Science Friday - How The COVID-19 Vaccine Was Developed And Is Being Distributed. Jan 15, 2021, Part 1

Episode Date: January 15, 2021

How Did A Vaccine Get Developed In Less Than A Year? From the first discovery of a strange new respiratory virus in Wuhan, China, in January of 2020, it took less than a year to get a vaccine into the arms of frontline healthcare workers. More than two dozen vaccine candidates have made it from basic safety trials to Phase 3, where efficacy against COVID-19 is tested. That’s particularly remarkable as before the pandemic, it was rare for a vaccine to take fewer than 5 years from start to finish. The extraordinary speed of these critical developments is thanks to decades and decades of previous work, including research on the original SARS virus, and even HIV. Ira talks to two researchers who have contributed to COVID-19 vaccines about the foundations these innovations rest on, and how increased resources and collaboration helped save time in 2020. How COVID-19's Vaccine Development Will Benefit Future Vaccines For months, much of the world’s attention has been on COVID-19 vaccines—people want to know when they will come, how well will they work, and when can I get one?  Fortunately, the pharmaceutical industry has rapidly developed and tested multiple vaccines for SARS-CoV2. Now, the discovery that two vaccines based on messenger RNA technology have over 94% efficacy is drawing attention to new ways to think about vaccines. We’ve come a long way from the days of the inactivated poliovirus vaccine used by Salk, or the attenuated virus vaccines developed by Sabin. Ira talks to vaccine researcher Paul Duprex and biotech reporter Ryan Cross about how these new developments improve our ability to fight infectious disease, and looks ahead to where the future of vaccine development might lie. West Virginia Leads In Race To Distribute Vaccines Healthcare workers have had mixed success getting COVID-19 vaccines into people’s arms across the U.S. A big reason for the unequal rollout is the lack of federal requirements for who gets vaccinated, and in what order. There are, however, federal recommendations—for example, this week Health and Human Services Secretary Alex Azar recommended that vaccination strategies should prioritize people age 65 and older. But states are on their own when it comes to distribution, resulting in 50 different plans. One of the states with the highest percentages of residents vaccinated for COVID-19 is West Virginia. Though it’s predominantly rural, the state’s high population of elderly people has resulted in a large-scale, largely successful effort to reach its residents. New York state, on the other hand, has been less successful. Bureaucratic infighting between state and city officials delayed vaccination, and many residents eligible for vaccination are turning down the opportunity, citing concerns about safety. Joining Ira to talk about COVID-19 vaccine distribution are Fred Mogul, health and government reporter for New York Public Radio in New York City and Dave Mistich, senior reporter at West Virginia Public Broadcasting in Morgantown. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

This is Science Friday. I'm Irafledo. This week, we're dedicating an entire hour to understanding the various COVID-19 vaccines, how they're distributed, how they work, what makes them different than the history behind their production. So let's begin. Getting the vaccine into people's arms has been a real mixed bag across the U.S. A big reason for that. There is very little federal guidance for who gets vaccinated and in what order. This week, Health and Human Services Secretary, Alexander, They're recommended that people age 65 and older should be eligible for vaccination. But states are on their own when it comes to distribution, leaving 50 different plans. We're going to check in with two states, one that leads the country in vaccinating its residents, and one that's had a fair amount of, what shall we call, roadblocks, many bureaucratic. Let me introduce my guests. Dave Mistitch is senior reporter for West Virginia Public Broadcasting in Morgantown, West Virginia. Fred Mogul is health and government reporter for WNYC, New York Public Radio, and Gothamist here in New York.

Welcome both of you to Science Friday. Thanks for having us. It's great talking to you, Ira. Nice to have you. Dave, I want to start with you. West Virginia is at the top of the country for getting residents vaccinated for COVID-19. Right now, more than 6.5% of West Virginians have received the vaccine and the average for the country is about half that. What's the secret sauce in West Virginia?

for the rollout. Right. And I think it's, you know, you pointed out those numbers there. And Governor Jim Justice has been lauding those numbers. You know, as you say, you know, six to seven people out of every 100 in the state, you know, getting vaccinated. That's, that's leading the nation. And according to the West Virginia Department of Health and Human Resources, there's been more than 100,000 total first doses of the vaccine given in the state. They say that more than 20,000 people have gotten the second shot and are fully vaccinated. And the one thing that I should point out with all this is that we've seen the federal government make these partnerships with these big chain pharmacies like CVS and Walgreens. But here in the state, we opted out

