U. S. We will get the latest on the research and learn how the pandemic is affecting how you shop for groceries. Join in on the conversation our phone lines are open. Good monday evening, a lot to get to, but we will begin as we always do with the numbers courtesy of Johns Hopkins university. Northern 3 million confirmed cases around the world, 185 countries and regions. 210,000 deaths in the u. S. Deaths. Death toll athe about 55,000. Joining us from philadelphia is the director of the vaccine and Immunotherapy Center on the campus of the university of pennsylvania. Thank you for being with us. Guest my pleasure. Host let me begin with where you are at in terms of the research for vaccine. As i understand, you are among the most aggressive in finding a vaccine. Of a program,part coalition for epidemic preparedness and innovation. They have assembled a coalition of many different parties to ame together to develop vaccine countermeasure for covid19, and our particular focus of this group is to make a dna vaccine, which is a newer type of vaccine. Advantages in speed and deliverability, and has been tested in multiple outbreaks before. Host how does that differ from the more Traditional Research with a vaccine . Guest four traditional vaccines, it is quite different. Traditional vaccines relied on two premises. One, a pathogen that was weakened come and after a lot of testing, it would grow at a weakened rate and produce immunity. Rubellameasles, mumps, type traditional vaccine. Those take a very long time to develop and test enough to know they are safe. Is preparation, where you take a virus, for example, and add formaldehyde and basically destroy activity. Those need significant time to develop and activate, usually. Then we have more modern are different pieces, synthetically made pieces. All of those use the protein and sugars of the virus itself. Case, these modern approaches like dna, those use the information, the code, genetic code itself, and it is an engineered genetic code, a small fragment that when delivered into an animal or person, will instruct the local the arm that person, in for example, to produce a copy of one specific protein or so. Fools the immune system and it can react and produce a vigorous antiviral immunity. Host let me get your reaction, from the new york post, the vaccine entering trial at unprecedented speed. Can you elaborate . Guest our vaccine, we were one three teams funded, and those were announced on january 23 that they would fund three different groups initially. They have since funded more groups. 10 weeks later, we were given the ability to proceed in Clinical Trials. Which was at the beginning of april. That was just 10 weeks from funding, although into Clinical Trials. Trial should be fully recruited this week. Host let me get your reaction to this oped in the wall street journal from the former fda commissioner, saying America Needs to win the Coronavirus Vaccine race. The first nation to develop a vaccine for covid19 could have an economic advantage as well as a tremendous Public Health achievement. Doses will be limited initially as suppliers ramp up and the country will focus on not collating most of its own population first. Even with Extraordinary National collaboration and multiple companies, it could be years before vaccine is produced at a scale sufficient to help the entire world. The first nation to the finish line will be the first to restore its economy and global influence. America risks inc. Second. China is making rapid progress. Guest i think it is very important for us to develop a vaccine and move that vaccine forward as soon as possible. I think we are all in agreement with that. That those are the best approaches. We also need to move probably more than one forward because we want to be sure we have some that hit that mark, which is being safe, being effective, and prevent infection and disease in the population. So i think that is a very important goal, and that is our , toral goal in the program do that as soon as possible. 10 weeks, as i mentioned, is one of the fastest ever to advance. I think that is a really important goal. It will have great benefit. Host what are your markers to determine whether or not you are succeeding . Guest thats an important question, steve. Ist we have been doing, this our fourth pandemic outbreak that we have focused on. We learned a lot from the other outbreaks on how to advance Vaccine Technology rapidly. We did that with making, developing a backup countermeasure for ebola, which was moved to the clinic. And then the mers outbreak, which impacted significantly in korea. We developed a countermeasure that showed good protection in models as well as immunity in humans. Fastest to of the move forward with his ecovaccine. This was even faster. I guess to focus on what our goal is, to create immune responses that gives a virus no quarter. Comexample, we would like we developed assays to help us measure this, develop antibodies , the proteins that are produced and in our blood and secreted aom our tissues that block virus from moving around the body and getting where wants to go. We also would like the antibodies, the hand grenades of the immune system, to complement proteins like that and further directly destroy and be landmines for the virus. We would like those antibodies virus so they prevented from even being able to get into human cells with any good efficiency, and attached to their receptor, which is in our lungs and other tissue. Induce theso like to killer t cells, so that the immune response will be able to more rapidly clear infection and wipe out virus through the antibody defense that tries to hide in ourselves host hide in ourselves. China is leading the u. S. , and Great Britain in terms of local trials. Guest these entities know each other pretty well. We have collaborators from many different organizations. Several groups are funded by fundedogram, which is initially by the bill and Melinda Gates foundation. Of information, sharing a lot of discussion at higher levels, and a lot of groups have been brought in as well. In addition, the reports from these different groups as we submit publication like we have done, on the kind of immune response we are seeing, the quality of the vaccines, they are deposited in an open database so people can look at them almost in real time, which is completely different than before this outbreak. Host important to point out, the Institute Dates back to the 1950s with polio, correct . Guest yes, you are exactly right. 