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Saturday, December 26, 2020

Moderna’s Vaccine Is A Startup Triumph, Too

 With the first doses of Moderna’s vaccine rolling out to frontline workers across the country, it’s easy to forget that the company behind this crucial tool toward ending the pandemic is itself little more than a startup.


To deliver a vaccine for mass inoculation with 94.5 percent efficacy in clinical trials in under 11 months is obviously in itself an astonishing achievement.

But what makes Moderna‘s accomplishment all the more remarkable is that the company behind the effort got its start less than a decade ago and went public only two years ago. Its founding principle—the notion that the human body could be harnessed to make its own medicine—was considered outlandishly futuristic at the time.

In the words of co-founder and early backer Noubar Afeyan, it’s “a powerful reminder of what is possible when we journey forth, armed with propositions that may—in just a decade—go from outrageous, to obvious, to lifesaving.”

Noubar Afeyan, co-founder and chairman of Moderna.

In an effort to shed some light on Moderna’s history-making startup journey, Crunchbase News sat down with Afeyan, a venture capitalist and serial entrepreneur who’s been building startups for more than three decades. In addition to his role as co-founder and chairman of Moderna, Afeyan is also founder and CEO of Flagship Pioneering, the Cambridge, Massachusetts, biotech venture firm that launched and funded the company in its early days.

A Beirut-born, MIT-educated biochemical engineer, Afeyan is a well-known figure in biotech startup circles. Soft-spoken demeanor aside, he’s a leading power player in the space, with a key role in the launch, funding and scaling of a long list of prominent public and private companies, including sustainable agriculture unicorn Indigo, microbiome-focused drug developer Seres Therapeutics, and, of course, Moderna.

Below are key takeaways from a conversation this week around Moderna’s early days, its startup DNA, immigrant leadership, and why the recent focus on a COVID-19 vaccine should not be called a pivot.

As a 10-year-old venture firm-founded company, Moderna is not far removed from its startup roots. And some things startups are known for is their willingness to work grueling hours, do things that have never been done before, move fast, and pursue long-term, longshot goals. I’m curious to what extent Moderna’s startup orientation was helpful in the task at hand of developing an effective vaccine in an extraordinarily short time span.

“It’s definitely a startup mentality,” Afeyan said, observing that: “Moderna’s culture has been to be unafraid of trying things that have never been tried.” The governing philosophy is to “be rigorous to a massive extent,” and to act urgently, but also “to recognize that it takes time to get things done.”

If there’s a cultural element, Afeyan said, it’s that which he calls pioneering. It’s a term he sees as different from innovating–another favored startup verb–in that pioneering involves “going to a place that’s never been inhabited before and making it habitable.” It’s also a term with a long history at Afeyan’s venture firm, which in 2016 changed its name from Flagship Ventures to Flagship Pioneering. At the time, Afeyan described the name change as part of a strategy to “purposely distance ourselves from current products and advances that represent only a short leap in innovation beyond them.”

Although Moderna is now a company with roughly 1,300 employees, the culture is still one of startup-like fearlessness around trying something new, Afeyan said. Specialization also benefited the company in tackling COVID-19, since unlike older, more established big pharma companies, Moderna remained focused since inception on a single area: messenger RNA (mRNA) therapeutics and vaccines.

 

So, the period when Moderna was founded, from 2010 to 2011, was a tough time for biotech. Investment was scarce and the economy was just beginning to recover from the financial crisis. To what extent did you face extra-normal challenges launching such an ambitious startup?

While the general investment climate was not the best a decade ago, Afeyan said its effect on Moderna was minimal as the startup was an in-house effort.

“The way we operate is that we launch our own explorations through which we discover things that will create a lot of value, come up with hypotheses, and go test them,” he recalled. “Moderna was the product of that … it was an exploration of: Could we make a drug inside a patient that could be effective?”

Founders initially envisioned applications in therapeutics, Afeyan said, but also, to a lesser extent, vaccines. After identifying a mission in the summer of 2010, Flagship launched an effort to look for ways to technologically accomplish its goal. The team was acquainted with a body of emerging research around messenger RNA focused on applying it to transform cells. “We thought: What if you could use it in animals or in humans,” Afeyan said. “That is essentially how Moderna got its start.”

