Lead vaccine developer says she wants to help rebuild trust brick by brick

Vaccines are on everyone’s minds these days.

As the first shots of the Pfizer/BioNTech vaccine are administered in the United States, and as Moderna gets closer to authorization from the US Food and Drug Administration, a recently released Kaiser Family Foundation survey shows 71% of the public says they definitely or probably would get a vaccine, up from 63% in September. Getting enough of the population vaccinated is key to achieving herd immunity and eventually returning to life as we knew it.

But the numbers are lower for the Black community, which is harder hit — more likely to get infected, more likely to be hospitalized and more likely to die — than non-Hispanic Whites. According to the same poll, only 62% of Black respondents answered they would be willing to get a vaccine, up from 50% in September.

That may come as no surprise: Persistent inequities in the health care system, and a long and deep history of racism have resulted in mistrust of the government and of government health initiatives within the Black community.

So, paradoxically, while Blacks have the most to be suspicious about, given past experiences, they may also have the most to gain from coronavirus vaccines, considering the toll this pandemic has disproportionately taken on them.

I recently had a chance to speak with viral immunologist Kizzmekia Corbett about these issues, among many others. If you don’t know her name yet, you probably will soon.

Kizzy, as she likes to be called, is one of the key scientists behind the Moderna coronavirus vaccine. She is a Black woman who, at 34, has been an important voice around many aspects of the vaccine.

At a recent event hosted by the National Urban League, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, praised the “exquisite levels” of efficacy of the Pfizer/BioNTech and Moderna vaccines and pointed out the Moderna vaccine “was actually developed in my institute’s vaccine research center by a team of scientists led by Dr. Barney Graham and his close colleague, Dr. Kizzmekia Corbett, or Kizzy Corbett.”

Kizzy, whom I had interviewed once before back in April, was a guest last week on my podcast, “Coronavirus: Fact vs Fiction.” Here are some excerpts (edited lightly for length and clarity) from our conversation, to give you an idea of the driven scientist behind one of modern medicine’s greatest advances.

Sanjay Gupta: You had basically said when we spoke, back in April, that by the fall we could potentially be seeing an authorized vaccine and potentially get health care workers immunized by the end of the year. And I remember thinking at the time, all I’ve heard is that it typically takes years, and for some infections like HIV, we still don’t have a vaccine 40 years later. How did you know?

Kizzmekia Corbett: Well, you know, there was a lot of faith in in those initial statements, but then also a lot of science. The HIV field, for example, has made a vast amount of developments over the last 40 years without there being a vaccine. The work that the HIV field has done has, in some part, actually benefitted the work that we’ve done in coronaviruses. So, we understood the surface molecule, the spike of a coronavirus, in so much intricate detail. And we had such a good understanding of how to deliver that spike protein via mRNA that we were fairly confident that we would be very quick to get into a Phase 1, which we did. But then, from there, that we would be able to work together to fuel this vaccine development trajectory, really out of necessity and also science. The necessity feeds into the HIV field, but the science hasn’t necessarily gotten there yet. And so that’s really the difference.

And you know what? The first thing that I really thought about as I initially started to speak about what could potentially be the timeline is that, ‘Oh, my gosh, if we get to December and we haven’t delivered a vaccine that shows some significant amount of efficacy, that has a trajectory towards licensure for the general public, then everyone’s going to think that we failed.’

And I knew, though, that with all of the things that were going to be happening over the next nine months from a science perspective, there was really no failure — because we would be informed on so many things, whether it be what type of responses are needed to protect people from coronavirus infection, whether or not these types of platforms have any utility at all for vaccine development and on a large scale. So, there were bound to be things that we would learn, whether there was a vaccine or not.

Gupta: I’ve got to ask [about] your own background, taking you to this this very intricate area of science in virology and understanding how viruses work in the body and how they may be combatted with vaccines. Where did this start for you? How did it come about?

Corbett: I think my love for science and solving problems came from childhood. I was the student who would not leave a math problem unsolved. I won regional science fairs all the way from elementary school and onward. And so, asking questions about the way the world turns, essentially, I like to think of it as somewhat of my purpose in life. And having been exposed to science from a laboratory perspective very early and getting a glimpse of what that looked like, by way of internships in high school, I think I it became clear to me that being a scientist is something that I could do and something that would be fun for me.

And also that, for every single thing that I’ve read in a textbook about science, someone has to discover that. And I felt that I wanted to be one of those people that for a line in a textbook, which hopefully mRNA-1273 [the Moderna vaccine] will be at some point, there’s someone who discovered that thing and helped to drive that theory, so to speak, forward. And so it’s just a love of discovery.

Then from a vaccine development standpoint, I think my love of discovery in science melded with my empathetic nature for people. And having studied health disparities from a sociological standpoint in college, and at the same time being in a vaccine lab and seeing how the two really could benefit from one another, helped me to say, ‘Well, if I’m going to be asking questions, I might as well ask some questions that inform vaccine development so that I can really have a translatable way that can help people en masse.’

