Front Burner - Everything you need to know about Pfizer's COVID-19 vaccine

Episode Date: November 11, 2020

This week, as COVID-19 cases continue to climb across the country, there is a glimmer of hope for returning to normal life: a vaccine. Pharmaceutical companies Pfizer and BioNTech say that results from a Phase 3 study of their vaccine candidate look promising and that immunity could last a year. Today, we hear from CBC science and technology reporter Emily Chung on what we know about the Pfizer-BioNTech vaccine that early results suggest is 90 per cent effective in preventing COVID-19.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hello, I'm Jamie Poisson. So across the country, COVID-19 cases are climbing. In Manitoba, the province declared a red alert level. The premier has ordered province-wide shutdown starting tomorrow.

There is no short-term fix. There is no one-step action that can guarantee that it will not be coming back. In Alberta, doctors are calling for a similar lockdown. And in Ontario, case numbers continue to break provincial records. 100% I'm concerned. These numbers keep me up at night and we're throwing everything we can at it. But this week we also heard about a glimmer of hope for returning to normal life. A coronavirus vaccine. Is this that breakthrough that we have been waiting for?

Exceeding what Dr. Anthony Fauci had hoped. All the stars are starting to align very, very nicely. On Monday, Pfizer and their German partner BioNTech announced that early analysis from their ongoing Phase 3 clinical trial suggests their COVID-19 vaccine could be 90% effective in preventing the disease. So today, we're going to be talking about everything you want to know about this vaccine with the help from CBC science and technology writer, Emily Chubb. This is FrontBurner. of this vaccine. And I felt like I had a physical reaction to it. Like I felt this weight kind of lifted off my shoulders. I was so happy to hear this news. We were jumping out of the chairs, screaming, we may put an end to this terrible pandemic. Pfizer's chief scientific officer, Dr. Michael Dolston. It feels to me as a physician scientist,

that this is one of the biggest, if not the biggest medical advance in the last 100 years. And I know we're going to be diving into the details today, but top line headline, should I be so excited about this? Well, it's definitely good news. So the news that the last stage of clinical trials, the last stage of human trials before a vaccine can get approved, this vaccine from Pfizer and BioNTech was shown to be 90% effective in preliminary results in preventing COVID-19. So that's a very, very positive result. It seems to be doing quite a good job at preventing COVID-19. So that's a very, very positive result. It seems to be doing quite a good job at preventing COVID-19. So I want to get into this study with you a little bit more today, but first I want to start with a story that's come out about this vaccine candidate, its origin story essentially, and that is the husband and wife duo that are in part behind it. And can you tell me a little bit about them? Sure. Ur Shaheen and Aslam Chorchi, who are a German couple who were medical researchers and they were interested in cancer.

And Shaheen is a prof at Mainz University and still is. So in 2001, they started Ganymede Pharmaceuticals, which was looking into cancer-fighting antibodies. And it was a very successful company in that they sold it for more than a billion dollars in 2016. And they founded BioNTech, a company that is now partnered with Pfizer for this vaccine. So it initially was still pursuing cancer immunotherapies. And one of the focuses was mRNA. When the pandemic hit in January, and they started talking about the coronavirus, there were publications talking about this new coronavirus and providing the code for the spike protein, Shaheen and his company,

they decided to switch to making a vaccine for COVID. We are considering all options how development can be accelerated. So we have, for example, implemented a 24-7 research program. We are collaborating with the authorities who help us to review our documents, including the safety data, almost in real time. Because, I mean, one of the cool things about mRNA vaccines is that if the main components are there, the main hardware, you can switch out the code and switch it between diseases.

And for people who maybe are just hearing MNRA right now, this is messenger RNA, which, you know, I understand is sort of central to this whole thing. What is this? It's one of the two genetic codes inside our body or the two kinds of genetic coding molecules inside our body. So we're all familiar with DNA. That's what our genes are stored in. mRNA is used to translate those genes into proteins. It's not just the proteins inside our bodies, but this is a code that's used by all kinds of living organisms. So in theory, you can take mRNA and translate it into proteins not just from humans, but also other organisms such as viruses. And so how is MNRA, this idea that these molecules are being used as messengers to teach our bodies to make things like proteins,

how is that being used in this vaccine for the coronavirus? You mentioned something about a spike earlier. That's right. So the coronavirus is called a coronavirus because it is covered with these spiky proteins on its outer shell. And so when you look at a coronavirus under the microscope, it looks like there's this crown around it, and that's why it's called a coronavirus.

So that spike protein is unique to every coronavirus. So that spike protein is unique to every coronavirus. And so this particular one that causes COVID-19, it's a very distinctive one. And it's also the protein that the virus uses to get into your body. Because of that, it's the protein that's targeted by a lot of vaccine makers. If we can get the body to recognize this spike protein from the coronavirus that causes COVID-19, then our body should be able to recognize it and develop an immunity against the virus and not let it into our cells. Basically, and I know that you have a PhD in chemistry, and I absolutely do not have a PhD in chemistry, so bear with me here. But basically, what you're saying is that these messenger RNAs or MNRAs, these molecules in your body that are exactly what they sound like,

they're messengers, they're like delivering instructions. They normally tell our bodies to make proteins, right? And then this helps you make things like muscles. But what you're saying is happening here is that the spike you're talking about is being introduced into our bodies via the RNA, messenger RNA. And then when the spike is introduced, the body can fight it off. You know, why can the body fight it off then? Right. So what's happening with this vaccine is the vaccine contains the mRNA, the recipe for the coronavirus spike protein.

