Factually! with Adam Conover - Where Oh Where is the COVID-19 Vaccine? with Derek Lowe

Episode Date: September 16, 2020

Drug discovery chemist Derek Lowe joins Adam to break down why producing an effective COVID-19 vaccine is so challenging, the science of how vaccines work, and the issues that arise when pharmaceutical research is conducted for profit. Learn more about your ad choices. Visit megaphone.fm/adchoices See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

You know, I got to confess, I have always been a sucker for Japanese treats. I love going down a little Tokyo, heading to a convenience store, and grabbing all those brightly colored, fun-packaged boxes off of the shelf. But you know what? I don't get the chance to go down there as often as I would like to. And that is why I am so thrilled that Bokksu, a Japanese snack subscription box, chose to sponsor this episode. What's gotten me so excited about Bokksu is that these aren't just your run-of-the-mill grocery store finds. Each box comes packed with 20 unique snacks that you can only find in Japan itself.

Plus, they throw in a handy guide filled with info about each snack and about Japanese culture. And let me tell you something, you are going to need that guide because this box comes with a lot of snacks. I just got this one today, direct from Bokksu, and look at all of these things. We got some sort of seaweed snack here. We've got a buttercream cookie. We've got a dolce. I don't, I'm going to have to read the guide to figure out what this one is. It looks like some sort of sponge cake. Oh my gosh. This one is, I think it's some kind of maybe fried banana chip. Let's try it out and see. Is that what it is? Nope, it's not banana. Maybe it's a cassava potato chip. I should have read the guide. Ah, here they are. Iburigako smoky chips. Potato

chips made with rice flour, providing a lighter texture and satisfying crunch. Oh my gosh, this is so much fun. You got to get one of these for themselves and get this for the month of March. Bokksu has a limited edition cherry blossom box and 12 month subscribers get a free kimono style robe and get this while you're wearing your new duds, learning fascinating things about your tasty snacks. You can also rest assured that you have helped to support small family run businesses in Japan because Bokksu works with 200 plus small makers to get their snacks delivered straight to your door.

So if all of that sounds good, if you want a big box of delicious snacks like this for yourself, use the code factually for $15 off your first order at Bokksu.com. That's code factually for $15 off your first order on Bokksu.com. I don't know the way. I don't know what to think. I don't know what to say. Yeah, but that's alright. Yeah, that's okay. I don't know anything. Hello, welcome to Factually. I'm Adam Conover. And look, let's think back to the first few months of the pandemic. There was this phrase that people used to say back then. You would hear it just on the wind. People would turn to one another at home, on their couches, just after having binged their 20th episode of Tiger King.

And they'd say, you know, when this is all over, I'm going to and then whatever, whatever fantasy they had of their previous lives, they would blurt out when this is all over. Now, it's been months and months and months, and I think we're all starting to come to terms with the fact that there is no when this is all over. This is just the world that we live in now. We now live in a world with coronavirus, with COVID-19, and we're going to have to adjust. So our fantasies are becoming more specific. Like one thing I would like to know is when I will be able to go work in an office again or to a sporting event or, hey, maybe even do my living and do comedy at a comedy club. That would be really, really wonderful. I mean, sure, maybe everyone do my living and do comedy at a comedy club. That would be really, really wonderful.

I mean, sure, maybe everyone at the comedy club will be wearing a mask. That would be fine. I would just like to feel safe in an indoor environment with other people, right? That's all I want. And even that seems a long way off. So when we talk about these plans for when it's all over, the closest to all over we're going to get, what we're really holding out for is a vaccine. We're expecting, we're hoping at least, that one day we can be injected with something that'll give us protection from the virus and

that will allow us to at least have a modicum of normalcy back in our lives. We're putting a lot of hopes on this thing, basically. And, you know, I'll be honest, that is not such a crazy idea because vaccines are without a doubt one of the most incredible inventions in human history. They have saved untold lives and increased the human lifespan on a massive scale. So it's not so weird to consider them our deliverance from pandemic and disaster. But if you look at their history, it's a little bit more complicated. There were some let's say there were some some bumps on the road. Let's go through it. Let's go through the history. In the early days, vaccination used to go by inoculation or variolation. Now, this practice

was long known in China, India, and Africa, but it didn't make its way to backwards old Europe until the 18th century, hardly the cradle of advanced civilization as it's often made out to be. Now, at that point in Europe, smallpox was killing up to 60% of adults and 80% of infants.

That's an enormous percentage of people. Those who survived had disfiguring scars all over their bodies. But the one saving grace was that you couldn't get it twice. So people would rub someone's scab. They would take the scab of smallpox, crush it up and make a wound on themselves and rub it into the wound or their kid in order to get a less deadly version of smallpox. And unbelievably, this actually worked. As opposed to 60% dying, only 2% to 3% of people who received the inoculation would end up dead.

So not a great safety ratio on the inoculation process compared to the drugs we have today, but it did, in fact, work with some horrible side effects. Now, of course, because it was killing that two to three percent, it did cause controversy. People didn't trust inoculation. The colonial era minister Cotton Mather actually had a bomb thrown in his house during a smallpox outbreak because of his inoculation efforts. And there were incidents in which the United States government would forcibly inoculate towns or areas in order to stop the spread of disease. But some people would die of those early crude inoculations. And the resistance to that practice

actually gave rise to a lot of the same ideas we see in the anti-vaccine movement today. to a lot of the same ideas we see in the anti-vaccine movement today. That movement is a lot less recent than we often think. But now look, that's inoculation. Again, we went from inoculation to vaccination because of the British scientist and physician Edward Jenner. In the late 18th century, Jenner heard that dairy maids were being protected from smallpox naturally after getting cowpox, which is a similar but

not fatal disease. And Jenner hypothesized that cowpox could be given to people to protect them from smallpox. So he got some pus from the fresh cowpox lesions of one of these milkmaids named Sarah Nelms, and he lanced that pus into a small boy named James Phipps. This is a revolting story. And it sounds very it sounds like it would be illegal in many different ways today. But I mean, in this case, I guess we could extend a little bit of happiness to the fact that they didn't have those laws because, again, this worked. It worked brilliantly. Jenner refined his technique into what we now know as vaccination, which gave it a scientific stamp of approval.

And over time, science made vaccines safer and safer and more and more effective. And since then, we have been able to use vaccines to eliminate smallpox. Smallpox just straight up does not exist in people anymore. This disease that used to kill vast numbers is now totally wiped out. And it's not the only one. The impact of vaccination since the 20th century is utterly profound.

