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In the Bubble with Andy Slavitt: Our Shot
All Podcasts The Future of Vaccines with Moderna CEO Stéphane Bancel

The Future of Vaccines with Moderna CEO Stéphane Bancel

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Description

Andy calls up Moderna CEO Stéphane Bancel for a remarkable behind-the-scenes look at the last two years inside the company. As Moderna’s booster shots start to roll out across the country, Andy and Stéphane discuss the origins of Moderna’s partnership with the government, how he thinks the vaccine will hold up against future variants, and the effort to vaccinate the globe. Plus, Stéphane’s riveting recollections of hearing about COVID-19 for the first time in January 2020, and what else they’re working on right now to help us end the pandemic.

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Transcript

SPEAKERS

Andy Slavitt, Stéphane Bancel

Andy Slavitt  00:18

Welcome to IN THE BUBBLE, this is your host, Andy Slavitt. Stéphane Bancel, the CEO of Moderna is on today. And if you have taken Pfizer or Johnson and Johnson, you are still allowed to listen. It’s an incredible conversation. And before we get to many of the questions that I think are really on people’s minds around how the vaccines working, how often we’ll need to get a booster, and how it’s doing around the globe, it begins with a story. In January of 2020. There was a flurry of activity in Wuhan, in Maryland, at NIH headquarters and in Davos, Switzerland. calculations were being made on napkins, experts and scientists who had spent entire careers on pandemics were slipping into semi familiar yet semi dreamlike realities. As most of us saw inklings of what was going on peeking through an opaque surface, it only took a look at travel routes and a passing knowledge of how Coronavirus is work for some to know that what we were seeing in Wuhan was likely already all over the world.

Andy Slavitt 

In the months ahead, scientists in and outside the government ran experiments with messenger RNA, a platform that had been a sleepy, but ready to go platform for decades, a platform that was more like software than medicine, a platform where scientists didn’t go into labs and down lab coats, but sat at iPads and computers in their homes. The power of that technology was in no place more of a focus and a small biotech company named Moderna. One of hundreds of obscure biotech companies in Cambridge, Mass, Moderna, or messenger RNA was a giant bet that this platform could do a number of miraculous things quickly miraculous things that we didn’t even dream about. Moderna CEO Stéphane Bancel is coming on the show. And what you should know about this company is that it is a collaboration of Tony Fauci and the NIH that made it possible, and the scientists and entrepreneurs within this small 800 person at the time company called Moderna. It’s a deep and intense interview I want you to know a bit how I did it. I wanted to begin by talking to him about the past and how we got here, I thought that might end up just being a warm up for a later more interesting interview.

Andy Slavitt  02:50

And it turned out to be an interview and of itself, maybe even a movie. Second, we moved to talk about where we are today and some of the things in front of us, including how the vaccines are working, what we know about them, booster shots, how often they’re needed. And we then transition into a challenging conversation about both the globe and the future. With some pretty intensive questions, you should know that this one’s obscure company is in a strange place now. It’s worth over $130 billion. Stéphane himself as worth billions of dollars. They’re facing increasing pressure over under allocation to countries around the globe. He is in an unusual and I think in an enviable position that I don’t think any human belongs in, to playing a role in who lives and who dies based on his decisions.

Andy Slavitt 

And I asked him what that feels like, and how he handles that responsibility and try to push him on how he makes those decisions. The conversation is utterly fascinating, incredibly practical, and very, very deep. I think maybe it’s one of the best interviews to date in accomplishing what I want to do on IN THE BUBBLE. And so the whole thing is here, nothing could be cut in what I want to do on the show is to inform you to make that process extremely interesting. And to make it gettable, and above all, to have all those things, ease all of our anxieties, and to add a human feeling to an often cold and scary subject. So this interview causes me to want to thank you for letting me do that. And I will now introduce Stéphane Bancel out and I’m eager to hear how you respond to this interview.

Andy Slavitt  04:48

Welcome, Stéphane. I appreciate you joining in the bubble.

Stéphane Bancel 

Thank you, Andy.

Andy Slavitt 

And I want to thank you for your work and your partnership over the last many years and certainly in the time that I was in the Biden administration, the really productive way that you guys ramped up production at the time the country desperately needed it. So I want to begin with my thanks.

Stéphane Bancel 

Thank you so much, it means a lot, the team has been working nonstop, literally Saturdays and Sundays for 20 months. So it means a lot. Thank you.

Andy Slavitt 

So let’s actually start with that I would be great. If you could, we could go back start a little bit with the history of the story of the mRNA platform and the mRNA vaccine, can you take us back even a couple of decades, to the origin story, and tell us kind of how this developed. Because you know, at the time, I’m sure no one quite knew that we’d be building something so powerful.

Stéphane Bancel 

So we started the company in 2010. It was a Cambridge based Massachusetts company team from Harvard, MIT, and a couple of our founders on this question, and that could use messenger RNA to make protein in people’s body. As you know, Andy, you know, since Genentech, and Amgen since the 70s, there’s been wonderful medicine made to help people across the world using protein mates, you know, initially in bacteria, that’s a biotech industry. And the notion that you could inject a piece of software because mRNA is instruction. That’s what you use in your body, you have 1000 copies in every one of your cells. And to get you and your cell is to make whatever we designed to protect you or to heal you if you’re sick. That was literally science fiction. And we ask ourselves, is it possible? And if it is possible, what would it mean for medicine? And we get really excited about what it could mean for medicine, we believed, it could mean dozen, maybe hundreds of medicines that are technically undoable using small molecule but all chemistry technology or pharma for the last 150 years, or biotech technology, making protein the technology over the last 50 years.

Stéphane Bancel  07:09

We also believe that it will have a massive benefit that traditional pharmaceutical medicines don’t have is the high predictability of going from the lab to approval. As you know, most drugs that go into clinical trial, 90% of them never get approved. But what if you could have a technology where every time it’s the same chemistry break that you used to get into the human body, when if you walk once, it should work for many, because it’s the same chemical compounds are given to the human body. Whereas in traditional pharma, every drug is different. So when scientists take a drug that looks promising in animals into the clinic, they have no idea, the type of safety issues he might see in humans because a mouse or monkey, another human, obviously, and mice, and monkeys don’t speak. And don’t say when they have a headache, or issues. And so that was a really exciting part. Everybody in the field for this was nuts.

Stéphane Bancel  08:12

Myself included, Andy, when I was first introduced by the founding team, when they were looking for a CEO, we had one scientist employee, he was a tiny concept of a company. My first reaction to the team was this is never gonna work. And the reason we believe that is that mRNA was believed to be very unstable, you got to be stable for seconds, which will not be good for medicine, and be very immunogenic, like giving a flu like reaction to your body, which, of course, will not be very good for medicine, it could be very sick from medicine. But what was very clear, there was some new scientific insight from many labs around the world, from Penn, from Harvard, and so on, that led us to believe that maybe now, we understood enough about the science that there could be maybe a way to make emmalin to a safe and effective drug.

Andy Slavitt 

When did you join Stéphane?

Stéphane Bancel 

So I joined in the summer of 2011, 10 years ago.

Andy Slavitt 

And when was the first time that even predating Moderna, that people started to work on mRNA as a concept was that, was that a 2010? Or was that a few years before?

Stéphane Bancel 

So it was actually a long time before when DNA and mRNA were discovered. Back in the you know, 50, 60, 70 years ago. people tried to make drugs out of mRNA in academic labs around the world, you can go back and read very old papers, but they failed. And so if you think about it, actually, the biotech industry as we know it, existed because mRNA has a drug failed, and so people find a convoluted way to put a piece of genetic information of a human DNA like insulin inside the DNA of a bacteria is equal. To make the bacteria the big reactor or make the human protein, and then they will basically kill the bacteria, purify out, extract out the human insulin, put in a vial. And Lilly and Genentech made the first biotech product which saved the life of millions, maybe hundreds of millions of people. And so people try that long time ago, when there was a company called CureVac, which recently announced unfortunately, the failure of a COVID-19 vaccine. They were started in 99. And then areas company that everybody knows now by BioNTech, which was started a couple years before Moderna in 2010 model.

