The surprising future of vaccine technology

We owe a lot to vaccines and the scientists that develop them. But we've only just touched the surface of what vaccines can do.

LOU REESE: The largest gains in human longevity ever are debatably attributed to vaccine technology.

The antibiotic revolution was very important, but vaccine technology is currently over 6.2 billion people in the world have been vaccinated right now. These are the most widely distributed medications and solutions that have ever been brought to mankind. And the consequence was that we really dramatically improved our quality of life and our longevity. We gave people better, healthier, longer lives.

LARRY BRILLIANT: Vaccines are the best thing science has ever given us. It saved hundreds of millions of children's lives. It eradicated smallpox. It has reduced the population explosion. I know that's pretty paradoxical but as long as there are vaccines children will not die as they did when I was in India. There were places that 50 percent of kids died before the age of five. When that happens parents have many more babies because they expect to lose so many. Vaccine has changed that.

BILL NYE: Vaccines, you know, part of the reason I'm able to be here talking with you is my grandparents did not die in 1918 during the Spanish flu when it is estimated 50 million people died. Twice as many people as were killed in combat in World War I died of this disease. If you go to old cemeteries you can see these tombstones of very young people that died of the flu. People just lost sight of history.

BRILLIANT: I live in Marin County. I live in the epicenter of the antivax movement. It's pretty obvious I have not been very successful in my own county in persuading people. And I understand. This is a very complicated business. Measles, for example, one of the M's in MMR, measles spreads faster than any other virus we've ever seen. One case can give rise to 20 or 30 cases in two weeks. If we had a lot of measles around and there were a lot of children getting sick all the time we wouldn't be looking at the marginal question of whether vaccinating my child or not was a good idea. We'd be rushing to get the measles vaccine and that's what happened. When polio was around and you always knew somebody in the neighborhood who was paralyzed in an iron lung. We all rushed to get that polio vaccine. In fact, there's photographs of parents standing in line for four or five hours to get the Salk vaccine or the Sabin vaccine.

MICHAEL WIGLER: It's unfortunate that the age at which parents begin to recognize autism in their children often correlates with the age at which they receive vaccinations. That's an unfortunate thing. One could go to Third World countries and do a study and ask is the rate of autism there the same as it is in the developed countries. No one has done a study that I know of that type but it certainly could be done.

BRILLIANT: When there's no measles around we change our calculus. Why should I subject my child to a one in a million risk if there's less than a one in a million chance of them getting the disease? This is where it becomes hard because we have to talk about prevention of a disease that still exists in the world but not in our neighborhood.

WIGLER: Anything having to do with the development of an organism has an environmental component to it. But you can only study that when there's some evidence which enables you to isolate that environmental component. I think the vaccine studies have been now largely discredited. They took mercury out of the vaccines and the rates of autism didn't change. And now of the 12 authors of the original paper that got some people very excited, I think 11 of those 12 authors have now withdrawn their backing for that paper and the methods used in that paper are really in doubt. I don't take it as there being any evidence that vaccines is such an environmental factor. I think every parent who has a child suffers through nightmares hoping that their child will be healthy. They give birth to a healthy child and then at age two or three the child suddenly stops developing. That's a tragedy of horrendous proportions and it's natural for the parents of such children to look around for the possible causes, something external. However, it should be born in mind that our brains continuously are developing at that age and it is well known that there are genetic defects whose onsets can occur at almost any particular age. For example, there are a class of disorders that are called storage disorders where the child develops normally but because of a buildup of some compound due to the faulty metabolism of some essential thing that they eat everyday builds up to a point and then begins to poison the brain. So the idea that you can't have sudden onset of an illness in a child that is two or three is just wrong.

