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Brian Lehrer: Brian Lehrer on WNYC, so the headline from the President's speech last night was that he's directing all states to allow anyone 18 or older to get in line to receive a COVID vaccine by May 1st. We'll get reaction to that and more COVID news from the last few days, including the strikingly positive new findings about vaccine effectiveness coming out of Israel from Dr. Leana Wen, emergency physician, Professor at George Washington University, contributing columnist for The Washington Post, CNN medical analyst, and former Baltimore Health Commissioner. Dr. Wen, always great to have you welcome back to WNYC.

Dr. Leana Wen: Thank you, Brian. Great to join you as always.

Brian Lehrer: What do you think of universal eligibility by May 1st? States have been trying to prioritize up until now based on risk factors.

Dr. Leana Wen: That's right. I am very excited actually by President Biden's announcement yesterday about this idea of having open season, the open eligibility for anyone, any adult American by May 1st. I think that that illustrates a level of confidence in the vaccine supply and distribution because, if we think about it, there are three major barriers to achieving herd immunity, supply of the vaccine, distribution and administration, and then vaccine acceptance. President Biden must be confident enough that we have enough supply and ability to get out the vaccine and they have done a tremendous job in ramping up distribution.

I think, again, this is exciting news. I am concerned about vaccine hesitancy and even more so vaccine complacency if you will, that I think we tend to think about it as the anti-vaxxers, but I actually think that there are a lot of people who are not actually anti-science anti-vaccine, but they may need an additional push, an additional incentive to get them to get the vaccine.

I think that's going to be the major challenge, but May 1st form a lot of people to do their own planning. As in people who are thinking, "I don't fall into one of these high-risk groups, when can I begin to sign up to get a vaccine?" Not that you're going to get a vaccine necessarily on May 1st, but when can I sign up? I think having that target date in mind is really reassuring to a lot of people.

Brian Lehrer: Do you think universal eligibility will be good, bad, or neutral for vaccine equity? Making sure the populations who are hardest hit by the vaccine aren't last in line to get it. We know equity has not been the reality so far.

Dr. Leana Wen: It's a really challenging question because we have two competing factors here. On the one hand, we know that when you open up the flood gates, and there are a ton of people who are eligible and few resources that it is going to be first come first serve, and in that first come first serve scenario, it is people who are privileged who are going to get access to the vaccine first.

I mean, that's just the reality and that we've seen this play out that there is a big digital divide, there are people who may not have broadband access and may not be  

able to have 10 family members who are calling and texting on their behalf and trying to figure out where to get the vaccine. If vaccine scarcity remains an issue and we're opening up eligibility, that's not good.

I think that if there are ongoing efforts to get vaccines to reach people where they are, really make vaccination the easy choice, as in, bring vaccines to pharmacies, to health centers in neighborhoods that are the hardest hit. I think even going beyond that, making sure that vaccines are available in churches, in schools, in local businesses, really making it easy for people to choose a vaccine.

I think if we can do that and increase supply, we could get to the point of having both the vaccine equity and allowing people who want to get the vaccine to get it because the other concern that I have is that there are states, I mean, Alaska has already opened up eligibility. There are other states where the demand for the vaccine is going to catch up with supply pretty soon.

You don't want to have a situation of having lots of vaccines in storage and the eligibility isn't yet open up and people who want the vaccine can't get it. I think both of these issues of addressing equity, as well as meeting speed, need to happen too.

Brian Lehrer: Listeners, we can take a couple of COVID science or COVID policy questions for Dr. Leana Wen, 646-435-7280. If you have 1 646-435-7280. Dr. Wen, the President also said in his speech last night that the CDC would issue more guidance on what vaccinated people can and cannot do within the coming weeks. I know that you were unsatisfied with the last round of guidance that came out earlier this week, you wrote that in The Washington Post, would you tell our listeners why?

Dr. Leana Wen: I think the CDC came out with what they and other observers would say is a cautious first step. Again, I understand the very fine needle that they have to thread here because they want to aim for caution, but I also think that there is a potential missed opportunity and that missed opportunity is to tie reopening policies with vaccination status.

We have many states that are loosening their restrictions, and more than 15 states don't even have mask mandates anymore. Texas, Arizona, West Virginia, Connecticut, even my state here in Maryland are essentially allowing many businesses to go back to 100% capacity. I think knowing that that's the reality of what's happening, I think that the CDC needs to go further and make very clear, "Here are the things that vaccinated people can do. Here are the things that you cannot yet do if you are unvaccinated."

I think by making that kind of distinction, they are giving a powerful incentive to people to be vaccinated now, because what I fear is that reopening is going to occur anyway. Then if everything is open at 100% capacity regardless of vaccination status, we are losing the carrot that we have, really one of few carrots that we have to really incentivize those people who are on the fence to get vaccinated.

Now, I know that for people who are so eager and desperate to be vaccinated down, they're thinking, "What more incentive do you need? These are vaccines that protect  

you from dying. Isn't that enough?" I can also tell you based on polls, based on anecdotal experience, that there are many millions of Americans who need that extra push. I hope that the CDC comes out with the kind of guidance to give them that push.