Nearly 200 million cases of polio, measles, mumps, rubella, varicella, adenovirus. That one was eradicated so long ago, I haven't even heard of it. Rabies and hepatitis C and approximately 450,000 deaths from these diseases were prevented in the U.S. alone. Now extend that to the rest of the world and it starts to really stagger the mind how many lives have been saved and how much suffering has been ended by vaccines. So we know vaccines work. So we want one for COVID-19 now or yesterday.

I mean, March would have been great, but we'll take it as soon as we can get. Here's the problem. Vaccines are incredibly hard to make. It can take upwards of a decade to develop a new vaccine. The biology is super complex and so are the trials. You can't just give someone a potential vaccine and expose them to the virus.

That would be unethical, even if it worked. No, you have to give thousands of people a potential vaccine and thousands of people a placebo and then see what happens to those two groups over time in their environment. And if it seems like just one person in the study might have had an adverse effect, as happened just this past week

in a trial of the COVID vaccine being developed by that company, AstraZeneca, the entire trial comes to a halt. This is how science works, slowly, and that's why it can take up to a decade. But look, we don't have up to a decade. We need a vaccine so we can restart human society, hopefully better than it was before. I'd love it to be a little bit greener

and more equitable, but, you know, we need to get things going again. So we need this vaccine as soon as possible. And as a result, there is today an unprecedented effort by companies and governments around the world to develop a vaccine as soon as possible. So how are they doing it? What is the progress? How do they make such a thing safe? Do we even have a shot at developing a vaccine as quickly as we need to? Well, to answer these questions, we have an incredible guest for you today. Derek Lowe runs In The Pipeline. It's an amazing and detailed blog on drug discovery and development published by the academic journal Science Translational Medicine. He has a Ph.D. in organic chemistry and he has worked in the pharmaceutical industry for decades. Please welcome Derek Lowe.

Derek, thank you so much for being here. Oh, thanks for having me. OK, so let's just break it down. I've been in my house almost never leaving for since March. I'm I haven't done stand up comedy in in months and months. I'm going stir crazy and I'm trying to figure out when's the next time I'll be able to do live comedy again. Well, when we all get a vaccine, that'll be when things change is my hope. When do you think is the earliest that might happen? What are the prospects from where you sit? What does that look like?

Sure. Yeah, these are the questions that everybody wants answered. And I can see why, because I feel the same way. I haven't actually eaten in a restaurant since back in early March. I haven't even been to my workplace physically since in March. It's a strange feeling and everyone wants it just to be over. Vaccines, though, it's going to come down to how comfortable are you being an early adopter? Because we're pushing the vaccine timeline faster than it's ever been pushed before. I think the previous world record for vaccine from a standing start is like three, four, five years.

And that's the Usain Bolt of vaccines. Exactly. Exactly. That's as fast as it's ever happened. And now we're talking about, can you have something for me by Christmas? Or perhaps, can you have something for me by the election? Yeah. So these are just timelines that we've never explored before. Well, so walk me through the timeline of how a vaccine is made. I mean, first of all, really basically, what the hell is a vaccine and how are they made? And especially when you have a brand new disease, how do you make one? Yeah. So a vaccine is just an attempt to mimic what would happen if you got the infection anyway, because if you have the misfortune to be

infected by the coronavirus, your body, it should anyway, start to generate an immune response. You start to find antibodies because you have tens of millions, hundreds of millions of different antibodies floating around your blood the whole time. They're built on spec, as they would say out in the film business. They're just hanging around, hoping that they find something to bind to sometime during your lifetime. And if some of these bind to this new pathogen, your immune cells start amplifying them and start cranking out more copies of these things. That's what should happen. And if you get a strong immune response with antibodies and with another line

of defense called T-cells, then you can fight the infection down and get better. So a vaccine is just an attempt to make this same thing happen without actually giving you the disease in the first place. So that gets back to your question about how do you even make a vaccine, especially for something new like this? even make a vaccine, especially for something new like this. Well, we actually had a leg up because of the SARS epidemic back in 2003, because this new coronavirus is pretty similar to SARS, nastier, more infectious, but pretty similar. So a lot of work was done back then trying to find a vaccine. And that really did help out because we already knew that there is a particular group of proteins on the surface of this virus that our body reacted to, specifically one called

the spike protein. And there's another one called NP, nuclear protein. But the spike has gotten the most attention. And it really does seem to be a good candidate. If you could get something like the spike protein into a person, inject it in, your body would look at that and go, whoa, foreign protein, immune response, come on, attack. And that attack and the memory that it raises in your immune system should be enough to protect you against a real coronavirus. So that's just like a little piece of the virus, like a protein on a surface, you said, and you were just able to somehow take that out

and inject that into a person. You're making this sound very easy. Oh yeah, oh yeah. And that's my problem, is that a lot of this stuff that I do for a living, drug discovery, sounds in principle kind of easy until you actually try to do it. And then you find yourself spending half a billion dollars and it doesn't work anyway.

So I just want to come back to that. You said the immune system has a memory. Can you can you elaborate on that? That sounds really cool. It is. It's a really neat feature. You've got a couple of kinds of memory. Sounds really cool.

It is. It's a really neat feature. You've got a couple of kinds of memory. When you have antibodies that react to a new infection, these get amplified by what are called B cells. And we are not going to explain immunology here because it's 500 pages in small type and will drive you insane. Molecular biology was the one subject in school I could never, I could not process it. So please don't go into too much detail. Give me the,

give me the gist. I'm good with metaphors. There we go. We're going to be using a lot of them because immunology, to use a metaphor, immunology, when you start studying it, you find yourself opening a door and stepping into what looks like an infinite corridor with lots of doors. And you pick a door and open it, and it opens onto another infinite corridor with lots of doors. It's that kind of subject. It's just crazy. It's just infinitely deep in like all directions. It's amazing. And there's a lot we still don't know about it. There are whole careers being made trying to figure out some of the puzzles. But the memory part comes from these B cells. It's a particular kind of white blood cell whose only job is to make antibodies. And when some antibody turns out to be

really good at blocking a new pathogen, blocking a new infectious agent, then these B cells get signals to make more of them. And some of them hang around for years or decades. They actually go down and hide in the bone marrow and sit there. And they will live, in some cases, for the rest of your life, sitting down in the bone marrow, the exact same cells, getting older, but still waiting to see if this thing ever comes back. Getting older, but still waiting to see if this thing ever comes back. They actually were able to test some people who had the 1918 influenza, that horrible pandemic right after World War I. Yeah.

