José María Ordovás: "We have let our guard down at a time when the covid attack continued"
August 28, 2020
The vaccine that will be tested in Spain could be approved at the end of 2021
August 31, 2020
The scientific director of the Moderna company responds about its experimental vaccine against covid, which has just shown promising results in older people
Your vaccine would require two doses.
Yes, we believe that a second dose clearly stimulates the immune response. If you can, you want to give it a push. Could one dose be enough? Can. We decided to try two doses because, given the severity of this pandemic, we do not want to take risks. I don't want to make something that's only half as good. I want to offer the greatest protection possible. And this is achieved with a second dose.
¿What are the implications of needing two doses? If with one dose it is already a great challenge to vaccinate almost the entire world population, two doses is something unprecedented.
It is true that, from an operational point of view, it is more complicated. And it is true that it will require more resources. But do we want a vaccine that is very effective or a vaccine that is effective? I want to offer the best vaccine possible. And I think the situation with Covid justifies the logistical challenge of giving people two doses. If it takes two shots to get rid of this pandemic, we will find a way to give two shots.
What can go wrong during the current phase 3 trial [the final test, with 30.000 people]?
What worries me most is that not enough people will become infected and have the disease during the trial. It is great for society that the [epidemiological] situation is under control and the virus disappears, but the ability of phase 3 to demonstrate the effectiveness of the vaccine depends on having more cases in the control group, whose members receive a placebo, than in the group of vaccinated people. If there are no cases, we will not know if the vaccine is effective.
“If there are no infections, we will not know if the vaccine is effective”
What are the risks of starting to vaccinate people too soon? It seems that Donald Trump would want to start vaccinating before the presidential election on November 3.
I'm not going to talk about politics [laughs]. I think it is important, for us and for society, to have a good understanding of the safety profile and adverse events before starting to vaccinate. We are doing a large clinical trial, with a control group that receives a placebo. If we see safety-related events, we will know if they occur with the same frequency in the placebo group and in the vaccinated group. If we start giving the vaccine to people, we must know that no vaccine is 100% effective. Some people will get sick despite my vaccine. How do I know these people haven't gotten worse from my vaccine? People may start saying, “Oh my God, I got your vaccine and I'm sick. Your vaccine has made me sick.” This is not scientific, but we need data to explain it. As trial sponsors, we want to ensure that we have data confirming the efficacy and safety of this vaccine before starting the vaccination campaign.
There is a logical rush to have vaccines.
I think there is a legitimate public debate about when you have enough information to justify the risk. Even if we wait until the end of the year or the beginning of 2021 to have more information about the trials, we will still have limited data and we will still not know what we don't know. There may be long-term adverse events. At what point is the risk of people continuing to die even though they could be vaccinated justified? It's a very difficult debate about risk and benefit. The more data we have, the better: at the government level, because in the end the Government of each country will have to decide if it compensates the risk/benefit, but not only at the government level. It is also an individual choice. I don't think anyone is going to impose mandatory vaccines. Each person, to want to be vaccinated, will have to be reassured that the vaccine is sufficiently safe and probably effective. So it's important to have this data, so people can make an informed decision for themselves. And so that governments can make informed decisions for their citizens.
“No vaccine is 100% effective. “Some people will get sick despite my vaccine”
The British pharmaceutical company AstraZeneca has assured that it will produce the Oxford University vaccine at cost price. Why will the Moderna vaccine be more expensive than other vaccines?
I think, to be fair, the price has to reflect the value of this vaccine to some extent. I think that the price we ask, with the value it has, is more than reasonable compared to the investment we have made. The price is less than that of a diagnostic test. And, every time you are sick, you need to take a diagnostic test. With a vaccine, you should be protected for a long time. So if we think about the value to society... Maybe other companies can offer their vaccines for free: it's their choice and maybe they can afford it. But I don't think we should be expected to be able to do this. And honestly, I don't think that's fair, given the investment that has made this vaccine possible.
How long will immunity last?
People often ask me how long the protection will last. And the answer is: I don't know, but obviously the higher the amount of antibodies [generated by the vaccine] you start with, the more likely it is to work and the more likely it is to last. We must reach at least levels similar to those of people who have overcome the disease, but if we can reach higher levels, we hope it will be better. We choose higher doses of vaccine because we think our platform allows us to do so in a safe and tolerable manner.
You and other Moderna executives have sold millions of dollars worth of shares in your company in recent months. Why have you sold shares, assuming that the vaccine works and you would earn more by selling later?
It is very simple. I answer the same thing I answered to my wife: I can't sell stocks based on whether the vaccine works or doesn't work. That is illegal, it is privileged information. I can only sell shares if I prepare a predetermined sale plan before knowing anything [conditions are set for automatic sale if the share price reaches a certain level]. When I prepared my plan we had not yet injected anyone with the vaccine. I did not know anything. What I knew is that I've been working with the company for five years, I had a little bit of money [accumulated in stocks] and I needed to diversify what I had. Looking back, I don't know if I was stupid, but I can't change it.
