In the Bubble with Andy Slavitt: Our Shot

Are We on Our Way to a Game-Changing Flu Vaccine? (with Uwe Schoenbeck)

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For decades, the messenger RNA (mRNA) platform was seen as too unstable and expensive to be used in vaccines or therapeutic medicines. That changed when the COVID-19 pandemic sparked enough urgency, resources, and money to bring about a breakthrough. Andy speaks with Uwe Schoenbeck, the chief scientific officer for Pfizer’s Emerging Science & Innovation team, about what makes the mRNA platform more nimble than conventional methods and its potential future uses, including a game-changing flu vaccine and gene editing therapeutics for cancers, Alzheimer’s, and HIV/AIDS.

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Uwe Schoenbeck, Andy Slavitt

Andy Slavitt  00:17

Welcome to the bubble. This is Andy Slavitt. It is Wednesday, April 27. This is an episode where I asked the question, what is the best news coming out of the pandemic? It’s a weird question. But if you look at it, there’s got to be some good news coming out of it. Now, look, I’m the kind of person that if you tell me things are super rosy, I’m going to be a little bit skeptical. And if you tell me things are all bad, I’m going to be a little skeptical. I’m also not a big fan of people finding, quote unquote, silver linings in difficult situations, but doesn’t mean they don’t exist. And I think that if we step back and say, for all the misery and all the challenges, and all the reasons for pessimism that we might have felt during different times during the pandemic, there are some really amazing things that have happened. And one of them is we may have just tripped on a set of technologies, a set of biotechnology, that set of therapeutics and vaccines in areas in science that could transform medicine. And that I want to focus on in this show today, where I have an expert on the topic of the mRNA platform. And you know, if you’re like oh my god, I’m going to turn this off, because it’s like, who wants to hear about some scientific platform that developed a vaccine, for we just had no, stop, don’t hang up. Don’t press pause. Don’t speed through this. Just listen to this for one second. We may be on the verge of having a set of transformative medicines to transform the way we as humans live. Because of this platform, now, I’m not going to overhype it, I want to get into the facts. So they don’t believe again that it’s all rosy or all negative, I just, I want you to understand the facts. Because the facts of how this platform works, how this technology works, is astounding, including some really amazing things like the fact that we could be on our way to being able to create gene editing and therapeutic medicines, that we could be on our way to creating many, many, many treatments and vaccines beyond COVID 19 vaccines, including potentially a vaccine that almost wipes out the flu for those who are taken, taking a flu regimen, which today is you know, as we know, maybe bounces between 40% to 50% effectiveness and most years to 90%, which would be massive at historic. And this is really good news. So I have Uwe Schoenbeck, who was the chief scientific officer at Pfizer, and that, you know, Pfizer struck a partnership with BioNTech. To use the mRNA platform, they were on the way to creating a vaccine for the flu when COVID hit. And this is where the story with Uwe, begins. One thing you should know, before I get to this interview, is that the company that Uwe worked for is Pfizer, Pfizer does advertisements on the show. And you may know that advertisements on the show go to after we pay the expenses of the team, the money that goes to me goes directly to charity. But I just want to call that out. You know, they’re kind enough to give us access to some of the people that give us great answers like this, as well. Oh, and one more thing after the show. We’re gonna talk about whatever happened with those Webby Awards that I’ve mentioned to you in the URL. So kind as to vote for.

Andy Slavitt  04:14

Welcome to IN THE BUBBLE. So glad to have you here, Uwe.

Uwe Schoenbeck 

Thank you. Thanks for having me.

Andy Slavitt 

So now my understanding is correct. You guys just invented the mRNA platform about a year ago, right? It’s just brand new, came out of whole cloth.

Uwe Schoenbeck  04:28

It’s probably a little bit more than a year ago.

Andy Slavitt 

A little more than a year ago, maybe 50 years ago. Tell us the history and the promise that’s been out there for mRNA technology, and maybe explain a little bit about how it works.