By 2011, Flagship had assembled some intellectual property around its latest venture, initially named LS18. The plan was to incubate and grow the company in-house, its typical practice, using capital from its most recent venture fund. It was more at the later stages, Afeyan said, that founders envisioned bringing in outside investors.

“The company’s adversity was rather more in attracting people and large sums of capital in that what we were doing was both unheard of and unbelievable,” Afeyan said.

In the end, Moderna skipped outside venture financing in favor of an enormous strategic investment from AstraZeneca. By 2014, the pharma giant had invested $300 million at a peak valuation of $3 billion, an astonishing sum and valuation at the time for such a little-known newcomer. Other big pharma names—MerckAlexion and Vertex—rounded out Moderna’s strategic investor pipeline. Later financing came from Moderna’s IPO in December 2018.

 

To what extent did the clinical trials and research that didn’t go as hoped pave the way with insights and research results to enable success with the COVID-19 vaccines?

Although Moderna, like virtually every biotech involved in clinical trials, has seen disappointing results at times, Afeyan pushed back against the come-from-behind narrative that Moderna’s tale is one of serial disappointments followed by a breakthrough success.

“It’s the conventional story line. And it’s not that we didn’t have disappointments … But a lot of this idea that nothing worked and we pivoted and we got a vaccine is provably wrong because we had vaccines in our product concepts in 2010. We worked on vaccines as early as 2013 and 2014, and the very first clinical trials Moderna ever did were for two vaccines—influenza vaccines—in pandemic strains that did not yet enter humans,” Afeyan said.

In its earliest trials, Afeyan continued, Moderna used mRNA to show it could stimulate an immune response in humans. Since then, the company has worked on 10 human vaccines in parallel with 10 non-vaccine products.

Afeyan said the conception that a particular project is either flat-out succeeding or failing isn’t consistent with how things actually work at Moderna. The company describes its process as a platform approach, with researchers commonly applying Moderna’s mRNA technology to more than 20 programs at the same time. It’s less about canceling one project and greenlighting another, and more about shifting resources to and away from particular efforts, presumably based on factors like progress and urgency.

 

Moderna, like a lot of transformative American companies, is founded and led by immigrants. Reading your bio, you were born in Lebanon to Armenian parents, immigrated to Canada as a teenager, and then got a Ph.D. from MIT before launching Flagship. And Stéphane Bancel, Moderna’s CEO, is a native of France. I’m curious to get your thoughts on the state of immigrant startup entrepreneurship in the U.S.

There’s been quite a lot of attention paid of late to immigrants in the vaccine space, Afeyan observed. It’s reflective of the fact that there are a lot of immigrant scientists in immunology and biotech. However, Afeyan added that he’s acutely aware that many immigrants today face greater hurdles than those, such as himself, who obtained American degrees and founded companies here decades earlier.

Afeyan said he’s encouraged to see that leading research universities continue to attract students from all over the world, and many, if not most, would choose to stay. However, he’s concerned that if the country shuts off more immigration, it will harm our ability to keep building transformative companies. He also makes the case that immigrants are uniquely well-equipped for startup life.

“The immigrant experience and survivalist mindset of having to make do in a new culture; that spirit absolutely ports to entrepreneurship,” he said. Just as your brand doesn’t mean anything when you’re a startup, your family name and home country credentials don’t mean much when you’re an immigrant.

 

In a letter to staff, you talk about propositions that may—in just a decade—go from outrageous, to obvious, to lifesaving. I’m curious if that arc of progress appears to be accelerating. Ten years, by historical standards, sounds pretty fast, particularly for biotech.

“It’s an interesting question, because you know enough about the industry to know that’s fast,” Afeyan said. It’s especially fast, he added, if you consider that “in those 10 years, the first eight years, you have to explain to people why they have to believe you every day.”

He credits the maturation of the platform approach to biotech company-building, in part, for Moderna’s historically fast evolution from pie-in-the-sky concept company to purveyor of a pandemic-ending vaccine. Urgency also played a role, Afeyan said.

“The pandemic, if it did nothing else, it gave us the ability to prove everything from soup to nuts in a short time frame,” he said.

