Episode 977: Where's The Vaccine? : Planet Money Coronaviruses didn't come out of nowhere. They've actually been around for years. But economics makes it hard to find a vaccine. | Subscribe to our weekly newsletter here.
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Episode 977: Where's The Vaccine?

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Episode 977: Where's The Vaccine?

Episode 977: Where's The Vaccine?

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UNIDENTIFIED REPORTER, BYLINE: This is PLANET MONEY from NPR.

AMANDA ARONCZYK, HOST:

So as you might've heard, we are in the middle of a coronavirus outbreak, and this isn't the first one. There have been three bad ones in the past 18 years.

SARAH GONZALEZ, HOST:

There was SARS. Remember that one? That was a coronavirus. It hit in 2003, and it probably came from bats. And then there was MERS, which started in 2012, and that came from camels.

ARONCZYK: And now there is COVID-19. That's the official name of this current coronavirus disease. And that one probably also came from bats.

GONZALEZ: And once you know that these coronaviruses aren't something that came out of nowhere, that they've been around for years, the obvious question is, where's the vaccine?

ARONCZYK: That would be great. A vaccine would be great right about now.

GONZALEZ: I think people would buy it.

ARONCZYK: Yes, we would.

(SOUNDBITE OF ANDREW PETER KINGSLOW AND ROGER ROGER'S "DEATH OVER DINNER")

GONZALEZ: Hello, and welcome to PLANET MONEY. I'm Sarah Gonzalez.

ARONCZYK: And I'm Amanda Aronczyk.

GONZALEZ: The free market is supposed to solve these kinds of problems, provide the thing that everyone wants. But it hasn't.

ARONCZYK: Part of the reason is all of these coronaviruses are a little different. This one's new. So no matter what, it is going to take time. But another reason is economics.

GONZALEZ: The market for emergency vaccines for pandemics, diseases that spread around the world - it is not like the regular market for, you know, bikes and raspberries. It is a lot weirder than that.

ARONCZYK: Today on the show, we find out just how weird. This story involves the anthrax scare.

GONZALEZ: And an undisclosed number of secret government chickens.

RICK BRIGHT: Hello. This is Rick Bright.

GONZALEZ: Rick Bright, you are the hardest person to get ahold of.

BRIGHT: Unfortunately, it's been a busy month or two, yes. And it seems to be getting busier.

GONZALEZ: Rick Bright is the director at BARDA, the Biomedical Advanced Research and Development Authority in Washington, D.C. They help prepare and respond to everything from nuclear and chemical threats to biological threats, like viruses. So he's super busy.

BRIGHT: Very, very long days right now.

ARONCZYK: And we were not the only ones who wanted a little bit of Rick Bright's time.

GONZALEZ: I was bumped this morning. I was told it was Vice President Mike Pence.

BRIGHT: You probably have some good information there.

GONZALEZ: (Laughter) OK.

ARONCZYK: Rick Bright is in his early 50s, and he's worked on viruses pretty much his whole career. He was at the CDC, then the biotech industry. Now he's back working for the government. But his interest in viruses started on a farm.

BRIGHT: Very few people know that, you know, I was born in a small town in Kansas on a farm nearby.

GONZALEZ: Did you have chickens as a farm boy?

BRIGHT: We had chickens. We had a lot of animals (laughter) at the farm. Those chickens were just for eggs to eat.

GONZALEZ: Eggs are a big part of Rick's life still.

BRIGHT: I do have an Egg Genie in my office, as well, as a Christmas gift someone gave me. And it's like a little incubator. I can make omelets. I can heat up seven different eggs and poach them at one time.

ARONCZYK: And Rick Bright got into vaccines because of something that a lot of people think was also born in Kansas - the 1918, 1919 pandemic flu. This was one of the deadliest outbreaks in human history, killed somewhere between 50 million to 100 million people around the world.

GONZALEZ: And that pandemic came from birds. Basically all flus do, even the swine flu - starts in birds. But we didn't know any of that back then.

BRIGHT: And my motivating force through my entire career is a small-town boy from Kansas could have the power or the ability or the knowledge to stop the next pandemic. So everything I've done in my career has put me right here right now.

GONZALEZ: Rick Bright came to this pandemic preparedness agency, BARDA, 10 years ago when it was still fairly new. The event that led to this agency started one week after the 9/11 attacks. Anxieties were really high. Everything seemed like a potential terrorist attack. And there was this kind of crazy thing happening. A number of anonymous letters were being mailed out.

