November 20, 2020

Albert Bourla

CEO Albert Bourla discusses Pfizer’s eight-month race to develop a COVID-19 vaccine, which he thinks will be available to frontline workers in December and the general public before the summer. He talks about efficacy, safety and distribution.

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Hope in the fight against COVID-19 — a vaccine breakthrough.
This week on ‘Firing Line.’
‘What is at stake is beyond the imagination,’ according to Pfizer C.E.O. Dr. Albert Bourla, when describing his company’s race to create a vaccine.
Last week, Pfizer announced its COVID vaccine is more than 90% effective.

90% is a game-changer.

Other candidates are promising, too.

This is something that just is now going in the very, very strong right direction.
The vaccines are effective.

So, how and when will Americans get the vaccine?
Will enough people take it?
And does this mean life will one day return to normal?

Pfizer C.E.O.
Dr. Albert Bourla, this week on ‘Firing Line.’

‘Firing Line with Margaret Hoover’ is made possible in part by… Corporate funding is provided by…
Welcome to ‘Firing Line,’ Albert Bourla.

Thank you very much, Margaret.

Dr. Bourla, the question on everyone’s mind is, when will average Americans realistically be able to get the COVID-19 vaccine?

I believe, sometime in the next year — maybe the third or the second quarter.
And the reason why I’m saying that — we will be able to provide to the American people around 20 million doses or more this year.
But this is 10 million people with two does, and I’m sure that the health authorities would like to use them strategically.
So, at the beginning, who will get the vaccine will be predetermined by them.
And likely, I assume, it will be people either with high risk or first-line workers.
So I believe that we will reach a level around second quarter that maybe people can just go and get them in their pharmacies or at the physician office at their will.

Do you think, by next summer?

I think so.
By next summer should be fine.

Tell me about the shot.
The vaccine uses mRNA technology, which is a breakthrough technology for vaccinations.
Now, can you explain to us in laymen’s terms exactly what is going on inside of a person’s body when they receive a dose of Pfizer’s shot?

When they receive a dose of Pfizer’s shot, they are getting a very large number of small lipid nanoparticles.
So, this is very small pieces of lipid.
And inside each one of these particles, there is a code that it is an RNA code.
I remind you that RNA code — messenger RNA — is the way that cells are replicating information about DNA.
So, to make a long story short, this messenger RNA, it is a code that will tell our cells to produce proteins that they are similar to the proteins that the vaccine has.
And that will create an immune response from our body as this is happening.

The mRNA technology is a breakthrough technology for vaccines.
What does it mean for the future of vaccines?

I think, great news.
I think that mRNA technology is here to stay.
I believe that in the future, this technology will be used to produce many more vaccines against viruses, but also I believe it will be used in other medical applications, like, for example, fighting cancer and many others.

So, you said a person will need two shots.
In what timeframe will they need both of those shots?

In our protocol — and I think this is quite important — only three weeks apart.

That might seem like a lot to people who are used to just getting vaccinated once.

There are several vaccines that there are two doses.
Not the flu.
Usually, there are one dose of flu, but there are multiple vaccines that require two or three doses.
So I don’t think people should have any concern with that.

What was the moment, Dr. Bourla, that you knew Pfizer would devote itself to innovating a COVID-19 vaccine?

Well, the moment was in March, when I really sat down with our scientific team, particularly the team that is responsible for the development and design of vaccines, and I asked them which technologies do they think we should be using if we wanted to develop a vaccine.
This is when things started.
Now, it may seem only nine months, but for me it was a very long nine months, and, I’m sure, for the world that they were living the consequences of this virus.
So, when I first heard — and that was on this Sunday at 2:00 p.m. when they called me to tell me that we have a successful vaccine, and then they told me the level of efficacy.
And I was thrilled.
I had tears in my eyes.

Did you have any indication, before that moment, that the vaccine would be as successful or as efficacious as they reported to you?

No, none.
I was hoping, frankly, to successes in the 70%s.
And FDA was asking a minimum of 50%. To get the minimum of more than 90% — actually, much closer to 100% than to 90% — is a very big — very big achievement.

Nearly 44,000 people participated in the trial.
Of those, 94 contracted COVID-19.
Pfizer has announced that the vaccine is more than 90% effective.
So does that mean, Dr. Bourla, that at least one of those 94 COVID cases was contracted by someone who had received the vaccine?