 

This has been a big year, of course, for Moderna, but Flagship also has been keeping busy, with several portfolio companies closing new rounds and a few stealth projects probably still in the very early stages. I’m curious about some of the next new things you’re finding most intriguing.

At a big-picture level, for people who work on things that are out there, Afeyan said he’s intrigued by the area they call health security.

“If you look at human health and what we call health care, it’s usually sick care,” Afeyan said. “So to go from sick care to deterring and preventing disease, in a world where securing our health is the focus instead of treating sickness, that would itself be a gigantic market.”

Broadly, health security involves taking all our knowledge and looking at the conditions before a sickness. There is a long period when bodies go through patterns of alterations after which a disease becomes manifest, and a paucity of care around monitoring and prevention.

Afeyan said he compares health security to the way we think about military spending. A lot of funding goes to weapons systems. However, a great deal also goes to monitoring, security, intelligence and other functions that allow us to deter threats so we don’t need to use those weapons. The same should hold true for health spending.

“We think society’s going to have to shift capital and incentives to getting ahead of disease,” he said.

https://news.crunchbase.com/news/moderna-covid-vaccine-noubar-afeyan/

1st Covid-19 Vaccines Given in Latin America, But Region Faces Challenges

 Three Latin American countries administered their first doses of vaccines against Covid-19 on Thursday, as the region hardest hit by the pandemic begins what health officials say will be a long slog toward inoculating the masses.

Ten thousand Pfizer Inc. vaccines shipped by air from Belgium landed in Costa Rica and Chile as both countries kicked off a vaccination drive that is expected to speed up in early 2021 with the arrival of millions more doses. Mexico began administering 3,000 doses from Pfizer, and Argentina will start inoculations next week after 300,000 doses of Russia's Sputnik V vaccine arrived Thursday from Moscow on an Argentine state aircraft.

The first injections in Mexico and Chile were broadcast live on television.

"It was something unexpected, I'm very excited," said Zulema Riquelme, a 46-year-old Chilean nurse who works with Covid-19 patients and became the first in that country to receive the vaccine. "These have been difficult months because I haven't been able to see my family, a lot of exhaustion. I feel proud that they chose me."

The arrival of the vaccines, which most countries are administering first to front-line health-care workers before giving them to the elderly, offers a glimmer of hope for a region of 650 million that has logged over 470,000 deaths from Covid-19, about 30% of the world's total, and more than 14 million cases. With a new surge of deaths and cases now hammering the region, health officials in most countries are still negotiating purchases with pharmaceutical companies or awaiting delivery of vaccines early next year.

That is raising concerns among health policy experts tracking the pandemic that fully vaccinating the region could lag into 2022 or beyond. Health and government officials said there are limited funds for imports and logistical hardships in distributing vaccines, some of which require ultracold storage that is a challenge in poor, remote regions with intermittent electricity service.

"We need 70%-80% vaccination rates to achieve herd immunity and the way we're going, the coverage is not going to be uniform," said Dr. Carlos Espinal, who leads the Global Health Consortium, a health education initiative at Florida International University. "Without a coordinated effort, the vaccine itself will become a marker of inequity."

While the challenges are similar in much of Africa and Asia, Latin America's needs are particularly pressing because the region has some of the highest daily death rates from Covid-19. Brazil and Mexico, the region's most-populous countries, are each registering nearly 1,000 deaths daily. Fatalities are climbing again in other countries after a lull.

With families across the region ignoring public health warnings to avoid large gatherings and vacations during the holidays, cases are expected to rise even more by early January.

Vaccination is the solution, but most countries lack capacity to produce their own vaccines and must depend on those being manufactured in the developed world, where wealthy countries have made large bulk purchases while moving quickly to administer doses. One million people have already received the shot in the U.S.

Many poor and middle-income countries -- among them a number of countries in Latin America -- are counting on supplies through the Covax multilateral initiative led by the World Health Organization. But it is still unclear when and how many doses will become available.

"We are not Canada or the U.S., with capacity to buy several times our population's size in vaccines," said Fernando Ruiz, Colombia's health minister. "We have much more modest means and have to buy wherever we can."

