The Pfizer/BioNTech vaccine (BioNtech/EPA)
HOPE OF DELIVERANCE
Derek Lowe has been my go-to guy for vaccine analysis. He writes at a level that’s a step beyond my level of comprehension, which is just how I like it (he’s actually a very clear writer but yes, he gets technical). He is generally cautious, but the news from Pfizer and Moderna has him positively exuberant. He points out that if we’ve had results that were above the 50% efficacy bar set by regulators but not that far above, then we’d actually remain in quite an unstable and unpredictable situation. We’d have a vaccination program, which would make people feel more relaxed, but the vaccine wouldn’t necessarily be strong enough to protect against too much social contact. So we’d get into a weird dynamic that would be difficult for governments to manage. The fact that both these vaccines came in at 95% efficacy is therefore extremely good news. What we have here, Lowe says, are “pandemic breakers”.
In late April this year, a panel of superforecasters (yes, there is such a thing, no it’s not woo-woo) estimated a 6% chance that the US would have a widely distributed vaccine by April 2021. They now think it’s 95% likely. In other words, we are getting there a lot faster than seemed likely a few months or even a few weeks ago. The UK is on a similar timeline to the US - maybe a little slower given we don’t have as much access to the Moderna vaccine? - but certainly the plan is to have everyone vaccinated by April. Much depends on the Oxford vaccine, which the UK government has its biggest bet on. I would hate to be the Oxford team right now: Moderna and Pfizer have set the bar so high and now everyone is staring at them - no pressure guys! (They just published a paper showing that older patients respond well to the vaccine, that’s good news; now we await the efficacy data, which should arrive in December).
One thing I do feel reasonably confident about is that the UK’s roll out of the vaccine will be pretty good and better than we’ve done with test and trace. Unlike T&T we have done something like this before and we are lucky enough to some serious expertise and capacity in vaccine production. In an earlier Ruffian I recommended the government-sponsored vaccine podcast, which features Kate Bingham, head of the vaccine taskforce. This week I listened to the episode on “making the vaccine”. It features a group of experts in vaccine production who have been co-ordinating on this since the beginning of the year, before the government got involved - a true bottom-up effort. They have planned for this moment in painstaking detail - one of them talked about the need to manufacture a particular kind of glass for the vials, which requires sourcing a particular kind of sand. Do listen - it’s a truly heartening half hour or so, not least because of all the regional accents involved. It’s the sound of a nation coming together to get shit done. And not just for us: they project being able to make enough to provide for other countries too.
In case you missed it, I wrote a long piece on why Biden won and why so many people didn’t think he could.
How the different vaccines work, in 80 seconds.
A really fascinating backgrounder on how mRNA vaccine technology was developed, which has some juicy stuff about biotech industry rivalries. Also includes a story about the woman who did most to develop it and how at one point she got demoted from her research post because her mRNA work was seen as a dead end. She should have given up, really, but she kept going….(btw it’s striking how female scientists are at the forefront of these developments, at Oxford, BioNTech, Pfizer…)
This is a nice explainer on how the immune system works, here’s a much longer one, in the New Yorker. They both emphasise the way in which it follows the logic of evolution - throw up a lot of random variation (here, in antibodies) and see what sticks. It reminded me of the theory that the best way to do great creative work is to generate a lot of ideas, thus raising the odds that one of them will be brilliant. It is a good argument for not being afraid to create rubbish work, which is what most often inhibits people from doing any creative work at all. You need the garbage to get to the diamonds.
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LAST MAN UPSTANDING
Mitt Romney stands alone among senior Republicans - again - in saying what needs to be said. A year ago, Romney was the only Republican senator to vote for impeachment (he did not vote for him in the election). We should not underestimate how hard, how painful it is for a politician to break with their own side, especially in an intensely polarised environment. Romney stands to gain nothing from this, zero. There is no constituency in the GOP for anti-Trump moderates, or for constitutionalism. All he will get is grief from his own tribe, and derision from the other one (after all, he remains very much a Republican; he voted to confirm Barrett, for example). If you want a case study in principle and courage, the last year of Romney’s career provides one.
Dolly Parton, not content with just being a great singer-songwriter or helping kids to read, has now saved humanity. Yes, she part-funded the Moderna vaccine after talking to her doctor friend (who by the way is the father of Radiolab’s Jad Abumrad, who made a brilliant podcast series about her). In her honour, but really for your pleasure, I recommend listening to Do I Ever Cross Your Mind, a song of hers she recorded with the late great country guitarist Chet Atkins. The two were friends from childhood and it shows. Right up to its closing seconds, this is a shot of purest dopamine. Thanks Dolly.