Yes, correct.
There were very, very few cases in the vaccinated group, and all the rest were in the placebo.
This is how we calculated more than 90%. It is between 90% and 100%. Closer to the 100%. Let me put it this way.

How long do you think it will take to get emergency use authorization from the FDA?

I don’t want to speak for themselves.
It’s not appropriate.
They are an agency that they have very high scientific expertise, so they are very competent in understanding the nuances of new technologies.
They are staffed by people of very high integrity.
And I’m sure — and I have seen it — that they have very high sense of urgency, given that every day we have 1,400 people, right now, dying.
I think they should take their time, but having in mind that people are needing this vaccine.

If it were to go as fast as possible, when do you think the first ‘first responders and front-line workers’ could receive the vaccine?

I believe, in December.
And that’s, right now, our plan.
I think, December, they should be able to get vaccinated.

So, Pfizer was the first to reveal its findings on the efficacy of the vaccine.
You were followed this week by another company, and you tweeted about that company, ‘I am thrilled to hear the good news coming out of Moderna’s COVID-19 vaccine development program.
Our companies share a common goal — defeating the dreaded disease — and today we congratulate everyone at Moderna and share in the joy of their encouraging results.’
A number of other companies are also in the final stages of trials.
So, Pfizer has plenty of company, doesn’t it?

Yes, and we hope that many of them will be successful.
We know very well that the demand for these vaccines will be so high that none of us will be able to meet the demand 100% in the next one or two years.
So it’s good if there are options.
I hope they are equally effective, the other vaccines, so that we will be able to set an end to this pandemic sooner, rather than later.

So, one of the differences between your vaccine and some of your competitors is the temperature at which it needs to be stored.
The Pfizer vaccine needs to be stored at 94 degrees below zero.
How does the below-freezing temperature storage requirement impact your distribution?
Are there certain places in the world, for example, you won’t be able to at least initially reach because of the temperature requirement?

I do not believe that would be anyplace in the modestly developed world.
I think what we need is very basic infrastructure, like roads, for example, so a track can reach the vaccination center.
Our engineers designed a box — a container — that it has a small size — something like that.
And this container can hold from 1,000 to 5,000 doses.
And it’s an isothermic box, so we load it with the vaccine, so loaded with dry ice, and you can send it to wherever you want in the world, without refrigerated trucks or without refrigerated airplanes.
Normal trucks or normal airplanes will carry it.
Once it’s received there, people either can put it in super freezers that are available commercially and most of the facilities have.
And then they can store it for months.
Or they can store it in this container that we send, for weeks, or they can put the doses that they want out of this container in the refrigerator and use it for days.

So, just to be clear, you’re saying, Dr. Bourla, that there’s nowhere in the world that your vaccines won’t reach?

As I said, as long as a plane or a truck can go, the vaccine will be there.

Is it true also — There’s been reporting that you’re also working on a powdered version of your vaccine for the following year.

Correct.
We are working in a version that this powder will not need this super-cold logistics and cold chain.

What is your sense, Dr. Bourla, for how long the vaccination will confer immunity?

This is a very, very good question, and this is a major unknown for us and for every other vaccine.
We are going to monitor the people that receive the vaccines for two years.
And we will do that so that we can know when we have a drop in their immune responses.
And we don’t know before that.
It is a reasonable scenario that at a certain point, the immune response will fade, so then there will be a need for a revaccination.
A good news is that with the mRNA technology, you can boost, you can revaccinate.

So, last month, you began enrolling children as young as 12 years old in the trials.
And those children would have now, at least, received a second shot.
What can you tell us about the vaccine’s effect on children?

You know, it’s too early, because this is why we are doing the experiments.
But I hope that children will have strong immune responses and they will be protected, if anything, better than adults, although it’s very difficult to have better protection, because it’s almost approaching perfection — the adult protection level you have right now.

But you think there’s a chance that children could have even better results than the 90%-plus that adults have?

It’s common in vaccinations that the younger the individual, the better the immune response of his body.
So, as a result, the better the protection.
That’s a common rule, but does not apply always.
So we need to make sure that this is happening with data.

You released some information about mild side effects of the vaccine.
Especially for people who have concerns about vaccines generally, what can you say to put people’s minds at ease?

