RFK Jr. Cuts $500M in mRNA Research. “It’s a Disaster,” Says Epidemiologist

CHRISTIANE AMANPOUR: And when pushed on the vital role of vaccines during COVID, Kennedy claimed incorrectly that we were, quote, “lied to about everything.” Dr. Michael Osterholm is the founding director of the University of Minnesota’s Center for Infectious Disease Research and Policy. And his new book, “The Big One,” examines the global pandemic and how we could prepare and should prepare for the next one. He tells Hari why the health secretary’s latest moves could spell disaster.

HARI SREENIVASAN: Christiane, thanks. Dr. Michael Osterholm, thanks so much for joining us. Your new book is titled “The Big One: How We Must Prepare for Future Deadly Pandemics.” Before we get to the, what’s in the book.  really wanna talk a little bit about what’s in the news these days. Just in August 5th, the Health and Human Services Department announced a cut of $500 million in mRNA research, which will impact 22 projects being led by big pharmaceutical companies. Right? And in a, in a recent interview there you, you said, “I can say unequivocally that this was the most dangerous public health decision I’ve ever seen made by a government body.” Explain why.

MICHAEL OSTERHOLM: Well, first of all, again, assuming that the next pandemic might very well be influenza, that’s a virus that could easily kill even many more people than we saw with COVID. Our ability to respond to that really is back to vaccines. And currently the capacity we have in the world to make influenza vaccines is limited. We use chicken eggs largely to grow the virus in. In a year to 15 months after a pandemic began, we could probably make only enough vaccine to vaccinate less than a quarter of the world. It turns out that the mRNA technology, the same we use for COVID, actually can be applied to influenza. And that it’s not gonna be a better vaccine in the sense that it’s gonna protect a whole lot more, it’ll still provide that same protection we saw with the COVID vaccines, but we can make enough vaccine within a year to probably vaccinate the whole world. That’s the difference in millions of lives lost, just that one simple decision. And we need these vaccines badly for future pandemics. And right now the likelihood of that happening is, is close to zero because of that decision.

SREENIVASAN: You know as, as part of the rationale for these cuts, secretary RFK Junior said “The data shows,” this is his words, “these vaccines fail to protect effectively against upper respiratory infections like COVID and Flu. We’re shifting that funding towards safer, broader vaccine platforms that remain effective even as viruses mutate.” How do you respond to that?

OSTERHOLM: Well, let me put it into context. One is science. Science has given us some major improvements in health over the last a hundred years that meant that life expectancy rose from the fifties to the nine– into 80 year olds just in one year or one 100 years. And today, we have to count on science. Unfortunately, what Mr. Kennedy is promoting and sharing is in fact misin- disinformation. What we really call magic or smoke and mirrors. And the public has to understand that his comments, while they may sound very professional and official, are meaningless, that in many cases they make no sense whatsoever. And so we have to continue to emphasize if we wanna maintain the kind of health protection we’ve had in this country and around the world, and improvements on it, even when we have had great challenges with infectious diseases, we have to stick with the science. If we follow the comments, the recommendations or the actions of Mr. Kennedy, we are doomed to see public health really denigrated greatly.

SREENIVASAN: You know, back in 2017, you wrote a book called “Deadliest Enemy,” and it was prescient in a way. And now you’ve teamed up with the same co-author Mark Olshaker, and you wrote “The Big One: How We Must Prepare for Future Deadly Pandemics.” And I think, you know, a lot of viewers will be surprised that your fear is not the COVID-19 vaccine. It’s actually something you know, worse, and you play out these kind of worst case scenarios. And how we should prepare for that. Explain.

OSTERHOLM: Well, when I say worst case scenario, lemme just be clear, I’m not even sure that this scenario is the worst case. It’s a very realistic situation. If the listeners may remember back in 2003, we had a global outbreak of SARS. At that time, the first real coronavirus infection that caused serious illness in humans. Because that virus was not very infectious, we were actually able to suppress it to transmission and stop it from being spread around. But it did kill 15 to 20% of the people that got infected. Then along came MERS, the Middle Eastern Respiratory Syndrome, another Coronavirus infection in 2012 in the Middle East. And that virus then also spread to Seoul, Korea in 2015 when a visitor to Saudi Arabia returned back to Seoul with this virus infection. In those instances, this, the, the MERS virus killed actually almost to 35% of the people had infected.

And so you can see the difference with what happened with COVID, where it’s only about one and a half percent of people died. And I say only with great regret. So the point being here is, is that if you had a new coronavirus that could kill like SARS or MERS, but be spread like SARS CoV-2 or COVID, that would be disastrous. And that’s what the scenario is about. Well, guess what? In just recent months, we’ve actually found viruses in bats and caves in China that have the ability to spread likely that of what we saw with COVID. And they also have onboard the same genetic pieces that would make it possible for them to cause very serious illness with deaths potentially in that 15 to 35% range. So this is not some kind of science fiction in that sense. This is, I think, anything just a, a harbinger of things to come, reality that we have to deal with. 