They still have B cells in their blood. Wow. When it's like 80 and 90 years later, they still have B cells waiting to see if that influenza ever shows its head again. These cells are like the soldier on the island who was never informed the war is over. You know, it's just sitting there with a gun going, if they attack, I'm ready. Exactly. Or like the fellow in England that they supposedly paid to watch on the coast to see if Napoleon was coming and they didn't get rid of the job for like another 120 years. But that's it. That's exactly what they do. These things are sentinels and they're sitting there waiting. You also have T cells. That's the other thing I mentioned. The antibodies attack the virus or bacterium directly and stick to it and trigger other white blood cells to come

attack these things and eat them or whatever, or just blocks them from ever sticking on to your human cells. The T cells don't do that. They look for your cells in your body that have been infected, and they kill them. If they just patrol your own cells, they kind of give it a signal like fighter aircraft use you may have heard of this thing called iff a friend or foe radio signal that fighter jets are constantly sending out to show no don't fire a missile at me i'm one of yours yeah the body does the same thing t-cells are constantly going around interrogating yourselves and saying are you one of us or have you been turned and that's the system. Now this is,

I'm remembering like childhood education in this. This is the system that's disrupted by HIV, right? Exactly. That was the insidious thing about HIV is that it messed up the T cells. So you no longer had this line of defense going around checking for infected human cells and killing them off. Yeah, that was the big problem. Fortunately, the coronavirus does not do that. And thank goodness. Okay, good. Well, so let's talk about the actual vaccines that are being made and what the progress is and what the challenges are. Because you said, okay, sounds simple, but it could cost billions of dollars and take you years and still not work. We would like something faster than that for this virus. So, yeah. What are what are the projects that I've read that the University of Oxford vaccine is like the press is saying it's, quote, out in front of the vaccine race? Is that tell me about that? And is that deserved? It's way up there.

Is that deserved? It's way up there. It's hard to say who's in front right now because we've got three, four, five candidates that are all deep into human trials, and we're all sitting around waiting for the key numbers. We've seen numbers on all of these when they give them to people who aren't sick and seen that, yeah, they do generate antibodies and they do generate these reactive T cells just like you want. All of the candidates seem to do what they should do. But now we're getting to where the pharmaceutical rubber hits the pharmaceutical road.

Will these things protect you from getting the coronavirus? Or if you do, will they keep you from really getting sick or passing it on to others? And we don't know. The only way to find that out is to give it to thousands and thousands of people and watch to see how many people get sick and how sick they get. So it's going to be like a live human trial on us. Absolutely. It's going on right now.

Moderna has 30,000 people. Pfizer has 30,000 people. Oh, really? They're already doing this? They're already doing it. Johnson and Johnson has started enrolling up to 60,000 people. The Oxford AstraZeneca group has got thousands of people all around the world. It's going on right now. It's an unprecedented thing. We've got what's basically a giant immunology demolition derby going on right now. And we're all going to find out more or less at the same time how all these things work. Now, those people in the trials, they obviously cannot purposefully infect them with coronavirus. So is it just that they're giving, hey, we got 30,000

people who agree to take this vaccine. And then we ask them every couple of weeks, hey, have you gotten coronavirus? And we just see if that population has seems to have a lower infection rate than, than, uh, you know, a random 30,000 control people. That's pretty much it. And only you don't take their word for it. You test their blood over and over and you test their noses and everything. That's it. And to do that well, you have to go to the places where the coronavirus is actively spreading. So that means you have to pick places where the chances of getting it are fairly real. So you don't want to go to New Zealand, for example. You want to come to LA, where I live. Right, there you go.

Yeah, you want to go to places where there's a real problem. Right now, I would say Des Moines, Iowa might not be a bad choice. But you have to keep moving because there are places where the epidemic will kind of spike up and then come back down. the epidemic will kind of spike up and then come back down. And if you find yourself committed to a big trial, when the coronavirus infection seems to be receding, you could be left high and dry as far as your data go. Wow. So what are the differences between the different vaccines? Are there differences between them that would be interesting or even intelligible to me? I'll take a crack at it. There really are.

And that's another unprecedented thing because we have so many different kinds of vaccines going at the same time. That's actually good news because most of the time, most things don't work in my business. We have like a 90% failure rate. Across all drugs? Across all drugs in the clinic. It's brutal. And vaccines aren't much better. But in this case, we had a leg up because of the SARS business. We knew that the spike protein is probably a good thing to go for. And we've got so many different techniques going that I'm actually kind of hopeful. So, yeah, I can try to break those down for you. Let me see.

First one would be what we were talking about earlier. Find that protein and just inject it. Novavax is a company that's doing that, and there are some others. They are just making this protein industrially, like the spike protein, and giving it to you. Now, that technique, you usually have to add something else called an adjuvant, which is something to make your immune system really sit up and notice. Sometimes it's like these compounds from tree bark. They used to use aluminum salts. Sometimes those are still in there. It's really kind of voodoo. There are just some

things that when you inject them, the immune system goes, whoa, what the hell was that? And sets off a bigger response. So that's one, you inject them, the immune system goes, whoa, what the hell was that? And sets off a bigger response. So that's one, you inject the protein directly. Another one is you cause your own body cells, some of them, to make that protein, just like it was a virus infecting you. And one way to do that is to take a real virus, rip out its genetic material and substitute in a little genetic instruction set just to make that one coronavirus protein. Wow. That's what the Oxford vaccine is. Oh, wow. So it's like a little it's like a zombified version of the of the actual virus that instead of getting you sick it just does like a very

it just what makes the protein instead exactly it just makes that one coronavirus protein and it can't make copies of itself like a real virus so it just goes in whatever cell infects it makes that cell spit out coronavirus protein and stop so that's what the oxyvirus does now let me just say that's a it's kind of a creepy prospect, right? Because it really, it feels like, it starts to feel like when people get worried about, you know, biologists playing God, right? That we've taken this virus and we've rewired it and now we're going to infect you with it. But no, no, no.

We know the mechanics of how your cells work well enough that we know that this is going to have a very specific effect on you. Like it sounds like one of those, you know, when I hear about CRISPR, you hear, you get winked out by when I learned how CRISPR works, um, like this sort of like really molecular tinkering with, with, uh, cells. Um, I, I feel similar when, when you describe that, I mean, what do you think? Yeah, I can, I can understand that feeling, but if we don't get a chance to play god with this one we're not going to have anything for you very quickly yeah yeah i'm not saying that's a reason why i wouldn't take it i just mean you know yeah it's true and this technique

this idea of having a hijacked virus like this has been kicked around for years. But this is now, there's only been one vaccine that does it. The Ebola vaccine actually works that way. It uses another virus called VSV and is rejiggered to only make an Ebola protein. So the same team that did that is trying it with coronavirus. There's another team trying it with measles virus, where they're stripping out all the measles instructions and putting in a coronavirus one. And there's several with adenovirus, a couple of Chinese ones, Johnson and Johnson, the Oxford group and all that. So we've got several of these going at the same time. And the Ebola vaccine was successful. It was.

