When the United States launched its “warp speed” drive to develop a vaccine against the novel coronavirus, Dr. Larry Corey knew he would be getting a call from his old friend and colleague, Dr. Anthony Fauci. Sure enough, Fauci tapped Corey and The Fred Hutchinson Cancer Research Center — which Corey led for several years — to serve as the operational command center for an ambitious network of clinical trials.
Since then, Corey’s life has been a nonstop blur of Zoom calls and logistical juggling, as he and his team orchestrate an unprecedented number of trials with tens of thousands of participants at sites across the country and globe.
With Pfizer’s vaccine gaining emergency approval last week, and Moderna’s likely close behind, Corey — who’s been called a “global virology star” — told The Seattle Times he’s starting to feel the pressure ease.
“I find myself smiling a lot more than I did a few months ago,” he said. “Spontaneously smiling.”
Corey also answered questions about what comes next, what we still don’t know about the vaccines, and why even vaccinated people need to keep wearing masks, at least for a while. (The conversation has been edited for clarity and conciseness.)
Q: It’s been less than a year since this virus was discovered, and we have two highly effective vaccines on the verge of being rolled out. Did you ever imagine that would be possible?
A: I didn’t think a vaccine with 95% efficacy would be possible in one year. When Tony (Fauci) first said “twelve months,” I said: “Hey, Tony. Can you make it 12 to 18, please?”
So the fact that we cranked out these studies, designed them, conducted them, got through all the phases and got two (vaccines) with similar results within 11 months is astonishing. Sometimes you have to pinch yourself. It’s a new pathogen, a unique virus, but it looks like we understood it enough to find its Achilles heel and design vaccines that really do work.
Q: Do you see the end of the pandemic now?
A: I think you can see a beginning to an end. Right now, we have vaccine scarcity, and you’re not going to end the pandemic until that scarcity is gone — not just in our own country, but globally. Because we saw how rapidly the virus spreads.
I predict this virus is not going to go away. It’s really adapted to humans. It is more infectious than flu. The way you control the pandemic is that everybody gets vaccinated.
Q: How do you see things playing out over the next year or so?
A: I think the hardest thing is going to be the next four months because we have this huge expectation that now there’s a vaccine and these committees say that medical-care workers, people in nursing homes, the elderly, people with comorbidities and essential workers should all be vaccinated. But that’s more than 200 million people, and each needs two doses. And we only have 200 million doses (guaranteed so far from Pfizer and Moderna).
So we have vaccine scarcity, and the only way to relieve that in the short terms is to have other vaccines emerge as effective. In Operation Warp Speed we always knew we needed multiple vaccines, that we couldn’t make enough of one vaccine to cover the entire U.S. population in a short period of time. That’s why multiple vaccine platforms were selected in the first place.
Q: The Moderna and Pfizer trials showed the vaccine protects people from symptomatic COVID-19, but didn’t determine whether it prevents them from getting infected — which means it’s not clear whether vaccinated people can spread the virus to others. Why is that important, and what are you doing to answer the question?
A: I honestly think this is the most important question, that affects daily life the most. The issue of: Can (people who are vaccinated) get infected, not know that they’re infected and still have virus in their noses and then transmit it. We don’t know if that’s the case, but we have to assume it is and masks are still needed.
It takes a different kind of study to answer that question. You have to vaccinate people and essentially swab them every day and test the samples every day. It might end up being a million samples. That’s how you find out if the vaccine prevents people from having asymptomatic shedding.
That’s the kind of study we’re thinking of, maybe on college campuses or other types of closed communities.
A: If I look at the risk versus benefits, I have no doubt what the decision is for me. I’m going to get an mRNA vaccine as soon as I can qualify for it and receive it. I look at my two daughters-in-law, they’re both physicians, practicing and seeing patients. One’s an obstetrician and one’s a pediatrician, and I say: “Both of you need to get this.”
