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Speaker 1: From Blueberg News and iHeartRadio. It's the big take. I'm

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Speaker 1: Weskosova today a flu shot that might actually work thanks

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Speaker 1: to COVID. Hey remember to get your flu shot. You

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Speaker 1: hear that every year at the start of flu season,

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Speaker 1: and every year you might say to yourself, does it

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Speaker 1: even do anything? Is the flu shot outdated?

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Speaker 2: With this year's vaccine only protecting one in four people,

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Speaker 2: It's six to.

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Speaker 3: Eight month log time.

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Speaker 1: It's kind of like predicting the weather.

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Speaker 4: You tell people go buy a bunch of a bunch

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Speaker 4: of snow coats, and if it rains, you're in trouble.

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Speaker 1: Okay.

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Speaker 2: So the solution is what Hopkins Sciences make a better

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Speaker 2: flu shot. So if I want to avoid catching the flu,

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Speaker 2: should I take a flu shot?

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Speaker 3: Yes?

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Speaker 2: Influenza vaccination clearly protects you. It isn't a perfect vaccine.

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Speaker 2: It doesn't protect you one hundred percent, and it varies

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Speaker 2: from year to year. But the best way to avoid

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Speaker 2: influenza is to get your flu shot every year.

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Speaker 1: That hit or miss flu shot may soon be a

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Speaker 1: thing of the past. Bloomberg biotech reporter Angelica Peebles is

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Speaker 1: covering a huge push to fight flu with the same

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Speaker 1: advanced technology behind the COVID nineteen vaccine.

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Speaker 3: We've all been.

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Speaker 5: Thinking about COVID so much these past few years, but

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Speaker 5: flu is still very much a problem, and this year

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Speaker 5: we saw it come back in a big way here

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Speaker 5: in the US. I was looking at the data this

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Speaker 5: morning from the Centers for Disease Control and Prevention, and

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Speaker 5: they estimate there were twenty six to fifty million flu

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Speaker 5: cases this year alone, which of course is not great

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Speaker 5: if you're one of those people, if you're a parent

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Speaker 5: who's dealing with this. And so even though we've forgotten

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Speaker 5: about flu a little bit, it's still very much a

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Speaker 5: problem here in the US as well as around the world.

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Speaker 1: How many people actually get flu each.

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Speaker 5: Year it can vary depending on the severity. This year,

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Speaker 5: even though it came early, it was considered a pretty

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Speaker 5: normal flu year. But again, about fifty million people in

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Speaker 5: the US alone, and it can kill hundreds of thousands

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Speaker 5: of people every year. The World Health Organization estimates that

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Speaker 5: it can be about six hundred and fifty thousand people

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Speaker 5: a year die from flu.

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Speaker 1: And yet every year the flu shot comes out, a

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Speaker 1: lot of people ignore it. Sometimes you can find out

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Speaker 1: doesn't really work that well.

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Speaker 5: The flu shot is our best defense against the flu,

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Speaker 5: but unfortunately it's still not that great. This year was

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Speaker 5: a pretty good year, and it cut the risk of

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Speaker 5: hospitalizations by about half, but in some years it only

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Speaker 5: decreases your risk of getting infected with the flu by

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Speaker 5: about ten percent, and so that variability is a huge

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Speaker 5: problem that we face every year, and that unfortunately also

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Speaker 5: causes people to not want to get the flu shot.

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Speaker 3: So in the US, only about half.

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Speaker 5: Of people who are eligible get a flu shot every year,

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Speaker 5: and that's something that public health officials are fighting every year.

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Speaker 5: There's always this big push to get vaccinated, but people

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Speaker 5: have this idea that it's just the flu, and that

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Speaker 5: the flu shot isn't that great, So why should I

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Speaker 5: bother getting it?

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Speaker 1: Why isn't the flu shot that great?

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Speaker 5: There are a number of reasons why our flu shot

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Speaker 5: isn't as good as it could be. And one of

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Speaker 5: the problems is that we're using this method that's from

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Speaker 5: the nineteen thirties, and we make the flu. We grow

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Speaker 5: the virus in chicken eggs, and so it's exactly how

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Speaker 5: it sounds. You have these fertilized chicken eggs, we inject

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Speaker 5: them with the virus and it replicates in there, and

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Speaker 5: then eventually we take that and activate it and put

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Speaker 5: it in a flu shot. And the problem is that

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Speaker 5: while it's growing in the egg, the virus can adapt

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Speaker 5: to its egg environment. So, as one scientist told me,

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Speaker 5: if we were vaccinating chicken eggs, it would be perfect,

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Speaker 5: but we're vaccinating humans, and that's why it's a problem.

