The Daily - A Vaccine Breakthrough

Episode Date: November 12, 2020

It’s a dark time in the struggle with the coronavirus, particularly in the United States, where infections and hospitalizations have surged.But amid the gloom comes some light: A trial by the drug maker Pfizer has returned preliminary results suggesting that its vaccine is 90 percent effective in preventing Covid-19.With the virus raging, how strong is this new ray of hope?Guest: Carl Zimmer, a science writer and author of the “Matter” column for The New York Times.Background reading: Pfizer has announced positive early results from its coronavirus vaccine trial, cementing the lead in a frenzied global race that has unfolded at record-breaking speed.Meet the couple behind the German company, BioNTech, that partnered with Pfizer to develop the vaccine.We want to hear from you. Fill out our survey about this show and others at nytimes.com/thedailysurvey.

From The New York Times, I'm Michael Barbaro. This is The Daily. Today, a major breakthrough in the race to develop a vaccine for the coronavirus is raising hopes that mass immunization could bring the pandemic to an end. We turn to our colleague, science writer Carl Zimmer. It's Thursday, November 12th. Carl, tell me how you learned the news about this vaccine. So Sunday afternoon, I'm sitting on my deck doing a little work on a story,

and I get a message from my colleague, Katie Thomas. And Katie says, this is it, guys. And I knew what it meant. What it meant was that the drug company Pfizer had some big news. We knew that Pfizer had been doing clinical trials on a vaccine and that they were very far along with it, and that they might even be finding out soon whether the vaccine actually worked or not. So I start reading a draft of Pfizer's press release. And the first thing I read is,

vaccine candidate was found to be more than 90% effective in preventing COVID-19. found to be more than 90% effective in preventing COVID-19. And I just have to stop. I think I am not reading this correctly. I actually went back and started reading it over again because my brain could not accept that 90% figure. I even wondered if maybe they had typed nine instead of five. They actually meant 50%. But no, there it was, 90%.

And Carl, why is a 90% effectiveness rate for a coronavirus vaccine, why is that so astonishing? It's astonishing because we didn't even know if this would work at all, period. Because no one has made a licensed vaccine for people for any kind of coronavirus. So it could have completely failed, totally. The FDA had said, well, if you can get it to be 50% efficacious, that will be good. That's the minimum we want. And so I certainly had adjusted my expectations. But over 90%, at least in this preliminary data, puts it at least in the

ballpark with some of our most potent vaccines that we have. So, Carl, let's put that 90% figure into some context. What was Pfizer testing? How many people was it testing? And how does it get to 90%? What does that mean? Sure, yeah. And it's important to understand that this is preliminary data, and the final results

will probably be different. That's just how science works. So in July, Pfizer launched a clinical trial that has been recruiting 44,000 people. A lot of people. A lot of people. You need a lot of people to know if vaccines work. And what they did was they gave half of those people the vaccine. They got two doses separated by three weeks. The other half got a placebo. They got salt water. Right. And so then they waited. What they were waiting for was for people in the trial to get COVID. And then after a certain number of people got sick, then a special outside group of advisors would take a look at the data and see, well, how many of the sick people got vaccinated and how many of the sick people got the placebo?

So far, they have only examined 94 people who got sick. Based on that alone, their estimate is that the vaccine is over 90% effective. their estimate is that the vaccine is over 90% effective. Carl, 94 cases doesn't seem like a whole lot of cases, especially given the number of people that Pfizer recruited. So what do you make of that? Well, actually, statistically speaking, 94 cases is a pretty good number if you're trying to figure out if a vaccine is effective or not. It's kind of like rolling dice. If you were to roll dice once and get snake eyes, you'd look at it and say, okay, whatever. If you did it again and got snake eyes the second roll,

you'd say, that's odd. And if you kept rolling the dice and nine out of ten times you got snake eyes, you would know that there was something funny with the dice. Right. So, you know, if you get a whole bunch of people in your set of 94 sick people who had the placebo and very few had the vaccine, that's telling you something important. Carl, you said that this clinical trial isn't complete. You called it, I think, preliminary data. How preliminary? And why publish data early? Well, it's a standard thing in clinical trials that at certain pre-specified times, a drug company will take a look at how the trial is going. And when drug companies get early