Q: Many people are reluctant to take a coronavirus vaccine for various reasons, among them a sense that the testing process was rushed and subject to political pressure. What would you say to them?
A: I would say that every step of the process and the data — the phase one trials, the phase two trials, the phase three trials, and the decision by the FDA in evaluating it — is public. Everything’s been published, and there’s been incredible scrutiny. We have worked in a fishbowl … and that is the most transparent way to work.
Q: Have you felt political pressure?
A: I haven’t felt any political pressure. We have been given all the resources we need. As scientists, especially academic scientists, we’re pretty stubborn. And we have a long history of doing what’s right for our trial subjects or patients. So you shrug your shoulders at what was going on at the top, and we went ahead and did our business. In the end, the judgments that were made were good judgments.
What that says is that if the professional staff that populates our major institutions are left alone, they’re incredibly competent and really do their jobs — and our country should be proud of that. And we should also make sure that we don’t change that. There certainly have been attempts … to prevent the scientists from speaking out. But in the end, science wins. Science wins by being transparent, by making its findings public. It’s really hard to mask data, and that’s just not in the conscience of scientists in this country.
Q: A couple of people who got the Pfizer vaccine in the U.K. had serious allergic reactions, and the USDA said it would require monitoring for similar reactions in the United States. How concerned should we be about possible severe side effects?
A: People who had a long history of allergies and who were hyperallergic were excluded from the (Pfizer and Moderna) trials. Every clinical trial has exclusions, so there are groups of people we have no experience with. We don’t know everything, and we may see some infrequent (side effects), and we have to be tolerant and recognize that might happen.
I have a sister who’s 82, who has lupus — one of these kinds of allergic, autoimmune diseases. Should she get it or not?
There’s a risk-benefit ratio. She lives in the Midwest where there are huge outbreaks and a lot of people who aren’t wearing masks and she’s tired of being in her house for such a long time. So for me that translates into saying: I think she should get the vaccine. But there are still unknowns, and there has to be some individual choice allowed.
Q: How will possible serious side effects be detected and reported?
A: One message I would like to get out to our citizens is to encourage them to participate in the CDC surveillance system when they get their vaccine. (The system, called V-Safe, is a voluntary smartphone tool that checks in on people by text after vaccination, and allows them to report any reactions to the shots. It is in addition to traditional adverse reaction reporting systems through doctors and database analysis.)
That’s the way to pick up things that occur in one in a million people, or one in 500,000. Whether you had a reaction or didn’t have a reaction we need to know that, because we want to know how frequent these things are.
Q: None of the vaccines have been tested in pregnant women and children under the age of 16. What’s being done to fill those gaps?
A: In January, there are a series of studies that Moderna and Johnson & Johnson are starting in children, at first down to 12 years old. I certainly have been pushing our organization and the companies to get the vaccines tested and get the right dose for children. We want our kids to go back to school, so that’s a very high priority.
Studies on pregnant women are harder to organize, but they’re getting started now. That is on everybody’s mind.
Q: One of the major unknowns about the vaccines is how long protection will last. What are your thoughts?
A: I personally believe that vaccines will have benefits long-term. I think that these vaccines are making the kind of immune response that is similar to natural infection and that we would expect long-term memory B cells. Then if you get reinfected in a year or two because the virus is still circulating in our society, I think our memory B cells will recognize the virus and mobilize a huge amount of antibody. You may get mild illness, but you won’t get severe illness.
But we don’t know that yet. It’s just speculation on my part — hopeful speculation.
Q: Will emergency approval of the Pfizer and Moderna vaccines affect ongoing trials of other vaccines? Won’t people enrolled in those trials just drop out and get the approved vaccines?
A: I’m optimistic we are not going to see any problems whatsoever. First of all, (people enrolled in the other trials) won’t be able to get the (Pfizer or Moderna) vaccines anytime soon because there will be a huge shortage. And most of those trials end in January, so I think if people hang in there until then, we will get answers out of these trials.