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As he steps down from his decades-long career with the National Institutes of Health (NIH), Anthony Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID) and one of the nation’s leading experts on COVID-19, isn’t finished imparting his public health guidance. On Dec. 16, Fauci joined Massey Cancer Center’s Facts & Faith Fridays for the second time, answering questions on the winter risks of COVID-19, flu and RSV, discussing the outlook for this and future pandemics and sharing some of his proudest moments from his long tenure of public service.

The virtual discussion started with a few words from Va. Sen. Jennifer McClellan, a member of the VCU Health System Board of Directors and a candidate in the Democratic primary to replace the late U.S. Rep. Donald McEachin in Virginia’s 4th district. McClellan encouraged those eligible to vote in the Firehouse Primary on Tuesday, Dec. 20.

Jeanine Guidry, Ph.D., associate professor with VCU Robertson School of Media and Culture and director of the Media+Health Lab, then presented the results of a study of COVID-19 vaccine uptake in self-identified evangelical Christians. Out of the 530-person sample, 60% had not yet received a COVID-19 vaccine as of October 2021. Guidry and her team identified variables that seemed to impact the likelihood of vaccination, including the perceived benefits of the vaccine, conversations with healthcare providers and conversations with clergy.

“While we can’t generalize the results of this study to the entire faith community or even the entire evangelical community, the faith-based variables in particular show us that congregations can play a role in driving vaccination efforts,” said Guidry. “Pastors are not just there to take care of the spiritual lives of their congregation; they also can play a role in the physical health of their community. As trust in science has taken a hit over the course of the pandemic, there is opportunity for more partnerships between science and faith-based organizations.”

The program then shifted to a conversation with Fauci, moderated by Facts & Faith Fridays founders and community leaders Rudene Mercer Haynes and Robert A. Winn, M.D., director, Massey Cancer Center. Since the last time Fauci joined the program in Jan. 2021, COVID-19 rates have improved, and the number of deaths has been significantly reduced. Despite this trend, Fauci emphasized that the virus is still a threat heading into the winter months.

“Even though we’re doing much better than we were a year ago, we shouldn’t be complacent in thinking that 300 to 400 deaths a day is a good thing just because it’s lower than 3,000 deaths – it’s still too high,” he said. Noting that just 13% of the eligible population has gotten the updated BA.4-5 booster, he urged community members to go get their booster dose, adding “There’s no reason for anybody to die from COVID with the vaccines that we have and the drugs that we have to treat people. We’ve got to get the community to appreciate how important it is to protect yourselves, your family and your entire community by getting vaccinated.”

In response to a question from Haynes about whether changing recommendations on how often and when to receive the booster have led to confusion and fatigue from the general public, Fauci acknowledged the likelihood of a shift to an annual booster. “If we keep making recommendations about every 3, 4, X number of months people are going to get confused and they’re going to get put off. Once a year isn’t 100% perfect but it’s an orderly cadence that people can understand,” he said, adding, “The thing that’s unique about COVID is that the durability of protection is measured in months to a year – that’s in stark contrast to something like measles, where the duration and the durability of protection is measured at a minimum of decades. That is not the case with COVID, and we have to accept that [the vaccine] has to be boosted – otherwise you’re not going to be fully protected.”

Answering a question about the implications of COVID and the COVID vaccines on immunocompromised people like those undergoing cancer treatment, Fauci sought to correct a misimpression that if people are immunocompromised, they shouldn’t get vaccinated. “That’s a big mistake – that’s exactly the reason why you should get vaccinated, even though your response may not be as robust as someone who’s immune competent.”

Many families in the community are struggling this fall with the so-called “tridemic” of COVID, the flu and RSV, and Haynes asked Fauci why we were seeing such a surge. “The wearing of masks and the restrictions on movement specifically among indoor settings for the past two years has resulted in a sharp decline in influenza and RSV,” he explained. “When we got vaccines, and people were infected with COVID and had a degree of protection, they took their masks off, they went out into society and before you knew it flu and RSV were back with a vengeance because people did not have the experience of getting gradually infected over two to three years; now it’s like you’re having it all at once.”

After citing the many infectious disease events Fauci has overseen in his leadership role at NAIAD – including HIV, Ebola and SARS – and noting his dedication to putting diversity, equity and inclusion at the forefront of clinical trials and working to make them equitable and accessible, the moderators asked what he sees as his most impactful project.

“On sheer numbers alone it would have to be the fact that I was given the honor and the privilege by George W. Bush to go to Africa and be the primary architect of the President’s Emergency Plan for AIDS Relief (PEPFAR), because President Bush felt strongly that if there are countries in the world with poor resources who don’t have the capability of saving their lives by getting drugs, prevention and care that we have a moral obligation to help them with that,” Fauci answered. “The PEPFAR program has saved more than 20 million lives—that’s the thing I feel most proud and happy about.”

Throughout the program, speakers referenced the rise of misinformation and distrust in the medical field. “We have to continue as scientists, health care providers and public health officials to be out there and consistently coming out with evidence-based, data-based and fact-based information and guidelines,” Fauci emphasized. “Misinformation and disinformation is rampant, and when you get constant feeding of disinformation, after a while people don’t believe scientists anymore, which is a tragedy because if that happens their ability to provide appropriate interventions and preventions for people is going to be markedly impaired. We have got to be out there, all of us, actively spreading the truth and be consistent in what we say based on data, otherwise the disinformation is going to win out.”

Winn closed out the program giving thanks to Fauci for his service: “This belief and the courage you had to stand by science has actually stiffened the backbones of other scientists and health professionals around the country to know that the science is something we that have to validate and trust and that we can bring the science closer to our communities.”

Written by: Annie Harris