I think it’s very, very safe, from what we have seen so far, and we have seen thousands of people.
The tolerability — First of all, we have seen no serious adverse effect — nothing.
And the tolerability, it is very good right now.
I mean, like 10%, 11%, 12% of the people that may demonstrate, let’s say, fever or headache.
Also, older people likely will not have any of that.
There will be very, very little with older people.
But the bottom line — if someone thinks the benefit that he’s getting — more than 90%, close to 100% protection — and less than 10% — or maybe close to 10% that they will have fever for a day, I think it is, in the middle of a pandemic, I think it’s a no-brainer.
And also, people need to understand that the decision to vaccinate or not yourself affects not only your health — which is, at the end of the day, your own call — will affect the health of your family, of your neighbors, of society.
Because if you don’t vaccinate, you’re becoming the weak link that will help this deadly virus replicate.
So they need to really think it.

Tell me, Dr. Bourla, for someone who is watching the program and is inclined to be skeptical anyway, when they hear you say that it’s safe, they are going to think, ‘Well, he’s the C.E.O. of the company.
Of course he’s saying it’s safe.’

Mm-hmm.

What can you say to help even the most skeptical feel confident in the safety of the vaccine?

I can tell that Pfizer is a company with 170 years of legacy.
And we would, at any cost, like to — at any price, would like to respect this legacy.
But even for those that still they are not convinced, we’ve chosen to be extremely transparent with the development of this vaccine.
We published our protocol.
This is something that we never do.
The protocols are discussions between us and regulators, not for public discussion.
We signed pledges that we committed that no matter what will be the political pressures, or any other type of pressures, we will only submit when we feel that we have a safe and effective vaccine, based on the guidance that we have received from Europe or FDA.
We started publishing our safety data before the study is completed.
We never do these things.
And then, of course, in addition to that, they should hear scientists that they know the information and they are known for telling things the way they are, like Dr. Fauci and other scientists out there that they don’t have any interest for any particular company.
They have, deep in their heart, the interest of the American people.
So, all of these things, I think, will be helpful to convince even the more skeptic.

Your company has a 170-plus-year history.
This program began airing in 1966.
It was hosted by a man named William F. Buckley Jr.
And in 1989, on that program, William F. Buckley Jr. hosted a debate about free-market competitiveness in the United States.
Then a Democrat Congresswoman, Pat Schroeder argued in favor of government involvement in research and development, and against U.N. Ambassador Jeane Kirkpatrick.
I want to show you a clip from that program.
Take a look.

We noticed that.
[ Applause ] [ Chuckles ] Well, but the government…
[ Chuckles ]
Dr. Bourla, what is your view of the ideal relationship between a private company and the federal government, when it comes to partnership on a COVID-19 vaccine?

I have to say I agree with the lady that spoke.
I think the COVID-19 — the success of the two vaccines so far is a great testament to the power of science, but also to the power of the private sector and the power of innovation at the hands of the private sector.
I think of the speed with which you can move in the private sector, the risks that you can take without having to worry about your spending taxpayers’ money, and the ways that performance also is very focused in the private sector can create miracles.
And despite the fact that I know very well that the pharmaceutical industry were not enjoying a high reputation in the last few years, for reasons that we can discuss maybe in another show, but I believe that the way that the pharmaceutical industry worked and collaborated into the pandemic is a clear demonstrator of the valuable position that this industry has to society.
And I believe and I hope that this event will be a catalyst that will help us bring the reputation up to the levels that it deserves.
It’s not going to be enough, just this success.
We need to keep doing the right thing, but I think it is a very, very good first step.

It’s a great testament to the power of private industry.
And I wonder if, Dr. Bourla, having worked in universities and other labs, if you think this vaccine could have been innovated simply at the hands of the government, without the private sector involved.

You know, I don’t want to speak if it was going to be or not, but I believe that the speed with which, and the quality with which we were able to move, this is something that very difficult can be achieved outside the private sector.

I want to take a look at something President Trump said last week about your company, Pfizer.
Take a look.

Pfizer said it wasn’t part of Warp Speed, but that turned out to be an unfortunate misrepresentation.
They are part.
That’s why we gave them the $1.95 million — billion.
And it was an unfortunate mistake that they made when they said that.

Okay, let’s set the record straight.
Unlike companies like Moderna and Johnson & Johnson, Pfizer took no money for research and development.

This is true.

The U.S. government will pay Pfizer $1.95 billion for 100 million doses if your vaccine is approved by the FDA.
Would you get any of that without success FDA-approved vaccine?

