>>> THERE WAS HESITANCY IN THE
BEGINNING, I THINK, AT THE EARLY
PART OF THE DATA.
TO SAY THAT DEFINITIVELY
BECAUSE, AND CORRECT ME IF IM
WRONG, THERE WAS WORRY THAT
BECAUSE THE DEPENDENT VARIABLE
THAT THE DRUG TRIALS WERE
TESTING ON WERE INFECTIONS AND
NOT TRANSMISSION, IT REMAINED
POSSIBLE --
>> RIGHT, RIGHT.
>> -- ALTHOUGH NOT LIKELY THAT
THERE WAS SOME HIDDEN RISK OF
TRANSMISSION, RIGHT?
AND WHAT IM GETTING FROM YOU
AND FROM THE CDC IS, THE DATA IS
COMING BACK AND THATS NOT A
PROBLEM.
>> YOU NAILED IT, CHRIS.
THATS CORRECT.
THATS ABSOLUTELY CORRECT.
THE RISK IS EXTREMELY LOW OF
GETTING INFECTED, OF GETTING
SICK, OR OF TRANSMITTING IT TO
ANYBODY ELSE, FULL STOP.
>> SO DR. ANTHONY FAUCI WAS VERY
CLEAR ABOUT THE AMAZING EFFICACY
OF THE COVID VACCINES WHEN WE
SPOKE EARLIER THIS WEEK BASED ON
THE DATA THAT WERE SEEING IN
THE REAL WORLD, RIGHT, NOT JUST
THE TRIALS.
BUT WHAT WE DIDNT TALK ABOUT,
AND WEVE BEEN GETTING A LOT OF
VIEWER FEEDBACK ON THIS, IS THE
FACT THAT THERE ARE MILLIONS OF
IMMUNOCOMPROMISED AMERICANS, 3
TO 4% OF THE U.S. POPULATION,
FOR WHOM THE SHOTS MAY NOT WORK
FULLY OR AT ALL.
SO WHAT EXACTLY SHOULD THOSE
FOLKS IN THAT CATEGORY BE DOING
TO PROTECT THEMSELVES AND WHAT
DOES THE NEW CDC MASK GUIDANCE
MEAN FOR THEM?
DR. PETER HOTEZ IS SOMEONE WHO
UNDERSTANDS THAT VACCINES ARE
NOT AS EFFECTIVE IN
IMMUNOCOMPROMISED PEOPLE SO
THEYRE AT HIGHER RISK FOR COVID
INFECTION EVEN AFTER
VACCINATION.
HE JOINS ME NOW.
DOCTOR, LETS TALK ABOUT WHO
THIS GROUP OF PEOPLE IS, WHAT
ARE THE VARIOUS FACTORS THAT
COULD LEAD TO BEING IN THIS POOL
OF FOLKS WHO ARE
IMMUNOCOMPROMISED.
>> CHRIS, FIRST OF ALL THERE IS
A LOT OF THEM.
ROUGHLY MAYBE TO 3 TO 5% OF THE
U.S. POPULATION THATS BEEN
GETTING VACCINATED.
AND WEVE GIVEN OUT 158 MILLION
DOSES OF VACCINE.
SO YOU DO THE MATH, THATS, YOU
KNOW, 5, 6, 7 MILLION PEOPLE.
AND ITS PROBABLY THE SECOND
MOST COMMON REASON WHY PEOPLE
SEND ME EMAILS.
EVERY MORNING IVE GOT EMAILS IN
MY INBOX FROM PATIENTS WHO ARE
ON VARIOUS IMMUNOSUPPRESSANT
THERAPIES, THEY RANGE FROM BONE
MARROW TRANSPLANT PATIENTS,
THOSE GETTING CORTICOSTEROIDS,
GETTING CHEMOTHERAPY, T-CELL
THERAPY, MONOCLONAL ANTIBODIES,
B-CELLS, PRIMARY
IMMUNODEFICIENCY PATIENTS.
IN THE AGGREGATE, ITS A HUGE
NUMBER.
AND WERE ONLY NOW STARTING TO
REALLY GET DATA ON HOW THEY DO
IN TERMS OF RESPONDING TO
VACCINES, BECAUSE MOST OF THEM
WERE EXCLUDED IN THE PHASE 3
CLINICAL TRIALS THAT LED TO
EMERGENCY USE AUTHORIZATION.
THE GOOD NEWS IS IN MOST OF
THESE INDIVIDUALS THE VACCINES
ARE SAFE, ARE ABOUT AS SAFE AS
THEY ARE IN PATIENTS WITH NORMAL
RECONSTITUTED IMMUNE SYSTEMS, OR
NORMAL IMMUNE SYSTEMS.
