StarTalk Podcast: Cosmic Queries -- COVID-19 Vaccines

this is star talk cosmic queries a special edition on vaccines my co-host paul mercurio are you ready for this one i i feel sick already you feel sick already so so you're ready for this one i think go ahead yeah i'll go ahead and of course neither of us have any expertise in this at all other than reading about it in the papers so we we we we found one of the best if not the best at this dr paul offit paul welcome to star talk thank you thanks for asking me yeah so i looked at your your pedigree here director of the vaccine education center and professor of pediatrics in the division of infectious disease at the children's hospital of philadelphia so you're the man for this for this episode i'm not exaggerating here correct i think i'm a-man [Laughter] the man but before we get to our abundant questions that have been submitted to us by our fan base on all manner of our social media platforms um i just i have some just basic questions about what we're all going through in this pandemic why was i so naive to think that 100 years ago we had the the flu pandemic oh that was a hundred years ago this is the 21st century that can't happen we have other issues but not that what what is going on what why was why why did this even happen at all in what we are thinking of as modern times so um this is essentially a bat coronavirus that has adapted itself to growth in humans this happens fairly frequently i mean we saw there was sars one that happened in 2002 that was followed a few years later by years which came out of the first one came out of asia the second one out of the middle east so these are we're constantly in association with other animals and then we sort of share our viruses and one adapts to one or the other most of the infections of people actually originally started an animal so it's not unusual we've had warnings for this we just weren't ready for this one so if we if we if we focus on vaccines for for this if you know this is in the works at all times is is there a hope that we can be out ahead of these things instead of running up behind them i think it's it's hard to to predict exactly how it's going to happen that it's going to happen is clear when it's going to happen is exactly what the virus is going to look like we don't know but once we identified and this this was i think the tragedy of this when this fire started to sweep across gujan and and cause people to suffer and be hospitalized and die and they were building hospital after hospital and wuhan trying to handle all this we should have known about that early earlier the world should have known about that earlier we shouldn't have had to rely on a whistleblower to tell us that this was going to happen a whistleblower that ultimately died we should have had that virus in hand back in november and and all the the world then should have been working on a vaccine way back then but so we there was a late start with this so uh and of course you're in the middle of i mean i get some of it because it's anti-science when i see people saying i'm not gonna do a vaccine i think they're dangerous you know they're making their own decisions you know in a free country we encourage people to to be independent and you know there's this conflict of messaging to say you live in a free country and i have freedom of choice but now you're saying i don't have freedom of choice even if i don't want your vaccine so you're in the middle of that how does how do you deal with this well it plays out at many levels i mean this notion that uh that i don't want to wear a mask i i it's my right it's my freedom as an individual in this country because it's in the constitution paul you saw that right yes it's uh they were using mass made out of uh cowhide at the time they were very sweaty but uh by the way i just wanted to interject i have covert i'm recovering from it and i got it because i was around people that refused to wear masks and some thought it was a hoax and my concern is when the vaccine comes out that they're talking about you know hurt immunity the same people they're going to declare declaring their right not to wear a mask might declare right not to take a vaccine and this is just going to be a bigger problem you know because i think what we're all missing is it's right plus social responsibility to your fellow man right so how do you how do you how do you walk that line or is it aligned to what well it's not to me this is not a line at all it's it's not your right to catch and transmit a potentially fatal infection any more than it's your right to deny your child a potentially life-saving vaccine sorry i mean any more than it's your right to run a stop sign just because you feel like it i mean you do have a responsibility to society and this is an example of that it really it's really hard to watch people say i'm not going to wear a match because it's about my matter of mind it doesn't just affect you it affects people who come in contact with you just uh i got it i got it and my son got it and his girlfriend got it for that reason i had someone come up to me and say take your mask off this is in florida this whole thing's a hoax yeah and paul that's why we shipped we shipped paul mccurry to the moon so he's broadcasting to us yes i'm in a giant i'm in a giant plexiglas box actually you can't see it it's a little hab module yeah exactly so if uh so uh dr offit if you one of your roles is education a vaccine education it's in your title so what have you seen to be the greatest challenge at this well to make a vaccine quickly i think it's actually remarkable how quickly it's going to be made you know the the average length of time it takes to make a vaccine is 15 to 20 years i was fortunate enough to work with the team at children's hospital philadelphia that created the strains that became the rotavirus vaccine that was a 26-year effort it's amazing that we're going to make a vaccine in a year and a half and we are we just got the virus really in january there will likely be a vaccine by no later than the middle of next year i want it now hey i just got the russia vaccine and it's fine there's no problem at all and you speak russian overnight so paul mccurry both paul um let's go to the questions and see what people have all righty you have patreon ones on top these are uh as you can tell all patreon wow okay