Show Transcript
Promising trial results from Moderna Inc.’s experimental vaccine for COVID-19 lifted equity markets on hopes that a vaccine may be within sight. Anthony Okolie talks with Dr. Vipan Nikore, Chief Medical Director at TD Bank, about the latest vaccine development and state of the pandemic.
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- Let's start with the encouraging results from Moderna's experimental vaccine just released yesterday. Certainly the stock market liked the news. Dr. Nikore, what do the results from Moderna actually indicate?
- Yeah, Tony, obviously there was some positive feedback from many people regarding these results. And I do think it's positive news. What it showed was that we had 45 people in a study from Moderna. And this is actually the first one that we've seen published in a major research journal, the New England Journal of Medicine. 45 people that were healthy, 18- to 55-year-olds. 15 got a low dose, 25 micrograms, 15 people received 100 micrograms, and then 15 received a higher dose of 250 micrograms. After one month, they've received a second dose.
And there's two parts when it comes to vaccines-- their safety and then efficacy, so how well does it work. So this first phase, what we look at is how safe is it. And what it did show is that-- well, really two things. One, it did appear safe. There were no major side effects. So things like transient fatigue, chills, headaches, muscle pains, pain at the injection site, but nothing significant, which is a very good sign.
And then the second part, it showed that antibodies were made in all of these people. So an immune response was generated. So this is positive news. And what it means is now they're going to take this group of 45 people-- not this group, but they're going to expand upon this group of 45 people, expand that to around 30,000 people to really now focus on the efficacy, how well does it actually prevent the coronavirus. So that's where we stand. That's at the end of this month that this will likely start.
- And are you optimistic about the results?
- I overall am optimistic. I think sometimes people, when you look at sort of the markets and other people, there may be a little overoptimism. And the reason I say that, not that this is not great news, but you know, we've been pegging that we're going to get a vaccine in a year, year and a half, when typically vaccines take several years. Now, we were able to accelerate upon several years because of learnings from SARS, et cetera.
But one of the important pieces here is that this year, year and a half was expected-- for things to be done in a year, year and a half, it was expected that we were going to have things go very well. So this is kind of in line of what we're expecting. It's kind of like having a world-class championship team that is touted to be the best team ever, and they win the first round of the playoffs. It's great, it's good news, but it's expected, and we've got to keep making sure that things go in the right direction.
- And of course, next week we're awaiting trial data from AstraZeneca. University of Oxford vaccines are coming out. Are there any other vaccines or treatments in development that you think have some promise?
- Yeah, good question. You know, as you know, there's 150 vaccine candidates or so out there. 23 are being tested in human trials right now. Some of the big ones you've sort of touched on, the Oxford University study one, Novavax, there's Johnson and Johnson, BioEnTech. Those are some of the big ones that are out there that people are looking at.
- And once in development, how long would it take before it's widely available to the public?
- Yeah, so there's a couple parts. One, actually making sure it's safe and effective and you've got the vaccine, and now we can declare to the world, hey, we've got a vaccine that we feel very confident works. You know, hopefully, in the best-case scenario, by the end of the year, maybe we may have that. But then, of course, the key is rolling that out to 7 billion people. Right?
And that's the major challenge now. With many different vaccines, and people working on different-- sort of having that race to get that vaccine, we may get multiple different vaccines that work. And that will certainly help with distribution. We're also seeing a lot of the companies sort of investing preemptively in terms of their operations, which will help accelerate the process, as well.
So I didn't really answer your question. It would be several months after that initial development. So if you say we, you know, in the best-case scenario end of year, start of next year, it would be several months before we start really rolling that out, if that makes sense.
- No, it certainly does. What happens if the virus mutates? And there's been reports in other countries that this is already happening. Will the vaccine still be effective?
- Yeah, it's a very good question. So there's different types of viruses, RNA and DNA viruses. The COVID-19, or SARS-CoV-2 virus, I should say, is an RNA virus. RNA viruses don't have the same sort of correcting mechanism that DNA viruses do, so they're more prone to mutations. But we've actually seen that the mutations in this virus have not been rapid when we look back compared to January. So you know, these small changes are expected. They're not out of the norm. Viruses mutate, particularly RNA viruses. The influenza virus, it does change, it seems, at a quicker pace than this virus. So that is why we have to get a new vaccine, or a variation of it every year.
The vaccine that we get will likely handle many of the mutations that we're going to see. So if it replicates or changes a little bit quicker than we expect, it just means there may have to be some modifications to the virus, but-- I'm sorry, to the vaccine-- but I don't think it's going to have major implications, to be perfectly honest.