Okay. It was, that was a Johnson and Johnson one. And they're taking the same technique and trying it with the Corona. You keep saying Johnson and Johnson. These are the same people who make the baby shampoo. Yep. Yep.

They also make vaccines. Oh yeah. Oh yeah. J and J is humongous. Will I, will I cry if I get the vaccine from them? Not as much as if you get the coronavirus. You're quick.

I like you. Okay. I know that China is also developing vaccines. I don't know if it's the nation or if it's companies within the nation. It's kind of hard to tell the difference sometimes. Fair enough. Well, yeah. Are they taking a different approach? It's companies within the nation state. It's kind of hard to tell the difference sometimes. Fair enough. Well, yeah.

Are they taking a different approach? They have several things going. Yeah, they've got some of this adenovirus stuff happening. But I've got to tell you, I don't like their adenovirus one as much because they picked one that's really fast and easy to develop called adenovirus 5. Problem is a lot of people have already been infected with adenovirus 5. Problem is a lot of people have already been infected with adenovirus 5. It doesn't do much to you. It gives kind of a light, common coldish sort of thing, but about half the Chinese population has already had it. Oh, so this is the virus they're trying to use to carry the vaccine. Right. A lot of people already have it. So that means that when you give them this new vaccine, your immune system attacks this

new Trojan horse and makes it less effective. So that's a real problem. And that's why I don't like theirs as much. It was fast, but it's probably not going to work as well. It's a quick fix. Exactly. Meanwhile, Johnson and Johnson, they use a really weirdo adenovirus called AD26 that almost no one has ever had. And they stripped the genetic material out of that.

And the Oxford group picked a chimpanzee adenovirus that no human has ever had and ripped the genetic material out of it. Just trying to avoid that exact problem so so when they uh okay say say that one of these trials works let's say the oxford one uh works really well uh or or any of the other ones that's your favorite um and and the the trial works out well the 30 000, they get favorable results on them. And they say, we really think we've got a good one. What are the steps to then getting the vaccine?

How long is it before I get the vaccine? What needs to happen? And what are the challenges there? Yeah, that is a key question. Because once you get the readout, under normal conditions, the company wouldn't even start manufacturing this on scale until they saw those numbers because a lot of these things don't work. So why the hell would you spend all the time and money? We're not doing it that way. Everyone is manufacturing at risk,

as they say. They're already cranking out tens and hundreds of millions of doses of these things in the hopes that they will work. If they don't work, all that stuff will go into the incinerator along with all the- Wow. Okay. But that's good. I mean, that's what we want them to be. Exactly. Exactly. Hit the ground running. So if we get good results on these things, then you go to the FDA and you present your whole data package and they do what they do. They look at safety and efficacy. How safe is this thing versus how much of a benefit does it give? Tricky part with vaccines is you're not giving vaccines to sick people. You're giving vaccines to healthy people.

Right. So your safety profile has to be really good. But you're also sometimes, though, giving them to slightly sick, not people who have coronavirus, but you're going to give them to the elderly. You're going to give them to folks with immune conditions and who have all different, you know, all different bodies and all different base health. And so you have to make sure it's safe for for those people as well. And that's why a traditional vaccine development takes years. Absolutely. And that's why a traditional vaccine development takes years. The rotavirus vaccine that they give to children, that thing took like 16, 18 years to develop. Because as you can imagine, if you're giving it to children, you want to make sure that you're not causing any long-term problems or any nasty safety. So they kept trying it over and over in different groups of kids with different body types, different ages, different vaccine schedules again and again and again. But, you know,

we do not have the time to do that for this one. And what are like the I'm most curious about the fears that you have that are not the obvious fears, right? Like, obviously, the big fear is that, oh, my gosh, none of these pan out and they all fail. And then it takes a really long time. But, like, is there a chance that, like, okay, we get a vaccine and it comes out and it actually only helps a little bit? Like, it makes you a little bit resistant, but we still have a lot of coronavirus floating around. And so it because obviously our fantasy is that, hey, it's all wiped out. Everybody gets vaccinated. We get up to a certain rate, no more coronavirus. But I mean, that might not be,

I mean, look, we all get, I get my flu shot every year. That doesn't mean that there's no flu. The flu still kills thousands every year. Exactly. And the flu is on one end of it. And meanwhile, you've got something like polio on the other end. You get your polio vaccine when you're a kid and you never get polio. Yeah, we can eradicate some diseases through vaccines.

That's what we would want. And that's exactly what we've got to find out. Sterilizing immunity is what they call the polio type thing. You get this and you are armor plated. We don't know if we can raise sterilizing immunity or not. So your question is a really good one because it might be that some of these vaccines are pretty good but not perfect. And then we're going to have to sort out the different kinds of pretty good. Maybe this one works better in the older population, but this other one worked better across all the other groups. Maybe this one was not good with people who had high blood pressure. Or this one over here is not bad, but it's harder to manufacture.

Another one like that is one of the Pfizer vaccines. We didn't even get to those guys. Those guys are also taking over your cells and telling them to crank out virus protein by giving them RNA. virus protein by giving them RNA. Turns out the Pfizer vaccine has to be shipped and stored at like minus 70 centigrade. So you've got to have a serious laboratory quality freezer, even to keep it around. So that's going to be like everywhere that like they got to have that at the

quest diagnostics at my CVS. Absolutely. And that's a real head scratcher because they don't have one of those right now. So how are we going to do that? And who's going to who's going to make all that dry ice to ship it in the 18 wheelers? So on top of the medical challenge, there's a huge logistical challenge of once you've got your vaccine or your suite of vaccines you might want to use, you have to get everybody vaccinated. Exactly. So you got the medical challenge, then you had the regulatory challenge of figuring out which ones to approve and who to approve them for. And then exactly the logistic challenge of how do we get this delivered in dose? You want another logistic challenge? how do we get this delivered and dose you want another logistic challenge

every single one of these vaccines except the johnson and johnson one every single one of them is going to be a vaccine and then three or four weeks later a booster and it doesn't work unless you get the second one wow okay so that makes it hard. Like if you want to vaccinate, like I, you know, you know, here in L.A., I volunteer with unhoused folks and, you know, you know, they're making an effort to test those folks. with folks who move around a lot, how do you follow up with them and get the, get the booster to them? It would be a real challenge. And let's also talk about the societal challenge.