let's do it uh so this is eli patreon i've heard that people have become infected with cobit twice how is this possible unless the virus has mutated please enlighten me and thank you yeah excellent all right so um if you're going to make a vaccine successfully the most important thing is to watch what happens with natural infection you want natural infection to protect against disease associated with re-exposure that doesn't have to completely protect you just wanted to protect against moderate to severe disease which apparently is what this virus does so if you're infected with this virus you can get still get infected again you can still get asymptomatically infected or mildly symptomatically infected what you haven't seen with the exception of one person i've read about you haven't seen people get moderate to severe disease and then say five six eight months go by and then they get moderate to severe disease again which then suggests the natural infection doesn't protect against these which means you're going to have a hard time making a vaccine that's so so what's happening is is what you would expect to happen the virus it's not because the virus mutates it's because this particular type of virus coronavirus induces protection that is short-lived meaning likely to last years but not decades and incomplete meaning protection against moderate to severe disease but not all forms of reinfection so why can't you go in to everybody who's been affected find their antibodies and isn't that the anti-coronavirus magic potion why does it require this i know it's a naive question but if you have all of these people that have achieved natural immunity go in there and like clone whatever the antibodies and then stick that in into other people's bodies is or is that what fighting a vaccine is well so advantage of that the advantage of a vaccine is that then you're you instruct your body to be able to make the antibodies that you need when you confront the virus which is a lot less expensive way to do it and also if you're going to take the so-called convalescent plasma antibodies from people who've been convalescing from infection who've survived infection you would have to give it really prophylactically preventively it really wouldn't work to treat unless you gave it really just just even before one had symptoms it's true of all all sorts of antibody preparations they don't work really once you've already started to develop symptoms so that whole thing with convalescent plasma and donald trump standing up there and saying how this was going to be a major breakthrough you know convalescent pilot first of all i was on a conference call with some nih researchers and one of them said yeah major breakthrough maybe it'll win the nobel prize in 1890 i mean and nih you mentioned that that's the natural institutes of health yes right can i so if you know the idea is to create these antigens uh uh to combat these pathogens and corona this this virus is in the family of coronaviruses uh why can't we quickly and i know you said it's on a fast track compare comparatively speaking but why can't an easy adaptation of a vaccine we're already using for a coronavirus be used here what's going on in the body so there is no other coronavirus vaccine there's four strains of human coronary virus that circulate every year listen if you're going to contradict me with all your knowledge i don't need this i got coronavirus buddy i'm sick go ahead sorry sorry that was the cove at speaking that wasn't me now you know why we put them on the moon [Laughter] right so as you know there are four strains of human core other viruses circulate every year they account for about 15 to 20 of the respiratory infections that come into our hospital every year um and an infection with one coronary virus type if you will stereotype does protect you against sort of moderate to severe disease for a few years so that's good um but you know it's it's not um we're not going to uh eliminate this virus with so-called natural occurred immunity which you've heard sometimes from the administration that just let's get it let's everybody get sick then they'll get hurt immunity and then we won't have to watch this this uh virus circulate anymore that's never happened for any infectious disease i mean we eliminated smallpox because we had a vaccine we eliminated measles from this country in 2000 because we had a vaccine natural infection will never provide enough herd immunity to eliminate the virus um yeah i mean it's a misnomer in a way because you need the vaccine to create hurt immunity but the people have conveniently skipped over that um we're going to jump to paul josh v how do vaccines work can you give a vaccine 101 explainer perhaps a vaccine science for dummies sort of thing can i just say right up front the public confidence right now in the cobie response isn't great so let's not use phrases like vaccine for dummies it's going to really freak people out so but go ahead yeah so i i'd enjoy this as well so vaccine 101. so the goal of a vaccine is to induce the protective immune response that is a consequence of natural infection without having the person pay the price of natural infection so you want the immunity without having to have the severe symptoms that's how you make every vaccine and you and and why does it take 20 years well you have to sort of do things sequentially so so normally what you do is so-called pre-clinical trials and experimental animals you find for example syrian hamsters get you know when you inoculate the messiah's cov2 virus develops symptoms similar to people then then you they use have an idea for a vaccine i'm going to take the virus and activate it with a chemical so that it can't reproduce itself so that it can't cause disease but hopefully it can still induce an immune response and see if that works to prevent protect this little syrian hamster from getting infection and then you do it in a lot of hamsters or a lot of mice or rats or ferrets or monkeys um and then you so that's your proof of concept now you know this way the strategy you have for making a vaccine might work plus you get to really literally dissect out that part of the immune response in the animal that seems to be protected okay so now you think you have your vaccine so now you do phase one studies just be clear so a vaccine is a way of tricking your body into thinking