TRANSCRIPT
Sarah Turgeon:
Welcome and thank you for being here. I'm Sarah Turgeon, I'm the James E. Ostendarp Professor of Psychology and Neuroscience. Currently chair of the neuroscience program here at the college. Amherst is tremendously honored to welcome Dr. Stephen Hoge, class of 1998, back to campus this weekend to receive an honorary degree. And it's a special honor for me to introduce him this afternoon.
Dr. Hoge, or Stephen, as he was known when I first met him and still is, was one of my earliest thesis students. He was in my lab in my second year at Amherst, and at the time he was one of seven thesis students. And I just counted, he's now one of 80 thesis students. So I've been at this for a while.
Needless to say, I had to get a chair to climb up to the top shelf to get a hard copy of his thesis, because that's the way they were back then, and remind myself of what he actually did, which was brilliant by the way.
For those who are interested, he examined the effects of PCP, the drug PCP, in rats on bar pressing for food reward to see whether PCP could model the schizophrenic symptom of anhedonia or decreased reward function.
We did end up publishing some of his data a few years after he graduated, and it turns out at least a few people were interested. The paper's been cited a healthy handful of times, and in some cases by authors that were not me, so that's good.
While I am a bit hard-pressed to remember too many details from that time, I was actually at the time pregnant with my now 24-year-old twins, so I was a little distracted. I do remember very clearly that Stephen won the neuroscience thesis award that year. The old prize is presented at the honors assembly on the last day of classes, which used to be a Friday. And the reason I remember this so clearly, of course, was because of the thesis' brilliance, but also when they called his name for the award he wasn't there.
Turns out he had some other last day of classes festivities planned, so he didn't make it to the ceremony. I'm not sure of this, but I believe that's when the college started sending out notes to the award recipients to make sure they were in attendance.
After he graduated, the next time I saw Stephen was when I was sitting in my living room one morning a few years ago watching the news. And holy cow, that's my thesis student on television being interviewed about COVID-19 vaccines. Dr. Hoge, as I presume most of you know, is the president of Moderna, a pharmaceutical and biotechnology company where he leads scientific research and clinical development.
One of the many fascinating things about Stephen's career path and one that may be of particular interest to members of the class of 2023 and their families, is its seemingly non-linear nature.
After graduating with a BA in neuroscience from Amherst, he earned a medical degree from the University of California, San Francisco. However, during medical school, he did something fairly unconventional. He took a detour back to the lab bench, I guess he just hadn't had enough.
He then returned to the clinical track and worked as an emergency room doctor for a few years. As I recall, he said this felt like delivering the mail or something like that. Every day you deal with the immediate problem and then you send it off to the specialists, and so he decided to change directions at that point.
And in 2005, he left medicine to join the healthcare consulting practice of McKinsey and Company. After becoming partner there, he made another leap to a tiny little biotech startup dedicated to the then novel concept of using messenger RNA to create a new generation of transformative medicines and vaccines.
Stephen joined Moderna as head of drug invention in 2012 and was named president in 2015. When Stephen spoke to a group of science majors on Zoom last year, his description of his path and the choices he made clearly struck the students. As they realized that one, they didn't need to have it all figured out right now, important lesson, and two, their Amherst education prepares them very well to take big risks and pursue new opportunities when that feels like the right thing to do.
And aren't we all glad that Stephen took those risks? Moderna is currently working on research and trials for vaccines and treatments for flu and Zika and cardiac disease and cancer, metabolic and autoimmune diseases, and probably others.
So I'm pleased to welcome Dr. Hoge, ag. I would note that we have microphones in these two spots and one up in the balcony for questions. We'll have a question and answer period after he's finished, but please join me in welcoming for a talk titled no false hope.
Dr. Stephen Hoge:
Thank you, Sarah.
So I struggle immensely with podiums, and so if it's okay with everybody, I'm going to try and do this from the floor. It'll allow me to move and be a little bit more comfortable.
Thank you, Sarah, for those very kind remarks. It is an absolute privilege to be here. I'd like to thank President Elliot and the trustees and everybody. I also want to thank all of you for showing up. My kids were certain that nobody would come, nobody was going to come. And we've actually done okay, kids, we're doing all right. So thank you family.
As you all know, family is important and is [inaudible 00:05:15]. It's one of the most important things to me. I am, without a doubt, an imposter, and maybe there are others in the room, but let me just tell you, there is no way I deserve the attention you're going to give me or maybe some of the credit that I've gotten even from this college for what I've been doing over the last 25 years of my career since I left.
Side Note, I actually have not been back to campus for 25 years. I graduated 25 years ago in the class of '98. My father actually graduated the class of '67, and so that just shows you.