- Now, I know it's been a while since you've updated us on the state of the pandemic. I think the last time you were on, some of the US states and provinces were just in the early stages of opening up. How are we doing today in Canada?
- Yeah, a very good question. And I think now we can sort of reflect and look back and see that, you know, in On-- or actually, I should say in Canada, overall we've done quite well. The first cases of COVID-19 came into Canada and US around the same time. And of course, in Canada, we've had-- I think it was around 340 cases yesterday, compared, of course, to the US, where they're getting 10,000, 15,000 cases in certain states. Now of course, we're 1/10 of the size as the US, but the proportion, when you do the math, it's not proportional.
We've seen the measures that we've taken in Canada have worked, and worked-- you know, a lot of this is driven around behavior. So and that can come from different areas. That can come from sort of leadership driving behavior through policy, through messaging, et cetera, just compliance of the people, however that may be. But what we've seen is that the lockdowns in Canada, people were overall pretty compliant.
They were able to quiet the disease down. And then upon reopening, of course, there have been some that have not complied. But for the most part, most people have complied, and we've been able to bring down the numbers in Canada. And it's a small margin of people, the percentage of people that are non-compliant. When that goes up even just a little bit, that can really make the numbers go up. So that's what we've seen in the US, unfortunately.
- And as you mentioned, the US is becoming-- quickly becoming the epicenter of the pandemic. Is this a cautionary tale for Canadians that this could happen to us here if we relax too much and we fail to observe the protocols?
- Tony, you're 100% right. This is a warning-- I won't call it a warning, but as you mentioned, a cautionary tale. We are not out of the woods yet. A second wave in Canada, or any country, any region until there is a vaccine, is possible. So I think we have to be aware of that. And we've seen this virus can quickly grow out of control. I think we have to be prepared, our governments, to shut down quickly. While we open up in a phased approach, that makes sense, in a very slow approach, but when we shut down, if we need to shut down, we have to shut down quickly, and bring our tiers down in terms of going back from stage three to stage one, or possibly lockdown if we see certain signals.
Now, of course, hopefully that can be regionally only, if we are on top with our surveillance and our testing. But those are some of the things we have to get right. And people still need to realize that we're going out, and we're starting to go into phase three and other phases, but the virus is not gone. And if we look back when we had just a few cases, we were still sort of worried and being mindful of some of our measures, and we still have to keep those measures on until we have a vaccine, and be vigilant.
- Dr. Nikore, thank you very much for your insights.
- Always a pleasure.
[MUSIC PLAYING]
- Let's start with the encouraging results from Moderna's experimental vaccine just released yesterday. Certainly the stock market liked the news. Dr. Nikore, what do the results from Moderna actually indicate?
- Yeah, Tony, obviously there was some positive feedback from many people regarding these results. And I do think it's positive news. What it showed was that we had 45 people in a study from Moderna. And this is actually the first one that we've seen published in a major research journal, the New England Journal of Medicine. 45 people that were healthy, 18- to 55-year-olds. 15 got a low dose, 25 micrograms, 15 people received 100 micrograms, and then 15 received a higher dose of 250 micrograms. After one month, they've received a second dose.
And there's two parts when it comes to vaccines-- their safety and then efficacy, so how well does it work. So this first phase, what we look at is how safe is it. And what it did show is that-- well, really two things. One, it did appear safe. There were no major side effects. So things like transient fatigue, chills, headaches, muscle pains, pain at the injection site, but nothing significant, which is a very good sign.
And then the second part, it showed that antibodies were made in all of these people. So an immune response was generated. So this is positive news. And what it means is now they're going to take this group of 45 people-- not this group, but they're going to expand upon this group of 45 people, expand that to around 30,000 people to really now focus on the efficacy, how well does it actually prevent the coronavirus. So that's where we stand. That's at the end of this month that this will likely start.
- And are you optimistic about the results?
- I overall am optimistic. I think sometimes people, when you look at sort of the markets and other people, there may be a little overoptimism. And the reason I say that, not that this is not great news, but you know, we've been pegging that we're going to get a vaccine in a year, year and a half, when typically vaccines take several years. Now, we were able to accelerate upon several years because of learnings from SARS, et cetera.
But one of the important pieces here is that this year, year and a half was expected-- for things to be done in a year, year and a half, it was expected that we were going to have things go very well. So this is kind of in line of what we're expecting. It's kind of like having a world-class championship team that is touted to be the best team ever, and they win the first round of the playoffs. It's great, it's good news, but it's expected, and we've got to keep making sure that things go in the right direction.
- And of course, next week we're awaiting trial data from AstraZeneca. University of Oxford vaccines are coming out. Are there any other vaccines or treatments in development that you think have some promise?