1950s, a scientist at the university of pennsylvania started testing type one polio, one of the first rains of polio vaccine to be tested as a live vaccine. That strain is now in our. Odernday vaccines host lets get to our viewer and listener calls. Deborah is from illinois. Good evening. Caller good evening and thank you for taking my call. I have to say, i was a polio baby back in the 1950s. Here is my question. I watch cspan and everything else, and i have a question. We know there is no cure for the corona yet. Season a couple of months away, we know what coronan heavy, if the decides to come back at the same medical geniuses of the world handle this and help all of us . I have not been sick but i know people who have survived it and it, but i knowh a lot of people because i live in a county that is very high, who have not. It breaks my heart. My brother was one of them. I am asking, are you as a professional in your field, can you help us so we do not have this major flood all over again in the fall, or late summer and fall . Professor, can you ask lane . Can you explain . Guest thank you for the question. We are all concerned about a second wave. That is from a modeling, it suggests we dont have protection enough in the herdnity, we dont have immunity it is called, when you get enough people infected that it makes the pathogen goal to come back difficult to come back. This pathogen has a heavy penalty, not just the mortality rate, that is concerning. More than 50,000 u. S. Casualties. In addition, the morbidity, how many people end up in a very sick condition, in the icu, etc. , that is a very worrisome condition. E do need countermeasures vaccines or a therapeutic that would slow the progression or eliminate the progression. This is what people are working on around the globe. In the United States, is a fullblown effort by many different researchers collaborating with academic institutions and companies to try and test and develop things rapidly and onthefly. A professor at the university of Pennsylvania School of edison and director of the center for vaccine and pennotherapy at the campus. Our color is from birmingham, alabama. Good evening viewed good evening. Is, i thinkuestion in september that i had this. Virusctor said i had a and he did not know what it was that i was very ill and had the same symptoms. And i have been in the hospital. I had a blood transfusion and bone marrow transfusion. I had all of these things. I have a daughter who is a veteran. On saturday, they gave toldnumber to call, and i saidady the symptoms, she she has the symptoms but doesnt have a fever. What am i supposed to do . I am her being very active. Now she goes from her room to the bathroom. What am i to do when i cant even get her tested to find out what is going on . The v. A. Is just sending her pills through the mail, they are not saying get her in here and get her tested. I am afraid. I dont have an immune system. Host how old is your daughter . Caller 35. Host how old are you . Caller 68. Host thank you for the call and good luck to you. I hope you stay healthy. Guest thank you for the question. We are very concerned about being infected, we are all very concerned, and very concerned when we have symptoms. Is way currently management is that a person presents with early symptoms. Most of those people, especially younger people, most people, 80 will recover on their own. They are not encouraged, therefore right now, for the most part, to come into the hospital. They are usually monitored by calling their primary care physician and discussing the situation as it goes along, and keeping tabs. And hopefully most of those people will get better. The vast majority will get better. Some will eventually need to go to the hospital. At that point, they would be treated in the hospital. Right now, it sounds like that is what your position your physician recommended. Throughyour daughter go your taking care of her. Seeing how she gets better over and and sort of watching taking good care of her and seeing how she progresses. Host can you explain how the testing for vaccine works and how you make sure it is safe for those your testing . You are testing . Guest that is an important question. Safety is at the top of everyones list. Part of the platform that we have developed, have been developing, and part of the way chosen,the groups were based on technology that is awer in some ways that have conceptual safety advantage. That is, they dont, they are not live, the dna is not live, it is not spreading. It cannot change something inside of you permanently, it doesnt integrate. It is a transient piece of information that then tells the body to make this artificial protein that itself has eliminated quickly. These kind of concepts give us some basic level of understanding. Then you have a comfort in that these might be safer results than in several thousand people who have received dna approaches. As i mentioned, there are rigorous Animal Studies and data and different models as well as which are filed to the fda. Now there is a whole host of questions and studies that are part of the overall study. It follows volunteers through the process so we get the best and most robust information back on safety. Host just a underscore, you are using a synthetic dna, correct . Guest correct. We are using a synthetic dna, which is a piece of dna designed on a computer in the lab, and it will instruct the cells of the arm in this case to create this artificial antigen in modelvirus, and studies, it will fold into the correct shape so that it lets the immune system see the enemy before it encounters it. That stimulates the immune response and is produced in the cells itself, so it can give rise to antibody responses as well as t cell responses to help clear infection. Host our guest is joining us from his home in philadelphia. Richard is next from new york. Good evening. Caller thank you for taking my question. Assuming your efforts are successful, how long do you expect the