Uwe Schoenbeck 

Sure. I mean, it kind of took us 60 years from the discovery of what was called mRNA to, you know, the first vaccine approved vaccine. I think it goes back to a publication by a group of PIs that became quite famous off the Brehmer agenda Co-op and Ms. Wilson, who reported in what was called an unstable intermediate carrier for information from the gene, which is your DNA, basically to the ribosome, which is kind of the protein manufacturing plant in your body. That was 1961, if I remember correctly was an […] article actually, and was arguing for the role of mRNA in gene regulation. It took us another more than a decade, I think was a decade and a half until late 70s, when the first mRNA was actually isolated, and was then demonstrated to produce a protein in mammalian cells. And from there on, it became very clear that the messenger RNA or short mRNA is really the mediator between your DNA, your genes, and to find the proteins that make up your body. And it wasn’t the 80s that we started to discuss kind of the role and use of mRNA, not just in protein production, but then also in the 90s, about potential use and flus and flu vaccine. So the first mRNA flu vaccine was thought of and actually tested in mice, somewhere in the 1990s. So you know, a quarter of a century ago. But it didn’t work out really, because the RNA degrades very quickly and back then we didn’t have any optimization tools available. Since then, we’ve done a number of additional changes to the RNA to really help us stabilize it and drive it forward. When you think about the vaccine, specifically, it’s really a fairly unique approach. You know, conventional vaccines use actually part of the virus, either the whole virus, or part of the virus, and deactivate it, for example, he treatment or some other kind of treatment and makes the virus no longer a dangerous element, but still allows the body to recognize it through the immune system and build a response to it. Now, if you do that, if you can imagine you first have to isolate the virus, you have to determine which are the parts of the virus structure that really create an immune response. And then you have to reproduce those parts in some form or shape either by isolating it and deactivating it or by producing parts of it, that you then have to inject in your body. So it finally can build the immune response against it.

Uwe Schoenbeck  07:36

The mRNA platform works quite differently, it circumnavigates that you have to deal with the virus with the structure of the virus with the components of the virus itself, you can just use the mRNA sequence that quotes for the relevant viral protein and inject that mRNA into a human. And that cell will then produce part of this virus, the particle that the RNA coded for, the mRNA platform allows you to be much faster in your response to adapt to new strains or new variants, or to new viruses. We started this in partnership with BioNTech was 2018, I think, to develop an mRNA vaccine against the flu. And the reason why we picked the flu was exactly what I just mentioned, the flu varies from year to year, sometimes within a given season, you can have more than one strain. And that’s one of the challenges of the current vaccine, it takes you several months, if not half a year or longer to determine this new strain, and then use the conventional method. With the mRNA, you can respond much faster probably in the period of two to three months, which you can adjust the vaccine against the new strain and therefore be much more nimble, much faster, much more streamlined, how you can treat this kind of infection. And as you can imagine, we had just worked on this for a couple of years or a year and a half with BioNTech when the news about the COVID 19 outbreak came across the globe. And at that point, we decided then to very quickly adjust our partnership. And instead of focusing on the flu, we focused on for the next year, very strongly on the COVID-19 vaccine to apply exactly this mRNA platform for the first time.

Andy Slavitt

So it’s a story about preparation and investment over time, needing a moment, throughout this time period that you talk about from the 60s and 70s the 80s and 90s. And you know, I can’t tell you that each time I’m thinking about each music era we went through so we’re going through the Beatles we go through the Rolling Stones, we get Nirvana when the things failing. Now we get into I don’t even know the latest music. That’s happened since then. I’ve been you know, as far as I know, we’re still listening to that stuff. But you will go through a lot of different music here. Was it during this period of time, people were saying, what? About mRNA about the promise or mRNA, that it was fantastical, that it was potentially breakthrough, but that it had this flaw in being and not being able to be stabilized. But people thinking of it as something that had helped create great therapeutics or great vaccines. But it had been so long without anything happening, that the story had to be a little bit muffled.

