Corona virus researcher Dr. Stuart Weston joins me again for an episode in which we discuss the new vaccines that will be coming available in the next few months.
I first spoke with Dr. Weston back in August as we talked about treatments for Covid-19 and what would be the “end game” of getting out of this pandemic.
We talk about:
- What have we learned about Covid-19 since our first conversation?
- The difference between mRNA vaccines and traditional flu vaccines
- When these vaccines will become widely available
- Will the side effects be readily known?
- Could someone have manufactured this virus?
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About the Transcript
Keep in mind that the following is a transcript. I use a service that automates the first draft. As much as “artificial intelligence” is included in the description of every bit of technology these days, it’s clear that computers understanding human speech is more artificial than intelligent. The transcript has been edited to take out human speech bites, you know, um, okay, uh, but it’s not been edited to be an “article”.
Jon Johnston: Welcome to Jon’s PostLife Crisis. I am Jon Johnston, founder of CornNation.com, your Nebraska Cornhuskers site of things that aren’t football sometimes, and this is one of them. There are coronavirus vaccines coming onto the world to a place near you in the next few months. This is a big development. I brought back Dr. Stuart Weston to talk to me again about these vaccines. Dr. Weston is a research fellow at the University of Maryland School of Medicine in Baltimore, and he’s been studying coronaviruses long before we even heard of them. How are you doing, Dr. Watson?
Dr. Stuart Weston: Very good, thank you. It’s nice to be back talking to you and hopefully spreading some good information about these vaccines.
Jon Johnston: There’s a number of them, but there seems to be two that are kind of at the forefront. One by Pfizer and one by Moderna. I don’t know anything really about how vaccines are developed. I don’t know. I just take them if they tell me to. I’m one of those guys. You do research on this stuff. Months ago, we went into lockdowns. It seems like the death rate has dropped significantly. It seems like we’ve learned a lot more on how to handle this thing. But can you tell us, what have we learned and what do we know right now that we didn’t know, let’s say, five months ago?
Dr. Stuart Weston: I think what we’ve learned with respect to the death rate dropping, I’ll just take that one is in that initial wave when we were first hit in sort of springtime, since then, we’ve learned how to better treat the patient. So the health care workers who are dealing with the people with the most severe disease in hospital, they’ve worked out a lot of things that work and a lot of things that don’t. So now they’re much more equipped to deal with patients. So, for example, ventilators, we use quite a lot at the staff, but quite early on, it was found that they were actually exacerbating things and not helping in the way they should. So they were being used when it wasn’t necessarily essential to use them and that was making the condition worse. And those people were then going down and dying. But that was rapidly learned by the health care workers. So they stopped using vents, unless it was absolutely essential because those people just couldn’t breathe. So things like that. There was another example of proning people, say rolling them on their stomach instead of having them on their back, helped with the breathing when they were suffering from low oxygen.
Dr. Stuart Weston: So all the all these other things that have been learned by the health care workers mean that people who developed covid-19 and have to be hospitalized are now getting better treatment because now they know how to treat them better. So obviously that means that death rates are going down. On top of that, hospitalization is slightly different as well because the demographic has changed for who’s being infected.
Dr. Stuart Weston: So during that initial lockdown and that initial spread, a lot of the deaths and the hospitalization was in the older age groups. And of course, we also knew that there was a lot of silent spread of the virus. So people who don’t develop symptoms, but we didn’t have enough testing to see all of that, Kate. All of those cases testing has gone way up. So now we’re seeing many more cases and we’re seeing a lot in my age range in the 25 to 35 kind of groupings. And they’re also the people who are largely responsible for this new wave because they’re all going into bars once they opened up in restaurants and that socializing and all these kinds of things. So is this split between a different demographic of who the main bulk of infections seem to be in, combined with the better treatment in hospital that’s responsible for this sort of changing thing we’re saying?
So the two vaccines, my understanding... I hate to go here because my brain is going to explode, but I think we want to cover this anyway. They’re both RNA based vaccines and this is different than a viral vector vaccine. See, I’ve done some reading. I can say those things, but honestly, what I understand about them is this. We’ll see how good this is. A virus is like a protein wrapped in genetic material.
Dr. Stuart Weston: It’s protein wrapping in genetic material. Yeah, you said you said it almost the other way round, but yeah, the genetic material is inside protein.So basically that.
Jon Johnston: The difference between these types of vaccines are how they attack the virus.
Dr. Stuart Weston: Not quite. The difference between them is how they train our body to attack the virus.
Jon Johnston: Mr. Semantics, I tried really hard.
Dr. Stuart Weston: It’s important to know. Those semantics are important.
Dr. Stuart Weston: I’ll give you my my description of the differences and I’m going to, as I was saying about the Pfizer and the Moderna vaccines. I also want to give credit because the Pfizer vaccine was developed by a German company called Biontec. So it’s the Biontec Pfizer vaccine. Just because Pfizer are the ones who are funding all the clinical trials and the distribution. But it was actually developed by Biontec. I don’t want them to get swept away. Where’s Moderna did all that stuff and get a lot of funding from the NIH. That’s how they’re doing all their clinical trials. So, yeah, you’re spot on that they’re both RNA based vaccines. And so I’ll just do a little step back into Biology 101 to explain how that works.
Dr. Stuart Weston: So humans and all lifeforms, we see are DNA based, deoxyribonucleic acid DNA. That DNA encodes the instructions to make all of the protein and everything that you see is essentially built through protein. The way that the DNA gets made to protein to produce life is through an intermediate of RNA. DNA makes RNA, makes protein. And specifically the protein making RNA is called mRNA. So this is messenger RNA and these vaccines are mRNA based vaccines.
Dr. Stuart Weston: Now, viruses themselves are these really cunning parasites where they just take over every life form on the planet. So every life form has viruses and they use what that life form does naturally to make more copies of themselves. So you have viruses that can be DNA based. So then they just go in and they trick your body to think its own DNA and then they make more more copies of that DNA. They make a protein that makes more virus. Or they can skip a step and they can just be RNA viruses, which is what coronaviruses are. So they’re coronaviruses are just made up of RNA, that genome. That genome gets into a cell, the cell thinks it’s its own RNA, makes the proteins from it, not knowing it’s copying viral material and then produces more viruse. So they completely parasitize ourselves to copy themselves. And our cells aren’t smart enough to really know that that’s what’s going on. OK, with me so far?