of that. And our state government is working with locally owned and independent pharmacies to play a role in vaccine distribution. And that's to nursing homes and long-term care facilities. And given the fact that West Virginia is a largely rural state, you know, all this seems to be working well. So much so that I've seen reports from other media outlets in some of these other rural states wondering why they didn't do the same. And West Virginia's population skews older, right? I mean, who's getting these vaccines first? That's right. And, you know, West Virginia has, of course, like other states, had made a big push for frontline health care workers and those living and working in long-term care facilities to be vaccinated. And I think that that's no

different than the rest of the country, really. Since then, you know, they targeted the elderly population. At first, it was ages 80 and up. And on Wednesday, Governor Jim Justice announced that those 70 in older are eligible to get the vaccine. You know, he also said that he hopes to get those 65 in order as soon as next week. So, you know, things are moving really, really quickly here. Have there been any hiccups in this process? Well, you know, there was one big one recently, and there was this vaccine clinic in Boone County, which, you know, most of West Virginia is rural, but, you know, there are some, you know, cities, so to speak. But Boone County, it's a very rural southern part of the state. You know, at a clinic there recently, more than 40 people were

mistakenly given the antibody cocktail remdesivir when they were supposed to be getting the vaccine. State health officials say they notified those who got the wrong shot. There's been no reported negative effects, but they've also made it a priority to get the vaccine to those people. Again, you know, even still, it's a major mix up. state health officials, you know, are suspending distribution of the vaccine at that clinic, at least through that local health department. And, you know, honestly, I've gotten some emails from people who have had trouble connecting with local health departments. People have been, have told me that they've not been able to get their phone calls answered. But I should point out

that people are really persistent in trying to get their parents or grandparents or elderly friends and family vaccinated. So many of these people, you know, have gotten through over time. And things seem to be back on track with these vaccination clinics that are springing up more and more. Fred, let's move to the Big Apple, which has had a less successful rollout with a lot of bureaucratic infighting. And in New York, about 3.5 percent of New Yorkers have now been vaccinated. There was a bumpy start over here. Tell us why that was. Well, I should say, it's kind of like the best of rollouts and the worst of rollouts.

Many people have had, you know, fairly smooth experiences. I just talked to someone who found a place. You know, there's these whisper networks. He's found one of the hospitals in central Brooklyn. Mostly serves a relatively impoverished communities. But he got word that there was no online signup necessary, bolted over there, got in and out relatively quickly. There are a lot of positive stories. But indeed, there is bureaucratic infighting.

Our mayor in New York City, Bill de Blasio, our governor, Andrew Cuomo up in Albany. They don't get along so well, famously, on all. all kinds of things with the pandemic response. And why should the vaccination be any different? So you have two different systems, two different portals that don't talk to each other for signing up, except it's not exactly signing up in either case. They're really more, as one city councilman called, glorified store locators. They really just, for the most part, give you places you can call, with the exception of the public

centers, vaccination centers run by the state and the city. So you can do registration there. That's where you've had a lot of people crashing. Savvier people have just kind of hit eject on that and started calling around to different hospitals and health care systems. And they've had a little bit more luck that way. You know, I also hear that it seemed like the state was worried about the wrong people getting the vaccine, that it delayed things for everyone. Well, I don't know if it was the wrong people exactly. I think they were hopeful and optimistic that their highest priority people would sign up in greater numbers.

than they did, the healthcare workers, the 1A people. So that was, you know, hospital personnel, clinic personnel and nursing home, both residents and personnel. And they've found so far it's really been kind of slow, not necessarily any significantly more slow than the rest of the country, but about, you know, 36% statewide. So you've got a lot of vaccine that's delivered that's not being used. At that point, they decided to open it up to everyone 75 and over, to broader categories of essential workers. And then on Monday, the federal Health and Human Services Secretary, Alexander Azar, came out with broader guidance that they should open up to everyone 65 and older. So now the floodgates have largely opened. And a lot of these places, it seems, you know,

if you know somebody who knows somebody, like you said, hey, there's a site, there's a place in Brooklyn that's giving them out. Let's get over there. Yeah, this is really troublesome in a lot of ways because there is supposed to be a very high priority on people who are from vulnerable communities, communities that fared very poorly in their health outcomes in the earlier surge of the pandemic in the spring, you know, the areas that were just devastated, frankly. They had very high exposures. They had multi-generational families living in tight quarters. And there was to be a push to really get these people vaccinated first.