And so for me, this is a bit of coming home and showing them, but for me, it's also dealing with that imposter syndrome that I have. Which is I definitely do not deserve the honor the college is giving me, but maybe what I'd like to do in my talk is cover a bit of my history. The people that loved me and raised me, taught me what to do, the places that nurtured me and animated me as a scientist, and then maybe weave those into the role that I played in building Moderna for most of the last 10 years. And then leading Moderna through the pandemic.
And hopefully in that way do some honor to them, including Sarah and my loved ones up here. Because for sure, I am just a product of their nurturing and love, and don't really deserve much credit myself.
So how do I describe myself and the product of all that investment and love? I consider myself a scientist. I think Sarah at least honored me with saying that I did some science in undergraduate, and science really is for me a bit of my religion. It's my passion. It's the thing that I get most excited by.
I still consider myself a scientist, even though there are now thousands of people conducting science at Moderna. My son in the live, laugh, love shirt up front here thinks that I actually can't be a scientist because there's thousands of people at Moderna, and so I just have a people job because I don't actually get into the lab anymore. But I do still find that to be the thing that animates me the most.
And what does science mean? Why does that religion matter to me? There are three things that I really picked up, including principally at Amherst, that have really driven me throughout that career.
Science for me is about purpose, it's about curiosity, and it's about optimism. And I'll try and talk through those three, how they've meant something to me, what we've done at Moderna, and maybe what we did through the pandemic. And where we're still going.
And then I will try and leave some time. Let's have some fun with the Q and A at the end, which can be a question about anything at all. So what do I mean by purpose?
Science is a relay race, it is the passage of knowledge through generations. All of us, myself for sure, but everybody in science stands on the shoulders of others entirely. And the objective, the goal of science, and Sarah said, we got some references on those papers, so we're moving down the goal. But the goal of science is to have others stand on your shoulders to contribute, as a poet would say, the verse, a verse to a larger song.
And that is, for me, the purpose of science. It has therefore a direction. It is a vector for those who are scientifically minded. It goes towards expanding knowledge on just a belief that if we expand that knowledge and pass it down to successive generations, they will know what to do with it. They will do good with it.
And so that belief, that idea and the purpose of science, actually for me as a concept was founded here at Moderna, or sorry, at Moderna, at Amherst. At Amherst. I'll do that more than once. I've been given a lot of talks. And not in a place that you might imagine, it was not in a science class, it was in a history class. Because this is Amherst College, because we invest in liberal arts, in broadening people's minds in lots of different directions. I got to take a class called the history of science, but it was the history of science.
It talked about the emergence of science as an extension of philosophy, as an extension of the acquisition of human knowledge passaged down through generations. And it was eye-opening for me, because it suggested to me this idea that science really was about something much bigger. And it did have a vector to it. And that really is the purpose that still animates me today, and I'll talk through how we use that [inaudible 00:10:05] in the pandemic.
The second thing is curiosity, the idea of asking questions for which you don't know the answer. Now, I grew up thinking I loved science in undergraduate, first year or two, and certainly in high school, because I thought science was just an accumulation of facts. It was cool things you could learn about the way the world works, and you would learn those, whether they were physics or chemistry or biology, and that was really interesting information. That is not at all what science is.
And it took me actually working with Sarah in my thesis to start to understand what science actually is, which is it is not a collection of the known. It is an approach to the unknown, and the result is you acquire new information.
But science is how we ask questions and try to answer them so that we can pass on to successful generations that information, I learned that the hard way. I learned that in the thesis, which is a unique feature of this college, and from a liberal arts perspective, something we should be incredibly proud of. Which is that we were allowing students in undergraduate to try and write theses, come up with a scientific question, and then try and actually conduct experiments and then answer that question.
And I'll tell you, the question itself, I was mostly Sarah's. I tried to contribute, but it was a really interesting question I almost didn't understand as I was getting into it. The conduct of the experiments, well, that wasn't the fun part. Honestly, the conduct of the experiments I found to be an unbelievable grind. It was really hard. I'd rather be eaten by piranhas.
It was really terrible. But what we got to at the end was a set of data that needed to be explained and contextualized. And that was where I discovered this idea of what is it really? It's an approach to the unknown. You have to take your work and do a bunch of scholarship on the work of others, and figure out how it fits in as a piece of the puzzle. Lots of the work I did didn't fit into the piece of the puzzle. Actually, what I learned at the end of writing my thesis was I asked the wrong question because I didn't really understand the question up front. And that was one of the most valuable things I'd ever learned about science.
It was this idea that your questions really matter. Actually, there's an engineer, a famous engineer, Kettering, who once said that a problem well-stated is half solved. And it is that idea, you've got to get to the right questions and then go explore them. And I'll talk a bit about that, about how that animated Moderna.