I don't want to dwell too much on people who are firmly anti-vaccine because that's a topic that has been well covered. And, and you know, that's, that's thankfully not a massive part of the population, but for, for average people, right.

Even that there is a social issue of convincing. You have to convince everybody in the country to go get this. And it strikes me that you might have one shot to do that. That if you run with a vaccine that actually is not that effective, right? And you say, everybody's got to get this vaccine. And everybody gets it. You make your big push. You advertise everywhere.

You say, everybody go down to the CVS, go down to the to the free health clinic, the county clinic and get your get your vaccine. And then it actually is not that effective. And six months later, you got to get them to all do it again. It's not going to be easy the second time. And that is a big risk. That is a major worry. And we have actually an example of that. That is a major worry. And we have actually an example of that. 1976, I was 14. The swine flu was a big worry.

And the Ford administration ramped up a quick swine flu vaccine program. And two things happened. One, the swine flu turned out not to be as big a problem as everyone feared. So that was good news. Second problem was the swine flu vaccine actually had a higher side effect problem than most other flu vaccines and probably made more people seriously ill than swine flu actually did. Oh, wow. Yeah. And that's a that's a common that's a common thing that vaccine denialists say about vaccines. Or, you know, you hear people say that not even just the committed ideologues, but people who are a little skeptical or worried. They say, oh, isn't the doesn't the vaccine have worse side effects than the disease?

That's what some people think about the flu shot, for instance. And the problem is that you can't that you don't want that actually be the case. No, because it could be the case. And that's what the FDA is supposed to be deciding when they do risk reward. And that's the problem is that you yeah, you could come up with a vaccine that would be worse than the disease. And you want to make sure that that never sees the light of day. And you also want to make sure that you can catch things like that before they get rolled out to the population. Yeah, well, this is a really great topic and I want to come back to it, come back to these social issues right after the break. We'll be right back with more Derek Lowe.

OK, we're back with Derek Lowe. So talking again about the public and vaccines, what do you think are the biggest misconceptions that folks have about vaccines generally? Yeah, good one. They're kind of misconceptions at both ends. They're kind of misconceptions at both ends. On the one end, there are a lot of people who, despite their experience with the flu vaccine, may have the idea that every vaccine is like smallpox or polio. One shot, you're done.

You're protected for life. I wish they were all like that, but they may not be. I found out just a few years ago that my measles immunity had worn off. I actually had my blood titer checked, and I don't have measles antibodies anymore. So I got another vaccination because of the various crazies who are not vaccinating their kids. So the only way to find that out is to wait a few years and see if it lasts. So on the one hand, people might regard the vaccines as better than they really are. And then, of course, on the other hand, you have people who are convinced that they're all much worse than they really are, too. There's a lot of ways to screw this up. And this actually brings me to a question I

meant to ask you earlier when you mentioned this. Why is it that some diseases that we can have, we can have vaccines that have the sterilization immunity, as you put it, where, you know, you get the smallpox vaccine. And I mean, smallpox is like now it only exists in a lab, right? Like we like wiped it out across the world. It used to be an incredibly deadly disease. But then flu, the flu vaccine is like, well, every year it'll reduce your chances of getting the flu, which is very important. But, you know, it doesn't immunize the whole population.

We got to go get a new shot every year. That is very important, but it doesn't immunize the whole population. We got to go get a new shot every year that is very effective, but not a sure thing. Yeah. Those are good examples because they're kind of two ends of the spectrum. Smallpox as a virus doesn't mutate much at all. It really sticks with its standard form and doesn't go crazy on you. And we are the only animal that gets smallpox. There's no animal reservoir. There's not a bunch of raccoons or, you know, fruit bats or something out there that are carrying smallpox. So if you can wipe it out in the human population, it has nowhere to go. On the other hand, flu mutates

all the time. It's proteins on the surface, kind of like that spike protein with the coronavirus. Flu has a system where it mixes and matches and swaps surface proteins constantly. It's a real pain in the ass.

And lots of other animals get it too. Pigs get it. Birds get it. We all get it. And so even after you resist it, it can come in from another animal again. Exactly. And it has now changed its coat protein and your immune system doesn't recognize it anymore. It's put on sunglasses and a dark hat and here it comes. recognize it anymore. It's put on sunglasses and a dark hat and here it comes. I was going to say the mutation is almost like, makes me think of like in a sci-fi movie, like a cloaking device. It's like they're scrambling their signal. And that signal, the memory that your immune system has only applies to what it used to look like, not what it looks like now. Exactly. Another disease that does that is malaria. The malaria parasite scrambles its proteins constantly. And that's why people spike fevers over and over with malaria,

because your body catches on to the malaria parasite and starts to kill it off and you get a fever and you start to knock it back down. But the mutated kind comes back up again in a month, and you spike another fever, and again, and again, and again. So it mutates even while it's in your body, it's mutating that fast. Absolutely. Isn't that great? Wow. I mean, no, it's not great. So do we know which one of these the coronavirus is? So, yeah, do we know which one of these the coronavirus is? Fortunately, it's not that bad.

If it were changing coats as often as flu, we would be in big trouble. But so far, they've tracked a lot of coronavirus mutations, but none of them seem to do anything serious. Now, there's one that people may have heard about. It's called D614G, if you're a molecular biologist. One amino acid in that spike protein has changed. That one seems to be a little more infectious, but two things not to worry about. One is it doesn't seem to make the disease worse, and all the antibodies and vaccines that we're developing attack that one just as hard or harder than the original. OK, so that's good. So so it's not quite like it's not like flu. There's a new mutation like every year. Right. And I've read that one of the challenges, the vaccines, they have to sort of predict almost like like a weather report.