Now, I won't say that they've abandoned that, but there are a lot of people who are, you know, adapted gaming the system and just part of networks. I put on a woman the other evening who had a big snafu. She had driven 40 minutes to get on one, and she had a printout in her hand, but it wasn't the right printout. I put her story on the air, and the next day a family friend contacted her and said, you know, come to my hospital, we'll take care of you. But not everyone can do that, of course. Yeah, this is a very New York way of doing things. Dave, I want to shift gears and talk a bit about vaccine hesitancy in your state. Do you get a sense of how big of an issue fear or hesitancy is in West Virginia? Yeah, well, I think it's still pervasive. A colleague of mine

here at West Virginia Public Broadcasting, Emily Allen, reported this week that more than 60% of state corrections officers had refused to get the vaccine. And also back in December, I was in the room when vaccine doses first started being given to employees of WVU Medicine, that's the largest health care system here in the state. Their chief pharmacy officer there told me that only about half of workers were interested in getting the vaccine. But I checked in with him just recently and he told me that about 40% of staff had been vaccinated as of January 5th. But he says that that number is now nearly 50%. And with some of these numbers, I know that those in charge of health systems and some of these institutions across the state that maybe are,

are in charge of people that are particularly vulnerable to the virus, that they're still making a push to get their staff on board to get the vaccine. I know that prisons have been a huge source of COVID-19 outbreaks throughout the pandemic are incarcerated people getting vaccinated? Well, you know, right now, as of right now, those that are incarcerated are not listed as a priority. There's a big push from some advocates in the criminal justice system to make that a priority to get these people vaccinated. But like I said, more than 60% of state corrections officers

have refused to get it. So it's sort of two things working there. One being that there's a particularly vulnerable population inside the prison and as well as one, you know, that's coming and going from these prisons and jails. But again, those on staff don't seem to be overwhelmingly in support of getting the vaccine at this point. And Fred, hesitancy. an issue in New York. I was hearing reports that even members of the New York Fire Department don't want to get the vaccine. Yeah, you know, listening to David, I mean, it just really strikes me that this is kind of a great unifier in a perhaps unfortunate way between rural and urban, black and white, red and blue states. Perhaps there just are relatively low numbers. And as one,

you know, ER physician I talked to, put it, you know, if we're having this difficult, with health care workers. I mean, mind you, there, a lot of them are supportive service workers in divisions like the custodial staffs and the security staff and so forth. But nonetheless, if within our four walls and our temples of science and health care and medicine, if we're having these problems, boy, what is what's the rest of the community going to face when we broaden the access to this vaccine? Now, in a sense, as they've broadened it, it's not an issue initially, you know, then now, now there's enough people rushing to get the relatively small supply, but as the supply grows, you know, hopefully the demand will grow, but I don't know that how quickly

it will catch up. Well, we'll see how it works. We'll see how it works out for everybody across the country and in West Virginia and New York. Thank you both for taking time to be with us today. Thank you. It's great talking to you, Ira. Fred Mogul is Health and Government reporter for WNYC, New York Public Radio, and Gothamist here in New York City. and David Mistitch is senior reporter for West Virginia Public Broadcasting in Morgantown, West Virginia. We'll keep covering vaccine rollouts across the country as vaccinations continue. Let us know how your state is handling this process on the Science Friday Vox Pop app wherever you get your apps. We're going to take a break, and when we come back, we'll talk about the COVID-19 vaccines.

You know, they didn't come from nowhere. We'll take a look at the years of foundational work that helped scientists move, so quickly when the pandemic hit. This is Science Friday. I'm Iroflato. At the beginning of 2020, there were no vaccines available, much less approved for COVID-19. But now in the first weeks of 2021, we have two, as well as a pipeline of dozens of vaccine candidates in clinical trials. As doses become available for frontline health care workers and the broader public, trust

is a concern. We've even heard from listeners who wonder if the sped-up timeline or the novelty of MRNA are compromising safety. I think I sort of understand how our current vaccines for like smallpox work, but I'm not sure I understand what it is that happens with these MRNA vaccines. How much confidence do we have in the efficacy of this treatment primarily due to the fact that, that it was pushed so fast. I'm a pediatrician in West Bloomfield, Michigan. Even among the community of parents who accepts all other vaccines, there is some hesitancy. There should be a way to explain how the streamlined vaccine approval did not sacrifice safety considerations.

