01x02 - The Race for a Vaccine

[bunniefuu]

[div]
-[doctor] Hi.
-Hi.

[narrator]
You're witnessing
an historic moment.

Right now, there's a worldwide hunt
for ways to fight this coronavirus.

Scientists are trying everything,

from existing medicines to new therapies.

But the most likely way
we'll end this pandemic

is a vaccine.

On March th, ,

the first one was tested.

I'm Jennifer Haller,

and I was the first person to receive
an experimental COVID- vaccine.

[narrator]
We've made other test vaccines
pretty quickly.

One for SARS took months,

one for Ebola, seven months,

and one for Zika, around six months.

But this vaccine candidate
crushed those records.

It was made in just days.

If it's going to end
this pandemic, though,

it's got a long way still to go.

See, any potential vaccine
has a difficult path ahead,

a long and twisting course
full of challenges and trials.

In the US,

typically it takes a vaccine candidate
a decade or so

to make it from start to finish,

and around % fail to complete it.

We don't have that kind of time.

Every day, people are dying,

and the economic losses are mounting.

Experts are hoping a vaccine
can be widely available in .

To pull that off,

it will have to get through every stretch
of this course in record time.

[car engines roaring]

[announcer]
This is the supreme test
of man and machine.

But while many are called
to the starting line,

usually less than half
finish the grueling drive.

[narrator]
Fortunately, more than
vaccine candidates are giving it a shot,

made by scientists all over the world,
from veterans at universities...

We have a dedicated group
of extraordinary scientists

that are in the lab day and night.

[narrator]
...to pharmaceutical giants...

We have the teams to do this,
and everyone is excited.

[narrator]
...using proven techniques...

And, of course,
with the coronavirus vaccine,

we have a particular head start.

[narrator]
...and approaches
that have never been tested before.

Everybody competes with each other,

but eventually,
only the very best survive.

[narrator]
But getting a vaccine
is also going to take a lot of money...

Okay, here we are. You know,
we can get money out really fast.

We can do evaluations of these things.

Now we're all trying to step up

and look all over the world
for the best ideas.

[narrator]
...and collaboration.

The entire global scientific community

has come together
in a truly unprecedented way.

[narrator]
...and brave volunteers.

We're all feeling so helpless,
and this was something that I saw

that I could do that could
potentially make a difference.

[narrator]
Together,
they're in one of the most

high-stakes scientific races in history.

I compare this to a space race.

We have so many contenders reaching for
something that was previously unknown.

"How do I get to Mars?"

"How do I get to Venus?"

"How do we create
the next COVID- vaccine?"

[narrator]
And the other big question:

how fast can we do it?

[theme music playing]

Given the fact that we now have the virus
in our hands,

we will develop a vaccine.

[man ]
We can move very fast in ways
that have not been previously achieved.

[man ]
It's only once that vaccine
has been proven to be safe

that it'll be allowed out of confinement.

[man ]
What they needed was a vaccine,

and the fight never stopped
till it was found.

[man ]
There remain other viruses
to be isolated, other vaccines to come,

but they will.

[narrator]
This coronavirus,
and all viruses, are so hard to fight,

in part because they're so simple.

They're basically just little vehicles

that carry instructions
on how to make more of themselves.

To reproduce, they smuggle
these instructions into our cells

and force our cellular machinery
to make more and more viruses.

They spread through the body
and hijack more cells,

damaging them in the process,

which makes us feel sick.

But we're not defenseless.

[alarm blares]

-[narrator]
Cells in our immune system
-[siren wails]

can find the intruder

and identify a marker,

a distinguishing feature
which we call an antigen.

Then they mobilize to seek out
and destroy anything with that antigen.

Our immune system also produces
little molecules called antibodies

that stick to that antigen,
tagging and subduing the virus.

But from the day we're infected,

it can take almost two weeks
for this response to ramp up,

enough time for this coronavirus
to swarm through the body,

wreaking havoc.

And sometimes our immune system
ramps up too much

and causes even more harm.

In some people,
all this damage becomes overwhelming,

and they die.

In one shift,
I pronounced six people dead.

[narrator]
This is where
having a treatment would help.

Some inject antibodies,
those molecules that subdue the virus,

either synthetic antibodies made in a lab,

or from the blood of people
who've recovered.

Others rein in our immune systems
if they're getting out of control.

And some, like Remdesivir,

actually enter our cells
to block the virus from copying itself.

Early results showed it could
potentially make the virus less deadly.

It is a very important proof of concept,

because what it has proven
is that a drug can block this virus.