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Speaker 5: So the virus that we're vaccinating against can be a

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Speaker 5: little bit different than what's circulating, and that's a problem.

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Speaker 5: And also because it takes so long, it takes about

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Speaker 5: six months to make the vaccines using this method, that

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Speaker 5: we have to make the predictions so far in advance.

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Speaker 5: And the problem there is that flu isn't just the flu,

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Speaker 5: even though we think of it.

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Speaker 3: As one virus.

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Speaker 5: It's really all kinds of viruses in the same family,

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Speaker 5: and we never really know what we're going to get,

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Speaker 5: and so the World Health Organization and public health officials

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Speaker 5: around the world have to make predictions, usually six months

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Speaker 5: at least in advance of when the flu season actually starts.

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Speaker 5: And so they're making these predictions so far out about

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Speaker 5: what actually circulates, and sometimes they're wrong. Sometimes even their

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Speaker 5: best guesses miss the mark. So that the vaccine that

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Speaker 5: we're getting doesn't match what is actually circulating, and so

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Speaker 5: we're constantly behind the virus and trying to keep up

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Speaker 5: with it, and we usually aren't that great.

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Speaker 1: And what is it that the scientists have to guess?

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Speaker 5: Think of it a little bit like the covid variants, Right,

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Speaker 5: we had this one, you know, covid that we thought

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Speaker 5: of and now it's been changing. It's omicron ba one

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Speaker 5: BA four five, and so similarly, flu is changing just

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Speaker 5: ever so slightly, and they have to guess exactly which

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Speaker 5: strains will be circulating. And it's not at all a

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Speaker 5: guarantee because the viruses, as one scientist told me, the

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Speaker 5: viruses are smarter than we are.

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Speaker 1: How many eggs do they use in a flu season

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Speaker 1: to make all those doses?

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Speaker 5: We are currently making about five hundred million vaccines flu

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Speaker 5: vaccines every year, and so you're thinking about hundreds of

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Speaker 5: millions of eggs every single year to make enough flu

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Speaker 5: shots to vaccinate the world. We've asked specifically this year

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Speaker 5: about bird flu and whether that's been a problem for

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Speaker 5: the vaccine manufacturers, and what they've told us is that

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Speaker 5: these are completely separate eggs that are under different sorts

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Speaker 5: of protection and in theory immune from the problems that

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Speaker 5: we're seeing at the grocery store and that you're dealing

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Speaker 5: with when you try to buy eggs.

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Speaker 1: So to fix this problem that you describe, we now

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Speaker 1: have scientists taking a look at the mRNA technology behind

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Speaker 1: the COVID shots to use that for a flu vaccine.

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Speaker 5: Flu could be a big opportunity for mRNA, And the

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Speaker 5: idea is that mRNA proved itself so well against COVID

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Speaker 5: that flu could be the next big opportunity here. And

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Speaker 5: so Pfizer and Maderna, of course, the two COVID titans,

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Speaker 5: if you will, they are the leaders in this space

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Speaker 5: right now. They're both testing their mRNA flu shots in

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Speaker 5: late stage studies, so they should have data from their

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Speaker 5: shots as soon as this year, possibly in the next

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Speaker 5: few weeks, if not later this year.

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Speaker 3: And they're not the only ones.

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Speaker 5: The big flu shot manufacturers that are currently dominating the space,

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Speaker 5: they're also getting in this and I think that just

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Speaker 5: speaks to the excitement about mRNA as a possibility for

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Speaker 5: flu shots.

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Speaker 1: Angelicoat why is mRNA better for a vaccine than the

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Speaker 1: traditional flu vaccine We're all used.

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Speaker 5: To the thing that came up over and over in

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Speaker 5: the course of my reporting was just how much faster

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Speaker 5: mRNA technology is to make. And that is what people

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Speaker 5: see as the biggest game changer here, because right now

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Speaker 5: we're making our predictions for what will be circulating so

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Speaker 5: far in advance that we're constantly behind the virus. And

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Speaker 5: in theory, the mRNA technology could have the time between

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Speaker 5: making the prediction and actually vaccinating people, and so that

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Speaker 5: is what people are so excited about. And the reason

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Speaker 5: that it's so much faster is because right now, with

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Speaker 5: the chicken eggs, you have to grow so much virus

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Speaker 5: in these chicken eggs, and with mRNA, you don't need that.

