FULL EPISODE: 1/2/2022 Dr. Jeanne Marrazzo talks mRNA vaccines; Dr. Sean Tucker covers COVID vaccine pill trials

Published: Jan. 1, 2022 at 7:01 PM EST
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Washington, D.C. – Greta Van Susteren interviewed Dr. Jeanne Marrazzo, director of the Division of Infectious Diseases at the University of Alabama at Birmingham (UAB), and Sean Tucker, Ph.D., the founder of Vaxart, whose company is developing a COVID vaccine pill, about the latest surge in coronavirus cases, the Omicron variant, and the future of vaccines for Gray TV’s “Full Court Press with Greta Van Susteren” airing Sunday, January 2, 2022.

Dr. Marrazzo told Van Susteren the current surge in COVID cases can be attributed to “a combination of holiday gatherings, being inside during cold weather, waning immunity, and now this crazy Omicron variant.”

Still, Marrazzo said, she does not believe this cycle will continue indefinitely. “What I think will happen is that we will have progressive waves like this, and with increasing vaccination rates, with catching up as new variants emerge, with new vaccines – I’m sorry to say that I think more vaccines are in our future – the hope is that every single wave will have a lower height in terms of serious problems. So it’ll become more like a seasonal flu or a seasonal cold.”

Marrazzo also said there were some signs of emerging herd immunity, explaining: “One of the reasons that we think that the northern part of the country right now is having higher rates of infection while the southern part … is that we had such a horrible summer with Delta that we now have a fair amount of herd immunity in the southern part of the United States.”

And Marrazzo expressed hope over new vaccine technologies focusing on spike proteins, saying they “are going to be interesting and very promising in the coming months, and they potentially could be modified very quickly if new variants emerge.”

Dr. Sean Tucker, whose company is developing a COVID vaccine pill he promises will be easier to store and distribute than injectables, says an oral vaccine could sway people who haven’t gotten the shot because they don’t like, or have a fear of, needles.

“We did a survey and just asked the question: If you had a pill vaccine versus a shot, which would you rather take? And seven out of 10 people said, ‘Hey, we would take the pill over the shot.’ And then even people that were reluctant to take a COVID vaccine at all, 25% of Americans … We found a third of those would take the vaccine if it was given in a pill.”

Interview excerpts are below.

Dr. Jeanne Marrazzo Highlights

Greta Van Susteren

Doctor, we have a winter surge. Is that because everyone got together because of holidays and because we are all in indoors, we’re not outdoors, and because of this new variant? Is that to be expected?

Dr. Jeanne Marrazzo, Director, Division of Infectious Diseases at UAB

I think it is to be expected. Then I think there’s another factor, too. That is that, for people who haven’t gotten that booster shot, the immunity from their first series of the vaccine is probably waning. We know that that is really good for probably the first five to six months, and then after that, we do see a decline in antibodies. The combination of holiday gatherings, being inside during cold weather, waning immunity, and now this crazy Omicron variant coming onboard has set us up for a bit of a pickle during the holidays.

Greta Van Susteren

Is this going to go on forever? Is this ever going to end?

Dr. Jeanne Marrazzo, Director, Division of Infectious Diseases at UAB

I don’t think it’s going to go on forever. You know I hate making predictions about this virus because it’s a surefire way to publically make a mistake and be proven wrong later. But I am comfortable saying that what I think will happen is that we will have progressive waves like this, and with increasing vaccination rates, with catching up as new variants emerge, with new vaccines – I’m sorry to say that I think more vaccines are in our future – the hope is that every single wave will have a lower height in terms of serious problems. So it’ll become more like a seasonal flu or a seasonal cold. That’s the ideal. How long will that take? I don’t know. Some people are saying a year, some people are saying a couple of years.

Greta Van Susteren

Can the vaccines, though, keep up with the mutations?

Dr. Jeanne Marrazzo, Director, Division of Infectious Diseases at UAB

That is a billion-dollar question. We have a big scare on our hands with the emergence of Omicron. The reason that people are agitated about this particular variant is because of the combinations of mutations in that spike protein we’re always talking about, because that’s the part of the virus that the vaccines make your body make antibodies to. If the virus messes around with that spike protein, it might escape from the antibodies the vaccine induces. We have to try to stay ahead of that. What’s going to happen is variants are going to emerge and we’re going to have to quickly, within the first couple of weeks to a month, check in the lab to see if our current vaccines work against the variant. If they don’t, then it’s back to the lab to create a new booster strain.