Thanks to listeners, Tom, Arnold, and Isabel for their comments on our Science Friday Voxpap app. While SARS-CoV-2 feels like it came out of nowhere, these vaccines did not. They rest atop years of research, vaccine technologies with proven safety records, tweak just a bit for this new virus. Even MRNA is not new, and we can thank the first SARS epidemic for much of that. Influenza and HIV vaccine research have also contributed. Here to talk about it, two vaccine researchers with their own COVID-19 vaccines in the pipeline. Dr. Maria Elena Botazzi is Associate Dean at the National School of Tropical Medicine, Baylor College of Medicine

and co-director of Texas Children's Hospital Center for Vaccine Development in Houston. She's done work on SARS and is part of a project to make vaccine for COVID-19. Welcome, Dr. Batazzi. Hi, good morning, Ira. Very nice to be with you. And Dr. Rama,

Professor of Microbiology and Immunology at Emory University's National Primate Research Center. He joins us from Atlanta. He's been applying his expertise from work on HIV vaccines, also in the name of a COVID vaccine this year. Welcome, Dr. Amara. Hi. I, Anna. Very nice to be with you. Nice to have both of you with us. Let me do a time warp. Let's do a time work back to, let's say, it's January 2020, Dr. Batazzi, and you're researching SARS and mayors, let's say, and you've just heard about a new virus with pandemic potential. Tell me,

Tell me what the vaccine researchers do first. Absolutely. So, in fact, it was more like December of 2019 when we already were hearing about this pneumonia-like virus. So in the moment, January 11, we got the sequence that it was a SARS-like coronavirus. We took that sequence and compared it in that case to, for us, to the SARS sequence.

We saw that both sequences were around 80% similar. and we tinkered it very quickly because we already knew how to work with it from our SARS experience. And honestly, I have to tell you what we used to do for SARS that took us three, four years, we actually managed to do it in three, four months because we knew exactly how to manipulate the new sequence. So that's what we did first. We looked at the sequence, took it, synthesized it, and put it into our yeast expression system to be able to make a recombinant protein. So your lab was already ready to get working on this?

Absolutely. This is what we were trained for. Our center now has 20 years of operation. We have, of course, many other vaccines we're working on, but we've already had 10 years of experience working on coronavirus vaccines, MERS, as well as SARS, as you mentioned. And Dr. Amara, you were working on HIV vaccines before pivoting to COVID-Candidate.

What could you apply from this work on the HIV vaccine to this virus? Absolutely. So there is a wealth of information that we learned from the HIV vaccine development. We are interested in using both neutralizing antibody as well as cytotoxic killer T cells, as well as helper CD4 T cells against the virus. that would give you a broad coverage from the immune system to attack the virus from multiple fronts. And we learned a lot about the safety of this and how to deliver it and how to make high levels of this SARS virus protein when a vaccine is delivered.

And we also know that what kind of immune responses the vaccine induces when it is given. Considering all that, when we decided to make a coronavirus vaccine, we could jump right into it and then made a vaccine within a few weeks. So in other words, you already knew how to tweak the immune system to respond to the HIV vaccine, and you adjusted that for the new vaccine. That's correct. So the success of the COVID-19 vaccines stem in large part from the work that's being done on the HIV vaccine. I absolutely believe that because there's a lot of the money that invested in HIV vaccine development and paid off in making the COVID-19 vaccine. For example, whatever AstraZeneca is using, even in Moderna and Pfizer and Biantec and JNJ, all these platforms have been used are actually developed for HIV. So all these platforms were, and our MBA too, right?

So all these were developed for HIV, and then because so much knowledge existed, now they are able to, we are all able to quickly apply this for COVID-19. And I don't know if you realize, but the clinical trial networks around the world where these vaccines actually are being evaluated actually are HIV. vaccine trial networks. Yeah, so they really mobilized all the HIV's infrastructure, not only technology, but the infrastructure. And that has given even a lot of low-middle income countries the opportunity to evaluate some vaccines because they just plugged into an infrastructure that was created with HIV funding. Do you think that success with the COVID-19

vaccine is going to spur a development of an HIV? HIV vaccine? In general, HIV vaccine program has been so slow because they follow standard vaccine development path. I'm hoping that now the experience with the COVID vaccines, I think they would actually try to change things to speed things up. It seems that neither of you have been working on MR&A vaccines, but it feels like, you know, these are the stars of the vaccine hunt and kind of seem to come out of nowhere as a technology. Where were M RNA vaccines being developed before COVID-19, Dr. Batazzi? I have to say that, in fact, our laboratories do do work on the RNA technology. We opted for not applying it for COVID-19, mostly because our center also

is very interested, as you see, because we collaborate with global health entities. to make a vaccine also quite accessible, affordable, safe, of course, for low-middle-income countries. And we know that there's still a little bit to go to make these vaccines using these new technologies not only large-scaleable, but also maybe even affordable. And they're a little bit more difficult, as you have been hearing about even coal-chain manipulations. But ultimately, the role of the RNA vaccine is similar to eventually what the protein, vaccine does, right? What you're giving your body is a code that can become a protein in your body, and then the protein really is what induces your response against it and therefore protect you.

