The shots that have been around the world

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Katalin Karikó has worked for decades to harness the power of messenger RNA to fight disease.Credit: Hannah Yoon / Bloomberg / Getty

The First Shots: The Epic Rivalries and Heroic Science Behind the Coronavirus Vaccine Race Brendan Borrell Sailor (2021)

A Coup to Save the World: The Inside Story of the Life or Death Race for a COVID-19 Vaccine Gregory Zuckerman Portfolio (2021)

It has been almost two years since the first cases of SARS-CoV-2 appeared in hospitals in Wuhan, China. Meanwhile, the virus has left a trail of devastation across the planet. The number of deaths is estimated between 10 million and 19 million, according to the unique model of excess mortality built by The Economist magazine. Without the extraordinary invention of COVID-19 vaccines, these grim numbers would be even higher.

The race to create these vaccines involved many people. But it all started with one: virologist Zhang Yongzhen from Fudan University in Shanghai, China. On January 3, 2020, a metal box arrived in his laboratory. Inside, wrapped in dry ice, was a sample taken from a person with pneumonia in Wuhan. After 40 hours of work, he and his colleagues had determined the genetic sequence of the virus responsible for the epidemic. It was a coronavirus. He knew exactly what it could mean.

Zhang was not the first to sequence SARS-CoV-2, but accepted the first release of the data. He did not ask permission to do so. He also did not wait for the footage to be published as an article (F. Wu et al. Nature 579, 265-269; 2020). Instead, it was deposited on the public website Virological.org on January 11, launching a global hunt for vaccines. This effort, unlike anything the world had ever seen, saw billions of public and private dollars invested in jeopardy. Now, two books follow the key runners of the great vaccine race of 2020 in quite different ways – one close-up, a wider angle. Taken together, they provide a glimpse into some of the people and technologies that escalated when it mattered most, and the politics that either flattened or blocked their path.

Heroes and Villains

In First shots, reporter Brendan Borrell tells how the U.S. government and academics at the U.S. National Institutes of Health (NIH) have advanced the development of national vaccines, specifically the use of messenger RNA to induce cells to make antibodies that fight the virus, in partnership with the biotechnology company Moderna, based in Cambridge, Massachusetts. Beyond vaccines, there are entertaining digressions in the tortuous US public health response, the outbreak on the cruise ship Diamond princess, ventilator shortages, US efforts to secure a supply of masks, etc. A delightful detail features then-President Donald Trump: “Did you see my tweet?” he barks at subordinates. “Why didn’t the FDA approve convalescent plasma?” “

Borrell’s book shines in its gripping tale of how, against all odds, the government-backed public-private vaccine development plan – Operation Warp Speed ​​- grew out of the primordial mud of development. pandemic policies inside Trump’s White House. After all, it was an administration that had just about everything 180 degrees wrong about the pandemic and the virus – and, at times, seemed to be at war with science and scientists.

Much of the epic rivalry mentioned in the book’s subtitle is due to the egos in alphabet soup from US government departments and other factions. There are some intriguing minutiae. At first, one structural biologist – hoping for an inside line on the unpublished genetic sequence of SARS-CoV-2 – is said to have bitched when it was posted: “Everyone has it now.

A health worker injects a dose of AstraZeneca COVID-19 vaccine during a vaccination program in Sanur, Indonesia.

Bali, Indonesia: People are receiving the vaccine developed by the University of Oxford, UK, and AstraZeneca.Credit: Johanes Christo / NurPhoto / Getty

Yet the pursuit of COVID-19 vaccines is not just an American story. He’s an international. It also has roots, for example, in the mRNA work of the husband-and-wife team Uğur Şahin and Özlem Türeci of the company BioNTech in Mainz, Germany, which has partnered with a vaccine with Pfizer, based At New York. It is by covering these global angles that First shots arrives short. Borrell’s American characters, such as Michael Callahan, an American doctor who traveled to Wuhan in mid-January to witness the devastation at local hospitals, or vaccine designer and public engagement star Kizzmekia Corbett’s are well drawn and metaphorically square-jawed. The fact that the rights to the book were sold to HBO TV channel in July 2020 may have influenced the way the story is told. British scientists, for example, appear to be a “distant group”.