What kind of flu is going to happen? And then they try to build a vaccine for that. And then the mutation means you have to do that every year and so so uh sars cov2 doesn't uh mutate that fast it's more like just sort of different strains or yeah and you can track these strains and in fact there's a couple of large international efforts that sequence this thing and track the strains and that's how they, aha, this country got some from a person who traveled to China. And then someone from Italy came in because we recognize that Milan strain. And then that started to spread over here and on and on. But hopefully the same vaccine would work for all or most strains. Yeah. So far, every time people have tested a whole

bunch of coronavirus mutants against the antibodies that these vaccines raise they mow them down so it's good news okay oh that's great yeah so what do you feel what do you what do you feel the most likely outcome is for these vaccines or, or, or what, what do you think you're looking, you're, you're obviously reading every paper as it comes out,

I assume, and you know, being that this is your field where you're trying to keep up as best you can. And so you're looking at it. What do you think is likely to unfold leaving out the social part of it, the political part of it, just the,

but just scientific part. Yeah. Yeah. OK. What I think is likely is I think it's very likely that we're going to have one or more effective vaccines and probably more than one. I don't know how they're going to sort out, though. Like we were saying earlier, there may be some that we would want to have more than one where we say, okay, you people over here should take this one. You folks over here who are younger and don't have high blood pressure or whatever should take this one. I think that the efficacy of these things is going to be good to very good, but I don't think we're going to get the sterilizing immunity that we want, the polio shot kind of immunity. I would be thrilled to be wrong about that, but I think we're going to end up with a very good level of protection, but not 100%. The good news is, is that very good level of protection, if enough people get vaccinated, is still enough to break the back of the pandemic

and stop it from spreading. So it's going to be somewhere sort of between smallpox and the flu, where you don't need it. It's not going to completely wipe it out, but you're not going to need to go get a new shot every year. Hopefully, it's not going to mutate that quickly. That's what we're hoping for. And it looks like the antibody response lasts long enough where you're not going to have to worry about that. People, when they got infected with SARS, kept antibodies around for several years, and they kept T-cells around for even longer than that. So I think we'll be okay there. And the good news is, is that this coronavirus, so far, we haven't identified an animal reservoir like we do with flu. Flu infects all these farm animals, all the pigs and geese and chickens. So humans are

constantly being re-exposed and swapping viruses. We don't have that with this coronavirus. So if we can kick it out of the human population, it may just stay out. Wow. So that's a really fascinating way to put it, because we know that coronavirus did leap to humans from an animal, but we don't have a reservoir like with pigs. We just got millions of pigs hanging around. There are there a food supply. They're also a virus supply, basically, is what you mean by reservoir. Wow. So, wait, I've read that there have been a couple of cases where people have been reinfected with coronavirus after after having it once. They have it again.

And I thought I saw something about the antibodies only lasting a couple of months. And as a naive person not knowing the science, I'm like, wait, does that have concerns for how effective a vaccine could be? Oh, it would. The good news on that is, is that the reinfection seems to be extremely rare. There have only been two, three, maybe four cases in the world found of reinfection. two, three, maybe four cases in the world found of reinfection. And what we don't know is what kind of infection they had the first time in many cases. How severe was it? How good a response did they even raise that first time? So it might be that the vaccine response is going to be strong enough where you don't even see that. And it looks like the reinfection when it happens is also very

mild. And we're trying to find out now, but it could well be that these reinfected people, because it's a mild infection, don't really spread the virus much either. So I'm not too worried about the reinfection because it's been so rare. The time the antibodies last is a tough one. We have had reports earlier that it could be short, but there was a big paper from Iceland just earlier this week. Iceland, of course, has got a very good statistical framework in their healthcare system because they're all Icelanders and they have this huge data collection system going. They have found that the antibodies are less. They're basically an experimental population right there. They are. They are.

They're all sitting out there on this island all by themselves and ready to be our guinea pigs. Iceland's a living lamb. That's how it happened in the gene sequencing days. The Icelanders were the first people to get massively sequenced. But we found with them that the antibodies are lasting as long as they had to write this paper, which is like four or five months, and they're still there. So I'm pretty optimistic on how long these things last

and the T cells maybe even last longer. So I think that, you know, I'm pretty, pretty optimistic that we, if we do this right, we can, as I was saying, kick this virus out of the human population. Now, yeah. Talk to me more about that. You say we can we can break the back of the pandemic. So how does that work? Even if we have a vaccine that is not a sterilization, I would say when you kick it out the human population, that means it's like smallpox and you never get it again. And you're saying instead we'll have a vaccine that's very effective, but maybe not perfect. How does that still break the back of the infection and kick it out of the population?

That gets into epidemiology because you look at this number called the R0 that suddenly everyone learned about this year. How many people on average does an infected person spread the virus to? It turns out the R&R is really variable with this one. A lot of people, the number is zero. A lot of people get infected and they just don't really spread it to anyone.

Other times, though, you end up with these super spreader events where one person, I'm about to say one bozo, ends up spreading it to 20, 50, 100 people because they went to karaoke night and yelled in everyone's face all night in a crowded room. So it varies a lot. But if we can get enough people vaccinated where many of them will not get infected, and the ones that do get a very mild infection where they don't spread much, the virus will run out of human hosts. If we can stop spreading it to each other, then it doesn't have anywhere to go. I mean, it's from the pangolin or the bat or wherever

it came from, but if we can just get it out of the human population to where it just, finally, the last bits of brush fire die down and we pour cold water over them one by one. Then it's gone. I was about to use the metaphor of fire. Yeah, that makes a lot of sense to me because to to put out a fire, you don't need to remove every piece of wood or every piece of fuel. piece of wood, right. Or every piece of fuel. But if you remove enough, you remove like the, you take the newspaper out of the fire and you take a couple logs out like,

and there can still be some other logs around the edge of the fire, but Hey, now they're, now they're too far apart. So there's still some stuff burning, but it doesn't spread. Instead it dies out. That's really great. I really like that. Right. So you have these, you have these places where it's still going to be around and we'll come in and do some tracing on these folks and say, all right, okay, you guys isolate yourselves. Honestly, if we had as a nation or even as a species been able to trace and isolate everyone, we could have done this without a vaccine. It's probably too much

to ask in the modern world. But if everyone who got infected immediately locked themselves in their basement for two weeks, the virus wouldn't have had anywhere to go, but it's just not going to happen. Well, this is what was done in New Zealand, right? My understanding is New Zealand, actually, because it's an island and relatively small population and they handled it well, they were able to contact trace everybody who came in. And as a result, like, you know, tamped down those initial couple outbreaks so that it has never fully entered New Zealand. And so if that could have been done on a global scale, then we would have been able to stop it. But we were not able to do that as humanity. No, no, no. And some countries did a better job than others. Now, the New Zealanders, of course,

that means they have no immunity in their population at all. If you took a whole bunch of people from some sorority down in Alabama and scattered them all over New Zealand for karaoke night, you would let the virus rip across New Zealand that they'd have a hell of a problem again. But the idea with the vaccine is not only do you isolate this stuff out, but you also make it much harder for anyone else to catch it. So, and with the fire metaphor, not only are you moving the logs away from each other, you're also making it so these logs can't even catch fire so much anymore. Yeah.

