You Need To Listen To This Leading Vaccine Expert From Korea | STAY CURIOUS #30

hey everybody it's stephen from asian boss if you're sick of coven 19 and all the lockdowns or having to wear a mask that keeps flogging on my glasses like this you're not alone but with the virus spreading out of control in many parts of the world and surpassing 10 million cases in the u.s alone we're running out of patience for covet vaccine just exactly when is it going to be ready what would the distribution process look like for some answers we're back here at the international vaccine institute if you remember we visited ivi about five months ago to have a chat with dr jerome kim director general of ivi and one of the leading vaccine experts in the world i'm sure dr kim has a lot of updates to share so let's go and hear what he has to say to see you again great to see you again i was nice to chat it's been five months since uh we last spoke it's gone by very quickly yeah yeah kovan 19 still is still here uh things are getting worse in many parts of the world including uh in the u.s so we're hoping that you can provide us with some updates i'm happy to try what have you been doing uh at your end so you know i guys continuing to work with companies to try and advance covet 19 vaccine development as quickly as possible there's anovio which is an american company and we're in discussions with other companies as well to see if we can participate in some of the what we call phase 3 testing of different vaccines against covid19 so it's been very busy we've been writing applications and talking to people to try and put things in order in order to you know really get something over the finish line as quickly as possible just for people who may not know who you are just could you briefly introduce yourself so my name is jerome kim i'm the director general of the international vaccine institute which discovers develops and delivers safe effective and affordable vaccines for global health a retired military officer the us army which most people don't know has developed a lot of vaccines and i have worked on hiv vaccine development for most of my research career my background then is really in vaccine development but i've also run a number of different kinds of laboratories one that looks at something called neutralizing antibody that is proteins that bind to and inactivate the virus i run a cellular immunology laboratory and a sequencing laboratory so i have a lot of expertise but but i'm not an expert necessarily in all of them how many years have you been doing this so i started doing research in hiv in 1987 but it wasn't necessarily on hiv vaccines hiv vaccine started in 1991. so fair to say you have many many years of executive decades few decades that's comforting to know i suppose for people who are still not kind of familiar with the distinction between a cure and vaccine how do you describe the difference between the two vaccines in general prevent infection or actually more correctly probably prevent disease preventing infection is a is also important not all vaccines do it many vaccines will just prevent the disease from manifesting itself fully cures or drugs can be used to treat infections so once you have an infection you can take a drug that will make the infection go way more quickly improve the outcome and you know for for covid19 we are still in the process of developing effective safe and affordable treatments that will allow the disease to go away more quickly so for instance people are using a very old drug called dexamethasone which appears to decrease some of the body's overly exuberant responses to the virus president trump got dexamethasone there's a drug that was approved by the fda called remdezavir which appears to have a direct antiviral effect although people dispute whether its effect is as great as we had hoped initially there are other drugs that are in the pipeline but none have really kind of moved to the front yet i mean to the front in the sense that this is clearly going to be a silver bullet that really does a great job at getting rid of the disease nothing analogous to the drugs that we have for hiv where you know we went from basically what was a disease that was nearly untreatable to 10 years later having drugs that effectively reduce the level of that viral growth in the body to zero we don't have anything like that yet for covert but we've only actually known about kovitt for 10 months which is really amazing because president trump got this like a cocktail of uh treatment people seem to conflate the two between whether that was a vaccine or a treatment that's not a vaccine right correct so what the president got when he came down with coven-19 infection uh was a a mixture of a variety of different things he got some things like vitamin d um which are not necessarily shown to protect but which we think may have a protective effect probably not very harmful he also got rim desevere which is an antiviral so something that may decrease the the growth of the coven 19 virus he also received a special kind of cocktail of what we call monoclonal antibodies so you know your body makes antibodies against covate if you if you acquire infection antibodies are proteins that are made by a particular cell of the immune system and they're very specific they recognize covet 19 but they won't recognize the influenza virus for instance so if you had coven-19 infection you'll develop these infection-fighting proteins called antibodies what we can do now in the laboratory is to develop very very specific ones so what your body does is it makes a lot of different antibodies what we can do now in the laboratory is identify the ones that are the best that appear to be the best at neutralizing in activating the virus and we can grow them up in these giant steel vats and companies in korea like celtrion and samsung biologics are actually among the world's leaders in the manufacture of these proteins so actually i think uh 50 of the world's monoclonal antibodies actually come from korea interesting so do people have access to that yet so no so they're these monoclonal antibodies are available on a research basis only so in clinical trials the president got a special exemption um i think one of very few that would that were issued for the use of this vaccine for the use of these monoclonal antibodies because he was the president or is the president of the united states and you know they wanted to do everything possible so they kind of threw the kitchen sink at it let's look at the timetable for clinical trials and whatnot are we actually going to get a vaccine first or are we going to get a treatment first so rendezvous has been approved whether