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Speaker 5: So the way it works is that your taking a

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Speaker 5: virus that you've grown and injecting it into people and

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Speaker 5: showing your immune system this whole virus. And with mRNA,

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Speaker 5: you can teach the body to make a particular protein,

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Speaker 5: such as the spike protein and the novel coronavirus, and

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Speaker 5: if you do that, you can then get the immune

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Speaker 5: system to build a tailor made defense against a threat,

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Speaker 5: and that eliminates the need to build this virus and

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Speaker 5: you're just making it. You're using your body as a

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Speaker 5: vaccine manufacturing facility.

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Speaker 1: So how do you make an mRNA vaccine? You don't

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Speaker 1: need the chicken eggs, but they have to produce it.

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Speaker 1: How is it produced?

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Speaker 5: It's a really fascinating process and honestly one that you

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Speaker 5: need to use your imagination for. So I went to

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Speaker 5: one of Pfizer's manufacturing facilities outside of Boston, and what

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Speaker 5: struck me is that you go to this huge campus

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Speaker 5: and the rooms where they're making the mRNA are just

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Speaker 5: two little rooms.

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Speaker 3: Think of going to a brewery.

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Speaker 5: And I was actually at a brewery this past weekend

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Speaker 5: and it was bigger than what it took to make

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Speaker 5: all of this mRNA. So they only have a few tanks,

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Speaker 5: and inside the tanks they're growing all of the all

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Speaker 5: of these things called plasmids, which is basically a DNA template,

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Speaker 5: and they're growing so much material in these little containers

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Speaker 5: and a single one and ten liter batch produces enough

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Speaker 5: for twenty two million doses of a vaccine.

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Speaker 4: Yeah, so what you're looking at is our DNA production

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Speaker 4: facility as part of the COVID mRNA based vaccine. You

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Speaker 4: see a number of my folks in there. This is

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Speaker 4: probably one of the better windows we'll see on our

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Speaker 4: tour the next windows quite a bit smaller, But as

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Speaker 4: Jim said, the DNA is really the start of this process.

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Speaker 5: You walk in and you see these metal tanks like

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Speaker 5: the ones that you'd find in a brewery, and inside

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Speaker 5: those tanks they're growing tens of billions of bacteria to

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Speaker 5: help make the material for the mRNA.

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Speaker 4: So we've got really good industrial controls. We control things

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Speaker 4: like pressure, temperature, flow rates. So if you can't really

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Speaker 4: see if we have a two thousand liters per manner,

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Speaker 4: you can see some piping with some yellow labeling. These

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Speaker 4: come down and actually feed our for manter it penetrates

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Speaker 4: through the floor that you can see up in the

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Speaker 4: upper back.

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Speaker 5: So all of this is happening in these small little rooms,

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Speaker 5: and it's happening at such microscopic levels that you look

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Speaker 5: inside the rooms and you can't even see what's happening,

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Speaker 5: as opposed to going to say a chicken egg manufacturing facility,

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Speaker 5: where you would see palettes of eggs everywhere.

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Speaker 1: So using this method, they're able to make all the

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Speaker 1: various potential flu strains that might pop up in a

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Speaker 1: given year and more quickly kind of put them all

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Speaker 1: together into a single vaccine.

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Speaker 5: The way it works is that they make one strain

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Speaker 5: at a time. So, for example, when I was there

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Speaker 5: and they were walking me through the way that they've

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Speaker 5: been making their most recent boosters that contain two strains,

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Speaker 5: they make one strain at a time, They make tons

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Speaker 5: and tons of that, and then they do the next

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Speaker 5: strain and that's for cross contaminating purposes. But in theory,

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Speaker 5: with the flu shot, which typically contains four strains, they

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Speaker 5: would make one strain at a time and then you

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Speaker 5: put them all together.

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Speaker 1: And are they more effective? Do we know whether they

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Speaker 1: actually work better than the traditional flu vaccine.

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Speaker 5: We don't know yet, and that's what these big trials

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Speaker 5: are for. So Pfizer and Maderna both are testing their

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Speaker 5: mRNA flu shots in tens of thousands of people, and

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Speaker 5: we will know as soon as this month what it

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Speaker 5: will look like and whether these can truly live up

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Speaker 5: to the promise that we've all been so excited about.