The third piece, as I mentioned, is optimism. And I really view optimism as a product of my upbringing, the privilege of optimism given as a gift to me by the people who raised me, and by the opportunities. Actually, the privileges that I had here at Amherst College. Optimism is this idea we all know that actually tomorrow could be better, that we actually could do something that makes it better.
Science inherently has that as a belief system, because why else would you do these experiments and ask these questions?
And it's inherent this belief that we can actually move things forward, and that that will be a positive direction, not a negative direction in our experience. And that optimism has probably been the greatest privilege of my life. I do believe it was given to me. I do believe it's a gift, and I'll come back to that in my last couple of comments. It's a gift that I think is extremely fragile.
We have certainly seen and lived how communities denied optimism, the privilege of optimism can be destroyed. Whether that's through systemic racism in this country or other things. We definitely have to nurture and protect it. And I think right now, actually, technology's not our friend in protecting it.
So those are the three things for me that animated me. Those are the gifts that Amherst, my family, and my early career gave to me. My understanding of science, which is about those three, purpose, curiosity, and optimism.
And I'll fast-forward through my career, because Sarah did it all right. I didn't deliver the mail, and I wish sometimes I hadn't said it that way, but I wanted to be a physician. And [inaudible 00:14:12] the doctor, it's God's work. Nothing has higher purpose than caring for others and giving them more time. It wasn't a place where I was fully living my dream of being a scientist.
And after I wandered through some careers in investing and towards biotechnology, I found myself at Moderna. And you could ask the question, why did I decide to join? Why did I join a company that at that time not only had you never heard of, nobody had ever heard of, there were like 10 or 15 employees. Moderna didn't even have a website, let alone a name that anybody would recognize. And it was being run by a group of people that, well, let's just say they were eccentric in the beginning.
And the reason I joined was because Moderna was founded on an incredibly simple and incredibly big idea that resonated for me about the core principles of science. That really simple idea, now, forgive me if I go do a little bit of biology here, molecular biology, but messenger RNA is life's information instruction molecule.
The way to think of it is it's like the software program that runs anything in your life. It is literally the instructions that tell a cell in your body, every cell in life what to do. And so you're constantly sending instructions. You think of information as stored in your genes, but actually the genes are like a hard drive. It's you turn the power off, it's not so useful. It's the instructions that are coming out that are messenger RNA.
In fact, people believe, like we all believe, although you can't prove it, that life started with messenger RNA. It's just sending information.
And so the idea of Moderna, the big idea, was could we figure out how to write medicines in life's instruction molecule? Could we just literally say, we'll make a spike protein, or make a protein that causes you to attack that cancer? And those sorts of questions and that ability to write instructions, if we could do it, would actually turn medicine into just an information technology. You'd be copying and pasting.
You'd be using the same technology every time, but you'd be copying and pasting new drugs in over and over again. And that very simple idea, which like, Hey, can I write in life's information molecule, had pretty profound implications if it was going to be true. Not the least of which is that you'd be able to personalize medicines, you'd be able to move incredibly fast if there was ever a pandemic. You'd be able to do dozens of things in parallel. And theoretically over not my lifetime, but over many lifetimes as a relay racing scientist, that technology, that ability to write instructions of life molecules would mean that you could treat or prevent every disease.
And for me, the idea of being a part of that story, running a part of that relay was just too exciting to miss. And so I dove into a company with no website, no money, no hope of success.
Molly, my wife, said, "You should just get a red car with a convertible, and some other version of midlife crisis please, but not this one. Because this is going to be really expensive and difficult."
But I was passionate about it. I really felt like it brought me back to the things that I loved about science and the opportunity to contribute, and no higher purpose than trying to make medicines to extend the life of others and contribute to that.
So anyway, I joined Moderna at that point, and this is now 11 years ago. Let's just say that we were eccentric as I said at the beginning, there was nothing about Moderna's approach that made sense.
Formal drug developers, people who did this, serious people who did this for a living, worked on a drug, they didn't work on a technology. We were saying, "We're going to be on the platform that's going to make dozens of medicines, and eventually be able to move really fast." And people would pretty regularly say, "Why? For what?"
And for the better part of the first year or two, we were just trying to keep the lights on, literally. We would often not have the money to be able to pay the year-end bonuses at the beginning of the year that we were trying to do. So we were building the company, as I said, I was about the 15th, 20th employee. And very early on it became clear to us that we were not the smartest people, that should have been obvious to everybody, but we were pretty sure we were not the smartest.
