Opinion | The Man Behind America’s Race for a Vaccine


[MUSIC PLAYING]

archived recording

(SINGING) When you walk in the room, do you have sway?

archived recording (chris wallace)

President Trump, you have repeatedly either contradicted or been at odds with some of your government’s own top scientists. The week before last, the head of the Centers for Disease Control, Dr. Redfield, said it would be summer before the vaccine would become generally available to the public. You said that he was confused and mistaken. Those were your two words. But Dr. Slaoui, the head of your Operation Warp Speed, has said exactly the same thing. Are they both wrong?

kara swisher

If you were listening to the debate on Tuesday and able to make out any of it amid all the terrible noise, you heard the moderator drop a name, Dr. Slaoui.

archived recording (donald trump)

The left, or I don’t know if I’d call him left. I don’t know what I’d call him.

archived recording (chris wallace)

So you’re suggesting that the head of your Operation Warp Speed, Dr. Slaoui —

archived recording (donald trump)

I disagree with him. No, I disagree with both of them. And he didn’t say that. He said it could be there, but it could also be much sooner. I had him in my office two days ago.

archived recording (chris wallace)

He talked about the summer, sir, before it’s generally available.

kara swisher

Dr. Moncef Slaoui isn’t a household name. He’s not Dr. Anthony Fauci, who we all know as the Covid guy. You can even buy a Fauci bobblehead. I have one right in my kitchen.

Slaoui, on the other hand, is more of a behind the scenes guy, even though he’s in charge of something very big. He’s the head of Operation Warp Speed, the American government’s $10 billion effort to develop, manufacture, and deliver a Covid-19 vaccine as fast as possible. Slaoui is an experienced vaccine researcher who came out of retirement to work for Trump in a moment of national crisis and now serves a president who’s been hospitalized for the virus.

Slaoui is already in the Washington crosshairs. He’s been criticized for not confirming the president’s ambitious vaccine timeline and for his pharmaceutical industry ties. The question is, can Dr. Slaoui beat the virus before politics beats him?

So you’ve been on my radar for a while. Other people might not know it yet, but they definitely heard your name at Tuesday’s presidential debate. I want to start talking about going from the boardroom of a pharmaceutical company and working within the pharmaceutical industry and also as a venture capitalist to working in the executive branch. These are two different kinds of power. Can you compare and contrast these?

moncef slaoui

Well, I mean, remember, I’m an advisor. I’m not a decision maker. But of course, there is significant influence. I think in the context of the operation, there is a thirst for experience and knowledge of what it takes to make a product. When, in fact, this is not the mission of these Organizations so from that standpoint, there is a very high receptivity to knowledge, to information, to advice, definitely. There is really no need, I don’t feel, at anytime, that there is an exercise of power in the sense of authority, if you wish.

kara swisher

But when you say you’re just an advisor, come on. You’re more than an advisor. You have great, massive influence over this.

moncef slaoui

Yes. There is. Of course, there is significant influence.

kara swisher

I mean, a lot of people that go into government from the business sector do complain about that. I’ve talked to dozens of tech people. And you’ve been a venture capitalist. So you know the difference in speed. And this is called Warp Speed.

moncef slaoui

Yes. Well, you know, I’m not working in the government. This is a mission. It’s really interesting. And I think everybody is aware that this is a mission. And we’re all focused on that mission. We have adopted certain ways of working of the Army that, in the beginning, it was really surprising to me. For instance, we have battle rhythm meetings, which in the beginning, I was, like, what are we talking about?

kara swisher

Battle what?

moncef slaoui

Battle rhythm.

kara swisher

Battle rhythm. OK.

moncef slaoui

Yes. So every morning at 8:00 in the morning, we review the projects that are vaccine projects. At 10:00 in the morning, we review updates on the therapeutic programs. And that creates a rhythm that really creates that sense of urgency. And at no point, things are falling between the cracks. There is immediate follow up. You know, it takes 5 minutes or 10 minutes for each project. And it’s really incredibly effective. When I will go back to the private sector, I will definitely —

kara swisher

You’re going to do battle rhythm?

moncef slaoui

— introduce a certain type of battle rhythm on projects that require urgency and that require immediate actions. I think it absolutely worked. Because it keeps the whole organization on its toes, totally focused on the objective. There is no waste. But it’s a mission. I can see —

kara swisher

Who do you talk to daily? Who do you talk to everyday? General Perna, Secretary Azar —

moncef slaoui

Yes. So General Perna and myself — if I talk about vaccines, Dr. Matt Hepburn, who looks specifically after the vaccines, or Dr. Janet Woodcock, who used to be one of the critical leaders in the F.D.A. as regards therapeutic, plus a number of four or five other individuals. We are kind of a leadership team that’s really tied together. We’re all, every morning, at those battle rhythm meeting, there in person. And we work together on an ongoing basis. And then there are project teams that oversee each one of the vaccine programs that have a large number of individuals from the N.I.H., from the C.D.C., from BARDA, from the Department of Defense that interact with each one of the sponsor companies that own that particular vaccine. Several times a day we have, you know, teleconferences, et cetera. Yes.