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Speaker 1: And Angelica, beyond the flu vaccine itself, you write that

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Speaker 1: what these pharmaceutical companies are hoping is that they can

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Speaker 1: then bundle this mRNA flu vaccine with vaccinations for other

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Speaker 1: diseases too.

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Speaker 5: The big thing that these companies are so excited about

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Speaker 5: right now is the possibility of combining covid and flu

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Speaker 5: into one shot, because if you think about it, it's

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Speaker 5: a lot easier for people because who likes two needles?

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Speaker 5: Not that many people, so then you get it all

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Speaker 5: in one shot. And of course, if you're a COVID

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Speaker 5: vaccine maker and you're watching your sales decline precipitously, you

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Speaker 5: see flu as an opportunity to bring those sales back up.

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Speaker 5: So there's a business case here, but there's also, of

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Speaker 5: course the public health side of things that, especially as

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Speaker 5: people have lost interest in the COVID vaccines, if you

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Speaker 5: have them coming in for flu, you could then use

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Speaker 5: it as a way to get them to get the

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Speaker 5: latest covid booster. One other thing that Maderna wants to

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Speaker 5: combine with is RSV, the respiratory virus that so many

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Speaker 5: people heard about this past winter with tons and tons

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Speaker 5: of kids getting infected with it, and so Maderna recently

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Speaker 5: had positive phase through trial data for its RSV vaccine,

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Speaker 5: and assuming that flu is also positive, they could then

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Speaker 5: look to combine covid FLEW an RSB into one shot.

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Speaker 1: ANGELICAC remind us what is a phase three trial.

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Speaker 5: Phase through trial is typically the last test that a

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Speaker 5: company needs to succeed before it can seek approval from

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Speaker 5: the FDA for a new drug, and so a phase

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Speaker 5: three trial looks at both efficacy and safety for a

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Speaker 5: new drug.

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Speaker 1: So that means that these tests are getting close now

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Speaker 1: to the point where they'll be able to submit them

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Speaker 1: to the Food and Drug Administration for evaluation.

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Speaker 5: Yes, if these trials are successful, then Maderna and Pfizer

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Speaker 5: are both planning to seek approval for these vaccines.

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Speaker 1: When we come back, will people weary of COVID vaccines

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Speaker 1: and boosters line up for a new, improved flu shot? Angelica?

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Speaker 1: This new flu shot sounds promising, but do you think

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Speaker 1: people will we'll actually get it? We've obviously seen a

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Speaker 1: lot of vaccine skepticism and even many people who've got

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Speaker 1: their first COVID shots are choosing to skip the recommended boosters.

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Speaker 5: People have lost interest in the COVID vaccines for a

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Speaker 5: few reasons, but one of the biggest ones is probably

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Speaker 5: that people are still getting COVID anyway. And it's a

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Speaker 5: question that I ask the vaccine makers all the time.

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Speaker 5: You know, what would you tell people, and of course

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Speaker 5: they say, well, these vaccines are still preventing people from

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Speaker 5: getting really sick and dying, which is the most important thing.

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Speaker 5: But I don't know about you, but I talk to

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Speaker 5: people all the time, my family, my friends, and people

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Speaker 5: say well, I got COVID anyway, So these vaccines don't work,

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Speaker 5: and that's a real challenge that they're going to have

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Speaker 5: to contend with going forward, whether it's COVID or flu

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Speaker 5: if we do see that same problem, and that's partially

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Speaker 5: what's contributing to the fact that only sixteen percent of

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Speaker 5: eligible Americans opted to get the last COVID booster.

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Speaker 1: Aside from COVID, of course the flu and RSV, are

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Speaker 1: there other illnesses that are under consideration for mRNA vaccines.

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Speaker 5: One of the big ones right now that Maderna's exploring

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Speaker 5: is a personalized cancer vaccine. And this is different than

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Speaker 5: what we would think of as a vaccine. It's more

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Speaker 5: of a treatment. But they are still using mRNA technology

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Speaker 5: to enhance the potency or the effect of another cancer drug,

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Speaker 5: key Truda, and that one is really exciting right now,

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Speaker 5: and we're expecting to see more data from Maderna and

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Speaker 5: they're saying that they are ready planning to test mRNA

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Speaker 5: and all kinds of other types of cancer based on

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Speaker 5: that data.