[narrator]
But as of May,

none of these treatments
can stop a person from getting sick,

or spreading this coronavirus to others.

A vaccine would,

and it does it by taking advantage
of something

our bodies have evolved
over millions of years:

memory.

After it deals with a virus,
our immune system remembers the antigens,

sometimes forever,

other times just for a while.

We know our bodies can remember these
other coronaviruses for a couple years.

So if this coronavirus is similar

and it shows up in our bodies again
in that time,

our immune system can ramp up much faster
with overwhelming force,

wiping out the virus
before it can make us sick

or spread to someone else.

This is what it means
to be immune to a virus.

A vaccine makes us immune

by safely showing the body
what a virus looks like,

faking this first infection
to teach your body how to respond,

so when it does encounter the real virus,
it's ready.

No vaccine is % effective,

meaning not everyone who receives one
will be perfectly immune,

but vaccines don't need to be perfect
to end epidemics.

Smallpox used to be
a leading cause of death,

and measles k*lled millions a year,
most of them children.

But thanks to vaccines
that are around % effective,

we've wiped out smallpox

and made enormous progress
against measles.

Vaccine makers are hoping to make
a vaccine that effective.

If all we could make was a vaccine that,
let's say, had % efficacy,

so it prevented about
half of the infections,

if that translates into stopping
half of the deaths,

that's really good news.

[narrator]
The fact is,

vaccines are one of the most
significant inventions in human history.

The world doesn't agree on much,

but more than % of all people believe
childhood vaccinations are important,

and that's crucial,
because to wipe out an infectious disease,

you need most people in the world
to be immune.

It's called herd immunity.

The idea is that individuals become immune
either by getting infected and surviving,

or by getting vaccinated.

When enough people are immune,

the virus has trouble spreading,
and slows down.

You know, you are also protecting
by vaccinating yourself

not just yourself, but you are protecting
weak members in the community

who may not be able to get the vaccine.

[narrator]
Like newborns, the elderly,
and people with weak immune systems.

So it's both an act of protecting yourself
and it's also an act of altruism.

[narrator]
So defeating
an infectious disease

requires the whole world coming together,

and in the COVID- race, the world has
come together like never before.

Out of the over candidates
in the race in May,

almost half are in North America,
and are in China.

And they're funded in different ways,

most by private industry.

But the main difference between them
is their vaccine platform,

how they're showing the body
what the virus looks like.

Some vaccines inject a weakened version
of the virus into the body.

It can't reproduce or do damage
but it still has that antigen,

so our immune system can learn
what to watch out for.

That's how we vaccinate against polio,

the measles, mumps, and rubella,

chicken pox, rotavirus,

and for the flu.

This is by far
our most tried-and-true method,

but it's a slow way to do it.

We have to grow the virus for months
in other living cells, like chicken eggs,

a method we've been using for decades.

We'll call these
the first-generation vaccines,

and there are nine in the race
as of early May.

Other scientists are trying
a newer approach.

Instead of the whole coronavirus,

they're giving the body just an antigen,

a piece they think will activate
the immune response.

Those antigens also need to be grown,
sometimes in yeast cells,

or attached to another harmless virus.

This is how the vaccine
for hepatitis B works,

and for whooping cough, and meningitis B.

We'll call these
second-generation vaccines,

and they're the most popular kind
in the COVID- race, with candidates.

Finally, there's a brand new
type of vaccine

that doesn't use any part
of the actual virus at all.

Instead, it just gives our bodies
the virus's instructions,

tiny pieces of genetic code that tell
our cells to produce the antigens,

which then activate the immune response.

No vaccine using this approach has
ever been approved for use in humans.

We'll call these
the third-generation vaccines,

and there are in the race.

Because they don't involve
growing any part of any virus,

they can be made extremely fast.

This record-breaking vaccine
was a third-generation candidate

from a US company called Moderna.

But making a vaccine candidate
isn't the hard part.

This next phase is.

Clinical trials.

[engines rev]

[announcer]
And they're up to speed.

[narrator]
Traditionally,
there are three phases.

First, teams give their vaccines
to a small group of people,

wait a few months, and see if any of them
report dangerous side effects.

If everything looks good,

the vaccine moves on and is given
to a couple hundred people,

again, to see if there are
any dangerous side effects,

but also to see if
people's immune systems ramp up.

That involves more waiting,
usually months.

Then the candidate moves on
to the third test,

where thousands are vaccinated
to triple-check for side effects

and see how well it works.

