WASHINGTON — President Donald Trump is so fixated on finding a vaccine for the novel coronavirus that in meetings about the U.S. pandemic response, little else captures his attention, according to administration officials.
Trump has pressed health officials to speed up the vaccine timeline and urged them to deliver one by the end of the year. He has peppered them with questions about the development status and mass-distribution plans. And, in recent days, he has told some advisers and aides that a vaccine may arrive by Nov. 1, which just happens to be two days before the presidential election.
Trump's desire to deliver a vaccine — or at least convince the public that one is very near — by the time voters decide whether to elect him to a second term is in part a campaign gambit to improve his standing with an electorate that overwhelmingly disapproves of his management of the pandemic.
"We remain on track to deliver a vaccine before the end of the year and maybe even before November 1," Trump told reporters at a Friday news conference. "We think we can probably have it some time during the month of October."
Trump has repeatedly offered similar promises, adding to the pressure scientists and officials at the Food and Drug Administration and the National Institutes of Health feel to develop, test and authorize a coronavirus vaccine on what some of the president's aides refer to as "Trump time."
Several Trump aides said one key to the president winning reelection is having a vaccine or demonstrating rapid progress toward one, as well as a robust economic turnaround, over the next two months.
Democratic strategists, too, said a vaccine announcement could play in Trump's favor, but they cautioned that it is unlikely to significantly change the contours of the race.
“If they pull a vaccine out of their a — it will be the October surprise of October surprises,” said Cornell Belcher, a Democratic pollster. “I think you’ll see some of the angst lifting off of the American electorate. But I think it will be difficult connecting the dots to Donald Trump given where public perception of him is on COVID, and given that this is a guy who a couple months ago said people should try to get sunshine and disinfectants inside of themselves.”
There is intense disagreement over whether the FDA should use its emergency authority to clear a vaccine before it is formally approved, which some in the scientific community say could be dangerous.
Top health officials, including FDA Commissioner Stephen Hahn and Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, have said a vaccine could be available before the end of the year. But they have been careful to qualify their statements and, unlike the president, have stopped short of promising one by then. White House officials also have been careful not to project a specific date for a vaccine announcement.
Fauci said in an email that "the most likely timetable for a vaccine to be utilized by the public" is November or December of this year or the beginning of 2021. He said it is "unlikely, although possible" that the efficacy and safety of a vaccine could be determined in October.
Asked about an emergency use authorization by the FDA, Fauci wrote, "If an EUA was granted before we had established that the vaccine was truly safe and effective, I would be disappointed. An EUA for a vaccine should be based on a considerable degree of safety and efficacy … I would be against an EUA if it were issued without sufficient data to establish a strong signal of efficacy and safety."
Other experts said it was unlikely that a vaccine would be ready by Election Day, but that Trump could be able to tout progress on it before people vote.
"Everything would have to be unfolding according to perfection," said Scott Gottlieb, a former FDA commissioner in the Trump administration. "The vaccine would need to be highly effective, and you'd need to have trials ahead of schedule."
Democratic presidential nominee Joe Biden has accused Trump of putting "political considerations ahead of the safety and well-being of the American people with tragic results" throughout the coronavirus pandemic. The former vice president said in remarks Friday, "My guess is he is going to announce a vaccine, he's going to say it's going to be available around Election Day, he's going to hype it."
Biden spokesman Andrew Bates said Biden is eager for a swift vaccine, but not at the expense of safety.
"Joe Biden wants a safe vaccine ready yesterday," Bates said in an email. "But there is no excuse for the wealthiest, most technologically advanced nation in the history of the world being the hardest-hit by this pandemic. The inescapable, tragic, infuriating reality is that Donald Trump has never taken the deadliest public health crisis in 100 years seriously."
FDA officials both publicly and privately insisted that politics will not influence their decision on when to approve a vaccine. Current and former administration officials, as well as vaccine experts, said they were confident in the career regulators at FDA to make a science-based decision.
One former senior administration official, who spoke on the condition of anonymity to share a candid assessment, said the FDA's leadership is "weak" and "fails to articulate that it's going to stand for regulatory science." But this official expressed confidence in the officials at the FDA's office of vaccines.
"I know they take this responsibility very seriously and they understand what's at stake," this official said. "Without a clear blessing from this office, I don't think Americans would be willing to be vaccinated."
Underscoring the concerns about the vaccine process appearing political, the Trump campaign communications director Tim Murtaugh was unwilling to discuss the politics of vaccine development or assess how a possible breakthrough could impact the campaign — even though Trump's second-term agenda, distributed by the campaign, includes "Develop a Vaccine by The End of 2020." Murtaugh deferred all questions on the matter to the White House.