Colombia has seen its documented daily cases top 14,000 this week, more than the country of 50 million had logged in the last peak in August, when strict quarantine measures were still in place. After signing deals with Pfizer and AstraZeneca PLC in recent days, the government plans to vaccinate nearly 20 million people next year. But that leaves another 15 million who are older than 16 left to inoculate without a clear plan on where those vaccines would come from.

Government officials from Colombia to Chile had been anticipating the results from late-stage trials in Brazil of a Chinese vaccine, hoping that its approval would lead to rapid production in Brazil and exports to neighboring nations. But the announcement on the vaccine's efficacy, which had been expected this past Wednesday, was delayed until January.

Bolivia and Paraguay, two poor, landlocked countries, have yet to sign contracts for vaccines, though health officials in both nations say they are in talks with pharmaceutical companies.

In Peru, which has had one of the world's highest Covid-19 mortality rates, authorities have come under fire because millions of people had been expected to be vaccinated before April's presidential election. But officials this week said they have been unable to close a deal with Pfizer to receive 9.9 million doses.

Former President Martin Vizcarra said that instead of approving purchases, Peru's Congress focused in November on removing him from office in a controversial impeachment. "In all countries they closed contracts to purchase vaccines in November, while here they carried out an illegal impeachment," he said in a tweet.

Carlos Neuhaus, the businessman appointed by the Peruvian government to oversee vaccine distribution, said he faces a range of challenges, including inadequate infrastructure for storing vaccines. He said he has gone so far as to scout supermarkets, fisheries and other companies with large refrigeration facilities.

The Pfizer vaccine, which requires colder refrigeration than other vaccines, "is easier to be applied on the coast, in Lima and the big cities," Mr. Neuhaus said as he discussed Peru's rugged Andean geography. "The other vaccines...should go to the more complicated places."

In Argentina, opposition lawmakers have harshly criticized President Alberto Fernandez for importing the Russian Sputnik V vaccine, which they say needs more testing.

Final results of Sputnik V's trials on patients over 60 haven't yet been released, they said. And 68-year-old Russian President Vladimir Putin, the drug's main promoter, said in his annual news conference earlier this month that he would wait for it to be approved for his age group before getting a shot.

"The national government has improvised since the arrival of the virus to the country, and it is continuing to do so with the vaccines," said Luis Petri, an opposition lawmaker who added that Argentina has been unable to secure supply contracts with multinational pharmaceuticals.

Mr. Fernandez, the president, has said the vaccine is safe and that he would be first in line to take it to shore up confidence. But two dozen lawmakers from the opposition Together for Change coalition want to form a commission to investigate the government's acquisition of Sputnik V vaccines.

"This vaccine doesn't have a guarantee," Elisa Carrio, a prominent former member of congress who is critical of Mr. Fernandez, said in a recent television interview. "This is a great national scam. They are lying to society."

https://www.marketscreener.com/quote/stock/PFIZER-INC-23365019/news/First-Covid-19-Vaccines-Are-Given-in-Latin-America-But-Region-Faces-Challenges-32085847/

Hungary gives 1st vaccine shots a day before EU's rollout

 Hungarian doctors and health care workers began getting vaccinated Saturday with one of the continent's first shipments of the Pfizer-BioNTech vaccine against COVID-19, upsetting plans for a coordinated rollout on Sunday of the first shots across the 27-nation European Union.

The first shipments of coronavirus vaccines arrived across the bloc late Friday and early Saturday. It was not immediately clear why Hungarian authorities began their vaccinations a day early. Authorities in Slovakia also announced that they planned to begin administering their first doses on Saturday evening.

European Commission President Ursula von der Leyen released a video celebrating the vaccine rollout, calling it “a touching moment of unity.”

“Today, we start turning the page on a difficult year. The COVID19 vaccine has been delivered to all EU countries. Vaccination will begin tomorrow across the EU," she said.

In Hungary, the first shipment of 9,750 doses — enough to vaccinate 4,875 people, since two doses are needed per person — arrived by truck early Saturday and were taken to the South Pest Central Hospital in Budapest. The government said four other hospitals, two in Budapest and two others in the eastern cities of Debrecen and Nyíregyháza, would also receive vaccines from the initial shipment.

