Well, we're all waiting with baited breath and vast anticipation for a vaccine for COVID19- as if that's going to solve everything. But what if the real battle starts after the vaccine or vaccines arrive? Now what Carl Zimmer's got great insights into this. He's a renowned science and medison writer who recently did a piece for the New York Times called first A vaccine approval, then chaos and confusion. Definitely caught my eye, and I'll be honest. It's it's really given me a lot to think about, and I'm delighted to have him with us today to pick out so. Of the major themes there around this race to a vaccine, and almost as importantly around the perception that we have of what that's going to result in since our interview, Pfizer, an maderna, have announced remarkable levels of efficacy in their vaccine candidates. But the challenges that lie ahead regardless of which or how many vaccines get approved in distributed remain vital. Carl, you write about this. Hope that I think we all have that this vaccine is the end. It's the off switch we can go back to normal. Next week or the next month? Not really the case, is it? No? I mean, it's going to be essential to getting life back to the way we remember it, but it's going to be a process and we have to be ready for that. A lot of us think of some vaccines that we had when we were kids. We had him once, it immediately inoculated us and that was it. We were done. Why is this not that kind of an off switch? We just don't know. We've got several of these phase three trial vaccines and we've got a whole bunch more there in earlier stages. But no ones ever made a vaccine to this kind of a virus before, and so you know it could be incredibly effective. Or it could be an so so the FDA says they want to benchmark of 50% protection, roughly speaking, so you know, if you got a shot would be a little like the flu shot in some years where you might still get the flu, but you're much less likely to get it, so you have to remember that, so efficacy is an interesting question. You bring that up now. There's every covid vaccine have to come in at these 90%. Efficacy rates that we've been hearing about lately, or can there be some that come in more like a flu shot in the thirty 4050% range and still be useful and vaccine for covid with 50% efficacy could be incredibly important and could really could save thousands and thousands of lives, but. A lot of people have to take it. You would have to get 7080% of people in the country to get vaccinated with it in order for it to be really difficult for the virus to get around from person to person. And that's slow. Down means that the daily new cases drops so you know if you have a 50% efficacy vaccine and like 10% of people take it, it's not going to make a big dent in the situation. If someone told me like I can cut your chances of getting coded by 50% with just one shot, I'd be like. Sure, give it to me as long as I know it's safe. So now I want to talk about safe. There is something you described in your article that I'd never known about before. It was really interesting to read about the usage of what's called Master Protocol in traditional vaccine development, and it's not necessarily being adhered to in the development here in the USA. As I understand it. So tell us what Master protocol is and what the downside of it not being used is the traditional way of doing a vaccine. It's kind of what we're doing now, which is that. You do some small trials and then you do a big trial of a vaccine where half of the people get it. Half of them get a placebo and you start to see how things go. The two groups, and that's fine when you're kind of going into kind of a slow pace, one vaccine at a time, and especially when there's no other vaccine that you can use but were no kind of. A weird situation where we have all these vaccines being made at once. And there's a problem that if they all put out their data from independent trials, it's actually really hard to compare them and really have a clear idea of which ones better, maybe ones better for one group than another. Maybe one of these vaccines is going to have an edge for older people might be safer. So so in the United States, actually a number of scientists, including Tony Fouchy. He told me they were advocating for what's called a master protocol were basically it's sort of a mega trial like you take 5 vaccines and you give them in a randomized way each vaccine to say 15000, people, and then another 15000, people are placebo. For the whole thing, and then it's all randomized in the same place at the same time, and now you can get results of the mall you can see with all of them are they safe. You can see are they effective and you can start to compare them. Each other. We didn't do it. It's not clear to me why you know it could be that the drug companies just weren't willing to play ball, but the World Health Organization is going to do this kind of a vaccine trial, so that will be very interesting to watch. So it sounds like by averting the traditional master protocol in the US development, we are getting a little bit of a disadvantage of being able to see the full ranking. Of all the vaccines that will arrive an they will kind of be in their own silos of evaluation. Yeah, well, each each