We were also sure that we were not traditional. We did not have the information, we didn't have the background or experience. So what do you do if you don't have experience and you're darn sure that you're not the smartest, and you're just trying to survive? Well, our answer to that actually became a mindset that's now on our website. Our answer to that was, well, we just got to figure out how to learn the fastest.
And for the most part, when we told scientists that, they were like, you're an idiot. What does learn the fastest mean? And how is that different than being the smartest? In our case, it really boiled down to we had to be willing to fail, and fail a lot. Learning is about learning what to do as well as what not to do.
And a lot of learning that happens in science is based on people trying to take an incremental step, come back to that idea of curiosity. They're actually trying to look for the answer under the lamppost. They really don't want to wander off too far into the dark, because that's pretty scary out there. You could fail out there. You could look like a fool out there.
Well, if you're not the smartest and you don't have the most experience and you're just trying to survive that year, you're not afraid of looking like a fool. And so we said, we're going to be a company that celebrates taking really big chances and that actually is not afraid to learn by falling down.
First thing we had to do is remove the word failure from the company. So when an experiment didn't work, you were not allowed to call it a failure. It was negative information.
We said there's two polarities to information, negative and positive, and both are inherently good. So you had positive information and negative information. And we also said that negative information is going to be measured by whether it actually teaches us something. And what we found pretty quickly actually is we learned more from the things that didn't work than the things that did work.
When something worked, it was like finding your keys under the proverbial lamppost. You already knew that, you didn't learn anything new. It's when you tried something that you thought was going to work and it didn't, that you often found a really surprising result. So as a company, we said, we're going to obsess over learning. We are going to obsess over the pace of that learning, and we're going to pursue, if necessary, negative information, really well-formed questions that teach us through our failures.
It is interesting if you pull back, that the entire history of mRNA vaccines that have had a pretty big impact in the world over the last few years is dependent upon us being willing to do that. So messenger RNA vaccines and lipid nanoparticles were first discovered in 2013, 2014 at Moderna by a scientist named Eric Quang who worked for me.
And the way we got there was through negative information. So a little bit of history on this. Moderna was called back then Moderna Therapeutics, not Moderna Vaccines, Moderna Therapeutics. We were working on cancer and rare metabolic diseases and a whole bunch of other things. We were not actually working on vaccines. We were trying to make medicines that we could give to people repeatedly and keep them alive in rare metabolic diseases, for instance, on IV infusion or a cancer medication.
And what we discovered, unfortunately, was that when we started giving animals these medicines is that we could give them a dose and it would help keep them alive, and we'd give them a second dose and they would start to not do so well. And it wasn't that it was unsafe, it stopped working.
And by the time we give them a third dose three or four weeks later, it was done. There was no effect. We couldn't figure out why. We had no idea. We thought we must be doing something wrong. The entire organization underneath you was focused on trying to figure out and pull that problem apart, and say, why is that the case?
And it took Eric, an enterprising scientist, thinking of that in terms of negative information. Whoa, that's not a failure, that's a success we just haven't figured out yet. And what Eric thought in 2013 was that has got to be the fastest immune response, the most potent immune defense response we've ever seen in drug discovery.
And if that's the case, could this thing be a vaccine platform? Could we use it to, let's say, generate really strong responses against viruses or other things like that? Now, Eric came to me and said, "Look, I've got a crazy idea and I want to do this."
And we didn't have much money. So we said, "Okay, run one experiment, Eric, go run one really good experiment, but it has to be willing to fail. So pull in all the best vaccine technologies everybody else is using, do all the other ways about it, and go try and do something, a flu vaccine that's well-established. And you have to do better. If you do not do better, we're not better. We'll move on. We got to go fix this therapeutic problem."
Fast-forward about three, four months, Eric brings me that data, and he's Eric, pacing out in front of my little office back and forth.
And I'm getting nervous, like, what's going on? Why is he so anxious? And he comes in and he basically says, "I'm not going to tell you the data."
I said, "Why?"
He says, "I think we have to repeat it. I think something went wrong."
And I talked him out through that. He showed me the data, and we were 10 times more potent than any vaccine technology had ever been. And it was Eric's first shot at trying to develop a vaccine. And he's like, "There must be something wrong in the assay data."
And so he said, "I'll tell you this, but you have to give me the money to do it again before we tell anybody else, because I don't want to look like this big of a fool." This is positive information. It's a problem. We're not used to it. What are we doing with this?
So Eric took that information, repeated that experiment, and at the end of 2013, '14, it not only worked, it worked time and time again in animals. It just kept working, and it was far better than any vaccine technology that anybody had ever discovered.
We tested against everything. Viral vectors, proteins, everything everybody else was trying to do, and it just kept beating in every experiment we're doing. This was the therapeutics company. This was not what we were trying to do, but it was a profound change in vaccines.
