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[Recorded on October 26, 2020.

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COVID-19 vaccine development

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and ethical considerations[br]around human challenge trials

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are constantly evolving.]

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In April 2020,

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I made what many perceive[br]as a risky decision.

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I volunteered to be deliberately[br]infected with COVID-19.

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This infection would be part[br]of what is called a human challenge trial,

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where young, healthy people[br]are given a vaccine

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and are deliberately exposed[br]to the virus that causes COVID-19.

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These trials help researchers[br]figure out more quickly

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if a vaccine is working.

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I think this research is crucial,

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because today, I'm going[br]to speak to you for six minutes.

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In that time,

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roughly 1,250 people will be[br]confirmed infected with COVID-19.

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Twenty-one people will die.

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And then this pattern will repeat[br]hour after hour and day by day,

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until we're able to vaccinate[br]most of the eight billion people

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affected by this global crisis.

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Scientists have been working[br]around the clock

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to make those vaccines a reality.

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But what should we do when the human cost[br]of waiting for those vaccines

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is rising by the day?

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This is where human[br]challenge trials come in.

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They're different from the traditional[br]phase III vaccine trials

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taking place now,

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where people are given[br]a vaccine or placebo

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and asked to go about[br]their everyday lives.

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Here, researchers have to wait[br]to see how many people in each group

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become infected.

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Until enough of them get sick,

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we don't have enough data[br]to know whether a vaccine is working.

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Finding an effective vaccine[br]with this method

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can take months or sometimes years,

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and it requires thousands of volunteers.

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A challenge trial works faster

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because researchers control exposure,

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instead of waiting for people to get sick.

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So instead of a year,

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we could know in as little as a month

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whether a vaccine seems effective.

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Instead of thousands of volunteers,

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a challenge trial relies[br]on just 50 to 100.

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Because we know for certain

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when people are exposed[br]and develop disease,

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these trials also allow us to gather data

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about the early stages of infection[br]and our immune response.

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This data is impossible to gather[br]in any other way,

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especially for people who become infected[br]but never show symptoms.

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This knowledge is important[br]for designing policies

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that limit COVID-19 transmission.

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The time saved translates[br]into precious months' head start

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on manufacturing,

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getting us more working[br]COVID-19 vaccines faster.

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These trials are useful --

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even though recent phase III results[br]sound encouraging.

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The arrival of the first vaccine[br]is going to be a monumental breakthrough.

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It just isn't quite the fairytale ending[br]we're all hoping for.

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We're going to need multiple vaccines,

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because we just don't have[br]the infrastructure needed

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to immunize all eight billion people[br]on the planet with just one kind.

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Each type of vaccine requires[br]its own special process and equipment

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to make, store and deliver it.

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If we had multiple[br]working COVID-19 vaccines,

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we could make use of all[br]of our equipment at the same time.

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Some of the leading candidates[br]need to be kept extremely cold

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before they are delivered to people.

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This can be really hard,

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especially in countries[br]where there isn't reliable electricity

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or a secure method to store them.

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Scientists have been using[br]human challenge trials

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for hundreds of years.

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They've sped up the development[br]of vaccines against typhoid and cholera,

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and they've helped us better understand[br]how immunity develops

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to things like the flu,[br]malaria and dengue.

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We've even used them[br]for other types of coronavirus before.

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There's been a lot of debate

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about whether challenge[br]trials are too risky.

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I happen to think[br]that those risks are worth taking.

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A challenge trial would only recruit[br]young and healthy participants --

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think between the ages of 20 and 29.

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Fewer than one percent of people[br]in that age-group

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need to be taken to hospital[br]after becoming infected with COVID-19.

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So it would likely be even lower[br]in a challenge trial,

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because researchers check to make sure

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that participants have[br]no preexisting conditions.

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The risk of a young healthy person[br]dying of COVID-19

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is around five thousandths of a percent.

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That means for every 100,000 20-year-olds[br]who become infected with COVID-19,

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about five die.

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If I were to give birth[br]in the United States,

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my risk of dying[br]would be higher than that.

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Or you could choose[br]to think about it this way.

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If my little sister needed a kidney,

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I wouldn't hesitate for a moment[br]before I offered her mine.

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And if I can take on that risk[br]to benefit a loved one,

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it makes sense to allow people[br]to take on a similar risk

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to speed up the development of a vaccine

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that would benefit[br]not just their loved ones,

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but everyone around them as well.

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There's a lot we still don't know,

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especially about the long-term[br]effects of COVID-19 infection.

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I volunteered despite that uncertainty

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because like many of you,[br]I feel frustrated

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knowing that hundreds[br]of thousands of people are dying.

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And that's without mentioning[br]the millions more who are struggling

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as measures to stop the spread[br]take a toll on their physical,

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emotional and mental well-being.

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It turns out I'm not alone[br]in feeling this way.

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Since May, over 39,000 people[br]from across the world

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have volunteered to participate[br]in potential COVID-19 challenge trials

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through a nonprofit I helped found[br]called 1Day Sooner.

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We advocate for challenge[br]trial participants

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and have been encouraging stakeholders[br]to begin preparing for these trials.

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As early as May,

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when challenge trials[br]were still being considered

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for their role in the fight[br]against COVID-19,

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the World Health Organization[br]cited 1Day Sooner

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as an example of the kind[br]of public engagement needed

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to run a challenge trial.

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In mid-October,

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the UK government[br]formally announced their intention

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to conduct a challenge trial[br]at the beginning of 2021.

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It is clear that the COVID-19 pandemic[br]is a global crisis.

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It has inspired[br]record-shattering innovation,

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and it has highlighted the heroic acts[br]of many frontline workers,

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but is has also taken a catastrophic toll.

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The arrival of each new vaccine[br]brings us one step closer to rebuilding.

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But the true global solution

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lies in those vaccines being in the hands[br]of people all over the world.

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Challenge trials could be[br]a part of that solution.

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Thank you.