WEBVTT - Getting the Public to Trust a Vaccine 0:00:03.760 --> 0:00:09.120 Welcome to Prognosis. I'm Laura Carlson. It's day one eighty 0:00:09.200 --> 0:00:14.680 two since coronavirus was declared a global pandemic. Today's main story. 0:00:15.920 --> 0:00:19.680 Health agencies and drug companies are taking steps to reassure 0:00:19.720 --> 0:00:24.200 the public that they're developing a vaccine safely and not 0:00:24.320 --> 0:00:28.320 being guided by political pressure. They might have to do 0:00:28.480 --> 0:00:32.120 a lot for the public to trust an eventual vaccine, 0:00:33.680 --> 0:00:48.800 but first, here's what happened in virus news today. India's 0:00:48.840 --> 0:00:54.400 coronavirus fatalities are creeping up. The country recently surpassed Brazil 0:00:54.560 --> 0:00:59.760 to have the world's second highest number of cases. India 0:00:59.840 --> 0:01:03.400 has reported more than one thousand deaths from COVID nineteen 0:01:03.760 --> 0:01:09.080 for eight consecutive days. That's higher than the daily death 0:01:09.120 --> 0:01:13.840 toll in other hard hit nations like the US, Brazil, Russia, 0:01:14.000 --> 0:01:20.080 and Mexico, with almost seventy four thousand virus related deaths. 0:01:20.600 --> 0:01:25.160 India has the world's third most people killed by the virus. 0:01:26.760 --> 0:01:31.440 In at least one US city, Halloween festivities are canceled. 0:01:32.600 --> 0:01:36.600 Los Angeles is not allowing door to door trigger treating 0:01:37.040 --> 0:01:40.679 as well as other traditional Halloween gatherings this year to 0:01:40.840 --> 0:01:44.480 curb the spread of the virus. That's according to the 0:01:44.480 --> 0:01:50.240 city's Department of Public Health. So called trunk or treating 0:01:50.280 --> 0:01:53.240 events where children go from car to car to receive 0:01:53.320 --> 0:01:57.440 treats have also been banned, as have gatherings with non 0:01:57.520 --> 0:02:02.800 household members, even those out doors. Finally, one of the 0:02:02.840 --> 0:02:08.600 most promising coronavirus vaccines has stumbled, delivering a reality check 0:02:08.639 --> 0:02:13.120 about the odds of developing a drug quickly. Astra Zeneca 0:02:13.440 --> 0:02:18.160 paused tests of its experimental shot after one patient became ill. 0:02:19.360 --> 0:02:22.959 Doing so is routine in the farming industry. The patient's 0:02:23.000 --> 0:02:27.160 illness could be a harbinger of something worrisome or something 0:02:27.440 --> 0:02:32.680 entirely unrelated to the vaccine, But in a world crippled 0:02:32.720 --> 0:02:36.400 by the pandemic, the setback comes as a reminder that 0:02:36.520 --> 0:02:41.120 vaccines can fail, or worse, that they can sometimes deliver 0:02:41.520 --> 0:02:46.640 more harm than good, a disclaimer for politicians and governments 0:02:46.880 --> 0:02:50.760 promising that a COVID nineteen fix is around the corner, 0:02:57.400 --> 0:03:01.520 and that brings us to today's main story. Rate. An 0:03:01.639 --> 0:03:05.800 unsubstantiated claim two weeks ago by President Donald Trump that 0:03:05.919 --> 0:03:09.320 the Deep State was slowing approval of a COVID nineteen 0:03:09.400 --> 0:03:13.560 vaccine has set off an effort by government officials and 0:03:13.720 --> 0:03:18.160 private industry to ensure the White House doesn't interfere with 0:03:18.240 --> 0:03:24.560 a methodical, careful scientific process. Leaders of the U s. 0:03:24.560 --> 0:03:28.160 Food and Drug Administration are trying to insulate the agency's 0:03:28.280 --> 0:03:33.720 vaccine reviewers from outside political pressure. They're also making clear 0:03:33.760 --> 0:03:37.320 to f d A staff that the political noise shouldn't 0:03:37.400 --> 0:03:42.720 influence the agency's decisions. F d A Commissioner Stephen Hahn 0:03:42.840 --> 0:03:46.960 last week sent an email to all seventeen thousand staff 0:03:47.000 --> 0:03:51.120 members promising that the agency would adhere to strictly the 0:03:51.320 --> 0:03:56.120 science in a vaccine review. I talked to Bloomberg senior 0:03:56.200 --> 0:04:00.280 editor for Healthcare Drew Armstrong about why measures like these 0:04:00.320 --> 0:04:04.480 are necessary and what agencies and companies are trying to 0:04:04.520 --> 0:04:09.280 do to make sure the public can trust an eventual vaccine. 