SREENIVASAN: So if you could summarize, what are some of the biggest mistakes that we should be learning from, from COVID?

OSTERHOLM: Well, first of all, we didn’t understand as a society that this was gonna last for three years or more. And therefore we planned for it much like you might think of with a severe hurricane, where basically you find, you know, for 12 to 18 hours, it’s, it’s, it’s horrible. But you can go into recovery shortly thereafter. And so one of the challenges we had early on is that people wanted to approach this from the idea of a lockdown or closing everything down, and then we’d come back out the other end. And unfortunately we had a number of our leaders saying that that is what would happen.

We, in January of 2020, actually laid out the fact that this is likely to last many years as two, three, maybe even four. And we had to be prepared. How are we gonna handle for that? And what our real goal was, was, it should have been at least, was to make sure that our hospitals were not overrun. The one thing that could save more people’s lives was to have adequate healthcare. But if you’re running your hospital 140, 150% capacity, at that point, you didn’t really have any chance to hopefully provide better medical care. And so one of the things we propose is, rather than doing lockdowns, is use what we call snow days. So that if in fact you are in a community where your hospital bid census is now at a hundred percent – and you know that number every day, it’s publicly made available – at that point, you can say to the public, please, for the next you know, 10 to 20 days, we need to back off whatever we can in terms of public engagements crowds coming together, et cetera, so that we can get that census down in our hospitals and hopefully provide medical better medical care. If we had done that, that would’ve made all the difference in the world in people understanding that lockdowns aren’t the answer. There are a number of events just like that, that we could learn a lot from with COVID.

SREENIVASAN: Just this last week we had the director of the Centers for Disease Control removed by RFK Junior and we had several officials who resigned. One of the officials in an interview said that, “based on what I’m seeing, based on what I’ve heard with the new members of the advisory committee for immunization practices or ACIP, they’re really moving in an ideologic direction where they want to see the undoing of vaccination. They do want to see the undoing of mRNA vaccination.” What does that mean for our public health?

OSTERHOLM: Well, in very simple terms, it’s a disaster. We are literally watching a hundred years of public health activity that has resulted in saving millions and millions of lives potentially flushed down the drain. And it’s that important for the public to understand that because you need to be talking to your local, your national elected officials and saying, is this the kind of government that you want to provide to us? Because this is not an issue where one day we’ll still have a debate, well, which one was right? I can tell you what’ll be right. It’s gonna be the science side will be right, because the numbers of people who will die because of following the same kind of ideology approach are gonna become very apparent and, and, and not a too distant of a future. Again, if we had that same mindset going into a pandemic right now, it would be an utter disaster.

And it’s not just HHS and Health and Human Services Center, that Secretary Kennedy heads up. Right now, there’s no one in the White House, no one who is overseeing bio-preparedness for a future biologic event, one that might even be manmade, meaning a bio terrorist attack or a pandemic. This is such a major, major shortcoming in our preparedness. And so I think we need to take a step back. And I, I just wanna point out that again, ideologically in the first Trump administration, they did a lot of really good things to help get us better prepared for a bio preparedness event. And, and I don’t know why now, suddenly that type of activity is frowned on, if not totally discouraged, when in fact, that was the hallmark of the Trump one administration.

SREENIVASAN: We had recently a man who, you know, opened fire at the Centers for Disease Control in Atlanta, and he was motivated in part, I guess, by his discontent with the COVID-19 vaccine. And that leads me to kind of come back to that sort of disinformation question. I mean, you know, on the, on the one hand of the column here, you’ve got scientists working with a series of facts. You’re talking about, you know, efficacy and trying to communicate better. Then on the other hand, the team that wants to disinform and actively, you know, engage users for their clicks, et cetera, they don’t have to do any of that. They just have to have emotional appeals and kind of get into somebody’s head. And that is pretty effective.

OSTERHOLM: That’s scary. And let me just tell you, on a personal level, having, you know, been in the front row of the pandemic response during COVID and having received death threats, I know what the concerns are of many of my colleagues in terms of why do we do our job every day? What, what do we do to protect ourselves and our family members? This is a huge challenge. And in the first instance, the public has to understand what’s at risk here. Is – losing public health will mean that there will be many, many more outbreaks of diseases that we could easily control with vaccines or by having safe water supplies, dealing with mosquito populations that are suddenly spreading exotic viruses around the country. That’s the kinds of things that public health does all the time. And if public health does its job really well, you never hear about anything because we actually prevent it from happening.