That's another few months
or years of waiting.

This isn't like testing a drug

where you give it to people
with a disease

and see if it makes them better.

You're giving it to people
who don't have a disease,

and then checking later to see
if they still don't have the disease.

In normal times, this whole process
can take around four years,

testing around , people.

But vaccine developers are hoping
to do some of this testing simultaneously,

still testing the same number of people,
but all in around months.

It's how some candidates
are moving so quickly.

The FDA has cleared the Moderna vaccine
for phase two of its trial.

[reporter ]
Moderna moving at record speed.

China's already given approval
for another clinical trial.

It's now at the second phase.

The vaccine, uh, that is
most promising right now

is the one from Oxford University.

-That has merged phase one and phase two.
-...which is speedy.

[narrator]
This stage of the race can't go
any faster, for good reason.

[Kirchhelle] Without running through
all of these trials,

it would be absolutely unethical

to roll out a vaccine potentially
to the entire global population,

because you could do some real harm there.

[news reel announcer]
Our men today
are safe against yellow fever.

A few drops of vaccine will give them
dependable and lasting immunity.

[narrator]
During World w*r II,

Allied soldiers were vaccinated
for yellow fever.

Thousands developed jaundice
and hepatitis,

and some died.

That should never have happened.

If the vaccine makers
had done their research,

they would have discovered reports
of these side effects dating back to .

Then in the s,

some poorly made vaccines infected
, people with polio,

and k*lled around .

Known as "the Cutter incident,"

it led the US government to tighten
requirements for vaccine manufacturers.

Nothing is licensed without undergoing
extremely stringent safety considerations.

And even after it's licensed,
the vaccine continues to be monitored.

[narrator]
Today,
according to the US government,

for every million doses of vaccine
that are distributed,

only one person is compensated
for serious side effects.

Vaccines need to pass an extra-high bar
because they're given to healthy people.

[Hatchett] What we can't do
is take shortcuts

where safety and effectiveness
are concerned.

I think there are ways
to streamline some things

and do more things in parallel,

but it's going to be tough,

and it's going to be
a carefully orchestrated dance.

Rather than running everything in series

and having just one person doing
each of these steps along the way,

whole teams of people have been put there

to ensure that we still maintain
the same quality and safety.

[narrator]
But some teams
did have a head start here,

because this isn't the first coronavirus,

or the first coronavirus
to inspire a race for a vaccine.

[reporter ]
The impact of SARS.

[reporter ]
The SARS disease
has spread across the world.

[reporter ]
The battle against
an outbreak

of Middle East Respiratory Syndrome,
or MERS, continues in South Korea.

[narrator]
When SARS and MERS viruses
caused outbreaks,

many scientists got to work on vaccines,

including a team at Oxford University.

We've learnt a lot about coronaviruses
and their biology,

actually, because of
the last two big outbreaks.

[narrator]
In , Oxford University
got a promising MERS candidate

into human trials,

hoping to stop the next outbreak
of this rare coronavirus.

But then a year later,
this latest coronavirus broke out.

Because it was similar,

the team easily adapted their MERS vaccine
into a COVID- one.

And so that has really been
a major shortcut that we've had,

by not having to go back
to the drawing board and start again.

[narrator]
They sped through
the first phase of trials,

putting them on track to begin
the next phases in the summer.

We don't know for certain that
that will all go to plan,

but if it does,
then it's certainly possible

that there could be millions of doses
available in the autumn.

[narrator]
Unfortunately,
Oxford's story is uncommon.

Peter Hotez also made a promising
coronavirus vaccine for SARS years ago.

It was all going well,
and then the grant ended.

And we thought,
"Well, we've gone this far.

We'll just get funding to move it
into clinical trials."

And unfortunately, we couldn't.

[narrator]
This happened to so many
promising vaccines

that this stage is often called
"the Vaccine Valley of Death."

Of these vaccine candidates

that scientists race to make
in record time,

only Ebola reached the finish line.

Because when these outbreaks ended,
so did the funding.

After every

catastrophic pandemic
or epidemic,

I say, "Maybe this is the one
that moves the needle

and gets public funding in place."

And I said that after SARS in ,

I said it after HN in ,

I said it after MERS in ,

I said it after Ebola in ,

after Zika in , and I'll say it again.

[narrator]
Peter's COVID- candidate
is based on his SARS candidate.

But if he had been able
to test it back then...

We would have had the safety testing
potentially finished,

and that's not insignificant, right?

So that's too bad
that we lost that opportunity.