Gupta: You are at the National Institutes of Health; you have been at the forefront of helping develop the platform for this mRNA vaccine. When you started to do this sort of work, was it hard to break into? I imagine there are a lot of people who had who had been there for decades doing this sort of work. And again, you’re 34-year old woman. What was that process like?

Corbett: So slight correction: the platform came to me in a way of collaboration with Moderna and has been developed largely with academics for years. But understanding how to deliver the right antigen via the platform, for coronaviruses, is the work that I’ve been doing for the last six years.

And so, the work around the spike protein and the immune responses by the spike protein — that field was wide open six years ago, believe it or not. When I got to the NIH in 2014, we didn’t know what a spike protein looked like in any level of detail. And that was one of the goals of our research program, was to just simply figure out what the spike protein looked like.

So the field was not crowded at all. Actually, that was, from my perspective, beneficial from a career perspective because I would be allowed to work at a pace that allowed some sanity and also not really necessarily have that much competition by way of the science that I wanted to do. And I could ask really direct questions. So that was very important to me.

Gupta: People, I think, often wonder, ‘What are these teams of people who are helping create these vehicles out of this pandemic — what are they really like? What is Dr. Corbett really like?’ I mean, how busy has it been? Has this been around the clock? Nothing can be totally around the clock, but I feel like I’m working as hard as I ever have. When you’re not working on this, what is your life like lately?

Corbett: I actually saw someone on Twitter ask you what you’re going to do when the pandemic is over. And you simply [tweeted] you’re going to take a nap. And I retweeted it because I feel the same way. And obviously, we haven’t been working without sleep for the last nine months, 24-hour a day. But, I have, at least until the Monday morning that Pfizer’s efficacy results were announced, felt that I slept with the burden of the world on my shoulders in so many ways. And it was very hard to rest in the real way that we think about it.

I meditate and I have a wellness coach and all of these things, but I didn’t feel myself — until that Monday morning, at my 8 a.m. meditation — really outside of my work. I came out of that 30 minutes thinking, ‘Wow, I didn’t think about anything regarding this vaccine response.’ And so largely, what’s been happening for the last several months is that we’ve just been working.

And Dr. Graham has said a vaccine response takes a thousand different decisions, and also a thousand different things to go right. And I would say maybe, of those thousand different decisions, I may have had some influence on 10% or so of them. So, I felt like I was constantly having to make a decision about something …

So I spent a lot of time working, and that’s OK, because I found that I also got very much closer to my faith. I got closer to my family, especially my nieces and nephews, oddly enough, because they are the telephone generation and so that’s all we could do. And so, I found time to make for them and I found time to make for my friends, virtually, etc.. And so, I did do other things, other than work. But on any given day, work definitely takes the priority and most of my time.

Gupta: That pressure you describe — we’re in the midst of the worst public health disaster in 100 years, you’re working on a team that could help fundamentally address that through a vaccine, you wanted to get it right, obviously. How do you describe that pressure?

Corbett: I felt like there was no room for mistakes, which was difficult because science — mistakes are actually part of the beauty of it. Not necessarily tons of mistakes, but you learn a lot from things that don’t necessarily always go right with experiments. But in this case, we only had the bandwidth to learn from things that were going to go right. Otherwise, you lost time and people died.

And so that pressure, I could feel myself tensing up just by hearing an email ding, especially if it came at three o’clock in the morning. But the tears that I shed when the efficacy results came out were largely a sigh of relief. I was just so happy that there was finally light at the end of the tunnel.

Gupta: You look at the polling data right now in terms of people’s willingness to get a vaccine. What would you say to those skeptics, those anti-vaxxers, or at least vaccine-hesitant people? And what about the skeptics within the Black community specifically?

Corbett: It is most certainly an issue, and I wake up to oftentimes on social media, to people who are vaccine hesitant with lots of questions and concerns, and I think that what I would say to people who are vaccine hesitant is that you’ve earned the right to ask the questions that you have around these vaccines and this vaccine development process.

And this overarching mistrust of the medical institution in general is something that is being highlighted now because of the dire circumstances of which we’re in. But it is not news to me, because I’m Black and I have a Black family and I am well-read on the history of injustice when it comes to medicine in the Black community. And so, one of the things that I’ve had to step out of this and say that we’re not going to be able to prove trustworthiness in this instance quickly, and that is OK. But what we do need to do is decide that we’re going to take steps and, even beyond this pandemic, move in a direction to be more trustworthy.

And the reason why I say “we” and the reason why I say “trustworthy,” instead of using the terminology “they” or “distrust,” is because the first step is that scientists and physicians and vaccine developers and et cetera, is to understand that the onus of this problem is not on them and their distrust; it is on us and our level of trustworthiness. And so, trust, especially when it has been stripped from people, has to be rebuilt in a brick-by-brick fashion.

And so, what I say to people, firstly, is that I empathize and then, secondly, is that I’m going to do my part in laying those bricks. And I think that if everyone on our side, as physicians and scientists, went about it that way, then the trust would start to be rebuilt.