Biden Covid adviser David Kessler to exit as pandemic response winds down

WASHINGTON — David Kessler, the D.C. veteran who guided government dispatches of millions of Covid-19 vaccines and treatments, is exiting the Biden administration this month.

His departure comes as the White House winds down a nearly three-year public health emergency amid stabilizing case trends, but also continues to grapple with depleted coronavirus response funds and public fatigue around the virus.

Kessler, a pediatrician and former Food and Drug Administration commissioner, leaves weeks after top infectious disease official Anthony Fauci retired, vacating an NIH role he held for nearly four decades and his post as President Biden’s top medical adviser.

Kessler’s departure comes amid looming questions about when the public health emergency will end. Health and Human Services Secretary Xavier Becerra just this week extended it for another 90 days, but this could be the last extension as coronavirus deaths, hospitalizations, and vaccination rates flatten.

“Whether he was leading our effort to develop and distribute safe and effective Covid-19 vaccines and treatments, or sharing his perspective during daily strategy sessions and data deliberations, Dr. Kessler’s contributions to our COVID-19 response have helped save lives,” Becerra said in a statement.

Kessler came into the Covid-19 response during “a transition from Operation Warp Speed to an Operation Warp Speed-like approach,” Fauci told STAT, referring to the Trump-era effort to develop new vaccines and treatments. “We had to really put a major effort into the actual vaccine distribution,” he added, noting Kessler always served as a “strong liaison” between the administration and companies racing to develop then distribute vaccines and drugs.

Then-presidential candidate Biden brought Kessler and longtime ally Vivek Murthy on board as advisers in March 2020 amid the first widespread coronavirus lockdowns. Kessler and Murthy, who Biden later tapped for surgeon general, “would be up until four in the morning” preparing briefings for Biden on the evolving pandemic, “what we were dealing with and what would need to be in place … once he became president,” Murthy told STAT.

Kessler officially joined the White House Covid-19 task force as chief science officer in early 2021, weeks into the rollout of the first coronavirus vaccines. Working under Biden’s pledge that 100 million shots would get into Americans arms in his first 100 days, Kessler’s team dispatched hundreds of millions of Moderna and Pfizer-BioNTech vaccines around the country while managing the fallout of a safety pause on Johnson & Johnson shots and manufacturing concerns with other vaccine makers.

The administration hit its 100-day goal that March. But what had started as a sprint to meet overwhelming national demand soon turned into a campaign to convince vaccine holdouts. By late summer, the message had grown more complicated, as Biden officials realized Americans would need booster doses to keep up against new strains of the virus.

Today, while the administration has distributed nearly a billion shots nationwide, 663 million have been administered. Just under 70% of the eligible population is considered fully vaccinated and only 15% have gotten at least one booster.

Kessler also handled government purchases and distribution of different coronavirus treatments, such as the pill regimen Paxlovid and a range of monoclonal antibodies that became vital injections for immunocompromised people looking to prevent infection. He and other officials have warned in recent months that without new Covid-19 funding from Congress, the federal health agency won’t be able to purchase new treatments, even as antibody options are depleted.

However, the prospect of new coronavirus response funding is increasingly unlikely. No specific funds were allotted in the recent sweeping omnibus package, and Republicans have grown more critical of the administration’s spending, questioning where billions of dollars appropriated in past legislative packages have gone.

Biden officials have said they had to “repurpose” money to meet different needs as the pandemic evolves. “This entire time as we’ve been fighting Covid, we’ve been talking about making hard choices, given limited funding,” a senior official told reporters in December when the administration announced a new round of free Covid-19 tests.

Kessler also guided the nation’s international vaccine donations, agreements that occasionally came under fire from public health advocates who argued that the administration was slow-moving and primarily donating less-preferred vaccines from Johnson & Johnson and AstraZeneca, the latter of which was never authorized in the United States.

Advocates also pressed for pharmaceutical companies to waive patent rights so lower-income countries could produce the shots themselves, a plan Biden backed away from after an initial pledge to pursue patent waivers.

Kessler’s team instead engineered a September 2021 deal with Pfizer and BioNTech to donate 1 billion shots to international organizations.

That did not totally cool criticism from public health advocates. Weeks later, co-panelists at an event about worldwide vaccination efforts interrogated Kessler about vaccine makers refusing to share manufacturing information with facilities in other countries such as South Africa.

“We don’t have a great track record of doing this. It’s very hard,” Kessler said at the time, but maintained that in the short-term, donations were easier than setting up new facilities. “I’m not saying that there’s not a lot of work ahead, but I think it is absolutely essential to begin now, recognizing that it will take several years to build capacity on the African continent.”

Besides the occasional panel discussion, Kessler generally kept a low profile as he helmed the vaccine and treatment efforts.

Before becoming a central figure in the coronavirus response, he was a vocal advocate of better tobacco regulation and nutrition education. The longtime pediatrician first became FDA commissioner under George H.W. Bush, but soon became a Democratic favorite for his efforts to regulate tobacco and improve over-the-counter drug oversight. He stayed on at the agency under Bill Clinton, becoming the first commissioner to have served across two administrations.

After leaving the FDA, Kessler served as dean of two different medical schools and focused largely on nutrition issues. However as the pandemic worsened, he and seven other former commissioners banded together to urge the Trump administration not to politicize vaccine development.

“A safe and effective vaccine will not be enough; people will also have to choose to take it,” Kessler and the others, including now-returned Commissioner Robert Califf, wrote in September 2020 amid public statements from President Trump suggesting there would be an FDA-authorized shot before Election Day.

“If the White House takes the unprecedented step of trying to tip the scales on how safety and benefits will be judged, the impact on public trust will render an effective vaccine much less so,” the former officials wrote in The Washington Post.