Jon Johnston: Yeah, actually, I went to Guardians of the Galaxy Vol 2 where he says every life form wants to replicate itself and grow.
Dr. Stuart Weston: Exactly. And that’s what viruses are. That’s all they want to do if we can describe that kind of desire to do anything. Viruses like coronaviruses are just made up of RNA. RNA goes into a cell, it copies itself, and it makes all of the proteins that make a coronavirus like SARS2, which is about 30 or so proteins. The way these vaccines work is they strip away all of the parts of the virus, apart from the one that stimulates our immune response. So when we talk about antibodies that we make against the virus, SARS2 virus that causes covid-19, those antibodies target the spike protein, which is the bit that sticks out. So when you see all the drawings of coronaviruses, those little bits that stick out, they’re called Spike. That’s the only bit that our immune system really sees of the virus. So that’s the only bit it can attack. So the antibodies we produce bind to that spike protein, and by doing so they block the ability of the virus to infect the cell and take it over to make more copies of itself. So what the vaccines have done against me stop me from losing you, it’s OK, but what the vaccines have done, they have just got the RNA to make the spike protein and nothing else. So they stripped the virus essentially down to the one part that triggers our immune response so that RNA then gets put into a human through injecting them with the vaccine. The cells produce the spike protein similarly to how they would if a virus was there, but only the spike proteins and nothing that causes damage. Our immune system sees that spike protein mounts, an antibody response, no damage because there’s no virus, but you have the antibodies. So then if the real full virus comes in, you’ve already got the antibodies that you can make, more antibodies that can then protect you.
Dr. Stuart Weston: And that’s essentially how these RNA vaccines are protecting.
Jon Johnston: One big concern people seem to have is that you’re not injecting people with, like a dead form of this existing virus or a living form that’s been like, I don’t know, cut down or minimized. That’s not happening here.
Dr. Stuart Weston: It’s not that killed form of virus, which is sort of the classic thing you think of with viruses. So, for instance, as influenza vaccines are made that way by completely taking a virus and making it completely inert by destroying it so that it can’t do anything, but it’s just there as a ball of protein and fat that the immune system sees.
Dr. Stuart Weston: So those vaccines are super safe because they can’t cause any damage. There’s nothing that virus can do. It just goes into the body. The body sees it. I was saying these vaccines, they have essentially stripped away all the components that can cause any kind of issue to you because it is just about that one protein being produced. So just just that’s like protein being produced means there’s nothing else there that’s viral. So there’s no damage that can be caused except your body mounting an immune response to that one viral protein.
Jon Johnston: So this this sounds really nice.
Dr. Stuart Weston: I mean, it’s day, yeah, it’s great, and so, so many vaccines have been sort of set around the lot that we’ve never had a licensed mRNA vaccine in humans. This is a completely new technology, things like that. And that’s largely come down to just the fact that we’ve never been able to fully test them. So other ones have been produced. So that was one, I believe, for Ebola. I think they’ve done one for other coronaviruses, but that was never the chance to actually test if they were safe and effective. Well, safety is OK, testing, you just put in people and see if they have any issues, but to see if they’re actually effective, that was hard because the virus is spreading and we have vaccines, too already, there’s not much impetus to make new vaccines unless they’re terrible vaccines, which most of the ones we’ve got are good. Otherwise we wouldn’t use them in the first place. And any new viruses that emerged, they died out before we could fully test them. So like Ebola in 2014, for example, had that massive outbreak, but then it went down before we could fully test things. So this is the first time we’ve really been able to properly assess this new technology and so far is looking really good.
Jon Johnston: Ok, there’s two things there, and I hope my train of thought stays intact well enough for me to remember what they are. New technology always scares everybody. So when you say this is new technology, that sounds like, oh, my God, it’s going to turn people into zombies. That’s one thought. The second thought is this. When we first talked, we talked about the vaccine being the end game to this virus. We also talked about the fact that it would take at least a year to 18 months and this is way ahead of that schedule. A lot of people are concerned that, well, they just rushed this through without testing and it hasn’t gone through trials and there’s going to be side effects. That’s where I want to go. And here’s my sense. I sense a lot of people have way more apprehension about this than excitement. And I’m astonished by that in a way, because you look at this and you go, this is our path to having a full college football season and a full college basketball season and going out to bars and restaurants with our friends. And there are massive numbers of people are like, I’m not touching this stuff. I’m never taking this stuff. I know I said a lot, but let’s start with, is this rushed?
Dr. Stuart Weston: Well, so that that year to 18 month time frame we talked about before, that was always based on when we first started to be aware of this virus spreading. So that was always from around January, February time. So we’re not that far ahead of the one year mark in terms of thinking we have vaccines, that we’re getting close to approval. That sort of 12 month to 18 month window was always when we thought we’d start to see vaccines going towards getting licenses for use outside of trials. And that’s pretty much exactly where we are. What’s sped up the development of these vaccines is the fact that cases are massively spiking. So to test the vaccine, say if you actually need the virus spreads to come back to less than about the Ebola example, if the virus isn’t spreading, you can’t work out if it’s safe or not. Also effective or not, you can have it safe because you just if people develop bad reactions, but you can’t work out if it’s effective, if people aren’t being infected. So that weird silver lining to the fact that we’re having these spikes in America and Europe and all the places that are testing these vaccines means we get more data more quickly about whether this vaccine is protecting the people in the trials.
Dr. Stuart Weston: So we’re kind of just about in the time frame we expected. And again, I’ll stress that this minute the the Pfizer Biontec vaccine, they’ve just I think today submitted the paperwork to the FDA to get the emergency usage authorization the EUA that allows them to start putting it into people outside of the trial. But that doesn’t mean it’s going to be widely available. It’s going to take a really long time until, well can take most of next year until these vaccines are actually available at the CVS or Walgreens or wherever you guys get your vaccine. So we’re still kind of in the time frame like so I think we’re a little bit ahead, but that’s because we hoped that we were going to get this under a lot more control than we have. And the other thing to be you’ve raised about the trials, so I’m saying outside of trials, they are doing all the trials. So these these vaccines have gone through their phase one trials, making sure that they can be injected into people and they don’t cause any rapidly noticeable effects. So that was a small number of people, probably under 100 people get at the first time just to be like, is this safe? Do they develop anything? Bless those people who take that as a it’s a risk that we can’t do without people doing that.
