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  • [Recorded on October 26, 2020.

  • COVID-19 vaccine development

  • and ethical considerations around human challenge trials

  • are constantly evolving.]

  • In April 2020,

  • I made what many perceive as a risky decision.

  • I volunteered to be deliberately infected with COVID-19.

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

  • where young, healthy people are given a vaccine

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

  • These trials help researchers figure out more quickly

  • if a vaccine is working.

  • I think this research is crucial,

  • because today, I'm going to speak to you for six minutes.

  • In that time,

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

  • Twenty-one people will die.

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

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

  • affected by this global crisis.

  • Scientists have been working around the clock

  • to make those vaccines a reality.

  • But what should we do when the human cost of waiting for those vaccines

  • is rising by the day?

  • This is where human challenge trials come in.

  • They're different from the traditional phase three vaccine trials

  • taking place now,

  • where people are given a vaccine or placebo

  • and asked to go about their everyday lives.

  • Here, researchers have to wait to see how many people in each group

  • become infected.

  • Until enough of them get sick,

  • we don't have enough data to know whether a vaccine is working.

  • Finding an effective vaccine with this method

  • can take months or sometimes years,

  • and it requires thousands of volunteers.

  • A challenge trial works faster

  • because researchers control exposure,

  • instead of waiting for people to get sick.

  • So instead of a year,

  • we could know in as little as a month

  • whether a vaccine seems effective.

  • Instead of thousands of volunteers,

  • a challenge trial relies on just 50 to 100.

  • Because we know for certain

  • when people are exposed and develop disease,

  • these trials also allow us to gather data

  • about the early stages of infection and our immune response.

  • This data is impossible to gather in any other way,

  • especially for people who become infected but never show symptoms.

  • This knowledge is important for designing policies

  • that limit COVID-19 transmission.

  • The time saved translates into precious months' head start

  • on manufacturing,

  • getting us more working COVID-19 vaccines faster.

  • These trials are useful --

  • even though recent phase three results sound encouraging.

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

  • It just isn't quite the fairytale ending we're all hoping for.

  • We're going to need multiple vaccines,

  • because we just don't have the infrastructure needed

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

  • Each type of vaccine requires its own special process and equipment

  • to make, store and deliver it.

  • If we had multiple working COVID-19 vaccines,

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

  • Some of the leading candidates need to be kept extremely cold

  • before they are delivered to people.

  • This can be really hard,

  • especially in countries where there isn't reliable electricity

  • or a secure method to store them.

  • Scientists have been using human challenge trials

  • for hundreds of years.

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

  • and they've helped us better understand how immunity develops

  • to things like the flu, malaria and dengue.

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

  • There's been a lot of debate

  • about whether challenge trials are too risky.

  • I happen to think that those risks are worth taking.

  • A challenge trial would only recruit young and healthy participants --

  • think between the ages of 20 and 29.

  • Fewer than one percent of people in that age-group

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

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

  • because researchers check to make sure

  • that participants have no preexisting conditions.

  • The risk of a young healthy person dying of COVID-19

  • is around five thousandths of a percent.

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

  • about five die.

  • If I were to give birth in the United States,

  • my risk of dying would be higher than that.

  • Or you could choose to think about it this way.

  • If my little sister needed a kidney,

  • I wouldn't hesitate for a moment before I offered her mine.

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

  • it makes sense to allow people to take on a similar risk

  • to speed up the development of a vaccine

  • that would benefit not just their loved ones,

  • but everyone around them as well.

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

  • especially about the long-term effects of COVID-19 infection.

  • I volunteered despite that uncertainty

  • because like many of you, I feel frustrated

  • knowing that hundreds of thousands of people are dying.

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

  • as measures to stop the spread take a toll on their physical,

  • emotional and mental well-being.

  • It turns out I'm not alone in feeling this way.

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

  • have volunteered to participate in potential COVID-19 challenge trials

  • through a nonprofit I helped found called 1Day Sooner.

  • We advocate for challenge trial participants

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

  • As early as May,

  • when challenge trials were still being considered

  • for their role in the fight against COVID-19,

  • the World Health Organization cited 1Day Sooner

  • as an example of the kind of public engagement needed

  • to run a challenge trial.

  • In mid-October,

  • the UK government formally announced their intention

  • to conduct a challenge trial at the beginning of 2021.

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

  • It has inspired record-shattering innovation,

  • and it has highlighted the heroic acts of many frontline workers,

  • but is has also taken a catastrophic toll.

  • The arrival of each new vaccine brings us one step closer to rebuilding.

  • But the true global solution

  • lies in those vaccines being in the hands of people all over the world.

  • Challenge trials could be a part of that solution.

  • Thank you.

[Recorded on October 26, 2020.

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