And I think that’s what the challenge is right now, is because we have enjoyed so much prevention from groups like CDC over the years, people say, ah, it’s not really necessary. Well, it will come back. And again, I just wanna stress over and over again. We can’t prepare for the big one if we’re not in fact preparing for everyday events right now. Somebody has to call the question, are we going to continue to pursue the kind of activities that Mr. Kennedy wants us to do, that some of the public are surely willing to even bring violence to the table to deal with that issue? Or are we going to continue to maintain that science-based approach where basically we’re constantly learning about these infectious diseases or other health conditions and trying to make the world a better place? Remember, no one goes into public health to get rich. No one goes into public health to become famous. People go into public health to serve, they go into public health to help. And that’s, I think, the question we have right now: what is it gonna take it to get us back to that norm?

SREENIVASAN: You know, right now our conversation so far has been focused primarily on the United States, but I also wanna ask about what happens when USAID has been slashed, as it has been, and what our visibility is for viruses, future pandemics overseas. Because viruses don’t care about borders. Right? And I, and I, and I wonder, is there – you know, that loss of funding and infrastructure, can you either quantify or qualify the effects that that will have downstream?

OSTERHOLM: We have withdrawn support, as you noted from USAID, one of the most successful soft power efforts ever put forward by any government, not just ours, in terms of lives saved, in terms of the endearment of locals in countries around the world for the United States support, and as well as the fact we pulled out of the World Health Organization. We’re no longer a member there. We actually are not part of the routine communications. We are not contributing to knowledge at WHO, but we’re also not learning from it. Why is that important? Because there are so many infectious diseases, for example, that start on a distant shore and can come to our country.

You know, look at what happened in 2015/16 with Ebola in Africa, and the concern we had for getting here by not participating on the international level, we actually shoot ourselves in the foot in terms of protecting ourselves. Borders in of themselves will not keep infectious agents from going from one country to the other. What does make a difference is stopping those outbreaks in their tracks in the countries where they begin. And so we are losing all of that opportunity. 

We are going to see a resurgence of HIV AIDS, we’re gonna see a resurgence of drug resistant tuberculosis. We’re gonna see a resurgence of malaria and in areas that used to control the mosquitoes that are not now gonna happen. And guess what? They’re all gonna land in the United States eventually. And because we live in a world where travel now is so ubiquitous, we’re also gonna see US citizens going to countries around the world in much greater risk for being in that country than before because of this very decision to pull out of the global health arena. And so, all I can say is that this, again, is a penny wise pound foolish effort. We are not helping us at all. You know, we keep talking about putting America first. This puts America last.

SREENIVASAN: You’re leading an initiative called the Vaccine Integrity Project. What, what’s the need that you’re trying to address with this?

OSTERHOLM: Well, what we realized early on after the election was that based on the 2025 document and what the priorities were for dismantling public health, that one of the first areas to go was likely to be vaccines. And of course, with Mr. Kennedy being nominated for Secretary of Health Human Services, we recognized that his major anti-vaccine theme was gonna be carried through. Actually in November of last year I wrote an article in the New York Times laying out what likely could be lost in public health in the future with a Kennedy HHS appointment. And sure enough the vaccine issues that we worried about are happening. Let me just say that at, at this point it’s very, very clear that the kinds of things that we’re seeing happen at the federal level, are gonna continue to happen unless we see Congress step up and begin to insert itself into this process.

Remember, at the time when the confirmation hearings were held, we actually had Mr. Kennedy promising to Secretary ca– or to Senator Cassidy that he would not take vaccines away from anyone. Well, he did. That really brought us at the, our center in Minneapolis with the idea that we need to figure out what can we do to help out, if in fact, the ACIP, the advisory immunization practices is suddenly done in. What roles did they play? And so we started this new initiative, and with that, we actually first did focus groups in with a number of vaccine enterprise experts all the way from research and development to the final shot into the arm to say, what can any non-governmental organization do to help support ones– what was there with ACIP? And one of the things we learned was, in fact, to make recommendations for vaccine use, we needed to have a comprehensive data that the ACIP used to present.

Well, we picked that up. We actually, as a, a effort out of the VIP project, begin doing a review of all of the vaccine information for COVID, for RSV and for influenza to have it in time for the season, this upcoming winter season. And we did the analysis where we were able to identify over 17,500 different pieces of information, articles about these vaccines. We summarized that using a very specific protocol approach and that is now the information being used by our medical societies to determine their own vaccine recommendations, and so from that perspective we are now providing what ACIP once did.

SREENIVASAN: Founding Director of the Center for Infectious Disease Research and Policy at the University of Minnesota, Dr. Michael Osterholm, thanks so much for joining us.

OSTERHOLM: Thank you.