The Invisible Siege by Dan Werb

Author:Dan Werb [Werb, Dan]
Language: eng
Format: epub
Publisher: Crown
Published: 2022-03-02T00:00:00+00:00

January 13, 2020, Cambridge, Massachusetts

Tal Zaks, Moderna’s chief medical officer, had been eagerly awaiting the start of the vaccine war games. But as Moderna and the National Institute of Allergy and Infectious Diseases negotiated the details, a real live enemy materialized. “We were planning to do this thing in 2020,” Zaks said, “and then in December, you start hearing about people coughing in Wuhan.” In early January, when experts like Anthony Fauci were telling Americans that there was at present no reason to be concerned, Zaks had been hearing a different message: “This is not a drill, this is actually live fire, and it’s time to muster up.”

Though the pandemic-ready pathogen arrived earlier than they would have liked, it had the effect of focusing, rather than undoing, the meticulous plan the team (including Zaks, Fauci, Graham, and others) had developed. With the broad strokes of their war games agreement already in place, both sides were primed for launch. The drill would have seen NIAID start the ticking clock by sending Moderna a viral sequence, which the company would then program into a vaccine and start production on doses. NIAID would then initiate a Phase 1 clinical trial as fast as possible, to test whether the vaccine worked. With the hazy reports of the novel coronavirus cohering into a picture of a formidable pathogen capable of extreme illness and efficient, asymptomatic transmission, only one thing had changed: NIAID was no longer going to choose the virus nor set the clock. Instead, it would start on Friday, January 10, 2020, when the sequence of the novel coronavirus was uploaded and shared with the world.

Graham wasted no time. Early the following morning, he headed to his lab at the Vaccine Research Center in Bethesda, Maryland, and spent the rest of the weekend holed up there, analyzing the sequence. By then, only forty-one cases of the novel coronavirus had been confirmed, all in China, and only one infected person had died. This low prevalence was no deterrent; Graham had spent his entire career tracking emerging epidemics, and they had all, by definition, started small. By Sunday evening, he and his team had isolated the spike protein sequence and had stabilized it using their 2P adjustment, which held it in the shape it had when it first entered the body, which boosted the immune response that a vaccine produced. By Monday morning, while the rest of the world was still conducting business as usual, Graham sent the stabilized sequence to Zaks and the Moderna group. That same day—January 13, just three days after the public release of the genome—Moderna launched production of mRNA-1273, its COVID-19 vaccine.

It was, despite the unfolding terror of the pandemic, the best-case scenario. Moderna and Graham’s team had already produced a MERS vaccine candidate that Baric had shown effectively protected both young and old mice from illness (though the slow spread of MERS had left them with too few numbers for a clinical trial among humans). The vaccine that Zaks’s team

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