Greta Van Susteren

If there’s a new variant, how fast can the messenger RNA be re-engineered to meet the new variant?

Dr. Jeanne Marrazzo, Director, Division of Infectious Diseases at UAB

It depends on who you talk to. If you talk to the CEO of various companies, let’s just start with Moderna who commented very early that they would be able to probably do this in a few months. It’s technically not a big lift because all you’re doing is changing literally the sequence of the chemical basis that makes up mRNA, and you can easily do that in a lab to feed into the vaccine. You probably wouldn’t even need to do the same degree of safety assessments. You probably want to make sure you were doing some good clinical studies, but you’re not changing very much except that blueprint. Nothing else about this package is going to look different.

Dr. Jeanne Marrazzo, Director, Division of Infectious Diseases at UAB

My guess would be, let’s just say that we find out that the next variant is not covered by the current vaccines. Theoretically, we could have boosters that would work against it within four to six months.

Greta Van Susteren

That seems sort of long to someone when you have virus fatigue. Four to six months sounds a little bit long.

Dr. Jeanne Marrazzo, Director, Division of Infectious Diseases at UAB

Yes. Yes. When the variants are breathing down our necks and especially if we start to see increases in their transmissibility, because that’s where they start winning the race because they’re infecting people so fast, we can’t keep up with getting the vaccines, number one, changed, number two, manufactured, and number three, into people’s arms.

Greta Van Susteren

Is that necessarily such a bad thing that a new virus, a new variant is transmitted so easily? Because I think we spoke before and you told me that it pushes out the old, so the Omicron may dominate Delta, but Delta may make you more seriously ill.

Dr. Jeanne Marrazzo, Director, Division of Infectious Diseases at UAB

Yep. Exactly.

Greta Van Susteren

So we’d rather have Omicron on the horizon than Delta.

Dr. Jeanne Marrazzo, Director, Division of Infectious Diseases at UAB

Yep. I’m very hesitant to bring up this concept of herd immunity because there’s been so much, I would say, argument about it. People don’t understand it and it is complicated. We don’t totally understand it with COVID. But one of the reasons that we think that the northern part of the country right now is having higher rates of infection while the southern part, this is with Delta, is not, is that we had such a horrible summer with Delta that we now have a fair amount of herd immunity in the southern part of the United States.

Dr. Jeanne Marrazzo, Director, Division of Infectious Diseases at UAB

What if we have a next variant that spreads like wildfire, induces some good immunity, but doesn’t kill people? That’s a scenario that would certainly be better than what we saw with Delta. It’s not really in the virus’s interest to kill people, right? Viruses don’t want to kill their hosts. They want to be able to transmit from one person to another. So the perfect situation for the virus would be exactly what you said, much more infectious, easier to spread, maybe take people out a little bit, but nothing like what we saw with Delta, and maybe that creates more herd immunity faster.

Greta Van Susteren

Okay. Are scientists working on new vaccines and technology methods other than messenger RNA for COVID?

Dr. Jeanne Marrazzo, Director, Division of Infectious Diseases at UAB

They are. Absolutely. Yes. Remember there are, as you mentioned with the AZ vaccine and the J&J vaccine, those are viral vectors, so they put those same protein and coding parts in another virus that’s harmless, they think. There are people still working on different viral delivery systems.

Dr. Jeanne Marrazzo, Director, Division of Infectious Diseases at UAB

One technology that people are really excited about is protein vaccines. This is where you literally give people spike protein. Why bother going through the step of having their body take mRNA in and make the protein? This is where you literally give them naked spike protein, but it also has to be delivered in a system. I think those are going to be interesting and very promising in the coming months, and they potentially could be modified very quickly if new variants emerge where you have mutations in that protein that are of concern.

Greta Van Susteren

Okay, so we need sequencing in order to figure out what we have to develop the vaccine. How complicated is it to do the sequencing, and is it time-consuming? How fast can we move on it?

