WEBVTT 00:00:01.432 --> 00:00:02.883 [Recorded on October 26, 2020. 00:00:02.907 --> 00:00:04.258 COVID-19 vaccine development 00:00:04.282 --> 00:00:06.902 and ethical considerations around human challenge trials 00:00:06.926 --> 00:00:08.148 are constantly evolving.] NOTE Paragraph 00:00:08.172 --> 00:00:09.854 In April 2020, 00:00:09.878 --> 00:00:12.320 I made what many perceive as a risky decision. 00:00:13.245 --> 00:00:16.765 I volunteered to be deliberately infected with COVID-19. 00:00:17.109 --> 00:00:20.800 This infection would be part of what is called a human challenge trial, 00:00:20.824 --> 00:00:23.736 where young, healthy people are given a vaccine 00:00:23.760 --> 00:00:27.554 and are deliberately exposed to the virus that causes COVID-19. 00:00:27.578 --> 00:00:30.196 These trials help researchers figure out more quickly 00:00:30.220 --> 00:00:32.068 if a vaccine is working. NOTE Paragraph 00:00:33.585 --> 00:00:35.212 I think this research is crucial, 00:00:35.236 --> 00:00:38.259 because today, I'm going to speak to you for six minutes. 00:00:38.283 --> 00:00:39.434 In that time, 00:00:39.458 --> 00:00:43.844 roughly 1,250 people will be confirmed infected with COVID-19. 00:00:44.481 --> 00:00:46.425 Twenty-one people will die. 00:00:47.060 --> 00:00:51.329 And then this pattern will repeat hour after hour and day by day, 00:00:51.353 --> 00:00:54.435 until we're able to vaccinate most of the eight billion people 00:00:54.459 --> 00:00:56.526 affected by this global crisis. NOTE Paragraph 00:00:57.131 --> 00:00:59.275 Scientists have been working around the clock 00:00:59.299 --> 00:01:01.362 to make those vaccines a reality. 00:01:02.045 --> 00:01:05.862 But what should we do when the human cost of waiting for those vaccines 00:01:05.886 --> 00:01:07.338 is rising by the day? 00:01:07.362 --> 00:01:09.973 This is where human challenge trials come in. 00:01:10.458 --> 00:01:13.514 They're different from the traditional phase three vaccine trials 00:01:13.538 --> 00:01:14.720 taking place now, 00:01:14.744 --> 00:01:16.934 where people are given a vaccine or placebo 00:01:16.958 --> 00:01:19.497 and asked to go about their everyday lives. 00:01:19.521 --> 00:01:23.283 Here, researchers have to wait to see how many people in each group 00:01:23.307 --> 00:01:24.587 become infected. 00:01:25.220 --> 00:01:26.807 Until enough of them get sick, 00:01:26.831 --> 00:01:30.298 we don't have enough data to know whether a vaccine is working. NOTE Paragraph 00:01:30.322 --> 00:01:32.418 Finding an effective vaccine with this method 00:01:32.442 --> 00:01:35.093 can take months or sometimes years, 00:01:35.117 --> 00:01:37.497 and it requires thousands of volunteers. 00:01:38.624 --> 00:01:40.410 A challenge trial works faster 00:01:40.434 --> 00:01:42.196 because researchers control exposure, 00:01:42.220 --> 00:01:44.569 instead of waiting for people to get sick. 00:01:44.593 --> 00:01:46.680 So instead of a year, 00:01:46.704 --> 00:01:48.482 we could know in as little as a month 00:01:48.506 --> 00:01:50.532 whether a vaccine seems effective. 00:01:50.926 --> 00:01:52.822 Instead of thousands of volunteers, 00:01:52.846 --> 00:01:55.902 a challenge trial relies on just 50 to 100. NOTE Paragraph 00:01:56.385 --> 00:01:57.712 Because we know for certain 00:01:57.736 --> 00:02:00.148 when people are exposed and develop disease, 00:02:00.172 --> 00:02:02.545 these trials also allow us to gather data 00:02:02.569 --> 00:02:06.053 about the early stages of infection and our immune response. 