and how effective it is at controlling virus growth is is still a source of some debate um we probably will hear in november or december about at least one maybe up to three of the different vaccines and what we'll what we'll have is what we call interim analysis data so when you do a big trial involving thirty thousand or sixty thousand people you design the trial so that you're allowed to peek at the data and this is actually done very strictly and actually you take something called a penalty when you look because you know the statisticians the people who look at the numbers really don't want you to to peak too often because it it impairs the ability of the trial to really understand uh how the vaccine is or if the vaccine is protecting so the first of those interim analyses should become available this month or next month and what it'll tell you is based on a relatively small number of people whether the vaccine is protecting against disease or infection and is safe now on the basis of those data a company could go to the food and drug administration in the united states or to the ema the european medicines agency to ask for emergency use or conditional use i think is what it's called in the european union and that will allow them to start giving the vaccine to more people and depending on how it's structured it could just be you don't have to sign a consent to to get the vaccine you may just you may actually get a piece of paper that explains to you that this vaccine is still experimental we're still collecting data on it if you become sick you need to let people know that you receive the vaccine so that we can we can monitor uh if the vaccine is working so is that considered like part of the trial still emergency use would not be within the trial the trials would continue right until a more definitive answer is obtained and a more definitive answer would be you know the food and drug administration the who have set very strict criteria for whether the vaccine is working and so licensure in the united states will be based on it having protective effect against infection of greater than 50 percent and having a lot of confidence that that is correct that is actually the standard definition that the fda uses for other vaccines whether or not they allow emergency use to proceed with less than that information is is a possibility and and one that the fda has openly spoken about the one caveat that they put on it is that they wanted to have at least two months of follow-up information for safety on the average for everyone in the trial which is very important because they're saying okay we understand there's a huge pressure to have a vaccine especially one that's been shown to be effective on the one hand on the other hand our job they're saying now speaking as the fda they're saying our job is to make sure that it's not only effective but that it's safe so we want to have at least two months of safety information other organizations are doing something called a rolling review so the ema the european equivalent of the fda is allowing companies to submit data as it becomes available so that the ema can now review data in real time other organizations are considering that you know the chinese have an fda equivalent called the nmpa and i think they're expecting to potentially see data from the companies in december so chinese american european a lot of regulatory agencies are looking forward to seeing the first hint that a vaccine may be protecting or not i think the reason why people are so anxious or even like the emergency use that you talk about is because covet cases are just like getting out of control especially in the us i mean do you see it the same way yeah so you know the us's is now in its third wave i mean there was the first wave there was the wave over the summer and now there's a wave that's even higher than the previous ones in korea you've seen a different kind of you you've seen explosions outbreaks but the government in general has been able to suppress the um the outbreak back down to less than 100 cases usually although they're still struggling with that now um but but you know when you think about korea with 99 local infections i guess yesterday with 51 million people that's pretty good that that is pretty good um you know the it's been difficult because i think you know when governments uh release some of the requirements people went out and they did what people normally do but we have to continue to message and we have to continue to emphasize that the things that protected you the things that will keep countries out of lockdown the things that will allow you to have economic freedoms or the freedom to move around and do things masks distance and hygiene you know if that's the price of being able to do the things you want to do i think in korea people accept that mainly in asian countries people accept that asian countries maybe australia and new zealand a very few other countries but you know i think when you look at the uk which is undergoing um a series of lockdowns or italy where certain regions are under lockdown now you wonder what the trade-off is and how countries are going to decide what the appropriate balance of you know economic freedom or mandate around mask wearing around hygiene and distance and you know it's it's funny because even in korea i mean you walk out on the street and people are wearing masks you know the masks are important distance is important and you know it's it's you have to keep it in your mind all the time am i protecting myself that's why people are like looking for this this vaccine to put an end to all this and uh when we spoke five months ago you said that things are progressing at a lightning speed this is like the fastest that anybody's ever tried to develop a vaccine is this still the case so a vaccine from scratch you know the the annual flu vaccines are developed in the over the course of you know six months six to nine months so but that's a vaccine that we're familiar with a vaccine for which they're you know the regulatory agencies accept lab tests you don't actually have to do a trial in 30 000 people um but from starting from scratch we've moved at unprecedented speed and if those vaccines are shown to be protective uh this month or next month then that would be remarkable progress and you know we've made remarkable progress in other things too i mean there's an international consortium led by w.h.o gabby the vaccine alliance and sepi which are is trying to put together agreement on getting 2 billion doses of vaccine and distributing it to 190 countries around the world 20 percent of their estimated supply will be provided by this thing called kovacs i mean we've never