vaccine if it. If they have good signals from these trials are going to give it to the FDA, and the FDA is just going to look at it on its own and say, OK, you passed our our benchmarks were going to give you an emergency use authorization. That's possibly what could happen so we could be could be in a situation in the spring where you have 45 vaccines, all with emergency use authorization. Now I should say like in some ways that's a great thing because there's no one company that's going to be able to vaccine. All of the United States on their own Pfizer can't do it. Johnson Johnson can't do it, they just they're not going to be able to do it fast enough for what we want, so we'd like to be able to sort of roll out this combination of vaccines. But then you have to say, like, well, how do we decide which one to use for which group? And so on like it would be nice if we had data from a master protocol trial. We have been a much sounder footing for saying, like, OK, this one goes to kids. This one goes to. The elderly, this one goes to people with some other, you know some sort of pre existing condition that puts them in a certain kind of risk. We don't have that, and so there's going to be. It's going to be difficult to make sound choices, which gives me concern that will awareness of that. Should that be further discussed beyond just the coverage you've done, will give a fair number of people pause to get a covid vaccine. They'll say, well, I don't know, it sounds like they've got a mishmash of them that are of various effectiveness. I don't know which one I should be getting my gain. The right advice. Should I just wait? Do you think that has a public perception problem like that? It potentially could if our government doesn't really just show the leadership that it needs to, you know what's going to be crucial this spring is that our government put out coherent, consistent messages about how the public should view these vaccines and what they should do. It can't be one day. They're saying one thing, the next day, they're saying another an, or you have two agencies that are. Fighting with each other. That'll be a bad thing, so you know. So communication is going to be key. If these vaccines are become available. That's because the FDA has decided that they've met. These met these benchmarks in terms of safety, for example, and they will continue to be observing the safety of these things, and they need a way to keep to keep telling people like, hey, we're tracking all of this, and we have evidence still that all these different vaccines are safe because you don't want a situation where, let's say like in Pitts Burg. You know, vaccines show up in Pittsburgh and 1st. A bunch of people get vaccinated in Pitts Burg and then, like the next day, like 10 people have heart attacks, who got vaccinated and then everyone says like, My God, it cause heart attacks. So the government needs to be ready with data to say like actually everyday in Pitts Burg X number of people get heart attacks. So these people getting aren't tax. It's much more likely that it's just. People getting heart attacks. You're talking about a triumph of science over social media. You know that's not possible. Well, social media is going to be a really big issue because there's going to be all this information. I mean, it's going to. It's going to happen not just from X anti vaccine groups, but you know from Russia. Russia is has already been doing vaccine. This information for a couple years now they find it. It's a way that they can kind of drive wedges between people in the United States. Amply documented, and so they've already had practice at that. So just imagine what they're going to be doing next spring in my business over here in consumer electronics, we always look to generation 20. or so. We know it's dramatically better than 10. you right in your piece about how there may be kind of a defacto sort of arrangement in this whole race that may hamper the ability, or dissuade companies who are coming in the 2nd way with a better vaccine from even getting there. What's that all about now? Seems to be closest to the finish line. Some of them are coming from really big companies like They're huge company. Some of them like Madonna, smaller company, but they've had lots and lots of help from the government. They've gotten billions of dollars in support. Because this is expensive stuff. It's very expensive to run these trials and it's very expensive to gear up factories to start manufacturing them. So. But there are dozens and dozens of small groups either at university labs or small biotech companies that have all sorts of innovative vaccines they're working on right now. Which very well might be much better than the ones that are gonna come out first. So how are they going to show it and unfortunately, there are some built in problems because once one of these vaccines gets approved. Are authorized. It's possible that regulators might say like, well, you can't do a placebo test anymore. You have to compare your vaccine, your experimental vaccine to our authorized one, and that that's harder. You need a bigger trial may take longer. It's going to be a lot more expensive and will the money be there for that? I don't know. But If there's a better