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given that i've covered vaccines for so
many diseases for so
long i am incredibly reserved
about the pace of progress
in february when i learned what the
disease really looked like
in a large group of people and we got a
clear picture that
most people recovered that gave me a
sense that
we could do this but getting from there
to a safe and effective vaccine
it's a big leap there are eight
different platforms people use to make
these vaccines
the vast majority focus on the spike
protein
the spike protein is on the surface of
the coronavirus
it attaches to a receptor on our cells
if you can block that with an antibody
in theory
you can prevent infections the story i
just told you though is a story
antibodies aren't the whole game a lot
of viruses get
past antibodies and infect ourselves and
get inside
and vaccines still work we have a whole
arm of the immune system called t cell
immunity that can
target and eliminate infected cells
antibodies are made by b
cells t cells do the mop up job when
antibodies fail
t cells also are the conductors of the
orchestra and tell
b cells and these killer t cells when to
go up when to go down
so you need these three different things
working in concert
the b cells making antibodies the t
cells that kill
infected cells and the t cells that
direct the orchestra
vaccines aim to do all of that
the simplest idea is you take the gene
which is what mrna is of spike
and you wrap that up in some fat
it hopes to create antibodies against
spike but it also hopes to create
t cell immunity you can take the gene
and you can put it inside of a trojan
horse
inside of a different harmless virus
or you can make the whole virus and then
you can chemically inactivate the whole
virus
take the whole virus or take the spike
protein made in this big container
add some adjuvant to it that makes the
immune system pay attention
and you can inject that all of these
different vaccines are working to some
degree
there's also never been this much
concentrated effort
to understand why vaccines work if we
learn
why this vaccine works precisely i mean
down to the level of antibody you need
against spike or the end protein or
whatever
whatever it might be you can then take
that information and instead of
running an efficacy trial in 40 000
people with a placebo arm
you could possibly find better products
simply by testing an experimental
vaccine in a person
seeing what immune responses occur and
then
pitting that against what we know
actually works
and that's where we're heading down the
road to that bridging
study that allows us to more easily
evaluate
what might be better vaccines for the
future
i think supply and access and equity
are now moving to the front burner
we're going to struggle to also do this
equitably in a way that the rich people
in the world
aren't hoarding and benefiting from all
the vaccine
i've covered hiv aids for
30 years and i watched
lots and lots of people die from aids
after good antiretroviral drug
combinations
proved their worth in 1996. i witnessed
horrible things occurring against
a backdrop of a phenomenal medical
success
if this vaccine only helps rich people
we failed but there is a mechanism the
kovacs facility which is unique
and revolutionary in its structure to
try to address this equity
and access issue they're going to get
out hundreds of millions of doses
to resource limited countries
i'm optimistic about our capability to
do better
and i'm optimistic that we will have
more momentum
but i'm pessimistic about how long
the memory will last of how very bad
this has been and how we really don't
want to be here again