And fast-forward a few years, we actually then eventually took that into humans before we really told people we were trying. And we took two different pandemic vaccines into humans and both worked. And so we finally decided in 2016, we're ready to tell people about it. This is a thing. It's going to be a thing. And we actually started building a factory that was going to make our vaccines, the factory that ended up dosing 500 million people over the last couple of years, a number that still blows my mind.
And so we did this. We just piled up what little treasure we had. We started building the factory. We went out to tell the world in 2016, we're a vaccine company. And people again, "So what? Who needs a vaccine company? Really? That's what you spent five years on?"
And we went through a moment of people saying, "There's not a need for you. There are plenty of good vaccine technologies out there."
But we had a high degree of conviction in the science that we built and the purpose of what we were trying to do, so we just kept pushing forward. Now, fast-forward through 2014, 2018, oh, sorry, '17, '18, '19. We were starting to make progress in our other medicines, and I'd love to tell you a little bit about that. I will in a moment. But we made real progress in cancer, real progress in rare diseases, and some of that data has since come out. But we kept pushing forward our vaccines platform.
I told you we went two for two in 2016, two different clinical trials, two different vaccines, both worked early stage, just antibodies in the blood.
By 2019 at the end, actually by January, 2020, we had gone nine for nine. We didn't think it was possible that it was some sort of fluke anymore. We'd gone nine different viruses, multiple influenza viruses, multiple pandemic strains, lots of respiratory viruses, viruses that caused birth defects, Zika, which you may have heard of. We just kept going through all of it and it kept working, and we were convinced that we were onto something really special.
And for the most part, people just thought we were doing science, experimenting. They only wanted to talk about our rare diseases. They didn't really want to talk about our vaccines platform. But we kept pushing. So it's January, 2020, January, 2020, what happens then?
So we get this email, Hey, there's a lot of stuff happening in China, respiratory virus, it looks like it's coronavirus. And we go, yeah, okay, let's make a vaccine. That could be a threat. We have no idea. We have no great insight, by the way. No matter what you might read about me microchipping people with Bill Gates, or that there's some great conspiracy that we were aware of this. I had no idea.
People say, "Well, what did it feel like to create the vaccine?" It was like a five-minute hallway conversation. It was like, "Well, there's this thing. It's a Coronavirus. We've done Coronaviruses before. We did MERS, we did SARS, we've got all the things. And we've got nine for nine, we should just do one."
It's like, "Okay, do one. One."
Now, for the spike protein, the number of mRNA vaccines, because it's software, that could be used to make that spike protein is 10 to the 80th. It's just the way that the software of life actually works. There's three ways to include almost every amino acid. There's almost 2000 amino acids, and so there are 10 to the 80th.
There are more ways to make an mRNA vaccine for COVID, for the spike protein, than there are molecules in the known universe. Let's just do one, that was how. Man, that makes it sound like we were a bit flippant, but we had confidence in the science, and we definitely said, "Let's just take one shot. Let's do one thing."
We then did that thing faster than anybody thought was possible. We actually made it, shipped off to a bunch of different clinical research sites that were going to go run that in clinical study. We did it in about 21 days, if I remember correctly, from mid-January to the early part of February.
It's because we'd built this platform and capabilities that allowed us to do it, the foundational science that we had. We shipped it off to the NIH, and Tony Fauci's team at NIH. And then they sat on it for three weeks, and we were like, what?
[inaudible 00:28:27] some paperwork and we got to do something. It's like, with what? But that was our experience with that first vaccine. We did one and we shipped it. And then February happened, February, 2020. And it went from being this question to something very different. So I have two really big memories of February, 2020, and they relate to what we were doing at the time.
So in February, 2020, we had to raise money again because the lights were going out, and we had to raise money desperately. And we went back to investors who'd been supporting us. We're a public company at that point. The way you raise money is you sell stock, you sell stock to shareholders. By the way, our largest shareholders are mutual funds. If any of you have 401k, thank you.
You are responsible for funding the COVID vaccines creation in our platform since 2018. But those mutual funds, those investors will look at us and say, "Well, wait a second. Two years ago you went public, and you promised that we'd be all the way here. And I see you're making progress, but why do I have to keep giving you money? Why do I have to support you to keep the lights on at this level?"
And we had what's called a down round. What that means is people took a loss on their investment in February, 2020. So we went public, our share price is $23. That sounds silly now. We had to sell shares in February, 2020, right as the pandemic was ramping up, at $19. And we had to take phone calls from all those people who'd given us money at $23 and have them tell us all the terrible things we'd done.