White House spokeswoman Sarah Matthews said in an email, “The rapid research, development, trials, and eventual distribution of a COVID-19 vaccine is emblematic of President Trump’s highest priority: the health and safety of the American people — it has nothing to do with politics. This President understands that this vaccine cannot get bogged down in government bureaucracy, which is why he has cut through every piece of red tape to achieve the fastest-ever launch of a trial.”
Inside the West Wing, there is some concern and nervousness about "potential politicization" and people not trusting a vaccine if they believed it was produced in a "rushed process," according to a senior administration official, who like some others interviewed for this story spoke on the condition of anonymity to be candid.
The administration has developed Operation Warp Speed, a process to mass distribute an eventual vaccine, and is planning a $150 million public service announcement campaign to convince people that the vaccine is safe, effective and can be trusted, this senior official said.
The communications strategy developed at the White House would limit Trump’s personal messaging about a vaccine — other than to “spike the football,” as the senior official put it — and instead be led by experts, including Fauci, Hahn, White House coronavirus response coordinator Deborah Birx, and Moncef Slaoui, the chief scientific adviser to Operation Warp Speed.
The White House plan would stress to the public that a vaccine went through the "traditional FDA rigor," as well as seek validation from throughout the scientific community, in medical journals such as the New England Journal of Medicine and from medical professionals with large media platforms, such as CNN's Sanjay Gupta, according to the senior official.
The plan, according to a draft shared by the senior official, is to “replace distrust, disbelief, skepticism and cynicism with trust, credibility, confidence, certainty, transparency and optimism for COVID-19 medical countermeasures.”
Although the White House aims to depoliticize the vaccine rollout, the draft plan lists as one of its objective to "ensure the administration is able to receive due credit for undertaking this historic and unprecedented effort."
Trump's opponents are preparing for the president to try to mislead the public about the status of a vaccine in the run-up to the election, much as he has exaggerated many other aspects of his record over the years.
Rick Wilson, a strategist who helps run the Lincoln Project, a group of anti-Trump Republicans airing advertisements aimed at defeating him, said the group's internal polling data suggests that many voters would not trust whatever breakthroughs Trump proclaims.
"We think Trump's lying is priced-in with a lot of people," Wilson said. "So if he could say tomorrow, 'We've cured it, it's done,' many people, even some of his supporters, will say, 'That's just Donald being Donald.' "
Officials on the administration's coronavirus task force said that a vaccine was not on the agenda in the early months of the outbreak. Vaccine developments are discussed in smaller groups or among the principals directly involved.
"We should have been talking about a vaccine instead of having weeks of discussions on masks, but they have caught up well now, it seems," said one official familiar with the task force.
As part of the administration's communications push, Slaoui and Health and Human Services Secretary Alex Azar wrote an op-ed published Wednesday in USA Today describing how the United States was developing a vaccine at record speed with safeguards in place.
"The strategy we devised for OWS will allow us to accomplish this goal while following all the same procedures for safety and efficacy, applied by the same apolitical FDA experts, that Americans expect with all vaccines," Azar and Slaoui wrote.
Experts warned that Trump's promises that a vaccine would end the pandemic are dangerous.
"There's this general feeling that the vaccine is going to get us out of this. There are so many people hanging everything on the hopes of a vaccine starting in January," said Rochelle Walensky, chief of the division of infectious diseases at Massachusetts General Hospital. "Getting out of this pandemic has to be a multipronged approach and no single thing is going to get us out. Certainly I don't think a vaccine in the short-term is going to get us out."
Trump's repeated pressure on the FDA not only to approve a vaccine, but also to advance coronavirus treatments has undermined public confidence in the FDA, as well as in other federal agencies, according to medical professionals.
The FDA approved an emergency use authorization for hydroxychloroquine, an existing anti-malaria drug, to treat coronavirus, but had to eventually revoke the authorization because the drug was shown to be ineffective and cause heart problems in some patients.
Last month, Hahn and Azar appeared alongside Trump and hailed convalescent plasma as a "major therapeutic breakthrough" despite the treatment being around for more than 100 years and having only a modest effect.
“I’d like to think at this point in the administration, when people see Donald Trump hyperbolize, they see it as hyperbole,” said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia. “That’s the problem. If President Trump stands up and says, ‘This is a major breakthrough, this is going to save all our lives,’ people can’t necessarily believe that.”