Andy Slavitt  10:40

can you just spend a minute on Moderna’s partnership with the government, and the funders and some of the scientists there, Barney Graham and others and that partnership was, like how a small startup biotech company meets up with this massive bureaucracy of share research dollars, but also, you know, just lots of priorities and difficult to see how they focus. How did that occur? And what was that partnership like?

Stéphane Bancel

Sure. So a few years ago, I decided to reach out to Dr. Fauci. Once we have clinical data. I said to myself, if I reached out to Tony, which, of course, is no wonder, key leader in the field of infectious disease for a long, long time. I’m like, if I reached out to those guys too early, they will, like most people probably say, this will never work. So I need to go to Tony at the right time. And so a few years ago, once we already had several vaccines with human data, I reach out through one of my board member to Dr. Fauci and sending the data and say, I would love to come down and see you at Nyad. To show you what we’re doing, why we think it could change, vaccine ology. And if you are interested, find things grouped together.

Andy Slavitt  12:07

And what was the application at the time, what was the vaccine you were working on?

Stéphane Bancel 

So we showed them data on flu vaccine, and so on Zika, this was supposed to the Zika, you know, outbreak in the America, and so on CMV, cytomegalovirus. It So there we are known to the public, unfortunately, but it’s the number one cause of birth defects in this country. More than down syndrome, there is no vaccine that exists because it’s a very complex virus, and we had a beautiful vaccine. And so we share all that data to Dr. Fauci and to his team. And after that, we say, look, if you want to partner with us, we’d love to find a couple viruses that we are both passionate about. And we’d be willing to partner we’ll send you mRNA for free, just so that you can see how the technology works and make an opinion for yourself.

Andy Slavitt 

Wow, fateful meeting. Wow. So take us to January of 2020. Can you just describe the sequence of events that occurred?

Stéphane Bancel 

Sure, so I was made aware of in new infectious disease happening in China just in the first few days of January. Because I have worked Andy all my 25-year career in infectious disease one way or another. And so I’m very passionate about infectious disease. And so when I heard about that, I reached out to Barney Graham, who by then was a partner we’re working on a few vaccines together.

Andy Slavitt 

And Barney Graham is on Dr. Fauci team, just for the audience’s.

Stéphane Bancel 

Yeah. And Barney is one of her in my opinion, the best scientists in the world to design and to pick antigen, the protein of the virus that are going to be relevant to vaccines and vaccine design. And so I reached out to Barney who had made many times over three years of partnership we’ve had since that first trip I did to the NIH, and I just asked the Barney because no we collaborate a lot so just shoot him an email and say, there’s a new thing in China is it a virus or bacteria because we didn’t even know at the time what type of bug it was. And Barney replied and say we think it’s a virus, but we don’t know a lot yet. We’re talking to our contacts. And then maybe the day after he sent me an email, it’s not flu, but it’s a virus. And then we realize a couple more days it’s Coronavirus, but it is not sars and it is not mers. It’s a new Coronavirus. And the reason that was important for us is one, we had done nine vaccine in clinical studies at Moderna alone before that there so but he was always for viruses, not for bacteria.

Stéphane Bancel

Because viruses and bacteria are very different in terms of a eukaryotic precariat type of cells they are. We didn’t know if we could make bacterial vaccines but we knew we could make very good viral vaccines. And so once we realize it’s a new virus, what we have to wait for is the sequence, the genetic information of the virus. And the body and over contacts we have in infectious disease that the company told us it should be, you know, in a few days, the sequence will be put online by the Chinese. And indeed, I think it was January 10, the full genetic information of a virus is put online. And what we do at that time is the team at Moderna tried to design a vaccine from that information. The team at NIH works on designing a vaccine using our technology, baseline information, and then the team compare notes with it was a right way to do it, to do it actually independently, to increase the chance of doing it right. And what was very good is that both teams picks exactly the same protein, the spike protein, and they both advise to go for full length spike protein spike is a very big protein is four kilobytes.

Stéphane Bancel  16:02

4000 instructions is very, very big. And they all both teams recommended independently, that this was what’s going to give us the best vaccine. The place where we were lucky, is one of the many vaccine we’re working on together with the NIH was Morales, which is also Coronavirus. And because of that, we had learned a lot about Corona viruses using Moderna is mRNA technology. And so once both team decided at full length spike was the right vaccine, it was off to the races, more than a team made all the technology choices, because they are many 1000s of technology choices that have to be made for every vaccine, once you agree on the protein you want the mRNA to make. And so the team did that. And then they literally design that on a computer. That’s how we make drugs at the company. And we never had access to a virus, physically, we had no virus, we just had the code. We just had information on the screen.

Stéphane Bancel 

So if I picture people in a lab? No, it’s people sitting behind their computers.

Stéphane Bancel 

Yes. And there’s even an iPad version of it, you can do it from your couch at home, if you want to just a new way to do biology. And so we started to do two things at that time in parallel. One was to get as fast as we could mRNA, ready to go into animal testing. So we could send some to all Cambridge Moderna lab and some to Barney’s lab in parallel again to do as much work as we could. And we said to make right away at risk, because there was an outbreak in humans and people were starting to die, the vaccine, a human grade, FDA grade, so he could go into a clinical study that were agreed in the meantime, that we will make the product and pay for it Moderna. And the NIH will run the study that was kind of we decided to divide and conquer. And then the week of January 20, I am in Davos with two amazing infectious disease doctors. One is Dr. Jeremy Farrar, who is the head of a Wellcome Trust. And the other one is Dr. Richard Hatchett, the head of CEPI. CEPI was spun off from the World Economic Forum with the Wellcome Trust, Gates Foundation, and so on to prepare for next pandemic.

Stéphane Bancel  18:19

And so I spent a week with those two doctors who I’ve known for many years. And for over a week, there’s a lot of data coming out of China. And those two doctors because they’re so well networked in China, get data that is not official data yet from their friends that our doctors in Wuhan, and for Chinese CDC, and so literally three or four times a day, we will meet together and on the phone, they will show me the new data they we’re getting and literally on a napkin will start to plot the r naught of rate of infection that everybody knows now. And the death, the death rate. And it was all very dirty with big arrow balls. Were just trying to guess where things were heading because there’s so little data at the time.

Andy Slavitt 

I hope you kept that napkin.

Stéphane Bancel

We did not unfortunately. And then by Wednesday, it started to be pretty clear that it is really bad. It is really, really bad. I mean, what made it worse is on the Wednesday, China announced they’re locking down Wuhan as a city. And I’m like I never heard in my life in modern history that a city of millions of people was locked down. I’m like, what do the Chinese know that we don’t know. And if you think about the data set, we get the more and more data that is really bad, very infection rate, people start to die, and they lock down the city, which we never did for Sars. And so I remember being with them and getting my iPad or my work bag and take to Google Wuhan realize it’s a very big city. And what I didn’t know is the flights going out of Wuhan because remember, cases that were turning in Vietnam and Thailand and Japan. And I google, the flights coming out of Wuhan. And I realize their flights to every capital in Asia. Every capital in Europe, and all the big cities on the west coast of the US. And I remember raising my head for my iPad. It’s a moment I remember one of my life and looking at Jeremy and I said, Jeremy, remind me because I’m not a doctor. Okay. So Jeremy, remind me of Coronavirus. It’s 7 to 10 days incubation, right? He said yes, it’s around 7 to 10 days.