BRIGHT: To news reporters, to Congresspeople, to others.

ARONCZYK: And inside these letters, white powder.

GONZALEZ: Anthrax.

BRIGHT: Anthrax spores.

GONZALEZ: And everyone is like, what do we do? How do we detect this? How do we treat this? Like, we don't know what to do right now.

BRIGHT: During those days, it took too long to know what we were seeing and what was happening, and we were scrambling.

ARONCZYK: If you inhale this powder, it can kill you. Five people died.

GONZALEZ: It was clear that the United States wasn't prepared for bio threats - bio meaning, like, biology, nature.

BRIGHT: Anthrax comes from nature.

GONZALEZ: Where does it come from?

BRIGHT: It's actually in the dirt, and it can also be isolated from nature and dirt. And terrorists can then grow and cultivate the organism itself to use as a weapon.

GONZALEZ: And there wasn't really an anthrax antidote readily available. Things in the dirt that can kill you wasn't really a huge focus at the time.

ARONCZYK: And right around this time, another threat popped up. Chickens picked up a strain of flu from wild ducks.

GONZALEZ: Why these wild ducks and chickens were hanging out - still a charming mystery. But this flu, called avian flu, was spreading from chickens to people. And everyone thought, what if it starts spreading from people to people, you know, like the seasonal flu does?

ARONCZYK: Everyone thought this might be the next big pandemic. And there were nowhere near enough vaccine doses for something like this - not in 2001, not in the United States, not really anywhere.

BRIGHT: So it was an alarm bell that went off around the world.

ARONCZYK: This is a big moment. The U.S. government realizes they can't get the drugs and vaccines they need when there's an emergency. There wasn't really a market for them.

GONZALEZ: Now, for the regular vaccine market, like the vaccines you get as a kid - the one for the chicken pox or measles, mumps and rubella, HPV - that vaccine market is fine. Pharmaceutical companies can predict that market size, predict how many doses of the measles vaccine they'll need to make and build a facility to make that amount. They know that there's a long-term market as long as babies are being born.

ARONCZYK: But the market for emergency vaccines and drugs to treat things like pandemic flu or anthrax - that's the problem because it's really, really expensive to develop a new vaccine really, really quickly. And also, the market is uncertain.

BRIGHT: With something like an emerging infectious disease, such as Zika or MERS or SARS or this novel coronavirus, it's really difficult for them to predict a market size. There's really no long-term promise of a revenue stream for those vaccines.

GONZALEZ: Here's why. Outbreaks go away, sometimes on their own. Sometimes we contain them - right? - like SARS, the other coronavirus that came from bats. It came, then went, but it will come back at some point. Everyone says this. Viruses like this come back. It's just no one knows when. And this is a problem for this industry because markets hate uncertainty.

ARONCZYK: So during the avian flu/anthrax attacks, the U.S. government is like, if pharmaceutical companies aren't going to make this on their own, we'll give them a little incentive. We will become the market. We will become the buyer for this drug and this vaccine.

GONZALEZ: So would it have been like the U.S. government told pharmaceutical companies, hey, if you make an anthrax antidote, we will buy it, so just make it, and we promise to buy it?

BRIGHT: Absolutely. That's the commitment - that if you make these for us, then we will buy them from you.

GONZALEZ: Congress sets aside billions of dollars for this and, a few years later, opens up a whole new part of the U.S. government - the Biomedical Advanced Research and Development Authority, BARDA, where Rick right now works. BARDA tells companies, we will share the cost of developing these new products. We will share the cost of paying the researcher of building the facilities. Bio threats are national security threats. Let's just accelerate this process.

ARONCZYK: Which is hard to do because vaccines require time. Life needs to grow. Consider one of the most common vaccines that we make every single year, the flu vaccine.

GONZALEZ: It is a shockingly fragile, delicate, expensive process involving chicken eggs - thousands of them. And hens only lay one egg a day, so you need thousands of chickens working around-the-clock for their one egg. And then those eggs report for work straight from a farm to a pharmaceutical company. Every morning, they line up.

Like, millions of rows of chicken eggs?

BRIGHT: It is millions of rows of chicken eggs.

ARONCZYK: The eggs are gently placed on a conveyor belt. Needles drop down, poke a hole in the eggs. And then a live flu virus is injected into the holes.

BRIGHT: That hole will be sealed, and then those eggs will go into an oven - an incubator - for a number of days - say, 10 days.

GONZALEZ: The virus needs to grow in there, all cozy in an incubator. They'll come back out after those 10 days, back on the conveyor belt.