kara swisher

You developed vaccines for malaria, cervical cancer, Ebola, and many others. What was the one thing that drew you to this work? What drew you to it?

moncef slaoui

So early in my youth, I learned about my young sister that, out of a disease that later on I learned to be pertussis disease, whooping cough. And I could see in my parents, this was a trauma. And as you know, I was born in Morocco and raised and grew up there until I was 17. I went to college, university in Belgium. And I had a fierce commitment to social justice and changing the government nature in Morocco that was quite authoritarian, let’s say. So I engaged in very significant activities of politics that were against the government. And after three years. I ended up having significant challenges with the powers in Morocco to the extent that I couldn’t go back and see my mom, who was very ill. So I decided I need to do this impact on society in a different way and decided to invest myself, frankly, in science. I loved immunology. And I had a PhD in immunology. And then I came to the U.S. in 1983, actually, to Harvard Medical School. Did a postdoc there. And realized that their true impact on society would happen through designing, developing vaccines.

kara swisher

OK. When you were called from H.H.S. this year, to come work for them, what was the first thing that crossed your mind when you thought of working for the government?

moncef slaoui

Well, frankly, the first thing that crossed my mind was the alignment with the administration which, as I have expressed, is not my alignment.

kara swisher

But what do you mean by not my alignment? You’re talking about you being a Democrat, correct?

moncef slaoui

Yeah, that’s what I’m talking.

kara swisher

Talking about that.

moncef slaoui

But that point was very quickly taken over by my commitment to public health and global health and really a knowledge that I could add value if I could impact. So my next point of focus was, will I be able to impact? And when I had the interview with the Secretary and with the Undersecretary of Defense, the Secretary of H.H.S., and Jared Kushner, who were my interviewees, those were the two points that I said. I said A., is this role empowered to really drive, and second, can this role just go through bureaucracy and not pay attention to it? And I told them, listen, I have no knowledge. I have never worked in government. And I am certain I have huge allergy to bureaucracy and slowness. So I’m going to just ignore it and run through it. And they said, that’s perfect. That’s why you’re the right person for the role.

kara swisher

So that job also meant you have access to the president. Was that something that appeal to you or scared you?

moncef slaoui

Neither, frankly. What appealed to me is really the mission, the impact. I hope nobody ever has to do this again because there would be no other pandemic. But if there was, it’s just an incredible mission. And if you realize that you can really add value and make a difference, which has always been my motivation in my career and in my life, there was no more hesitation. And I had been to the White House before under the previous president. And I’ve been to it now. And that’s not the appealing piece.

kara swisher

Not the appealing piece. OK. So were there any stipulations you made to the White House, that you needed in your contract before you said yes?

moncef slaoui

It was really to be empowered with no interference.

kara swisher

Mhm.

moncef slaoui

And to not have to deal with the bureaucracy and just drive through it.

kara swisher

And was there anything they didn’t agree to?

moncef slaoui

No. Frankly, no.

kara swisher

No.

moncef slaoui

But it was really at the level of the principals. And the principal was totally agreed to.

kara swisher

OK. So the name Operation Warp Speed. It’s not a name you picked yourself. It’s a “Star Trek” reference. Dr. Fauci said the name implies reckless speed. What would you name it instead if you had to pick it? I had one — Operation Open Nation. Get it? It rhymes. Is there any that you would call it if you could characterize it?

moncef slaoui

Interesting. So first, let me confess I didn’t know what Warp Speed meant. [LAUGHTER] I swear! I discovered a lot of —

kara swisher

You never watched Star Trek? OK.

moncef slaoui

No! I went back home from the interview. And I told my wife, it’s Warp Speed. My wife is American. She knows very well. And she told me, oh, this is what it is. I said, OK, all right. Thanks very much. I think, I like Open Nation. I would say something around saving the world that say — yeah, something like that. But I think speed is essential. I have to say naming it Warp Speed gave us a focus on a sense of urgency that never disappears. And I have to say everyday I remember, there is 1,000 people dying every day. Every day, we have to go faster — safe, but faster.

kara swisher

All right. So give it to me straight. When do you really think we’ll have the vaccine by? I want to hear it from you directly.