Stéphane Bancel  20:31

And so I’m like, it’s everywhere. And then Jeremy, look at me yeah, it’s everywhere. It’s everywhere. And so that’s the day I realize it was gonna be like 1918, like the flu pandemic, it was gonna be really bad really long. And it was not an outbreak, which is what I believe the last few weeks I thought it was gonna be like SARS and MERS. At that moment, I’m actually going to be a pandemic. And so I was in Zurich, in I mean, I was in Davos close to Zurich. I was supposed to go to Germany after and I called my assistant, I said, I need a one-way ticket to Washington. And she’s like, when are you coming back to Boston? I don’t know. I come back when I come back. And I flew over water Sunday to the sea. And Monday morning, I met with Dr. Fauci and Barney, and John Muscular who runs the vaccine research center for Dr. Fauci. I then went to BADA. I went to DARPA. And then I went to the FDA to meet with Myron Gruber, who runs a vaccine division and your team to figure out how do we get the vaccine approved by the fall? And everybody thought that was a little bit cuckoo.

Andy Slavitt  22:02

I have so many questions that we won’t be able to ask here. But I’ve been actually thinking about you personally, having these realizations. And at some point, feeling like we might have been doing all of this work for the last decade, for this very specific moment. Or some realization might may have hit you’d like that, because people don’t always realize about biotech companies is because they’ve heard of the very successful ones, that there’s 1000s and 1000s of them with no products or one product that’s under looking for approval. And it may or may not ever happen. So there was a confluence of events, which could have led to Moderna, dying in obscurity.

Stéphane Bancel

Oh, very much when we started the company, it was very clear that either we’re going to find out how to make money safely, before we run out of cash, and we’ll go bankrupt. Or this will be a company because it’s a big platform that could do dozens of drugs and change medicine forever and impact millions, I didn’t think billions at the time. And if you’re in that moment, I don’t have too much time to think about it. I’m just glad that we’ve done nine vaccines before. So we know how to make vaccines that we worked on […]. And so I had a pretty high confidence that the vaccine we designed was going to make a high level of antibodies in human because a man is a platform, and we’ve done nine before. And I was so thankful that in 2016, I went to my ball and recommended to build the plant in Massachusetts, which they thought I was nuts at the time, because he was you know, committing $150 million, you know, of concrete, and steel. At the time, when we had one phase one studies of very early-stage clinical data on like, 20 people. And that’s all my […], we have to be the plant now. And they thought I was nuts. And I was so thankful because that’s a plant from which all vaccine that has been helping, I think 60 or 70 million Americans have come from.

Andy Slavitt  24:11

Yep. So not to put too fine a point on it. But American taxpayers for years, pay their taxes don’t know what the taxes go towards. And some of it certainly goes to things that people would disagree with, or find wasteful or all that not gonna suggest we’ve got the most, then everything’s done efficiently. But some portion of our taxes have been going to basic research. They’ve been going to fund things that we don’t yet know if there’s applications, and that includes trying to prepare for situations that could emerge in the future. We have the foresight of people like Barney Graham like Tony Fauci, who are on the hunt. I’ll just tell you; they take hundreds of meetings like the one they took with you, and many of them are interesting and they don’t they don’t go anywhere but some of them they say, you know, we need to do some work here. So getting to where we’ve gotten today, it feels as I listen to your story. Like we’ve got, we’ve got a bunch of people to thank we’ll never know, for their planning for being purposeful, for being thoughtful. But both your scientists, the scientists at NIH, and then all of us as taxpayers for deciding that we are worth investing in.

Stéphane Bancel 

Yes, exactly, Andy, and you have a piece, I think over entrepreneurs that take a risk with their career, to try something that most probably is going to fail.

Andy Slavitt 

Forget the entrepreneurs. No, I’m kidding. It’s, actually, it’s a great point. Because, you know, people sometimes ask me the question, what it will take to make a better US healthcare system. And the wrong way to answer that is to, I think, is to say, well, if we had to start from scratch, what would we do? I think one thing I have to think about is not what are our weaknesses alone, but what are our strengths? What do we do well, here. And, again, you know, this is a story of a lot of things coming together. One of them is risk taking, and entrepreneurship, for sure.

Stéphane Bancel  26:19

And I think this country is really uniquely positioned. I mean, as you can tell from my accent, I was not born in Boston. But I think what makes America amazing in terms of the ability to combine, you know, to your point, scientific risk that the government takes that a lot of academic labs around the world take the entrepreneurs capital. I mean, another piece that is not very well known about Moderna, we invested $3 billion of capital from investors before COVID even had the name. 10 years with no sales, no revenues, and even no knowing when they might be around you one day. And that’s probably something that would have never happened in Europe.

Andy Slavitt 

Yeah. So what you’re saying is risk-based capital, people, which, you know, oftentimes leads us astray. I mean, there’s not always, it’s not always there’s parts of the capitalist system in […], that frustrate me to no end. But this is a story where people put capital behind an idea that was transformative, and it paid off, let’s move towards today. You went through the trial process, you tried to get data back, the vaccine when it to 30,000 people, then you went to the FDA, you got emergency with authorization. And you started to see your vaccine in millions of people, can you talk about what surprises you’ve seen as it relates to the effectiveness, and the durability and the safety? What’s been confirming? And what’s been surprising?

Stéphane Bancel 

Yes, so the piece that was confirming was, we believe that and Dr. Fauci with us, that neutralizing antibody was very a good indicator for efficacy. And so when in March, we got a challenge […] where you give the vaccine underwent a very high dose of a virus to a mice, and you find no virus in the mice. And then you do the more after the same in non-human primates, and you find no virus in the lung, and very high antibody in their blood. And then when on May 18, you know, we announced to the world, even the smallest study in our 20, 40 people. But it was remarkable for me and gave me a lot of hope. And I believe to Dr. Fauci too, is that 100% of people had antibodies, neutralizing antibodies, but good antibody, above the level of antibodies that people that were naturally infected to COVID had in their system, and people that that survived COVID. And so it was a very good indication about the breadth of response that everybody made the antibody and made a lot of it. And what was very exciting to me, because as you know, we are still learning a lot about the virus we still didn’t know as much as we know today in May of 2020.

Stéphane Bancel 

But what we knew because of hospitalization and death, right? That the elderly, and people with high comorbidity were at the highest risk. And the children were doing pretty well at the time, if you remember. And the piece that I was most exciting about is that in that study, there was young adults and older adults, and not like over vaccine that aside to publish like from China and other places. We made as much antibody in a 75-year-old, they need an 18-year-old with an anti-vaccine and that gave me a lot of hope, and made us push really, really hard to save every hour save every day that we could because we believe with a very serious travels to a vaccine with high efficacy. Of course, we didn’t know the efficacy like the rest of the world until mid-November. But we believe we had serious chance to have a vaccine that could help other people.

Andy Slavitt  30:10

Yeah, and I don’t know, people were aware at the time, but there were, there was a very big possibility that we could end up with a vaccine that just simply didn’t work on older people, or didn’t work well, or didn’t work very well. And that was one of the things we were holding our breath around. And I remember being in planning meetings talking about, well, we may need to ring vaccinate the elderly, because this may not work. And so in the midst of all of the news that came out, that one got a little bit lost. That was very good news, in terms of how it treats people. Now, maybe talk a little bit about the surprises and I wonder how you thought at the time about the durability, because indeed, there was a good, a great reaction included in the elderly. But we had we didn’t know anything about durability at the time. What did we think that and what do you see now?