promising preliminary results, they send out a press release and usually no one pays attention to them because we're not in the middle of a pandemic usually. But suddenly everybody is paying very close attention to clinical trials and all their tiny little details. And so this was a case where they took an early look and an agreed upon time. And the early look is really good. Got it. So let's talk about what we know about how this vaccine,

that so far is 90% effective in preventing coronavirus infections, how it actually works, how it functions, how it confers immunity in the people who get it. And recognizing that this science is pretty complicated, I ask you to make it simple. So in general, what vaccines do is they teach your immune system a very important lesson. They instruct your immune system how to recognize a virus

and mount a really fast attack on it. The typical way that this happens is that, let's say you get a flu shot. What you might get would be dead flu viruses, essentially, and they're floating around. They can't make you sick because they're dead, but their proteins get touched by immune cells and the immune cells say, hmm, that's interesting, that's new. And they essentially learn how to make antibodies to it and how to kill infected cells because they know what a flu virus looks like. Right. So when the real thing arrives, you're prepared.

That's right. So, Carl, is that how the Pfizer coronavirus vaccine works, with basically dead elements of the coronavirus injected into people? No. Pfizer is using a new design for a vaccine. Instead of delivering proteins from the virus into our bodies, the vaccine is actually delivering genetic instructions for making virus proteins into our bodies.

You've got these little genetic instructions in these molecules called RNA, which are wrapped up in little oily bubbles. And those oily bubbles go into our muscle cells, delivering those genetic instructions. And so now our cells get these instructions and they say, OK, I will make this protein. It just so happens to be a protein from a coronavirus. And then these cells release the proteins into the rest of our body and immune cells that are wandering around bump into these viral proteins and say, hmm, what's this? And they start making antibodies to them. All right, Carl, let me just speak on behalf of potentially

terrified listeners. Our body starts producing coronavirus proteins? Yes. That sounds a little scary. Well, you have to bear in mind that an individual virus protein is not going to make you sick. In order for a virus to make you sick, it's got to have all these genes that it uses to hijack your cell and then to produce millions of new viruses that spill out and infect other cells. One viral protein on its own doesn't do anything. Got it. So it may sound scary, but it's not. Right. So if the coronavirus were a person, then this would be like this discarded toenail. It would be this sad little element of the virus, not a risk, but something that, if created in the human body, would trigger an immune response. That's correct. You got it.

body would trigger an immune response. That's correct. You got it. And Carl, do we know from Pfizer how long this immunity lasts based on the data that they have published? That's an incredibly important question, and the answer is we do not know how long it lasts. Vaccines can last for different lengths of time. You know, flu vaccines are really only good for about a year because the flu changes. There are other vaccines you can take that you get as a child and they can last your whole life. We don't know whether this vaccine even lasts a year. Maybe it don't last a few months.

We're going to have to wait and see. You know, these are early days yet. So Carl, given everything you've told us about the early effectiveness of this vaccine, but knowing that this clinical trial is not yet complete, what do we expect will be a timetable for this vaccine to potentially be approved by U.S. regulators? It's not a foregone conclusion that Pfizer is going to get an authorization for the vaccine. We still have to wait for them to collect more data from this trial. They need to make sure not only that it's effective, but they also want to ensure that

it's safe. So far, there's been no serious adverse effects. So if they meet all those benchmarks, my bet is that at the end of November, they're going to approach the FDA and they're going to say, here, we want to apply for what's called an emergency use authorization. The FDA is then going to take this application, which may be literally 100,000 pages of documentation, and they're going to go through it very carefully. They're going to run their own analysis on the data to see if it meets their standards. Won't happen in a day or two, but it might happen in a couple weeks. And if they say yes,

happen in a day or two, but it might happen in a couple weeks. And if they say yes, then Pfizer will have the green light to go forward with starting to distribute the vaccine. And I want to talk about distribution, because that feels really important. And accepting what you just said, that we don't want to put the cart before the horse, we don't know if this is going to be approved. But I recall from previous conversations with our colleagues on a science desk that the United States has been working with big pharmaceutical companies in this project, Operation Warp Speed, to make sure that it is manufacturing vaccines even before they are approved. So is this one of those vaccines that's already being manufactured? Yes. Pfizer has factories that are making this vaccine already. And if this vaccine does get authorized, they are going to get a vaccine from Pfizer?