moncef slaoui

Yeah. Listen, I am very confident there will be, probably, two vaccines between now and December. It’s impossible to tell you the date —

kara swisher

Right.

moncef slaoui

— or even the month. Because there are two variables that drive that. One variable is what is the real efficacy of the vaccine? And I can explain that in a second. And the second one is how much transmission of the disease is happening in the study population. We recruit 30,000 people that live their life normally in their homes and work, et cetera. And they are just naturally exposed to the virus. There may be a lot of transmission. Or there may be limited transmission. We tried to localize the clinical trial sites in areas where there was transmission at the time we started the trial. But we know that the virus comes and goes. If you look within a zip code, usually the duration of presence of the virus is six weeks or eight weeks or something like that. So we can’t predict how much transmission there will be. That’s number one. Number two, when we designed the trial, the mathematics behind all the statistics that allow us to confirm the data tell us, OK, you have to assume a certain efficacy to help you size the trial. And the F.D.A. helped us say, OK, we will not consider a vaccine that is less than 50% efficacious. And where we have 95% certainty that it’s at least 30% efficacious. That’s what that lower limit — but 50%, I’m going to call that a moderately effective vaccine.

kara swisher

Mhm.

moncef slaoui

I would expect a vaccine to be 75, 80, 90% effective.

kara swisher

Right.

moncef slaoui

OK?

kara swisher

So are these numbers aligned with other vaccine’s efficacy that you’ve worked on?

moncef slaoui

Yes. Commercially, a vaccine that’s 50% efficacious is not a great commercial vaccine.

kara swisher

Right. No, it’s not.

moncef slaoui

It’s a toss of a coin. But in a pandemic where you have thousands of people dying every day, yes, it is. If you can prevent 500 deaths a day, I think it is. Therefore, I think it was appropriate to set criteria that are — I’m going to call them moderate. It doesn’t mean that we expect the vaccine to have moderate efficacy. I was asked a number of times what do I expect? Honestly, I expect it to be between 80 and 90%.

kara swisher

OK.

moncef slaoui

If it is 90%, we would need few cases to show it. We would need maybe 50 cases, or 50, 60 cases. If it’s 50%, we’re going to need 150 cases in the study. And you can see immediately that, you know, we don’t know how efficacious the vaccine really is. And we don’t know how quickly the cases are accumulating. All we know is they are accumulating. So we’ll see.

kara swisher

So when you say by December, does that mean a vaccine that works, or a vaccine that is out there? How do you determine it? Because there’s so many different words going on here by various people saying what you said and what you didn’t say. You said extremely unlikely, but not impossible that the vaccine would be available by the end of October. I mean, I can say it’s extremely likely that I’ll grow three feet, but not impossible by anytime soon.

moncef slaoui

Yeah.

kara swisher

Tell me what you meant by that.

moncef slaoui

I meant by that, really, what I meant by that. I’m a facts and data driven person. If I was able to exclude that it would never happen in October, I would have said it.

kara swisher

Right.

moncef slaoui

So what I can tell you is I know we are able to manufacture a vaccine. And we are stockpiling doses of vaccines, the two vaccines where we have already recruited either very close to 30,000 or more than 30,000 subjects. And it’s possible that in one or two zip codes, there is an outbreak. And all of a sudden there are 50 cases that happen, then we will have enough cases in the study to conclude it. It’s impossible to predict. So because it’s impossible to predict, it would have been wrong of me to say it will never happen in October. That’s why I said it’s very unlikely, but not impossible. And it’s more likely to happen in November. And it’s even more likely to happen in December. And likewise, I know we will have a handful of million of doses in October, 10 or 15 million doses by November, and maybe 50 to 80 million doses of vaccine in December. And therefore, if efficacy is achieved, and safety conditions are met, we will be able to have vaccines for, I would say, the highest risk population, that would be for the C.D.C., A.C.I.P. to decide who those people are.

kara swisher

Right.

moncef slaoui

And those are the reasons why I say, yeah, I think it will happen. I think it’s very likely to happen before the end of the year.

kara swisher

And for the general public, getting the vaccine and getting a lot of Americans vaccinated, do you have a timeline for that?

moncef slaoui

So I can tell you my current thinking, and I think with all the team, is that by the end of the year, we should be able to immunize 30, 40 million people who are likely to be, for instance, the very old very frail people in the country and may be the most exposed health care workers. By the month of January, we will have another capacity to immunize another 40 million people. So probably we would be able to cover all the elderly and all the health care workers. And then every month from there on, we are able to immunize between 80 and 90 million people. And that means we have enough doses to give them two vaccine shots for the vaccines that require two shots, on one vaccine shot for the one that requires only one shot. This is assuming the fact that the clinical trials will work.