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Speaker 1: What are these new vaccines going to cost? Are they

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Speaker 1: going to be much cheaper because they're easier to make.

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Speaker 5: The current flu vaccines cost about thirty dollars, and although

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Speaker 5: the mRNA vaccines are easier to make, it's conceivable that

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Speaker 5: they will be more expensive. So even the current flu

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Speaker 5: shot makers, when they've developed newer, more potent doses typically

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Speaker 5: use for older people, they've been more expensive. So the

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Speaker 5: high dose vaccines that are currently on the market are

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Speaker 5: about eighty five dollars, and the COVID shots Pfizer and

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Speaker 5: Maderna have both talked about pricing them at up to

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Speaker 5: one hundred and thirty dollars a shot, so you can

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Speaker 5: imagine that the flu shots would be, if not one

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Speaker 5: hundred and thirty dollars, let's say even one hundred dollars.

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Speaker 5: Of course, the companies don't talk about price until something

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Speaker 5: is on the market. That's true of all pharma companies.

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Speaker 5: They don't like to give the price until they absolutely

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Speaker 5: have to. But if you just look at where the

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Speaker 5: higher potency shots are today and their COVID vaccines. I

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Speaker 5: would think it's fair to say that these are going

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Speaker 5: to be more expensive than the typical flu shots that

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Speaker 5: most of us are getting.

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Speaker 1: And why do you think that they're going to be

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Speaker 1: more expensive? What's the rationale.

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Speaker 3: Behind that rationale?

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Speaker 5: Is that if they're more effective, then you can charge more.

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Speaker 5: And it's this kind of an interesting dynamic that you

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Speaker 5: see in every new drug product that comes to market.

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Speaker 5: But we see companies give these calculations of, well, our

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Speaker 5: vaccine is this effective and therefore will prevent this number

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Speaker 5: of people from going in the hospital, and therefore will

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Speaker 5: save the healthcare system this much money.

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Speaker 3: And so it's a lot more complicated.

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Speaker 5: Than just saying it cost us x amount to make

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Speaker 5: and therefore it will charge x price.

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Speaker 3: It's this whole.

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Speaker 5: System of this is how effective it is, and this

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Speaker 5: is how valuable it is to society, and we're going

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Speaker 5: to base our price off of it.

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Speaker 1: During COVID, of course, the government stepped in and subsidized

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Speaker 1: the price of the vaccine so people could get it

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Speaker 1: for free. Do you think that there's going to be

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Speaker 1: pressure not to charge a lot for a flu vaccine

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Speaker 1: that people need to get every.

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Speaker 5: Year based on what we've seen recently. I don't know

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Speaker 5: that the pressure will extend to the flu vaccines because

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Speaker 5: even Maderna, when the CEOs to Fan Bonzel testified before

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Speaker 5: the Senate panel a few weeks ago, he managed to

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Speaker 5: brush off a lot of the heat and made his

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Speaker 5: case that look, we are charging what is fair based

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Speaker 5: on the value that our vaccines are providing, and as

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Speaker 5: long as they can make the case that these vaccines

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Speaker 5: are truly better and help keep people out of the

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Speaker 5: hospital and save money, they're going to charge what they

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Speaker 5: think they can. But that's the big question here is

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Speaker 5: that in theory, these vaccines could be better, they could

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Speaker 5: be more efficacious, but they need to prove it. And

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Speaker 5: that's something that when I talk to analysts who are

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Speaker 5: making these predictions on how much money flu shots can make.

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Speaker 5: That's a big point of controversy, is whether they can

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Speaker 5: be better and whether they can prove that they are

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Speaker 5: worth the cost, because of course, with COVID there's nothing

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Speaker 5: else to compare them to. There are other shots that

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Speaker 5: have been approved but haven't been used that widely, and

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Speaker 5: so they dominate that market. But now they have to

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Speaker 5: come in and prove that it's worth paying more money,

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Speaker 5: especially for twenty year olds or thirty year olds for everyone,

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Speaker 5: and those higher potency shots that do cost more today,

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Speaker 5: those are typically used for the older populations, so people

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Speaker 5: who are at risk, and it's easier to make that

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Speaker 5: case now. To make the case that all of these

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Speaker 5: mRNA shots for everyone should be more expensive, they're going

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Speaker 5: to need to prove it with the data.

