Science Vs - Coronavirus: Dude, Where's My Vaccine?

Episode Date: June 19, 2020

All through the pandemic, we’ve been waiting for a possible silver bullet: a vaccine. How soon could we actually get one? To find out, we talk to microbiologist and immunologist Professor Karla Satchell, immunologist Dr. Kathryn Stephenson, Pfizer executive Mike McDermott, and Ian Haydon, who’s participating in a vaccine clinical trial. Here’s a link to our transcript: https://bit.ly/3egWFrc This episode was produced by Wendy Zukerman, with help from Michelle Dang, Sinduja Srinivasan, Laura Morris, Meg Driscoll, Rose Rimler, Meryl Horn, and Mathilde Urfalino. We’re edited by Blythe Terrell with help from Caitlin Kenney. Fact checking by Lexi Krupp. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Marcus Bagala, Emma Munger, and Bobby Lord. A huge thanks to all the researchers we got in touch with for this episode, including Dr. Barney Graham, Dr. Melvin Sanicas, Dr. Norbert Pardi, Professor Peter Waterhouse, Professor Edward Mocarski, Dr. Ramin Herati, Dr. Rachel Roper, and Dr. Yvonne Genzel. And special thanks to the Zukerman family and Joseph Lavelle Wilson. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hi, I'm Wendy Zuckerman, and you're listening to Science Versus from Gimlet. From early on in this outbreak, scientists have been on the hunt for something that could shut this virus down and give us our lives back. A vaccine. A few months ago, there was a lot of excitement as the very first clinical trials for the coronavirus began. It was in record time. The search for a coronavirus vaccine has become one

of the fastest moving in history. Vaccines usually take years, not months, to produce. This is happening at warp speed. Never before have hundreds of scientists all over the world been focused on the same thing at the same time, creating a vaccine for COVID-19. And more and more vaccine candidates are entering the fray. We're at the point where around a dozen clinical trials are on the go. Hundreds of people have volunteered for a jab in the arm to test all kinds of different vaccines. And as part of this, scientists are taking some big gambles.

The vaccine that we're looking at is an incredibly modern type of vaccine. It's not the traditional way of building a vaccine, so we're going as fast as humanly possible. Many of them are not traditionally vaccine companies. They are using novel ideas from oncology, from things they've learned treating cancer. It's never been used in a vaccine before. And if one of these gambles pay off, it could be huge. We could get a vaccine soon. The US government says that their goal is to get a vaccine to Americans by January 2021. They're calling this Operation Warp Speed. And if it could be done, this would be unprecedented. So, could we really be celebrating 2021 with champagne and a shot in the arm to fight the coronavirus?

And what would it take to make that happen? That's today on the show. Because when it comes to getting a vaccine, it feels like... This is happening at warp speed. But then there's science. Science versus when on earth are we getting this vaccine? It's coming up. Just after the break.

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that we could get a vaccine in 12 to 18 months. That could mean early next year. And in the land of vaccines, this would be record-breaking. It often takes something like 10 years for a vaccine to go from the lab to the doctor's office. And in the land of vaccines, this would be record-breaking. It often takes something like 10 years for a vaccine to go from the lab to the doctor's office. So can we really do it? Get out of this pandemic by January, before Santa even catches his breath. Well, to get there, labs all around the world are scurrying around,

experimenting with different kinds of vaccines. But they all have the world are scurrying around, experimenting with different kinds of vaccines. But they all have the same goal, to train our immune system to recognise and kill this coronavirus. And to do that, many vaccine developers have homed in on one thing. Professor Carla Satchell at Northwestern told us all about it. If you think about the picture that you've seen of coronavirus, like everywhere, it looks like a ball with little points coming out of it. If you think about the picture that you've seen of coronavirus like everywhere, it looks like a ball with little points coming out of it. Those points are the spike. The spike protein. You know it. I know it. It's the most famous spike since Spike Lee and the most famous protein since collagen. Anyway, this spike is so important because

it's a major thing that tells our body, wait, this virus, it doesn't belong here. That actually is what our immune system sees most readily. It sees the spike. After our immune system sees the spike, it learns to recognize and quickly respond to it by creating things like antibodies to fight it. And then some of those antibodies hang around so that if the virus shows up, then the virus will just be cleared away by our immune system so that the next time we see that disease, we don't get sick in the first place. So if you're making a vaccine, how do you get your immune system to quickly recognize this spike?