kara swisher

Right. And there’s efficacy.

moncef slaoui

Yes.

kara swisher

So what happens here is that citizens get confused by this. And of course, there’s the whole political overlay. You were mentioned in Tuesday’s presidential debate by President Trump in several different ways. He said he’d spoken to a lot of companies. We can have it a lot sooner. It’s a very political thing. And then he specifically referenced you when he said, he disagreed with your timeline. And then moments later, said he agreed with it. And I know you don’t want to get — I don’t want you to be dragged into politics. But politics are here. You know, it feels like it’s being rushed for the election, for some political means. Everyone’s confused about it. What is more important, speed or safety to you? And then how do you get citizens to feel trusting of the government and what you’re trying to do?

moncef slaoui

So speed and safety, frankly, in my view, are not contradictory.

kara swisher

OK.

moncef slaoui

If you are a race car driver and you look at races, the challenge you set yourself is to be very fast while being very safe. And those conditions happen in many settings. I think if you can find circumstances under which you can be very fast while being very safe in the context of a pandemic, that’s what you should do. And what that takes is to be able to take very big significant financial risk. And the second thing that it takes is that you are able to have incredibly disciplined project management. So you understand every step where you are and what’s the next step. And thirdly, frankly, it was visionary to put together H.S.S. and the D.O.D. to bring in the logistical dimension. General Perna who is my co-leader, you know, we are one team. We are one team. We literally work like hand in glove or glove in hand, whichever way you say it. And it’s incredibly effective. We are able to go very fast because A, we made — I’m going to call them experience-based judgment call on selecting vaccines that are using platform technologies. That we understood and we could predict their behavior. We sped up every step except actually the size of the clinical trials. If you look into the clinical trials, the phase one, phase two, and phase three studies are all way bigger than the size of normal phase one, phase two, phase three studies. Because we knew if we put the logistics behind and the money behind it, we can recruit more subjects in the trial, which allows us to actually conclude the trial faster because we may accrue cases faster or we can demonstrate immunogenicity with narrow statistics around them to very quickly move to the next step. We also manufactured the vaccine. And we continued to do it at risk. So we didn’t cut any corner that has to do with quality or safety.

kara swisher

And so at the debate, when the president’s saying he’s spoken to the companies and we can have it a lot sooner, it’s a very political thing, does he have information that you don’t? And do you disagree? Because it was confusing. I mean, is it just that people are talking about possibilities and hope?

moncef slaoui

Listen. First, as I said before, I don’t want to get into the politics. Second, frankly, it was difficult to understand who is talking what because everybody was talking at once. Thirdly, I would say it is possible, as I said earlier, that efficacy could be demonstrated during the month of October. Yet, it is extremely unlikely. But it is possible.

kara swisher

So possible, but extremely unlikely. Go ahead.

moncef slaoui

Yes.

kara swisher

OK. So you’re —

moncef slaoui

And likewise, yeah, it fits with what I was saying. And likewise, it will be in the second quarter of 2021 when we will have enough vaccine doses to have immunized the whole population. So I do think that was a political debate. I just want to say the numbers. We will have enough vaccine doses by April, May 2021 to immunize 330 million people, which is the population of the United States. Now will we be rolling out, month by month, and immunizing that number, or will it happen differently, I think will depend on the efficacy of the vaccines. Right?

kara swisher

And in that meeting he spoke of, in that particular meeting, you said exactly what you’re saying here to me?

moncef slaoui

Yes.

kara swisher

That’s what was said?

moncef slaoui

That’s what I consistently say, absolutely. And I have been saying it for quite a while. And I have been asked the question many times. I’d like just to say it, frankly. I have never felt pressured. I have always expressed my independence of thinking. And whether it’s from the president or his entourage or the Secretary here in H.S.S., I have never.

kara swisher

Do you feel heard in these meetings with leaders? And especially President Trump, do you feel like you’re being clear? Or you know, there’s a thing called selective listening. I do it all the time with my kids. But do you think you’re being heard? Because what you’re talking about is something very sophisticated, the idea that that there’s a possibility doesn’t mean it’s a probability.

moncef slaoui

Well, I express myself very clearly. I apologize if I have an accent. And that is what I control. The rest I can’t control.

kara swisher

And what I’m trying to get at is a consistent message. How do we get a consistent message? Because it’s not just — I mean, Robert Redfield and he had it back and forth. I just want to get to the idea that our citizens deserve a consistent message.

moncef slaoui

Yes. And I want to suggest a different name to the consistent message.

kara swisher

OK.