- Yeah, good question. You know, as you know, there's 150 vaccine candidates or so out there. 23 are being tested in human trials right now. Some of the big ones you've sort of touched on, the Oxford University study one, Novavax, there's Johnson and Johnson, BioEnTech. Those are some of the big ones that are out there that people are looking at.
- And once in development, how long would it take before it's widely available to the public?
- Yeah, so there's a couple parts. One, actually making sure it's safe and effective and you've got the vaccine, and now we can declare to the world, hey, we've got a vaccine that we feel very confident works. You know, hopefully, in the best-case scenario, by the end of the year, maybe we may have that. But then, of course, the key is rolling that out to 7 billion people. Right?
And that's the major challenge now. With many different vaccines, and people working on different-- sort of having that race to get that vaccine, we may get multiple different vaccines that work. And that will certainly help with distribution. We're also seeing a lot of the companies sort of investing preemptively in terms of their operations, which will help accelerate the process, as well.
So I didn't really answer your question. It would be several months after that initial development. So if you say we, you know, in the best-case scenario end of year, start of next year, it would be several months before we start really rolling that out, if that makes sense.
- No, it certainly does. What happens if the virus mutates? And there's been reports in other countries that this is already happening. Will the vaccine still be effective?
- Yeah, it's a very good question. So there's different types of viruses, RNA and DNA viruses. The COVID-19, or SARS-CoV-2 virus, I should say, is an RNA virus. RNA viruses don't have the same sort of correcting mechanism that DNA viruses do, so they're more prone to mutations. But we've actually seen that the mutations in this virus have not been rapid when we look back compared to January. So you know, these small changes are expected. They're not out of the norm. Viruses mutate, particularly RNA viruses. The influenza virus, it does change, it seems, at a quicker pace than this virus. So that is why we have to get a new vaccine, or a variation of it every year.
The vaccine that we get will likely handle many of the mutations that we're going to see. So if it replicates or changes a little bit quicker than we expect, it just means there may have to be some modifications to the virus, but-- I'm sorry, to the vaccine-- but I don't think it's going to have major implications, to be perfectly honest.
- Now, I know it's been a while since you've updated us on the state of the pandemic. I think the last time you were on, some of the US states and provinces were just in the early stages of opening up. How are we doing today in Canada?
- Yeah, a very good question. And I think now we can sort of reflect and look back and see that, you know, in On-- or actually, I should say in Canada, overall we've done quite well. The first cases of COVID-19 came into Canada and US around the same time. And of course, in Canada, we've had-- I think it was around 340 cases yesterday, compared, of course, to the US, where they're getting 10,000, 15,000 cases in certain states. Now of course, we're 1/10 of the size as the US, but the proportion, when you do the math, it's not proportional.
We've seen the measures that we've taken in Canada have worked, and worked-- you know, a lot of this is driven around behavior. So and that can come from different areas. That can come from sort of leadership driving behavior through policy, through messaging, et cetera, just compliance of the people, however that may be. But what we've seen is that the lockdowns in Canada, people were overall pretty compliant.
They were able to quiet the disease down. And then upon reopening, of course, there have been some that have not complied. But for the most part, most people have complied, and we've been able to bring down the numbers in Canada. And it's a small margin of people, the percentage of people that are non-compliant. When that goes up even just a little bit, that can really make the numbers go up. So that's what we've seen in the US, unfortunately.
- And as you mentioned, the US is becoming-- quickly becoming the epicenter of the pandemic. Is this a cautionary tale for Canadians that this could happen to us here if we relax too much and we fail to observe the protocols?
- Tony, you're 100% right. This is a warning-- I won't call it a warning, but as you mentioned, a cautionary tale. We are not out of the woods yet. A second wave in Canada, or any country, any region until there is a vaccine, is possible. So I think we have to be aware of that. And we've seen this virus can quickly grow out of control. I think we have to be prepared, our governments, to shut down quickly. While we open up in a phased approach, that makes sense, in a very slow approach, but when we shut down, if we need to shut down, we have to shut down quickly, and bring our tiers down in terms of going back from stage three to stage one, or possibly lockdown if we see certain signals.
Now, of course, hopefully that can be regionally only, if we are on top with our surveillance and our testing. But those are some of the things we have to get right. And people still need to realize that we're going out, and we're starting to go into phase three and other phases, but the virus is not gone. And if we look back when we had just a few cases, we were still sort of worried and being mindful of some of our measures, and we still have to keep those measures on until we have a vaccine, and be vigilant.
- Dr. Nikore, thank you very much for your insights.
- Always a pleasure.
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