The characterization of Oxford University vaccinologist Sarah Gilbert is a good example. Gilbert co-created the adenovirus vaccine that the university developed with AstraZeneca, based in Cambridge, UK, and which is now on sale at low cost worldwide. Bypassing his leadership role, Borrell delves into the detail in which the reserved scientist made an appearance in Vogue magazine wearing an Armani blouse and Manolo Blahnik boots. He chooses not to pursue the deeper question of why she might be in an article on “Women Who Shape 2020”. Gilbert certainly found the attention of the press overwhelming and initially did not welcome interest in her as a “woman” scientist. Over time, she has come to accept that she is a model, co-writing her own book (see Nature 596, 29-30; 2021).

A more comprehensive assessment of how the world came to create the 20 or so vaccines that have received limited or full approval so far was always going to be a tall order. In One shot to save the world, Gregory Zuckerman, business reporter for the newspaper The Wall Street Journal, takes a closer look at key vaccines and takes a broader historical perspective, giving a confident account of research, ideas and people.

Hope and promise

Like many great scientific tales, the story features serendipity, failures, tenacity, frustration, and tantrums. It winds through the deep origins of the idea of ​​making better recombinant proteins in insect cells. It traces long years of thankless work by Katalin Karikó, most recently at BioNTech, and others, to overcome the challenges of working with unstable and delicate mRNA molecules. (Karikó and colleagues’ mRNA triggered disturbing immune responses when first injected into mice.) The book also chronicles the growing difficulties of the adenoviral approach: in 2007, it was found that an HIV vaccine using this technology made participants more likely to be infected, not less.

The conduct of this narrative is a solid cast. Stéphane Bancel, the French CEO of Moderna, comes across as rude and arrogant, telling staff: “Fifty percent of you won’t be here in a year. At BioNTech, Şahin and Türeci have a work ethic that sees them marrying on their lunch break and celebrating new efficiency data with a 30-minute walk. At the Jenner Institute in Oxford, director Adrian Hill is portrayed as bossy, determined and caustic. Zuckerman reports verbal lashes such as, “This is the most ignorant thing I have ever heard.” Some close colleagues are more affectionate, describing Hill as a “pot personality” – the strong taste you love or hate. For anyone working the bench, it won’t be surprising that some of these brilliant minds are obsessive, rude, or eccentric. This is not to excuse bad behavior. But it is the context in which to visualize the characters that have been put in the spotlight. We shouldn’t expect them to be central cast heroes.

Zuckerman delves deeply into a key historical moment. It gives a superb tale of the misery of Pfizer executives on the morning of November 8, 2020, a Sunday, as they wait for hours for the results of their Phase III clinical trial, the first of one of the vaccine candidates. They squirm in a conference room, wearing black masks printed “Science will win”. Finally, Kathrin Jansen, head of vaccine research at Pfizer, calls to say the jab is working: “We did it… we won. The room bursts into cheers and cries. The boss Albert Bourla shouts: “I love you! to his colleagues.

This emotion spread around the world the next morning when the news broke. TO The Economist, my editor picked up on the message at our main Monday editorial meeting on Zoom. “Is 90% efficiency good, Natasha?” She asked me. “It’s fucking amazing. Absolutely amazing, ”I blurted out, feeling a wave of relief and joy. The data came from an interim analysis; the number later improved to 95%.

Pfizer’s result was proof that the gamble on a completely innovative vaccine had paid off better than anyone dared hope. It was also proof that the idea of ​​boosting immunity to the coronavirus ‘spike’ protein was a good idea – something that bodes well for many other vaccines. Today, as we fight the woes of resistance and distribution, it remains a privileged moment of hope and promise.

Neither book deals with non-Western vaccines; their stories are not easy to tell. But you have to tell them. The first COVID-19 vaccines did not come from the West at all. In August of last year, the use of the Russian vaccine Sputnik V was authorized. Shortly after, the Chinese vaccines CoronaVac and Sinopharm arrived. These approvals came before the full scale testing was completed and were seen as ethically dubious and reckless.

Yet Chinese vaccines have come to the rescue of middle- and low-income countries. China exported very early and in large quantities. So far, it has sent around 1.1 billion doses to more than 120 countries and territories. In contrast, the United States has played a more ambivalent international role. It was only in the last few months that she started donating vaccines; as of October 21, he had administered 206 million doses.

Perhaps it’s understandable that the messy geopolitics and nationalism that have hampered the equitable distribution of vaccines around the planet is not part of either book. It is, as they say, another story – a story that always unfolds tragically.


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