moncef slaoui

And I’ll explain why. I would like to suggest that we say a transparent message. And the reason I make a difference between the two is the following. See, when you want to build a bridge, you know how to build a bridge and you can predict everything. It’s physics. Here, we’re talking about biology. In order to produce the vaccine we need to grow cells. Some days you look at them the wrong way, and they don’t like it. And you have a 2,000 liter fermenter that dies, or get infected with a bacterium, and you have to do it all over again. And it takes three weeks to regrow that amount of cells in order to produce the vaccine.

kara swisher

Mhm.

moncef slaoui

Whoops, you’ve just lost three weeks.

kara swisher

Right.

moncef slaoui

Or you want to recruit 30,000 subjects in your clinical trial. And you say I’m going to do it super fast. But those are human beings with their life. They’re volunteers. They may come and be recruited in eight weeks as you planned. Or it may take you seven weeks. Or it may take you 15 weeks. Then you plan, you know, I’m going to have a certain transmission of virus that’s going to be, let’s say, 0.1% per week in the study. And it turns out to be 0.3% — you’re going to go much faster. Or it’s going to turn out to be 0.05%, and you’re going to go slower. So when people think that we don’t want to be transparent about the message because it may be evolving, it’s evolving because we learn as we go. And we can’t predict the behavior of biology. I would say, frankly, please, let’s talk about transparent message. Every time there’s a change, we’ll talk about it and explain it.

kara swisher

OK. China’s developing a vaccine. Operation Warp Speed has already said that anything developed by China is out of the question. On top of that, we’re not involved in the COVAX, the World Health Organization’s global initiatives. Could you just explain why not cooperate with these other countries?

moncef slaoui

So first of all, we do talk to COVAX. I have a number of conference calls, et cetera. There is no specific formal collaboration. But there is a lot of exchange and discussions, absolutely. Some of the vaccines that they are working on and we are working on are the same. And we exchange information. The comments I personally made around the Chinese vaccine are more relating to the technology used. Which is, to grow the virus, kill it, and that’s the vaccine.

kara swisher

Right.

moncef slaoui

I personally think, in today’s age where we have technologies that allow us to not having to grow trillions of a deadly virus and then kill it — because we could have a leak. We could have a terrorist attack. We could have something where enormous amount of virus are let go into nature. I think we should avoid it. And that’s the reason I was advocating that that’s not a technology I would go after. [MUSIC PLAYING]

kara swisher

We’ll be right back.

On May 15, the day Dr. Moncef Slaoui started his job at Operation Warp Speed, he stepped down from his seat on the board of Moderna, a developer of one of the lead vaccine candidates. But he took a lot of heat for keeping his pharma stock. Senator Elizabeth Warren tweeted, quote, “It is a huge conflict of interest. Dr. Slaoui should divest immediately.” Slaoui sold his Moderna stock soon after. But that wasn’t the only company in his portfolio that was awarded an Operation Warp Speed contract. So was GlaxoSmithKline. And Slaoui kept his shares there, about $10 million worth. Although Slaoui’s contract technically allows it, some critics, like Senator Warren, see it as an ethical violation.

archived recording (elizabeth warren)

The first person to be fired should be Dr. Slaoui. The American people deserve to know that Covid-19 vaccine decisions are based on science and not on personal greed.

kara swisher

I’d like to hear your position on this. So make a case why your pharma holdings don’t amount to a conflict of interest. And I’d love to hear — it was said that you had an ethics disclosure. I’d love to know what was in that.

moncef slaoui

Yeah.

kara swisher

Or an addendum?

moncef slaoui

Yes. So first of all, I completely agree that there could be a conflict of interest and it should be investigated. And I’m absolutely transparent about it. I have been from day one. You know? As I was discussing, I didn’t ask for this role. I was called to do it. And I said here is what I have. And regarding GSK, I explained that’s really my retirement. Because GSK shares paid dividend. And I want to use that dividend. I’m not somebody who deals in the market. So for me, a steady income is important. And second, and I know this is my point of view, but you know, every morning when I wake up, I look at myself in the mirror and I have to agree with what I see. That’s my personal values. I know I am doing this to help people, not to enrich myself. And therefore, I said, anything I can do to make sure I don’t enrich myself in any way, shape, or form, I will do. Moderna is really an obvious conflict of interest. I cannot be sitting on the board of the company. And because I knew Moderna would be one of the key vaccines to take forward, for sure. And it is one, as we can see, the most advanced vaccine with the Pfizer vaccine, which by the way uses the same technology. So I thought, and I continue to think, that I have done everything that can be done other than divesting my GSK shares.

kara swisher

OK. Why not that? Because they were selected, also.