Dr. Stuart Weston: A credit to them. So they got that and those people were getting that back in probably March, April, May kind of time. So they’ve been assessed this whole way through and there’s no evidence of any long term negative impacts for those people. So that was all positive in phase one. In phase two, it was ramped up to more people. So probably thousands of people at this stage. And those people, again, got the vaccine or a placebo at that stage and again, looking for safety, seeing if they developed anything with an eye towards if there was protection. So phase two, you’re mostly looking at safety with a higher number of people, but you’re also looking a little bit if you see that the vaccinated versus placebo protected. And again, those people probably in summertime, we’re still seeing no long term negative effects in those people. And what we’re hearing about now is their phase three trial. So this is, again, ramping up the numbers of people. This for Pfizer, I think they have about 44000 people, and that’s divided evenly between vaccine and placebo. So that’s 22000 people who received the vaccine. And now we’re looking to see did they develop less or fewer cases of covid-19 versus the placebo group? This is a lot more about efficacy, but also has the safety.
Dr. Stuart Weston: So they’re still being monitored for any kind of negative effects, whether they develop anything serious right after they get injected and for the weeks and months after that. So constantly there is a constant assessment of whether this is safe. And in terms of the data that’s been released and both Pfizer and Moderna, it’s pretty comparable. It seems like people are only developing really mild stuff. So pain at the site of injection. So that’s a reportable side effect. I put it in air quotes for the people who are listening, we’re here on the video. But in side effects is pain in the side for injection? I don’t think I’ve ever had an injection that hasn’t hurt me a little bit. So that’s a side effect then. There’s things like developing a bit of a headache or a bit of fever. The fever is your body mounting the immune response. So that’s actually a good sign as long as it’s only short and these are a couple of days, there’s a bit of fatigue for a few days. All of these things are only occurring under five percent, in under five percent of people. So it’s really low numbers of really mild things. So it really does look safe at this stage is the point I’m trying to make there.
Jon Johnston: When this comes out, who’s going to who’s going to get it first? I mean, you’d think that it would go to the people that are the most exposed and honestly, the people that we need the most, which are health care workers and people who are directly involved in taking care of those of us who are being hospitalized for this. Right?
Dr. Stuart Weston: Yeah, exactly. So both companies have come out with with numbers of doses. They I think that will be able to produce by the end of 2020 and by the end of 2021. So Pfizer has come out to say that they think they can make 50 million doses by the end of this year and Moderna, say 20 million. By the end of next year, those numbers are 1.3 Billion and one billion for Pfizer and Moderna respectively. You need two doses of these vaccines. So that works out to 25 million and 10 million this year. And then 650 million and 500 million next year. So there is a limit because even though over a billion doses of these two vaccines is a lot, the world’s population is nearly eight billion. So that does have to be prioritization to the point you’re getting at. The companies are going to prioritize to get these vaccines and is going to be at the front line health care workers because that is most at risk of contracting this disease. And they’re the ones we don’t want to get sick, because I would say if you take down the health care system that’s got huge knock on effects.
Jon Johnston: I think it’s important to note that you’d have to consider that this isn’t just health care workers in America. This is health care workers in India and the Philippines and Malaysia and Madagascar, all the health care workers around the world. So this isn’t like Pfizer developed and paid for a vaccine to be used in the United States. We have to worry about the entire planet here.
Dr. Stuart Weston: Yeah, exactly. So that’s why I brought up the world’s population when I was just doing my calculations, because these are going to go around the world and I forgot the exact numbers. But America does have an agreement with Pfizer and Moderna for the number of doses they’ll get this year. So I think it might be something like 10 million doses of the Pfizer vaccine, although I could be wrong. But there is you can find the number of doses that they’ve agreed upon for this year. But that’s only, let’s say, 10 million of the 50 million, and that’s only five million people who can get that vaccine in America. What that means is it prioritizes and they’re going to give it to the health care workers and typically the health care workers are on the younger side as well. So if really big, if there are some potential side effects that we haven’t picked up in these trials, those health care workers, the ones who are going to be better equipped to deal with it than, say, the elderly or those with severe health conditions. So obviously, there is always going to be that concern about the safety as much as these trials are being done, but the thing is, in the trials, they do have underlying health conditions. They do have the elderly. So they’re going to keep monitoring those as they start to roll out. It will be in the healthiest and those at most risk of developing the disease we don’t want to get sick. After that, it will start to roll into those who are most at risk of severe disease, so those over 65, for example, and what was great with Pfizer’s announcement on this Wednesday, I keep losing track of time with these things.
Dr. Stuart Weston: On Wednesday, Pfizer announced their 170 people and their 95 percent efficacy data and that they said that there’s no difference in efficacy across age and across race and across ethnicity. So even in over 65, they still had 94 percent protection from their vaccine with no adverse events and no severe side effects from receiving the vaccine. So it really looks like it’s actually working in that population who are at most risk, which is really great to say. So it’s looking very promising. But as exactly as you’re saying, it’s going to be a slow roll out to those who need it the most and those who are at most risk of contracting the disease, health care, and then the those with health conditions.
Dr. Stuart Weston: So in the meantime, while all of that is happening in the background, when we first talked, we also talked about treatments, the treatments are getting better. So while this virus continues to roll around and you also said in that first conversation that it was a weird virus. Have they done any better at actually figuring out who it affects the most?
Jon Johnston: That would be you. You would be they, wouldn’t it?
Dr. Stuart Weston: I guess so, yeah. I’m part of the “they”.
Dr. Stuart Weston: So yeah we basically just really solidified the ideas we had back when we last talked. Those at most risk of developing severe disease are the elderly and those with underlying health conditions. Diabetes, obesity, cancer, lung condition. So all those kind of things that put your health at a lower level, let’s say. They’re the ones who are at the risk of severe disease.