it had the disease prefer not to use the term trick on the anti-vaccine people love that term okay it's a natural way of doing it you're eating these things naturally it convinces your body that it had the disease that's a lawyer it's basically like a lawyer like a personal injury lawyer trying to convince you to settle uh the wuhan no he's still going he's still going okay so i'll go quickly so then you go to phase one studies which usually twenty to a hundred people so-called dose-ranging trials you try and see what dose of that vaccine you want to use then you go to phase two studies which are hundreds of people to make sure that your vaccine is consistently safe and induces an immune response then you go to phase three studies which are tens of thousands of people who either get a vaccine or don't get a vaccine that's the only way you can show that it works then you may have to produce it which so as you go from from each of those steps you go from hundreds of thousands of dollars to pre-clinical studies to millions to tens of millions to hundreds of millions of dollars and then you mass produce it which is hundreds and hundreds of millions of dollars what's happened here is that essentially the government and other agencies have taken the risk out of it for pharmaceutical companies they've said we'll pay for the phase free trials we'll pay to mass produce it at risk meaning we'll mass produce it without even knowing whether it works or knowing whether it's safe and then if it doesn't work and it's not safe we'll throw all these these millions of doses away no company would ever do that so that's that's why it's so fast that's part of the fast tracking i get it do you really trust that the vaccine's going to come i know it's not going to come by the october as some politicians have said whatever but like it seems awfully convenient that the world is in a pandemic and we're all sort of freaking out and for the first time ever the pharmaceutical industry is able to generate a vaccine quickly does it feels a little too convenient or coincidental or am i just uh a negative pessimist you're you're a negative person he's on and he's on the moon yeah exactly you know when you're on the move it's very lonely the rare the rarefied atmosphere yeah i think you're right i mean if you look at the phrasing the language that surrounds all this warp speed race for vaccine finalists um it's scary and and we've never made a vaccine the fastest vaccine previous to this was was the mumps vaccine which took four years to develop so so it's scary that it says but i will say this as long as we do the phase three trial the big phase three trial this 30 000 plus person phase three trial where you see whether tens of thousands of people get the vaccine tens of thousands don't get the vaccine and to see whether it works that's typical for a vaccine trial uh you know the hpv human papilloma virus vaccine that was a 30 000 person trial the pneumococcal vaccine was a thirty five thousand first draw so this is typical so if we just let it go to completion then then i think we're good that's the that's the proof okay and this and this this responded to two questions that were similar just from patreon uh about uh how do you how does it how do you fight bad side effects of uh of uh of a vaccine and uh also a person asked is it really realistic quickly by the end of the year so uh it did address a couple of questions so let me move on leslie we got to take a quick break and when we come back we'll pick up more cosmic queries for dr paul offit vaccine specialist in philadelphia we'll be right back we're back on star talk cosmic queries vaccine edition got dr paul offit here uh thanks for taking time out of what i know is a busy schedule uh to to offer your expertise to our fan base and our broader audience so uh paul you've got some questions for us i do these are from patreon folks this is leslie goodwill my daughter trinity asks if a covid19 vaccine will reduce the numbers of anti-vaxxers meaning as they might see firsthand the benefits of vaccines and i don't know to me what definitely will change the minds of anti-vaxxers is dying from the disease maybe that would help change somebody's mind like yeah it's a darwinian solution to that problem yeah so paul is is are people just missing their daily miracle science miracle and this is why do you have any sense of what's driving this what's the anti-vaxx movement yeah so well the anti-vaccine movement's been around since the first vaccine since the smallpox vaccine in the late 1700s i think i think at the heart of it is um i i guess i divide it into two groups i i think one group in the most common group and this is okay or people who are vaccine skeptics um they're concerned about whether or not the vaccine is safe and effective that's fine i mean i think i'm a vaccine skeptic i'm on the fda vaccine advisory committee i think everybody that sits around that table is a vaccine skeptic we want to see the data i think the the true anti-vaccine activist is really a vaccine cynic i mean they think that pharmaceutical companies control everything it doesn't matter what the data are they know the truth they know that bill gates started all this they know that the virus is transmitted through the 5g network they know that influenza vaccine actually has sars cov2 in it they know all those things and there's no talking them out of it so i don't think anything will convince them of anything other than vaccines are always bad um how about just saying to them have any of your friends recently called in to work sick with smallpox how about how about that that's a pretty convincing one who was it that said you can't use reason to argue someone out of a position they didn't get into by using reason that's a good point yeah you know that's uh that's one of the great challenges so uh dr often i didn't i didn't hadn't thought about it these two separate camps and so it seems to me if you could convince people who are skeptics that will take us quite a long way and the rest are just you're not going to get them no matter what yeah i think reason and logic works for people who are reasonable and logical you just have to find a way to and you do this better than anybody to convert you know some difficult scientific uh issues and try and make it understandable and to present it in a compassionate and passionate and