So I think that ultimately the end goal is the same, the use of these RNA technologies, which, by the way, they have been being evaluated for years now. It's not like they're brand new either. they may not have ever been licensed before, but they've been evaluated for even Zika virus vaccines and even rabies vaccines. They've been trials already using those technologies. Eventually they may take on around the world as more people use them and learn how to make them. They may become even more cheap to produce and more scalable. So I think overall, whether it's an RNA vaccine, whether it's a RNA vaccine, whether it's a viral vector like Dr. Amara is using or a protein-based vaccine or even live-attinuated

or inactivated vaccines. What we were very lucky is that this is a coronavirus and we already knew exactly what to tackle. We knew that the vaccines had to be produced targeting the spike or a piece of the spike. And I think that also is the reason why we were very quick at producing these vaccines because we didn't have to search for what candidate to tackle. The COVID-19 vaccines that are going into arms now took less than a year from start to finish. I understand it's rare for a vaccine to be approved within five years.

How much did money allow us to save time? I think it was a very critical piece in this big picture. Typically what happens is that we make a vaccine in the laboratory, we tested in the animals, show it is inducing the desired immune response, and it can provide protection against a viral challenge in the animals. And then you go into the human trials through initial phase one study where you look at the safety and the phase two, where you look at whether you are able to get desired immune responses in a few hundred people,

and then going to the phase 2B or phase 3 study, that we'll test for the effectiveness of the vaccine in thousands of people. And once that is done, there will be plans to also scale up the manufacture of this vaccine, of any vaccine. So all this takes a lot of time. Each step takes at least a year. There are multiple steps that are involved. So because organizations like the WAPSPET invested in manufacture and manufacturing these vaccines,

even before we knew that, even before we had any data that these vaccines would generate the desired immune response and provide protection. So it was a big gamble we had to take when I say we, I'm talking about a field in general. So that really paid off. If they had to do it in a traditional way, this would not have been possible in a short time. And we keep hearing about hesitancy of people to take the vaccines on safety concerns. You heard some of our listeners mention this at the top of our program here, even after all the trials and the other research, even after panels of experts have given

intense scrutiny to the vaccines that have already been authorized. Maria is one year of safety data, really? as good as five or more years? Well, I think that you have to remember that when you initially launch a vaccine and you rely on not only the phase one, phase two, and even phase three safety data, I think we're talking that it's already thousands of people that have received such vaccines. And so safety, usually, if there's going to be something quite a stopper, is going to really show up pretty quickly.

What we need to remind everyone is that safety evaluations don't stop ever, even after, indeed, they get even licensed. Right now we're under emergency authorization, which of course they're still considered experimental. But once the companies reach the entire full licensure, we still do a lot of what we call post-marketing surveillance. So surveillance never, never ends. What I also would like to remind everyone in the context of we've been discussing that it's not the first time that we've been evaluating coronavirus vaccines in the clinic. And we've been doing this with also the SARS vaccines that have reached the clinic or even the MERS vaccines that have reached the clinic. And even though we were never given the opportunity of fully advancing the vaccine development for those two, mostly because the virus was pretty much. controlled and making this phase three clinical trials, you require a level of virus circulating

in the community, right, to see the efficacy. But we already also had a lot of safety evidence from prior trials from all our research on coronaviruses before. I think, you know, we should remember that now also not only RNA vaccines, but many of these other platforms of vaccines, there's now millions of people that have been vaccinated. So I think that, that it gives you quite a strong assurance that they are safe, I think. And most likely they all will work, some better than others. Some will work better for some demographics, maybe even some regions of the world. But I think right now they're really going to be the game changer to really try to reduce

the virus circulating in our communities, while at the same time really offloading some of the health care pressures that we're having. because people are going to have a lot less symptoms using these vaccines. I'm Ira Plato. This is Science Friday from WNYC Studios. We've talked about the existing research. We've talked about the money. But are there other ways, the effort to create COVID-19 vaccines? We're able to happen faster without compromising quality, Maria? So three things, right?