Dr. Stuart Weston: There’s a few other things that have come to light. For example, they found a group of people who have mutations in part of the immune system and don’t mount a proper immune response. That was unknown before, but they’re in the severe groupings. So the kind of things you might think of that would put you at risk of a severe infection seems to hold true. So right now, it’s just kind of following the trend and just solidifying the data that those most at risk are those you’d expect to be, of course, that are the outlier cases where the 25 year old who runs marathons drops dead from covid-19 that we don’t know why, but there’s always going to be outlier cases like that. And of course, the fact is an outlier doesn’t mitigate the loss to the people who lose that person, of course.
Jon Johnston: The other thing that stuck with me is from that first interview was we talked about the fact that this is a very, very virulent strain of coronavirus. In other words, it’s very contagious, easily spread. And obviously we’ve seen that with all of the ups and downs and continuing whatever. You also said that it isn’t very deadly, compared to the other strains of coronavirus.
Jon Johnston: We know.. I mean, if you don’t know this, if you’re listening and you don’t know this, you have to have your head under a rock. Not living in a cave. You literally have to have taken a big frickin rock and put it on top of your head. We know that we are going to have more pandemics. We know that we’re going to have more strains of viruses. There were people when I asked for questions for this that asked, do I have to get a different flu shot from this every year?
Jon Johnston: And the answer would be yes, because this is going to change as time goes on.
Dr. Stuart Weston: Yeah, so with respect to I guess I’ll take the first part about the severity of the death rate of this virus compared to the others, so spot on to what we were talking about last time, the two previous severe coronaviruses, SARS1, the original SARS and MERS, Middle East Respiratory Syndrome coronavirus, they killed 10 percent and about 35 percent respectively. This virus seems to be hovering around one percent or lower. The difference and why this spreads much more easily, is the fact that you get the people who don’t develop symptoms and they spread before they develop symptoms. The other ones, you’ve you only really spread at the peak of disease. And therefore, it’s much easier to isolate people in hospitals or at home and stop them spreading. Whereas this one, you can be walking around with it for 10 days without knowing you’ve got it and give it to all the people that come into contact with. So that’s why this one is different. We don’t know why that’s the case. There’s some ideas, but it’s not really clear why this spreads when people don’t have symptoms versus the other ones. But that’s ongoing research that we’ll probably learn eventually. And then in terms of the vaccination for this and the question of every year, that one remains to be seen. That one is actually going to be a bit interesting to think about and look at because with flu, so flu is the comparator virus mutates very rapidly. So every year that virus is mutating and changing and mutates enough that it can escape the previous antibodies that were produced by the previous vaccine. The difference with coronaviruses is they don’t mutate anywhere near as rapidly as flu. So the reason for that, just for anyone who’s interested. When the virus is copy their genomes, they make mistakes in the copying process and that mistake is what makes a mutation and what changes the layout of the protein so that the antibodies can recognize it. So flu makes a lot of mistakes when it copies its genome and therefore the proteins it produces are different and can’t be seen by our antibodies, which is why we then play catch up with a new vaccine to target that new virus. Coronaviruses are able to proofread that copying. So if they make a mistake, they can actually go back and correct that mistake and keep doing that until they copy their genome, not perfectly, but closer to perfectly than flu. So they don’t mutate anywhere near as rapidly because they can actually correct the errors. And we humans do the same things. When we copy our DNA, we proofread, we make sure there aren’t mistakes. And if there were, we’d all be, well, single cell life forms.
Still, we wouldn’t be humans if we can do that. So the coronavirus is just generally don’t mutate as rapidly as flu viruses do. So therefore, there is a hope that we may not need a new vaccine every year because the virus may still be pretty much the same as what we saw before, the antibodies can still bind to the spike protein because it hasn’t changed. The one gets the bigger concern, though, is how long lived those antibodies and the antibody response is. So, of course, as the stories of people getting reinfected, they’ve had the disease once they get infected, the stories of antibodies waning over a period of six months and things like that. So that’s more the question is, how long do the people who got the vaccine maintain their ability to mount an immune response? And that may only be a year, so the reason we may need a vaccine every year is more about our response rather than the virus. In this case, it’s different from flu. But for this one, it’s possibly more about our ability to maintain that ability to produce an antibody response.
Jon Johnston: It would seem to me that the natural, I don’t want to say evolution, but the natural progression of life as we move on, we are going to encounter a virus that is both very, very virulent and very deadly. How much does what we’re doing now protect us against later, and I think the science is a big part of that. Human response we’ll talk about in a bit how people react to this stuff, because that part’s nuts. But how much of what we’re doing now is really kind of setting the stage because you know that day will come up for sure. It’s a logical conclusion to this, right?
Dr. Stuart Weston: Yeah. I mean, the hope is that this is a good trial run for when that day comes and that we learn from all these mistakes and therefore that day doesn’t actually come. We nip it in the bud before it takes off. We never really know. Right. That’s the hope is that we never know that that was the virus. That would have been the one that spreads as rapidly as this virus and kills as many as MERS, let’s say 35 percent of the people. So the hope is we do learn from this and we move forward. Something we were saying just before we started recording was the classic line of those who don’t learn from history are doomed to repeat it. So hopefully we do learn from that history that we’re living to be better prepared. And that’s really the key is to make sure we are better prepared. So doing things like surveillance of viruses in the wild that have the potential to infect humans are really important. So there’s loads of coronaviruses out there circulating in bats and other animals, many of which have the ability to infect human cells. If you put them in a lab, they can infect human cells. They don’t necessarily grow very well or at all, but they can get into the cells.
Dr. Stuart Weston: And that’s the starting point, because then evolution kicks in and you can potentially select the viruses that would. So the more we know about the viruses that are circulating, the better prepared we’re going to be because we can look, oh, there’s one person there, isolate, isolate, isolate, get them away from anyone so that it doesn’t spread. The surveillance is a key to dealing with this matter, and then, of course, the other keys are to have a better arsenal of weapons to attack these with. So we may have talked about this last time, but if you think of bacteria and antibiotics, you can take the same antibiotic for a lot of bacteria. You don’t need specific treatments because antibiotics are broadspectrum. We don’t have anything like that for viruses right now. So every kind of drug treatment is very virus specific. So you get your your treatments for HIV, you get your treatments for flu, but they only really work on those specific viruses. If we could develop a broad spectrum that hits a lot of different viruses. That’s a great thing to have for any new emergence of viruses are all very similar. So all the coronaviruses are very similar.