compelling way and i think people are convinced as long as data can convince them stevenson when he was running for i guess it was president um and you know he's an intellectual right and he and that's the quote goes something like he says but i i have the vote of every uh thinking person in the country and his his team said but sir you need a majority but but but a cynic on vaccine is doing the same thing in a way as people who won't wear masks they're putting others at risk by refusing to protect themselves right so there's again going back to this sort of social responsibility and ethics question that you can't seem to get around am i right exactly right you're not making a decision for yourself only if you want to die from tsar's code v2 that's your decision but the the point is you're pulling down other people with you okay uh this is uh also from patreon rude vander linden do we already have an idea of what people will be vacs what people will be vaccinated first will it be the most vulnerable or will it be specific groups that have the potential to be super spreaders is there any strategy for this and who will be responsible for executing the strategy that's a brilliant social question yeah right so there are two groups that make this decision one is the so-called advisory committee for immunization practices which advises the centers for disease control and prevention or cdc and the other is the national academy of medicine both of them are in the i've been putting out actually who will be that first tier of people who will get this vaccine so the answer to the question is it's both it's both people who are vulnerable specifically those greater than or equal to 65 people who have certain comorbidities like you know chronic lung disease asthma obesity and other comorbidities and then people who are on the front lines essential workers health care workers teachers people who work in in say in law enforcement etc so actually if you look at the numbers that were generated by the the uh the cdc it's about half of the american population american adult population children will not be on the front line initially of getting these vaccines um so it's you're talking about 150 million people to what is likely to receive to be a two dose vaccine that's 300 million doses that we would have to get out there for a two dose vaccine that has to be separated by about a month it's going to be very difficult to to do that yeah but it's it's it's it's a uh i don't want to call it a dry run because it's a real run but if it's something that we're going to have to do more in the future we might as well work on getting it right this time agreed and i think i think we'll learn as we go i think also people will feel better because not everybody's going to get the vaccine initially initially it'll be 500 000 people then a million then 2 million and as you see that it's safe now in that many people as compared to say the 20 000 that were studied uh pre-approval i think people will be more and more comfortable with the why why are two doses needed um it's just it's it's that's what's required to induce immune response that we think is what works we don't know that yet i mean the the phase three trials have not been completed we don't know any whether any of these vaccines work so the second shot the second shot would be the same uh the same uh vaccine and amount as the first one or is it sort of one has to build on the other it boosts the first one the only example of a vaccine where it's actually a different virus from the first first shot then a month later the second shot is the russian vaccine actually okay um okay by the way and i know this is your area doctor but i have personal knowledge that the people who are going to get it first are lebron james um anybody that gets the board first class and not and uh you know the kardashians because they're not going to sit in a parking lot in the car and just waits for someone to come so you figure that out yeah exactly moving on to gordon vu uh uh do you think cover 19 will linger on even though we have developed vaccines something similar to flu so so flu's different i mean flu mutates so much from one year to the next it changes its surface coat so much from one year to the next that natural infection or immunization the previous year doesn't protect you so we need to give a yearly vaccine i don't think that's going to be this virus i mean this virus has only been out there for about 10 months or so so it's hard to know exactly and although it does mutate all viruses like this so-called single-stranded rna viruses mutate a little it doesn't appear to functionally mutate in a way that suggests it's going to evade the vaccine at least not yet so i think we can i think we can make a vaccine that can protect us for a few years i think if we're still willing to to wear mass and do hygienic measures which we're going to have to do we're going to have to do both things i think people are going to think well i've gotten the vaccine i can don't have to worry about a mask but if a vaccine is 75 effective which i think everybody would be happy with that means that one out of every four people isn't protected against moderate to severe disease probably a greater percentage of that still could shed virus and be contagious with you know mild symptoms or asymptomatic so i think we're still going to need to wear a mask and it's it's been hard because obviously that's not the administration's message the administration's message is the opposite of that i mean donald trump does everything he can to try and discourage people from wearing masks it's really hard to watch because that's the more powerful of the two i mean i was on service last week at children's hospital philadelphia walking around the words if you and and came in contact with people if you ask me which of the two i would prefer a vaccine or a mask mask i mean that's that's much more likely to be effective than the vaccine a quick herd immunity question so if you have people who are rejecting masks and they're walking around and and they're rejecting vaccine and then everyone else gets vaccinated then and they don't get sick because everybody else got vaccinated and everybody else wore masks they would just say see none of that was necessary because now no one is left to make them sick so this this could this could interfere with people's rational