0:04:16.400 --> 0:04:20.640 What are pharmaceutical companies like Astra Zenica doing to try 0:04:20.680 --> 0:04:24.960 and quell fears that a vaccine might be rushed or unsafe. 0:04:26.320 --> 0:04:30.000 We're in such an interesting time right now for the 0:04:30.040 --> 0:04:35.800 development of these vaccines because you have these two forces 0:04:35.800 --> 0:04:41.200 pushing on exact opposite sides, and it's created a really 0:04:41.240 --> 0:04:45.719 interesting tension for both the companies developing these vaccines. The 0:04:45.960 --> 0:04:50.119 government's overseeing them and pretty much all of science. Because 0:04:50.960 --> 0:04:53.359 on one hand, you have this desire for there to 0:04:53.400 --> 0:04:58.200 be incredibly robust safety and efficacy data, the type of 0:04:58.240 --> 0:05:00.000 thing that you want on any vaccine, because you're giving 0:05:00.000 --> 0:05:01.680 a healthy people and you want to know that it 0:05:01.760 --> 0:05:05.440 works and that it's not going to create any harm. 0:05:05.520 --> 0:05:07.680 And then on the other hand, you have in the 0:05:07.760 --> 0:05:11.479 United States close to a thousand people dying a day 0:05:11.520 --> 0:05:15.479 of this disease, which is a real counterweight. And so 0:05:15.560 --> 0:05:18.560 you have these dual desires pushing against each other, and 0:05:18.600 --> 0:05:23.480 the development of these vaccines is stuck right in the middle. Um. 0:05:23.520 --> 0:05:26.600 So one of the things that we have seen uh 0:05:26.839 --> 0:05:29.719 to try and reassure the public that these will be 0:05:29.880 --> 0:05:33.400 safe and that they will be effective, is a pledge 0:05:33.560 --> 0:05:36.960 from vaccine makers that are engaged with the US government 0:05:37.000 --> 0:05:40.640 that they will not submit anything to the US until 0:05:40.680 --> 0:05:44.279 they have robust safety and efficacy data. Now that is 0:05:44.560 --> 0:05:48.000 would in normal times be a very very bland statement, 0:05:48.320 --> 0:05:51.560 but put up against some of the public statements from 0:05:51.600 --> 0:05:55.120 the President um where he has accused parts of the 0:05:55.160 --> 0:05:58.200 FDA of being the deep state to slow him down 0:05:58.760 --> 0:06:02.880 or giving optic, mystic timelines about a vaccine being ready 0:06:02.920 --> 0:06:06.480 before election day, which obviously has pretty serious political implications. 0:06:06.880 --> 0:06:10.360 It has seemed to be a necessary step by by 0:06:10.440 --> 0:06:14.000 the industry to kind of protect health regulators inside the 0:06:14.080 --> 0:06:18.120 US government from some of those pressures. And I definitely 0:06:18.120 --> 0:06:21.120 want to talk about the political pressures and certainly the 0:06:21.200 --> 0:06:23.880 role of the f d A, but let's stay on this, 0:06:23.880 --> 0:06:27.279 this development that's happened with astra zenica in the course 0:06:27.279 --> 0:06:31.240 of you know, a usual vaccine study, UM a participant 0:06:31.279 --> 0:06:34.520 falling ill. Is this an unusual step in the process 0:06:34.520 --> 0:06:38.040 at all. It's not. And I think to understand this 0:06:38.080 --> 0:06:40.440 a little bit better, you have to know how these 0:06:40.480 --> 0:06:43.599 things get handled. Anytime you have a large trial of 0:06:43.640 --> 0:06:46.680 a drug, you have a group of scientists who are 0:06:46.720 --> 0:06:50.279 helping oversee what's happening there, called the Data Safety Monitoring Board. 