Stéphane Bancel 

Yeah, so at that time, we didn’t know because the vaccines were developed so fast that as you know, they were authorized, which was the right thing to do for the country, you know, after only two months of data after second dose. So what we had and everybody saw the 95% efficacy for both the Pfizer Moderna vaccine was very high, but he was two months after the second dose. And it was hard to know how long that was gonna last. First, because there’s never been an amount of vaccine approved. So we don’t have the data set over many years. And two, it’s a new virus. It’s not a virus that has been around for 50 years, and we know very well. And so what is interesting, if you look at it, there is a Coronavirus that circulate in the community called OC43. It has actually been the root cause of around 10% of hospitalization in the US. And it is believed by scientists to be actually at the origin of a pandemic in 1890. That was called the Russian flu. Because at the time, there was no PCR test to know if it was flu, or Corona, or RSV, or anything. So it was flu like symptoms. So people thought it was a flu pandemic, but actually it was a Coronavirus pandemic. And if you look at that virus that stills circulating the world like SARS‐CoV‐2 is gonna stand me because many of us have said for quite a long time. But it’s interesting to observe about that virus is that people that are older, so let’s say 60 and above get reinfected and sick every year. People that are I would say in their 40s-ish, it’s around every two years that they get sick again. And people that are more in the teens, or teenagers, it’s their own every three years that they get sick again.

Andy Slavitt  32:47

I’m asking for a friend, what about 54.

Stéphane Bancel 

54 maybe once a year, maybe every 18 months or so, and so it’s a bit too early to know. But what this show is SARS‐CoV‐2 virus is going to be endemic, it’s not going away from the planet. We’re going to need boosters, based on what I just told you of these viruses that exist and goes around to the community, I think it will be every one to three years based on your age and commodity factors. But I think the good news is modernized working on the flu plus COVID booster single dose. And we want to add even more respiratory virus. There’s around 10,000 viruses in this country and around the world that get people to go to hospitals, that they look like the flu. But if you do PCR they’re not the flu. And what we want to do at Moderna is to get all of those in the same single dose and your booster, single shot get one shot every year, at your school, at your CVS at your workplace. And you spend a nice winter.

Andy Slavitt 

COVID, flu.

Andy Slavitt 

Now, if it wasn’t for mutations, the world would be in a very different place right now. If we hadn’t seen Alpha, and then Delta, we would very likely be sitting here today in that endemic situation that you talk about. And I think we’d be feeling very, very confident that thanks to the great work of your scientists and scientists and other companies and countries, that we had the formula to beat this thing. And I’d say you know, even with Alpha, at least in the US, we would have probably crushed the virus. You may disagree with that. And if you do that, that you can, you should certainly say so. But when Delta happened, you know it took the bar up from you know, call it 75% to 80% of people that needed to get vaccinated to higher than that, maybe close to 100, hard to know. And also, in addition to the waning of the of the vaccine, it contributed to vaccine not being as effective at least preventing symptoms and over and also over time hospitalizations and potentially even deaths partly because it was a quick incubation period and you know, the vaccine typically could respond, can you talk about how related to delta but also in general, to future mutations, how you feel Moderna and the vaccine are set up to respond?

Stéphane Bancel 

Sure. So you’re right, what has really helped us in this country and around the world with Delta was first that because of a drift, the genetic drift from the initial strain in the vaccine design, there was less efficacy because of that. And the other piece is duration since vaccination to infection, because as we know, there is waning immunity just with time. And so we got the double whammy to your point, and we’ve got the time waning immunity, because a lot of people at risk were vaccinated in December, January, February, and two, we get unlike Alpha, which was a very high efficacy of a vaccine, you lose a bit of vaccine efficacy with Delta. So the good news about the mRNA technology is you can change the genetic information coded in the mRNA very quickly. We have worked on a Delta version, it’s in the clinical trial as we speak. If it’s needed, it could be authorized very quickly now. And we’re also very carefully following where the virus is going, one of my biggest worry is going to so many people on the planet since the big wave in India in the spraying with Delta, that the chance for mutation is pretty high, where the virus continues to drift away to evolve away from Delta.

Stéphane Bancel  36:45

And so we are following that very closely. We’re working in academic labs, including labs using AI. Because if you think about the mutation, they are just random. And the new strain that evolve and takes over, like Delta more recently, is because it’s more infectious, the virus is not programmed to kill, if you die, the virus dies with you. So from an evolutionary standpoint, the virus is just trying to replicate faster. And so when those mutations happen, those that have a better affinity to the h2 receptor of your cells mean the virus, that new version of a virus mutated, goes inside yourself faster, replicate faster, and then it takes over. That’s how mutations happen. But it’s totally random. And because it’s random, you can model it with math. And AI is fantastic to use math modeling with binding receptor from a chemical standpoint. So you can know that all of those things we have said no more recently second quarter conference call. When head of R&D was asked, he thinks that delta is going to evolve with some mutation of beta one first identified in South Africa. And most probably we’re going to a better plus delta down the road. And so one of you I think we’re already testing the clinic as we speak, and the is to mRNA. In each vial, where we’ll have a Delta mRNA from Moderna, a better mRNA in the same virus will give you the neutralizing antibody against both as potentially your 2022-fold booster. So we’re working on that so that we can be ready wherever virus go. Moderna is committed and we’ll be ready to keep people boosted. So those who wants a vaccine can feel safe and live a normal life.

Andy Slavitt  38:56

Can you give everyone a sense of and this is both a question of the power of the mRNA platform, but also the scalability of production. How long from the time you see a variant that you say this will require us to adapt our vaccine? How long till, two questions. One is how long until such time when you say it’s done, and it’s sufficiently safe and effective to be able to be ready to produce? How many days? And then how many days from there till where you feel like it can be really globally distributed so people can have access to it?

Stéphane Bancel 

Sure. So on the clinical side, which is the first part of your question, we think in three to four months max, you could go from the first time the sequence of a virus is published by scientists somewhere in the world where these things happen, two having the FDA authorizing a new version of a booster three to four months and we’re working really hard by investing in tech neurology adds on to shrink that time. I think we could go down to frame offs of every tiny bit less. The second question is manufacturing. And I think the answer will depend on when this happens, because we are still lack of a company’s ramping up manufacturing capacity, we still adding equipment as we speak and hiring more people as we speak. Because we really want to get to a place next year more than I would have two to $3 billion capacity for the year of 22. And we need to have enough booster for the entire planet. So that somebody wants a vaccine, where they live, you know, in Africa, but even Boston, whether they got infected naturally, or they got a vaccine, if it’s a J&J vaccine, or Moderna anything that you can mix and match, and you can get the booster. So that’s what we’re aiming for. And we believe that between Pfizer and us, there’s going to be roughly next year $7 billion of mRNA capacity from the two best vaccine on the market.

Stéphane Bancel  40:54

And we believe that’s one vaccine for anybody who wants one on the planet. So I think we’re really getting close to that. So if you wait for that time, where we have that type of capacity, I think you’ll be able to get literally, because if we have, you know, two to $3 billion a year, that’s 200 to 300 million dose a month. So if we start with a free two, four time, three to four months lead time, from sequence to shipping, you could put up to a billion dollars, the day you get the new version authorized. That would be very different from when we got the vaccine authorized the first time, you know, we push to the CDC, in December 2020, 20 million doses to Americans, which was fantastic $20 million. For those who got it, he was of course, way too little to vaccinate the country, of course to vaccinate.

Andy Slavitt 

So the manufacturing processes have so far seemed to be quite scalable, which has been very impressive. Now, manufacturing a vaccine and having a vaccination, there’s still a gap there. And that has to do with the transportation, the storage, having sufficient needles, and being able to do it in remote parts of the world. And then of course, that says nothing of the effect of vaccine acceptance, which is a whole another topic. But getting good at last mile, you know, feels like today, I think it would surprise people to know that right now, as we and I don’t want to shift the conversation a bit to the global that the issue isn’t today whether we will have enough vaccines to vaccinate the globe. Thanks to the manufacturing expertise in scaling. That’s not the issue, the issue is actually last mile. So with global peace, I’m going to ask you some questions which I think are some of them are tough questions because they are the existential questions that in some respects no human should ever have the responsibility to make it some of them land you know, in at least partially in your lab.