BRIGHT: And then there's a series of knives that will swing through and chop off the top portion of those eggs - just kind of clip off the upper, you know, one-tenth percent of that egg.

ARONCZYK: Then new needles drop down - not ones that poke holes - suction needles.

BRIGHT: They will vacuum out all of that allantoic fluid, or that egg white...

GONZALEZ: The egg white, OK.

BRIGHT: ...That's in there - the egg white.

GONZALEZ: That is where the virus has grown - in the egg white.

BRIGHT: So it sucks out that - the egg white.

ARONCZYK: Dumps it into a giant spinning container that separates any particles that might've gotten in by accident.

BRIGHT: Maybe it's some eggshells, maybe it's some of the yolk that got in it.

GONZALEZ: Eggshells always kind of get in a little bit, so sure.

BRIGHT: You always get a little eggshell, yes.

GONZALEZ: Now you have just the egg white that has the virus in it, which you now have to kill because it's live virus.

BRIGHT: You kill the virus.

GONZALEZ: By chopping it up.

BRIGHT: You have to make sure it's dead.

GONZALEZ: By chopping it up more. And then you kind of wash it with detergent.

BRIGHT: Just regular detergent.

ARONCZYK: By the end, there's almost zero actual egg white left, so you mix it with other fluid.

BRIGHT: That becomes your vaccine. Many, many, many, many months of work in that process.

GONZALEZ: And in an emergency, you need a lot of eggs all at once.

BRIGHT: Very few people realize that in a pandemic influenza outbreak that you need 900,000 chicken eggs every single day for a six- to nine-month period of time to make the vaccine supply needed just for the United States.

ARONCZYK: And just in case there aren't enough incubators, Rick does have that Egg Genie.

BRIGHT: I'd tell myself and six of my closest colleagues, anytime, if there's an outbreak, I can probably whip you up a vaccine and save some people.

ARONCZYK: So that's seven eggs' worth of vaccine.

GONZALEZ: OK, so very slow process. And back in 2001, in the middle of the avian flu scare, there was only one company in the U.S. making a flu vaccine. The rest were in other countries. So the government was like, we got to start making more on U.S. soil so we don't have to wait for some other company to ship it to us in an emergency.

BRIGHT: We can't rely on other countries to share vaccines with us.

GONZALEZ: Meaning, like, we should have our own chickens in the United States laying eggs so that we can make an avian flu vaccine.

BRIGHT: One of the first thing we did was secure a large number of chicken flocks, yes. And we call it our egg supply program.

GONZALEZ: So these are like hardworking government chickens.

BRIGHT: They are hardworking government chickens. But we have...

GONZALEZ: Where are they?

BRIGHT: A lot of farms that we have in undisclosed places. As you can imagine, it's our national security.

GONZALEZ: It's a secret where they are?

BRIGHT: It's a national security secret.

GONZALEZ: I feel very attached to them all of a sudden.

BRIGHT: (Laughter) We have to protect those flocks.

ARONCZYK: We aren't even allowed to know how many chickens there are. It's super, super top-secret.

GONZALEZ: The government is paying for a year-round supply of eggs just in case there's a pandemic flu outbreak, so that a pharmaceutical company can, you know, turn on the machines right away. No one has to go looking for new chickens. And if the eggs are not used to become a vaccine, which happens often, the government still pays for them. They become animal feed. Because what the government is doing here is creating a market for the down times when we're not in the middle of a crisis just to keep the chickens around, keep up the capability.

ARONCZYK: To be clear, there are several newer, faster ways to make a vaccine. So a lot of the coronavirus vaccines that people are working on right now - they're using less chicken-oriented techniques.

GONZALEZ: And maybe fire the chickens - the government chickens?

BRIGHT: Yeah, I'd like to retire...

GONZALEZ: Retire.

BRIGHT: ...The government - retire the government chickens and let them get some rest and go about doing other important things.

GONZALEZ: The government now buys all kinds of vaccines and drugs.

BRIGHT: Smallpox, anthrax - we're the buyer for the - we're planning to be the buyer for the Zika virus vaccine.

ARONCZYK: And they don't just buy it one time in bulk. Drugs and vaccines have a shelf life. They expire. So in order to make sure pharmaceutical companies keep making them, the government has to keep buying them.

BRIGHT: 'Cause if I don't have a company that can make them when I need them, then I basically don't have the drug or vaccine.