Well, one way is that scientists can take a coronavirus and then make it less dangerous. Say they kill the virus. Most commonly, vaccines are made by growing up the virus and inactivating that virus, sometimes with a chemical, sometimes with heat, and then that has been injected. Another way scientists can do this is make a version of the virus that's too weak to make

you sick. And this is how we make a lot of vaccines that we're familiar with, things like the measles and chickenpox and flu vaccines. It's tried and tested. We know it can work. And some companies are going this way to try to make our coronavirus vaccine. But other groups are ditching this meat and potatoes vaccine method. They're using newer tech, more experimental ways of building a vaccine. And these experimental methods are getting a ton of attention and funding right now because governments and big pharma are hoping they'll deliver the goods faster. So for these, instead of giving you a

whole coronavirus, these vaccines are basically using genetic material from the coronavirus, and then they're plopping that into your body. And scientists have chosen a very particular piece of genetic material. The spike. It's the recipe for the spike protein. And this can come in a couple of forms. One is called mRNA. Our body will see that as a normal mRNA and just translate it into a protein. Wow. So this, if this vaccine works, it would encourage your body to make little coronavirus proteins. Yes, that's the idea. Wow, that seems so futuristic. As scientists, we're like, you know, that's really cool, right? So you're getting the body to generate that protein for you. Yeah. So these spike proteins that your body has made will then be floating around.

And the idea is that your immune system will see it, make antibodies, and ta-da, you'll have immunity. And many of the vaccines in this race are delivering this genetic material to us in different ways. So some are shoving mRNA into a ball of fat so that your cells will slurp it up, while other groups are trying to smuggle in that code using, get this, a totally different virus, one that won't hurt you. Is it fair to say that they've taken a different virus and then they're like Halloween, like they're dressing it up, like the coronavirus?

Yes. What? This is insane. So this all sounds a little bonkers mad. The question is, will it really work? That is, will these vaccines protect us if we get exposed to the coronavirus? Because if they don't, they're kind of useless. Or as my boss likes to say, if it's just dishwater, then you're not going to get anywhere.

This is Katie Stevenson. She's a doctor working on vaccine development at Harvard. And she says that one of the key ways we'll know if a vaccine is working is if it makes you produce antibodies. And she's looking for not just any antibodies, but neutralizing antibodies. What is a neutralizing antibody? Aha. So a neutralizing antibody is an antibody that binds to a virus and neutralizes it. This is the dream, right? Yeah, exactly. It's the dream, right? It just binds to the virus and prevents it from entering

a cell. So the body sees that and just like throws it in the garbage. So this is what Katie is going to be looking for in the results of all these clinical trials. And if she doesn't see these neutralising antibodies, she'll be thinking, well, that was kind of a dud. And Katie says, ideally, you'd see a lot of these. So what's a lot?

Well, you measure milk in litres. OK, so I measure milk in litres. And you can measure antibodies in titres. So one study which looked at people who had been infected with this coronavirus and then recovered found that their antibody titres tended to be at least 100. And when Katie's colleague vaccinated monkeys with an experimental vaccine,

they found that having a similar antibody titer of 100 protected them from getting infected. So while we're still learning a lot here... I've been kind of looking for 100. OK, that's nice. It's nice and, like, poetic, right? You know, 100. Yeah.

We have a handful of results that companies have released from different clinical trials, but just one paper that's published in a peer-reviewed journal. It was from a Chinese pharmaceutical company who injected more than 100 people with one of those new Fandangle vaccines, and it was back in March. They tested three different doses,

and Katie says they didn't get near this antibody-tighter target. Like, at the highest dose, they averaged around 34. You know, I was a little bit disappointed, so I'm a little bit reserved. I'm happy that it elicited an immune response, because that's not a given. Sometimes it's just zero, zero, zero. But I would have liked to see something closer to like a hundred. Another company, Moderna, injected 45 people back in March with their vaccine. And they said that eight people had good levels of neutralizing antibodies. But they didn't tell us about the others in the trial. When we asked Moderna about this, we didn't hear back.