00:02:06.624 --> 00:02:09.553 This data is impossible to gather in any other way, 00:02:09.577 --> 00:02:13.346 especially for people who become infected but never show symptoms. 00:02:14.346 --> 00:02:16.759 This knowledge is important for designing policies 00:02:16.783 --> 00:02:18.983 that limit COVID-19 transmission. 00:02:19.497 --> 00:02:22.823 The time saved translates into precious months' head start 00:02:22.847 --> 00:02:24.259 on manufacturing, 00:02:24.283 --> 00:02:27.581 getting us more working COVID-19 vaccines faster. 00:02:27.885 --> 00:02:29.124 These trials are useful -- 00:02:29.148 --> 00:02:32.042 even though recent phase three results sound encouraging. NOTE Paragraph 00:02:32.737 --> 00:02:36.673 The arrival of the first vaccine is going to be a monumental breakthrough. 00:02:37.094 --> 00:02:40.221 It just isn't quite the fairytale ending we're all hoping for. 00:02:41.102 --> 00:02:43.283 We're going to need multiple vaccines, 00:02:43.307 --> 00:02:45.759 because we just don't have the infrastructure needed 00:02:45.783 --> 00:02:49.322 to immunize all eight billion people on the planet with just one kind. 00:02:49.743 --> 00:02:53.482 Each type of vaccine requires its own special process and equipment 00:02:53.506 --> 00:02:55.937 to make, store and deliver it. 00:02:56.680 --> 00:02:59.403 If we had multiple working COVID-19 vaccines, 00:02:59.427 --> 00:03:02.537 we could make use of all of our equipment at the same time. 00:03:03.570 --> 00:03:06.482 Some of the leading candidates need to be kept extremely cold 00:03:06.506 --> 00:03:08.530 before they are delivered to people. 00:03:08.554 --> 00:03:09.720 This can be really hard, 00:03:09.744 --> 00:03:12.998 especially in countries where there isn't reliable electricity 00:03:13.022 --> 00:03:14.784 or a secure method to store them. NOTE Paragraph 00:03:15.421 --> 00:03:17.831 Scientists have been using human challenge trials 00:03:17.855 --> 00:03:19.571 for hundreds of years. 00:03:19.595 --> 00:03:23.413 They've sped up the development of vaccines against typhoid and cholera, 00:03:23.437 --> 00:03:26.310 and they've helped us better understand how immunity develops 00:03:26.334 --> 00:03:29.214 to things like the flu, malaria and dengue. 00:03:29.810 --> 00:03:33.071 We've even used them for other types of coronavirus before. NOTE Paragraph 00:03:34.731 --> 00:03:36.080 There's been a lot of debate 00:03:36.104 --> 00:03:38.341 about whether challenge trials are too risky. 00:03:39.096 --> 00:03:42.135 I happen to think that those risks are worth taking. 00:03:42.745 --> 00:03:46.111 A challenge trial would only recruit young and healthy participants -- 00:03:46.135 --> 00:03:48.952 think between the ages of 20 and 29. 00:03:49.858 --> 00:03:52.205 Fewer than one percent of people in that age-group 00:03:52.229 --> 00:03:55.908 need to be taken to hospital after becoming infected with COVID-19. 00:03:56.500 --> 00:03:59.024 So it would likely be even lower in a challenge trial, 00:03:59.048 --> 00:04:00.905 because researchers check to make sure 00:04:00.929 --> 00:04:03.515 that participants have no preexisting conditions. 00:04:04.143 --> 00:04:07.754 The risk of a young healthy person dying of COVID-19 00:04:07.778 --> 00:04:10.267 is around five thousandths of a percent. 