0:06:50.760 --> 0:06:53.400 Their job is to look at anything that happens into 0:06:53.440 --> 0:06:57.400 the trial that might be a worrying side effect or 0:06:57.400 --> 0:07:00.000 adverse events what the industry calls it, and make sure 0:07:00.040 --> 0:07:03.080 it's not related to the vaccine. So any time anyone 0:07:03.120 --> 0:07:05.159 gets sick, whether or not it seems like it's related 0:07:05.240 --> 0:07:06.880 or not, they look at this. If someone is in 0:07:06.920 --> 0:07:10.560 a car accident, um, you know, or it gets god forbid, 0:07:10.600 --> 0:07:13.400 hit by a bus crossing the street, they have a 0:07:13.480 --> 0:07:16.520 heart attack. You have to look at it because, as 0:07:16.720 --> 0:07:18.600 odd as it seems, you want to make sure you 0:07:18.640 --> 0:07:22.080 don't have you know, let's just say hypothetically that that 0:07:22.160 --> 0:07:25.440 the drug or the vaccine didn't cause one of those things. 0:07:25.680 --> 0:07:28.280 A lot of those can be looked at and ruled 0:07:28.320 --> 0:07:30.680 out relatively quickly, but then you get a category of 0:07:30.760 --> 0:07:33.880 things that you might say, you know, hey, we need 0:07:33.920 --> 0:07:37.040 to actually pause and examine this a little bit further. 0:07:37.480 --> 0:07:40.160 Sometimes they will be found not to have any relation 0:07:40.200 --> 0:07:43.400 to the vaccine. It's just bad luck that happens. Anytime 0:07:43.440 --> 0:07:46.200 you have a large trial tens of thousands of people. 0:07:46.560 --> 0:07:48.679 People get sick, and you know that that can happen 0:07:48.720 --> 0:07:51.200 in the course of the trial. Things can happen to people, 0:07:51.520 --> 0:07:53.320 but you have to investigate that and you have to 0:07:53.360 --> 0:07:57.280 make sure that it's not something that is potentially caused 0:07:57.280 --> 0:07:59.880 by the vaccine. That's an important step, and I think 0:08:00.000 --> 0:08:03.320 in general people should probably take confidence that this is 0:08:03.360 --> 0:08:06.840 happening right now. It's certainly might you know, set back 0:08:06.920 --> 0:08:09.520 the timeline or the best possible timeline to see these 0:08:09.560 --> 0:08:11.720 types of things, but it should give people confidence in 0:08:11.720 --> 0:08:14.040 the science, that science is going to be allowed to 0:08:14.080 --> 0:08:17.840 play out. Any adverse events caused by these vaccines are 0:08:18.000 --> 0:08:20.760 going to be looked at, and that they're going to 0:08:20.880 --> 0:08:24.560 do the hard work and the sometimes you know, unfairseeming 0:08:24.600 --> 0:08:27.920 work of trying to find a vaccine that's um that's 0:08:27.960 --> 0:08:32.320 safe and effective. And so let's also take a look 0:08:32.360 --> 0:08:35.320 at the role of the f d A. You know, 0:08:35.400 --> 0:08:38.439 once the pharmaceutical companies have a vaccine that they think 0:08:38.520 --> 0:08:43.280 is safe and effective, what pledges or what stance have 0:08:43.400 --> 0:08:46.880 they taken in terms of guaranteeing that a vaccine that 0:08:46.920 --> 0:08:51.440 they approve is going to be safe and effective. You know, 0:08:51.600 --> 0:08:54.800 the f d A has always had very high standards. 0:08:54.880 --> 0:08:57.920 It's been thought of as the kind of gold standard 0:08:58.040 --> 0:09:01.880 for the world in terms of drawing and healthcare regulation. 0:09:02.440 --> 0:09:05.640 And one of the things that we've seen, UM is 0:09:05.679 --> 0:09:09.280 that the FDA has really had to emphasize to people 0:09:09.400 --> 0:09:12.280 because of some of this noise coming from the President 0:09:12.559 --> 0:09:15.880 UM about vaccine timelines and other things, that you know, 0:09:16.040 --> 0:09:19.240 it's not willing to let things be politicized, that it 0:09:19.360 --> 0:09:21.600 is going to stick to the science, that it will 0:09:21.679 --> 0:09:25.840 do a full and deep review of these vaccine products. 