REESE: The big problem with vaccines is that you could never use them against non-external targets. So, they worked great with viruses whether it was Ebola or Zika, polio, smallpox. We actually can solve those problems pretty fast for the external targets. But now what's killing us more than everything external are actually for the first time this year the bar crossed and internal things are killing us more. So the agents of chronic illness, so, it's no longer fighting bacteria and viruses in these other external causes of death or causes of suffering or causes of disease. Instead it's internal ones. It's things that are causing arthrosclerosis and heart disease and stroke. Things that are causing cancers. Things that are causing diabetes, Alzheimer's, Parkinson's. All of these different chronic illnesses. Now why don't we vaccinate against chronic illness? Well, the idea is that you would be fundamentally targeting something that's in your own body. You'd be targeting something your body was making and so what does that sound like? It sounds like an autoimmune disease. It sounds like if you made your body do that it could trigger an autoimmune disease. And it turns out that that's one of the big challenges in making vaccines against things your body generates. And they call that the self-barrier or breaking self-tolerance or all of these different things that describe this phenomena. But the bottom line is the body does not like to attack itself and it's trying not to. For millions of years our immune systems have evolved so that we don't do exactly that. Now, what's awesome is that our technology platform has been able to do it and do it safely and we've been able to do it in a lot of applications. Something that I found out that blew my mind was that this year for the first time since the Spanish flu we will have three years in a row of decreasing longevity in the United States. We will live less long three years in a row. Less long than ever and everybody else believes that we're living longer and longer and longer. It's driven primarily by two things and primarily Alzheimer's is the number one driver in this. And the secondary driver unfortunately is drug overdoses and suicides. It's related to the opioid epidemic. We're actually developing products for both of those primary problems, for both of those decreasers in longevity. So, we're working on a suite of nonopioid pain alternatives, but our lead compound is a vaccine for Alzheimer's. So, if we look at the cost of Alzheimer's, if we look at the cost of – and this isn't all neurological disorders, this is just Alzheimer's. If we look at those costs, direct and indirect, we're spending as much taking care of people with Alzheimer's every year as an Iraq war.

So, the magnitude of these numbers is astronomical. These numbers are devastating and we could all be pretty morose about it. The reality is that I've never felt more optimistic to be alive. I've never felt better about the environment that we're in in terms of solving problems, being able to identify them, being able to direct resources to them. If you look at it from a disease progression state these toxic proteins are building up in your brain 10, 15, 20 years before you have any symptoms. So, this is something that is laying there in a lot of us and just waiting for its chance to jump up. And so knowing that and having seen that in lots and lots of people the general thought is that you have the beta amyloid levels rising. Thereafter you have the tau levels rising, and consequence and in concert with the tau level rising there's some correlation with the actual cognitive impairment. So, the goal is to create endobodies naturally that cross the blood-brain barrier and engage the toxic forms of a beta plaque. And the way that I think about it is like this. A beta is naturally occurring in everyone. A beta amyloid is made by every person's body. It's when it starts to get stuck together that it becomes a problem. So, first two of them get stuck together it's a dimer. Then a bunch of them get stuck together it's an oligomer. Then a bunch of those get stuck together it's a fibral. Then a bunch of those get stuck together it's a plaque. So, by the time it gets to be a plaque it's a toxic form of that protein. What I'm excited about is that I believe that we can target safely and effectively the toxic forms of that misaggregated protein or that aggregated protein and remove them safely.

My audacious goal for my team is if you can go early enough and your product is safe enough there's absolutely opportunities to prevent the accumulation of these proteins in the very first place. So, before there are symptoms, before there are any of those things. We vaccinate 500 million pigs a year for less than a dollar a dose with over 70 percent margins. If you think about – now obviously human there's slightly different CMC and different manufacturing but the bottom line is that technology platform is going to be accessible and it's going to be available for everyone of the millions of people that are suffering from this disease. And it's going to be able to solve these problems potentially in ways that we envision to be or to be part of a solution for these problems in ways that we really envision to be beneficial for society, for people and for their families and for this global impact idea.