The vaccines developed by BioNTech and Pfizer arrived by truck in very cold conditions were delivered warehouses across the continent on Friday and early Saturday after being sent from a manufacturing center in Belgium before Christmas.

The rollout marks a moment of hope for a region that includes some of the world's earliest and worst-hit virus hot spots, including Italy and Spain, and others, like the Czech Republic, that were spared the worst early on only to see their health care systems near their breaking points in the fall.

Altogether, the 27 EU member states have seen at least 16 million cases of the coronavirus and more than 336,000 deaths.

“It’s here, the good news at Christmas," German Health Minister Jens Spahn said at a news conference Saturday. "This vaccine is the decisive key to end this pandemic.”

“It is the key to getting our lives back,” Spahn said.

The rollout is the result of coordination on the part of all 27 member states, helping the bloc to also project a sense of unity in a lifesaving mission of logistical complexity after difficulties in negotiating a post-Brexit trade deal with Britain.

The first doses, however, are limited just under 10,000 doses in most countries, with the mass vaccination programs expected to begin only in January.

Each country is deciding on its own who will get the first shots — but they are all putting the most vulnerable first.

French authorities said they will prioritize the elderly, based on the high impact on older populations in previous virus surges in France. The French medical safety agency will monitor for eventual problems.

Germany, where the pandemic has cost more than 30,000 lives, will begin with those over 80 and people who take care of vulnerable groups.

Spanish authorities said early Saturday that the first batch of the coronavirus vaccine to reach the country had arrived in the central city of Guadalajara — where the first shots will be administered on Sunday morning at a nursing home.

In Italy, which leads Europe in confirmed known deaths, a nurse in Rome at Spallanzani Hospital, the main infectious diseases facility in the capital, should be the first in the country to receive the vaccine, followed by other health personnel.

In Poland, the first two people to be vaccinated on Sunday will be a nurse and a doctor at the Interior Ministry hospital in Warsaw, the main coronavirus hospital in the capital, followed by medical personnel in dozens of other hospitals.

Prime Minister Mateusz Morawiecki recently called it the patriotic duty of Poles to get vaccinated — a message directed at a society where there is a high degree of vaccine hesitancy born from a general distrust of authorities.

In Bulgaria, where suspicions also run high, the first person to get the shot will be Health Minister Kostadin Angelov, who has promised an aggressive campaign to promote the benefits of the shots.

In Croatia, where the first batch of 9,750 vaccines arrived early on Saturday, a care home resident in Zagreb, the capital, will be the first to receive the vaccine on Sunday morning, according to state HRT TV.

HRT TV also reported that authorities would launch a pro-vaccination campaign that will include celebrities and other public figures getting the vaccine on camera.

“We have been waiting for this for a year now,” Romanian Prime Minister Florin Catu said on Saturday after the first batch of the vaccine arrived at a military-run storage facility there.

The vaccinations begin as the first cases of a new variant of the virus that has been spreading in the U.K. have now been detected in France and Spain. The new variant has caused several European countries to restrict traffic with Britain.

A French man living in England arrived in France on Dec. 19 and tested positive for the new variant Friday, the French public health agency said in a statement. He has no symptoms and is isolating in his home in the central city of Tours.

Meanwhile, health authorities in the Madrid region said they had confirmed the variant in four people, all of whom are in good health. Regional health chief Enrique Ruiz Escudero said that the new strain had arrived when an infected person flew into Madrid’s airport.

German pharmaceutical company BioNTech is confident that its coronavirus vaccine works against the new UK variant, but further studies are needed to be completely certain.

https://www.marketscreener.com/quote/stock/BIONTECH-SE-66771992/news/BioNTech-Hungary-gives-1st-vaccine-shots-a-day-before-EU-s-rollout-32088196/

CoronaVac efficacy at 50-90% in Brazilian trial

 The CoronaVac COVID-19 vaccine developed by China’s Sinovac Biotech Ltd showed efficacy between 50% and 90% in Brazilian trials, Sao Paulo’s state health secretary said, and its Brazilian producer said full trial results will be released by Jan. 7.

Results of trials in Brazil are known exclusively by Sao Paulo state’s Butantan Institute biomedical research center, which has an agreement with Sinovac to produce the vaccine, said health secretary Jean Gorinchteyn.