analysis of what had just happened it's like saying you don't need you don't need dandruff shampoo you don't have dandruff it's the same meanwhile it looks like he came in from a snowstorm right no it's just a writer right you're a free writer the free writer right yeah and so i think it's so i think we can eliminate this virus from the united states and usually when you talk about what percentage of people need to be immunized in order to eliminate it depends on two things the contagiousness of the virus and the effectiveness of the vaccine if this vaccine was 75 effective you'd probably need to vaccinate about two-thirds of the american population to stop spread roughly okay so people can still live within that they'll just free ride on everybody else all right again in a free country if that's what you're going to do okay so paul you got another one i do i have by the way paul just so you know i'm calling you paul i'm going to call our good doctor dr offit so i'm going to call you or you could call me paulie which is what everybody in my family calls is that right okay that's why i will just distinguish the two of you all right paulie yeah paulie two shoes that's my name um everyone is talking about rushing a vaccine which means there will be risks given that copenhagen is way less severe on young people than older people would it be possible for young people the risk of vaccine that is not fully uh tested is higher than the risk of getting it getting covert 19. uh so i think they're saying you know test it on young people first in a way that must be an old person who who said that it's a fair question i mean it's always a matter of risk benefit if you're a healthy young person you are unlikely to die from this infection there was just an article that was published in something called morbidity immortality weekly report just yesterday which looked at of the 109 that's a publication with that title are you serious oh my god wow wow little a little light reading at night before you go to bed just from your stuff you guys are missing it you know yeah okay i'm sorry to interrupt go on what it did look at the people morbidity and more more it's a great beach reading it's great beach reading sorry sorry okay continue dr off it continue um the uh yeah so what they did was they looked at this they looked and more almost 200 000 people have died from this virus of the the number of people who have died who are less than 21 years of age even though they make up 26 of the population is only point 0.08 so you're right you're much less likely to die if you're a healthy young person um and so therefore it does have to be held to a high standard i think it has to be very clear that this virus is safe in in that age group before uh you can reasonably give it to them because you're right there the risk benefit ratio is different i mean for somebody like me who's obviously a very very very old person um you know for me based on what you're reading it's pretty clear that that's your very i think so the risk benefit ratio really does depend on what your risk is of getting the disease and so then the those ratios change so just i just understand your number you said oh sorry that age group is 25 of the population but what percent of the cases are they well of the deaths it's 0.08 of cases it's about 380 000 cases in what it what's prob reported cases but i think it's probably a tenth of what it actually is all right so so they're particularly deadly to old people if they can be cavalier about possibly getting it but they'll then be carriers and spreaders of it yeah you certainly can spread the virus asymptomatically that's that's what's the surprise that's the scary part yeah yeah so therefore everybody's pr everybody everybody sees a problem i got it my son got it i had symptoms my son had barely any and that's that's generally true children get it generally less frequently and less severely good now we're scared of everybody we see on the street right because anybody could carry this virus it's made for strange time just a quick follow-up question relating to kids for small children i don't mean that like literally you know nine years old eight years old is there some special protocol in addition to what they would normally do with vaccines given that they're children do they take greater precautions do they have to be prepped more i i don't know what the term is but so um this is not a vaccine that's initially going to be given to children all the trials that are being done in the united states are not done in people less than 18 years of age i mean i worked on a vaccine rotavirus would that virus cause fever and vomiting and diarrhea and dehydration and death in young children babies usually less than two years of age so therefore the studies were all done in babies i mean our trial was a 70 000 person baby trial you know that took four years and was in 11 countries and and was a massive trial so that's what you do i mean if you're worried about the disease in children you test it in children so what's going to happen here because i think people will want to vaccinate children down the road i think these vaccines will be approved then they'll get out there and then they'll be tested in children because you can't really give it to children unless you test it you have to make sure that at some level it's safe and effective before you put it into children and so i just think that's all going to happen after these vaccines are approved okay related to this uh john paul we gotta take another our last break uh before we go to our third and final segment and we're talking about vaccines in the coronavirus pandemic on star talk cosmic queries we'll be right back we're back star talk we're talking about vaccines in this modern pandemic of covet 19. i got dr paul off it i don't know is he the man the man on town on the town was gonna fix all of this is that right or at least tell us how to get through it uh thanks for being here as our uh in-house expert for these cosmic queries paulie you got some more questions for us yeah we were talking about uh before the break we were talking about kids and and the effect of this on them in the vaccine related to that john jacobson uh have there been investigations which strongly suggest that young people are perpetuating the spread by their greater socializing if this is true how do we convince young