, in California, in L.A., where their system is really strained. And, as you probably know, from the news yesterday, there are some situations where they will be doing temporary lockdowns because they can't strain the healthcare system anymore.

The unimaginable thing that no one wants to see happen, that when you have such a strain on the beds, and on the personnel, the healthcare personnel, that you're going to deprive people from the kind of care that they need, be it an intensive care bed or an experienced intensive care-ist to take care of them. We don't want to go there.

And if it requires doing more drastic things, or draconian things, like maybe some temporary shutdowns, in some areas, I think some of the areas of the country, are thinking of that. I know, as a fact, that in California, and some places, in California, they are thinking about that.

COOPER: I want to get to some viewer questions. The first one is a video question. Let's take a look.

(BEGIN VIDEO CLIP)

DR. KEVIN JAMES, RETIRED ARMY ORTHOPEDIC SURGEON: My name is Dr. Kevin James, a retired Army orthopedic surgeon.

My first question is about the time frame it takes to develop the desired immune response.

All of the commentary, thus far, is about the sequence of getting the vaccine and the number of doses required. No one, to include the manufacturers, has shared with the public, how long after the vaccination, does the body develop the desired immune response. With most vaccines, it takes approximately two weeks.

The second question is, during the trials, did anyone develop symptoms of the virus between the first and second doses, while the immune system was ramping up? Additionally, did anyone develop symptoms during the two-week period after the last dose?

This information is critical. And the public must be educated, in that the immune response is not instantaneous. All personnel administering the vaccine should be required to pass this information to each person they vaccinate.

Thank you and stay safe.

(END VIDEO CLIP)

COOPER: Dr. Fauci?

FAUCI: OK, so both of the vaccines that we're talking about, the Moderna vaccine and the Pfizer vaccine are what's called a prime boost. One injection, followed in four weeks, by another injection, 28 days.

So, what you have is you get some degree, not optimal, but some degree of immunity a couple of weeks after the first dose. That's not optimal. After the second dose, you get optimal immunity anywhere, from seven days to 10 days, after the second dose.

When you look at the clinical trial, the data and the efficacy was so high, 94 percent to 95 percent, that there were very, very few people who got vaccinated, who actually did get infected and did get symptoms.

[21:20:00]

Obviously, the ones who did not get the vaccine would get symptoms, the normal five days, six days, after they were infected.

But if an individual fails the vaccine, you would expect them to get symptoms within the same time frame as if they were not vaccinated, maybe a couple of days later, delayed because of a partial immune response.

All that data is available, and those kinds of things are made known to individuals when they prepare them for the vaccine, and when they take an informed consent in the trial.

Once a vaccine is approved, there is a list of all the potential side effects of the vaccine itself, but not the information that the person just mentioned about, if you happen to get infected, when you would start to get symptoms.

That's very well-known. The incubation period is two days to 14 days with a median of about five days.

GUPTA: You can get immunity, as you're talking about, Dr. Fauci, by getting the infection or getting the vaccine. Is the expectation that people who receive the vaccine will have longer or stronger immunity versus people who got that immunity via infection?

FAUCI: Sanjay, that's a great question. It really is, because that's what we used as the parameter of how potent the immune response is.

If you look at the vaccine, the level and quality of neutralizing antibodies was comparable to and even better than what you see in convalescent plasma of people who actually were infected and developed an immune response. It's at least as good as the response associated with natural infection.

GUPTA: We got another text question coming in. This one is from Terra, who writes, "Will the public have a choice in which vaccine they receive?" Dr. Fauci.

FAUCI: Well, what's going to happen, in practicality, Sanjay, is that there will be shipments of vaccine, according to contractual arrangements, to different pharmacies, be it CVS, or Walgreens, or whatever hospital clinic or private practice doctors' office. And it is unlikely that they're going to get both. They'd likely are going to get one or the other.

But since these vaccines are almost identical, I don't think it makes any difference. If you were to ask me, would I rather have one versus the other, they're both RNA, mRNA vaccines, and they both have 94 percent to 95 percent efficacy, and they both have almost 100 percent efficacy against serious disease.