Dr. Stuart Weston: All of the flu viruses, that lots of flu viruses, they are all very similar. But there’s also similarities between coronaviruses and flu viruses. So potentially you can attack both with the same drug. So developing things like that, broadspectrum antivirals makes us better prepared should we not nip it in the bud? And it does start to spread. And then, of course, vaccines, again, as we’re talking about there, another case. This is why, I can speak for myself and I think quite a lot of scientists are quite excited about these mRNA vaccines working. It’s because they’re very easy to change. So I’m saying that mRNA is the spike protein of this virus, but it’d be really easy to change that to the spike protein of SARS3, let’s say so if we can make these malleable vaccines, that allows us to respond much more rapidly so that instead of this one year that it’s taken, it may take six months to get a vaccine ready and to go into humans.
Dr. Stuart Weston: So it’s all those kind of development processes learning from the mistakes we’ve made here scientifically. I mean, I’m talking here about science stuff, not the the social stuff. That’s a whole different topic. But I’m sticking to my safe zone of the science. But it’s those kind of things that allow us to to be ready for the next one in the hopes that we don’t get SARS3 in 2030. Or if we do, we never really know about it.
Jon Johnston: Do you want to be a psychologist for a little bit?
Dr. Stuart Weston: I guess I can try with the with the disclaimer that this is going outside of my my realm of expertize, but I can try. I am a human, I guess.
Jon Johnston: But, you know, you’re having a drink of rum there, BAM, you’re a psychologist. There you go.
Jon Johnston: Don’t tell people that. It’s 9:30 in the morning.
Jon Johnston: Basically what we’re saying is this is the first responders in the most exposed people are going to go first. And as we develop more and more millions of people taking this, we’re going to find out if there are side effects. Now, the downside of that is, is we’re going to have more and more millions of taking this and any time you do anything with millions of people, you’re going to have something happen. So you have this door where you’re learning more. You have this thing where you’re learning more, but you’re also opening this door to these anti VAX people. Are you familiar with? I don’t know how to pronounce this VAERS database. V-A-E-R-S, it’s an online vaccine response system that is completely online. There’s no control on it. Antiva people use it quite a bit to promote, well, anti vaxxing. You can go... I think somebody did this. You can go out there and put in a response to it that says, I took this vaccine and I turned it into the Incredible Hulk.
Dr. Stuart Weston: That sounds all right. Then you can just start four and start The Avengers.
Jon Johnston: It does. But, you know, that’s the problem. We will discover more stuff. But we also have this stoking of fear. And we’ve seen that really used very well during this. Let’s touch on that. Are you familiar with the 1976 swine flu thing?
Dr. Stuart Weston: Briefly, I saw a few things about it yesterday, but I didn’t have time to go fully down the rabbit hole of it, because obviously this is hard to get the good information in these areas because of the floods that comes from the disinformation of the antivax movement. So could you just recap just to see if I’m thinking about the right things?
Jon Johnston: Ok, 1976, two soldiers got ill in Fort Dix at Fort Dix, New Jersey. And the concern was, is this was a strain related to the 1918 flu, Spanish flu that killed one hundred million, four hundred million people around the globe. I don’t remember which. The nation started this massive vaccinating program. By the time they were done, they vaccinated 45 million Americans. Think of that just by itself. And what they they discovered was this increase the vaccine that they used increased exposure to, I always call this guillain barre, and that’s not the pronounce. It’s French guillain barre.
Jon Johnston: Ok, so out of forty five million people, four hundred and fifty people developed a rare neurological disorder, guillain barre. If you had forty five million people take a drink of water, they’re going to have some kind of effect, you know what I mean? There might have been 150 of them die tangled in their bed sheets because that is a death statistic. And I guess my fear with this thing is this is it goes on. Yes, you are going to learn more, but you also are open to the exploitation of fear. Because any time you do something, something’s going to happen in human beings, we die. That’s what we do. That’s our logical conclusion to life. So that’s where I’m going. And now you’re the psychologist. Tell us how we’re going to deal with this part of this equation.
Dr. Stuart Weston: I mean, this is the hardest one to deal with. So this is why I stick to just being in the lab with my cells in the mice and stuff because they are a lot easier to deal. You’re spot on. If you give 45 million people a glass of water, statistically, some of them are going to die. And this is that this is the thing that is hard to wrap the head around at times is people don’t necessarily grasp statistics and risk. I wish I could remember the book I’m thinking of with respect to this. I might have to look up and email and you can put into show notes or something, but that’s what there’s much writing about, the fact that people don’t understand. It’s really hard for humans to grasp the idea of relative risk. So if this vaccine, let’s say, Vaccine X, let’s not even talk about the coronavirus vaccine. Right now, the Vaccine X that say it has a severe adverse event. So it kills someone, let’s say, at a rate of very much less than not one percent in the total of America. That’s going to come out to seemingly quite a high number of people.
[A note about Dr. Weston. He’s English, so instead of saying zero, zero, zero, zero, he says “naught, naught, naught” to signify a number such as .000001. The transcription software was completely confused and I had problems following too, so just imagine really tiny numbers here.]
So quick some I guess it’s going to be about three hundred to three thousand. I forgot how many naughts I used. But 300 million Americans? Naught naught naught One percent. That’s going to be 300 to 3000. And obviously that’s going to hit the news - all these people got the vaccine, they’ve all died statistically, they have also got naught point five percent chance of dying in a car crash.
Dr. Stuart Weston: So I’m just using hypothetical numbers here, but I’m kind of trying to illustrate a point that it’s all about the relative risk. The vaccines are safe. They they are incredibly safe. Millions and millions and billions of people around the world are vaccinated every year. And there’s very few examples of severe issues with them. That’s not to say there aren’t. I mean, I’d be wrong to say that all vaccines are 100% safe because that’s just verifiably incorrect. But the numbers of those severe cases are so small compared to the number of people who receive the vaccines. The trouble is, it’s easy to amplify those negative things. If you think about news cycles, they feed on negative negative news. Right? If it bleeds, it leads, whatever the line in journalism is so then amplifies, then it just hits that mindset of, oh my God, it’s everyone’s getting this death from viral vaccine. But that’s only because that’s what you’re seeing. You’re not seeing all the millions and millions and millions of people who are safe and also all the millions and millions of people who aren’t getting the virus to now to bring it back to SARS2, let’s say it’s one percent, not five percent of people who get it die.