Andy Slavitt  42:49

And so I think it’d be great to know how you think about them taking as for given that you know, you’re a for profit company, you can only make vaccines if people buy them and pay for them and send them to countries. Yet, you know, we sit here today with close to half the globe vaccinated and only, you know, 2% to 5% of Africa vaccinated. And with COVAX really, it’s hard to call COVAX a success. At this point, they had bigger hopes, bigger commitments, and they just haven’t been able to live up to them. And there’s reasons for that. But maybe help us understand how you think about how, what was start with Moderna is doing around global distribution and global equity. And then maybe we go a little bit from there.

Stéphane Bancel 

Sure. And I think you’re 100% right. And the issue that I worry deeply about to get the planet vaccinated is on vaccine is last night. If you look at the numbers today just ballpark numbers for people. As of today, 3.7 7 billion people vaccinated. There’s a little bit over 5 billion adults on the planet. That gives you a gap. If you just look at adults for now, of 1.3$-1.4 billion. To dose let’s run the numbers. 3 billion doses, the industry […] in the last 30 days, shipped 1.3 billion doses for […]

Andy Slavitt 

In the last month.

Stéphane Bancel 

In the last 30 days, you know. And so if you do the math, we are two to three months away to have more vaccine available than adults. So the last month is a biggest challenge. Look at how hard it was in the US in December, January, just from last month. I was in Europe and everywhere because we have never done as a world. Such a massive, quick vaccinations company. It has never happened in the history of the planet. And when you see how it was in countries that have so much resources like the US or Europe, you can just imagine the countries, just a number of doctors and nurses per capita is so much lower in the country us not have enough nurses and doctors to inject them in arms even if you get them in front of people the vaccines. And so what we did as a But these are a few things first, we partner with COVAX and committed 500 million doses to COVAX, we have the rest go on that, that over all the vaccines to donate them, which seems easy on a podcast like this, right. But to be able to get vaccine to your country, you have two things you need to do, or just from a legal standpoint, one is to get the vaccine authorized in that country.

Stéphane Bancel 

If it’s not authorized, you’re not allowed to ship it, it’s illegal, two, you need a system to report side effects. It’s obligatory by law. It’s not only law in the country, but law in the US, I need to report like every other pharma company, any side effects from any country in the world to the FDA, that’s the law in the US. And so I’m not allowed as a company to ship products if it’s not approved locally. And if I don’t have a system where somebody can call an 800 number, to report a side effect. And so we scramble for the summer, when the US Government Code and we wanted to help deeply. So those would not go to waste. And we got them into a lot of countries, including places like Haiti, to help low-income country. The piece that is very sad, if I just take a recent example in Haiti, is there was a story reported on Bloomberg or Reuters a few weeks ago, where the US government sent a half million dollars to Haiti. A few weeks ago, they shipped back 400,000 doses that were unused. And that’s heartbreaking. Totally heartbreaking.

Stéphane Bancel  46:36

Those might expire by the end of the year. If they’re not used, they’re gonna go into the garbage that is just heartbreaking. And so the prime we have your very right is last mile is education, anti vaxxer, awareness, access for people. So we did that as well. The other piece we did is we put a statement in October 2020. And we talked to the media that we will not going to enforce our IP. Moderna is the only company in the world with mRNA. That done infectious disease vaccine before COVID. And so there’s a lot of patterns we follow over the years. And it was very important for us as a company to put this out there saying, please, if you do mRNA vaccine go at it. Our goal as a country as a company, is to get as many vaccine in arms as we can. Don’t be afraid we will not sue anybody until the pandemic is going because we should only focus on one thing, is stopping this virus? Not fighting each other as humans but stopping this virus.

Andy Slavitt 

Can you make a distinction between it? Look, I think that statement at the time was very encouraging. But can you help us understand the difference between not enforcing your IP and sharing your IP is that the same thing is that are those different things?

Stéphane Bancel 

So it’s a same thing, Andy because our IP, if you’re a scientist, you can go on to the US Patent Office website, you type in Moderna in the search box, and you get all of our patents. So and for those of you that are listening that don’t know, IP law patent can only be granted. It’s one of the criteria for granting a patent. If somebody is killed in the […], can read it, and reproduce it. If it’s not true […] you can find it…

Andy Slavitt  48:26

Are people to your knowledge doing that, are they trying to replicate the IP?

Stéphane Bancel 

There are groups of people that are working on mRNA around the world. And I’m sure that they have read our publication and they have read our patents to save time, because things that took us […] years to invent, if you can just read the recipe, it’s much faster than having to figure out the signs that nobody has done before.

Andy Slavitt 

And yet, as you know, the World Trade Organization is trying to come to consensus on the issue of doing something like that. But making essentially this the case for all the IP. I’m not describing it perfectly well, but I’m trying to make it understandable enough. Do you support that? Do you think that’s a good idea? Or do you think that’s a bad idea?

Stéphane Bancel 

So I think it won’t help much. And here’s why. I mean, again, we’ve done that as a company we said we want sue for IP, the IP waiver is the same […] nobody can sue anybody on the IP so […] what we did as a company, a year before this topic was even a topic. The reason that fake is not gonna help much in 21′ and 22′ is to make a pharmaceutical product in a technology that did not exist before like mRNA. It’s a 6 to 12 months lead time. If you know everything. That’s what is taking us and we’ve done mRNA for 10 years, because you have to design machines, get them made, get them shipped, install them, qualify them to very high FDA standards. Need to get the raw material you need to hire the people and train them. This is assuming you have a factory available already, because it takes several years to build a cleanroom, where you have to make the product because it’s injected in somebody’s body, it has to be sterilized. If not, you’re going to give him septicemia, which will defy the purpose.

Stéphane Bancel  50:15

And so what I’ve said at the time, when the discussion was ongoing, it will not get one models of a mRNA vaccine made by anybody. In the time that matters for this pandemic, we’re going to be swimming in vaccine in a few months. At the pace at which the industry is going, there’s most probably 15 to $20 billion, made in 2022. That’s more than humans assuming to those. And by the way, in 2022, most of the planets only need one dose for our booster because we just did the math into frame off. So let’s say call it January, February, there’s no vaccine to prime people with two dose. And so if you figure most of 2022 is going to be a boost opportunity for people. So it is not a vaccine issue anymore. The only time to make it if we could make vaccine in two weeks, like this, yes, this could have helped. But because there was no mRNA factory sitting idle in the planet, because nobody has made mRNA vaccines before. It was not just not true.

Andy Slavitt 

And just to clarify something, if someone’s built a vaccine factory for a purpose, other than mRNA.

Stéphane Bancel 

it cannot be used by mRNA, because the machines are different. The raw materials are different. The training that the operators need are different. That is why it will not help. Because somebody who has done let’s say, Sanofi or GSK that have done vaccine for 50 plus years. They couldn’t make mRNA the next week, they just could not they don’t have even the machines for it.

Andy Slavitt 

Yep. Okay, so I think you gave us a practical answer, we’re going to be swimming in vaccines, it’s not gonna help in the short term. And in the long term, we’re gonna have plenty of production. But I think I want to put that to the side, because it’s one thing for that to be the practical reality. And it’s yet another thing for you to be sitting in a position where you have the keys, and to solving a big global problem. And saying that I’m going to decide not to share that. And so what I heard you say is, if someone wants to take that, because they’re building a factory in India that you’re not aware of, or we’re not aware of, and it’s gonna come online quickly. That from Moderna’s perspective, you support that.

