The invisible race

A Shot to Save the World: The Remarkable Race and Ground- breaking Science Behind the Covid-19 Vaccines

Author: Gregory Zuckerman

Publisher: Viking, an imprint of Penguin 

Pages: 355

Price: Rs 799

Traditionally vaccines take years to develop. Paul Offit, a renowned infectious diseases specialist and rotavirus vaccine developer, held the same view and ridiculed the optimism to develop the Covid-19 vaccine in a year.

On March 16, 2020, however, a few months after the first case of novel coronavirus was detected in China, Jennifer Haller, became the first person to get a Moderna vaccine against Covid-19 in a clinical trial. That’s nothing short of a miracle, and Gregory Zuckerman’s book explains how that happened.

A special writer at The Wall Street Journal, Mr Zuckerman spent 17 months engaging with organisations and picking the brains of executives, scientists, virologists, independent researchers and marketers to present a detailed account of how vaccines get developed. For all — from the organisations that successfully develop vaccines to the enthusiasts that have entered this space — Mr Zuckerman notes, the fight is the same: To produce a vaccine first amid “heated competition, crippling insecurities, and unbridled ambitions.”

Mr Zuckerman’s engaging book begins with the medical fraternity’s determination to create a vaccine for a new human retrovirus, the human immunodeficiency virus (HIV), which led to a disease that the Centers for Disease Control and Prevention would name Acquired Immune Deficiency Syndrome, or AIDS, in 1982.

With this segue, he lays the groundwork for the layperson to understand how the human immune system works, explaining its two lines of defence — the “fast-acting, first-line” innate immune system and the body’s “adaptive” immune system, which creates antibodies against a pathogen — before delving into the hullabaloo of developing, marketing, and distributing vaccines.

Mr Zuckerman credits the American geneticist Jon A Wolff, who, in 1990, suggested the possibility of synthesising and delivering “normal DNA or mRNA, without the mistakes, straight into human cells to replace defective genes.” It was Wolff’s study that proved pivotal in developing the Covid-19 vaccine. But no one predicted that Moderna — whose name is a “mash-up of “modified” and “RNA”,” a company that “didn’t have a website, wouldn’t talk to the press, and forced employees to sign confidentiality agreements preventing them from sharing information, even with spouses,” and above all was “searching for money to stay ahead of the pack [BioNTech, Pfizer, and Johnson & Johnson]” — would develop it first.

There were several reasons for Moderna’s success. First, using mRNA for drugs is a “fast process each time, relying on a specific sequence of genetic code and cheap enzymes to produce each protein.” This helps avoid, as Mr Zuckerman notes, “enormous costs.” Also, the mRNA approach, “was so new and unique it likely wouldn’t infringe on existing patents, meaning almost every kind of medicine could be produced without legal troubles from drugmakers.” Finally, it was Moderna’s CEO Stéphane Bancel who “had the nerve to ask for a lot of money,” which he got from AstraZeneca, which agreed to pay $240 million. Overcome with joy, when 

Mr Bancel broke this news to Noubar Afeyan, founder of venture capital firm Flagship Pioneering and co-founder of Moderna, the latter “stopped him short,” saying he was overlooking a crucial thing: “Now everyone in town will hate you.”

With the money, the only goal for Moderna was to produce results, which it did in a “pressure-packed atmosphere,” which Mr Bancel loved but his employees dreaded. Moderna’s scientists, Mr Zuckerman writes, were falling to the floor after working overtime and braving harsh language. He justifies this environment by pointing out that “biology is slow-moving and eureka moments are rare, so pressures slowly mount. Take too long to publish your findings and a rival will beat you to the punch, dooming your career.” 

The book also underlines how vaccine development is dominated by white men, who hate it if someone, especially a woman, that too from a minority, is smarter than them. Hungarian biochemist Katalin Karikó is a case in point. It’s little known to the media that it was Ms Kariko who laid most of the groundwork for the vaccine development for both BioNTech and Moderna.

Claudia López Lloreda of STAT  — a media company exclusively covering medicine and healthcare — notes that Ms Karikó, 66, did not “receive a single R01 grant, the main way the National Institutes of Health funds scientists” for the first 40 years of her research.

Though Ms Karikó has been given her due over the years, she was dismissed early on for being “rude” — she was forthright and honest in her feedback. She was demoted once, but it didn’t deter her spirits, for she was passionate about using mRNA for therapeutics.

One thing that I found striking in this book and missing in others is how it introduces Wuhan. Most writers indict the city for spreading SARS-CoV-2. 

Mr Zuckerman begins by describing Wuhan as a beautiful city through which the culturally important Yangtze and Han rivers flow and detailing its multi-connectivity, which helped spread the virus. This detour should make us ask ourselves: Should China bear the burden of the blame or should leaders such as Donald Trump be blamed for downplaying the virus’s danger to safeguard their vested interests? It isn’t just scientists’ responsibility to protect the world; common sense and human-centric leadership can do wonders as well.