First trials showed efficacy above 50%, the minimum required by Brazilian health regulator Anvisa, and below 90%, Gorinchteyn said in an interview with CBN radio aired late on Thursday.

At Sinovac’s request, Sao Paulo’s health department has not received the Chinese drugmaker’s full trial results, he said, adding that the company will review the data before announcing final results.

Butantan will disclose the data trial results in up to 15 days, or by Jan. 7, the institute said in a note on Friday.

The South American country has registered 7,448,560 confirmed coronavirus cases and 190,488 deaths from COVID-19, the country’s Health ministry said on Friday.

On Wednesday, Butantan had declined to specify the efficacy rate from a trial with 13,000 volunteers, citing contractual obligations with Sinovac, raising questions about transparency.

The CoronaVac vaccine showed 91.25% efficacy in Turkey, according to an announcement on Thursday of interim data from a late-stage trial in the country.

https://www.reuters.com/article/us-health-coronavirus-sinovac-brazil/coronavac-efficacy-at-50-90-in-brazilian-trial-sao-paulo-official-idUSKBN28Z0PX

Russia approves Sputnik V COVID-19 vaccine for people over 60

 Russia on Saturday approved its main COVID-19 vaccine, Sputnik V, for use by people over the age of 60, Russian news agencies cited the health ministry as saying.

People over 60 have thus far been excluded from Russia’s national inoculation programme, as the shot was tested on this age group separately.

https://www.reuters.com/article/us-health-coronavirus-russia-vaccine/russia-approves-sputnik-v-covid-19-vaccine-for-people-over-60-media-idUSKBN29005A

Friday, December 25, 2020

How Oracle Is Tracking COVID-19 Vaccinations In The Cloud

 Tech giant Oracle Corporation (NYSE: ORCL) plans on assuming a leadership role in the COVID-19 vaccine program by providing technology that gives real-time progress of the efforts, the company said in a press release.

What Happened: Oracle designed and launched in early 2020 a National Electronic Health Records Database and other applications designed to collect and analyze COVID-19 data.

Now that the general public has access to at least one vaccine, Oracle said it's ready to expand its technology to include up-to-the minute data on how many people have been vaccinated.

Oracle's EHR Database was first used in June to keep track of the more than 500,000 people who volunteered to take part in vaccine and therapeutic trials.

Oracle worked collaboratively with government entities to help manage the data that would have otherwise been impossible given the "existing fragmented provider based EHR systems," the company said.


Why It's Important: Oracle's technology will act as the CDC's central data repository for the vaccination data, and it will be stored on the cloud.

The data will be coming from all corners of the U.S. and will be anonymized to protect patient privacy.

Health care providers can also use the platform to manage deliveries and make sure each shipment arrives at the proper temperature.

What's Next: Every single person who receives a vaccine will be granted access to Oracle's system to report side effects, including injection site pain or a headache.

This data will prove to be vital in helping health experts identify any adverse events, even months after the injection.

https://finance.yahoo.com/news/oracle-tracking-covid-19-vaccinations-183752382.html

Email hack exposes data of 485K+ Aetna, Blue Cross members

 An email hack at EyeMed, a company that health plans contract with to provide vision benefits, led to a data breach that affected at least 484,157 Aetna members and more than a thousand BlueCross BlueShield of Tennessee members.

Cincinnati-based EyeMed said that on July 1, it discovered an unauthorized person gained access to an EyeMed email mailbox. The person sent phishing emails to email addresses that were housed in the mailbox's address book. The access was blocked on the same day.

Aetna was informed about the breach in September. The insurer said breached information includes names, addresses, dates of birth and vision insurance account information. In some limited instances, Aetna said full or partial social security numbers, birth or marriage certificates, medical diagnoses, treatment information and financial information may have been exposed.

BCBS of Tennessee was also affected by the breach, but on a smaller scale. The insurer estimates about 1,300 members were affected by the hack, according to the Chattanooga Times Free Press. 

EyeMed said there isn't any evidence that the information has been stolen or misused.

https://www.beckershospitalreview.com/payer-issues/email-hack-exposes-data-of-485k-aetna-blue-cross-members.html