And this is a recipe that your body doesn't normally have. And this is a recipe that your body doesn't normally have. And so when you inject this as a vaccine into the body, it gives the instructions to your cells how to make this coronavirus protein. And that coronavirus protein is something your immune system is going to recognize as something that's not normally found in your body. Your immune system doesn't know that this particular coronavirus protein was made by your own cells in your own body. It just recognizes it as foreign. And so that will trigger an immune response without a real viral infection. That's how this vaccine

is supposed to work. But mRNA vaccines have never actually been widely tested in humans. Oh, that's interesting. So is this the first mRNA vaccine? Well, there's been a lot of experimental mRNA vaccines, mostly used in cancer therapies. But yes, if this is approved, it would be the first of its kind to be approved for widespread human use. Okay. And I guess it would be worth mentioning that of all of the coronavirus vaccines in clinical trials right now, there are other ones that are using this technology, right? clinical trials right now, there are other ones that are using this technology, right? mRNA. Moderna, another biotech company, also has been working on a vaccine. They're another frontrunner and they're using the same technique, right? That's right. There's quite a few vaccines in clinical trials right now. Well, there's a handful anyway that use this technology.

And then there's a bunch more that use DNA, which is quite similar. Okay. So let's talk a little bit more then about this vaccine, the Pfizer vaccine that has the supposed 90% efficacy rate and some of what we know so far about it, how this is going. So, you know, we mentioned earlier the 90% effectiveness rate. What does that actually mean? Like, how do they know that it's 90% effective? does that actually mean? Like, how do they know that it's 90% effective? Vaccines have to go through three stages of human testing. In phase one, they have a small number of healthy volunteers, and they are just checking for safety. They just want to make sure there's no major side effects. And if that goes well, they go on to phase two, where they try and figure out, well, what's the best dose and how far apart should the doses be? And of course, they're also monitoring for side effects.

And they also check to see if there's any kind of an immune response. So they'll look in the blood and see, are there antibodies being produced and that kind of thing. Phase three, though, is when you need to actually test in the large population, people walking around outside, you know, going to work, going to school, whatever, and see, okay, if they get the vaccine, are they less likely to catch the disease in the community? Will it prevent the disease compared to people who have a placebo or a dummy shot. So these are huge studies. This one has almost 44,000 volunteers so far in six different countries. And the people are in two groups, but they don't know which group they're in.

One group gets the real vaccine and the other group gets a placebo. Right, right. They don't want people to know which bucket they're in. So you've got these two buckets and what do we, of people, the people that got the placebo and the people that didn't get the placebo got the actual vaccine and what do we know about what happened? Right, so these volunteers, they got two shots and seven days after their second shot got two shots. And seven days after their second shot, they were all checked for, you know, symptoms of coronavirus. And if they had symptoms, they were tested. And then all this data was sent to an independent review board. And the independent review board looked at the data and saw there were

94 infections among these groups, and that people in the group that received the vaccine were 90% less likely to have tested positive. So if you've got 44,000 people in this group and 94 people end up getting it, we're talking about like eight people in the group that got the vaccine and then the rest would have been in the group that doesn't have the vaccine. It's this terrible math on the fly, but does that sound about right? That's right. Okay. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem.

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And he said that, you know, while this is great news, this is also science by press release. People are supposed to get a dose at day zero and day 28. And they're saying that people were protected seven days after that second dose. Again, I know I sound like a broken record. It's science by press release. We always have to be skeptical. We always have to see the primary data. And there's still lots of stuff that we don't know. And what does he mean when he says that? Well, this is only partway through the clinical trial. And so they don't have all the data in for one thing. And in fact, at this point in the clinical

trial, it's very unusual for any company or anyone who's doing this kind of testing to even release data. And so in order for the trial to be completed, there are a couple of things that need to happen. So far, they've had 94 infections, but it was agreed that the trial wouldn't end until they have 164. So they need another 70. And it's possible that those will happen much more quickly than the first 94, just because the pandemic is ramping up all over the world. And there may be more people, more chance to catch it among the volunteers. The other thing they have to do is follow half the participants for two months to check for side effects and that kind of thing, which brings us to the other purpose of the phase three trial is to look for

side effects, rarer side effects that you might not see in the earlier trials. And so we actually don't know about those yet. Have we seen any safety data related to this vaccine from even the previous trials? Because, you know, you mentioned before, this is such a new kind of vaccine. Right. Well, I mean, what we do know is they haven't had to stop the trial because of any major incidents. You might have heard about this happening in other vaccine trials where, you know, one of the participants falls ill. They don't know whether that person is in the group that had the vaccine or didn't have the vaccine. They need to investigate it and so on. Johnson & Johnson's had to put its crucial late-stage testing in humans on hold. J&J and AstraZeneca both getting the go-ahead to resume their phase 3 vaccine trials. J&J saying there's no evidence that the vaccine caused the event.