Dr. Stuart Weston: They’re not dying anymore. And only 000001 percent or whatever from the vaccine says about that, managing the relative risk. It’s so hard to convey because it’s it’s hard to comprehend those kind of numbers. We just see the negative. We just we focus on the negative too much it seems. That’s kind of my view, sort of a bit rambly. But let’s say it’s outside outside my comfort zone.
Jon Johnston: One of the things I did to prepare for this was I had a conversation last night with my son. My rotten son as my website knows him because he attends the university in Minnesota, not Nebraska. He is an applied math, but his girlfriend is trying to get into med school. And she’s the one that I had this conversation with. And she brought up something that really was a perspective. They’re testing this on thousands of people. Millions more are going to take it. There are still people out there that say, I don’t care, I’m not taking this. And I guess her response was, what else do you want them to do besides give it to massive numbers of people? What else is going to make you convinced that this is OK? And I think that, the answer for some of those people is they’re never going to do anything. And I don’t understand that mindset, I guess. Yeah, that’s where you’re the psychologist again, you are a doctor.
Dr. Stuart Weston: I am, just not just not a doctor of psychology, a doctor cell biology, but that’s exactly exactly right.
Dr. Stuart Weston: So there is sometimes no getting through to people. If you take masks for an obvious example, the fact that people refuse to wear masks is still beyond me because it’s just a bit of cloth that goes over your face when you go into a supermarket or a restaurant or whatever. There’s always going to be those people. We can try and we can try and we should try and try and try to get through to them all. But eventually, some people just won’t take it, or we can do on the science side as scientists to try and put out the information, explain why it’s safe, explain that it’s been through the trials, explain what it means, which obviously is what I’m trying to help with to some degree here with you. Give out good information and then eventually it just comes down to people’s own personal choice. It is just down to that, that their personal freedoms are whether they take it or not. And of course, we want everyone to take it. And most people I think if you look at the polls, most people want to people to take the vaccine. They want to take it themselves. But at some point you won’t. And this also that kind of leads into the bigger idea about herd immunity. So when people talk about herd immunity, it’s about getting as many people immune to a disease as possible to really mitigate its spread. The idea there is that there’s always going to be a certain number of people that you can’t make immune, either because they’re immunocompromised or because they refuse to take vaccines and herd immunity always factors in for those those kind of situations.
Jon Johnston: Ok, I. I kind of hate to go here, but I feel like I need to because. Because I want to address this because you’re a smart guy, you’re a doctor, a cell biologist, I have someone in my life who insists that this thing was manufactured in the United States and sent to Wuhan. OK. Because they don’t believe that it just magically evolved from a bat or something. And I looked at them and they said, well, it’s biological warfare. And I said, how would you make a virus that only attacked old people because you thought they were a liability? How do you make a virus that goes after specific parts of the human race and not others? And how do you keep it from evolving or mutating so that it doesn’t kill everybody? This is the kind of thing you watch a movie for? It literally it’s like James Bond type stuff. So as much as I hate to ask you, could you address that lunatic fringe and yes, guy in my life, I called you a lunatic. Please, Dr. Weston, could you address that side of this?
Dr. Stuart Weston: Yeah, I mean, I’ll I’ll address the specific one a little bit further as you were doing as well.
Dr. Stuart Weston: So if it was a specific attack on China, it’s a really weird way to do it because they’ve got so much governmental power that they can lock down the whole country for two months like they did and completely stop it spreading while it’s spreading around the rest of the world. So it’s a really silly way to do it. But as a more general point. The the amount of viruses in the world or on earth is absolutely staggering. Again, I’m racking my brain to pull out the numbers. I think it’s estimated that there are 10 to the power of 31 viruses on. So that’s 10 the number 10 followed by 30 zeroes or 31 zeros. So then there’s the things you can do at your average virus particle is 000001 of a centimeter, 100 nanometers. If you lined up all those virus particles in a line, they could span the Milky Way two thousand times something. So it’s just this staggering, staggering number of virus particles out there. And they are infecting all forms of life, as I was saying earlier, that they, in fact, everything from humans to bats to whales to yeast to make beer and bread, they have viruses that affect them as viruses everywhere. So you’re hitting almost an infinite number, as infinite as we can almost think of viruses. So every kind of possibility can potentially happen. Almost. So the fact that the fact that the thought that this virus couldn’t evolve in nature when there’s all of these possibilities that it could is so so minute. It’s surprising it hasn’t happened sooner, almost, because there’s so, so much complexity, so much diversity out there in nature that we don’t know about.
Dr. Stuart Weston: And the reason we’re starting to find these things happen is because we’re encroaching on nature more. So the idea the idea is that this virus was probably in a bat in caves in China, evolved as a virus and but the similarities between humans and bats and the proteins that make us up, so it has the ability to get to humans. Chinese people farm the guano in a bat cave by caves for things, for fertilizer, for farming and things like that. So they’re going into the bat cave, they’re exposing themselves. They’re coming into contact with these viruses. And then that’s how people get infected. So that encroachment on nature, this almost infinite, limitless possibility of any combination of virus that could infect humans is probably out there somewhere. So. Just in terms of numbers and statistics, it’s so, so likely that evolved in nature and it wasn’t something produced in a lab. I don’t know if that’s necessarily the best argument to go against these things, talking about the numbers. But again, it’s one of those where it’s so hard to go through without directly talking to people, because people who have their own ideas about these things and there’s so many different ideas that, you almost have to try and pick apart each one in turn. So I’m trying to get that big overview of that is almost an infinite amount of virus out there. So there’s an infinite probability or possibility that they could infect humans. And that’s exactly what we’ve seen.
Jon Johnston: I think as an amateur psychologist myself, that the need for people to invent boogeymen because inventing boogeymen is easier for them to comprehend than the uncertainty that is the world we live in, that is forever astonishing to me where we can’t deal with chaos. So we have to organize it into James Bond villain creating viruses, I guess.