No, we will not.
And we haven’t — first of all, haven’t received anything yet.
Secondly, we didn’t receive the promise to receive anything for the development of our vaccine or for the manufacturing at risk.
We are taking all the risk to manufacture the doses, but we have a contract that if we are successful, we will sell at a certain price — 100 million doses to the U.S. government.
And the contract clearly stipulates that if we fail to get regulatory approvals, the government owes us nothing.
And we just have to write off the product.
I felt that we would move much faster and much more reliable if I could protect my scientists from the bureaucracy.
But when you get money, always comes with some strings attached.
This is why we didn’t get it.

How would you characterize the level of risk you took on, as the C.E.O. of a publicly traded company, if it hadn’t worked?

It was high. Very high.
It was not going to break the company.
I’m not reckless.
It took billions, right off.
It’s very painful for any corporation, even at our size.
But I think it was a very well calculated risk, because it is a highly risky proposition, but also highly rewarded if you are getting it right.
I don’t think that Pfizer had ever been admired by people all around the world more than the last one week.
And only that gives our board and myself and our employees a tremendous pride that we’re able to do that.
And the fact that we are connecting our name with a solution to the largest, by far the biggest challenge that humanity faced in the last 100 years, it’s worth absolutely the risk of $2 billion.

You wrote a letter to Pfizer’s employees after the first presidential debate.
You said… Dr. Bourla, why did you need to write that letter?

Look, first of all, I was frustrated.
I’d heard our vaccine, the effort to save the world, being discussed in political terms, rather than scientific terms.
And also I could see the danger of that and the danger of, in terms of public health perception, because when you put the vaccine in the heart of the debate, then, based on your political affiliation, you will think that it is good or bad, safe or not safe, and you will take it or not.
And this is terrible, as I said, for the credibility that is much needed of a vaccine like that.
I have 90,000 employees that were shocked to hear Pfizer’s name there.
And I told them that some people want us to move faster.
Some people want us to move slower.
We don’t miss any of them.
We will move at the speed of science.

The speed of science moves at a time that the political cynics say is just to suspicious.
I mean, the efficacy announcement came on Monday, November 9th, two days after Joe Biden became the projected winner of the election.
So, what do you say to those people who, as you said, were on the other side of the debate?

I told them what I told the other people before.
If we could bring it in October, we would.
This is 1,400 people dying every day.
So this is not political, right?

Yeah.

And I heard the results, 2:00 on a Sunday, and the news came out 6:00 Monday morning.
And it’s — it’s unfortunate to discuss this in political terms, but I don’t know what else could I have done.

Your personal story, Dr. Bourla, is rather remarkable.
I mean, you were a — You’re from Greece.
You are a trained veterinarian.
You spent 25 years rising through the ranks at Pfizer, before becoming its chief executive officer.
And I’m particularly interested in your perspective, as an immigrant to this country, on how you’ve observed the United States of America in this time of crisis.

It’s a great question.
First of all, I have great admiration for this country.
I became a U.S. citizen.
And I like to say, I’m Greek by birth, American by choice.
And I remember when I was elected by my board, and they brought me in to inform me that I am going to be the next C.E.O.
And they asked me, ‘Do you have anything to say?’
I told them, ‘Only in America,’ because I truly believe that this is the country that when you become American, you are one of them.
This is not easy to accomplish in any other country of the world.
One can debate the effectiveness of different governments, in terms of controlling the virus, and you can see undisputably in their results, in the outcomes.
But people of America, I think they suffer as much as everybody else, and I’m very happy that now, at least, they can see the end — at the end, a little bit of light at the end, too, now, of the tunnel.

Finally, Dr. Bourla, millions of Americans are finalizing their holiday plans right now.
And as a person who has overseen the production of what we hope will be the solution to the pandemic, what is your advice for the next few months?
Because, as you said, we won’t have the vaccine.

Yeah.
I would like to caution everyone that they should be very, very, very careful.
I believe that the good news of the vaccine, that it’s coming, should not relax the caution that everybody is taking.
That will be the worst that can happen.
So a lot of caution, please.

This is the final stretch, is what you’re saying.

It is the final stretch.
I would be very careful with my family.
I’m more optimistic about summer holidays that may come.
But, right now, please, follow religiously the instructions of the health authorities.
And there is nothing better than this mask here, right?
So, which I published a lot of them — ‘Science will win.’
And we gave them to our employees — right? — so that we can remind them that they can be very proud to wear them.
Wear a mask.
Save lives.

Dr. Albert Bourla, with that, thank you very much for spending your time here with me on ‘Firing Line.’

Thank you very, very much.
It was a great honor.

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