Uwe Schoenbeck  10:27

Well, I think there’s a couple of things that come together. So number one, don’t forget where the first description of a unstable […] was, it was called I think, in the 60s came out. And that wasn’t 100% clear what the true meaning of this is more from a biology perspective than from a therapeutic perspective. You know, biology, we can better understood now how you know, the DNA, your genome is translated to proteins, fine. But how do you make this a therapeutic approach takes way more understanding of the mechanism and how to actually apply it safely to men, and the safe piece is a very big item of this, if you think back on to gene therapy, for example, gene therapy, you know, was very affluent in the late 90s, there were a lot of clinical trials and gene therapy ongoing. But the delivery vehicle that was used was not as safe as one would have hoped. And so therefore, field had somewhat of a setback, because what’s then, you know, 15-20 years later, that we identify actually much safer ways of advancing gene therapy that then allow it to come back. RNA, it’s not much different. I think there was first recognition of potential for RNA by investigators, like Catalina carveco, who was really a key driver of the field. But back then there was a lot of concern of whether it’s safe, it’s unstable, how could this work? You know, is it the risk would be way too high to invest into it from a therapeutic angle approach. So there was not enough momentum really out there. And it came at a time where small molecules were kind of the essence of drug discovery, so to speak. So it didn’t fit that element either. It was really, probably far ahead of its time. And even when you think about we tried it in the 90s, as a PhD as a flu vaccine the first time, it failed, because it degraded very quickly, we didn’t understand how to bring RNA safely inside the cell, not just inside your body, but inside the cell. And so it was then requiring additional work, which found out that once you alternate certain nuclear sites in that RNA, it doesn’t change the information that carries and just renders it more stable, less inflammatory in its nature. And then on top of this, we had to learn that we have to build a vehicle in which you can put the RNA to bring it inside the cell, the so-called lipid nanoparticles, LMPs that I think many folks are now somewhat more familiar with. And it has to be really these two fields coming together, that you pack a more stable RNA into actually, into this lipid nanoparticle. And then use that to bring it into the body into the cell and create the immune response.

Andy Slavitt  13:56

Let’s start by talking about the use in the COVID-19 vaccine because that’s the first time we have been able to see it live and see that, we had Albert Bourla Pfizer CEO on the podcast last week, he talked about and wrote about that when it came time for Pfizer to decide which vaccine to go with. He had been skeptical that the mRNA platform was as of yet even ready for primetime 50 years later. And obviously, you know, the story was that he was subsequently persuaded by the scientific team. But if we play back the tapes, and I think about 2020, and the different vaccines under development, people were talking about the mRNA vaccine is promising, but it was by no means certain that it would produce a highly effective vaccine. And in fact, people were talking a lot about the disadvantages, for example, that it would acquire in cold storage and so on and so forth. What did you think at the time, did you think that the mRNA technology was ready to meet its opportunity?

Uwe Schoenbeck 

So I would say that I saw the biggest potential for a successful vaccine to actually come from an mRNA vaccine. From a technology perspective, for the reasons I mentioned before. It’s much more adaptable, it can be developed much faster. And we have by then also developed delivery vehicles that would allow for safe delivery and effective delivery into man. Now, that’s easier said than done, because it was never done before.

Andy Slavitt 

Right. Well, plus, it had the challenge of planting the microchip in us.

Uwe Schoenbeck 

Yeah, I heard many, many stories of what we all put into the vaccine. I mean, I have to say, I’m glad we were able to put the RNA and deliver nanoparticle together, what are you talking about putting anything else in there. I wish we wouldn’t be as sophisticated as that is sometimes, you know, but no, I think the big risk was that it hasn’t been tested before. And that sense, now we knew the individual ingredients were safe, but we didn’t know whether the combination of everything will not just be safe, but actually effective.

Andy Slavitt  16:12

Sure, well, so as the first step, the very first step, but as we were sitting here, 2020, you had to undergo a clinical trial, and there were 30,000 or so humans that were going to get this inserted into them. You know, I want to go on and talk about the promise of mRNA for some of the other applications. But I am just intrigued by the fact that here we are in a major crisis, where we’re throwing a long pass in football terms, to use a technology that’s had lots of lots of promise, it should work. But as always, had one challenge or another over the years. And it never really, as you said been put into to humans, and then we’re going to inject it into not just sick humans, but very healthy humans. Humans had nothing wrong with it. What did that feel like? What was that like?