people to change their behavior to continue their ability to benefit the world society i mean i think you argue with them until they're blue in the face then tell them that that they're thick-headed and that they ruined thanksgiving you know you're the thing you say to every kid the usual the usual yeah uh you know so what are your what are your tactics yeah i mean because kids feel you know they're risk they're risk-free right like they nothing i mean you know that some kids are breaking their necks doing keg stands in college right but it's sort of like hey you know so how do you get through that risk-averse point of view beats me i mean if you if you look at what happens on college campuses you know they they they want to have on-site uh learning which makes sense but you know you can't ask these 18 to 22 year olds to be something other than 18 to 22 year olds they're going to have parties they're going to drink they're going to have on-site or off-site or off-campus parties and and to convince them to try and convince them that they're at risk and they are at risk i mean it's it's uh you know it's certainly not risk-free this virus is is can be fatal even in a young person but but these are people who have an age where they believe they're invulnerable you're not going to convince them of that so i think if you're going to have them be back on campus realize there's going to be a certain amount of disease um and and this is the whole problem in general is if we want to avoid this virus if you want to avoid catching it or dying from it then stay inside for the next two years i think that's that's the answer if you're going to walk outside then realize you're taking a risk so i think what we have to do in any situation whether it's elementary school or college or middle school is we have to figure out the best way to mitigate the risk especially for those who are at highest risk like the teachers who are older and and realize there's going to be some spread and there's going to be you know there may even be some death and and you know but the other side of this pandemic that nobody talks about as much is that the the the is that it's led to massive joblessness which has led to massive homelessness which has led to all the the problems of homelessness like food insecurity and depression and suicide and child abuse and domestic violence i mean that's the other part of it so we do need to find a way to get back to work our country is so bad at this it is hard to watch other countries have been able to do that they've been able to revive their economy they've been able to get back to work they've been able to get back to school here we have roughly four percent of the world's population and 25 of the world's deaths it is unconscionable we are a technologically advanced society with economic advantages and we just are tr our han our way of handling this is to say to basically try and deny it or hope there's some magical way of making it go away like you know the uh oleander extracts or you know your uv light or clorox or whatever it's just painful to watch but but how do you really feel though we're not really sure you gotta stop mincing words yeah yeah it's just it's just well listen i mean if you know i think the vaccine is gonna take a while because you know it sounds like it i mean maybe because these maybe is it the researchers are working from home and nobody gets anything done working from home right you got to play with the kids you end up down an internet rabbit hole the next thing you know yeah youtube a youtube uh right yeah and you're you know at home depot buying a circular saw that you really don't need you know that's you know um this is an interesting question and it's a little silly but this is interesting to me and i think there's something a point of view here that's pretty strong this is a k profit 2032 patreon if is a vaccine even necessary when you look at the actual mortality rate of the disease to me that feels like someone that doesn't believe in vaccines or whatever but but anyway if we want to really eliminate this virus from the face of the earth and we can his history teaches us that the only way that's going to happen was with a vaccine we did it with smallpox we've done it with two out of three strains of polio we can do it with measles we have done it with measles in the united states at least until 2000. um that's it that herd immunity from natural infection is not going to do it masking alone is not a long-term solution so i think the combination of masking and social distancing and hand washing and along with vaccines is our way out of this but it we're not going to get out of this without a vaccine so you mentioned earlier all the collateral damage that doesn't get talked about as much as the direct cases of the virus like you said the loss of jobs and the homelessness and domestic violence and the like so that's the total cost of the pandemic right it's not just the medical cost it's the rest of its what it has inflicted if you will on society but but going forward what we wanted we we just don't want this to happen again so are you really telling me you can't you can't have a shelf of serums a shelf of vaccines ready on the in the wings for anything that comes up that handles classes of viruses all right our virus is so diverse that they they defy your ability to have a serum that takes out whole categories of them and so specific right like every virus has its own animal so to speak right i think you can do this i think you can have a worldwide surveillance system when the minute something like this pops up that you that the world knows about it then you have the virus in hand but but i think in terms of how to best make a vaccine is really pathogen-dependent i mean what we've chosen to do here is we've chosen the vaccines that frankly are the easiest to construct the fastest to construct and the easiest to scale up that's that's that that's how that choice was made this so-called plug-and-play vaccine is genetic vaccines i mean you know that you know what you're interested in you know the protein of the virus you're interested in it's that spike protein that emanates from the surface of the virus it gives it its name it makes it look like a crown corona so that's that's the protein that attaches viruses to cells if you can prevent the virus from attaching to cells you can prevent