The technology that allowed us to know that the secret. of the virus was done in less than a week, it's amazing. So technology in general is accelerating. So not only technology in the sequencing, but also technology in being able to track the virus. And we could have done a little bit better with the diagnostics, but at least, you know, technology is key that is very different what we have today from even 10 years ago. The fact that there's so much virus circulating, unfortunately, in our communities, allowed this large phase three clinical trials to really reach there,

what we call clinical endpoints, quicker because people were getting infected. So therefore, you know, they could measure how well the vaccines would reduce the clinical symptoms. And clearly what Dr. Amara said, that the influx of money to advance manufacturing, because usually companies wait until they know the vaccine works before they even say, okay, now I'll invest in making bulk loads of, of the vaccine. The fact that they made a lot of vaccine production ahead of even knowing whether they would work, that probably skimmed off another couple of years. So those are really the three main aspects that I think have really had a drastic reduction of the timeline.

We have run out of time. So much to talk about. So little time to talk with you. I want to thank both of you for taking time. Dr. Maria Elena Botazzi is Associate Dean at the National School of Tropical Medicine, Baylor College of Medicine, co-director of Texas Children Hospital Center for Vaccine Development in Houston. Thank you for being with us today. Thank you so much, Ira. It was a great pleasure to share this with you and with Dr. Amara. You're welcome.

And Dr. Rama Amara, a professor of microbiology and immunology at Emory University's National Primate Center in Atlanta. Dr. Amara, thank you for taking time to be with us today. Thank you. It's my pleasure, and it sounds a pleasure. to be with Dr. Maria. We're going to take a break and continue our hour-long talk about vaccinations. What's next in the world of vaccine development?

Will COVID-19 change vaccine development in the future? We'll discuss. This is Science Friday. I'm Ira Flato. In case you just joined us, we're talking this hour about vaccines and for the rest of the hour, the future of vaccination. Can what we have learned in developing COVID-19 vaccines change how vaccines are made going forward? Joining me now are my two guests, Dr. Paul Joprey.

He's the director of the Center for Vaccine Research, Professor of Microbiology, Molecular Genetics, University of Pittsburgh School of Medicine, of course, in Pittsburgh, and Ryan Cross, biotech reporter for Chemical and Engineering News based in Washington. Welcome both to Science Friday. Thanks for having us. Nice to be here. Nice to have you. Dr. Jupre, there's a lot of focus right now on the MRNA vaccines. How do they fit into the overall vaccine toolkit? How did we get here from the days of the SOC polio vaccine?

Whenever you think to the past of Salk and Sabin, they had limited numbers of ways in which they could weaken viruses. And the technical term we use for that as attenuate viruses and make vaccines. So, for example, we talked from Pittsburgh, as you've said, Salk worked here. He determined how to chemically inactivate the poliovirus that he had grown. And that was the vaccine that was the first one to be generated for polioviruses and really has been instrumental in leading to the near eradication. But of course, first is not often best. And we need to have a number of different ways to make vaccines.

So the Saban vaccine was also used in the eradication program. And it, rather than being chemically inactivated, was biologically changed. What Saban did was he weakened it by passing it in cells and the virus changed. And eventually the virus instead of causing the disease of poliovirus, it formed the ability to generate antibodies in the individuals. And again, when we're talking about coronavirus, antibodies are super important. So we had poliovirus antibodies generated.

we didn't get the disease. And that's the real basis of vaccination. That's where a lot of it started. These were empirical people who knew what they were doing. They were very systematic in their studies. But one of the things which is super interesting about vaccines is we still don't know how many of the great vaccines that we have work. So for example, I work on measles, worked in measles all my professional life. We still don't know the molecular basis for why the measles vaccine is such a phenomenally good vaccine. So that's the past, fast forward to 2020, 2021. The toolkit that's available today is something that Salkin Seven could only have dreamed about. We can use the modern approaches of molecular biology. We understand how RNA goes to proteins.

We understand how DNA goes to RNA goes to proteins. And remember, the proteins, are the things that the immune system recognizes. And that's why we end up with super cool and very different ways to make vaccines. Now, to answer the question about MRNA vaccines, why they're really interesting is because we have never until late 2020 licensed an MRNA vaccine. Completely new modality, a completely different way. What you're doing is you're not showing the person. the shape of the virus by showing them inactivated virus or even the proteins from the virus.