moncef slaoui

I am explaining. Because I think that if I commit to give any accrued value on those shares to research once I finish the role, any accrued value that is above the average of the industry, and frankly, if people would like it, any accrued value that is above the value on day one when I started, I’m fine with that. I am not about the money. I’ll give it to the research. I want to make a precision around GSK. GSK, frankly, is a small player in the equation. The vaccine that was selected is the Sanofi vaccine that is associated with an adjuvant, which is an addition that’s added into the vaccine to make it stronger from GSK that has been discovered. It’s like a booster to the vaccine that you add into the vaccine, too. So I don’t think there has been any untoward behavior or any encouragement of GSK or of myself.

kara swisher

May I give your own words to you? Why not just make it transparent? Why not just list all the things — you’re a VC at this company, Medicxi, is that the right way to pronounce it?

moncef slaoui

I did. I did list them. In fact, my contract, I have sent the contract to a committee of Congress with the addendum sites, the companies of which I was a board member —

kara swisher

Right.

moncef slaoui

— and the VC that I am a partner into. It’s also listed the companies, the boards from which I resigned, and the date at which I will resign. And they are all around May 15 or May 17. Because when the company is public, I couldn’t resign before my new role was announced. And the last company from which I effectively resigned is called Clasado, which is a product for GI discomfort that’s a consumer product. It has nothing to do with Covid. I told them I will resign in May. They asked me to look for a new chairman and be hired before I effectively resign. And that happened early in September.

kara swisher

I mean, getting business people into government is critical. So how do you imagine solving this problem?

moncef slaoui

Frankly, again, by being transparent and by being in agreement with investigation. I have never been in disagreement with investigation. The fact that Senator Warren on her own decides that I am a corrupt person and that I am greedy, et cetera, is an accusation. It’s not an investigation. And you know, if people want to come and see what I am doing, what I have, it’s an open book. And I can tell you, people can come and look at everything they want. I feel very comfortable. I know I have not done anything wrong. And I know I am not here to enrich myself. I know I have knowledge, expertise, and experience that can help. I am passionate about helping.

kara swisher

And what would you say to Senator Warren?

moncef slaoui

I would say to Senator Warren that people deserve the opportunity to explain. That it’s inappropriate to prejudge. That prejudging is something that carries a different name that’s much more difficult to say to a senator. It’s wrong. So if somebody asks that we investigate, please investigate. If somebody asked me a question, I’ll give you the answer. Just ask me the question and be fair. And you know, publish or take into account the totality of my question.

kara swisher

OK. But you have this influence on major government decisions. You have the ability to persuade people to direct money in ways that might benefit you. I’m presuming you are honest. Like, let’s start with that presumption. But there are dishonest people. And there’s billions and billions and billions of dollars here running through this government.

moncef slaoui

Yes.

kara swisher

So how do we make sure this doesn’t happen?

moncef slaoui

I think it’s really by having two things. One is transparency. And then it’s a team is making a decision. See one of the other things that I would say to Senator Warren is there are N.I.H. leaders, great scientists, there are C.D.C. leaders, there are army generals, four stars, one star, two star, three star, there are BARDA leaders, all together with me. We’re sitting together, and we’re making these decisions, these choices. They are principal investigators. This is not something happening in a black box by Moncef Slaoui, who says, OK, this is a choice. Go execute. That’s not how it works. We discuss as scientists. We have rational decisions. We listen to each other. We come to a common view. We make that decision. We progress. I do influence those decisions. Otherwise, honestly, I wouldn’t be here. Why would I be here? I bring my experience. I’ve been doing this for 30 years. And in a humble way, I was fortunate to, I have been involved directly in 14 vaccines that became approved. It’s an experience that I feel passionate about sharing it to help our country and the world deal with the coronavirus.

kara swisher

I think the issue is some people, expertise and ethics shouldn’t be mutually exclusive. I think that’s what happens in that regard.

moncef slaoui

And they are not. And frankly, people should look into my track record and my reputation. I was in a large company. I drove the company to invest for 27 years in a malaria vaccine that is designed to save the life of babies in sub-Saharan Africa — zero return. I worked very hard to make the company make a vaccine against Ebola, zero return. I worked very hard to create a proposal that was called the Bio-Preparedness Organization, by the way, which I shared with the US government to offer a facility that the company had to prepare for, unfortunately, what’s happening now. I have a long track record that people should go and look. I mean, have I been a slimy, sleazy, greedy person? Or have I been with high integrity across my career? I think I have. And people can go and ask. It’s very simple.