Now, that makes me ask, is having some amount of spread in the, you know, we've talked about, we've heard about herd immunity, right? That once people have the antibodies, hopefully that means they won't catch it again. Now I know Sweden famously used an all herd immunity strategy where they didn't shut down anything and it went disastrously for them.

They had a lot of people die. Their economy did not actually benefit from this. It was a bad strategy to use to manage it. But I am wondering, like, say, you know, I'm just looking at the numbers in L.A. County where I live. We've got 10 million people in L.A. County and we've had a quarter million cases so far. So does does is that sort of a piece of the puzzle that like once you have it sort of gone through a community that there's is going to be some immunity level. How does that piece of it work? Yeah, there is going to be some. But the tricky part is, is that to the best of my knowledge, no natural infection has ever gone through the human population enough to reach herd immunity. Unless maybe you count the Black Death.

Yeah, the Black death might have done it but otherwise the black death didn't it just kill a third of all people yeah yeah so that's not and then after that it's like okay it burned up the forest and now it's it's gone out by itself exactly so we don't want that but think about measles or chicken pox or before the vaccine, polio or smallpox. These things had been around in humans for thousands of years. We never reached herd immunity with those. We never did. The way to do it is with a vaccine.

Because then you're able to increase, you're able to go much further than the natural immunity we might get from getting the disease because you're able to give it further than the natural immunity we might get from getting the disease because you're able to give it to healthy people in a much more powerful way. Exactly. And give it to them all at once and catch a big part of the population. So that without vaccination, I don't think we would ever hit herd immunity. So what concerns do you have now getting back to the social piece of it and the political piece of it what concerns do you have here in the united states about okay hey oxford johnson and johnson

they did their job they're like we got the vaccine we're making it right uh what are your concerns about our social ability to deploy it because certainly certainly I would have to say the United States has disappointed me in terms of our ability to manage this disease in terms of the tracing. I still like, let's not even talk about lockdowns. Just where is the contact tracing? I'm not seeing it. You know, it seems like we have failed in a way that other countries have not. So what concerns do you have about how we might handle distributing a vaccine? Yeah. What we need, and I think we're getting this together, some of this has started appearing this week, what we need is an extremely transparent rollout plan to say who gets it first. Do we go to healthcare workers? I think that's a good plan.

Do we go to folks who have jobs that are essential for the economy that require them to be in close contact with people in confined spaces, et cetera, et cetera? Do we roll it out to people who are in these different risk categories? And if so, who gets in line first? We've got to know this. It's got to be transparent, and we've got to follow it. If we get in a situation where it's someone who knows someone who gets the vaccine first, we are going to be hosed. This is America. That is going to happen to some extent. I mean, just look at, you know, I'm pretty sure the NBA has better testing than the LA unified school district does.

Right. And people have been willing to put up to a point, but I think if, if that turns out to be the law of the land that you have to be in the special super duper class in order to get the vaccine first, that's not going to go over well. I really hope we don't do that. Yeah. We need to be able to get it. I mean, look, rich people are going to get shit faster. That's

how the world works. But we also need to have a way to get it to everybody as soon as possible. That needs to be our focus. Absolutely. And if we get it to the people who are most at risk and most likely to catch it and most likely to spread it, that's the best for the country as a whole. Anyway, that's where we should be turning the hose onto this fire. Yeah. And do you have concerns about our ability to do that? I mean, in terms of our public health agencies? A few years ago, I would have said no.

Now I will say yes. I do have concerns. I've been doing drug discovery for 30 years now, and I have never been more upset about the state of the FDA, the CDC, and the NIH than I am now. All three of them? All three of them. All three of them we're we're seeing i don't want to get political but we're seeing what happens when you try to inject politics into what should be medical and scientific decisions i mean it's very hard to keep politics out of things but it doesn't mean that you have to come over with a big steaming bucket of politics and pour as much of it in there as you can get. I think that's a good way to put it. I mean, I'm of the belief that when people say take politics out of this, take politics out of that. Hey, politics is just that's

humanity. Politics is how is humans making decisions together? That is what politics is. making decisions together. That is what politics is. And so you can't exclude it even in, hey, you know, even the Albert Einstein had politics in the department that he worked in, you know, like this is how we are. But you can try to not make that the priority you can focus on. Let's focus on the science first and on the medical need and try to make sure that politics doesn't drive the decisions that are made. Exactly. And in some cases, the political decision-making process can be actually quite helpful to have

it all thrashed out by people with their own interests trying to convince each other. I mean, a little bit of Tabasco sauce in my chili is a good thing. But does that mean that I should then grab, you know, a 16 ounce bottle, pop the cap off and plug it right in there? No, probably not. Yeah. I'm also concerned that, you know, the sort of deliberate evisceration of some of these departments that they've had their capability reduced, especially you mentioned these big alphabet departments, but also our local public health departments that need to be distributing the vaccines. The county health departments in,

I know the one in Riverside County here again to talk about SoCal was really taken apart. And those are the departments we're gonna need to distribute the vaccine, make sure everybody gets it. Like that's a real, our capability has been deliberately reduced in order to, I guess, save tax money over the past couple of decades. And you know, we were talking earlier in this podcast about HIV and the way it attacked the T cells in the body, this important part of the immune defense. From a public health standpoint standpoint we have been attacking our own public health t

cells and making our defenses weaker and it sucks man so fiscal austerity as the hiv of the body politic it can be um it can be yeah i mean there's a time and a place for saving money but you know one of the things you kind of want a government to be supporting is public health. That's something that we can't do alone. Exactly. You need politicians who are thinking, okay, let's not piss all the money away, but let's find the things that really we have to spend it on and spend it on those that we have not been doing a good job of. Well, let's move from that. Just for my last question, I'm really curious about the role the private sector plays, like obviously very hot button, you know, big pharma, private drug development.

The guy who bought the Wu Tang album jacking up the price of the much needed medications like we've all heard those stories. price of the much needed medications. Like we've all heard those stories. I'm curious your view of it as someone who spent 30 years in the industry and especially as relates to these vaccines, because Johnson and Johnson, I know that's a for-profit company because I know they sell the baby shampoo at my drugstore. So I know that's not a nonprofit. So how do you feel those things interact? I mean, I am concerned about, okay, this is a vitally needed vaccine. Are they going to be trying to make a profit on it and thus making it less accessible to people? But on the other hand, I know, hey, that's the system we have. What's your view?