What you're doing is you're using the person to be the factory to make the proteins so that the immune system recognizes that spike protein we're all too familiar with. And the immune system begins to make those antibodies against the spike protein, which of course decorates the outside of SARS coronavirus too. Ryan, you follow the biotech industry. is MRNA, the big hot new thing that Dr. Jupre is talking about? It is. And it has been for a few years now. You know, I think people have been working on this idea of an mRNA vaccine or even an mRNA therapy for really decades. It really goes

back almost to the time of DNA vaccines. But over the past 10 years, it started to pick up interest from biotech investors. And really just a handful of companies, Moderna and Biontech to to name the two that we have approved here in the U.S. now, have really invested billions of dollars in trying to make this experimental technology actually works. So I think this is something that maybe gets lost in the shuffle of news is that even though these are the first MRNA vaccines that have ever been authorized here in the U.S., they're really built on the backbone of more than 10 years of work and a huge amount of investment in the technology. Would you have predicted Dr. Jouprey?

at the beginning of all of this, the success of the MRNA approach? Of course, hindsight is a wonderful thing. But I honestly do believe if you had asked biologists to give you a number before the studies were presented and looked at by the FDA, I'm not sure that too many vaccinologists, biologists, epidemiologist, immunologist would have really picked the number 94%. And I just love that. hard work. And as Ryan has just said, you know, this doesn't come out of nowhere. It comes out of

hard work, perseverance, comes out of really good formulation, important delivery, all those bits to give us a completely new way to make a vaccine. So I'm not sure that I would have said that it would have been as high, but I love the fact that it is as efficacious as it is. I really hope that we continue to learn because what do we know? First generation becomes second generation, second generation becomes third generation. We just get better at delivery. We get better at understanding. So hopefully this is just the beginning of a new way to deal with not just infectious diseases, but other sorts of diseases as well. Ryan, is anyone thinking of replacing existing vaccines that are not MRI ones with MRI ones? What I'm hearing is, what I'm hearing is,

that a lot of our existing vaccines, our childhood vaccines, a lot of them are pretty good. And some of them have even almost eradicated the diseases they're designed to prevent. And there's probably not going to be a lot of motivation to replace those. Some other vaccines, such as the flu vaccine, there's a lot of room for improvement with that. It's really hard to make flu vaccines because that virus is so much more variable and changes so much more quickly than even something like the new coronavirus. And it's been really hard for vaccine makers to make a vaccine that matches sort of the current genetic makeup of that flu virus. Since MRNA vaccines can be made, designed and manufactured so

much more quickly, there's a potential that they could be really revolutionary for flu vaccines. You know, the companies are working on that right now. It remains to be seen whether they're going to live up to that potential. Why would a big pharmaceutical company like Johnson and Johnson, who is working out. They're on the third phase of a vaccine, a coronavirus vaccine, but it's not an MRNA vaccine. It's an adenovirus vaccine. Why would they go in that direction, Paul?

The old phrase, don't keep all of your eggs in one basket, is very important. I think Ryan's point is well made. Just because we got 94%, 95% with the SARS coronavirus and an MRI vaccine does not mean that that will be the same for influenza, for example. So I think it's really important to be creative, be developmental, because I just don't believe there's ever going to be a one-size-fits-all approach to vaccination.

We need to just think about it as adding to the toolkit, having abilities, different modalities that can be tuned for specific viruses. Because remember, what we do know, is viruses emerge. We've talked about flu. Why do we need to make flu vaccines again and again and again? Because viruses emerge from animals and they also change within people

whenever the people are infected. So we need to be ready to be as adaptable as the viruses and the pathogens that we're trying to fight. And you don't have only one weapon in your armory whenever we are beginning to learn how evolutionarily clever these viruses are, SARS-2 is,

how it makes deletions, how it makes changes, how it's evolving already under this selective pressure. That's why you don't just have one vaccine approach. If you don't mind me adding to that, these different pharmaceutical companies have all invested in different technologies. I think we're really fortunate that before, the pandemic, Pfizer had actually started working with Beyond Tech on MRNA vaccines for the flu. And those are still in a much earlier experimental stage. But because of that partnership that Pfizer had, they were able to sort of pivot and start working on an MRNA vaccine for COVID quickly. Johnson and Johnson took a different approach, as you said, these adenoviral vector vaccines,

which is not MRNA, but it's sort of its own kind of genetic vaccine, since it involves really taking, you know, a gene for that coronavirus spike protein and putting that. in this shell of a common cold virus. You have this genetically engineered virus that you can also make pretty quickly, which, you know, it's moving a little more slowly than the mRNA vaccines, but still compared to normal, quite fast. And we could really expect to find out whether that vaccine is effective or not next month. So are the days of a dead or attenuated virus vaccine done with? It doesn't sound like that, Paul. I think they're not over, but we have to use the right vaccine against the right disease in the right way at the right time. Remember as well one aspect