the virus from infecting cells i.e infecting you so you know you know the protein you're interested in you know the gene that makes that protein so all these these strategies messenger rna dna so-called replication defective adenoviruses or simian adenoviruses are all based on that just just take the gene plug it in and give the vaccine now that just because they're the fastest to make doesn't mean they're going to be the last best vaccine i suspect two or three years from now we're going to find there's a better vaccine out there but but that's how this was all constructed so in other words like do you develop a short-term vaccine because it's a quick fix and simultaneously or then you go to find something that has a longer lasting effect well hopefully these vaccines will be great see the problem with this is that we don't know anything about these vaccines message rna dna replication defective antiviruses there is no commercial equivalent for those vaccines so so this is new territory so basically you're taking a new virus the bad coronavirus that's already had a number of surprising clinical and pathological manifestations and you're going to meet that with vaccine strategies that have never been used to make a vaccine before what could possibly go wrong right so what you're saying is that's why some of the early attempts at vaccines or or or cures were things that had been already fda approved for other purposes and then because then that would speed it to to implementation if that worked for you well we could so so for example the chinese have an inactivated sardis cov2 vaccine take the virus grow it up kill it with formaldehyde we have those kinds of vaccines the inactivated polio vaccine is that the hepatitis a vaccine is that the rabies vaccine is that so you always feel comfortable with those strategies because you you have a long history with those kinds of strategies um but you know the ones that are currently going to be coming out first you don't have as much history from which and so there'll be a learning curve here i think over the next few years i'm sure there's things that we're going to learn in the next few years that we wish we knew now we just have to be open-minded to that and we also most importantly have to be transparent with the public about what we know and what we don't know moving forward again another question that we have another one yeah a couple more couple more john jacobson uh if coven 19 vaccines cannot produce sustained antibodies for a considerable time in a person are researchers concurrently investigating another line of defense or with virus mutation over time and or herd immunity be our only hope you don't always just need antibodies in your circulation to to neutralize the virus sometimes all you need is so-called immunological memory meaning that you have so-called b and t cells in your body that remember that it's seen this this virus before and then there's enough time when you then confront the virus for those kinds of memory cells to become activated differentiate to antibody producing cells that protect you so i i do think that we can have a vaccine that protects one for a few years one two is i think this is a single serotype virus this is not flu i mean all the evidence so far is that this is not flu meaning it's not going to mutate one year to the next although just don't hold me to any prediction i make on this show [Laughter] for everything that becomes wrong we have to like flash up a date he said this before we knew exactly people be outside with the sticks and stones outside your house pitchforks pitchforks is this exactly right universal sign isn't the answer at this point magic spells and chanting to get rid of this thing isn't that pretty much it i mean i think you need sort of sock puppets and a magic 8-ball there you go there you go alex lopez patreon dr paul offit what is the effect efficacy required for an upcoming covet 19 vaccine for us to be able to return to normal or close to normal as possible i think it's going to depend on what level of disease and death we feel comfortable with again i mean it's last year for example based on [Laughter] how much death do you want yeah we you know who we have he's dr evil that's who [Laughter] so for example let me explain last year we had 780 000 hospitalizations from influenza and 60 000 deaths could we have prevented a lot of that sure we could have prevented by wearing mass and social distancing watch what happens this year this year as we enter the winter because a lot of people still are wearing mass in social disney we will have one of the the least harmful flu seasons in a long time so there you have it we can we can prevent the flu with hospitalizations and deaths every winter if we want by wearing mass and social distancing more but we don't do that because we sort of have grandfathered flu deaths in as being okay i do think as as time goes on with this virus we are going to probably reach find that there's a certain level of disease and death that where we feel we we're as a risk we're willing to take and go back to our normal lives see doesn't sound like does that sound less evil a little less just a little less evil i feel death all around me right now i think the philosophers call that a utilitarian approach [Laughter] um [Music] a couple more couple more phillip lyons uh this person seems skeptical they say is there any possibility that vaccine could be developed as fast as by the end of the year doesn't this sort of thing take years to prove effective and safe so dr offit what's interesting about that question is you could conceivably develop a vaccine quickly but the trials take so long so what are the medical ethics of saying i have a vaccine that could save tens of thousands of lives but we have to test it just to know and where do you draw that line in your panels that you're on and all the rest you have to test i know we're in the midst of a pandemic i know a thousand people are dying a day but you can't put a vaccine out there that may end up not being effective and then have people think that it's effective you can't put a vaccine out there that that might be safe and find out that it's not safe because then you've taken an already scared american public and scared them more and possibly lost any chance you have of doing a vaccine i'll give you another example polio i am old enough to