There's the slick, turtleneck-loving CEO who's really good at raising cash for his company that has yet to release any data. There's the workaholic power couple focused on curing cancer. There's the researcher who co-invented a recombinant DNA technology but stays at a small biotech that's limping along.
All of these characters are the unlikely heroes who helped bring COVID-19 vaccines into the world, and their personalities are brought to life by Wall Street Journal reporter Greg Zuckerman in his new book, A Shot to Save the World: The Inside Story of the Life-or-Death Race for a COVID-19 Vaccine.
A lot went wrong in the race to develop a COVID-19 vaccine, but Zuckerman calls his book the story of what went right. He details the long and winding road of scientific advances that laid the groundwork for the vaccines, as well as the researchers, executives, and government officials who made it all happen.
Zuckerman spoke with app about his new book by phone. The following is an edited transcript of that conversation.
What's missing from other accounts of the scientists and executives who made COVID vaccines a reality?
Zuckerman: We're all aware of the vaccines, but it struck me that the full story of how they were developed wasn't understood. What's important to understand is that there were a series of small breakthroughs over the years. I think some people are aware of . Maybe some people are aware of . But it was almost like a relay race. They ran strong races and they contributed a lot, but in some ways, they just sort of passed the baton.
It was my suspicion that there were breakthroughs that no one was aware of behind the scenes, so I wanted to shed some light on those. People like Kerry Benenato at Moderna. No one's ever really heard of her and she never gets much publicity. She's not a senior scientist. Yet she played a really important role [in modifying the lipid nanoparticle delivery system in order to diminish unwanted side effects of mRNA delivery].
How was it getting access to those people, in addition to the big names?
Zuckerman: Some were easier to speak with than others. Government and academic scientists are much easier. That's part of why they've gotten so much attention. There's a reason why most writers talk about or . Academics and government scientists are usually easier to access, and as a result they get a lot of the limelight.
They clearly deserve the credit, but it takes some digging to figure out who are the young scientists or mid-level scientists within Moderna who contributed a lot.
For instance, I was struck by , the early Moderna scientist who didn't even stay there that long. He was their first employee. He's the one who came up with ... the actual modification [to the mRNA molecule itself that is currently used in Moderna's vaccine].
That modification is the one that BioNTech uses also. It's not the one from Karikó and [Drew] Weissman. They're really important and they're pioneers, and I'm not sure we would have these vaccines without them. But I also don't know if we would have them without Jason's work.
This book gets at the personalities behind the science. Who are some of the most interesting ones?
Zuckerman: I don't think enough attention has been paid to the Chinese scientist who was struggling with whether to share the genetic sequence [of SARS-CoV-2] in early January 2020, Zhang Yongzhen. The guy's a hero. He risked so much. The Chinese did share the genetic sequence subsequently, like a day later, but I'm not sure they would have done it without him. I think he doesn't get enough credit.
Juan Andres, the head of manufacturing at Moderna, is one of my favorites. Very early on, he's freaking out [about COVID-19] and his family thinks he's nuts.
He also encapsulates this theme of how a lot of Moderna people are just emotionally shot from the past year. I don't think people appreciate that. We all think they're focused on the stock price and how wealthy they are, and that they're not giving enough vaccines for the rest of the world. There are reasons to criticize that. But they've never had a partner and I don't think that's been emphasized enough. They tried to get Merck on board, and they couldn't, so they've had to go all out over the past year. There are people who are just killing themselves working so hard.
Yet Juan Andres doesn't feel like he's done enough. I'm not saying they're perfect human beings and I'm sure they want to get wealthy as much as the next guy. But there are a lot of really caring people who really do seem to want to do good for the world.
Novavax's first big product was an estrogen cream that was done in by side effects seen with hormone replacement therapy in the early 2000s. The company has almost made a comeback but they're not quite there yet. What happened?
Zuckerman: I found the Novavax story just fascinating. We dismiss companies, dozens and dozens of them, whose stock prices are $5 a share. They say they're making progress even though there's no proof, so we tend to dismiss them.
What I've learned is that there are credible, serious scientists within these companies, including Novavax. They're just plugging away. They're resilient, they're stubborn. Maybe they're deluding themselves, or maybe they are making slow progress.
A lot of them could have left, like [who developed the used to make proteins for recombinant DNA products]. He could have worked elsewhere and done well. Yet these people just liked the work. They believed in their approach. Sure, maybe nine times out of 10 it won't work out, but there's a lesson in having respect for the bench scientists at the company that's selling at under $5 a share.
Novavax hasn't quite succeeded yet. There's from last week. ... They had to sell their manufacturing assets right before 2020. ... They got kicked out of the . The manufacturing is what hobbled them. I find them easy to root for.
Why was Katalin Karikó, now of BioNTech, treated so terribly for most of her academic career?