0:09:25.880 --> 0:09:28.280 And that will do so transparently and let the public 0:09:28.360 --> 0:09:32.600 see the data. You've also seen some reports out there 0:09:32.640 --> 0:09:35.960 of top government scientists saying they wouldn't participate in a 0:09:36.080 --> 0:09:39.400 process that they thought the scientifically compromised. You know, the 0:09:39.480 --> 0:09:43.160 FDA is attempting to guard its reputation here quite carefully, 0:09:43.360 --> 0:09:46.800 and that's become harder and harder when you know the 0:09:46.880 --> 0:09:49.880 vaccine has gotten wrapped up in a political environment where 0:09:49.920 --> 0:09:54.679 the president's re election depends quite heavily on the administration's 0:09:54.720 --> 0:09:57.600 response to this virus. So they're doing their best to 0:09:58.080 --> 0:10:02.320 emphasize that independence, try to kind of shield the agency 0:10:02.520 --> 0:10:06.319 from real or perceived pressures. Because the public confidence in 0:10:06.320 --> 0:10:09.840 the agency is um it has its own significant importance, 0:10:10.440 --> 0:10:14.600 along as well as the scientific integrity of the agency. Now, 0:10:14.640 --> 0:10:19.599 looking at this highly politicized landscape of the development and 0:10:19.720 --> 0:10:24.640 approval process of COVID nineteen treatments and therapies, what have 0:10:24.760 --> 0:10:28.640 been some of the say, political tools that have been 0:10:28.760 --> 0:10:34.640 deployed to perhaps either fast track or expedite the availability 0:10:34.679 --> 0:10:39.520 of these UM treatments for for COVID nineteen. Right, So, 0:10:39.760 --> 0:10:41.760 when we think about the tools that have been deployed, 0:10:41.920 --> 0:10:44.560 I would I would emphasize that, you know, they're less 0:10:44.600 --> 0:10:48.959 political tools and more policy tools. Um, the Operation Warp 0:10:49.000 --> 0:10:53.120 Speed program that the Trump administration has set up is 0:10:53.440 --> 0:10:58.680 essentially a way of artificially stimulating demand for a vaccine 0:10:59.240 --> 0:11:03.000 by striking billions of dollars worth of deals with pharmaceutical 0:11:03.040 --> 0:11:04.880 companies to say, we are going to pay for the 0:11:04.920 --> 0:11:07.680 manufacturing these, We're gonna help fund the development they use, 0:11:07.720 --> 0:11:10.600 and to allow them to kind of produce or attempt 0:11:10.720 --> 0:11:15.400 to chase multiple, multiple different vaccine targets all at once. 0:11:15.679 --> 0:11:18.080 That's kind of the strongest policy tool that I think 0:11:18.080 --> 0:11:20.839 we've seen applied here, which is, you know, part of 0:11:20.840 --> 0:11:22.440 the role of government. I mean, you want the government 0:11:22.480 --> 0:11:25.160 to kind of come in and provide incentives and do 0:11:25.240 --> 0:11:29.720 things that private industry might not necessarily do on its own. 0:11:29.800 --> 0:11:33.640 And in this case, it's saying, let's have everybody chase 0:11:33.679 --> 0:11:37.199 after the exact same thing all at once, even if 0:11:37.240 --> 0:11:39.240 we know there's going to be a great deal of failure, 0:11:39.400 --> 0:11:41.440 maybe only one of you is going to win. You 0:11:41.480 --> 0:11:45.600 want to reduce the risk for the pharmaceutical industry, so 0:11:45.640 --> 0:11:48.040 you get lots and lots of chances to do that. 0:11:48.040 --> 0:11:52.800 That's almost certainly the strongest policy option that the government has. 0:11:53.080 --> 0:11:56.640 At the same time, we will also soon need to 0:11:56.679 --> 0:11:59.920 see the government take steps to encourage people to get 0:12:00.040 --> 0:12:03.600 these vaccines. Um. I think that because of the political 0:12:03.679 --> 0:12:07.480 environment we're in where we have a presidential election coming 0:12:07.559 --> 0:12:11.760 up in less than two months, the vaccine itself, the 0:12:11.800 --> 0:12:15.520 development of the vaccine, access to the vaccine, people's willingness 0:12:15.559 --> 0:12:18.679 to take a vaccine, has really been wrapped up in 0:12:18.720 --> 0:12:23.480 the political process, and that presents some not insignificant challenges, 0:12:23.840 --> 0:12:26.479 not just to developing this, not just getting it approved, 0:12:27.120 --> 0:12:29.000 as we've talked about with some of the pushback from 0:12:29.000 --> 0:12:31.560 the pharma companies and trying to protect the FDA, but 0:12:31.600 --> 0:12:34.360 then also in terms of getting people to then take it, 0:12:34.400 --> 0:12:37.320 which is the most important thing once you have a vaccine. 0:12:37.400 --> 0:12:41.400 Vaccines are important not just because they protect individuals, but 0:12:41.600 --> 0:12:44.360 because they protect society. And if you don't have lots 0:12:44.360 --> 0:12:48.360 and lots of uptake to protect broad parts of society, 0:12:48.440 --> 0:12:52.199 you won't be able to solve this problem. So looking ahead, 0:12:52.400 --> 0:12:56.800 is there a broader risk or danger here, and that 0:12:56.840 --> 0:12:59.400 we might be in a situation in which we have 0:12:59.600 --> 0:13:04.320 and of available and approved vaccine, but one that the 0:13:04.400 --> 0:13:08.720 public doesn't trust I think that's a real concern if 0:13:08.760 --> 0:13:10.840 you look at some of the polling data out there. 0:13:11.880 --> 0:13:15.880 One poll from early August by the Gallup Organization UM 0:13:15.920 --> 0:13:18.199 suggested that about a third of Americans wouldn't take a 0:13:18.280 --> 0:13:22.920 vaccine when one becomes available. Another more recent poll showed 0:13:22.960 --> 0:13:27.080 that a large majority of Republicans and Democrats but that 0:13:27.120 --> 0:13:31.679 a vaccine approval process was going to be politicized. And 0:13:31.920 --> 0:13:34.120 I think that as we get closer to an election, 0:13:34.280 --> 0:13:38.600 with so much hinging on a vaccine um and it 0:13:38.679 --> 0:13:42.560 being such a priority for this president and UH and 0:13:42.600 --> 0:13:45.960 the Democrats making it an issue as well, we are 0:13:46.000 --> 0:13:50.400 going to see some of those concerns increase more and more. 0:13:50.559 --> 0:13:53.360 The noise around this is going to get louder and louder, 0:13:53.880 --> 0:13:56.240 and I think if we're not careful, we could see 0:13:56.480 --> 0:14:00.080 permanent damage done to trust of vaccines and drug in 0:14:00.160 --> 0:14:10.080 this country. That was Drew Armstrong and that's it for 0:14:10.120 --> 0:14:12.840 our show today. For coverage of the outbreak from one 0:14:13.240 --> 0:14:16.960 and twenty bureaus around the world, visit Bloomberg dot com 0:14:17.000 --> 0:14:21.760 slash coronavirus and if you like the show, please leave 0:14:21.800 --> 0:14:24.840 us a review and a rating. On Apple Podcasts or 0:14:24.880 --> 0:14:28.680 Spotify it's the best way to help more listeners find 0:14:28.720 --> 0:14:33.000 our global reporting. The Prognosis Daily edition is produced by 0:14:33.360 --> 0:14:39.040 top foreheads Jordan gas Pure, Magnus Henrickson, and me Laura Carlson. 0:14:39.720 --> 0:14:44.360 Today's main story was reported by Drew Armstrong. Original music 0:14:44.440 --> 0:14:49.000 by Leo cedri Our. Editors are Rick Shine and Francesca Levi. 0:14:49.640 --> 0:14:54.320 Francesca Levi is Bloomberg's head of podcasts. Thanks for listening, 0:15:15.520 --> 0:15:15.560 l