Stéphane Bancel  52:31

Yes. And as I said, we will not sue that we made that public and we wrote that on our website, talked about it so people will not worry they wanted to invest money and time that they will not get and get the lawsuit from Moderna. Because we care about getting as many vaccines as we can. I’ve said it last year. During the clinical trial, it would have been a horror scenario for Moderna to be the only vaccine working, I’ve said it on TV last year, I really wish that many of our vaccine would work because no company on the planet could have vaccinated the planet and it was a global problem. And because viruses do not know frontiers, or age or sex of religion or anything, until we have the planet vaccinated or infected and this immunized, this thing is gonna keep mutating.

Andy Slavitt 

And so let’s say somebody said, Hey, Stéphane, we’re using your IP, we’ve got the factory, we’ve got all these pizzas, but I need some help with the technology transfer, to set this up to make sure it works. We need to borrow a couple of your manufacturing or scientific people. How would you respond to that?

Stéphane Bancel 

So the challenge will be with that is what are we not doing internally, that will impact the short-term output. Because as I said, Andy, we are still getting delivery of machine. We’re still adding capacity. We decided to do that for the low-income country back in March of this year. The reason we only need to qualify the only build Moderna to make a billion dollars this year is because we had to make a decision in 2020. In 2020, we had no money because we never made a solid product. There was a lot of big companies Merck, GSK, Sanofi working on vaccines and the tide of flu volume, every flu vaccine for the entire planet across five companies is 500 million doses. So think about my board when I walk into my boardroom and say we’ll make a billion dollars next year. We’re like, what are you talking about? And so if I had known in March 2020, that we’re going to get the highest efficacy vaccine on the planet even longer duration that what is shown by CDC against this Pfizer vaccine, and that all of those vaccines are going to fail. I will have tried to get more money to invest more in manufacturing because of course a billion was not gonna be enough for 2021 and all the suffering But I had no idea that all those vaccines were gonna fail. And we’re gonna end up having the best vaccine on the planet.

Andy Slavitt 

At the time, I can vouch for the fact that there was a lot of uncertainty around mRNA. And things, the Oxford, AstraZeneca vaccine seemed like a sure bet. Johnson and Johnson. So we didn’t know which came to cause another question, which is we live with a shortage. And we had to make decisions in that, in that mindset of not having enough for and I think what you’re telling us is, you see that about the change, what I’m wrestling with, maybe I’ll take this to 30,000 feet for a second is that you are a company that was in obscurity. And Madonna is now darn near a household brand name, there’s people walking around calling themselves a Moderna’s, which is got to be quite amusing too, my wife is one of them. In the White House, they gave us Pfizer, by the way, so you might want to talk about that with somebody. And you went from a company that had zero sales, zero products, to a company that today is worth over $100 billion. And you have something that is in scarce supply, which is maybe not the vaccine IP, but maybe the know how to make the vaccine and to scale it.

Andy Slavitt 

In a day-to-day basis, you must be faced with decisions at running this company, where on the one hand, you have shareholders to satisfy and on the other hand, you have this scarce and valuable thing that at least for the next year or so. So we’ll save people’s lives based upon whatever decision you make. It’s such a rare situation to be in. You get phone calls from the Pope, to talk to you about vaccine equity, you talk to world leaders in poor and developing countries. They’ve got to be tradeoffs between growing from 100 billion company to a $500 billion company versus saving more people’s lives. And what I like to think that it’s all one in the same but how do you wake up and orient yourself in the middle of all this, to decisions like that, where I can imagine there are things that you could do to put a fine point on it, that would be good for the world, but maybe wouldn’t be good for Moderna, or vice versa.

Stéphane Bancel  57:23

Yeah. And the piece that we’re fortunate in this industry is because there’s so much demand from high income country selling at no profit, which is what we’re doing in low-income countries with COVAX and we have a few in a battle the like, you know, Peru and Botswana and so on. That is not a hard business decision. It has been done in industry before as you know GAVI, the vaccine, the world with UNICEF, and that’s how all vaccine companies do it. So it’s not something new that we had to invent, over companies are doing the same. And so that has not been a hard decision. What has been hard for us, in this world in 2021, where we ended up having the best vaccine on the planet, and only building a billion-dose capacity that we decided last year because we didn’t know so many vaccine over vaccines were gonna fail or not to work great. Is how much we’re being constrained by governments. Because, you know, the government’s where we make our vaccine, how are they huge say in what we can do with it.

Stéphane Bancel 

It has been true for us, where if you look at it, of what was supplied so far, this year, 60% of what we made has been bought by the US government, 60%. And we have a choice to not sell to the US government, we didn’t have the right to export out of the US until recently, to protect Americans and to ensure Americans will get as many doors as equally, it was the same in Europe. Europe does until the end of the year, except it will continue to keep making it longer. But as right now isn’t at the end of the year, there is restriction there on export out of Europe, where every time we want to export, whether it’s Botswana or Japan or even Switzerland, because it’s not in Europe, we have to feel farms, and it has to be reviewed by somebody who looks at how many vaccines went to Europe, how many vaccines went to the other countries to make sure that Europe doesn’t get shortchanged, basically. And so that has been what has been very, very hard is will be that as we easy and these we’ve got a lot of, you know, rich people or families people or high politician, asking us for a do you have 100,000 dose for me and my friends, quote unquote, and the answer was always no. We’re only supplying to governments, because they are the one who can decide in their countries who get the vaccines. I’m not able to decide to be […] in Massachusetts or you know, a nurse in India. That is not my job to do.

Stéphane Bancel  1:00:01

And so we only supply to governments. There’s a lot of private companies that have contacted us proposing a very, very high price for vaccine way higher than what it was sold to governments. There are a lot, and many will actually surprise you. And we always said, no, we say no to 100% of those requests. Because we sit from an ethical standpoint, it’s an it’s a global public health disaster, we can only supply governments, the piece that I wish I had, we had had, we should have made our life much easier from a political but more important, ethical standpoint. I wish there had been only one buyer in the world. The little about callbacks earlier, where they’ve been COVAX over US government, because for me, as a company, to sell over products to one party and say, please, you are okay, because I have no tools to allocate, who am I to allocate?

Andy Slavitt 

That’s a decision you don’t want, unfortunately, you’re stuck with the decision, the way the world works, that there’s no global, we don’t have the type of global leadership we may be once had, or global cooperation. But by the way, I should tell you that I bet you the same companies that called and asked you to sell them vaccines when I was in the White House. The reason I say I could because some call would call me and tell me why their employees all needed to get vaccinated first, most urgent situation in the world. So I bet you they were calling both of us. I guess if I were to push you a little bit on this question, I look at how Merck is rolling out the antiviral and for those who haven’t heard us talk about that, you know, that Merck has what looks like it’ll be the first very effective pill to take for once you get COVID, not a vaccine. But first for people who aren’t vaccinated. And Merck, and I think this is, you know, consistent with some of their track record, has pledged that this is going to be distributed really evenly around the globe.

Andy Slavitt 

They’re contracting with foundations as much as they’re contracting with the US government. Now, I’m not sure you had that option. Because the US government funded a lot of good research, the US government made a big commitment to buying the product in advance of everyone US government to give credit where credit is due, had the foresight to play some bets and make some purchases and other people around the world didn’t, if they did, they bet on other things, they bet and other drugs and you know, but there was a long period of time, when, because we didn’t have a central body buying all drugs, where the vast majority of your life saving product really has been going to wealthy nations. And it feels like that’s really deflating to people who I think a lot of people who saw this was exactly the way it was gonna happen. They foresaw this coming. They said, this is what’s going to happen. And it indeed happened that way. And I don’t know that where this responsibility lies. But I think feeling like we got to find a way to break that cycle. And as you said, you know, where we will get the next mutation will likely come as a very good chance to come from places that haven’t don’t have enough vaccination and replication can run wild.