So Katie is holding out for more info. Yeah, I just want to see the rest because it is, I mean, yeah, promising. I'd put promising right on there. But I do not know which one of these is going to work, if any. And that is the actual fact truth. So I try not to stray from that. And there are other fact truths to nail down here. Even if these vaccines do make you produce these antibodies, we'll still have to make absolutely sure that you're protected from the coronavirus if you do get exposed. And then if you are protected,

we'll have to work out how long for. So you might need more than one shot of the vaccine, say a booster shot in a year or so. Figuring all this out is going to take some time. And then there's another big question. Are these vaccines safe? I asked Carla about this. What could go wrong? I think a lot of things could go wrong.

I think, you know things could go wrong. I think, you know, safety is always the issue. What are the unintended consequences of what you're doing? The unintended consequences. I remember throwing up, and then I remember sort of waking up on the floor. Coming up, just after the break. Welcome back. So there's all this exciting new tech promising to get us a vaccine in record time.

What could go wrong? Well, one big thing, of course, is safety. Because even if you get the vaccine to work, you can't give it to millions of people until you're absolutely sure it's safe and won't cause nasty side effects. So to find out how these vaccines are faring, we're going inside one of the clinical trials. And we're going to talk to a human guinea pig, Ian Hayden. He was one of the first people in the world to get a coronavirus vaccine. It was part of Moderna's trial.

At the time I filled out the form, I didn't expect to hear back. Because do you know how many people applied? I was told it was thousands of people who applied. Wow. And then how many were selected in the end? 45? 45, that's right. Wow, that really is like a golden ticket situation. Yeah, I just feel extraordinarily lucky. But not long after the trial began, Ian got a little less lucky.

As part of the trial, he had to get two shots a month apart. And after getting his second shot, he went home. And that evening, he started to feel crappy. All of a sudden, I noticed that I had really severe chills. My fingertips were cold. I started shivering. I put on a bunch of sweatpants. And I kept asking my girlfriend, are you cold?

What's going on? I'm really cold all of a sudden. And she was not. And I was feeling just awful, really quite unwell. Later that night, his fever spiked. He called this 24-hour hotline for people in the clinical trial, and he was told to go to urgent care. He got fluids, painkillers, and was soon sent home.

Ian fell into bed. But the ordeal wasn't over. When I woke up, I woke up, this was at noon the next day. I had to get up to go to the bathroom. On the way there, I felt really nauseous and actually ended up throwing up in the bathroom. And then I just collapsed. I remember waking up on the floor though and looking up and seeing basically the underside of our kitchen table, which was a very confusing sight. When was the last time you fainted? I don't think I ever have. Moderna released a statement saying that three people out of those 45 guinea pigs had these kinds of severe but not life-threatening reactions.

And they all got better on their own. It really only lasted about 24 hours. The following day, I was basically back to normal. And ever since then, I felt 100% back to normal. And while we can't know for sure why this happened, Katie Stevenson over at Harvard says that with experimental vaccines, this kind of thing is pretty common.

And it's often because people's immune systems are going into overdrive. Because your body is like super revved up. It's looking around. It's like high alert. And that is manifested in these symptoms, the high fever, the muscle aches, all of that stuff is associated with this giant immune response. Because it's like, what did you just inject in me? Like, I got to get rid of this now. Yeah, yeah. In the clinical trial over in China that injected more than 100 people, they reported that about 1 in 10 got bad symptoms like Ian's,

say a really nasty fever that did resolve on its own. And this might seem scary, maybe even put you off getting a coronavirus vaccine. But this is the whole point of clinical trials, to see what's safe and at what dose. Because Ian, he was on the highest dose that they were testing as part of the Moderna trial. And everyone else who had a bad reaction, they were on that high dose too. And going forward, this high dose is not going to be tested anymore. They told you that?