So, I don't think it really makes any difference, and the general public should not really worry about which of those they get. It depends on who the supplier is, in the particular facility that you went to get vaccinated at.

COOPER: What's the update on the Johnson & Johnson vaccine? Because it's different in that it requires only one shot, and which would obviously make a big difference in terms of the ease of getting it.

FAUCI: Yes, what it is, it's a different what we call a vaccine platform. The Moderna and the Pfizer are what's called an mRNA, or a messenger RNA vaccine.

The one that is the J&J, or Janssen, is an adenovirus, which is a typical human virus, in which the gene of that particular spike protein, which is the protein that you want the body to make an immune response against, that is inserted into that vector.

You inject it into an individual. The protein is expressed. It's a single dose, and you start getting an immune response, 10 days to 14 days, after that single dose.

There are some advantages to that. It's less of a cold chain requirement, and it's a single dose, which means one dose, literally 10 days or 14 days later, you start to get a response.

You asked what the status of it is. The clinical trial is still on. The data have not been looked at, in the sense of any meaningful changes, by the Data and Safety Monitoring Board. But I think within a reasonable period of time, you will start to get a look at the data, very similar to what was done with the Moderna and the Pfizer trial.

GUPTA: Now Public Health England, Dr. Fauci, has said that if it's not possible to give someone two doses of the same vaccine, it is possible, they say, to interchange vaccines then. What do you think of that? You think it's reasonable?

FAUCI: That's not preferable, Sanjay.

[21:25:00]

For example, if you have a prime of a mRNA, you really want to have a boost of an mRNA. If you get a prime of an mRNA, and a boost with an adeno candidate, that may be OK, but we didn't do the clinical trials to show that that's effective.

So, it isn't is, if it's impossible, but there's no scientific data to tell you how good that prime with one and boost with another. So, you're actually going in unchartered waters. You don't really know what the responses could be.

It's conceivable it would be fine. But I don't think it would be as good as the boost being identical to the prime.

GUPTA: I have no doubt that you would get the vaccine, right, Dr. Fauci, when it was available to you. You have told me that.

I don't know if you know this though. "The New York Times" has this interactive that will give you an idea of where you are in line. So, we actually looked you up. And it says that you are pretty far up there, but there's about 321,000 healthcare workers in front of you, Dr. Fauci, which kind of surprised me. I thought you would be - you would be first in line there.

COOPER: It's fine.

GUPTA: But it'll--

(CROSSTALK)

FAUCI: Well I don't know whether they - yes. I don't know whether they plugged me in correctly, because A, I'm a healthcare provider, and B, I'm elderly. The Elderly are not in the "1a" as you well know. The "1a" is healthcare providers and people in nursing facilities. So, I would be in one of those categories, but certainly not the others, at least not to my knowledge.

COOPER: But I mean, the question, you know, every viewer who is watching this, wants - would like to know where they kind of fall in this.

Where do you think, just generally, for a general person, who is a citizen in this country, who is watching, and waiting, when do you think most people, who are not on the front-line, healthcare workers, or folks handing out groceries in stores, interacting with a lot of people, when do you think the average person can get it?

FAUCI: Yes, I mean, if you're talking, Anderson, about essentially a healthy, non-elderly person with no recognizable underlying conditions, will likely start getting it in, trickling in end of March, early April. Once you get into April, probably full blast, with those individuals.

That's the reason why what we would really like to see is that once you get into the open season, in the sense of anybody can get it, that we really have a full court press on getting people vaccinated.

Because the quicker you get the overwhelming majority of the country vaccinated, the quicker you're going to have that umbrella, of herd immunity, which would be so, so important, in bringing the level of that virus way, way down to below the threatening level. The sooner we get there, the better we are.

We have one of the two ingredients of the one-two punch that could knock out a pandemic.

One, we have a very, very efficacious vaccine. As I told you guys before, I would not have expected it would be this efficacious. 94 percent to 95 percent is as good as you get. It's almost as good as the gold standard, which is measles, which is about 98 percent. So, that's the first ingredient.