Uwe Schoenbeck 

Well, I think it’s probably fair to say, and I think we all have gone through kind of a historic and somewhat transformative time to be here at Pfizer or anywhere else in the world for the last two years. And I think what it showed is, you know, the value of teamwork, not just within groups, and Pfizer, but actually, across the healthcare industry, really, we’ve seen a probably to an unprecedented level. And also was interesting to see that, you know, given your large organization, yet you have to deal with these highly unusual circumstances, how can you be fully focused, really laser focused on the key purpose, which is to deliver this vaccine and really bring a change to patients here, and then require taking huge risks. And, you know, I think what was really remarkable for me was this coming together, within the industry and across the industry, to really hone in on something that was threatening the globe and be successful with it. So it was extremely daunting when it started. But as we started to see positive data coming in was also extremely rewarding. And doing it at a scale that had never been done before, and doing it at a pace that has never been shown before. So if you talk about the long pass, I would call this a Hail Mary.

Andy Slavitt 

Yeah, so it’s quite wide. And you know, BioNTech, which is a German company, who Pfizer partnered with, and Moderna here in the US. These were companies that, if I’m not mistaken, it really bet their entire companies on this technology. And in the case of Moderna, you know, they went through a decade, where they were a company without a product without necessarily a hope of there being a product. And, you know, it’s interesting in the context of how in our society, you know, we allow companies to place these kinds of bets, and many of them never pay off. And then one day and in some of these cases, I guess you’re just glad you did.

Uwe Schoenbeck 

I think you have to, right? I mean, we know that you know, the pharma industry, the biotech industry is unfortunately characterized by you know, having to go through biology and that means you have a lot of failures to the way of success you have to weigh you’re working way through not everything you will try will work and every compound you develop will work. But, you know, we were also very well aware that we couldn’t go about business as usual because usually Um, you know from idea to launching a drug takes you anywhere between 10 to 15 years on average across the industry, given a lot of the challenges I mentioned. So here, we had a technology that was allowing us to be much faster. But we also depended a lot on regulatory agencies, we depend a lot on government interaction, we depended a lot on our partner BioNTech, and others, to really help us drive this as aggressively as we could, not knowing whether it’s gonna work out, you have to put in tremendous amount of hours, colleagues had to do a lot of things in parallel and full risk. I mean, we put billions of dollars at risk. Because we advanced everything in parallel, there was the development of the vaccine itself, the development of the lipid nanoparticle, the manufacturing piece of it, the distribution piece of it. All of this had to be done in parallel. And, you know, in record times, which as you can imagine, comes with record costs, and not knowing whether you will be successful in the end or not.

Andy Slavitt  21:12

So I want to talk about how much this changes things. How much this is a game changer, you know, there are a lot of diseases, many cancers, Alzheimer’s, HIV-AIDS, where certainly we’ve made progress, we have some treatments. In some cases, though, there is the promise of a vaccine. In some cases, there’s a promise of better treatments. Let’s turn the conversation to focus on what can this mRNA platform realistically do now that we know that it is safe in humans? And then as you can produce an effective vaccine in humans? What does this go next? Where does it change?

Uwe Schoenbeck 

It’s a good question. I mean, there’s probably three or four avenues that come to mind and that we actually are pursuing I mean, first and foremost, it’s continuing to invest into the research surrounding the COVID 19 vaccine. And by expanding into younger populations, continuing to advance booster strategies, and addressing emergent variants, you know, we don’t know yet when the next variant will show up. And we don’t know what the consequence of that variant will be. So I don’t think we can let our guard down yet, on the COVID-19 vaccine, we have to stay vigilant, we have to continue to monitor and we have to be ready to address any new needs that are coming forward. But beyond that, the next one is really going into other infectious diseases that, you know, the mRNA vaccine platform might lend itself to, we’re making pretty rapid progress actually, on other mRNA vaccine research areas and have our eyes set on, you know, a number of infectious diseases, particularly viral infectious diseases, and that includes flu, as well as shingles. You know, both of which we’re pursuing, in partnership with BioNTech.