Dr. Stuart Weston: Yeah, that’s a great point. And that’s that really is the case. And a line that was often said during that period where there was a lot of debate about whether this was what made or it came from nature, which is sort of died down. And I’m not really thought about it a lot recently myself, but it was a line along the lines of Mother Nature is a lot better at this than we are and we could ever be. So while we know a lot about how viruses work, there is no way we could make something like this to do what you were saying a minute ago. There’s no way we could make sure it only kills the over 65 and leave the rest largely unscathed. There’s no way we can design it to spread asymptomatically like this virus does, it has asymptomatic spreads, what we’re talking about, we don’t know why that happens. We have no idea. So the thought that we can actually make something do that is. I mean, it’s a thought, but it’s so far outside the realm of possibility, there’s there’s so many fundamental things we don’t understand about viruses, which is why I have a job, for example.
Dr. Stuart Weston: Yeah, it’s it’s one of those that it’s going to hang around, to your point, because boogeyman get invented and it’s a psychological feature that they stick around with us for a while. And I guess the best thing is just to keep trying to dispel that and explain explain the science and explain the facts about everything, because there is a misunderstanding of what viruses are in many places. And so just the more the more information we can get out, I think the better.
Jon Johnston: So back to the viruses for a minute. Both of these vaccines, the prominent two that we’ve discussed require, one of them requires negative 70 degrees Celsius to be transported and to store, which sounds like a logistical nightmare to me, especially if we’re talking about Madagascar. Right? I don’t know. Maybe that’s an insult to the people of Madagascar, but more consider it my ignorance of what Madagascar is like. But it seems that we’re going to be months and months and months before you and I get to take this vaccine anyway. Do you see anything happening over the next few months? This thing is exploding now again, we’re going back into some lockdowns. What’s going to happen over the next few months, you think, until this is widely available?
Dr. Stuart Weston: Well, so in terms of the temperature storage, today is the Pfizer Biontec vaccine that needs the minus 70 to minus eight Celsius, which is four times cooler than your freezer you have at home just to do the conversion for Celsius and Fahrenheit to to make that clear. So that needs to be stored that cold. What Pfizer are trying to do is source freezers that can keep things that cold, but they’re also looking at technology that’s essentially a cooler box that they can keep at minus 80 for about 10 days. So that’s how they’re trying to get this distribution going. So you have your minus 80 freezes in, let’s say, South Africa, one of the more built up areas in Africa, and then you can distribute these cooler boxes to other places. Just use your example. You can get out to Madagascar within 10 days easily enough. So there are ways around that. Moderna’s vaccine has the advantage that not only needs to be kept minus 20 Celsius. So that’s really good news for Maderna. Much easier because you can just keep it in the type of freezer you have in your house. So that is why it’s really great to see Maderna coming out with similar efficacy numbers to what Pfizer was saying within. OK, so moving forward and distribution, I think what we’re going to see is, as I say, Pfizer have put in the emergency use authorization with the FDA as of today.
Dr. Stuart Weston: I think already this morning, just waking up when I read that so I might be wrong, I thought I read that when I was groggy I’d first thing in the morning. But they’re going to put it in the coming days, if not already. Moderna need a little bit more time. They need to hit their one hundred and sixty four hundred and seventy people, as Pfizer did this week. Then they’ll do the same for those authorizations. They’ll take a little bit of time. The FDA has to assess all the data. Look to see if it’s all true, what Pfizer reported in that press releases and Moderna have reported, make sure it all looks good and then they’ll potentially give the emergency use authorization. Both of those companies can then start to distribute their vaccines outside of trials. So those 50 million and 20 million doses I was talking about, they will start to be going into people by the end of this year. I’m hopeful in the next month or two we may start to see similar data coming from other vaccines. So there’s I think it’s nearly 10 vaccines, I think nine vaccines that are in phase three trials.
Dr. Stuart Weston: I could be wrong. And I can think of about three off the top of my head. I think there’s many others similarly in Phase three trial. So they’re doing the same thing that Pfizer Moderna are doing. They’re just waiting to get their positive cases to see how effective that vaccine is. So, for example, the Oxford University AstraZeneca vaccine, that’s in phase three trials that had to have the pause because there was a death in the trial, I think made possibly two pauses. If you remember seeing those headlines turned out both cases, that was nothing to do with the vaccine. That was just as we were talking about someone who died, wrapped up in bed sheets or whatever it was. So they had to pause, which obviously slow down on all of their trial, which is why they were a bit delayed compared to others. But in the next few months, we’ll start to see more more companies putting out their data from phase three trials and then start to apply for the same kind of emergency usage agreements. So then they’ll start talking to people with Pfizer Moderna, who are obviously a little bit ahead of the curve that will be using it in this emergency usage, the more and more people that use it, the FDA get more and more data to make sure it’s safe, make sure it’s working and all those kinds of things, then they can move it towards full approval.
Dr. Stuart Weston: So this, again, about safety. This is going to be continually assessed. And the whole time it’s being used, if anything starts to appear, that’s a negative consequence of this vaccine. The FDA will halt its usage until they can work out what’s going on. So they’re going to keep looking at it through all this period while it’s being given some more and more people through the early part of next year. Again, on that prioritization of health care workers and things like that, assuming all that’s good, then they approve it. The companies can ramp up their production and ramp up their distribution because the EPA has a limited distribution. They will you really ramp up then more vaccines come in behind following the same trend. So I think the. The numbers that we’re talking about, 2021, that’s when we’ll have vaccines going into people and by the end of 2021, it may be widely available to the public or, well, maybe available to the public, just not very widely.
Jon Johnston: You should say the fall of 2021 so we have a whole college football season.
Dr. Stuart Weston: There we go. Well, it’s probably I mean, it’s possible and it’s promising. So we’re talking about the numbers earlier about how the number of doses that Pfizer wouldn’t have promised to add up to just over a billion people. Let’s say that the AstraZeneca Oxford vaccine can do a similar amount and is similarly effective. That’s then one point five billion, let’s say, Novavax vaccine to Novavax, the company in Maryland that we’ve helped develop. And it’s not just why they come to mind if they can also do another half billion that then hits two billion people. So now you’re starting to get really wide availability of these vaccines. And I say vaccines because there’s different ones and you got to take the one you like the most. Let’s say you’ve got stuck in Pfizer or Moderna. Maybe you want to take that vaccine because it’s the one you got stock, whatever choice you decide to make or if it’s geographically available. Maybe for me it’s the Novavax one. Maybe for you it’s Moderna. It’s about so wow. I see this go and they’ll just be this gradual uptick in the amount of vaccines available, an uptick in the amount of people who have it, continual assessment of the safety of these and the efficacy. And optimistically, we start to see this pandemic come under control.
