Merck Chief Patient Officer on challenges of finding COVID-19 vaccine

Julie Gerberding, Merck Chief Patient Officer and Former CDC Director joins Yahoo Finance’s On The Move to break down the company’s search for a coronavirus vaccine.

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JULIE HYMAN: Of course, we continue to track all of the developments with coronavirus here, and in particular yesterday, the news that Merck was making a couple of moves in terms of vaccine development-- both making an acquisition of a company that has a vaccine development candidate as well as having a nonprofit partnership to try to develop a vaccine candidate as well. We are joined now by Dr. Julie Gerberding. She is Merck's chief patient officer, and she's also a former director at the CDC. She's joining us now from Philadelphia. [INAUDIBLE] thank you so much for joining us.

So with all of these moves that Merck is making, it's very interesting to me all of-- not only all of the moves the Merck is making, but all of the drug-makers that seem to be in vaccine development-- sort of the simultaneous tracks that everyone is on in this race to find a vaccine. How much do you think that increases the chances that we will get one quicker? And will we eventually see many different vaccines on the market?

JULIE GERBERDING: Well, thank you. And let me just start by saying that from the very beginning of the recognition of this pandemic, Merck has been working furiously in our laboratories to try to understand what we can contribute to the development of vaccines and antivirals. And of course, that's happening in most of the companies in our sector. Having multiple shots on goal in a situation like this is great, and I don't think you've seen more collaboration across the industry in terms of how we are actually all pulling in the same direction to try to get something done quickly, but also something done that will truly be game-changing for the contour of this outbreak.

ANJALEE KHEMLANI: Dr. Gerberding, I know that your CEO yesterday was definitely talking about what the risks are of this compressed timeline that we're all facing and what the concerns are. So how is Merck going about this? You are using a recombinant vaccine, so it is a newer technology as well. What are some of those sort of ideas or obstacles that you're facing?

JULIE GERBERDING: I think one of the things that we thought a lot about inside the company is what really would ultimately produce the fastest, the safest, and the most predictable results. So we were really looking for a vaccine that, first of all, was feasible to create and manufacture, second, one that ideally could be effective with just a single dose, and third, above all, a vaccine that would be safe.

And we chose to go with platforms with which we have a great deal of experience. So the measles vaccine platform is one that we've been working on behind the scenes with IMAS for some time on a different viral construct. And we've learned a great deal about how that platform operates. And of course, Merck has its own measles vaccine, so we have a long history of involvement in that particular candidate.

In terms of the RBSV vaccine, the IAVI partnership, that is the same platform that we use for our already-licensed Ebola virus vaccine, which we were able to bring across the finish line in the context of another global health emergency. So these are tried and true platforms. We expect that candidates in this category could be given as a single dose. And when you think about this pandemic, having the opportunity to immunize people effectively with one dose is ideal. So I think that's kind of how we set our standards and what we were looking for in terms of partnerships or acquisitions.

ANJALEE KHEMLANI: And what about the manufacturing part? That seems to be a major concern. And as one of the largest players in the vaccine space, you obviously have expertise with this. But what are some of the obstacles right now when it comes to global access, or even right now in the US, we know we've heard about the military being involved as well. So what does the whole process look like right now?

JULIE GERBERDING: When we think about access, we have to also think about uptake, because it isn't enough just to manufacture doses. We also have to be developing the systems to deploy them, to transfer the doses to the people who need them, and then the programs to build trust and confidence that it's a good idea to take the vaccine. So it's a big lift.

Having said that, just concentrating on the manufacturing side of things, of course right now, everyone recognizes that we're going to need to work in parallel, not in series. And so we have to begin the process of scaling for manufacturing at risk. There are a number of coordinating mechanisms, in particular the one we're most involved in at the NIH, to try to take a look at candidates and use the best wisdom of the crowd to predict which of these candidates seems to be the most promising, and let's place some bets on the scaling of manufacturing for those leading opportunities.

Merck is already doing that to be able to scale our vaccines as quickly as possible. We anticipate hundreds of millions of doses. So I think we'll be part of the portfolio if we're lucky enough to have a successful candidate emerge as effective and safe.

ADAM SHAPIRO: Doctor, it's Adam Shapiro. What does successful candidate truly mean? Is it 100% effective in 100% of the people? Or what's the lowest percentage that would be allowed to be considered effective and successful?

JULIE GERBERDING: Well, you know, we're in uncharted waters here. And I think anything that increases the overall population protection so that transmission falls below that proverbial R not of 1 is going to be a big help in this outbreak. But we need to have not only high efficacy in terms of preventing infection, but we also need to have high feasibility and tolerance. And that is where I am putting a lot of my own personal energy is really trying to understand the safety of these vaccines.

If you're talking about treatments, and people are otherwise facing very serious consequences or even mortality, the side effects of the treatment are more tolerable if you end up saving a life. But when you're talking about vaccines, you're going to be giving vaccine, potentially, to very healthy people, young people, perhaps even infants, senior people who are already vulnerable. We have to have a very high bar for safety, because we must make sure that we don't do more harm than good by getting this vaccine out.

