DR. FRANCIS COLLINS: A Long Talk With Anthony Fauci’s Boss About the Pandemic, Vaccines, and Faith.

I am guardedly optimistic that by the end of 2020 we will have at least one vaccine that has been proven safe and effective in a large-scale trial. Nobody should accept it as safe and effective without that large-scale trial. There are at least four vaccines that will be getting into such large trials this summer beginning as early as July. Each one of those trials will involve roughly 30,000 volunteers, half of whom will get the vaccine, half of whom will get a dummy placebo. You have to have that control or you will never know if the vaccine worked or not.

Those trials will have to be conducted in areas where the virus is actively spreading because that’s the only way you’re going to know whether it was protective. With four different vaccines with four different approaches, we’ve kind of hedged our bets against putting too much emphasis on one particular strategy. That’s good — because vaccines are really interesting science, but every new virus presents surprises in terms of how the vaccine turns out to work. So I’d be very worried right now if we had one platform that everybody was counting on. Having four makes me feel a lot better.

Maybe all four of them will work. As long as one of them works, we’ll be in a far better position by the end of the year to see our way out of this global pandemic mess. But there will be, then, a time of having to do the scale-up to have billions of doses, which might be what the world needs. So there will still be some time involved, even though we are doing everything possible to prepare for that by manufacturing millions of doses of each of those vaccines even before we know if they would work, so that the highest-risk people can get access right away. So I’m guardedly optimistic that we will see all that happen.

I’d add a “Faster, please,” except that they’ve been making remarkably fast progress already.