done that before i mean if we can do that that would be a really remarkable triumph of internationalism over that what we call vaccine nationalism hopefully these vaccines that were developed under what's called operation warp speed the u.s program um will be available for use in kovacs i mean some of the companies have already committed um not all of them china has has joined kovacs right now the two big standouts are the united states and russia so you know if president-elect biden is listening he should join kovacs and join the international effort as well because you know really there are data now modeling data that would say that you know if the high-income countries so and korea is one of the high-income countries but european countries the united states japan australia canada if they are to purchase the first 2 billion doses of vaccine as it becomes available and don't make some attempt to distribute that vaccine fairly according to the needs of to world global needs for covid that the number of deaths from this pandemic will double wow and bringing it under control will become less efficient because if you're only taking care of yourself the epidemic can continue to rage in other countries and you know as soon as you open borders and people start to move again right it'll get reintroduced and i think the other thing is you know the vaccine is not going to be something that works immediately right i mean it has to be made it has to be distributed we have to get people vaccinated and and it'll take some time and as that is happening there's still going to be large groups of people who have have never been exposed to the virus who are at risk who could become infected and and infect others so masks distance and hygiene are going to be necessary even into the next year as we're vaccinating you know maybe 70 to 90 percent of the people in this world first of all you said that number number will double uh if if we start pursuing this whole nationalistic approach why is the u.s not part of that right now so i think it had to do with the u.s walking out of the world health organization also in fact the u.s government did provide money eventually to another organization called sepi the coalition for epidemic preparedness innovations which korea joined also which is developing vaccines for outbreak diseases including covet 19. so other than the you know almost 12 billion dollars the u.s government has put in sepi provided almost one and a half billion to to kind of get vaccine development moving and and sepi's funding is very interesting because it comes with a requirement for global access which is very important when you think about all the other people in the world who need the vaccine it also comes with a requirement that the vaccine be sold at a reasonable price it comes down to you know are we committed to a global solution for a problem that is transnational we have to solve this problem we have to solve it in a way that where we address the problems that exist worldwide because no single country will have a solution or be immune if we fail when it comes to the clinical trials people probably watching the most of them are familiar that there are three stages right and where are we with that i would imagine that if vaccine could be almost like something could be done by december or january i would imagine that a lot of trials are in the the stage three phase so there are ten vaccines that are in phase three so the the determination of efficacy and safety there are three chinese vaccines uh one from a company called cannes sino one from a huge chinese vaccine manufacturer called cynopharm cyanofarm makes uh 60 to 70 percent of the vaccines used in in china and then a smaller company named synovac signup farm and sinovax vaccine are in clinical trials all over the world with tens of thousands of people and i think we're expecting to see data from those trials in december also if not sooner you know so if you combine that with moderna and pfizer biontech which also could become available in december and now oxford astrazeneca saying it may be available uh able to look at data in december as well i mean you're looking at most of the companies being able to report something before the end of the year wow which is just remarkable but you know i think that we get the idea that that everything's done but in fact there are 47 vaccines in human clinical trials there are some that are that haven't entered trials yet that look very promising and you know you know whether the same group of vaccines that the first to make it over the finish line now are the same ones we use five years from now or four years from now uh we don't know what are the sample size like sample sizes are well intense usually in the tens of thousands if it's a comparison of vaccine against placebo it really depends on the number of infections and so with covet 19 sort of raging in in brazil and the united states and parts of europe you know the companies have picked a sample size around thirty thousand so fifteen thousand people get vaccine fifteen thousand get placebo or an inactive substance and um some of the trials are even larger uh sixty thousand uh is one of the high side estimates other companies are trying to get by with smaller sample sizes by targeting their vaccine against particular populations with very high infection rates although that can be a little bit that can be a problem because as you've seen covet can come and go you know within the course of a few months an epidemic can be brought back under control by lockdowns yeah so it's a slightly riskier strategy but one that is faster potentially and then cheaper but again different companies are taking different approaches to that question the phase 3 trials are very important and they give you really important information about protection so the way you do a phase 3 trial with vaccine and placebo you're really looking at protection of individuals you know you give a vaccine to somebody are is he or she protected against infection or disease the other question though and one that may be more important for countries is well how do you protect society because you know something that's designed to look specifically at protection of individuals may not actually give you enough information about how you're protecting the rest of society against disease so if you're a country you may not care that much that people get infected as long as you're not seeing hospitalizations and deaths right um and you know i think dr fauci said this weekend but but it's something that people have known for a while which is that you know right now the current vaccines are preventing disease so they're looking at outcomes they're