Wells: What are the main logistical obstacles? What makes this hard to make and distribute?
Thomas: The scale and the kinetics of distribution required in the midst of a pandemic are a challenge, in and of itself. This particular vaccine currently has a requirement to be stored at a very cold temperature. It needs very specific types of freezers that go to very, very cold temperatures.
Wells: Does this change anything about the timeline? Is this speeding things up? Or are we on the track we’ve all been hearing about, which is: approval by the end of the year, widespread availability not until maybe late spring or summer next year?
Thomas: I’ve always been on that timeline, and I remain on that exact timeline. This positive news keeps this vaccine on the pathway that has been set for it. I don’t see widespread rollout of vaccines throughout the country to those first-tier recipients happening before the first quarter of 2021, or into the second quarter of 2021.
Wells: Okay, so ... great news. Doesn’t change anything. Can I ask you one more logistical question? You mentioned that people have to be willing to take the vaccine. We had vaccine skepticism long before COVID-19, but the accelerated timeline and terms like “warp speed” have made even people who trust vaccines have questions about things that we don’t know yet. We hear headlines every now and then about adverse reactions, and it sounds scary. Is this the kind of thing that we could find out years from now? How concerned should I be about adverse reactions, and how much we don’t know yet?
Thomas: With any medication or vaccine, there is always a risk-benefit [ratio]. Nothing is 100 percent effective, and nothing is 100 percent without risk. But with the process of developing vaccines and drugs, a lot of those risks can be identified early on. I know that people are concerned about the speed of this development—but I do think that there are some things that people may or may not realize which have contributed to the speed.
The first is that vaccines typically take a long time to develop, because it’s very, very expensive to develop a vaccine. It costs easily over a billion dollars—that’s kind of the historical benchmark. And so companies, when they’re developing vaccines, take a very pragmatic and very sequential approach to mitigate financial risk. What has happened with COVID-19 is that, in the case of Pfizer, they’ve underwritten their own financial risk. In the case of Operation Warp Speed, the U.S. taxpayer has underwritten the financial risk. And so processes that typically occur sequentially can now occur in parallel, and that can really shave off a lot of time. And that’s an acceptable risk, especially in the face of a pandemic, because it is not a safety risk.
The second thing is: For a lot of these vaccines that are in advanced development right now, this is not the first time that those [vaccine] platforms—messenger RNA or adenovirus vectored or chimp adenovirus vectored, all these different types of platforms—this is not the first time that they’ve been in humans. These are vaccine platforms that have been used to try to develop other types of vaccines, whether it be Ebola, influenza, Zika, or other types of vaccines. Hundreds and thousands of other people have already received these types of vaccines before, so folks weren’t really starting from zero.
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