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Speaker 1: I suppose. Another thing that comes into play, are just

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Speaker 1: insurance companies. Are they going to be willing to bear

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Speaker 1: the extra cost or does it mean that we're all

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Speaker 1: just going to wind up observing that cost because they're

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Speaker 1: going to pass it down to us.

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Speaker 3: Yeah.

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Speaker 5: When I talk to Stefan Bonseel, the Maderna CEO, he

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Speaker 5: says that people are really interested in a better flu

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Speaker 5: shot because of the cost. Right now, that if you're

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Speaker 5: an insurer and you have tons of people going into

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Speaker 5: the hospital every year because of flu, than they are

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Speaker 5: paying all this money for the hospitalization and everything that

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Speaker 5: goes along with it, and that if you can give

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Speaker 5: them a better vaccine, then you can save all these costs.

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Speaker 5: But again, they need to prove that, and right now

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Speaker 5: it's theoretical and the only thing that's going to help

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Speaker 5: answer that is what these studies show.

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Speaker 1: After the break. How long until this better flu shot

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Speaker 1: is ready to go? Suppose the phase three trials of

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Speaker 1: these vaccines that we've been talking about go well, the

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Speaker 1: FDA evaluates it, they approve these new vaccines. How long

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Speaker 1: until we actually start seeing them where we can use them.

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Speaker 3: It could be as soon as next year.

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Speaker 5: We need to see how soon the trial data come out,

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Speaker 5: and once we have that, we'll have a better idea.

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Speaker 5: But Maderna and Pfizer, assuming they have positive results from

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Speaker 5: their studies this year, it's likely that we could see

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Speaker 5: these shots as soon as twenty twenty four.

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Speaker 1: As you said earlier, a lot of people are just

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Speaker 1: not taking the COVID vaccine anymore, a lot of people

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Speaker 1: don't get the flu vaccine. And then we've had a

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Speaker 1: lot of politics surrounding vaccines where people made all kinds

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Speaker 1: of false claims they were dangerous, or there was a

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Speaker 1: government plot. We've heard all sorts of things like that.

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Speaker 1: Do you think that this could help or possibly hurt

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Speaker 1: with the public's perception of vaccines.

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Speaker 5: It's interesting I spoke to a number of people while

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Speaker 5: I was reporting this story, vaccine scientists, people who've been

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Speaker 5: in this field for a long time, and they all

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Speaker 5: say that in some ways it's counterintuitive, but the pandemic

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Speaker 5: actually hurt perception of vaccines and it hurt the public's

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Speaker 5: willingness for immunization. And even though at the beginning, when

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Speaker 5: the shots were rolled out and this data came out

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Speaker 5: that was so amazing and people were standing in line

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Speaker 5: for hours to get vaccinated, that that enthusiasm has been.

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Speaker 3: Replaced by skepticism.

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Speaker 5: And it's unfortunate because people don't know what to do

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Speaker 5: from here, because people aren't sure how we're going to

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Speaker 5: stem that tide. And one person I spoke to, one scientist,

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Speaker 5: she was saying that you could create a perfect flu

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Speaker 5: shot or a vaccine for anything, really that was one

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Speaker 5: hundred percent perfect, but there would still be people who

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Speaker 5: wouldn't take it. And it's going to take some work

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Speaker 5: to figure out how to combat that and to get

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Speaker 5: people excited about vaccination again.

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Speaker 1: And Jockay, you are covering mRNA technology pretty closely. Where

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Speaker 1: do you think it heads from here?

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Speaker 5: When it comes to vaccines, many people will tell you

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Speaker 5: that vaccines are just the beginning for mRNA, that it's

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Speaker 5: sort of the low hanging fruit, and even Maderna. If

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Speaker 5: you look at their pipeline, they have programs not just vaccines,

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Speaker 5: but treating disease with mRNA, and so there's a lot

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Speaker 5: more outside of vaccines, but even within immunizations. Like I said,

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Speaker 5: we have cancer vaccines that are in development and other

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Speaker 5: ways to use mRNA. And so, although the pandemic really

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Speaker 5: opened people's eyes and introduced people to this field, there's

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Speaker 5: still so much more that we can do.

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Speaker 1: And jelicap Peebles, thanks for coming on the show. Thank you,

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Speaker 1: thanks for listening to us here at The Big Take.

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Speaker 1: with another big take down down Don Don Peple Barter