Text: How vaccines for chronic pain could stop the opioid epidemic

REESE: The opportunity to create accessible, safe, and efficacious products to go after and train, to unlock the body's immune system and actually solve these problems ourselves is amazing. So, by turning the body into the drug factory because it's naturally producing these endobodies, I think that's a revolution in terms of the way we're going to approach chronic illness. And so I'm pretty excited about that part. We have unbelievable rates of overdose happening in this country that are unprecedented. Some of that is driven by genuine need and pain, and so some of those alternatives which are not particularly effective and there have been more studies coming out around this over and over and over again that I think we can find more effective alternatives that are safer than opioids.

What I like about vaccines is that if we can turn your body on to activate against something that is an agent of pain that your body itself is generating, then you can have a very easy way to take the product – it's a single shot once a year potentially. So, you have a great compliance rate with your patient so it's easy on your patient. The cost is absolutely affordable and attainable so the cost becomes something that is accessible and you are, in effect, having a long duration of that treatment. That's going to give us the best chances to, in my opinion anyway, it's going to be one of the approaches that maximize our chances against the opioids and against the epidemic that's outstanding. So, for example we have an IL-6 vaccine that I'm really excited about and there are indications surrounding sciatica there that are really compelling. I think that's a huge need in terms of being able to remove that suffering and that pain in a long acting, affordable, and accessible way. So, that's an example. Another one is there's been a lot of noise around CGRP and monoclonal antibodies that have been approved around that for migraine. We've got a vaccine for CGRP that we're extremely excited about. One of the big problems with getting people to take drugs is when they feel better they don't want to take them. But if your body is fighting that same target then you don't have that same compliance issue and so you actually make it easier for the patients to take the products that they're supposed to take in a timely manner and then maintain the benefits of those products. I think that's going to be a really interesting product that we're going to bring to market and I think that's a huge need. We should morally and we are practically focused on addressing those biggest possible problems.

So, it's only consistent and it's only right that we're also dedicating some resource and time and energy to addressing both the Alzheimer's epidemic, the Parkinson's epidemic and also the nonopioid pain epidemic. When we look at this going forward, just to underline it I guess, these are diseases that don't discriminate. I can't articulate that enough. These diseases don't discriminate, they don't care how much money you have. They don't care where you live. They don't care what color your skin is. And the bottom line is that our medicines can't discriminate either. And so our platform technology enables us to be accessible. It enables us to actually go where the need is, and for that I'm eternally optimistic. To me this is our Sputnik moment. This is my generation's opportunity to say for the first time the ecosystem, the pieces, the motivation, the goals are there. We're aligning around this and we have an absolute opportunity to make a dramatic impact. And it'll be that village, it'll be that ecosystem that ultimately achieves the goal. When we put people on the moon – and I tell my team this all the time – no one person put someone on the moon. There were over a thousand different companies that were all involved full time going a thousand miles an hour. There were companies that were making the screens. There were companies making the knobs. There were companies making the wiring systems, the rocket engines. There were companies making the external heat deflectors. These are so many little details and without all of them it doesn't work. So, when we go after things that are really big goals and when we go after huge problems it's that village, it's that ecosystem that solves it. I really have a firm belief that this is the greatest time that we could possibly be alive and solving these problems are some of greatest problems facing mankind, but they're also we've never had a better chance of solving them. So, I feel like it's a really great time.

  • "Vaccines are the best thing science has ever given us," says Larry Brilliant, founding president and acting chairman of Skoll Global Threats. From smallpox, to Ebola, to polio, scientists have successful fought viruses and saved millions of lives. So what's next?
  • As Covaxx (formerly United Neuroscience) cofounder Lou Reese explains in this video, the issue with vaccines is that they don't work against "non-external threats." This is a problem, especially now when internal threats (things that cause cancers, Alzheimer's, diabetes, and other chronic illnesses) are killing people more than external threats like viruses.
  • The future of vaccine tech, which scientists are already working toward today, is developing safe vaccines to eradicate these destructive internal agents without harming our bodies in the process.




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