kara swisher

OK. That’s a fair answer. Now vaccines are only useful if people take them. I’m sure you’re aware there’s a growing number of anti-vaxxers in this country, pushed by social media and other things. New polling suggests only 51% of US adults say they would get the Covid-19 vaccine if one became available. And I just had Elon Musk on my podcast. And he said he’s not going to take the vaccine because he doesn’t need it. How do you get people to take it?

moncef slaoui

Yeah. So first, I am very worried, really very worried by what’s going on here. And I think it’s extremely unfortunate that politics got involved in this vaccine development in this period. Because it has created that level of anxiety. I mean, we’re really, like, in a fishbowl, where everybody is looking. And everybody is simply looking to critique, or to support, 100%. But nobody to have, in a way, a more balanced perspective. It’s starting to happen. I have to say, I’ve seen in the media, we went from how could this possible— it’s impossible to do it. It has to be something bizarre and weird. And to now saying, well, we need to make sure the data are transparent. Yes, of course. Transparency is going to be number one. Continuous communication and engagement is going to be number two. And just telling people the facts as they are. This is why I come back to transparent plans of communication rather consistent communication. Because if I say something and I change it, please don’t take it that it’s a lie. Because we learn as we go. There are specifics that we cannot plan to the day or to the week. So I think that’s what we need to do. The other thing that I’d like to say to Elon Musk and many others who elect not to take vaccines is —

kara swisher

Well, I think in Musk’s case, he’s saying he doesn’t need it because he’s not going to — if he gets sick from it, he’ll be fine. I don’t think he’s saying —

moncef slaoui

Yeah. No, but I mean, I’m not talking, frankly, specifically about Elon Musk. But the unintended consequence is he may have a lot of followers that take that point of I don’t want to take the vaccine —

kara swisher

Right.

moncef slaoui

— as a general statement versus I feel protected. I don’t need to take it. The other point I would make to him is he may get infected without knowing it. He may be asymptomatic. He may be infecting other people. So taking a vaccine is not only about protecting yourself. It’s also about protecting the society around you. And our life, if there were no vaccines, would be like it has been in the last several months, with masks, with lockdowns, and there would be much fewer of us. And in general, we’d end up dying anyway of one of the many vaccine preventable diseases that we’re disseminating in the populations. The problem is, frankly, is when a danger isn’t here and now, we forget it. Many physicians even here, don’t know a number of diseases. Because we don’t see them anymore. And guess why we don’t see them? It’s because we are vaccinated. If we stop taking vaccines, all of these bugs are going to come back to us. Because they’re there.

kara swisher

So take them because —

moncef slaoui

Because they protect us. They allow us to live a better life and a longer life. And frankly, the biggest challenge that vaccines have is that you take them and then anything that happens going forward from there on, you chronologically associate with the vaccine. So if I take a vaccine and I have a car accident a week later, I may not say, you know what? I had the car accident because I took the vaccine. Because in our brain, we don’t associate car accident and vaccine. But if I take a vaccine, and a week later I am diagnosed with some disease, I almost automatically, and I should, do the hypothesis, oh, maybe it could be associated with it. I think the mistake is to conclude it’s associated, just because it was chronologically happening at that moment. Because, you know, somebody unfortunately may have a heart attack one day. If it happens that that heart attack took place one week or two weeks or a month after vaccination, it doesn’t mean it was caused by the vaccination.

kara swisher

All right. So there’s a lot of concern about the emergency use authorization and the general rush to get the vaccine out. President Trump really said he might reject the F.D.A.‘s new plan for having outside experts weigh in, as a political move. I’d love to know what your perspective on this. Because you said very clearly, I would immediately resign if there was undue interference in this process. Would this tempt you to quit?

moncef slaoui

I only believe in actions, not in words. So frankly, if the action took place. I would do it immediately. And I will raise my hand to explain why I’m doing it. I think, in this case, the EUA is, really, I describe it as a pit stop on a journey, the end of which is a full licensure, a BLA. It’s called a BLA. And it’s really close to it.

kara swisher

Sure. But in the instance of hydroxychloroquine, it got an EUA after Trump touted it. And then the EUA was revoked. How do you make sure there isn’t political interference? You yourself, what is your power to do this? And ensure citizens of this country that we’re getting a vaccine that is both safe and speedy?