Uwe Schoenbeck  22:15

So what will be the advantages, what will be the advantages of a flu or shing? I just had I just had my first shingles shot. For those of you who are over 50, I highly recommend it. What would you say are the advantages of the mRNA platform for shingles to start with shingles and then also with for flu?

Uwe Schoenbeck 

Yeah, I think, you know, if you think about flu there, because that’s where the work started, flu will remain sexually a life-threatening disease, which many folks might not realize what you know, worldwide, we depending on the season, you’re looking at a quarter million to three quarters of a million deaths over the past years, […]. One of the challenges with flu is that there is a new strain a new variant coming forward every season, as I said earlier, sometimes there’s more than one strain coming forward in any given season, using the conventional flu vaccine is going to be making a very challenging because A, your general effectiveness lies around 50%-60%. But on top of this, you’re much slower in responding to any new variant. So if you miss predicted the variant for coming season, your fluency might be less effective. The advantage of the mRNA vaccine is you can respond very swiftly to any new strain, any new variant coming forward. Because all you have to do is basically adopt your RNA, use the same delivery vehicle, use the same approach, just injected into patients.

Andy Slavitt  24:43

So let me see how good an interviewer I am. Let me see if I could pin you down. Like what would you imagine that we could see vaccine effectiveness be for the flu with an mRNA platform?

Uwe Schoenbeck 

I think it’s very difficult to predict I mean the vast the initial phase one studies right now and healthy adults. So we have a follow up 3.2. Right now dose range study will begin enrolling from that, we don’t have any data. So it’s pure, pure prediction. There is some hope that the mRNA vaccine for flu will be more effective than the 50 or 60% of you see today, by how much? I think that’s to be determined.

Andy Slavitt 

Can you imagine seeing 90%, effective flu vaccine, which does feel like a game changer?

Uwe Schoenbeck 

Absolutely. I think like I said earlier, when flu remains a very deadly disease, you know, 300,000, or 500,00, 600,000 people a year die of the flu, across the globe, including the US has a pretty significant number of deaths from flu. So if you can have a healthy vaccine that really provides real time protection against any strain that’s out there and done. So with 90%-95%. I think that would be great, particularly for the elderly, for the vulnerable folks.

Andy Slavitt  26:02

And how many years off would you say we are from that you started working a couple of years ago? So as long as you’re typing, you’ve had to work on COVID-19. What would you say the target would be?

Uwe Schoenbeck 

I’m not sure we can repeat the timeline from COVID-19, which was less than a year. But hopefully, within a year or two, we will see, you know, we will see data earlier than that from our Phase 1-2 trials. But to have it approved, might be taken us a year or two.

Andy Slavitt 

Yeah, because it because it wouldn’t be entered to remind the audience, it wouldn’t be under emergency use authorization. But you can imagine, one shot once a year for a multitude of viruses, including the flu, and COVID-19 updated for the latest variants of both. Do you see that as the likely future?

Uwe Schoenbeck 

I think so. Yeah. I mean, we’re starting to talk about, you know, the move from 100x situation to an endemic situation like we have actually with the flu. You know, I think the best predictions we have to listen to the experts in the field is that we will have to live with Corona going forward, you know, in some form or the other various strains evolving. It’s a highly infectious virus, not a similar to what we see with the flu. So my prediction would be that going forward, you know, we’re living in an endemic world for flu and COVID.

Andy Slavitt 

So that really is the vaccine, would you expect that there are other vaccine possibilities out there? I know that, for example, Moderna was developing their platform before they knew about COVID-19. Obviously, for a cancer vaccine, I’d say cancer, I don’t know if it’s pan cancer or specific cancers. We’ve been chasing an HIV vaccine. Recently, we’ve been making some progress. Can you talk about beyond the sort of viruses? Are there other potential vaccines that you believe are realistic in the next 5 to 10 years?