Yeah. Moderna has planned a trial in July with 30,000 people looking at lower doses. And of course, there's a lot more vaccine contenders here, like AstraZeneca and the University of Oxford. Well, that team is pegged to start a big trial with 30,000 human guinea pigs soon too. We'll see what happens. But the broader point here is that clinical trials and all these safety tests, they take time. Here's Carla Satchel again. There are certain parts that you can make go faster, but you cannot make it go so fast that

you make a mistake. Because a mistake can be very catastrophic if you roll out an unsafe vaccine in millions of people. A lot of experts we reached out to said that a safe vaccine for this coronavirus is possible. But when we do get one to pass muster in big clinical trials, we'll still have one big challenge to deal with. Since this virus is everywhere and affecting millions of people, could we make enough of this vaccine for everyone? For this, we turn to Mike McDermott.

He's the president of Pfizer Global Supply. Pfizer is working on its own mRNA vaccine, and it'll be Mike's job to pump out millions of doses. But he says that to fill the need for the world, it's going to take a lot more. We need billions of doses, not just hundreds of millions, right? We need billions of doses of a vaccine. Mike knows the ins and outs of mass producing a whole bunch of different vaccines, and he told us that how quickly we can get it into our hot little hands kind of depends on which kind of vaccine we're talking about. So for a traditional style, that meat and potatoes vaccine, like where you take

a coronavirus and make it less dangerous, ramping up production is a big deal. Factories often need these large vats of cells. Mike says, think about it like brewing. Yeah, so the analogy I use a lot in vaccines is really around beer and winemaking, right? So you're actually multiplying the cells just like you would with beer or wine. What companies can do is literally infect cells with the weakened virus. And then they let the virus copy itself and copy itself and copy itself. And eventually they'll purify the vaccine. And so that means the more cells you have, the more vaccine you can have.

It's all pretty cool. So to make this kind of vaccine, you'd literally take all these cells infected with this weak coronavirus and put it into this thing called a bioreactor. You put them in a big tank, you give it a great environment, you feed the cells, you feed them all kinds of rich nutrients. They're all excited and growing in there and having a big party. And of course, the faster you can grow them, right, the more product you can get out the door. To grow large quantities of a traditional vaccine, it can take a long time, weeks or months. But with some of the new vaccines in the works,

like the mRNA vaccine, Mike says it could all be sped up. So what might take days and months of bioreactor time to grow, we can actually make the mRNA in a day. And that's because you don't need time to grow, we can actually make the mRNA in a day. And that's because you don't need time to grow all those cells. Instead, you take your mRNA and pop it into your bioreactor along with a special cocktail of chemicals. And these ingredients coax the genetic material to copy itself until you have loads of mRNA. So we'll be able to do millions of doses in one vessel at a time. And we make multiple, multiple batches of those. And has this, like doing this kind of process for mRNA vaccines,

like making millions of doses, has anyone ever done this before? No, it has not been done before. So there might be some wrinkles that pop up. but a lot of experts agree that making an mRNA vaccine in mass quantities, it could be done. In fact, kind of oddly, it's looking like the biggest problem here for all vaccines is in its final stage of production. And that problem is sort of basic. You see, all these billions of vaccines... They all need glass vials. They all need stoppers. And the tricky thing is that all those vials and stoppers,

they need to be completely sterile. When you're putting a vaccine into this little tube, nothing can be contaminated. Mike told us what the factories that do this look like. So you'll see operators in full gowns, almost spacesuits while they're working inside of there. You have air quality that's 100 times cleaner than a operating room in a hospital.

We're talking about a process that doesn't have enormous amounts of capacity to just suddenly make hundreds of millions or billions of doses. And that's the bottleneck, so to speak. That is the primary constraint right now. Probably the hardest part of all of this is actually putting the vaccine into a vial.

Katie Stevenson told us the same thing. But it's surprisingly easy for vaccines to get tripped up by problems at the factory. Every single vaccine that's ever been made in the history of time has had experiences like that. The bottle, you know, came the wrong way or the boxes didn't fit in the other box, you know, all that type of stuff. Oh my God. Wouldn't that be amazing if like that's what blocks the timeline? You know, it's not these like really new high-tech vaccines, but it's just literally one packaging box doesn't fit into another packaging box and then we can't ship it. Yeah, it's just logistics.