[narrator]
In ,

a group of people funded in part
by the Gates Foundation

came together to fix this.

Well, unfortunately, even though
there's a substantial risk

of various types of epidemics,

there's not a natural incentive for people
to build products that anticipate that.

You've got to bring governments
and foundations together

to create the right incentive structure.

[narrator]
They call themselves CEPI,

The Coalition for Epidemic
Preparedness Innovations.

[Hatchett] What CEPI is,

is it aggregates funding
and creates a pool of funds

to support vaccine development.

So we can play fair broker

and take those billions that are available
for tools for the world

and make sure they go to the right place.

[narrator]
As of early May, CEPI is behind
nine COVID- candidates,

including two of the early front-runners:

Oxford's new candidate, and Moderna's.

And it's the success
of those two candidates,

and one from China,

that give experts hope that we can have
a vaccine approved in months,

but that isn't the end of the race.

Not even close.

[car engines roaring]

[announcer]
And around they go once more,

burning tires down to the fabric
as they pour on the coal.

[narrator]
Remember, to end this pandemic,
we need to reach herd immunity.

And for this coronavirus, experts estimate

that means at least % of the world
needs to become immune.

That's % of almost eight billion people.

[interviewer]
Billions of vaccines
need to be made?

That's correct.

We've never produced a billion doses
of a vaccine in the history of the world.

[Gates] You're in a new regime
when you talk about billions of a vaccine.

We don't make billions of any vaccine.

We make hundreds of millions,

but those we've had decades to work on.
And even the bottles,

that's a special,
pharmaceutical-grade glass,

the world doesn't have enough of that.

[narrator]
Just to start with,

to make a billion doses,
you need a lot of factories.

But each type of vaccine requires
a different kind of factory,

and ramping up production
in enough factories

can take years.

But a lot of the giants have a shortcut.

They have the factories
to start production now.

We have one big plant
which is fully operational.

So that can spit out million vaccines.

Now we are very quickly
setting up additional plants in the world.

[narrator]
But the newer types of vaccines
don't have many, or any, factories yet,

so some are placing bets
on candidates now,

building factories for the ones
they think might survive trials.

After all, those investments are,
at most, billions to save trillions.

[narrator]
And even if we can
make that many doses,

we'll still need to get the vaccine
to people all over the world,

and that's when politics
can get in the way.

[Andrew Cuthbertson] We have
a specific vaccine that we believe

will be able to protect millions of people
against this new HN flu.

[narrator]
During the swine flu epidemic in ,

an Australian company was
among the first to make a vaccine,

and the government made
them sell to Australians first.

Canada made a similar move.

And while the US promised
to donate some of its supply,

they waited until the epidemic was over.

So it matters where a vaccine is made.

Vaccine nationalism.

That is real.

There are early signs that people
are trying to buy by the biotech companies

that have lead contenders.

There's a long tradition
of narrowly putting

national interest above others,

and that's obviously often correlated
with people who have the money.

[narrator]
World leaders
have come together

and called for cooperation.

[in German] Science is never national.
Science serves mankind.

[in English] The commitment to ensuring
equal access is the key.

Victory against this virus
cannot be declared

before effective vaccines and therapeutics
are made available

to all in need around the world.

[narrator]
But as of May,
the US hasn't been one of them.

Who can get a vaccine
will also depend on its price.

How much should it cost?
Should rich countries pay more?

Should, you know,
poorer countries pay less?

And also, if this vaccine is developed
by a major pharmaceutical company,

how much money is this company
allowed to make off this vaccine?

[narrator]
Remember, most of these
vaccines are funded privately,

and based on how some
vaccine makers' stocks have risen,

some people clearly see
a potential windfall ahead.

But so far, some companies
like Johnson & Johnson

have promised to make
their vaccine affordable,

as little as $ a dose.

And that's critical, because a vaccine can
only win if it gets to billions of people,

including those who can't afford it.

So to vaccinate enough of the world,

we'll actually need more than one winner.

-[engines roaring]
-[crowd cheering]

[narrator]
This race isn't really
between the candidates.

It's between humanity and this virus,

that simple little vehicle
that's paralyzed economies

and ended hundreds of thousands
of lives around the world.

We can only beat it by doing
what we've never done before:

making a vaccine for everyone
in record time.

["Race For the Prize" playing]

♪ Two scientists are racing
For the good of all mankind ♪

♪ Both of them side-by-side
So determined ♪

♪ Locked in heated battle
For the cure that is their prize ♪

♪ But it's so dangerous ♪

♪ But they're determined ♪