Uwe Schoenbeck  28:13

Yeah, I mean, coming back to your original question, where do we see the mRNA platform going? I think that plays into it, you know, as I said, making sure we cover in COVID, making sure other infectious diseases. And then also non-infectious disease vaccines, like you mentioned in oncology could be an approach. What do you think is also very promising, though, are two other areas. One is really gene editing. And the other one is, you know, further optimization on the platform will also allow us to go into RNA therapeutics. I mean, maybe to talk about both in a little bit. If you think about rare diseases for is a rare genetic diseases. These are typically mutations changes in your DNA that cause the disease. So what if you could go in and introduce either the protein that’s mutated in an unhealthy form or even change the gene back to its healthy form? That would basically not just be a therapeutic angle to disease that would be a curative approach. And we started to see some strong successes actually, when you think about gene therapy, where you, for example, introduce a gene sequence into the human body and the human body produces to healthy protein like an haemophilia. haemophilia as a as a genetic disorder. There’s a mutation in your gene that you know, introduces a defect. But you can’t introduce actually the healthy gene into a muscle and the muscle produces or the liver produces enough of the healthy protein. So they have normal blood coagulation. Which for hemophilia patient, obviously is life preserving. So, in the first days of gene therapy, you introduced these sections of a gene into human tissue and they produced it. With gene editing, you get a little more sophisticated, you basically can replace just a single base, not a whole gene, but a single base or two in a gene. So it feels safer, it feels more efficient if you can do that. And you can leverage actually a lot of the tools that you use with an mRNA platform that come to play there, including delivery vehicles, including the mRNA, itself, and so on. So that is really, I would say, the next level that we see the mRNA platform to take, and really bringing change for patients outside of vaccines approach.

Andy Slavitt 

So just to boil it down for people that make sure I understand it. We can be producing medicines and vaccines for basically anything that impacts our genes in which include some of the rare conditions that you’ve talked about. Cancers, I suppose. I’m not trying to put words in your mouth, I’m trying to get a sense of what kind of the realistic pipeline is. And I’m also trying to understand, you know, on behalf of everybody listening, is this a place now where we start, because of the success with COVID-19, we start pouring in resources, and trying to pump out things faster and faster and faster. If we just gotten through to other words, a proof of concept, and we should expect a lot of things to follow, or does it not really change things as much as I’m applying?

Uwe Schoenbeck  32:03

No, I think it’s the former rather than the latter, I think we have demonstrated that we have a new therapeutic modality available. So the old days was only the small molecules to chemistry, basically, they gave you therapeutics, and drugs, then it became antibodies, antibodies, you know, 20-30 years ago became a new therapeutic modality in horizon, this lot of treatments out there in rheumatoid arthritis and other areas where we use antibodies these days. Gene therapy, we talked about a little bit earlier, was kind of the next level. And I think now we’re seeing mRNA, advancing as a new therapeutic modality that holds a lot of potential. And it does so as we pointed out in vaccines for infectious disease, non-infectious disease, oncology, is one example there. But it also holds potential to be used on the use mRNA directly as a therapeutic approach, or in gene editing efforts, we would allow to go into human into patients that have genetic deficiencies, that can be corrected, never the disease can be corrected, or with therapeutics, you can actually use mRNA itself as the agent and said of a small molecule or antibody to bring benefits to patients. This is still something that’s being heavily worked on. But I have no doubt that over the next years, we will see more and more breakthroughs that will allow us to a extend the stability of RNA and therefore the duration of action, but also allow us to deliver RNA safely into specific cell types and organs. And once you can do that, I think it opens a whole new sector of diseases that can be treated.

Andy Slavitt 

Does that mean like diabetes and heart disease?