Zuckerman: Karikó was treated as a second-class citizen at the University of Pennsylvania for too many years. ... She was up against all kinds of skepticism and career setbacks, and she just persisted and believed.
She illustrates a larger theme that for decades the conventional wisdom was that mRNA sure would be a great molecule to work with, but there's no way anyone should waste their time on it. It's hard to handle, it's unstable. You can't get it where it needs to go in the cell. The skepticism about Karikó reflects just the broader skepticism about mRNA, how the conventional wisdom can be so wrong, and how it takes some really determined, innovative scientists to overcome it.
It's interesting that Pfizer almost didn't go with the full spike protein for their vaccine. Would things have been different for that vaccine if they had chosen something else?
Zuckerman: I asked them, and they weren't sure themselves. It would have been great if I could have said, you know, that change had saved the day. It's not clear what would have happened. Truth be told, COVID-19 isn't as much of a challenge relative to other diseases. So maybe it would have been fine.
But it is fascinating that so late in the game, they were still debating that. Maybe you do have to give Pfizer a lot of credit for putting its foot down and saying, alright we have to make a decision here. We're taking too long and we need to speed things up. So maybe that was the important role they played.
Why wasn't Moderna the most likely candidate to respond to the global challenge of COVID-19?
Zuckerman: Among my colleagues in journalism, but also in the world of science too, we have a rearview mirror, and everyone was scarred by the Elizabeth Holmes/Theranos experience. People didn't want to be burned again, so we all looked for the next Theranos.
No one really was sure it was Moderna, but they raised suspicions, and for good reason. They weren't very transparent. They didn't share their work. They raised money, and often it was from these kinds of "tourist" investors who weren't really biotech investors and didn't have the greatest track record in this space -- sovereign wealth funds, people with maybe too much money.
[CEO Stéphane Bancel] raised so much money that it reminded people of Theranos and of Holmes. He never had people outright accusing him of fraud. There was no evidence of that. But he did raise suspicions. There were reminders of Holmes. He had the black turtleneck, he wasn't a scientist. He's an MBA, he's an engineer. He's super smart and very, very smooth.
There was jealousy, too. There was envy in the industry. Here's Bancel raising all this money, so others are wondering, why can't I raise this money? There's got to be something wrong, he's got to be doing something fishy.
It's striking that these are the people who partly saved the world. They're not the most likely candidates. It wasn't Merck, GlaxoSmithKline, Sanofi, the vaccine giants. Johnson & Johnson is a household name but it's not a vaccine giant. Pfizer had closed down its infectious disease business, they weren't a vaccine giant.
The J&J/Janssen vaccine has a long history using its Ad26 adenoviral vector technology in vaccines. Why is that history important?
Zuckerman: The average vaccine skeptic is a little concerned that we produced these vaccines so quickly. They think there's got to be something rushed here, so it's unsafe. I understand that impulse. Part of the reason I wrote this book is to reassure them that these techniques, these approaches ... took years and years of hard work and honing and improving.
dedicated his life to the Ad26 approach and also to an HIV vaccine. It hasn't worked for HIV.
There's been failure after failure with HIV. I kept hearing, we learned this back with HIV, and we learned that with HIV. We don't have a vaccine yet, but we learned so much, and it's paid off with COVID.
Ad26 was honed [in HIV research], as was the chimpanzee adenovirus approach that led to the Oxford/AstraZeneca vaccine. It's important to underscore that these vaccine approaches took years and years to develop, not a matter of months.
The book ends with BioNTech's Ugur Sahin saying that the work has just begun. What do you see as some of the most promising applications coming out of the COVID-19 work?
Zuckerman: I'm a journalist, I'm inherently a skeptic. I have seen biotech and other companies be over-optimistic too frequently. I know that, historically, there's a reason why there's such frustration with mRNA. My book is all about the success of mRNA, among other vaccine approaches, but I'm also keenly aware that at one point Moderna was called Moderna Therapeutics, and they had to shift from therapeutics. Broadly, I think one needs to be somewhat cautious about having optimism about some of the diseases and illnesses they're looking at.
That all said, BioNTech and Moderna have made so much money from these vaccines. They're going to take all that cash and plow it into cancer and immune-mediated conditions like multiple sclerosis and lupus.
You can't count these people out, Ugur Sahin and Stéphane Bancel and their teams. I know how hard they're all working and how [they] don't see COVID-19 as the end, but the beginning. It gives one encouragement that they will figure things out. They have the resources now, and they have the will.
For Moderna it was always about dominating the mRNA space broadly and developing lots of applications. Ugur Sahin's a cancer guy so this is one step in a long journey. His whole goal in life has been to tackle cancer.
So you could potentially see that this past year or two, as awful as it's been, may be a net positive for society, if it allows us to make real headway on things like cancer and multiple sclerosis and lupus and malaria. It is fascinating to envision that this has been just the first chapter of other breakthroughs.