The second ingredient is a very, very high uptake of the vaccine. And that's why it's our job to get out there, and explain to people, all of the things that they have skepticism about. "A," was it too fast? No, because we had technological advances that allowed us to do things in weeks to months that would have normally taken several years. That didn't compromise any safety. It didn't compromise any scientific integrity.

We invested an extraordinary amount of money to get the doses ready as soon as the vaccine was ready to be administered.

And then the decision, which we're going through right now, literally as we speak, the decision of whether or not a vaccine is safe and effective, the public has to know, it's not made by the administration. It's not made by the company.

It's made by an Independent Data Safety Monitoring Board, who, look at the data, scrutinize it, then they allow the company to see it. The company gives it to the FDA, to apply for this EUA, this Emergency Use Authorization.

And then, even then, yet again, another Independent Advisory Committee, the Advisory Committee that the FDA classically uses, to advise them as to whether or not to grant an EUA, and then when it does, then you start distributing. So, it's both independent, and it's transparent.

And Sanjay, you and I will be able to look at the actual data because it's all going to be published in a peer review journal. So, there's nothing shady about that. It's all open and transparent.

COOPER: Another viewer sent in this video. Let's take a look.

[21:30:00]

(BEGIN VIDEO CLIP)

EDWARD SULLIVAN, GRADUATE STUDENT: Hello, I'm Ed Sullivan. I'm 32- years-old, and like so many other young people, have grown tired of the COVID restrictions, even though I understand their necessity.

It has been said that even after the vaccine becomes widely available, some of these restrictions may need to remain in place. What, if any, restrictions will need to remain in place and will they apply to the people who have been vaccinated?

(END VIDEO CLIP)

COOPER: Dr. Fauci?

FAUCI: Well, yes, well the answer to that is there will be. I don't think we're going to soon see a complete abandonment.

Now, we've got to be careful of what the caller meant by restrictions. If what he is talking about is wearing a mask, watching your distance, staying away from crowds, to the extent possible, doing things outdoors more than indoors, we're going to be suggesting that no matter what. Because, remember, not everybody is going to be vaccinated at the same

time. So, let's say, you, Anderson, or Sanjay, got vaccinated in January or February, there may be half the country that still has not been vaccinated, which means there is a lot of virus floating around there.

And even if you are vaccinated, you may be protected against getting sick, but you may not necessarily be protected against getting infection. So, you may have some virus in your nasal pharynx.

It wouldn't bother you, and maybe it wouldn't even infect anybody else, but it could be there. That's the reason why you can't abandon all public health measures. You can gradually attenuate them.

The more and more people that get vaccinated, the less and less the threat in society is, until you get to the point, where if you have the overwhelming majority of people vaccinated, and you have a good umbrella of herd immunity, then I think you could get back to as close to normal, as you would really want. But that's not going to be immediately.

GUPTA: Dr. Fauci, April, in North Carolina, sent in another video.

(BEGIN VIDEO CLIP)

APRIL FLANDERS, PROFESSOR OF STUDIO ART: We need our children to go back to schools safely. When will the vaccine be readily available for kids?

(END VIDEO CLIP)

GUPTA: And Dr. Fauci, yes, I'm sure you heard the news today about the--

FAUCI: OK.

GUPTA: --the National Vaccine Advisory Committee voted against recommending an EUA for COVID-19 vaccine in children. You probably heard that. We know it's being tested but yes--

FAUCI: Right.

GUPTA: --I'm just curious what you think of her question.

FAUCI: Yes, yes, well, first of all, we should be trying, as best as we possibly can, right now, to get the children back to school, or keep them in school, if possible, obviously. Not everyone size fits all, but we should try to get the children back to school.

But the gist of the caller's question is when can we get them back to school with the protection of a vaccine, so we know it's really safe? I'm hoping, and I think it's not an unreasonable hope that by the time we get to the full term, we can do that with a good degree of impunity.

Regarding the question of the EUA for children, we've got to remember that this is a population of absolutely normal people. And whenever you give any intervention, safety looms large.