Fair question. Well, to stick with Johnson & Johnson, they have already announced that they are not going to do this on a for-profit basis. They're going to try to recover their costs, but they're not going to do this on a for-profit basis. They're going to try to recover their costs, but they're not going to try to make money off of it. So now we're probably going to have big arguments about what those costs are and whether or not they're actually making money or not. But they have already publicly stated that this is not going to be done on a profit-making basis. And most of the other companies involved in this have either said that or they see the writing on the wall. Because we mentioned earlier, the drug industry does not have

the most wholesome reputation in the world. But who else are you going to call to find drugs and vaccines against a worldwide disease like this? There isn't anyone else. We are the ones with the expertise, with the infrastructure, and with the resources to do it. No one else has it. You look at all the non-industry vaccine and drug efforts, like Oxford University. Where did they go? They went to AstraZeneca and partnered with them because they knew they couldn't do it on their own. Everybody else who has any kind of serious vaccine or coronavirus therapy idea, they come to the biopharma industry because they know it's the only place to turn. But that means that we in the industry have got a real responsibility to get this right and to not look like a bunch of pirates taking

advantage of a pandemic to line our pockets. That would be the absolute worst outcome. We could come out of this as some sort of variety of heroes if we do this right, or we could look like evil, greedy, Now fill in your pejorative word. I hope we're going to do the former. I mean, the best case scenario is sort of the World War II vision of corporate America where we're all in it together

and these private corporations, for-profit corporations, doing what benefits society as a whole. But I have to say, you know, my, my problem is I have trouble putting my faith in those. Hey, if Johnson and Johnson wants to say that, that's great. You know, and, and even if they want to do that, that's great. But then, and I, and I applaud them. Here's, here's the round of applause, right? But I have a concern societally relying on private companies to always do the right thing, because I know that most of the time they don't, right? And that I don't want to be at the whim of the CEO to feel like he wants to be a Boy Scout today. You know what I mean?

A good thing is you don't have to be. I'm going to quote from Adam Smith and Wealth of Nations, where he said, it is not from the benevolence of the butcher and the baker that we expect our dinner. He said it's from a regard to their own self-interest. And in this case, the self-interest of the drug companies is to not come across like pirates, because we know what will happen to us. The drug industry is already worried about regulation and price controls and having the government come down hard on us for having prices that are too high and all these other issues. So the last thing that we should want to do is give everyone an even better reason to come down on us really hard. So the self-interest of the drug industry is

actually to play this one straight. The short-term interest would be like, hey, you want a vaccine? It's going to cost you. But that would be a disaster. And honestly, everyone who's running a decent-sized company in this business is smart enough to realize this. You mentioned Martin Shkreli before, the Wu-Tang album guy. Martin Shkreli ran a company that had like 14 people. He was not smart enough to realize this. And you saw where it got him. Now, everyone who's actually a serious player in this industry is bright enough to realize what would happen if we play this wrong. I hope that's the case. And I think that this is such a crisis that I believe that in this case,

it probably is. But, you know, I still have those concerns about, you know, we're talking about the role of government. And there are some times when you need the profit motive to not be present, right?

In order to make sure that people get what they need. There are certain things that can't be provided that way. And I do think there's a larger conversation to be had about, hey, you know, the fact that much needed drugs that people just need are done

on a for-profit basis is kind of weird to me. And there are places in drug research where the whole market breaks down, like antibiotics. It's very hard to make money with a good antibiotic, but by golly, we need good antibiotics. Now I can also tell you you i've worked in antibiotic research and it is flipping hard i have killed off so many human cells in dishes over the years with my compounds because i'm a

chemist i make new compounds i have killed off so many human cells and rat and mouse cells i can't even count the number of toxic drugs I've made. I have never successfully been able to kill off a gram-negative bacterium that infects human beings. Those guys are brutal. They are tough. So there's two reasons for the antibiotic problem. One of them is that it's hard to make money, and two is it's really difficult to find a good antibiotic. Holy crap.

I never realized how bad it was until i tried it i mean do you do you wish that like look the nih is you know the largest funder of medical research i think in the world right um and uh but they're funding you know i mean is there a point at which the the government just says hey we need to be doing some of the basic research here instead of farming it out. There is, but they're going to have to pony up because the R&D budget of the biopharma industry is a lot bigger than the NIH, a lot bigger. So it takes serious cash to do this. And, of course, basic research is the engine that drives this stuff, all these weirdo discoveries. You know, Isaac Asimov once said, the sound of a scientific discovery is not someone yelling, Eureka! It's somebody looking at a little flask and going, huh, that's funny.

And that's exactly how it's been for me too. Every really neat thing I've ever discovered has started off with me going, what the hell was that? So we need to be able to plow money into that. But most of the time, those things don't mean anything and the money is gone. You know, I mentioned 90% of our drugs fail. That money is torched. We incinerate billions of dollars every year on drugs that didn't do what we thought that they would, because we don't know enough about the biology of disease. So if you're going to get into that process,

you better have some deep pockets. I'm, I would be fine for other players to come in, but they, they need to realize what they're asking for. Well, let's just getting back to the vaccine to close this out here. It's,

are you optimistic about, about the future future of coronavirus when you look a year, a year or two from now? I am. I really am. And I'm a fairly optimistic guy. I'm kind of a long run optimist and a short term pessimist. If someone walked up to me right now and said, I have the cure for coronavirus right here in my hand, I would say, no, you don't. But if someone says, you know what, a year from now, we're going to be beating this thing back into the ground, I'd say, yeah, I think we can do it. And I really think we can. We have so many different avenues of research, so many things going on with unprecedented speed and variety. I've never seen anything like it. I hope we never see anything like it again, to be honest. Well, thank you so much for coming on and

sharing your expertise with us. I have such a better idea now of how these vaccines work and what it takes to make them. I really appreciate you coming on. Glad to. I mean, when I started my blog, I realized that no one knows where drugs come from or how people discover them. So that's why I decided to write about it, because everyone said, hey, that's an interesting job. I didn't I didn't even know people did that. And the name of that blog is In the Pipeline. If you search for In the Pipeline, Derek Lowe and you'll find it.

Derek, thank you so much for coming on. Thank you, Adam. I really enjoyed it. so much for coming on. Thank you, Adam. I've really enjoyed it. Well, thank you again to Derek for coming on the show. I hope you enjoyed that conversation as much as I did. If you did, please consider leaving us a rating or review wherever you subscribe. It really does

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