And that was the moment of February '20 is feeling like people just really still don't understand what we're doing. Even the people who by the way have supported us in the past. It's amazing to think about that. At the same at the same time as we were going through that, still trying to convince people that we could build a platform and that we had developed a different way to make vaccines. At the same time as we were raising that money as a down round, something else was happening, which is my second really salient memory from February.
I was watching the news and China was building a hospital in three days in Wuhan. Everybody remember those cranes digging up dirt?
And it was like, you looked at it and you're seeing it going by. Ah, that's the thing. And then you stare at it and you're like, wait, that's like panic.
There's something really scary about to happen, because that, building a hospital in three days is not a trivial thing. And I remember at that moment is when we came together as a company and particularly as a leadership team and said, I hope one is enough. Maybe we want to have a second or a third option, but truly we have to go all in on this.
Now, the really difficult thing is that investors hadn't supported us in that, they wanted us to go do something else. And so we spent a good amount of time in February trying to figure out how are we going to do this? How are we going to go after COVID, that is a sign when somebody builds a hospital in a field in three days. And yet we're not able to do it, we're still barely keeping the lights on.
Then March happened. March, the kids came home and they never left. They all came home. The dining room where I was used to doing some work became a massive Star Wars Lego extravaganza. Those damn Storm Troopers took over, so I had to move someplace else. I moved upstairs to an attic. We all were in some version of stuck at home, although I had to keep going back into the office for science to work with a scientist on some stuff.
And we all started to experience a profound fear about what we were watching, which is that it did start to feel like not only was the pandemic spreading, it was spreading into our communities. And in fact, we started to witness what that meant from a death and morbidity and a burden to society perspective.
And my memory of those couple of years during the pandemic was just that intense sense of fear and that sense of failure.
We were constantly trying to raise money to figure out a way through the problem, to figure out a way that we could start making vaccine early. We knew that we were really believed in our science and that we're going to be successful, but we didn't even have the money to pay for raw materials. Glass vials to put the vaccine in, all the lipids that we used to make it. We just didn't have it.
And so we were going to everybody time and time again asking for funding, being told, "No, we're not sure what's going to happen. We've got other priorities." It was an incredibly difficult time, because there was this feeling of helplessness that went through it. It actually was a time, it was a low point for me in all of 2020, because there was that sense of the whole purpose for which I'd ended up in science was we were going to try and contribute, try and make a difference, and you knew it was going to work.
We knew because we'd gone nine for nine even though we didn't have clinical data in our vaccine yet. We just really believed it, and we couldn't find a way to make it happen. It was at that moment that we were talking about our potential. We really did believe we could deliver a vaccine quickly, where somebody we deeply respect, I deeply respect, a leader in our field gave an interview, and they said, "I think it's irresponsible of companies to say that they could develop a vaccine in less than a year and a half, two years, that we're giving false hope to the world."
And I remember it hit deep, because this is somebody we really respect. And it wasn't personal. They was just talking about all companies, and there were many companies working on it. And it had a profound effect on me because it got to that idea of optimism, that idea of we're doing science to make the world better. And hope, hope is about all we had in April and May of 2020.
Now, it actually didn't last long, that despair, because it actually turned very quickly for me into, no, there is no such thing as false hope. It's just hope, just optimism. It's the reason we're trying, and we need to keep going because the alternative sucks. Giving up sucks.
So we kept going, and actually it became galvanizing for a lot of folks in the company, not as those words no false hope, but this idea that we're not giving ourselves the choice. People worked incredibly hard through that time. And then it all started to change for us in May when the clinical data came out from that first product, the first clinical trial. We were able to develop antibodies. The human data looked amazing. It was the first time that everybody else started to believe what we already felt like we knew, which is that the platform was going to work, it was going to work in humans.
That was in May of 2020. All of a sudden, money showed up. It's funny how success does that. They're not there when you need them, but they're there when you don't. We actually went back to investors. They gave us one and a half billion dollars. It was amazing. We invested all that money in making vaccine. That's all anybody wanted us to do anymore. It's like, Hey, that cancer thing is cute, but you got to deal with COVID.
Okay, all right, that's a different, but I'll go for it. And we worked hard on COVID for the balance of that year. We obviously started getting help from the government as well. That was an interesting experience in its own way.
There were six companies that were selected to be a part of this warp speed effort, which was pulled together by NIH and everybody else. And the average age of those companies is like 150 years, and we're like 11 years old or whatever, eight years old. The average employee bases are like 80,000, and we're like, we got 800. We were the little engine that could, and we got put in the front of the line because we were moving first. And we felt really good about ourselves for that.