As in, if you are vaccinated or if you're, let's say, you're unvaccinated, you can travel, but ideally only for essential purposes and you still have to test before you travel and quarantine after you travel, but if you are vaccinated, you don't have to do that anymore. Or businesses can open at 100% capacity if you are vaccinated, but they can only open at 25% capacity if you're not vaccinated. Something like that that gives an additional incentive for individuals, businesses, and communities to really increase the vaccination rate.

Brian Lehrer: Interesting. Susan in Jackson Heights, you're on WNYC with Dr. Leana Wen. Hi, Susan.

Susan: Hi, Brian. Thank you. I have a question about, I was vaccinated with the Johnson and Johnson last Saturday, and usually with flu shots, I've had reactions, redness, soreness, flu symptoms, body aches. I've had no reaction whatsoever from my shot, and I was wondering if there's any tests given down the line that would show that I am protected with antibodies at this point?

Brian Lehrer: Great question that a lot of people have, Dr. Wen.

Dr. Leana Wen: Absolutely. Two things that you raised here that are really important. One is that of side effects, there are some people who after receiving the COVID vaccine end up having substantial side effects, and if they do have side effects like fever, muscle aches, soreness at the side of the injection, we say that's normal, that's expected. It shows that the vaccine is working because your immune system is responding accordingly, nothing to worry about.

There are some people who don't have these reactions and we should also tell them that there's nothing to worry about here. It's just a matter of different people's bodies responding in different ways. Just because you're having a strong reaction or no reaction, it doesn't mean that somehow the vaccine is working or not working.

We actually do not recommend antibody testing or any other type of testing after getting the vaccine because again, different people's bodies respond in different ways. Some people may mount a strong antibody response, other people may not, and it's not necessarily correlated to whether the vaccine is somehow working. Just know that if you've gotten the vaccine, you have received a safe and highly effective vaccine that protects you especially from severe illness. Still continue to use caution, still wear masks, for example, in public places, but there's no additional testing that you need.

Brian Lehrer: Shelley in Manhattan, you're on WNYC with Dr. Wen. Hi, Shelley.

Shelley: Hi, thanks. It's my first time calling in. Great show. Thank you, Dr. Wen. I've been following what you've published and your recommendation. I have a question

that I haven't seen addressed anywhere as far as the people who are in 5% or 6% it's not effective for them. That means that it's-- I'm wondering what the statistics mean as far as are they not protected as much as somebody who is unvaccinated or are they just maybe going to have a mild infection? I don't really know what those statistics mean.

Brian Lehrer: It's another great question that a lot of people have. If they say that the Moderna and Pfizer vaccines are 94-95% effective, what does it mean for that other 5% or 6%, Dr. Wen?

Dr. Leana Wen: It's a great question and I think it's important to describe what that statistic means. That statistic, here's what it doesn't mean. It doesn't mean that there are somehow 5% of the population who are not responsive to the vaccine. What it's saying is that when you compare the people who received the placebo versus who received the vaccine, the vaccine is 95% protective of you from getting symptomatic illness.

I think what this indicates in the real world is that these vaccines are very effective, but nothing is 100%. If you've received the vaccine, there is still a chance that you could be infected with coronavirus. Now, the good news is that all three of these vaccines, Pfizer, Moderna, Johnson and Johnson all protect you extraordinarily well from severe disease that's severe enough to land you in the hospital or cause severe illness and death.

That's great news, but could you still get sick? Yes, you can, and so this again is why my article that you referenced, Brian, is suggesting that at this point, we should be telling people about the nuance and complexity that's at this point in our pandemic. As in, we should not be talking about 0% risk and everything being totally safe or 100% risk and everything being totally dangerous. That at this point, we should be helping people, especially those who are fully vaccinated with making decisions based on different levels of risk.

There are individuals, for example, who are now fully vaccinated, who want to attend in-person church services, who may want to go to an indoor restaurant once in a while, who really are desperate to see their kids across the country.

These are not necessarily things that the CDC has yet said is fine to do, but I think we need to help people meet them where they are with the values that are most important to them, understanding that nothing is 100% safe, but can we reduce risk as much as possible, manage that risk, think about different ways to calculate risk so that we allow people to gain some sense of normality in their lives. I think that's the key about vaccination and also masking. Those are our tickets back to pre-pandemic life.

Brian Lehrer: I know you got to go in like 30 seconds, but can you give us a quick take on these study results from Israel where so many people have gotten the Pfizer vaccine and it seems like it's even better news than we thought.

Dr. Leana Wen: Absolutely. The news from Israel and in general is very promising

that in the real world, people who receive the vaccines also seem to be very well protected themselves. Also, there's a growing body of evidence that those who are vaccinated will also have a lower chance of being asymptomatic carriers, capable of infecting others.

Again, that's another reason why I think the CDC needs to come out with much bolder, more aggressive guidance about, "Here are all the things that vaccinated people can do relatively safely," while again, making sure that vaccinated people still wear masks while in public.

Brian Lehrer: Dr. Wen, we always appreciate your take on COVID science and COVID policy. Thank you for coming on with us again today.

Dr. Leana Wen: Thank you, Brian.

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