of the conversation which we should discuss is price. Not all of these vaccines are the same price. And we have touched a little bit on the fact that some of them have to be stored at very, very cold temperatures. I think it's really important whenever we're having this conversation to remember that it's just not about us. Whenever I say us, I mean us in the United States. virus somewhere in the world is pretty much a virus anywhere in the world and I think we don't need to be told that based on this current pandemic. It's not to blame where it came from in the world that's naive. But what we have to realize is these are global problems. So therefore we need to ensure and again during the development process we need to ensure that we are

developing vaccines not just for our part of the world but for all of the world. So we make products which have to be stored in such a cold temperature or cost a lot of money, we are not looking after people who are equally valuable, have equal meaning, have equal worth in all of the world. And therefore, we're not looking after this part of the world as well. So we want to make sure that we don't develop products that are too expensive. We want to make sure that vaccines are equitably distributed and that they can be equitably distributed So again, that's why you need to think about other modalities, adenoviruses, UVNactivated vaccines and activated vaccines,

whatever way you make those vaccines so that we have products for everyone, not just the privileged to be. I'm Ira Plato. This is Science Friday from WNYC Studios. Let me have you dream a little bit, Paul, about, let's even go as high as a science fiction mode. What is the science fiction now, the really out there, dream idea that people are having or you're having? One of the biggest challenges is viruses know

a revolution, how to be ultra-snaky. They are able to evolve pretty quickly. So we've talked about influenza. Wouldn't it be wonderful if we could get to the point where we could get these cocktails that were ready to anticipate the viruses that may come as opposed to the viruses that are here. The term that we use for that in the influenza world is universal influenza vaccines.

Or the other word we can use is pan vaccines. Wouldn't it be great if we had developed because we knew it existed a SARS-1 vaccine? But not just a SARS-1 vaccine, a pan-coronavirus vaccine, so that we were ready for the next coronavirus and there was MERS, which is the next coronavirus, and then there was SARS too, which was the next coronavirus, and there'll be more. Wouldn't it be wonderful

if we eradicated measles that we were ready with something just in case a new virus, like measles virus or polio virus emerged from an animal reservoir, because that's what happens. And making vaccines for the present is far from trivial. Dreaming about vaccines which have pan-universal activities is certainly challenging, and that's for the future. And I look forward to the day when such vaccines are made before the viruses are even known.

And we're looking at other companies. There was research being published this week talking about possibly using mRNA to treat other diseases, for example, cancer or other tumors. It seems to have crossed over now, Ryan, into these other areas. Yeah, you know, a lot of these companies like Moderna and Beyond Tech have actually spent a lot of money and time working on things that are not infectious diseases. over the past 10 years, they really have a lot of investment in cancer and autoimmune diseases, even rare genetic diseases. They think that they can use RNA vaccines to basically give your immune system a mugshot of what your tumor looks like. Or they can also use MRNA to basically

encode a drug or a protein that could treat a disease, not a vaccine, but a treatment. You know, I guess maybe just to follow up on the sci-fi question from a minute ago, I, you know, was thinking about my answer for that as well. And it's becoming harder and harder to sort of envision, you know, these science fiction scenarios because the things that people are doing right now almost sound like science fiction, right? People are working on universal coronavirus vaccines. People are working ahead to try to predict what kinds of viruses might emerge. And, you know, can we make prototype vaccines for those viruses right now so that we can be ready to be ready to, you know, we can be ready to. go and maybe you move even faster in the next pandemic. And it's incredible and hard to believe, but also really, you know, inspiring to see that happen. Thank you both gentlemen. This has been very, very informative. I'd like to thank Dr. Paul Jouprey, Director of the Center for Vaccine Research, Professor of Microbiology and Molecular Genetics, University of Pittsburgh School of medicine in Pittsburgh. Ryan Cross, a biotech reporter for Chemical and Engineering News, based in Washington, D.C. And they have a big issue looking back on a year of COVID science

coming out later this month. You'll want to look for that. Thank you both for taking time to be with us today. Thank you so much. Thank you very much indeed. One last thing. We wanted to let you know about a free resource created by our education team in tandem with our breakthrough series, short documentaries about women at the forefront of their scientific fields. It's a toolkit of research-based strategies for making STEM more inclusive in colleges and universities. If you're interested, go to breakthroughfilms.org slash toolkit to learn more and download our inclusive action toolkit today. That's breakthroughfilms.org slash toolkit. Charles Berkwurst is our director.

Our producers are Alexa Lim, Christy Taylor, Katie Feather, and Kathleen Davis. B.J. Leatherman composed our theme music. And of course, if you missed any part of this program, or you would like to hear it again, subscribe to our podcasts, or ask your smart speaker to play Science Friday. Have a great weekend.

We'll see you next week. I'm Ira Flato.