term of immunity to be and are you concerned that the spike protein could mutate in the interim so that whatever vaccine is developed would be less effective should the mutation occur . Those are my questions. Host thank you. Richard, what is your background . Caller i am a physician. Host thank you for joining the conversation guest . Conversation. Guest how long do we expect immunity to last . That we are looking at the study to see. In some of the other trials with our platform with the dnabased approach, for example mers, another coronavirus, which we for,oped a countermeasure they were studied out 50 weeks and still present at significant levels in the vaccinated people. There is similar data from the bolo vaccine study the ebola vaccine study as well. The second question was . Host in terms of the length, if you can determine how long the patient would be immune from the virus. Guest the patient will be immune as long as they have a measurable immune response, sometimes longer because of memory immune responses. If it is likely other vaccines weve developed, it would be 60 weeks or longer. Those would be followed in Clinical Trials to get a measure of that. Measuring the immune response to , but youf the presence would need an expanded trial to get more data along those lines. The second part of the question chaink was would the change . Rnabased virus. Based a fairly large rna virus. This type of virus, we associate them with viruses that change frequently such as hiv or oretitive see hepatitis c influenza. It changes quite a bit. Coronavirus, the coronavirus, it has a proofreading enzyme that maintains the correctness of the nucleotide sequence of this long piece. Aat likely attenuates to significant extent the ability of the virus to rapidly change, such as we see with hiv or other viruses. They do have some change, and those changes have to be watched closely. There are reports of some of those changes. For the most part, it remains at 99. 9 identical to the first identified. Be athange appears to least slow. That favors, at least in the short run, being able to make a vaccine against one particular type, essentially, the current, major form around. Host under the most optimistic of circumstances and scenarios, when do you think the vaccine will be available to the public . Guest the question of when a vaccine will be available has several answers. I guess you have heard dr. Fauci say, for example, that it is likely to take a year and a half to two years to have a license vaccine. I think that is an important statement. We will leave that statement where it is. In this case, if you ask when we might first see that a vaccine might have an effect, a positive effect, to impact infection, i have a feeling that will be sooner. When we are talking about a licensed vaccine, that is usually after phase two, which is the next phase after the phase we are in now, in which we expand testing and test the ability of the virus in the field and a limited way to prevent people from getting infected. Those trials are the ones that lead to the larger scale licensure trials. Those, it is likely this vaccine, it could be safe and showing good immune responses. Discussingnsidering fda trials in the summer. I think the group in england also was talking about their vaccine moving forward toward fall in those type of studies. I think we will start to see people pushing along those lines. As long as i have safety and immune responses that are consistent with preventing what the virus wants to accomplish, i. E. Infect ourselves and cause havoc. Depending on the number of cases and design, those trials might start telling us something toward the end of the year. They have been involved in polio, hiv and z go work. Zika work. Good evening from virginia. Caller thank you for taking my call. [indiscernible] on mers and ebola. How will you get the vaccine to the market and what is the expected average cost . Host thank you. Guest thank you for that question about the cost. I think we dont know what the final cost will be right now. I think the goal of the program is to be able to make a vaccine with this kind of platform that can be widely available. Tend todna products have a simple manufacturing process which keeps the cost down. The other thing about this type of approach is it is temperature stable. It doesnt require very expensive formulations to maintain that temperature stability. That can also have an impact on cost and distribution, etc. I think also it depend on how long the immune response lasts. We dont know the answers to those questions, but really there is such a great need and the cost of a vaccine tends to be one of the Cheapest Health things we do that provides enormous benefit for the population. I think in this environment where it is a very costly impact on our population, both ,sychologically and financially as a vaccines are developed, it will be extremely costeffective by that measure. Host debbie is next from maryland. Thank you for waiting. Caller good evening, how are you doing . Host we are well, thank you for your question. Caller from what ive been told, some people who have gone the virus, they say normally you army you are immune after that, but they got it again. I thought that would not happen. Host professor, can you explain . Guest thank you for the question, that is a very important observation. Questionr to that ,bout what is the protection that people who were infected if they are protected when they recover is essential. In the case of mers, when we developed that vaccine, one of the things we included an publication, involving collaboration with a larger group. We compared samples with the patient who had recovered from mers infection in korea. What we observed is the antibodies produced by our vaccine were relatively similar to those and the t cells were stronger even than induced by the natural infection recovery. In this case, the question is, it is not that i would expect and i think this is where we will get into a little bit of the weeds. If 98 of people do not get reinfected, that is a very important thing to know. But if a few get reinfected in a global population, that would not cause me great concern. I think we need to know, are these anecdotal cases . What percentage do