Six questions with Philly-area author of book on Moderna’s COVID vaccine

The technology underlying the first two COVID-19 vaccines — genetic instructions in the form of messenger RNA — is now taken for granted, with billions of people having received the shots.

But years of struggle and uncertainty preceded that success, most of it well before the pandemic. Wall Street Journal reporter and Glenside resident Peter Loftus goes behind the scenes in his new book, The Messenger: Moderna, the Vaccine, and the Business Gamble that Changed the World.

Among the early scenes in the book, from Harvard Business Review Press: a chance meeting at a copy machine between University of Pennsylvania scientists Katalin Karikó and Drew Weissman, in the late 1990s. The pair joined forces to demonstrate the promise of mRNA after most scientists had given up on it, publishing the first of several pivotal studies in 2005. Moderna was founded five years later in Cambridge, Mass., developing mRNA both for use in vaccines and to treat cancer, though initially with mixed results.

Loftus, who has covered the pharmaceutical industry for the Wall Street Journal since 2013, spoke with The Inquirer in a conversation lightly edited for length and clarity.

Now that the vaccines have been such a success, how might mRNA might be useful in making other drugs?

I think that’s the million-dollar question, or I guess at this point, a several billion-dollar question. What they’ve been able to show with the mRNA vaccine and COVID helps establish that this could be a useful technology for future outbreaks, to be able to quickly respond the way it went down in 2020, in particular against respiratory viruses. They are also working on vaccines for other viruses, including HIV, which has been notoriously difficult to find a vaccine against. The other big bucket of potential uses for mRNA is treatments for people already diagnosed with disease, rather than as a preventive vaccine. There’s a lot of hope that it could work for something like cancer or rare disease. I really think it’s too early to say with any certainty whether it will work.

When the vaccine trials started to show promise, there was debate on how much to credit Operation Warp Speed (the Trump administration’s effort to spur the development of COVID vaccines and treatments). Where do you come down on that question?

Moderna benefited from a lot of involvement with the federal government. They were already working with the National Institutes of Health even before the pandemic, and then very early in the pandemic they got started with the NIH on designing the vaccine and planning to test it. In May of 2020, when Operation Warp Speed was formally created, I think it did take it to a new level. Pfizer, which also was developing an mRNA vaccine, with BioNTech, because it was so much bigger, actually chose to minimize its involvement with Operation Warp Speed, even though it was essentially part of it.

The underlying science dates back well before that, with some of the early discoveries at Penn. What does that tell you about the pace of drug development?

These things that end up being breakthroughs, whether it’s a vaccine or a medicine, which might seem to suddenly appear on peoples’ radar, might have this long backstory that really took a while to advance from basic lab work in some academic scientists’ lab all the way through to getting to a drug company. Sometimes it takes a person who comes into a field of research and sees it in a different way.

You describe internal tension at Moderna about whether to go forward with the COVID vaccine, in part because the company’s earlier vaccine against Zika virus did not work well. What did you learn?

Most people might have assumed that the company was gung-ho from the start. But there was a period of debate of several weeks. Before they got into human testing, there were some people in the company who asked: “Is this the right thing to do?” In February of 2020, it wasn’t really clear that the coronavirus was going to spread as widely as it did. Some people said: “If we throw everything we have at COVID, that’s going to take resources away from other projects.”

Some have criticized how Moderna executives have reaped financial rewards for a vaccine that got so much federal support, such as a potential $926 million “golden parachute” recently approved for CEO Stéphane Bancel. Do you think those criticisms are fair?

Really almost from the get-go, there was criticism about the financial enrichment of Moderna as a company and its executives. And they did get this funding from the government, in the form of outright research and development support of well over $1 billion, and the supply contracts are worth many billions more. I touch on the critics, but also the people that defend the system that allows Moderna to profit so much. It spent a decade growing and putting all this effort into R&D, including spending its investors’ money with no product revenue for a decade. The defenders say this is an example of innovation and investments being rewarded. I would prefer to just present those viewpoints, and the readers can decide for themselves.

What prompted you to do a book on Moderna rather than Pfizer and BioNTech, the two companies that made the other mRNA vaccine?

I thought it would be an interesting way to tell a couple of stories. One was the story of the pandemic through the eyes of this company that most people had never heard of before, and all the drama and suspense along the way. I also saw a different story, about how a lot of innovation in medicine and in the pharmaceutical industry comes from these small, young companies that are really doing a lot of cutting-edge research.