I think January will be a reasonable expectation for enough of the vaccine for maybe 20 million people. Wow. That's pretty soon. It is. It shatters all records for vaccine development. But I should make it clear that initially, only certain people are going to be getting this vaccine. Healthcare workers may get it. Certain vulnerable populations may get it first. But the general population will not have access to this vaccine probably until the spring. Got it.

Carl, what does Pfizer's experience here mean for the rest of the vaccines that are under development that we keep hearing about from rival companies? Does this vaccine supersede them? Does it help them? Does it hurt them? Well, if Pfizer's vaccine works as well as it seems to from these preliminary results, that actually suggests that the others might work as well, because they are all using the same part of the virus as their target, a protein called spike.

target, a protein called spike. And so if Pfizer's spike vaccine seems to be so effective, then that suggests that vaccines made by other companies like AstraZeneca or Johnson & Johnson and so on, they may be effective as well. And so now instead of just having one authorized vaccine for COVID, who knows? I mean, we could see many of these. And that's a really important thing if we're going to try to get everybody vaccinated. Right. Because Pfizer alone is not going to be able to do it very quickly.

But if we have other companies producing authorized vaccines of their own in their own factories, then we can get hundreds of millions of vaccines churning out in a matter of months. Right. This is the dream scenario, given the nightmare that we are in. Multiple vaccines approved and being manufactured, being distributed so that we achieve a pretty high degree of immunity throughout the United States. Yes. And again, you know, this is something that, you know, I really, really hope happens.

We're not going to know if it can happen until that data really starts coming out. But this week we had some really, really encouraging news that gives us reason to be hopeful. We'll be right back. Carl, as good as this news from Pfizer is, it does come at a pretty scary moment in the pandemic as the second wave of the virus washes over the United States. And because of the presidential election, we have not really talked a lot about where things stand with the virus in the U.S. So catch us up. Where are we in the pandemic right now? We're in a really bad place. For the past week, the average number of new cases a day in the United States has been over 123,000. Staggering. Every day, people are testing positive in huge numbers. On November 10th, 1,448 people were reported dead from COVID. We have now gone over 240,000 deaths.

And the hospitalizations are reaching record levels. You're starting to get reports of hospitals in various places that are full up. They can't take more people. Their ICUs are full. They're understaffed now, not just because of the demand because of COVID patients, but because the hospital staff itself is getting sick and is having to stay home. In North Dakota, things have gotten so bad

that actually the governor said that he wants nurses who are infected but asymptomatic to keep working, which is not a good idea. But that's how desperate things have gotten. Right. This sounds just as bad, perhaps even worse than in the spring when we were told this is as bad as it's going to get. Exactly. And I think also part of the problem is that people have, for whatever reason, decided that they're kind of done with this. You know, people who may have, you know, made those sacrifices for the past few months and, you know, not seeing friends and family, not going out to restaurants, they're like, OK, I've had it. I want to get on with my life.

like, okay, I've had it. I want to get on with my life. And yet, Carl, correct me if I'm wrong, the death rate from the virus in the U.S. appears to be slowing down. Feels like fewer people are dying given the number infected. Is that a positive sign? It's definitely a positive sign. So if you look at particular hospitals that were dealing with a lot of cases all of a sudden in the spring, the rate at which their hospitalized patients are dying is much lower now. And there's probably a number of different reasons for that. One is that they are just getting to know this disease better. There are treatments like certain kinds of steroids that seem to be very, very effective, which is great. like certain kinds of steroids that seem to be very, very effective, which is great. But another reason probably that this death rate seemed to have been going down was that our hospitals were not overflowing with COVID patients.