Dr. Jeanne Marrazzo, Director, Division of Infectious Diseases at UAB

Yeah. It’s not that time-consuming. You need a highly sophisticated lab with good staff and facilities, and importantly, it’s probably more complicated getting a representative set of specimens to that laboratory than anything else. Once these very good labs, we do it at our institution, most academic institutions have these sequencers because they are doing genetic type virology research, so it’s done very quickly. The trick is to get the samples from the infected people to the lab and to get it going. When you go to your doctor, it’s not like they say, “Oh, I’ll send your viral sample off for sequencing.” You generally need to be admitted to the hospital or you need to be in a place where people are collecting those specimens purposefully, which is frankly what we should be doing.

Greta Van Susteren

If messenger RNA is so effective, such a good blueprint, will it be able to be used for other viruses, or is one of the advantages of COVID is what I’ve come to hear is it’s more stable? It’s not like the flu that changes every time we blink.

Dr. Jeanne Marrazzo, Director, Division of Infectious Diseases at UAB

Exactly. I think it will be brought to bear for other viruses, but there are just some viruses that are going to be impossible to use. I think HIV is a great example. If we could have made an mRNA vaccine for HIV four years ago, we would have done that already, and that’s going to be tough. Another example is hepatitis C. A vaccine against hepatitis C would be fantastic. That’s probably going to be a much tougher challenge. There are characteristics about the COVID virus, namely how stable this spike protein is and how important it is in binding and in creating immunity, that make it a perfect mRNA vaccine. Unfortunately, all viruses aren’t like that. They’re much more complicated.

Greta Van Susteren

Does it make any difference, assuming they’re all as effective, whether I get a vaccine by injection or whether I take it by a liquid like cholera, whether there’s some new pills that may be coming out down the road? Does it make any difference how I get the vaccine in terms of how protected I am, assuming that they all have the same efficacy?

Dr. Jeanne Marrazzo, Director, Division of Infectious Diseases at UAB

Well, if they have the same efficacy, no. The trick here is that the reason you take a cholera vaccine in a pill is because, what does cholera do? It infects your gut. It gives you sometimes fatal diarrhea. Right?

Greta Van Susteren

I think I drank my cholera.

Dr. Jeanne Marrazzo, Director, Division of Infectious Diseases at UAB

Exactly. But the whole point is you’re exposing your gut lining to the thing that you want to make... Your gut is lined with tons of cells that make antibodies. Gut immunology is really interesting. You want those antibodies in your gut in case the cholera shows up in your gut. In the respiratory tract, where do you really want the antibodies? You really want it in the nasal mucosa. Right? Right where people are going to be encountering the virus first.

Dr. Sean Tucker Highlights

Greta Van Susteren

Doctor, we’re all now accustomed to the vaccine shot in the arms. So tell me, you are developing a pill vaccine. How far along are you in the process?

Dr. Sean Tucker, Founder and Chief Scientific Officer, Vaxart

Well, as you mentioned, we are making a pill vaccine, and of course it’s a little bit different than the total shots. This is one of the pills in a blister pack. We are in phase two studies right now and currently enrolling.

Greta Van Susteren

Do you know how effective it is against the coronavirus and the variants?

Dr. Sean Tucker, Founder and Chief Scientific Officer, Vaxart

So we have not assessed efficacy yet. We are still early stage. What I can tell you from earlier work with our phase one study is that we made a very cross-reactive immune response in the nose, which is a little bit different than what the injected vaccines do, which they make a very nice serum antibody response that’s very specific-

Greta Van Susteren

The J&J shot is one type of vaccine, Moderna and Pfizer are messenger RNA. Is this a third type or is it just a pill form of one of those two?

Dr. Sean Tucker, Founder and Chief Scientific Officer, Vaxart

In some ways, it’s similar to the J&J vaccine because it’s a nonreplicating vector that you’re delivering. We happen to have a nice little trick so that you can swallow it very easily, it moves to the intestine where it does its work and produces a broader immune response than injected vaccines.