remember polio i mean when polio would cause 30 000 people to be children children to be paralyzed every year it would cost 1500 children to die every year yet before and so jonas tried to make a vaccine he he took the virus and activated it he tested it in 700 children in the pittsburgh area it induced a great immune response it was safe he could have said this is it let's put it out there but instead we did a one-year prospective placebo-controlled trial of 620 000 children actually to prove that the vaccine was safe and effective and if you think people were any less scared by polio then than they are sargeras cov2 now then that's because you're young because it was it was that was a devastating disease then i mean my parents were scared to death of that virus and in terms of we wouldn't let us go to public swimming pools it was it did change people's lives but we were willing to wait then and we can wait now and it's not that big of a wait it's really months long wait um we have one more if you want to do one more yeah let's do that one one more and then we got it we gotta call it quits all right nika schartzvilli sorry uh i'm doing the best i can uh how do scientists actually test the vaccine to avoid any bad side effects now we've you've talked about testing but to add on to that so what if what side effects are acceptable what are not acceptable yeah great question who makes those who makes those decisions ultimately the public makes those decisions i mean we we you in this pre-licensure trials that have been done so far the so-called phase one studies these viruses these vaccines do cause fever including high fever and then the symptoms associated with fever headache chills muscle ache i mean in a certain percentage of people in one one trial as high as 50 of people is that is that a level of side effects that you're willing to accept for this virus i think most people would say yes um it's it's basically a level of side effects we accepted a single vaccine i mean the shingles vaccine you know causes that same sort of level of fever and uh and you know muscle legs etc but you know to avoid shingles which is one of the worst pains of medicine people are willing to do now you could argue since i saw you shaking your head um that you know as a helper don't pay attention he's on the moon why are you even i'm not don't i don't none of this affects me dr offer don't feed the trolls okay um yeah i mean i think most people would accept that as a side effect fever as an occasional side effect because this is a scary virus and if it means they get to go back to work and live their normal lives again then then it's worth it so we'll see but i think what they wouldn't accept is they wouldn't accept any severe side effect that caused a permanent harm naming or some other kind of permanent so let me we got to end it but i got to ask you one thing uh paul not paulie paul uh in my field and in so many other fields uh computers uh simulations modeling has replaced actual sort of physical testing on live subjects or on in real situations we we can now simulate what it is to fly in an f-18 fighter jet okay why is medicine not there yet with being able to to simulate and test the effects of a vaccine on human physiology so that you don't have to run through all these trials you load up you have you got people's genome uh just can't you like shake and bake that and run a million simulations and say this will get headaches and this will get that that's good let's go to let's go to production um because historically there's always been surprises i mean i guess i'll give my personal experience um you know i worked on a virus called rotavirus which is a cause of fever vomiting and diarrhea and kills about 2000 before the vaccine came out kills 2 000 children a day in the world so when i came into that that that uh that um that virus when i came to first start working on that virus that field um it was the early 1980s um at that time the virus had been studied for 40 years it was known to be an animal pathogen it was known to be a human pathogen by the time the first vaccine came out which was not the one i worked on or we worked on but it came out in the late 90s so that virus at that point had been studied for 60 years and what that vaccine did was it caused intestinal blockage which was a serious and it can be an occasionally fatal problem the disease called into susception when your small intestine kind of telescopes into itself and then gets stuck see how i work telescope into this body i noticed i noticed i got you on that one um and it was so you're 60 years into this i mean and this was a complete surprise it was completely unpredictable and i just think that's the history really of of modern medicine i don't think there's been a breakthrough that hasn't been associated with a human cost i think we just invariably learn as we go you'd like to think we could predict it but but we just often don't yeah yeah i mean there's no viruses in the star trek universe they're in the 23rd century so we'll we'll look back on this conversation look how primitive that conversation was look at look at how quaint they were oh they're wearing masks although i gotta get that morbidity magazine that looks great i gotta get me one of those available at newsstands near you we've gotta call it we gotta call it chris there dr paul offit um i i've known your work i was delighted that you agreed to be our guest on star talk uh and i hear you're a fan of the stuff i do too so thank you for that as well and uh paul mercurio good to have you man oh always fun great time all right all right come come again on that all right this has been star talk cosmic query the vaccine edition i'm neil degrasse tyson bidding you

Channel: StarTalk

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Keywords: startalk, star talk, startalk radio, neil degrasse tyson, neil tyson, science, space, astrophysics, astronomy, podcast, space podcast, science podcast, astronomy podcast, niel degrasse tyson, physics, Paul Mecurio, Paul Offit, COVID-19, vaccine, vaccines, COVID-19 vaccine, pandemic, outbreak, anti-vaccine, vaccines 101, flu, computer simulation, human physiology, conspiracy theories, Fauci, CDC, public health, epidemiology, coronavirus, coronavirus vaccine, covid 19 test, covid 19 vaccine

Id: 0eTXnL4uEsE

Length: 49min 8sec (2948 seconds)

Published: Thu Oct 01 2020