Stéphane Bancel 

Yeah, I agree with you, Andy, and this is, as you can imagine, the biggest heartbreaking things about the job I do is, you know, we do what we do to help our people. You know, I was you know, educated with beverages with where you were, the motto is selling. And that’s why I love what I do. And we work so hard to do it because every life matter, you know, who saves the lives, you know, saves the world. And, and, and the piece that has been really hard is the fact that, you know, I like what you describe for Merck, which I applaud, what they are doing is they could do that, because it’s an old technology, it’s more molecular, there’s a lot of capacity. This was not even an option for mRNA, you’re getting there was no factory in the world, I could call and say please make a generic version of the vaccine, it didn’t exist, which is why we didn’t talk about it yet. We committed a few weeks ago to beat the plant in Africa. So Moderna is going to spend up to $500 million on money to build the plant in Africa for up to $500 million per year. Of course, it’s not going to help for this year, because as you and I know it takes several years to build a plant. But this human tragedy cannot happen again. And we really mean it as a company we’re gonna put […] on the line to do the right thing for respiratory virus because as we discussed, this is going to evolve to need for boosters.

Stéphane Bancel 

We’re gonna add flu and everything. So these things will be available in Africa as well. […] We’re doing that most people don’t know is we’re working as a company on tropical virus vaccines. We have a Zika vaccine in phase two, we have a Chikungunya vaccine. We are working on dengue in the labs, we’re working on the yellow fever. And those are killings, you know, hundreds of 1000s or millions of people every year, we never talk about those in America, right? You know, we talk about these when there is a huge outbreak of Zika. And it might be scary for Americans, I will talk about it. But this is daily life in those countries in those because of those mosquitoes. And so we as a company are very committed to use the platform that we have to develop a lot of product where we know we’re going to make no money. And it’s the right thing to do. Because the only incremental costs given we have a platform is that when you have software is you develop just another app, the OS has already been built. And that’s what we’re trying to find a lot of public private partnership to well, person, for example, Zika vaccine is being developed with Bada, where they only pay the incremental cost for that vaccine, we made a platform available for free. The other example is a Gates Foundation, we have a very cool HIV vaccine we’re working on with the Gates Foundation. And obviously, we’re not doing it for Americans, you know, where doing it for people where HIV is a big issue of HIV still kills. And it’s the same mother with the Gates Foundation, we said to them, please find only the incremental cost of the HIV program, we make the platform available for free, not $1 over prompt, and we committed to them that even vaccine is approved, we will provide it at cost to low-income country, it’s in the contract we signed with Gates Foundation,

Andy Slavitt 

How realistic is an HIV vaccine?

Stéphane Bancel 

So unlike Zika, or COVID, the biology of HIV is very complicated, because it mutates very quickly. But in cancer vaccine, because that’s another thing we do as Moderna, we do cancer vaccines, we have built the manufacturing infrastructure to do a vaccine just for you, in 60 days, just for you, based on the sequence of your tumor in the case of cancer, because HIV, once you’re infected will be in your body forever. But it’s going to mutate very quickly inside your own body. So what we can do is to do a vaccine now, for you Andy, based on the technique of blood work and know exactly what mutation you have of HIV in your body. And if in a year from now you have a new mutation, we’ll make a new vaccine for you.

Stéphane Bancel 

We can do that we can do those personalized vaccines. With today’s technology, it’s all science fiction. And so that’s what we’re trying to do with me. So test that concept in the clinic. And if it works, we’ll just do vaccines for people. And every year or so you will take another work. And we will just adapt a new vaccine for you. So you can live with HIV all your life, but just with a shot because you’re never playing with antiviral, which are a godsend. If people don’t take them, they gets really sick,

Andy Slavitt

Well, I want to come back and finish on that topic is a last question. But I want to ask one question before then. And then I do want to come to the really the promise of the platform. And here’s the question, and I’m not sure I’m gonna phrase it exactly correctly, but I’ll do my best. You had a lot of people that hold Moderna stock today. Some of them are people that have been long term holders and have invested in you when Moderna was worth nothing. And the promise of your story. And they’ve done very, very well. Then you’ve got people who’ve invested in your staff who are speculators, who, you know, they see opportunity, what have you. That’s the reality, you got to and there’s and everybody’s got different motivations. But how realistic is it for you to say to your shareholders, look, you either invested very early and you’ve done quite well, or, quite honestly, you’re in and out of the stock. And I don’t really care much about you anyway.

Andy Slavitt 

But there’s a portion of what we’re going to do in the future. Call it the work we do in Africa, where we’re not looking to make a profit, we have a large platform that has many, many profit-making opportunities for new discoveries around cancer around things that affect people in the developed world. But now we’re $120 billion, who knows when you look the next day company, we’re going to run a part of Moderna almost as if it were part of a connected to a global foundation. And we’re going to work with foundations, we’re going to work with last mile issues in Africa. And we’re going to build plants in Africa and in South Asia and other places that they need them. How do you think your shareholders react to that and is a CEO, could you get away with that?

Stéphane Bancel 

Sure. Investors and I’m talking people we invest, to build businesses and to get a return over time, people will trade the stock and not imagination, so we can trade the stock. It’s there right, of course. But talking about investors, the old investors I talk about, love what we’re doing for low-income country, what we’re doing for tropical disease, we even gave a drug. So listen to that well, Andy a few weeks ago, we gave away a genetic disease drug to UPEN because when we look at the math. The technology is very adapted for that rare genetic disease, it’s in the liver. But there are a few 100 kids in the world, when we did the math, just to return the cost of a clinical trial, we would have to charge millions of dollar per kids, which we thought was indecent. So we said, we’re not gonna do that this is not what we asked people. This is not right. And so we went to holiday to degree the other way, we say we’re gonna give it away to Penn for free.

Stéphane Bancel  1:10:27

We’re gonna make the drug on our own dime, to physically make the drug. If a drug is approved, we will make it and give it away for free. Because 100 kids a year, it is not a lot of drugs that you need. And again, he leveraged your platform, I do not need to build a plant just for that drug, I will use my over plants that use COVID and over drugs. And so I think what is really interesting about true universals, and I think it’s becoming more and more of a movement with corporate social responsibility. investors want CEOs to be able to optimize all the stakeholders. I think the world used to be obsessed about shareholder only. And I think it’s wrong. Shareholders are very important stakeholder. But my employees are very important stakeholders, my employees can walk out the building and cross the street in Cambridge and go work for any other company they want. There are hundreds, literally, of biotech company in Cambridge. Why would my employee stay at Moderna? They will stay in Moderna because we like what they do. But I believe, especially in today’s world, with those new people are joining the workforce.

Stéphane Bancel 

They care much more than previous generations. They care about the environment, they care about animals, they care about the world. And so that’s important for employees. But again, a lot of our investors either cared only about this year profit, or this quarter EPS. They would tell me, Stéphane […]. Why do I spend $4 billion per year in R&D, its profits and not giving to investors. But I’m investing formula $4 billion in R&D this year, because I believe that if we do a good job, over time, that 4 billion will translate into more sales. And so I think having a company that is for profit, but is a responsible, caring company, about the environment, and when we build the Norwood plant, we invested an extra $5 million out of $150 million to do it as green as we could. Installation, you know, and all other things. And with a lot of discretion at the time, which is it’s $5 million, that we want to invest in R&D to make another drug. And we have to make those ethical decision. And I told, I told my team said, look, we’re gonna have this plan for 40 years. It needs to be the right so we minimize the carbon footprint of that plant. And that’s what we’re trying to do. Is it easy? No, is it always a hard trade, yes. But I believe that in this business, where you make medicine, you have to care about people. And you have to do the right thing in the long term. And overtime, things would be good for you if you do the right thing.

