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Transcript: Dr. Scott Gottlieb on "Face the Nation", October 24, 2021

The following is a transcript of an interview with former FDA Commissioner Dr. Scott Gottlieb that aired Sunday, October 24, 2021, on "Face the Nation."

MARGARET BRENNAN: We're joined now by former FDA commissioner Dr. Scott Gottlieb, who also serves on the board of Pfizer. Good to have you with us in studio. 

DOCTOR SCOTT GOTTLIEB: Good to be here. 

MARGARET BRENNAN: So, we're headed into respiratory virus season. Is this new version, this new Delta variant, something that has you concerned? What is the direction we're headed in? 

DR. GOTTLIEB: Yeah look, I don't think this is enough to really change the trajectory, the direction we're heading in. We're much closer to the end of this Delta wave than we are to the beginning. The South looks very good right now in the Midwest, where there's been a very dense epidemic. We see cases starting to decline. There's a pickup in cases in the Great Lakes region in parts of New England, so that's concerning. This Delta wave still has to course its way through parts of the country. But I think as we get to Thanksgiving and maybe shortly thereafter, we're going to be on a downswing across the whole country. You're seeing cases come down all across the country. This new variant, we think it could be more contagious. I don't think it's enough to change the overall trajectory. My lament is that we're not better at figuring out these questions. I mean, we should have an answer to the question of just what the characteristics of this new variant are and what kind of risk it poses.

MARGARET BRENNAN: That's something you've been saying throughout this pandemic, and it sounds like you're saying we haven't gotten any better.

DR. GOTTLIEB: We don't really have a coordinated system globally. We parcel this out to certain academic groups; we were dependent upon certain academic researchers to do this kind of analysis. The UK is very good at identifying these- these new variants. They have better sequencing in place than we do, but we don't have good follow up in terms of the epidemiological work to try to figure out whether or not these new variants are spreading more aggressively. This one, if it is more contagious, it appears to be perhaps slightly more contagious. Again, the vaccine should be protective, and certainly people who are infected with Delta will be protected, probably against this new variant. So, I don't think this is going to be a new variant that sweeps across the globe. And we're back- we're back at square one here. I think that this is something that's going to probably push us in the direction of eventually reformulating our vaccines for Delta backbone vaccine, because what we're seeing is the new mutations are occurring within that Delta lineage.

MARGARET BRENNAN: So you said the other day there are two remaining pockets of vulnerable, the very young and the very sick. So let's start with the compromise. This week we lost the former Secretary of State Colin Powell. He was battling multiple myeloma. His family said he succumbed to COVID, though he had been vaccinated. What is the lesson there?

DR. GOTTLIEB: Look, I don't think anyone should die from COVID now. This is an avoidable death. People who are- have intact immune systems have vaccines available to them, highly effective vaccines. There's two pockets of vulnerability to point young children who will eventually be able to vaccinate and then people who are immune and competent. They can't mount an effective response to the vaccines because they are organ transplant patients, because they're on active chemotherapy. We have the tools to protect them. We could be using the antibody drugs and a prophylactic basis, giving them regular infusions, probably monthly infusions, to protect them through this Delta wave. The drugs are being used that way off label. They're available under compassionate use. There is an emergency use authorization sitting with the FDA right now for that specific use. Look, I was an adult cancer patient at one point undergoing chemotherapy. If I was in that position right now, I would be wanting to use these drugs on a regular basis to protect me. These patients have become prisoners in their homes because they know how vulnerable they are. We know there's people who aren't going to respond well to the vaccines. We can be protecting them.

MARGARET BRENNAN: So the former secretary was not given that antibody treatment when he became sick. You're saying, as a preventative measure, people should ask their doctors about this?

DR. GOTTLIEB: Right. It's happening. Look, these drugs are being used on a regular basis as a prophylaxis, not post-exposure prophylaxis for what- which is what they're approved for, but as a general prophylaxis in people who are immune incompetent, who can't mount an effective response to a vaccine because of their underlying health conditions. And it's a small subset of Americans, but it's our most vulnerable Americans.


DR. GOTTLIEB: The drugs can be used in that way. Regeneron is making them available under a compassionate use basis for that use. Again, there's an application before FDA, but we should be protecting these lives. These are fragile lives. We have the tools to do it. We're not making aggressive enough use of those tools.

MARGARET BRENNAN: You've been saying Nov. 4 is the soonest we could see vaccinations available for 5 to 11 year old's. What do you think of the administration's rollout plan that they detailed this week?

DR. GOTTLIEB: Yeah. Look, the effort has been to push the- the vaccine for 5 to 11 into pediatrician's offices. So, Pfizer, the company I'm on the board of, is developing a tray that's 10 vials, 10 doses each vial. So that's one hundred doses. That's small enough that any small-to-medium sized pediatrician's office can stock the vaccine and deliver it-- 

MARGARET BRENNAN: In a regular refrigerator?

DR. GOTTLIEB: --In a regular refrigerator. It could be stored in a regular refrigerator for up to 10 weeks. It was formed- It was purposely packaged that way. And so, the idea is to try to get it into pediatrician's offices because we know that, you know, getting children vaccinated is a much more consultative endeavor. Parents are going to want to talk to their own pediatrician about that. And so, you want the vaccine to be delivered at those sites. You don't want children to have to go to mass vaccination sites or even necessarily a pharmacy. You want them to go into the comfort of their own pediatrician's office. So, the administration has been behind that. The company has been behind it. That's been the plan all along. Once- if Pfizer does get the authorization on Tuesday from FDA, even before the CDC votes on this on Nov. 2 and 3, they'll start to ship it into the supply chain so it will be available for use once there is a hopefully positive vote from CDC. So, it could be as early as Nov. 4 and 5 that you can go into some locations and get your child vaccinated.

MARGARET BRENNAN: And toddlers and the smallest children still have to wait. I want to ask you to clarify the boosters and the information we received this week because it's a little confusing for people. When will the general population be able to get a boost? And with this authorization to mix and match, what should people go out and do? Where do they begin asking questions?

DR. GOTTLIEB: I think the guidance from CDC that's going to come out, they haven't put out the guidance on the use of boosters. I think it's going to recommend you sticking with the vaccine you've had unless you have a compelling reason not to. And there are certain patients who might want to switch vaccines, but I think by and large, most people are going to prefer the vaccine that they had or that's going to be the general recommendation that comes out of CDC. They didn't issue that guidance yet. In terms of the total general population, the criteria for who's eligible for a booster is fairly broad--


DR. GOTTLIEB: --and it was purposely broad, and the administration sent a signal to the pharmacy that they wanted this to be a frictionless process. So, I think they want these to be generally available for people who deem themselves to be at sufficient risk of contracting COVID or spreading COVID that they- they could benefit from a booster.

MARGARET BRENNAN: Dr. Gottlieb, always good to have you on the show and great to have you in person. We'll be back in a moment.

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