That's a very important thing. It's particularly important for vulnerable populations, which children are. So, the standard way has been done.

It's not particular for COVID-19. It's with any new vaccine is that you show that it's safe and effective, in a population of normal adults. And then you then do a Phase 1a or a Phase 2a trial, in children, and you do that a couple of months into the proof that you have a safe and effective vaccine for adults.

You don't need a 30,000-person or 40,000-person trial. You could do it with a couple of thousand children. You want to show A, that it's safe, and B, that it induces a kind of response that's comparable to the same response that you know is protective in the adults.

Once you show that, you can do what's called a bridging study. You can bridge the data of safety and immunogenicity from your Phase 1a and 2a trial, to the adult trial, and then make the decision that you can give it to the children, and it almost certainly will be effective, after you have proven that it's safe.

Just remember, safety is really important when it comes to children.

COOPER: Yes. Yvonne in Maryland sent in this video. Let's take a look.

(BEGIN VIDEO CLIP)

YVONNE SHASHOUA, MATHEMATICIAN: Will the vaccine only prevent me from getting sick or will it also prevent me from getting infected and spreading the virus to vulnerable members of my family?

[21:35:00]

If the vaccine only protects me from getting sick, but I could still be a carrier, and bring the virus home with me, then I have to stay isolated any way, to protect a family member who cannot be vaccinated.

(END VIDEO CLIP)

COOPER: What about that, Dr. Fauci?

FAUCI: Well, I think what the caller did was answer a question that someone just did a few minutes ago, which is the reason why that even though we get vaccinated, you still want to, until the level of virus in community is so low, you want to do some things, like wearing a mask.

But let's get to specifically what she's asking. The answer is that we know that the vaccine is 95 percent effective in preventing you from getting sick. We don't know yet, it could be, I hope it is, but we don't know if it's protecting you against infection.

If it doesn't protect you against infection, it's likely that the degree of immunity that you have is going to diminish the level of virus in your nasal pharynx. And even though you might be infected, it is likely, not proven yet, but likely that it would be very less likely that you are going to transmit it.

So, you could get infected. But the level of virus is so low in you, A, you don't get sick, and B, you have a very low likelihood you're going to spread it to other people. Although we don't have that answer now, as we get more and more information from the trials, we will get that answer for you.

COOPER: Dr. Anthony Fauci, thank you so much for joining us. Really appreciate it.

GUPTA: Thanks, Dr. Fauci.

FAUCI: My pleasure. Good to be with you guys.

COOPER: Ahead, Sanjay and Dr. Leana Wen will answer more of your questions.

Plus, 20 million Americans could get vaccinated by year's end. What makes these vaccines more than just a way to stop the spread, we'll take a look at that.

We'll also talk to a married couple, who'd take us through their experience volunteering for the vaccine trials. They don't know if either of them got the real thing or placebo. But what happened next may tell us a lot, ahead.

(COMMERCIAL BREAK)

COOPER: Dr. Anthony Fauci just joined our CNN Global Town Hall, said officials will start to get vaccines in people's arms by the middle and end of this month.

[21:40:00]

The nation is now in its most grim, most dire moment of the Coronavirus tragedy. But as Dr. Fauci was - remind us, we are also remarkably, just weeks away, in all likelihood, from the start, what will be a turning point that we are all so desperate to see.

GUPTA: Yes. In a moment, you're going to meet a couple, who took part in the Moderna vaccine trial, and they may give us some important new insight into what some of the rest of us, can soon expect.

When it comes to these vaccines, it's not just about stopping COVID. What we are seeing now is an entirely new way of thinking about the power of vaccines.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Since the first vaccine for smallpox in 1796, vaccines have all relied on the same basic concept.

Give a little piece of the virus, also known as antigen, to someone, not enough to make them sick, and then their body would be taught to make antibodies to it. Those are proteins that neutralize the virus, if that virus ever tried to invade again. That's what makes you immune.

But what if the body could be taught to do the whole thing, not just make antibodies, but to make the antigen as well, to essentially become its own vaccine-making machine?