looking at you know whether a person has a positive pcr test and has a symptom but you know that 80 percent of people who have covet are very minimally symptomatic or asymptomatic so those people are not necessarily being looked at as a primary endpoint in these trials right on the other hand you know we know that it's disease that we're interested in i mean we want to prevent deaths we want to prevent symptomatic illness we want to keep the hospitals from filling up with covet patients and so to do that you need a different kind of trial something that's usually done after efficacy but something that could be very important in helping determine this herd immunity i mean we talk about herd immunity all the time but protection of other people in society who are not vaccinated and what's the right level of vaccination that you need in order to achieve that and we don't know that and the trials that we're doing now won't necessarily tell us the answer that's interesting because i actually thought that we would have been able to tell what that threshold is we can guess at what it is but each vaccine may be different and and so again you know this is a separate set of ex of clinical trials that are done once approval is given we start to do what are called effectiveness trials you know it's great to have a trial where you know you get assigned at random to a vaccine or placebo and a nurse calls you up a week before you're supposed to come in and then a day before you're supposed to come in and says and you know to remind you don't miss your appointment you have to come in and get vaccinated but in the real world no one's going to call you right i mean and so if you miss your vaccination or if you're two months late or if you skip it all together you may never get the correct vaccination regimen so how is the vaccine going to work in under real world conditions the rna vaccines have to be kept one of them has to be kept at minus 70 degrees centigrade minus 70 degrees celsius yep yep that's cold that's very cold the refrigerator in your doctor's office doesn't keep that temperature so we need a separate distribution system to be able to give that particular vaccine now hopefully the company is working on a way to increase the temperature and is doing tests now to make sure that the temperature can be minus 20 which is still cold uh or two to eight which is refrigerator temperature and you know it's something that that would be difficult to transport in an airplane well that's right because you know 747s don't necessarily have the capacity to to have the freezers necessary to to keep something at minus 70. when you're talking about shipping hundreds of millions of doses that's a lot of cold capacity there's a difference between what works in the laboratory setting versus what really works in real life there are so many external circumstances or factors that are out of your control yeah right and and temperature and cold chain would be one of them distribution would be another you know you we're really good at vaccinating kids i mean you know in the u.s it's probably 80 to 85 percent of kids get all almost all their vaccines which is real attribute american parents actually um and around the world for the typical vaccines the ones that who recommends to be given childhood we're at about 80 to 85 also which is great so kids are fine but how do you vaccinate teenagers i mean we we really do have a hard time giving vaccines to teenagers and then how do you vaccinate working adults and how do we vaccinate the elderly and when you think about who needs a copic vaccine it's everybody and we don't have we don't routinely bring them in to care so if you're a small country in sub-saharan africa or in south asia and you have certain number of healthcare staff we're delivering the vaccines to kids and now all of a sudden you tell them okay time to start giving the vaccine to teenagers adults and the elderly they're going to just do this in their they're not going to just do it in their spare time it's going to take time away from everything else that they're doing do you think it's too much of like an outrage from i suppose like you know freedom perspective to mandate some sort of like a vaccine having been in the army and having received more than my share of vaccines i can tell you that it is possible to mandate it and get really high rates of compliance but not everyone's in the army [Music] so you know what it may come down to is the protection of society and i think countries and governments and insurance companies may actually in the united states may end up deciding because you know if your health care costs if you're a company say you're starbucks and you're not vaccinating your employees and a lot of your employees are coming down with covet and getting sick and going into the hospital your healthcare costs will be higher than a company that has been using vaccination to control that so if you're the insurance company what do you do you go to them and say you know you need to do something about this infection or we're going to raise your premiums and companies don't just raise premiums they you know they get a higher premium and then they pass it on to the employee so there could be other mechanisms that apply later on um and particularly in societies where health care is not universal but you know the the good thing i think is that many countries around the world view this as very important and they will engage the parts of the government that are good at convincing people um that vaccination is critical and and it's funny because different country countries are different you know in fiji some colleagues who work in the ministry of health there there was an outbreak of measles um actually in samoa and fiji decided well you know there's a you know we don't want measles to break out in in fiji also and they reminded people that the population of fiji way back in the 19th century had nearly been wiped out by measles and they used that as a as a reminder and they said we got over 100 i mean we had people coming in who didn't need to be vaccinated insisting that they wanted to get the vaccine but you know it's communication and it's convincing people that vaccines are safe and effective and you know often we don't do that um you know we talk about anti or vaccine hesitancy in the united states but i mean let's see there are 26 potential 26 or 27 individual shots that could be received for 14 different diseases and 80 to 85 percent of american parents make sure their kids are vaccinated they've probably never seen mumps or measles um because vaccines have done such a good job getting rid of them yet they give them so i think you know we have to emphasize