vaccine out there, don't we want it? Then as we get to the point of the chaos and confusion that's going to be coming around that first vaccine as it gets deployed and made available to us. Is there any kind of a breakpoint in there where you're going to say, we're embracing it or we're not as a people. It's gonna take a while because the. The, when that first vaccine gets authorized, there's going to be a very limited amount of vaccine and so that, probably there will there will be a program the CDC may run, to give it to to, for example, just health care workers on the front line. So like maybe 10 million, 20 million health care workers and other essential workers, they get it first. So you may not see so much of these issues about overall acceptance until like even the summer maybe we might start might you might have to wait till then to kind of get a sense of our people, recognizing the vaccination is our way out of this. this. OK, so it might not even be an available available choice for the majority of us for quite awhile. So the government has said I mean in press conferences has said that they want to have. Enough vaccines for everybody wants to get one by sort of late spring early summer. You know, that's their time. Pretty It is no it's it's unprecedented in the history of vaccines. << We talk a lot about the sourcing of all kinds of medical products from around the world. That's become a big issue of course. We're talking about Pfizer moderna j&j, all American companies. Tell me about the role of any overseas developers. Is it possible that a vaccine being developed in Europe? Becomes a leader or a winner in the US market, or do these things tend to stay in a certain region? There's a vaccine business is quite International. So Pfizer, for example, they actually Are in a collaboration with a German company called Biontech, which actually invented this vaccine. Then Pfizer said, Okay, we're gonna carry it across the finish line because we've got the resources. And you know, Pfizer, you know, they have plans to give us lots of the vaccine, but they're making deals all over the world. So So a lot of these companies are international, but on the other hand, there is a certain also kind of a nationalism going on. Like, you know, China, for example, has a whole bunch of vaccines near at the New York Times we keep track of them on our vaccine tracker. They've got a bunch of phase three and then a bunch more in earlier stages, and they're really pushing their vaccines. You know, just as part of like international diplomacy, making deals in Indonesia, in Qatar, all sorts of places so in Russia has their own as well and they're making deals do in places like Vietnam. So The the global picture is, is fascinating. So as we close out today, Carl, when the vaccine or vaccines, it'll probably be more than one arrive on this ambitious timetable. Do you think it will be more a triumph of speed of development? Or maybe a little more? A triumph of adoption, of shortcuts? Traditionally, vaccines have taken over 10 years, sometimes 1520 years, to go from design to actually getting into peoples And you know the [UNKNOWN] makers have done a lot of soul searching like what can we do, how can we make this faster without cutting corners. And you know that turns out that there's a lot of slack built into the system that if you're careful about it You can take it out and still have something that say, there's no indication so far that there's been any sacrifice of the standard of care about safety. And yet we are going. Going to break records like the record for the fastest vaccine development is just As for years. We'll have more than one within like a year and a half of the start. Of all this, we might have 10. It's going to be astonishing, Ann, I am confident. Certainly, at least in the United States that there's not going to be a sacrifice of safety. It's interesting when that day arrives and we have so many on the market. And like you said, you seem to have confidence that we're going to have broad safety. You know, a lot of things to workout, but this isn't some kind of a public health menace by any stretch, but it's either going to expose that, like you say, there was a lot of slack. It could have been taken out years ago in the pursuit of many vaccines. Why didn't it happen? Or the vaccine interest industries that were achieved a great fitness test here that is just made it stronger and taught are one of the reasons that it's going fast is because governments and big philanthropic organizations are basically putting out a safety net for them. This is not raw free market capitalism by any stretch of the imagination. This is government saying like will take the risk. You know, I mean, capitalism is all about risk, but in this case, guess what our government is spending billions of dollars guaranteeing that these companies can go ahead and build factories. Really expensive factories for vaccines. I don't even know that they work yet, and the government is going to eat that cost. And honestly, like none of this would be working the way it is so far. If these governments weren't doing that, I'm talking to Carl Zimmer his piece in the New York Times to me is must reading its first of vaccine approval, then chaos. And confusion.