It's exactly why Pfizer and Moderna have focused on this tiny strand of genetic material that our cells use all the time. It's known as mRNA. It stands for messenger RNA.

It carries the instructions for cells to make whatever protein you want, so, with a simple genetic sequence, we can then program the body to make an antigen. The vaccine is not virus at all. It is essentially just genetic code for a portion of the virus. This portion, it's called the spike protein.

Why the spike protein? Because it's the key the virus uses to enter the human cell. But if, you prompt your body, to make antibodies to the spike protein, the virus is then blocked from infecting the cell.

So putting it all together, once the vaccine, made up of genetic code, is administered through a shot in the arm, our own cells start making that spike protein, over and over again.

Now remember, you're just making a part of the virus, so you can't get infected from the vaccine. Within days after that, the body reacts, and starts churning out the antibodies, plug and play.

(END VIDEOTAPE)

COOPER: And we want to welcome the couple we mentioned who went through the Moderna vaccine trials.

GUPTA: With us, from Dallas, Susan Froehlich, and her husband, Dr. Thomas Froehlich.

Thank you both for joining us.

COOPER: Susan?

SUSAN FROEHLICH, MODERNA VACCINE TRIAL PARTICIPANT: You're welcome. We're glad to be here.

DR. THOMAS FROEHLICH, MODERNA VACCINE TRIAL PARTICIPANT: Thank you for having us.

COOPER: Yes. Glad you're here.

So Susan, can you just walk us through what the process was like for you? And before you describe your experience with the side effects, I know you're worried you might deter people from getting the vaccine. But at the same time, it is important to talk about what it felt like.

S. FROEHLICH: OK. Well, the first shot that we got was on August 21st. And I really just had a sore arm and didn't notice anything different.

But we went back on September 18th, to get the booster. And about 12 hours after I got the booster, it was 2:30 in the morning, and I woke up with a horrible stomachache and headache, and it was like I was at the beginning stages of bad flu.

And so, I didn't have anything to take for it at the time. So, I was in a lot of pain until about four hours later, when my husband woke up, and I had him go get me some Naproxen.

And once I took the Naproxen, I took 440 milligrams of it then all those symptoms went away. But it was like every part of my body was hurting for about four hours. If I'd have had Naproxen right away, I think those symptoms would have abated more quickly.

But so, my muscles hurt, my joints hurt, my bones hurt, my jaw hurt. But it was for such a short time. And I told Tom, I said, either I got the real vaccine or I'm highly suggestible.

GUPTA: I'm curious, Dr. Froehlich - I'm glad you're feeling better, Susan, and that the anti-inflammatory has helped you.

S. FROEHLICH: Thank you.

GUPTA: But I'm curious, Dr. Froehlich, because you're a husband, but also a Doctor, how worried were you then when you saw Susan start to feel sick? Did it concern you? Or did - was it sort of what you expected?

T. FROEHLICH: Well it's kind of what I expected.

I mean, what I recognized is that the symptoms she was having were really the signs of a big release of interferon, like happens, when we give people interferon, in cancer treatment, or like happens when you get the flu.

And that was my interpretation of what was going on was that this was a flood of interferon into her system and other transmitters of the - of immune system. And so, I wasn't terribly worried.

[21:45:00]

I felt bad that she felt so bad for a while, but then it resolved fairly quickly, once she took a couple of Aleve. So, really, it wasn't - it wasn't that bad. But I kind of recognized what was going on from my many years as being an oncologist.

GUPTA: Sure.

S. FROEHLICH: And Tom was in the same study that I was. So, we figured he got the placebo because he didn't have any of those symptoms - side effects.

T. FROEHLICH: Yes.

GUPTA: Yes. So, you're pretty sure of that, Dr. Froehlich, that you got the placebo - I mean it's a blinded study.

S. FROEHLICH: We know. GUPTA: So, you really don't know.

S. FROEHLICH: We know.

GUPTA: But you really had no symptoms?

T. FROEHLICH: Well we - yes, I did not have any symptoms.

So, I was pretty certain, because most of the time, when I've gotten vaccines, like I've had the shingles vaccine, I've had many flu vaccines, and I will usually get a response, not as severe as Susan's, but after I get a vaccine.