the safety the efficacy you know that the vaccines protect and we have to be um clear in the messaging you can't have the cdc saying everyone should get vaccinated and someone else saying no no don't get vaccinated it's dangerous or you know i would i wouldn't vaccinate myself i mean the messages from governments have to be clear and consistent the way they are in korea i mean you know around masks around distance around hygiene when they're about to make changes they let you know and then they reinforce the message time and time and time again i guess governments can try to do that around the world as far as korea yes we are getting a very consistent message and i don't think anybody's really dumb enough to question the efficacy of vaccine but there are so many like let's look at the united states right there are like media organizations there are all these like conspiracy theorists they have to have their own social media platform this type of like misinformation or disinformation it just i don't see that stopping in fact it it won't stop but i so if you look at the numbers you know probably 75 to 80 percent of people will take a vaccine if it's safe and effective um there's about another 10 or so people who are undecided we need to get them and we have to convince them with facts and information and you know there has to be consistent messaging we have to be absolutely sure that the vaccines are i mean we have to be convinced that the vaccines are safe and effective i mean that is going to be a really important part of this and then we have to get out there and we are going to you know the government as well as other organizations are going to have to convince people that this is something that we as a as a nation i guess would need need to do in order to get back to some semblance of of normality what i'm curious about is that once you get this one shot of a vaccine out of it could be one out of these 10 vaccines we have potentially coming up will once be enough so all but one of the vaccines um use two doses and with the other thing that we don't know and we won't know from the from the short-term data that comes out during november december january is how long that effect will last so you know often vaccines require a booster there's a suspicion that the coronavirus vaccines in general will require a booster but we don't know that yet because we don't know the data on how long the immune responses the protective responses that are generated by a vaccine we don't know how long those will last we hope that they last at least a year and that will allow us then to do booster vaccinations the thing is that we don't know so say there's the pfizer vaccine looks like it's working in the astrazeneca vaccine can you mix vaccines so if you get the pfizer vaccine originally can you get a booster with the astrozenic vaccine um some of the second wave of vaccines that would include the nova vac vaccine actually which may come out soon the sanofi vaccine some of the vaccines being looked at in korea may actually be better at generating very high levels of the protective antibody because they're based on there are a different kind of vaccine we call them protein vaccines and the protein vaccines generate much higher levels and we can give those proteins with something called an adjuvant something that boosts the body response the body's response to the to the vaccine and that may actually be able to get you two years or three years and if it's given at the right time a booster could last for a very long time and again we don't know the answers to that so one of the things that we need to do the day after efficacy is figure out did we really optimize the dose and the schedule and what other things can we do in order to do that do we can we decrease the dose can we spread the dose out a little bit you know what else can we do in order to maximize the performance of the vaccines that we have and then what other vaccines are available that may allow us to even to be even better to reduce the number of doses to one to increase to switch from a boost every year to boost every three years so those are really important questions for the day after you're basically saying that there's almost like a consensus that you will definitely need a booster for sure um there's a suspicion i would i don't think you could call it a consensus but you know people have been very concerned that um protective responses against coronaviruses don't tend to last very long in nature and whether or not the vaccines will give us better responses we don't know why in nature why does that happen it has to do with the different viruses and and the kinds of protective responses that they induce sometimes when a virus infects somebody or a bacterium for that matter um it does things to the body to trick it hiv would be the classic example hiv tricks the body in multiple different ways to weaken the body's defensive responses so sometimes by certain features or qualities of the virus will allow will cause the body's immune response to be less than optimal and i think coronaviruses have have evolved to develop very low levels of protective responses after infection in general so if you look at the eighty percent of people who are asymptomatic or mildly symptomatic it looks like their antibody levels the levels of protective proteins appear to be relatively low and appear to drop off fairly quickly although there's been some dispute recently about whether the killer cells or other parts of the body's defense system are still around it may not be enough to protect you against the second infection so i mean there have been a number of cases now around the world of very well documented second infections it doesn't happen that frequently and we don't know what level of protective response is needed in order to prevent that second infection we're hoping that the vaccines will be at that level for a long period of time but we don't know so there are still these another question for the day after efficacy is you know what correlates with protection how high does it have to be how long does it last and can we generate it with a vaccine or a combination of vaccines you know i guess it comes down now to two things how much is it gonna cost and when are people gonna actually get this thing yeah so cost is complicated um and and just to give you an idea here um if we took the pneumonia vaccine made by pfizer they sell that to the uh gavi for three dollars and five cents a dose so for people who don't know what gabby is could you just uh gavi is a vaccine alliance so they're an organization that receives funding from countries and philanthropic organizations around the world and they buy vaccine