And we were like, yeah, we're going to pioneer this thing. We found out a couple of weeks later that the reason they put us in the front of the line for running the clinical trials was, well, they didn't think we'd survive. They wanted somebody to go break down all the things that would go wrong, and then the serious companies would come in behind us and they would deliver the vaccines.
And again, a little bit of a crisis of confidence on that optimism. But we stuck with it, because this was what we could do. And actually one of the questions I get asked a lot is what did it feel like during that time? We were working 24/7. Nobody slept, nobody saw their families. All of us were experiencing that in different ways in our lives.
We had people that were stuck in other countries because they had to work on technology transfers, figuring out how to manufacture. Just it was a horrible time. But actually at Moderna it was also really uplifting, because we could do something. And I know so many folks felt like they wished they could. And so from our perspective, it was just living that optimism, living that belief that there was a purpose to what we were doing and following our science.
So fast-forward to the second question I get a lot is I get a question about, Hey, what was it like creating the vaccine? It was like, eh, we did one. We did it in a weekend. And the second question is what was it like when you found out it worked? And it was similarly perhaps not the answer you'd expect. It was on a Sunday morning. At that point, we had been working very closely with the United States government. I would have a nearly actually twice a week, I'd have some sort of conversation with Tony Fauci and the surgeon general and other folks. Everybody was very focused on us.
By then, unfortunately, the other vaccines had fallen so far back that they were not going to make it. And so the little engine that could was now the only engine, and we were supposed to deliver.
And on Sunday morning in November, we got word that we were going to find out from the Independent Monitoring Board the efficacy results from our clinical trial. It's a little bit of a strange thing, but the way that this works is that the Independent Monitoring Board is a group of scientists who actually get to look a couple of times at the data when we have a certain number of cases, and they will only tell us did it work or not.
And the reason we do that from a clinical research perspective is we as a company are conducting that trial, and you do not want to be biased in how you're conducting that trial based on whether or not you believe the results are trending positively or not. And so there's almost a Byzantine system, but it's a whole system around science and clinical research, which protects the integrity of that science, which is something that we all should be grateful for.
So I was the company representative. The government representative was Tony Fauci. And we get on this WebEx, because it's all remote, on a Sunday morning at about 11:00 AM. And you pop into the room and there are 15 esteemed biostatisticians and academicians and scientists who know the result of our life's work, of everything we worked on for 2020.
Tony and I pop in and you're kind just doing the, is anybody smiling, are they? And what I could quickly figure out is that they were bored. They'd been on that call a while. And whatever it was, I was terrified. It was not exciting.
And so then the lead biostatistician starts reading off the results, and within four sentences it becomes clear that it was 95% effective. That everything that had come before and betting the company on it and all the work had actually resulted in a vaccine that far exceeded any of our expectations.
I think I mumbled something. Tony said something really better. It was appropriate, it's outstanding result. And there was just this incredible feeling of relief. It wasn't joy. It was this feeling that everybody who'd been relying on us and all of the sacrifices of the people that I knew had been making to get us to that point actually had delivered something valuable.
In the relay race of science, we hadn't dropped the baton, we'd handed it off. And that relief, for the record I went on mute, ran to the top of the stairs, screamed the results down to my kids. My wife was like, "Oh my God [inaudible 00:40:26]."
I called everybody over. There was a lot of joy in that moment, but that relief was actually the overwhelming feeling I have of when I learned the results. We then entered a period that I will describe as the most challenging period at Moderna. That relief quickly turned into maybe it was, horror's too strong a word, but this sense of responsibility and the inevitable realization that we were doomed to fail. Because we had signed up to deliver about 100 million doses of vaccine, that's what we'd been building.
We thought, Hey, that's great. We could maybe stretch that to a couple hundred million people. We could have an impact in a couple hundred million people's lives. When all the other vaccines didn't show up, and there were really two ultimately that got approved. All of a sudden the world said, no, you have to give us a billion doses next year. One billion doses.
Now, for a company that had never made more than a few hundred thousand, and then the year before that, only a few thousand, that was almost an unbelievable ask. As a reference point, about 700 million people have iPhones. So we were being asked to give our product to more people than Apple. It was terrifying. In the beginning, people would call and say nice things and plead, and then they would call and yell. And then they would accuse you of not trying.
And for the most part, we were just drowning under the weight of that responsibility. And doing everything we can and could to try and deliver those billion doses. We entered a phase where the science we dedicated our lives to became political. You could be pro or anti-vaccine. I didn't know that was a thing. It's just a vaccine. You don't have to take it.
There were people that believed that we were microchipping them. There were people that believed that for some reason we were trying to control this, when every dose we ever squeezed out of our factories from people working 24/7 went into the hands of governments, mostly this one, United States government. And we just kept trying to deliver. But for that whole year, we felt like we were failing.