That hasn't happened in this trial. So that's good. But yeah, aside from that, no, we don't know anything about the side effects. And do we know anything about the efficacy of this vaccine for older people? Because I understand there are still questions about how well this vaccine could protect vulnerable populations. Yeah, we don't know. They haven't released that data either. And it is pretty important. And it'll be important when we're setting priority groups.

Now, older people are more vulnerable to this. But at the same time, they often don't respond as well to vaccines, which is why, you know, if you're a senior, you're often advised to get the higher dose flu shot, for example. This like super flu shot. My parents got this. If you're over 65, you have to get this because of all the reasons you just mentioned. What about kids? Are they part of this trial? They are part of the trial, but they didn't start testing kids until October, which means they would only have gotten their second dose in November, and they wouldn't have been included in this data. And I just want to pick up on one thing you said there. You mentioned doses. So we're talking about more than one dose here.

That's right. And you might be familiar with other vaccinations that require more than one dose. A bunch of the pediatric vaccines are like that. And same with the hepatitis vaccines often need more than one dose. So this is another one where I guess in their phase two clinical trial, they found that two doses worked best. And so all volunteers are given two doses. Okay. And do we have any sense of how long the protections last? So I'm thinking of the flu shot here, like we're supposed to get it every year. Is this kind of the same thing? Well, we don't know right now. It's just started being tested. We don't know how long the immunity will last. Pfizer thinks it will last at least a year, but really we don't know. And then I understand there are logistical issues as well, right?

Like with storage and temperatures. Can you tell me a little bit about that? Right. So RNA, mRNA is not very stable. While regular vaccines, you know, can sit in the fridge for quite a while, these, Pfizer says, can stay in the fridge for five days or so, but then you need to put them in ultra-cold storage, like minus 70, which is colder than any normal freezer. And so that could make it logistically difficult to distribute, especially in certain parts of the world that are less developed. Okay, so while there are still lots of questions, also, you know, thankfully, like lots to be optimistic about.

And how hopeful should we be about this vaccine being made available for Canadians? Well, the good news is that Canada has pre-ordered 20 million doses of this vaccine with the option to buy more. So that's enough for 10 million people, because remember, there's two doses per person. And that's about a quarter of the Canadian population. The logistical distribution of this vaccine candidate will require careful cooperation with provinces and with supply chains in order to be able to get it out to Canadians on a priority basis. We are already working on those necessary logistical supports. And then if this thing really works, what are our options to get more of this one or I guess of some other vaccine?

Well, Canada has actually so far ordered vaccines from seven different manufacturers, and it's lots of doses. So I think if this vaccine works, and it's based on the spike protein, that suggests that many of these other ones based on the spike protein should also work. And that's all good news. And that's all good news. So I think the question that a lot of people probably want to know is a timeline. You know, let's say this all goes relatively smoothly and there are no big bumps in the road. Like when might this vaccine actually arrive in Canada? Well, our agreement with Pfizer says that it'll be delivered in 2021. And a member of Canada's vaccine task force, Alan Bernstein, told one of my colleagues, Christine Burak, yesterday that a vaccine could be available between April and June. Now, there's a lot of caveats in that one, a lot of unknowns. So this is a guess more than anything. So this is a guess more than anything. But I know that the companies have been making vaccines now as we speak, even before they know the results of the trials.

But that doesn't mean that everyone will get it at that point. So basically, we're working on like a spring 2021 timeline. And also, we have to see what happens with all these other vaccines as well. This is sort of a moving target, right? Right. And just because, you know, Pfizer was the first to come out with partial results doesn't mean they're going to be the first one to come out with a vaccine either. So it's possible that another one of these candidates could leapfrog them. Yeah, and maybe not even leapfrog them, because like I said, it's quite unusual to release results partway through a clinical trial. There's a number of other companies that are in phase three clinical trials right now, too.

It doesn't necessarily mean that this will be the first one to hit the market. Emily, thank you so much for taking us through this. I know there's still lots to keep track of, and I hope you'll come back on soon and let us know what's going on. But thank you so much for this conversation. Well, thanks for having me, Jamie. It was my pleasure. Okay, so before we go today, a little more about Manitoba's new restrictions starting Thursday to curb the spread of COVID-19. They were ordered after 22 people died in one long-term care facility alone. The province's chief public health officer announced this week that Manitoba had its highest ever numbers of COVID patients in intensive care and more than 10% of the people getting tested are testing positive for the virus. In Ontario this week that number was more like 5%. So what is Manitoba doing about it? Parts of

the province like Winnipeg were already under a red alert with restaurants only offering takeout and delivery and some other pretty tight restrictions. But now the whole province will be under even stricter rules. Gyms, churches, and non-essential stores could be closed for about a month, and all social gatherings will be forbidden. That's all for today. I'm Jamie Poisson. Thanks so much for listening to FrontBurner. For more CBC Podcasts, go to cbc.ca slash podcasts.