Pfizer’s Moon Landing
An awesome accomplishment
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A newsletter that dives deep into whatever I’ve been thinking about lately. Let’s get started.
Pfizer’s Moon Landing
I’m excited.
In my life, I’ve been lucky to experience a handful of moments of pure, unadulterated awe. I’ve been struck still by nature’s majesty at the rim of the Grand Canyon, in the Alps, and in the Colorado Rockies. I’ve (perhaps ironically) felt a near-religious wonder as witness to man’s scientific accomplishments, often achieved in open defiance of what we believed to be natural limitations. The latter moments are especially few and far between – for me, the most recent may have been during the livestream of SpaceX’s first launch vehicle recovery landing. Oh, to have been alive in 1969.
This week, we had another one of those moments.
After ten bleak months – and one incredibly stressful week – we woke up to hear that Pfizer (and partner BioNTech) had announced preliminary results from its COVID-19 vaccine trial. Results that were, frankly, astonishing. After less than a year of development and only months of clinical trials, Pfizer has developed a vaccine that (based on initial results) is likely to be more than 90% effective. Everything about this process and outcome is wholly without precedent.
Here’s why:
Messenger RNA (mRNA) has never been used in a human vaccine; BioNTech has programmed it to instruct human muscle cells to simulate the Coronavirus protein “spike,” giving the immune system a blueprint to fight a potential infection. There has never been an approved vaccine for any form of coronavirus, including common variants (which typically cause common colds) and other rare, deadly forms like MERS-CoV and SARS-CoV, which have both caused serious outbreaks. Vaccines typically take 10-15 years to develop, and the previous record was held by the mumps vaccine, which took 4 years to develop and was deployed in 1967; COVID-19 was first identified in December 2019, and front-line workers will likely receive the Pfizer vaccine before the end of November. In general, only childhood vaccines (e.g., the measles vaccine) approach 90% efficacy; typical flu vaccines are ~40% effective, and the FDA’s target for the COVID-19 vaccine was only 50% efficacy, which is approximately the requirement for herd immunity with widespread inoculation.
How did we get here?
Facing the greatest public health crisis in a century, the global scientific community mobilized in a way that was previously unprecedented. Pharmaceutical giants partnered with universities, shared resources, and poured development dollars into the rapid development of an effective vaccine. The Trump administration, despite its otherwise troubling and inconsistent handling of the crisis, deserves credit for its implementation of Operation Warp Speed[1], the public-private partnership that has lowered bureaucratic barriers, offered funding for research, and guaranteed purchase volume and price for approved vaccines. While Pfizer didn’t take any research funding, it is the beneficiary of a guaranteed $1.95 billion order from the U.S. for 100 million doses of its vaccine, which will be given to Americans for free. Clinical trials have been run “absolutely as usual,” per Chief Advisor Mancef Slaoui, but FDA analysis of the trials has been significantly expedited, allowing for faster progression through Phase 1 – 3 trials, to emergency use authorization, and eventually to full approval.
What comes next?
This news is exciting, but I’m sure it offers little solace to the millions whose lives have been affected by the coronavirus, nor will it help most of the millions of others who may be infected in the months to come (as always, please wear a mask). Additionally, the Pfizer trial is ongoing, and more data is needed before a final determination of the vaccine’s efficacy can be reached. However, for the first time in a long time, there is a hope of turning the corner and returning to some version of normalcy. Pfizer projects to produce up to 50 million doses by the end of 2020, which will likely be given to front-line health workers, and up to 1.3 billion doses in 2021, which would be a huge help in protecting the most vulnerable among us. The success of the Pfizer vaccine also gives reason for optimism about Moderna’s competing vaccine, which relies on the same mRNA technology; Moderna is planning to announce interim results by the end of November and, if the vaccine is successful, could supply another 20 million vaccine doses almost immediately.
On a more personal level…
This monumental scientific achievement makes me more optimistic about the future. Breakthroughs of this magnitude tend to have positive knock-on effects that resonate for decades. The Apollo mission inspired the world and brought us advances in solar panels, pacemakers, dialysis, and surgical equipment from which we continue to benefit. Likewise, I suspect that Pfizer’s mRNA breakthrough will be an incredibly powerful tool in future fights against novel viruses, and that it may have other applications that we’ve yet to uncover. Perhaps more importantly, we’ve been reminded that the mass mobilization of our scientific community can solve problems that seem overwhelming. This long, long night might not be over yet, but I’m 90% sure that we’re starting to see some light on the horizon.
Some First-Newsletter Housekeeping
THANK YOU to everybody who read this first letter! I hope you enjoyed it and, if so, I hope you’ll mention it to a friend or two. If you have any feedback, I’d love to hear from you! If you hated it, please keep that to yourself. Going forward, I’m hoping to establish a biweekly publishing cadence to try to keep quality high and topics diverse. For now, stay safe, wear a mask, go outside, and call your family – it’ll make you feel better.
Until next time,
Carter
[1] As a Star Trek fan, I also applaud their name choice. Both the original idea for the program and the program’s name are attributed to Dr. Peter Marks, Director of the FDA’s Center for Biologics Evaluation and Research (and noted trekkie).