So, for example, the new shingles vaccines. Shingles is a two-dose vaccine, and after the second one, I felt like that for about a day, and then it resolved. And I recognized what those symptoms were.

So, and I've had - so, when I didn't have any reaction to that, either injection, I figured I must have gotten the placebo.

COOPER: And Susan, just for people out there, who heard your story, what you went through, knowing what you went through, personally, in terms of how it felt for those four hours, would you do it again? I mean, would you - if you hadn't had the vaccine already--

S. FROEHLICH: Absolutely.

COOPER: --would you take the vaccine?

S. FROEHLICH: Absolutely, hands down. And if it becomes necessary for me to get this once a year, you can bet I'm going to be the first one in line to get it again.

COOPER: So, it wasn't - it wasn't so terrible?

S. FROEHLICH: I don't want this virus.

COOPER: It wasn't so terrible that you're like, "Ah, I'll never do it again. I'm not going to do it every year?"

S. FROEHLICH: Oh, heavens no! We need to have everybody out getting this vaccine. It is so much better than getting the disease. And we've had several friends now, and relatives, who've come down with COVID, and I don't want to go through that.

COOPER: Yes.

GUPTA: Yes, I mean, it's amazing. Half the country now knows someone who's either hospitalized, who have died from this.

I mean, Dr. Froehlich, you have a long history in your career, as a doctor obviously, but also participating in these trials, getting others to volunteer for trials. I wonder if you could just talk about why this one, in particular, was so important and, also, how you motivate people to take the vaccine, and be a part of all this. T. FROEHLICH: Well, I've talked to a lot of my patients. And taking care of cancer patients for over 40 years, I've had a lot of discussions about whether or not they should get vaccinated. And with live virus vaccines, we always recommend that they don't get vaccinated.

With this vaccine, which is an mRNA vaccine, it's completely safe. They cannot get any infection from it. And I encourage, you know, my patients, I encourage them to get the flu vaccine, regardless of what kind of response I know that I think they will have.

Because I know that getting their immune system to fight off intracoronary infection while they're getting cancer treatment is extremely valuable. And knowing that this is a vaccine that can't possibly give them an infection, I will strongly encourage them to get it.

And I've already talked to people about our experience. And they've asked should they get the vaccine? I've said, "Absolutely, when it becomes available, and we'll help figure out how to get it for you."

COOPER: Susan?

S. FROEHLICH: But - but--

COOPER: Yes. Go ahead.

T. FROEHLICH: Hey?

S. FROEHLICH: We have kind of a surprise you might not know. I don't know if you know or not. We know whether we got the vaccine or not because we entered a second trial up at Mount Sinai in New York City.

COOPER: And - and - what happened?

T. FROEHLICH: Well, so that trial was basically an antibody trial.

COOPER: Got it.

T. FROEHLICH: All we had to do was send our blood to them. And they have a big virology lab at Mount Sinai, and they were looking for the antibodies.

They knew we had been in the Moderna trial, so they were specifically looking to see whether we had antibodies that would have been induced by the mRNA. And we know that Susan does have those antibodies and I don't.

COOPER: OK. Excellent.

T. FROEHLICH: So, that's confirmed our suspicion.

S. FROEHLICH: And - and I not only have those antibodies. They spun my blood serum down 2,880 times.

COOPER: Wow! S. FROEHLICH: And they still found antibodies.

COOPER: Wow!

GUPTA: Wow!

S. FROEHLICH: So, I'm really protected.

COOPER: Well send some my way. I'll take them.

S. FROEHLICH: I'm not sharing.

COOPER: Yes, that's all right. Susan, and Dr. Froehlich, thank you so much for talking to us, but also just for going through this.

GUPTA: Yes.

COOPER: I mean, a lot of people are scared of this kind of thing, and it helps people to know other people have gone through it. I feel better knowing your experiences, and I certainly would take it as soon as I could get it.

I wish you the best. Thank you so much.

