It’s too early to decide if coronavirus mutations are ‘a nonevent’: Mayo Clinic Vaccinologist
In recent weeks, treatments and vaccines for coronavirus have taken priority in the news and in daily life. Vaccinologist Dr. Greg Poland from the Mayo Clinic joins The Final Round to discuss his thoughts on vaccines and what has been learned about the coronavirus.
Video Transcript
MYLES UDLAND: To what's happening with coronavirus and happening with the efforts for a vaccine for the virus. I want to bring in Dr. Gregory Poland. He is with the Mayo Clinic.
And Dr. Poland, we've talked a few times in the last couple of months about the state of play with respect to the virus, and treatments, and vaccines. And we've had quite a bit of news in the last few weeks-- uncertain vaccine trials certainly that the stock market got quite excited about. From your vantage point, what are things that you have seen that you are encouraged by, interested in. And where do you kind of view vaccine development at this point in the proceedings?
GREGORY POLAND: Well, what I'm happy about is that it's going forward. We've got a number of candidates, in particular in the US, the Moderna study. We've gotten only very brief results, unfortunately, released by press release, rather than in peer-reviewed literature. But nonetheless, those early results were encouraging. There are non-human primates studies that back that up. So that's interesting.
We've got over 100 vaccine candidates in play. Not many of them yet in clinical trials, but more to join. And we're better understanding the immunology that drives all this. So all in all, a very positive view in the last couple of weeks.
MYLES UDLAND: And I guess, Dr. Poland, as you look at these potential treatments or potential vaccines, I guess, for the virus-- I know, we've talked in the past about the stability of the virus and how that's been, I guess, relatively encouraging in terms of finding potential solutions. Has that held up?
The more we learn about-- we've seen reports on the differences in strains that came to the US from Europe versus China. But it seems from my cursory outside view that this mutation fear that I guess we get from the movies and from influenza hasn't exactly so far been a part of this story.
GREGORY POLAND: Well, Myles, you're right. This is an important and critical issue, because basically all of the vaccine platforms so far, or what we would call S-protein-only vaccines-- I just published an editorial on this called "The Tortoise and the Hare," getting across the idea that the race is not always to the swiftest, right? We want to use wisdom in thinking about this.
So the virus does mutate. Mutations have been identified. The significance of those is unknown. But the virus tends to mutate very slowly, accumulating a couple of mutations a month. So it would be early yet to conclude that this is going to be a non-event. It'll be more important to know what's going to happen as we get close to fall, to a potential resurgence of this virus.
SEANA SMITH: And doctor, I know you don't want to go into the politics of this, but I need to ask you about what President Trump just said in his press conference. And he said that the US is terminating its relationship with the World Health Organization. Now, he has been very critical of the WHO now for quite some time. But my question to you is, what kind of challenge does this pose when we're in the middle of a pandemic?
GREGORY POLAND: I'm not sure what it means by terminating the relationship, so that needs to be defined. I guess what I would say is this. Coronavirus is a science and public health issue. It has political, and economic, and other consequences, but the bullseye of this target is public health and science. So how do you create a global organization that everybody's happy with and that can manage across sovereign nations this really wild pandemic?
I mean, we've seen some countries devastated. We're going to see more of that in the Southern Hemisphere, and then very likely a backwash of that into the Northern Hemisphere this fall. How do we manage that?
We haven't really figured out how to do it state by state in the US with some tussling over the role of the federal government versus the state government. That's even harder at the global level.
ANJALEE KHEMLANI: Doctor, This is Anjalee here. Talking about global access of these vaccines, that's one of the major concerns is this unprecedented demand that we have at a time like this when the World Health Organization's role is in fact to create those relationships and be open to all countries. Does that harm US companies' efforts? Or do you see that being a potential issue?
GREGORY POLAND: I don't think so. I think the demand for the vaccine is going to be so high and the world's manufacturing capacity limited that I don't think it's going to affect demand at all.
What will have to be negotiated is who gets what. If country A manufacturers the vaccine, will they not use the vaccine in their own country for their own citizens first, and then begin to supply the world? This is exacerbated, as you might imagine, if it's a vaccine that requires two doses rather than just one.
DAN ROBERTS: Dr. Poland, Dan Roberts here. Thanks for being back with us.
I just want to get your take, if we zoom out a little bit, as you said, it's a state-by-state scenario now and kind of landscape. And there's so much confusion. Just the average person right now doesn't really know, what's socially acceptable? I mean, even though my state says I can eat out at a restaurant and restaurants near me have opened for outdoor dining, is that OK? And other people say, oh, I can't believe you're doing that.
And another example that we've talked about this week is summer camps. In some states, summer camps are "Go, go, go! We're opening up." But in Maine and in upstate New York, many camps have already said, "Nope. There's no way we can open camp." I mean, as you look around, what do you make of how the various states have handled it?
And what are your concerns? Because, obviously, no one is going to stay completely cooped up in their home for however long it takes to have a mass vaccine, whether it's 18 months or longer. Things are going to reopen. But do you worry a lot about spikes of new cases?
GREGORY POLAND: I really do. And there's precedent for that based on what we've seen so far. So premature reopening absolutely leads to a spike in cases, even at the small level, for example, a choir practice, a church, a synagogue, something like that where you're just-- where you're only talking about a hundred people. And yet, you'll see a surge in cases. So it's a really important question.
And I think I'm not sure we're wise enough to do this. But these decisions should be made at the local and regional level based on metrics, not based on emotion, not based entirely on economics, not based on politics. But have you suppressed cases?
New York City, for example, is a place where my personal opinion is they've done a really good job in a very difficult situation. But they are using metrics. And when they achieve those metrics, then they begin not a light switch, but a dimmer switch of beginning to phase things. And to me, that makes a lot of sense, and it's science and evidence-based.
ANJALEE KHEMLANI: Doctor, it's Anjalee again. I know that there's a few different vaccine technologies that are being used that are in this global race, whether you're talking about recombinant or the mRNA of the newer one, and that has yet to be tested through the regulatory process. But looking at all the different ones out there, you have some of the larger companies doing a more traditional route, and then some of these smaller biotechs with these newer ones. Is there a sense of sort of which one does, in fact, instill more confidence right now? Is it the leaders in the race? Or are we looking more to the larger J&Js of the world?
GREGORY POLAND: Yeah, Anjalee, great question. Really too early to tell.
The whole idea is that biotech can take more risk and often leapfrogs us in the science, whereas a more established company is likely going to be using a more established platform, because they're comfortable with that. They have the manufacturing capacity, et cetera.
For me, what is really difficult-- and I express this in the editorial. I'm the editor in chief of the journal "Vaccine"-- what you have to hold in tension is speed versus safety. And that's something that we haven't had a very good national discussion on yet, because they're going to be people who feel we've sped this up too fast, and we don't really know about the safety, and other people saying, what are we waiting for? People are dying and getting sick.
Threading the needle involves doing this in a wise manner, being careful about how we do it, limiting exposure to the vaccine until we have evidence of safety, and then broadening that out. Again, it's not a light switch.
And this is something people really have to realize. If we want people to have confidence in whatever vaccines-- and I say plural. I think we're going to need a number of different type of vaccine platforms-- they've got to take the time to do adequate safety testing.
MYLES UDLAND: All right. Dr. Gregory Poland, a vaccinologist with the Mayo Clinic. We could go all day with you. We appreciate you taking the time today. Hopefully, we can talk soon.
GREGORY POLAND: All right. Thank you. Be safe, all.