for poorer countries what we call gavi eligible countries so vaccines that would be otherwise inaccessible because of cost are provided to countries around the world through donors and it's been remarkable this is a non-profit organization it is a non-profit organization dedicated to delivering vaccines to countries around the world now the countries have to promise that they will give the vaccine so that's the onus is on the country and they're responsible for putting in place the cold chain the delivery the healthcare workers you know they have to do that part but gabby will give them the vaccine either for no nothing or a very low cost now if you look at the gavi price three dollars and five cents a dose for the pneumonia vaccine in the united states it's two hundred dollars a dose well between 70 and 200 those were exactly the same vaccine so the pricing depends on a lot of things they go from a low of 1.37 cents to 70 dose the cheapest vaccine that the people have talked about is one from bharat which is an indian company it's what we call whole inactivated fire so they just grew the virus up and killed it and and they mix it up with something called an adjuvant and that's what they're using to vaccinate the most expensive vaccine at 70 dose is also whole and activated vaccine made by a chinese company sino farm now whether that's sign of farmers final price or whether it's the price now because it's only available on emergency use no one knows the thinking is that whole inactivated vaccines tend to be less expensive so it's probably closer to bharat's estimate ultimately but we don't we don't actually have the data moderna's vaccine is going to be around 35 a dose it could be slightly higher depending on how large the you know the larger the bigger the purchase the lower the cost um so it it's it's hard to say and you know many countries will provide it free for instance in the uk right if they have a national health service they provide the vaccines free vaccines that are required under the national immunization program in korea are provided free of charge kovacs so this mechanism that gavi sepi and the world health organization put together you know they're buying two mil two billion doses i mean not all not necessarily all of the same vaccine but that allows them to make a deal on price hopefully and in terms of timeline when is it likely that that we can actually get you know get a shot basically countries like the united states which have you know put 12 billion dollars actually if you look at the cost of operation warp speed it's 18 billion dollars and they've secured over 2 billion doses of vaccine now the united states has 330 million people so if they get two doses each that's 660 million doses but they have two billion doses pre-ordered and a number of those doses several hundred million doses are actually in the process of being made now so that theoretically once a vaccine is announced to be safe and effective they may actually have millions of doses available for immediate use dr fauci who is known to be you know correct much of the time has said don't count on widespread availability until the middle of next year and the cdc uscdc has worn the same thing now this is in the united states which has put a huge amount of money into ford you know pre-ordered vaccine what about other countries so you know and it turns out that around the world 8 billion doses have been pre-ordered not much of it is going to low and middle income countries that's actually going to probably happen through kovacs most of it has been pre-ordered by high-income countries so the european union has purchased 1.5 billion doses the uk 400 million doses japan 300 million doses i don't think that they're going to actually see all those doses i think that a lot of it were these were pre-orders in order to secure a certain level of vaccine if the vaccine is shown to be safe and effective but again you know kovacs um has to compete against these global players uh from high-income countries they you know basically have the fund have the money available to make um pre-orders but i let's hope middle of next year we'll start to see enough vaccine to to be able to really realistically vaccinate many people so we still have to wait and wait around at least another six or six to seven months possibly um and and i think it's important to recognize that you know the day after efficacy we're still good you know i'm gonna still put my mask on and distance and do the hand hygiene thing because you know if you imagine that it's going to take maybe till 2023 or 2024 to have enough doses to vaccinate the entire world um there's still going to be risk out there and you know again the vaccines do hopefully will be shown to be safe and and protective um but we don't know if you get vaccinated and you go out and you know to a bar surrounded by people who have covert 19 infection whether the vaccine won't just be overwhelmed and and we do know that that happens that could happen it could still happen um so you i mean even after you're vaccinated you should protect yourself um so there's a one of the examples of a person who was re-infected may have been exactly that he was infected he recovered and then he wasn't following any protective you know wasn't protecting himself he went out and he got a second infection and actually the second infection was worse now thankfully he didn't um he didn't die you know immune responses are protective but it's not absolute protection and so there's still a reason to to protect yourself against infection the other part which we it's harder to explain is that if you are vaccinated and you get infected um you may still be excreting virus so you know other people around you i mean the other reason to wear the mask is to protect others for the same reason that you wear masks now i thought the whole point of getting a vaccine is so that people can stop wearing masks and then don't have to socially distance but this is just at least initially until you know we reach a level of protection in society where when there are outbreaks that they're going to be self-contained and where the people who are most vulnerable say the elderly are protected against infection and and people who have underlying conditions or people whose jobs bring them into contact with with sick people and it's not necessary i mean it's clearly health care workers but think about teachers i mean children have a special capacity to be able to spread coronavirus amongst themselves and then to the people who are teaching them people who work in places where they see a lot of where they meet the public frequently like people who work in supermarkets or people who are doing