moncef slaoui

Yes. Here’s why I feel confident. Frankly, it’s almost impossible to do. And if it was to happen, it would be blatantly obvious. These vaccines are being tested in placebo controlled prospective clinical trial, the highest standard that exists to demonstrate whether something works or doesn’t work. For the hydroxychloroquine, for instance, there was no clinical trial that’s placebo controlled, right, et cetera. So that was made on a basis of a different standard of science, I would say. Here, we took the highest standards. So it will be impossible to say, oh, it worked, if it doesn’t work. Or there’s no side effect if there were side effects. By the way, I am very satisfied, unfortunately, there is a serious adverse event in one of the AstraZeneca vaccines trial. But you know, the trial was stopped instantly, regardless of the consequences, until we understand what happened. And then the F.D.A. and the data safety monitoring board, once they are satisfied, they may allow the trial to start again or not. They will make that decision. So things are being used to the highest scientific standards. You cannot come back from that. And if you try to come back from that, it will be visible to everybody. And I’ll be the first one to say it.

kara swisher

When you say you’d be the first one to say it, so do you believe that the president’s standards for efficacy and safety match your very own high bar? You’re talking about a very high bar here.

moncef slaoui

I really don’t want to comment —

kara swisher

OK.

moncef slaoui

— on the politics. I’m just telling you, we set the bar very high, very clear, very high in the sense of scientific standard quality. We didn’t set the bar very high in terms of expected efficacy, as I said earlier. It’s at 50%. I hope it will be much higher. But you know, we set the bar very high in terms of quality of the science, safety of the vaccines. If these vaccines are approved, I feel very comfortable they will be approved on the basis of full knowledge of their efficacy and of their safety. And I would like to offer, there is a limitation in what we will know about this vaccine, which is, because of the urgency of the pandemic, the follow-up time of vaccinees in the clinical trial is going to be limited, more limited than usual. It’s going to be at the time of EAU approval, if there is one, four months or five months, or something like that. Usually you wait a year or something. However 90% of adverse events associated with vaccines happen within 40 to 60 days from completion of immunization. And the F.D.A. is proposing that at least 50% of the individuals in the study population have at least two months of follow up on safety before the vaccines are approved. And secondly, we are working really hard with the F.D.A. and the C.D.C. to make sure we have a very active pharmaco vigilance surveillance system to allow us to continue to assess the safety of the vaccines as they are being used in the high risk population.

kara swisher

OK. I wasn’t talking about politics, actually. I’m talking about standards. And you’re talking about extraordinarily high standards.

moncef slaoui

Let me first say, if I may correct, I think they are the appropriate standards. They are not incredibly high standards. Vaccines are given to healthy people. They need to be safe. And they need to provide the benefit. And that benefit needs to be certain, which is what the clinical trial, as we designed them, will show, if they show it. OK? We will be transparent about the data. And I cannot guarantee that decisions would not be made by people who have the power to make them. I can guarantee that I will say what I think. And I am saying what I think.

kara swisher

OK. Do you regret doing this? Or do you feel — not this interview. [LAUGHTER]

moncef slaoui

Is this the last, last, last, last, last question?

kara swisher

No, no. I’m saying do you regret coming into the government and doing this? Do you feel, when you look back on it —

moncef slaoui

No. I mean, honestly — like, honestly, this is the best time of my professional career in terms of the content and the work and the team and the impact. This is the worst in my professional career in terms of being trashed, frankly. I can’t believe that somebody stands up that I have never met and say I’m a corrupt person.

kara swisher

Welcome to Washington, Dr. Slaoui.

moncef slaoui

Yes. But I am not. I am not a political person. And this is why I felt compelled to go and make interviews. And I will do it again and again if I feel I’m being unfairly treated.

kara swisher

OK. I want to give you one last chance to name the vaccine effort. Do you have any others?

moncef slaoui

Honestly, I like Warp Speed. I’m used to it. I love it. I love the process that we’re doing. We’re all working super hard. And you know, I would feel almost, like, doing something wrong for it. I love the name. Fine. I’m going to watch — after, when I have time, when I’m done with this, I’ll watch “Star Trek.”

kara swisher

OK. [LAUGHTER] Thank you so much.

moncef slaoui

Thank you very much.

kara swisher

I really appreciate it. And good luck. And we all — I really want a vaccine. I’m going to make Elon take it. I promise.

moncef slaoui

Great. Thank you.

kara swisher

All right, thank you. Bye. [MUSIC PLAYING]

“Sway” is a production of New York Times Opinion. It’s produced by Nayeema Raza, Heba Elorbany, Matt Kwong, and Vishakha Darbha. Edited by Adam Teicholz and Paula Szuchman. With music and sound designed by Isaac Jones. Fact checking by Kate Sinclair. Special thanks to Jeneen Interlandi, Liriel Higa, and Kathy Tu. If you’re in the podcast app already, keep on your masks and hit subscribe. If you’re listening on The Times website and want to get a new episode of “Sway” delivered to you, at warp speed, of course, download a podcast app like Stitcher or Google Podcast, search for “Sway,” and hit subscribe. We release every Monday and Thursday.



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