S. FROEHLICH: Thank you.

T. FROEHLICH: Well - well thank you for having us on.

[21:50:00]

And I just really wanted to be able to convince people that what you go through is certainly not terrible, and it's way better than getting the virus, particularly if you're elderly or have a comorbid condition that makes you at high risk for getting--

COOPER: Yes.

T. FROEHLICH: --seriously ill. I mean the worst thing is to end up on a ventilator.

COOPER: Yes.

GUPTA: Yes.

T. FROEHLICH: In the ICU.

COOPER: Appreciate it. So, thank you so much. Wish you the best.

S. FROEHLICH: Thank you.

T. FROEHLICH: Thank you.

COOPER: Next, well back with your questions. We got a lot of great questions that are all important. So, we'll get Sanjay to answer those, along with Dr. Leana Wen, when our CORONAVIRUS GLOBAL TOWN HALL, THE VACCINES, continues. (COMMERCIAL BREAK)

COOPER: Welcome back to our CORONAVIRUS GLOBAL TOWN HALL, THE VACCINES.

I love that couple, Sanjay.

GUPTA: Yes, they're so cute.

COOPER: It's so nice. I love the (ph) people like volunteer for clinical trials, I mean it helps everybody.

GUPTA: They're together.

COOPER: Yes.

GUPTA: I think that's a - that's a close couple.

COOPER: Yes.

As a reminder, at the bottom of your screen, you'll see our social media scroll that shows the questions people are asking. You can tweet us your questions with #CNNTownHall. You can also leave a comment on the CNN Facebook page.

Joining Sanjay and me to help answer questions - well not me, I'm not going to answer, no, I'm not going to be of any help, is former Baltimore Health Commissioner, Dr. Leana Wen, a visiting professor at George Washington University.

So, I want to get to as many viewer questions as possible. Sanjay, I want to start with you. This question from Laura who asks, "If you've had Coronavirus or believe you've had it, should you still get a vaccine?"

GUPTA: Yes, I think the short answer here is yes. I mean you do get immunity to some degree after natural infection.

But we just talked to Dr. Fauci about this, and I think one of the things that he said and others have said is that with the vaccine, we don't know for certain yet because it's two shots with these mRNA vaccines, a prime and a boost.

The hope, the thought is that the immunity that you get from the vaccine will be longer-lasting and maybe even stronger, so, the answer, yes.

COOPER: Dr. Wen, this next question comes from Kerry. Let's listen.

(BEGIN VIDEO CLIP)

KERRY DAHLBERG, PARENT, RETIRED NAVY OFFICER: I'm still breastfeeding my youngest. I'm completely pro-vaccine. But I'm concerned about a lack of testing in my lactating mothers. No one in my family is at an increased COVID risk. So, I don't know for sure whether to get vaccinated until I wean her next summer. (END VIDEO CLIP)

COOPER: Dr. Wen?

DR. LEANA WEN, CNN MEDICAL ANALYST: So, Kerry is right that currently there aren't studies being done on breastfeeding individuals.

[21:55:00]

And so, this becomes very tricky because we know that there are certain medications that are excreted through breast milk. We really have no idea whether there's any impact of this vaccine on breastfeeding, and so we need more information.

So, I would say that while the information is coming in, don't get the vaccine for now, and keep up with all these other measures that protect you, mask-wearing, physical distancing, not being part of indoor gatherings.

COOPER: Dr. Wen, this question is from Susan who asks, "I am an RN and I plan to get the vaccine. But I'm also trying to get pregnant. It is my understanding that the vaccine has not been studied on pregnant women. If I get pregnant, is it safe to take the vaccine?"

WEN: So, Susan is right as well that currently, the clinical trials are not being done on pregnant women either. And so, this again becomes very tricky, because on the one hand, you don't want to be doing clinical trials on pregnant women.

But on the other hand, you also don't want to be excluding pregnant people from the benefits, of this vaccine, especially since there are many pregnant women, who are essential workers, healthcare workers, and also pregnant women tend to have more severe effects because of Coronavirus.