To try to get ahead of these problems, some companies, including Pfizer and Moderna, say they're going to start manufacturing their vaccines before their clinical trials are done, or they get FDA approval. So, for example, Moderna plans to start manufacturing in July, just when their huge trial is going to start. And if these vaccines end up being bung, they're just going to bin them. It's a big risk. And Katie told us that this is one of the wildest things about this coronavirus vaccine process.

These companies have now agreed that they're going to be making these vaccines now, even though we barely have any data. And that's really, really unusual. So all these companies are basically going for the most ambitious vaccine push ever, which in some ways is great because we all want to get out of this pandemic. But we still don't know whether these vaccines are going to work. And Katie told us that to hit our deadline and get a vaccine by early January,

a lot of stars will have to align just right. I mean, you need everything to happen perfectly. The phase one studies have to go perfectly. Then you get into the big efficacy studies and it has to be absolutely perfect. Then you have to have this logistical manufacturing project, which has to be absolutely perfect. But it could be, I suppose. I mean, I'm hopeful. I'm an optimist. So if we really try hard, I think we can technically meet those timelines and we just have to keep our fingers crossed that it's perfect. Perfect, eh?

She says the middle of next year is a little more likely. And even for that, it seems we'd probably have to get pretty lucky. So, while we wait, perhaps it's time for a little NCVC? Time for some non-coronavirus content. NCVC for short. Today, parasites. A team of paleontologists in China were chipping away at rocks in a quarry when they may have found the

earliest evidence of parasites. It all started when these scientists discovered a treasure trove of fossils, these little sea creatures called brachiopods, which look a lot like clams. And these brachiopods, they lived more than 500 million years ago. The researchers looked at hundreds of them. They were perfectly preserved. And about half of them had something really curious. These little greyish-white tubes stuck to their shells. The scientists were pretty sure that these tubes were left over from some worms that once grew on the brachiopods when they were both still alive.

And the researchers looked closely and they figured, hey, these worms are perfectly positioned so that when the brachiopods open up their shell to grab food, the little wormies could take a cheeky snack for themselves. To see if their hunch was right, they did something pretty clever and pretty simple. They measured the brachiopod fossils. And they found that the ones with the wormies all over them

were 25% smaller than those without. So the boffins concluded that the worms were parasites. They were sort of starving their brachiopod hosts, making them a lot smaller, which makes these wormies the oldest parasite known to science. Turns out mooching is pretty much timeless. That's Science Versus. Hello.

Hey, Michelle Deng, producer at Science Faces. Hi, Wendy. How are you doing? I'm under a blanket. Are you really? But it's so hot. Oh, I mean, just for the purpose of recording. Oh, you do sound very clear.

Okay, good. Okay, good. Yeah. So what do you want, Wendy? Well, Michelle, I have called to find out how many citations in this week's episode. Oh, it's 84 citations. 84. And if people want to see these citations, where should they go?

They should check out our show notes. The link to the transcript is in our show notes. Great. Thanks, Michelle. Okay. Thanks, Wendy. Bye. This episode was produced by me, Wendy Zuckerman, Michelle Dang, Sindhu Jasrini-Barsan,

Laura Morris, Meg Driscoll, Rose Rimla, Meryl Horn, and Mathilde Erfolino. We're edited by Blythe Terrell with help from Caitlin Kenney. Fact-checking by Lexi Krupp. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Marcus Begala, Emma Munger and Bobby Lord. A huge thanks to all the researchers we got in touch with for this episode, including Dr Barney Graham, Dr Melvin Sanikas, Professor Norbert Pardee, Professor Peter Waterhouse, Professor Edward McCarskey, Dr Raman Harati, Dr Rachel Roper and Dr Yvonne Genzel.

A special thanks to the Zuckerman family and Joseph Lavelle Wilson. I'm Wendy Zuckerman. Back to you next time.