Uwe Schoenbeck 

I think you’ll really have to see where RNA therapeutics provide an advantage over a small molecule or an antibody kind of treatment. It will depend very much on the specific disease and on the mechanism that disease utilizes. Not every disease, you will be able to treat with RNA. But I think there will be diseases that we currently struggle with treating with the classical therapeutic modalities like chemistry or antibodies, that we now can tackle. And the more immediate entry path of this are, for example, genetic diseases, because of what I just described for a method perspective really lends itself to it, or diseases that you have to get into the cell. Because often antibodies can’t get into your cells. So that limits the range of what you can use there. We also need to think about penetrating the blood brain barrier, often very difficult, certainly with antibodies, but also with small molecules. But here you might have ways to specifically target the CNS, the central nervous system with specific delivery The platforms that might allow you again, to open up new areas of diseases that we currently struggle with treating

Andy Slavitt

The central nervous system, are you talking about Alzheimer’s? Are you talking about some of those kinds of targets?

Uwe Schoenbeck 

Yeah, could be neurodegenerative diseases could be neuromuscular complications. You know, I think it’s all to be determined. We don’t know the answer to it yet.

Andy Slavitt 

So I’m feeling greedy now that we’ve seen what we do so quickly. I’m sure you are, too. And I’m sure people listening would love to know. Like, how do we keep up accelerated track? You know, actually, Dr. Rob Califf coming on the podcast shortly. Maybe it’s like within a week of this, and these are good questions to ask him. Because, you know, if we have, you’d hate to say we’re back to waiting 10 to 12 years for breakthroughs or, or, or requiring a crisis in order to see this kind of development happen, if, indeed, we can attack some of these really crippling conditions. But they require us to change the way we conduct trials and so forth. But I really, I really hope that we figure out how to do that.

Uwe Schoenbeck  36:18

Yeah, hope we’ve taken some of the learnings, some of the lessons learned really, from the pandemic COVID, 19 pandemic forward. You know, I think, in particular about working with lightspeed really having a sense of urgency, not just in Pfizer, but not just the industry, actually, across the healthcare sector, I think it’s something that hopefully will carry forward. And, you know, there are many areas where we will see industry wide sea changes, I think, due to COVID-19, which, you know, as I said, will hopefully carry forward cross sector collaboration, public private partnerships. This level of engagement from so many different parts of the healthcare ecosystem has been really unique, but has been really enabling too. And I hope we remember that as we go into other diseases disorders, not just foreign at therapeutics, one area that we have to say, I think, somewhat missed as a global population is it was a global pandemic, and it would have required global coordination. And I, at the beginning, I had hoped that we would grow together globally, you know, more as a community trying to tackle this together. But I think what we have seen is that every nation for itself, and within given nations, even different states, you know, have put out their very own regulations, restrictions, approaches, that have been very confusing to people around the world. It’s not unique to the US. I mean, I’ve lots of friends and relatives still in Germany, and even their, you know, the states are very small compared to the US. Yep, every state has its very own regulations, and sometimes opposing regulations. So you drive an hour with your car, on the German autobahn, and you have three or four different states with three or four different COVID regulations, which makes it again, very confusing, and, I think difficult to really trust into the system. So I think here’s an opportunity for us to do better, as you know, for everyone to do better, with more transparency, better communication, and hopefully better coordination for something like this to happen again.

Andy Slavitt  38:40

Well, it was shown back, you know, there’s a lot that we cover a lot of difficult topics on the show, there are a lot of times people feel, you know, some amount of pessimism or dreariness as they think about things like the pandemic, the war in Ukraine, economic pressures here at home. But I think this is a really, really positive set of outcomes that are coming from this pandemic, they should give us hope that we have within our power, the knowledge, the science, the talent, the resources, and the collaboration potential if we choose to use it, to solve some of our most significant intractable problems and disease to save a lot of lives. And, you know, as I listened to you, I’d say the one hope I have, you know, we’ve seen the latest estimate that if you look at the count from WHO that the real number of people that have died from COVID-19 is about 14 million people. And, you know, we’ll never get, we’ll never get those people back. That’s 14 million family members will never get back. But I listened to you and wonder if the way we can maybe make some meaning out of this and out of those lives, is saving the next 14 million lives that otherwise might have been lost. But for some of the discoveries that we made, because of the pandemic, that when the story is written, in other words, we will have lost a bunch of lives. So we’re gonna go, take a, we’ve learned, take some of the positive progress we’ve made and go save just as many lives of more on the backs of this. And I think that would be a great postscript for what we’ve all lived through.