SO I THINK THATS GOOD.
THE NOT SO GOOD NEWS IS,
OFTENTIMES THEY DO NOT RESPOND
WELL TO THE VACCINE,
PARTICULARLY AFTER A SINGLE
DOSE.
SO INDIVIDUALS WHO WITH NORMAL
IMMUNE SYSTEMS MIGHT HAVE 50,
60, 70, MAYBE 80% RESPONSE TO A
SINGLE DOSE OF VACCINES, FOR AT
LEAST THE SOLID ORGAN
TRANSPLANTS, MAYBE THE BONE
MARROW TRANSPLANTS, THOSE
GETTING OTHER IMMUNOSUPPRESSANT
THERAPIES, ITS ABOUT 17, 18,
19%.
THE GOOD NEWS IS IT OFTENTIMES
DOES COME UP AFTER THE SECOND
DOSE.
BUT EVEN THEN, ITS NOT ALWAYS
COMPLETE.
SO, YOU KNOW, THE COMMUNITY OF EXPERTS IN THIS, THE
EXPERTS IN THIS, THE
HEMATOLOGISTS, ONCOLOGISTS,
RESUME A
MAYBE LOOKING AT A THIRD DOSE TO
ACHIEVE PROTECTION.
AND THE QUESTION IS WHEN DO YOU
GIVE IT, BEFORE YOU START
IMMUNOSUPPRESSIVE THERAPY?
LIKELY.
BUT IF YOU KNOW THEYRE GOING TO
STOP IT SOON, DO YOU WAIT FOR A
PERIOD OF WEEKS OR MONTHS BEFORE
YOU GIVE IT?
ALL OF THIS IS BEING LOOKED AT
RIGHT NOW.
ITS A BIT CHAOTIC IN TERMS OF DOING IT SYSTEMATICALLY, AN
DOING IT SYSTEMATICALLY, AN
INFORMAL NETWORK OF
HEMATOLOGISTS, ONCOLOGISTS, SO
ITS GOING TO TAKE A LITTLE BIT
OF TIME TO WORK OUT.
>> THERES TWO THINGS.
ONE IS WE WANT COMMUNITY LEVEL
SUPPRESSION, WE WANT TO KEEP
VACCINATING AS MUCH AS POSSIBLE
AND DRIVE THE CASE NUMBER DOWN
BECAUSE THE BASE RATE OF
TRANSMISSION WILL AFFECT
EVERYONE, THATS A NO-BRAINER,
WE WANT TO PUSH MORE VACCINES,
MORE VACCINES, MORE VACCINES.
BUT FOR THE PARTICULAR SORT OF
BEHAVIORAL EFFECTS FOR FOLKS
THAT ARE IN THIS CATEGORY OR
THEIR LOVED ONES, DOES IT MEAN
THAT THEY SHOULD STILL BE
WEARING AN N95, THAT THEY
SHOULDNT BE DOING SOME THINGS
LIKE FLYING AND GETTING IN LARGE
CROWDED GROUPS, ALL THE THINGS
WEVE BEEN AVOIDING PREVACCINE?
>> YEAH, THATS RIGHT.
SO I THINK IF YOURE AN RENAL
DIALYSIS PATIENT OR GETTING
IMMUNOSUPPRESSIVE THERAPY, A
BONE MARROW TRANSPLANT PATIENT
OR ONE OF THE OTHERS ON THE
LIST, YOU HAVE TO BEHAVE AS
THOUGH YOURE NOT VACCINATED.
YOU MAY BE PROTECTED, BUT WE
DONT HAVE THAT FULL SLATE OF
DATA ON IT JUST YET.
>> AND I THINK IT POINTS TO THE
LARGER ISSUE HERE WHICH IS WE
JUST NEED TO KEEP PENETRATING
THE POPULATION IN TERMS OF
VACCINATION, BECAUSE WERE
SEEING CASES GO DOWN.
WEVE JUST GOT TO KEEP THAT
GOING BECAUSE THAT IS THE
ULTIMATE THING THAT IS GOING TO
KEEP EVERYBODY SAFE, WHATEVER
THEIR PARTICULAR EXPOSURE OR
RISK OR PARTICULAR MEDICAL
SITUATION IS.
SO JUST KEEP THAT IN MIND.
>> YEAH, HERES WHAT WE NEED TO
DO.
WE NEED TO GET 75, 80% OF THE
U.S. POPULATION VACCINATED.
BECAUSE THE LITTLE KIDS ARE NOT