And that's one of the reasons that people struggle, I think, to really understand, why does it take a long time? Well, safety first, and we really do have to make sure that the vaccines go through the appropriate assessments of their likely safety threshold.

RICK NEWMAN: Rick Newman here. I'm wondering what's in it for the companies that do develop a vaccine that actually makes it to market. This is supposedly not a real profitable business. It's kind of a one and done. You've got so many companies jumping in here. I mean, why are so many pharmaceutical companies getting involved instead of saying, wow, there seemed to be such an accelerated effort here, we'll just sit this one out.

JULIE GERBERDING: Will, first of all, as a scientist, I would say we're fortunate that we have so many shots on goal, because this is a new virus. And so far, we don't have a successful human coronavirus vaccine for any of the emerged coronavirus challenges that we've faced in the past several years. So we've got a lot to learn, and science is a strict taskmaster. So all bets are off in terms of our ability to forecast.

Having said that, I think, you know, this is our DNA. I mean, Merck is an experienced and expert company. We've been making vaccines for a long time. We're known to be an innovator in this space. And as I said, we've already brought one emergency vaccine across the finish line under some pretty challenging development circumstances. So it's what we do. And we're proud of that. And we care deeply about the value that we can deliver to people.

So it isn't about profit. It really is about a pandemic. And it's our responsibility to step up. As I like to say sometimes for the whole biopharmaceutical industry space, this is our finest moment. This is what we get up and come to work and the morning to do. And finally, we're doing it in a place where, you know, it couldn't matter more for everyone around the world. As Dr. Perlmutter said when he was announcing the new relationships that we have for the development of these products, no one is safe until everyone is safe. And we recognize that as part of our commitment and our responsibility.

JULIE HYMAN: Julie, I want to talk about the commitment and responsibility of your former institution, the CDC. Because it seemed that there were some considerable missteps at the beginning of this, including testing missteps. And I imagine you might be reluctant to criticize your former workplace, but I'm curious what you think went wrong there.

JULIE GERBERDING: Well, I can't speculate about what happened behind the scenes, because I wasn't there. But I do know from my long tenure associated with the CDC that they are very good at developing tests under emergency circumstances. They did it for SARS, they did it for Zika, they did it for West Nile, they've done it for almost every emerged infection that we've had to contend with.

And the details of what went wrong with this particular protocol once it left the CDC is something that I don't have any insight into. But I also think we've come to understand that a lot of the planning for this kind of scenario was based off of influenza pandemic preparation. And in thinking about all the rehearsal studio, and the exercising we did for influenza, the scale of testing wasn't a big focus area, because we have influenza tests that are already out there-- point of care tests and being able to adapt those to a new influenza virus wasn't a big stretch.

I don't think our imagination took us to imagine what we would need to do if we had a brand-new virus and no precedent for a scaled test that had to reach, potentially, 300 million Americans. So I think there was a lack of appreciation in advance that a scaled new test might have to reach this large of a population in a very short period of time. So it's a really important lesson learned, and I'm sure that will be incorporated into future planning.

ANJALEE KHEMLANI: Dr. Gerberding, do you see the sort of shortage of information, at least publicly, from the CDC to be troubling in any way? Or are there no implications of not having a daily briefing, say, from the CDC right now in how we are able to respond to this outbreak?

JULIE GERBERDING: Well, during my tenure at CDC, we made it a highest agency priority to be as forthcoming and as transparent with information as it became available. And what that often meant for us is that we had incomplete information. So we would have to go out and say, here's what we know today. Here's what we're trying to find out, and as soon as we know more, we will tell you.

And I think as the social media world has evolved, people are increasingly uncomfortable communicating uncertainty, because it takes off on wings of its own, and suddenly uncertainty becomes fact or mythology. So there is a higher bar for making sure that the facts and the I's are dotted and the T's are crossed. And what that means is that information is slow to come out. So I think that's one challenge.

The second challenge is, of course, we're operating in an increasingly political environment. And I hate to see the CDC drawn into that kind of construct. CDC is known to have some of the most incredible scientists in the world, and they are working, I can assure you, 24/7 behind the scenes with state local health departments to really manage the day to day nitty gritty of this pandemic. And they need to be out talking about what they're doing and really helping set the context for the science that is leading the decision making that needs to be going on.

I think you're seeing some evidence of that as we look at how different communities are managing their decisions about isolation and quarantine and how states are thinking about how they are responding and evolving their response over time. So the information is there, but I think it works better when there is fidelity from the various sources of information coming from our government. And anytime there's daylight between what one person says and another person says, you run into a lot of confusion and conflict.

JULIE HYMAN: It's tough to find any aspect of this that has not escaped politics, unfortunately, right now. Dr. Julie Gerberding, thank you so much for your perspective, both on Merck and from your time at the CDC. Dr. Julie Gerberding is Merck's chief patient officer. Thank you again.

JULIE GERBERDING: Thank you.