Uwe Schoenbeck  40:24

I think it’s very much set. You know, I think we gotten used to feeling fairly safe in our environments. You know, I understand the concerns about Ukraine and other areas that concerns like this. But from a health perspective, we fell probably as good as it could get until we realize that nature is not discriminating what species you are. And, you know, this will probably not be the last virus that we will identify that targets mankind. But as you said, I think overall, this has become a very positive direction. Because we have been able to overcome this, we have been able to overcome this in record time. It does not bring back the patients that we lost, there’s no question and there is no way to ever really understand what that means for individuals. But I’m much more confident that if we happen to have the next COVID, you know, we had SARS, we had […], we have, you know, Spanish flu, we had a lot of events that occurred and decades apart. But they do occur, and something will come back, I have no doubts about that, probably in our lifetime, at least in our kids lifetime. And I think we’re much better prepared to protect the next generation that suffers lead than we were probably this time and that I think it’s a good feeling. And I think that’s something we need to build on.

Andy Slavitt  40:29

Uwe, that’s a perfect place to land it. Thank you for coming in the bubble.

Uwe Schoenbeck 

Thank you for having me.

Andy Slavitt  42:12

Okay, thank you to Uwe Schoenbeck for showing up and answering our questions about this very exciting technology and platform. Maybe we’ll come back and play this episode in five years. And say this was the beginning of something pretty extraordinary. I also want to thank the Webby and all of you listeners we had in the bubble was deemed the best health and wellness podcast. And we were we were also as you know, nominated as Best host. We didn’t win that category, but we were nominated. So that’s good. That’s a really nice acknowledgement. Thank you, it feels some sense that we’re gonna be on the right track with the show. And so it makes the group of us here who work on it, feel even more committed to delivering you great shows and great content. I certainly enjoy doing it. On Monday we have FDA commissioner Rob Califf. And I’m going to press him on when kids will be getting vaccines why it’s taking so long. What happens in the fall with bio valence therapeutics that are coming in, you know, he’s new into that job. So he’s got a fresh perspective on the FDA the tenure, and I think it’s going to be a canvas episode he is committed to talking to us before he talks more broadly to the world about some of the things he’s saying then in Wednesday. Janae Khaldoon who was the Chief Medical executive for the state of Michigan and one of the members of the COVID-19 Health Equity Task Force, under the Biden-Harris administration, really great conversation, and she’s now the Chief Health Equity officer for CVS health. But we’re going to talk about her experience in Michigan during the rough days of the pandemic, and how to push the notion that we get more equitable health care to all that’s a topic you’re gonna hear a lot if you’re on the show. And then coming up Deborah Birx. Deborah Birx, that Deborah Birx yes, that Deborah Birx. She has a new tell all book out, and so she’s ready to talk about her time in the administration. So don’t think that won’t be fun. Tune in for that one, too. Have a great rest of the week. I’ll be talking to you on Monday. By the way, don’t forget next week for the very first time ever. We will be bringing you the new three times a week in the Bubble with Andy Slavitt. Three times a week. So we’ll be talking to you Monday, Wednesday and Friday. I bet you’re as excited as I am. Have a great rest of the week.


Thanks for listening to IN THE BUBBLE. We’re a production of Lemonada Media. Kathryn Barnes, Jackie Harris and Kyle Shiely produced our show, and they’re great. Our mix is by Noah Smith and James Barber, and they’re great, too. Steve Nelson is the vice president of the weekly content, and he’s okay, too. And of course, the ultimate bosses, Jessica Cordova Kramer and Stephanie Wittels Wachs, they executive produced the show, we love them dearly. Our theme was composed by Dan Molad and Oliver Hill, with additional music by Ivan Kuraev. You can find out more about our show on social media at @LemonadaMedia where you’ll also get the transcript of the show. And you can find me at @ASlavitt on Twitter. If you like what you heard today, why don’t you tell your friends to listen as well, and get them to write a review. Thanks so much, talk to you next time.

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