deliveries or first responders policemen firemen um so i think we are still going to need to protect ourselves until we've reached that level of protection where society feels that it's safe what percentage of the population would have to be vaccinated we've been saying 60 to 70 percent but really that's something that should be determined in these what we call the effectiveness trials and the trials that are designed to look at the protection of society against infection the vaccines are going to be useful it's going to be much better than not having one but remember that the vaccines are going to be a part of a comprehensive program of prevention at least initially until we can determine that we're at the right level of protection in society could it also be possible that the virus will kind of evolve and mutate yes you know that's always a risk um you know the the most recent emergence of of this virus in minx emphasizes the problem that it's not only humans but this going back and forth between from whatever it was that infected the first human maybe bat to something to human then human to human then human to mink mink to human when did this happen so this is something that's been reported in the last week or so but it's presumably been going on for a month or so before that because they've accumulated now i think 200 cases wow where is this in denmark and i think part of the netherlands as well and one of the clusters that's called cluster 5 of these viruses appear to be less sensitive to some of the protective antibody so again we don't know if this will be a bigger problem if it's going to spread if that virus is capable of spreading as easily as the regular virus and we don't know that the vaccines neces at this point protect i'm sure those studies are going to be done very quickly so i guess it's not all just this magic bullet solution that we were all hoping for so the day after efficacy we're going to wake up and put on our mask yes and and you know hopefully at some point in the next few months we can be vaccinated and that will give us an additional level of safety and then everyone will have to make you know governments and people will have to make risk assessments i think though it is still very important to manage people's expectations they will still be like then what's the point of getting a vaccine right and people start becoming cynical knowing that this is not that absolute 100 protection magic bullet that everybody was hoping for what if the vaccine is not 50 but 80 protective and against disease and you know that would potentially be very important even at 50 it could significantly impact health in the community so and i i think i gave you this example before our oral cholera vaccine so it's a vaccine against cholera uh when you look in the randomized clinical trial that looks at individual effects it's maybe 55 to 60 percent efficacy and you'd say ah that's a partially effective vaccine but if you vaccinate a city or even half a city its effectiveness is 85 percent at preventing severe cholera so it's going to be important to stay tuned to be aware of what the actual protective effects are and it is going to be very important to have a vaccine and if it's available for us to be able to take it because it will speed the path to um being able to open things to be able being able to do things normally let's touch upon the whole equitable access type thing what are your concerns exactly when it comes to equitable access yeah so um you know typically with a vaccine discovered in the united states or in europe or in korea or japan the vaccine gets taken up and used by populations by children in high income countries and then eventually the vaccine is is rolled out in lower income countries so if you take a vaccine against rotavirus so rotavirus is an infection you get when you're little and it causes diarrhea and in the united states it caused lots of kids to be hospitalized for dehydration from the diarrhea an effective rotavirus vaccine was approved in the united states in 2007. by 2009 wh had reviewed the information and and also recommended it by 2020 now 11 years later 60 percent of children around the world have not received all three doses of rotavirus vaccine really and that's the way it normally is right it starts you know we implement it in high income countries and we gradually you know put it in the mechanism for gabby to purchase large quantities for it to be distributed around the world and for countries now not only will have the who recommendation but then they have to make a decision to use the vaccine to add it into the programs that are already overburdened by other vaccines so it's a it's a process but it's been 11 years 11 years yeah and it's a highly effective vaccine for disease that still probably kills between 100 and 200 000 children a year around the world and and we've made huge progress i mean if you look at the number of countries it's over 90 now countries have put rotavirus vaccine on their programs but they haven't been able to implement the program and so hopefully with covet 19 we will find an effect safe and effective vaccine we'll get it made in significant quantity with equity now with covax you know at least 20 percent of the doses will be handed out by the end of 2021 which will mean that the elderly can be vaccinated and people who are healthcare workers can be vaccinated and then by then i think the hope is that we have enough vaccine available so that kovacs is no longer necessary that countries can can gain access to low-cost effective and safe vaccines can you imagine scenarios where this could be almost like weaponized politically yeah actually there was a an article in foreign affairs about just this um about a country using covet vaccines and and loans and going to countries that are desperate for a solution and using it to gain future political leverage i'm not sure how that works necessarily you know the world has pushed kovacs forward but still you know covax is only 20 of the vaccine that a country needs what about the other 80 percent and you know if you can't get your vaccine through cove axis for some reason kovacs fails then it's really going to be every country for itself and in that situation you have a lot of opportunity for a country with money and vaccine to be able to make deals with countries that are less fortunate now we're hoping that that geopolitical act peace doesn't come to play but in order to make sure that it doesn't covax needs to work and it's still short of funding so what is ivi doing to hopefully address this situation or you know so you know we don't purchase vaccines and we don't manufacture vaccines so all we can do is really work with