GONZALEZ: Rick says all of these drugs that they buy wouldn't be available if the government didn't promise to buy them.

BRIGHT: The market would not exist without government intervention. I'm confident of that. That's where we were in 2001 - no one making those drugs and vaccines.

GONZALEZ: And getting into the vaccine business is risky for everyone involved - the government, pharmaceutical companies, universities - because there's this stage in this whole process that is time-sensitive. At a certain point, you have to test a new vaccine candidate on a human being to see if it works. And if the outbreak goes away, which, again, happens all the time, it kind of messes up that phase. Companies actually have to wait for an outbreak to come back to finish their product.

BRIGHT: We were working very expeditiously on a SARS virus vaccine back in 2003 and 2004. Fortunately, the SARS virus disappeared. Unfortunately, when the virus disappeared, the funding tended to disappear with it, and the companies that were making a SARS virus vaccine lost interest and shifted back to their more profitable vaccines.

ARONCZYK: A lot of people say the interest and the funding are only really there once an outbreak has started. So a real SARS vaccine would be helpful right now because it's a coronavirus, too.

BRIGHT: There's knowledge. There's experience from a SARS vaccine candidate. But I don't have any coronavirus vaccine candidate sitting in the freezer.

ARONCZYK: So what BARDA really does is share risk - you know, make it safe for companies to commit to developing the vaccines for outbreaks that will probably go away. Say, OK, we know it'll go away, but make it anyway for us. We will buy X many doses. And when it comes back, we'll be ready to go. There is a national stockpile of emergency vaccines and antidotes.

BRIGHT: There are several locations across the United States. And, yeah, they're not obviously marked. They're not branded as a strategic national stockpile in any way that you would see them, so it's not a single target if someone wanted to take out our strategic national stockpile.

GONZALEZ: Whoa. Picture warehouses filled with an anthrax antidote and other things like that.

BRIGHT: A stockpile contains vaccines and drugs for anthrax and many other threats that we face - smallpox, antiviral drugs.

GONZALEZ: Just little, tiny vials in dry ice - something like that?

BRIGHT: Some of the products are frozen and stored, yeah, in minus 80, or super cold. Some of those things are face masks or ventilators.

ARONCZYK: And they're hoping to add a COVID-19 vaccine to the stockpile as soon as possible. Right now, there are at least 20 companies, universities, labs all rushing to create a vaccine for this new coronavirus. And the U.S. government - BARDA - has partnered with two companies.

BRIGHT: What they're doing in the laboratory right now is basically all hands on deck. They're working long hours, long days. And they have shifted people away from other vaccine or drug products or projects onto the coronavirus.

GONZALEZ: Some companies say they already have a vaccine candidate, but they still need to test it, like, on human beings who volunteer in clinical trials. Rick Bright says it'll be about a year before there's a coronavirus vaccine on the market.

BRIGHT: And that is assuming everything goes well the first time through, and we've never seen that happen.

GONZALEZ: Oh.

(SOUNDBITE OF DANIEL ALEXIS PEMBERTON'S "DOCTOR DIZZY")

GONZALEZ: Do you have a chicken that works for the government or that lays special eggs we should know about?

ARONCZYK: Then you can email us at planetmoney@npr.org.

GONZALEZ: We are also on Facebook, Twitter and Instagram. We're @planetmoney.

ARONCZYK: We also have a newsletter. You can go to npr.org/planetmoneynewsletter to sign up.

GONZALEZ: Today's show was produced by Alexi Horowitz-Ghazi, Darian Woods and Liza Yeager. Alex Goldmark is our supervising producer. And Bryant Urstadt edits the show.

ARONCZYK: James Sneed fact-checked the show.

GONZALEZ: We need to thank so many people who helped us with this episode, like Kawsar Talaat - she helped us understand influenza - Josefa Steinhauer, Mike Osterholm - he helped us understand the market failures for emergency vaccines. And we have to thank the pharmaceutical companies Sanofi and GSK for helping us understand the vaccine race.

I'm Sarah Gonzalez.

ARONCZYK: And I'm Amanda Aronczyk. This is NPR. Thanks for listening.

(SOUNDBITE OF LEIGH MCALLISTER GRACIE'S "EDGE OF FEAR")

GONZALEZ: Yeah, it seems like the real problem here is birds, bats, pigs, camels, (laughter) dirt.

BRIGHT: And people.

GONZALEZ: And people.

BRIGHT: (Laughter) And people. And so we all live together as one ecosystem. And, you know, we all have to work and live in harmony.

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