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[Recorded on October 26, 2020.

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COVID-19 vaccine development

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and ethical considerations
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
as a risky decision.

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I volunteered to be deliberately
infected with COVID-19.

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

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where young, healthy people
are given a vaccine

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

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These trials help researchers
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
to speak to you for six minutes.

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In that time,

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

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Twenty-one people will die.

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

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

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affected by this global crisis.

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Scientists have been working
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
of waiting for those vaccines

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is rising by the day?

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This is where human
challenge trials come in.

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They're different from the traditional
phase three vaccine trials

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taking place now,

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where people are given
a vaccine or placebo

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and asked to go about
their everyday lives.

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Here, researchers have to wait
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
to know whether a vaccine is working.

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Finding an effective vaccine
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
on just 50 to 100.

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Because we know for certain

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when people are exposed
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
and our immune response.

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This data is impossible to gather
in any other way,

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especially for people who become infected
but never show symptoms.

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This knowledge is important
for designing policies

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that limit COVID-19 transmission.

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The time saved translates
into precious months' head start

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on manufacturing,

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getting us more working
COVID-19 vaccines faster.

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These trials are useful --

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even though recent phase three results
sound encouraging.

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

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It just isn't quite the fairytale ending
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
the infrastructure needed

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

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Each type of vaccine requires
its own special process and equipment

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to make, store and deliver it.

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If we had multiple
working COVID-19 vaccines,

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

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Some of the leading candidates
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
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
human challenge trials

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for hundreds of years.

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

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and they've helped us better understand
how immunity develops

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to things like the flu,
malaria and dengue.

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

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There's been a lot of debate

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about whether challenge
trials are too risky.

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I happen to think
that those risks are worth taking.

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A challenge trial would only recruit
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
in that age-group

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

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

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because researchers check to make sure

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that participants have
no preexisting conditions.

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The risk of a young healthy person
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
who become infected with COVID-19,

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about five die.

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If I were to give birth
in the United States,

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my risk of dying
would be higher than that.

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Or you could choose
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
before I offered her mine.

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

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it makes sense to allow people
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
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
effects of COVID-19 infection.

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I volunteered despite that uncertainty

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because like many of you,
I feel frustrated

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knowing that hundreds
of thousands of people are dying.

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

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as measures to stop the spread
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
in feeling this way.

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Since May, over 39,000 people
from across the world

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have volunteered to participate
in potential COVID-19 challenge trials

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through a nonprofit I helped found
called 1Day Sooner.

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We advocate for challenge
trial participants

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

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As early as May,

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when challenge trials
were still being considered

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for their role in the fight
against COVID-19,

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the World Health Organization
cited 1Day Sooner

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as an example of the kind
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
formally announced their intention

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to conduct a challenge trial
at the beginning of 2021.

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

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It has inspired
record-shattering innovation,

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and it has highlighted the heroic acts
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
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
of people all over the world.

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Challenge trials could be
a part of that solution.

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Thank you.