So, the trials, currently, don't include pregnant women. However, when you have tens of thousands of people enrolled in a trial, some people could become pregnant. And so, I think that we will get some more information in time to come.

And one thing that Susan could consider is, because she probably won't be in the first group of people, who are eligible to get the vaccine, could she hold off on getting pregnant, and get the two doses of the vaccine and then work to start her family then.

COOPER: And Dr. Wen, what about, I mean, for men, is there any concern about infertility? I mean, is there any data on that?

WEN: For the vaccine, no. There is no data but also one would not expect. There is no biological reason why the vaccine would have an impact on male fertility.

Interestingly though, there are some preliminary studies that show that the Coronavirus may impact the male reproductive system, which is also not surprising, considering Coronavirus impacts so many different body systems. COOPER: Sanjay, this next question was sent in by Mark. Let's listen.

(BEGIN VIDEO CLIP)

MARK NARENS, ATTORNEY: Assuming you could get ahold of them, is there any advantage to, or danger from, taking more than one vaccine, especially since the different vaccines work differently, and the Moderna vaccine is a new and different type of vaccine?

(END VIDEO CLIP)

COOPER: Sanjay?

GUPTA: Well it's interesting. I mean, you can't really overdose, if you will, on vaccines. But obviously, the issue is that there is a pretty significant shortage of vaccines. So, I mean, take the vaccine that you can get.

And, in the beginning, there may not be a lot of choice, given just the high demand and low supply. But ultimately, there may be more directed vaccines based on your medical history, and things like that, maybe in the next year, or two years from now.

COOPER: Dr. Wen, Ricki asks, " If I receive a vaccine in a foreign country, say New Zealand or England, will it be effective against the virus, and its mutations here in the U.S., or will additional vaccinations be necessary?"

WEN: Well, at some point, I do hope that we'll get many different types of vaccines. And it may be that certain countries have more of one type of vaccine than another. There is no reason for us to believe that there is any kind of geographic variation when it comes to one vaccine being effective in one part of the country or other.

But I agree with what Sanjay said that it may turn out that one vaccine is more effective in older individuals, or children, or people with cancer, or other conditions, and that remains to be seen.

GUPTA: Yes. And Leana, I don't know if you've done this "New York Times" interactive, where you can actually see where you would end up in line for the vaccine. We actually did it for Dr. Fauci, and I actually did it for Anderson as well. So, I want to show this. I think people should see.

For Anderson, 53-year-old, they call you a normal person.

COOPER: What? Well that - well, first of all, then I mean - all bets are off. This thing is not accurate. If they're calling me a normal person, I'm far from that. But wow, I'm - wait, I'm in line behind 268.7 million people across the United States? I'm behind 16 million others in New York? Fair enough!

GUPTA: Look, I think it speaks to your - to your tremendous health and your unlikeliness of getting ill.

COOPER: Wow! GUPTA: So, we're rooting for you.

COOPER: I think I'm like the last in line. But you know what? That's OK. That's OK. I will wait my turn. And you know--

GUPTA: I'll give you my turn, Anderson.

COOPER: --there's more important people ahead of me. So that's--

GUPTA: I--

COOPER: --268 million ahead of me? That seems like - how many people are in the United States? I thought there were 200 million. Wow!

GUPTA: 350 million, so there's a few, few--

COOPER: Oh? All right. All right, I'm out of - all the way at the end.

Well Sanjay, thanks for that. Dr. Leana Wen, thank you, as always, for answering our viewer questions as well. And Sanjay, well yes?

GUPTA: Let me - let me show you something--

COOPER: OK.

GUPTA: --before we go as well. There's one more thing. We always want to make sure we can tell people how they can help.

For more information, go to CNN.com/impact. Our Impact Your World team put all this together. It's an interactive guide of resources at CNN.com/Coronavirus. Please help there. And there's a list of organizations, resources, ideas for where you can donate, and hopefully find help for yourself or a loved one.

COOPER: Sanjay, thank you, as always. It's great to see you again.

We hope tonight, we have helped with some answers, to your questions, about the pandemic. We want to give a special thanks to Dr. Anthony Fauci, of course.