00:04:10.857 --> 00:04:15.762 That means for every 100,000 20-year-olds who become infected with COVID-19, 00:04:15.786 --> 00:04:17.159 about five die. 00:04:18.611 --> 00:04:20.739 If I were to give birth in the United States, 00:04:20.763 --> 00:04:23.225 my risk of dying would be higher than that. NOTE Paragraph 00:04:24.088 --> 00:04:26.681 Or you could choose to think about it this way. 00:04:27.110 --> 00:04:29.317 If my little sister needed a kidney, 00:04:29.341 --> 00:04:32.269 I wouldn't hesitate for a moment before I offered her mine. 00:04:32.920 --> 00:04:36.277 And if I can take on that risk to benefit a loved one, 00:04:36.301 --> 00:04:39.720 it makes sense to allow people to take on a similar risk 00:04:39.744 --> 00:04:41.807 to speed up the development of a vaccine 00:04:41.831 --> 00:04:44.649 that would benefit not just their loved ones, 00:04:44.673 --> 00:04:46.577 but everyone around them as well. NOTE Paragraph 00:04:46.601 --> 00:04:48.246 There's a lot we still don't know, 00:04:48.270 --> 00:04:51.470 especially about the long-term effects of COVID-19 infection. 00:04:52.088 --> 00:04:54.191 I volunteered despite that uncertainty 00:04:54.215 --> 00:04:56.411 because like many of you, I feel frustrated 00:04:56.435 --> 00:04:59.340 knowing that hundreds of thousands of people are dying. 00:04:59.364 --> 00:05:02.927 And that's without mentioning the millions more who are struggling 00:05:02.951 --> 00:05:06.278 as measures to stop the spread take a toll on their physical, 00:05:06.302 --> 00:05:08.540 emotional and mental well-being. NOTE Paragraph 00:05:08.564 --> 00:05:11.421 It turns out I'm not alone in feeling this way. 00:05:12.111 --> 00:05:15.718 Since May, over 39,000 people from across the world 00:05:15.742 --> 00:05:19.480 have volunteered to participate in potential COVID-19 challenge trials 00:05:19.504 --> 00:05:22.543 through a nonprofit I helped found called 1Day Sooner. 00:05:22.900 --> 00:05:25.080 We advocate for challenge trial participants 00:05:25.104 --> 00:05:28.936 and have been encouraging stakeholders to begin preparing for these trials. 00:05:29.881 --> 00:05:31.087 As early as May, 00:05:31.111 --> 00:05:33.414 when challenge trials were still being considered 00:05:33.438 --> 00:05:36.087 for their role in the fight against COVID-19, 00:05:36.111 --> 00:05:38.850 the World Health Organization cited 1Day Sooner 00:05:38.874 --> 00:05:41.635 as an example of the kind of public engagement needed 00:05:41.659 --> 00:05:43.237 to run a challenge trial. 00:05:43.261 --> 00:05:44.437 In mid-October, 00:05:44.461 --> 00:05:47.381 the UK government formally announced their intention 00:05:47.405 --> 00:05:50.944 to conduct a challenge trial at the beginning of 2021. NOTE Paragraph 00:05:51.420 --> 00:05:55.217 It is clear that the COVID-19 pandemic is a global crisis. 00:05:55.614 --> 00:05:58.295 It has inspired record-shattering innovation, 00:05:58.319 --> 00:06:01.828 and it has highlighted the heroic acts of many frontline workers, 00:06:01.852 --> 00:06:04.365 but is has also taken a catastrophic toll. 00:06:04.389 --> 00:06:08.960 The arrival of each new vaccine brings us one step closer to rebuilding. 00:06:08.984 --> 00:06:11.032 But the true global solution 00:06:11.056 --> 00:06:14.963 lies in those vaccines being in the hands of people all over the world. 00:06:14.987 --> 00:06:17.661 Challenge trials could be a part of that solution. NOTE Paragraph 00:06:18.311 --> 00:06:19.462 Thank you.