Doctors and nurses had more time to spend more care on each patient. So going forward, we can look forward to that superior medical knowledge being used by our incredible nurses and doctors, but they're going to be getting stretched really thin. They're already stretched really thin. It is going to get worse. And so if there aren't enough staff to give that good care, then the death rate is going to go up. Right. So in other words, the low death rate is contingent upon hospital beds being open. And right now, because of everything you just described, those hospital beds are being filled, which could then lead to more people dying. Exactly. And also, there's just a basic arithmetic here. If the death rate goes down, then you might expect fewer deaths. But if the infection rate goes way up, then even a lower death rate means a lot more deaths.

in the United States, Thanksgiving, traditionally a moment when members of families travel large distances to be with one another. And so I have to imagine that this is an especially dangerous moment in the pandemic. Absolutely. I'm very concerned about all the traveling that may happen for Thanksgiving and Christmas. People are going to mix together. They may cross state borders. And one day you may say, like, I feel fine. I can go to grandma's house and have Thanksgiving. You could be asymptomatic and not know it. If people come together and one of them is infected, it's very easy for it to infect everybody else. So, Kro, I'm going to ask you to channel your inner Donald G. McNeil Jr. here. Should people avoid traveling to see their families on Thanksgiving, for Christmas,

for Hanukkah, for Kwanzaa, for all the big holidays that are happening this fall and this winter? Hanukkah, for Kwanzaa, for all the big holidays that are happening this fall and this winter? I'm not taking my family to see my parents for Thanksgiving. They live three hours away. My family is none too pleased with this because they want to see grandma and grandpa. Right. But I don't think it's safe. And what I'm thinking is like, you know, maybe one of us is carrying the virus and we're going to give it to my parents who are not that young. So that is my choice.

Now, obviously, everybody needs to try to understand all the risks that we face in this time. And we have to manage those risks. I should say, Carl, my mother called me a few days ago and she said, in a very formal way, I relieve you of all guilt for not coming home for Thanksgiving. It's about a two-hour drive, and I appreciated being relieved of that guilt. I'm glad she absolved you. My parents understand, too, and I'm grateful for that. But I also understand grandparents who have been deprived of grandchildren for months and months and months.

I get it. We want to pretend that this doesn't matter anymore. But in fact, we're actually in a worse place now than we were in the spring. Right. The danger is even greater. Exactly. Karaz, you know we have a new president-elect who talks about the virus in a very different way than the current president. I wonder if the public health officials that you talk to, the scientists you speak with, do they think that having a new administration with a different and much more hands-on approach to the virus could make a difference?

Yes, the science shows that a more aggressive approach could make a difference. You could save hundreds of thousands of lives with universal masking and other kinds of measures. So if our leaders decide to do that, that can make a big difference. But I will point out that the Biden administration will not begin until late January. We have this promising vaccine data now, but it will take time for it to get approved and for people to get it. And we have a new administration, which will probably have a very different approach to the virus, but it won't be taking office for weeks. So what we do right now will make a big difference

about who lives and who dies this winter. Thank you, Carl. We really appreciate it. Thanks for having me. We'll be right back. Here's what else you need to nerdy. On Wednesday night, President-elect Joe Biden announced his White House chief of staff, appointing Ron Klain, a Democratic operative and Biden confidant with decades of experience on Capitol Hill.

Klain oversaw the Obama administration's response to the Ebola virus and has been highly critical of President Trump's handling of the coronavirus. Biden is not expected to begin naming his cabinet until later this month. And. later this month. And... The current margin stands at 14,111 between the president and Vice President Biden. On Wednesday, Georgia's Republican Secretary of State, Brad Raffensperger,

authorized a hand recount of the state's presidential ballots, a move advocated by President Trump that election officials said stood little chance of erasing Biden's lead. With the margin being so close, it would require a full by-hand recount in each county. Even if Trump were to somehow win Georgia in a recount, Biden would still maintain a victory in the Electoral College, given his win in Pennsylvania, where he leads Trump by about 50,000 votes. That's it for The Daily.

I'm Michael Barbaro. See you tomorrow.