Andy Slavitt 

But if I’m an investor, I want you to spend $4 billion in R&D, what would be puzzling to me and confusing and concerning, but ultimately, I might react positively, if you said, that $4 billion, investing a billion I bet I’m gonna make no margin on a billion, I bet it’s gonna go to back 3 billion, or 2 billion, you know, where we are, we have to make margin and of course, some of its gonna fail. And I think people have to know that, you know, part of your investment is, it’s not going to be, it’s not gonna be fruitful, which is, which is why people are taking risk. But look, I think you’ve got a tremendous set of responsibilities, decisions to make, you know, you become you become a global leader, quote, unquote, overnight, but I want to find a way to finish it with two things. One is, we wake up 10 years from now, tell me what the mRNA platform is doing for the world. What do you think the mRNA platform is going to be delivering for the world? What kind of things are going to be happening?

Stéphane Bancel  1:14:07

So how long do you have, so the short version is we’re gonna reinvent vaccines. What most people don’t know is that they are not one or two respiratory virus that get people hospitalized and sick and dying. They are 100,000. We want to get a single dose vaccine that we get in the beginning of the fall, that protects you against all those viruses so you don’t get sick. It’ll get to the hospital for winter, until you get the next update the year after, one. Two, most people don’t know this is hard for those and DNA viruses know mRNA and flu are mRNA virus. That because DNA is such a stable molecule, that once you’re infected, you’re infected for life. Those are in your body. They never gonna go, those virus are massive tool on your immune system. Cytomegalovirus number one cause of birth defect in this country, no vaccine on the market. People that have CMV live less years with more cancer when people that are CMV negative. People don’t know about that, EBV Epstein bar virus, that’s a virus that gives mononucleosis, no vaccine on the market. 90% of people that have multiple sclerosis are EBV positive and that mononucleosis 90%, most people that have blood cancer are EBV positive.

Stéphane Bancel

Dr. Fauci and his team published a paper recently showing that 90% of people that have long COVID are EBV positive, meaning they have EBV in their body. And we believe it has to be proven that the long COVID is basically as you get COVID infection. You have a reactivation in your body of EBV, which is latent, it’s dormant in your body. And if you look at the symptoms of long COVID fatigue, brain fog does that all mononucleosis symptoms. So there’s a lot of viruses like these that we are all infected with. And once infected, infected for life like I’m EBV positive personally, as of last year, still CMV negative, it might change tomorrow. That is massively impact heavy. If you think about healthcare, what is wrong about how we’ve done drugs 450 years, is we only come and help you when you’re sick. The best medicine is to help you not to get sick, which was vaccines are, certainly going to revolutionize vaccine. And I’m not even talking about the tropical vaccine, we mentioned briefly for the tropical countries.

Stéphane Bancel  1:16:40

And then on the treatment side, we have four drugs that are in cancer, we have very cool drug that’s going to get the clinical data very soon, reinjected in people’s health after a heart attack, where we recreate a new blood vessel that you make yourself based on all Imani after we had a heart attack, to grow new blood vessel in your house, to revascularize your heart so we can pump blood again, like if you didn’t have any thoughts. We’re working on genetic disease; we’re working on autoimmune disease. So because mRNA is ubiquitous, you have 1000s of mRNA whenever you sell, and we believe that over time, so 10 years is a lot of time, especially now that we are profitable, we can invest so much more in science. In the past, we were well funded. But we could only invest $500 million in the company between manufacturing and research per year. As I told you, I’m investing billions just in R&D and building many more plants like growing in Africa and in Canada. And so in 10 years’ time, could Moderna than 100 drug in development. I think so. Could Moderna have several dozen drugs approved? I believe so.

Andy Slavitt  1:17:48

Wow. Very exciting. I want to close with this. It’s been a fascinating conversation. And I really grateful for the time in your in your candor, I want to close with giving you the opportunity, if there are people in Moderna, who you want to call out by name, who have been involved in this, been working behind the scenes. If you don’t want to, that’s fine. But if you want to, and I know you can that difficulty with this that you can never acknowledge everybody. But a lot of people listen to this. There’s a lot of unsung heroes. I think people would love to know, who are some of the people who are dedicated themselves and I think an opportunity for you if you want to call out some thank yous.

Stéphane Bancel 

Yeah, so I will not call on anybody because it takes a village to make a medicine and it will be very unfair to the people that I cannot call. But I just want to share a few stories. You know, I was at a factory a few months ago, I go regularly. And it was 10 in the morning, I was with the engineers that are not gone to bed yet. That work the […] they pull an all-nighter; they went to the locker room to get a shower before I showed up. And they were still working. I know of people that have not been to family funerals, not because we ask them not to. But because it’s always if I go, the vaccine will be delayed for its access to the world. And I have dozens of stories like this and the everybody in the company. I mean, this was an 800 people company who pulled something that companies with 100,000 people could not pull. So the personal sacrifice, even in people’s marriage. I mean, there are people I know that have not had dinner their spouse for like a year. These true stories I’m not exaggerating, and this is the but people only read without us asking, the commitment to the community. The commitment to over human fellows has just been remarkable and I’m sure because it has been tried Moderna it was true in all the other companies.

Stéphane Bancel

You know never we have been attacked in our lifetime by a virus with such an impact. All of us have been impacted. Just being locked down. Our families, friends or family He’s infected. Some of his people die from COVID. And so the commitment of a team and the teams across industry and academia and the partnerships and the regulators I mean, I mean, they are unsung heroes at the FDA at the CDC, and Dr. Fauci seem that I’ve worked in the night and day and weekends, I have so many emails from two or three o’clock in the morning on a Saturday from, you know, civil servants in the government, who have done everything they could, lacking the company is because we were under attack, we are still under attack and you have a full commitment that and until everybody wants a vaccine and the right variant, adaptive vaccine, we will not slow down because we owe it to society and to humanity.

Andy Slavitt  1:20:42

Well, thank you, thank you to your scientists. I do appreciate you calling out career civil servants. I, it’s a cause of mine. They get belittled, and what they do is incredibly selfless service oriented. Well Stéphane, thank you. Thank you to your team, and really appreciate you being IN THE BUBLLE. And having really honest conversation here.

Stéphane Bancel 

Thank you so much for having me, Andy, and stay well.

Andy Slavitt  1:21:09

Coming up Wednesday, is Richard Besser, former CDC head and current president and CEO of the Robert Wood Johnson Foundation. He is one of the most experienced and articulate voices we have in public health and the values in public health in this country. Paul Offit coming right off of the FDA meeting to hopefully approve boosters for kids next week on Monday. And then Wednesday, one of I think all of our favorite people, Kara Swisher, the journalist, podcast host, and the sort of social force that she is, will be here on the show. And we’re gonna have a great time with that. So stay tuned. And enjoy your Monday and Tuesday and I’ll talk to you on Wednesday about that.

CREDITS

Thanks for listening to IN THE BUBBLE. Hope you rate us highly. We’re a production of Lemonada Media. Kryssy Pease and Alex McOwen produced the show. Our mix is by Ivan Kuraev. Jessica Cordova Kramer and Stephanie Wittels Wachs still rule our lives and executive produced the show. And our theme was composed by Dan Molad and Oliver Hill, and additional music by Ivan Kuraev. You can find out more about our show on social media at @LemonadaMedia. And you can find me at @ASlavitt on Twitter or at @AndySlavitt on Instagram. If you like what you heard today, most importantly, please tell your friends to come listen and please stay safe, share some joy and we will get through this together.

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