Greta Van Susteren

Is there any challenge to the distribution? Pfizer’s got to be at very cold temperatures and they’ve also got the problem that Pfizer and Moderna at least have thought to be a double vaccination, now they might think that it’s not even a double, but a triple, counting the booster as a third. But do you envision any sort of challenges in terms of distribution or is it just you can put them in a box and send them someplace?

Dr. Sean Tucker, Founder and Chief Scientific Officer, Vaxart

I think that’s one of the big advantages of having this oral tablet vaccine is that there’s not really the same sort of cold chain required or frozen chain if you’re comparing to the mRNA vaccines. We do envision that you could basically put it in a box, store it for long periods of time at room temperature, and just hand it out anytime that it’s needed, almost instantaneously vaccinated.

Greta Van Susteren

So who would take a pill vaccine? Is it someone who hates shots or thinks that this is more effective?

Dr. Sean Tucker, Founder and Chief Scientific Officer, Vaxart

Well, it’s funny. We did a survey and just asked the question: If you had a pill vaccine versus a shot, which would you rather take? And seven out of 10 people said, “Hey, we would take the pill over the shot.” And then even people that were reluctant to take a COVID vaccine at all, 25% of Americans said, “Hey, we’re never going to take this.” We found a third of those would take the vaccine if it was given in a pill.

Greta Van Susteren

There’s some vaccines that are oral already … Is there any particular response in the body why there might be a preference?

Dr. Sean Tucker, Founder and Chief Scientific Officer, Vaxart

Well, I think that from the oral vaccines in the past, those are basically attenuated replicating pathogens that are not as dangerous, and they basically are able to swallow them as a liquid. What we decided to do is to build something that could be reused for many different indications and to put in a tablet form because we thought that was the most simple, elegant way to basically get people to take the vaccine. And actually, the goal was to basically have the vaccine come to you rather than having to go get it.

Greta Van Susteren

I just heard recently that there may be 100 million doses of the injectable vaccine that may go bad, they’re passed the expiration date. Do you expect that your pill vaccine would have an expiration date, and do you have any idea what the length of time would be if they do?

Dr. Sean Tucker, Founder and Chief Scientific Officer, Vaxart

We obviously haven’t done the final stage or what I would call the stability studies to support, but we have done initial characterizations and we think it would last for years at room temperature.

Greta Van Susteren

If there’s another variant, is there some sort of technology that goes into developing this particular vaccine so that you could re-engineer it quickly to meet a new variant?

Dr. Sean Tucker, Founder and Chief Scientific Officer, Vaxart

Well, the good news about our vaccine is it’s very much plug and play. So if there’s a new variant that you had the match, you could just put it up, make a cassette, stick it into the vaccine, and then you’re off and running fairly fast like the mRNA vaccines. One of the things I think that’s very important about this technology is that while the injected vaccines make a serum response that’s based on a molecule called IgG, it isn’t as cross-reactive as the molecules that we make in the nose, which are called IgA. And we think that our vaccine today would do a better job of addressing the variants than the injected vaccines.

Greta Van Susteren

What got you started on this?

Dr. Sean Tucker, Founder and Chief Scientific Officer, Vaxart

So I started the company because I really wanted to make a difference. I wanted to basically develop something where the vaccine could come to you rather than having to go get the vaccine. And certainly from the standpoint of having an oral tablet easily distributed, you could make a big difference around the world not just in places that have a rich infrastructure, but places that don’t have this infrastructure to freeze vaccines and give them in shots every day.

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About Greta Van Susteren:

Greta Van Susteren is the Chief Political Analyst for Gray Media and host of Full Court Press. Ms. Van Susteren is a veteran of Fox News Channel, MSNBC, and CNN. Her prime-time Fox News Channel Show, “On the Record,” was number 1 in its time slot for 14 1⁄2 years. Before joining Fox News, she hosted CNN’s prime-time news and analysis program, “The Point with Greta Van Susteren,” and co-hosted the network’s daily legal analysis show, “Burden of Proof.” Her legal analysis for CNN’s coverage of Election 2000 earned her the American Bar Association’s Presidential Award for Excellence in Journalism. She continues to host the weekly 30-minute program “Plugged In with Greta Van Susteren” on Voice of America, which broadcasts exclusively outside of the United States.

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