1. I generally agree with your point on experience (wrote this in my reflection as well). Your specific examples do not track for me though. We knew that an mRNA omicron vaccine was coming. The point was, that no booster for LMICs was in the pipeline and mRNA vaccines were basically inaccessible in most parts of the world. We also were very aware of the low efficacy of plasmid vaccines but boosting with plasmid vaccines in the context of a new variant was something not tested before and the hypothesis was that it might be sufficient for significant additional protection against Omicron. The latter was certainly the riskiest bet but a valid scientific hypothesis worth testing.
2. It seems a general problem of start-ups that they are not as attractive to settled individuals. I can see how the sprint mentality might have contributed here. Luckily we eventually were able to attract a lot of mid-career professionals. And some people really appreciated the initial 3-month sprint plan, i.e. not having to commit to something in the long term.
3. Again, as far as I could tell no one was working on a COVID-19 booster optimized for LMICs. At the time there were valid concerns that Omicron might cause a lot of trouble for the world. How did we planned to outcompete Pfizer/Moderna? We didn’t plan to compete with them on their target audience, but have a vaccine that is shelf stable for 6-months at room temperature (which we achieved), that could be potentially be manufactured nationally, and hopefully sufficiently effective. I think it is worth pointing out that despite not being as amazing as mRNA vaccines, AZ for instance seemed to have saved the most lives during the pandemic because it was more accessible to the global south: https://www.economist.com/graphic-detail/2022/07/13/which-covid-19-vaccine-saved-the-most-lives-in-2021
Thanks for the thoughtful response Max, and I appreciated your separate write-up on this subject.
I do want to highlight though that in his write-up, Kyle listed the improved regulatory environment for updated mRNA vaccines as a reason why Alvea decides not to proceed with your first vaccine candidate. That’s really what I was addressing with my comment.
As to the second point about lack of efficacy for plasmid vaccines, I think there were different opinions on this within Alvea. One high ranking person I spoke to gave me the opinion that poor performance of a competitor COVID plasmid vaccine was due to competitor incompetence rather than an issue with plasmid vaccines themselves. That sort of comment is why I mentioned my concern that there may of been a degree of contempt among some in Alvea for big pharma.
Totally agree as to the “practical” efficacy of the adenovirus vaccines though!
Hey Matt,
thanks for your thoughts!
1. I generally agree with your point on experience (wrote this in my reflection as well). Your specific examples do not track for me though. We knew that an mRNA omicron vaccine was coming. The point was, that no booster for LMICs was in the pipeline and mRNA vaccines were basically inaccessible in most parts of the world. We also were very aware of the low efficacy of plasmid vaccines but boosting with plasmid vaccines in the context of a new variant was something not tested before and the hypothesis was that it might be sufficient for significant additional protection against Omicron. The latter was certainly the riskiest bet but a valid scientific hypothesis worth testing.
2. It seems a general problem of start-ups that they are not as attractive to settled individuals. I can see how the sprint mentality might have contributed here. Luckily we eventually were able to attract a lot of mid-career professionals. And some people really appreciated the initial 3-month sprint plan, i.e. not having to commit to something in the long term.
3. Again, as far as I could tell no one was working on a COVID-19 booster optimized for LMICs. At the time there were valid concerns that Omicron might cause a lot of trouble for the world. How did we planned to outcompete Pfizer/Moderna? We didn’t plan to compete with them on their target audience, but have a vaccine that is shelf stable for 6-months at room temperature (which we achieved), that could be potentially be manufactured nationally, and hopefully sufficiently effective. I think it is worth pointing out that despite not being as amazing as mRNA vaccines, AZ for instance seemed to have saved the most lives during the pandemic because it was more accessible to the global south: https://www.economist.com/graphic-detail/2022/07/13/which-covid-19-vaccine-saved-the-most-lives-in-2021
Thanks for the thoughtful response Max, and I appreciated your separate write-up on this subject.
I do want to highlight though that in his write-up, Kyle listed the improved regulatory environment for updated mRNA vaccines as a reason why Alvea decides not to proceed with your first vaccine candidate. That’s really what I was addressing with my comment.
As to the second point about lack of efficacy for plasmid vaccines, I think there were different opinions on this within Alvea. One high ranking person I spoke to gave me the opinion that poor performance of a competitor COVID plasmid vaccine was due to competitor incompetence rather than an issue with plasmid vaccines themselves. That sort of comment is why I mentioned my concern that there may of been a degree of contempt among some in Alvea for big pharma.
Totally agree as to the “practical” efficacy of the adenovirus vaccines though!