companies to try and show that the vaccines are safe and effective as quickly as possible to develop the optimal regimens so the right dose the right schedule determine what the optimal boosting is show that the vaccines are effective and generate herd protection because these are all going to be really important as countries try to make a decision about whether to buy vaccine how much of it to use who gets vaccinated first and when they can be sure that you know some of the restrictions can be lifted i guess 2020 has just been an extraordinary year and it's almost over and how do you reflect on this year when you look back um i think it's been a bit humbling with covid19 you know we are hit with a pandemic that we weren't expecting we've developed vaccines very very quickly but it's spread around the world so you know tens of millions of people are infected 1.2 or 1.3 million people have died how much does covet cost the world 20 trillion so when you think about the small investment in cobit vaccines against the entire cost of this pandemic it pales by comparison but getting countries to step up you know and and volunteer the funding in order to vaccinate the world has been more difficult there's been a bit of a you know a leadership vacuum i mean maybe the united states normally fills that but in the absence of the united states you know you have kovacs trying to do everything it can the who gaby sepia all working very hard i mean you can see china moving in to fill a vacuum but you know someone needs to challenge the world you know challenge the world to join kovacs to make it work um to ensure that vaccine is going to reach the the people who need it the most um and then we'll see but that'll require leadership and um and a fair amount of um of focus on what's important what's a priority and and how do we get people to do the right thing countries to do the right thing what would be your message to i don't know just the public who are absolutely sick of all these lockdowns the economic costs you know people with uh you know drug overdoses and and depression and suicide all these things that had that coveted 19 has has brought and the eventual lockdown has brought and people are just waiting for some some sort of a solution right and everybody's now looking at this thing as okay vaccine is the only way like what what do you say to these people um you know it's it's hard to say have patience but you know people are working as hard as they can to get a vaccine that is safe and effective and when we have that vaccine it's going to be really important that countries and and that citizens of countries understand what the benefits and risks are and that really you know this is a pandemic that is worldwide that is a you know as we say viruses know no borders well this pandemic has really showed us how closely we are all at risk i mean until the the pandemic is controlled everywhere we're really not safe and so we need to recommit to a to a global response to cobit 19 and hopefully this will serve as a model for future endeavors future pandemic response for people who are tired of the masks and are just waiting for vaccine solution you know the honest truth is that it's going to be it's going to be a year it's going to be years potentially until you know we're all safe and what's what relief we get will come in bits and pieces having the vaccine being vaccinated being able to go out and do things again it will come not all at once so we're going to have to be get used to living with masks and distancing and you know doing things to protect other people and spreading the vaccine message when we have a safe and effective vaccine we need to let people know we need to stop this information we need to talk truthfully about what the risks and benefits are you know we can't just be pollyanna and say well everything will be fine and we have to be honest and you know well i always hope that honesty is going to be the way that we convince people that we're sincere that we're not just saying well you need to get it because we own stock in a vaccine company but because it's actually something that will benefit all of us in the end thanks for sharing that inconvenient truth but it is important that we know the truth and understand the science behind it i think it's important for people to listen to to you know scientists like you and not politicians or well i'm sorry if it got a little technical but i have to say you know people really enjoy the um these uh asian boss interviews um i've gotten feedback from people like all over the world um thanks to you that's very humbling i think it's just whatever we can do to help right so what do you guys need actually ivi is um just about full now i mean we programs have grown and you know as we try to do a lot more things we're going to be stretched but you know i think uh countries like finland sweden korea india have been very supportive um individual donors have been very supportive and and hopefully we'll be able to do something but can i make one more um thank you so you know we focused on covet and covet is a really important problem because you know 1.2 million people have died around the world but the other global health infectious diseases continue yes you know if it's you know rotavirus diarrhea um group a strep kills 500 000 people a year and you know there isn't much funding to do research on a on a vaccine that prevents what we call strep throat in the united states or strep pharyngitis there still are other diseases and a lot of other programs that need to continue that have been put on hold because covid 19 has you know forced the closure of healthcare facilities because you don't want people necessarily coming in if they're going to expose themselves to greater risk yeah and you don't want to do mass vaccination campaigns because of the risk again that the crowds may spread coven 19. so it's a big problem kova 19 let's not forget it but there are other things that it's impacting i just can't thank you guys enough for everything you do the world is a better place because of people like you and so we just want to say thanks and then hopefully we get to catch up again thank you and it's always been great speaking with you

Channel: Asian Boss

Views: 524,531

Keywords: Vaccine, COVID, updates, Vaccination, news, trending, ivi, international vaccine institute, health, body, healthy, public health, doctor, WHO. world health organization, phd, medical, medicine, science, proof, evidence, theory, vaccine distribution, insight, information, expert, corona, coronavirus, COVID 19, South Korea, Seoul, Asia, Asian Boss, Stay Curious

Id: ebw1DlaY0yE

Length: 55min 49sec (3349 seconds)

Published: Fri Nov 13 2020