Jon Johnston: That would be nice.
Dr. Stuart Weston: And we have to, as I stress as well, that we have to keep doing all the other things that we are doing now. While that’s all happening. Just because we have vaccines going into humans doesn’t mean this is over by any stretch of the imagination, because obviously going to take time to vaccinate all the people. So we still need to keep them in face masks, physical distancing, just being sensible, trying to be outside as much as possible. It’s been referred to as the Swiss cheese model. I don’t know who first came up with it, but I’ve seen it floating around. And it’s a great picture where it has, as you can find on Google, if you’re Swiss cheese model coronavirus or something like that. So it has the layers of Swiss cheese or with their holes in and then the virus that can go through different levels of the holes. But the more you have and the holes aren’t all aligned, you’re eventually going to stop it. So you’ve got your mask, your physical distancing, your being outside, then your treatment, then your vaccines and things like that. And the more and more layers of protection, that’s how we get this under control.
Jon Johnston: I like that analogy. Was the guy who made it a scientist or a psychologist.
Dr. Stuart Weston: I’ve got no I’ve got no idea. I just saw it floating around on Twitter one day. I really wish I knew who had originally come up with that so I could give the credit to him or her, whoever made it made up, because it’s a perfect analogy for why we need all these different layers, because it is about making sure the holes don’t all align because it can get through certain levels, but it can’t get through them all.
Jon Johnston: You know, while you were talking about the different vaccines. I was thinking that maybe we should turn this into some kind of team sport. I like the EPL, you know, where I’m on Team Moderna, Team Moderna. I don’t know. That sounds kind of silly.
Dr. Stuart Weston: Team partizanship or partizanship and team team affiliations, they do count for a lot. So it’s not necessarily a bad way to get rolled out.
Jon Johnston: Maybe it would counter the people that are all like, I’m never doing this. I’m never going to touch this. Bill Gates is putting microchips in this.
Dr. Stuart Weston: Well, to say on that one says the person looking at up on their iPhone that tracks exactly where they are all the time. Right. It’s just I know Bill Gates is not putting microchips in them. Bill Gates is helping development because he’s got a lot of money. But that yeah, that’s just not let’s not even go there.
Jon Johnston: Is there anything else you’d like to add?
Dr. Stuart Weston: I was just going to say what we should do on that part of the team, things we should get all the team sponsored by a different vaccine company. So you’ve got Moderna on your Nebraska shirt.Maryland has Novavax, right? That’s that’s the way to go.
Jon Johnston: At least it would be fun, right?
Dr. Stuart Weston: I think we’ve covered all of the bases. Really, the main things I wanted to get across while we were talking was sort of an understanding of what the vaccine is and why it’s safe. The fact that just that one protein of the virus, there’s no there’s nothing that can cause damage, that the virus can cause itself to a much higher level. So it’s a really, really stripped back just to one one little unit of the virus. They seem to be super effective from what we’re seeing so far. They’re going to be continuously monitored for the safety. We’re not just because it gets approval for emergency usage doesn’t mean everything’s fine. It’s going to continually be assessed. There are people who are getting the vaccine are going to be follow the people in the trial. It’s still going to be followed for a year or two years. So if anything comes up that’s going to be found, that follow up is important because that’s how we learn how long lived the immunity is and then whether we need to vaccinate every year or not. And then finally, the fact that just because we’re getting vaccines doesn’t mean this is over.
Dr. Stuart Weston: We’re still we still have to do mask wearing. We still have to physically distance and stuff to be sensible because it’s going to take time for these vaccines to get around everyone. And those are kind of the main things I wanted to convey today.
Jon Johnston: It’s a lot for a guy like me that I had no idea what RNA is, this is a lot to take on. And I guess when you go out and read the media articles, you’re constantly confused by.. I don’t want to use. Well, I just I’m going to use the term “fake news” I don’t agree with that. Therefore, it’s fake news and I don’t know what to believe or what not to believe. Oh, this came from that paper that wrote that other article. And it’s just it’s mind boggling the amount of confusion that goes into this stuff. Even though we have the Internet, we have the entire world pretty much connected. I realize this pandemic is upsetting and it’s difficult. We’re still in the best time to be alive in human history. There’s less poverty throughout the entire world. There’s less war and violence throughout the entire world. You know, there’s less disruption. I realize that there’s more uncertainty right now because of this virus. But this is a damn good time to be a human. We could argue about the climate that we got, we got to give and take.
Dr. Stuart Weston: So, yeah, I mean, just just read some of the research from Steven Pinker or his most recent book that lays out all those things. If you don’t come across that, he’s made a great book basically explaining why this is the best time to be alive. Just do exactly the things you’re saying for all those reasons.
Jon Johnston: Well, it is. I guess you can you can choose to stay positive or you can you know, and honestly, the people around you can be toxic, more toxic than a virus and drag you into this hole. And we could go on there. We were being amateur psychologists again.
Dr. Stuart Weston: Yeah. Let’s try and end on a positive note. Let’s go for a positive ending, shall we?
Jon Johnston: Well, is there anything positive you’d like to end with?
Dr. Stuart Weston: Well, I mean, I guess just that we’re getting closer to having a vaccine. That’s super positive news and amazing scientifically because this is just being pedal to the metal science production, getting these vaccines tested. The people volunteering to go into these trials are absolute heroes that companies doing it all. And, of course, the heroes on the front line having to deal with this while we’re producing the vaccine. So, I mean, it’s there’s great humanity out there. I guess that’s the positive. I’ll I’ll try and end on. And we’re getting closer to getting this under control with these vaccines. And people, if we keep doing the masking and the distancing will hopefully get this under control next year. I think next year will be a lot more back to normal. I’m hopeful you’ll have a more capacity football season. They say maybe not 100 percent, but I think you’ll get out more fans.
Jon Johnston: Well, we’ll probably follow up with you in a few months and see where things are. All right. I have to tell you, this has been Jon’s PostLife crisis, talking about vaccines with Dr. Stuart Weston. And thank you for listening. Go Big Red.