Because over time, that's all people wanted to tell us is that we hadn't gotten far enough and done enough. It was one of the hardest parts of the pandemic. Actually, 2020 in retrospect was scary scientifically, but incredibly exciting. And 2021 was this long, slow grind to try and bring this thing to an end.
I'm proud of how we showed up. I'm proud of the optimism that persisted through that. But it was fragile. And actually we started measuring our progress, not in how many doses we delivered, but in some ways in terms of the number of people that broke down and couldn't keep going from the inside. It was really hard.
The end result was positive, which is if you fast-forward to the end of 2021, we'd finally gotten enough doses into the world by about a year and a half ago in the early part of 2022. Even countries that had previously not been given access, whether governments or otherwise had not given them access, started turning away our doses.
They said, "We don't need them. We're good." And most of the rest of this is we move on. And from a Moderna perspective, actually it's one of the most exciting moments for the company. Because we got to go back to the things that we love, return to that science, the purpose of why we're doing this, expressing our curiosity, and really that optimism.
And actually in 2022, it's been one of the most exciting years in the history of the company, we finally broke through in cancer. And I'm sure if there are questions, I'm happy to answer about that.
But we've developed a medicine, it'll sound like science fiction, an approach to preventing cancer in individuals that involves biopsying your cancer and making a medicine just for you so your immune system can clear it.
And we released clinical trial results at the end of last year actually that showed a statistically significant reduction in the relapse or death as a result of cancer from people who'd had melanoma against standard of care. Something that we started in 2016, but finally saw to come fruition. We've seen clinical trial results from our rare disease pipeline where we're now able to keep children out of the hospital and hopefully keep them alive for the rest of their lives with more normal lives by giving them medicines repeatedly.
By the way, we did solve that problem that Eric ran into with the vaccine platform. We are now able to repeatedly dose those kids. And we've gotten to meet some of those families and hear from them, and hear from them about that impact.
And it's in some ways been a rebirth or rejuvenation of our love of science at the company and what we're here to do. So throughout that whole experience, we've managed to keep that in place, that sense of purpose of why we're doing things, that sense of curiosity about asking questions.
But the one thing that I found most fragile, if I look back on it, is that sense of optimism. Because it was the thing that came under fire most regularly. And I think it is the special thing that we can give to each other, must give to each other. And if we don't, actually puts that risk. What I mean by it being a privilege is you don't have a right to be optimistic. And what I mean by being a gift is I actually don't think there are people that can give themselves the gift of optimism.
I think most of us have it given to us by others, people who imbue in us a belief that we can make tomorrow better. And there are unfortunately large portions of our society that that has been systematically denied to, but even individuals find themselves denied that gift of optimism.
We were able to rally together as a company around that. It was who we were from the beginning and pull that together. But one of the things that scares me a lot about my experience with the pandemic and particularly '21 and now where we are in 2023, is the way in which technology which can be so empowering, seems to be attacking that sense of optimism that we could be better.
And as a scientist, I used to think that there was something pure and perpetually good about acquiring information, passing it on generations, trying to enable others to run the relay race after you and solve problems.
And then I witnessed in the pandemic, I think we all did, how science can actually be politicized, just like everything else can be torn down and turned into a good or bad science. And that is actually something that I think we need to collectively fight. And that's not a scientific question, I think that's a societal one.
I do think it has a happy ending, because our experience through the pandemic and where we're going right now, even at Moderna and what we're doing, building the company to the next stage into things like cancer, it is imbued with optimism.
But I think it is fragile and it requires us to give that optimism to each other. Maybe that's not just a feature of science, but something that we're really passionate about.
Now, as a closing bridge to Q and A, and I think bridges have answers. And I don't know if there are any in this one.
The last thing I'd say is I am incredibly grateful to the people in my life and to this college, and the people at Amherst and Moderna who have given me that gift of optimism and have taught me what science means. And actually given me that sense of purpose in what I do.
I truly don't believe there's anything special about me. I'm certainly not the smartest in the room, and I'm certainly not the most successful at anything I try to do. But to the extent that there is anything that I have done over this time for which I guess I'm receiving an honorary degree, I think it is a product of those that came before and those gifts.
And so I only hope in sharing the stories of what I've been through, that I'm doing some honor to them. Sarah, who taught me a lot about what science actually is and set me on that trajectory. My parents who taught me a lot about optimism and curiosity and purpose. And then obviously my wife, Molly, and children who teach me all the time that I am not as good as I think I am.
Humility, it turns out, is important in science. Anyway, with that, I would love to answer any questions from anybody else.
Thank you.
Thank you. And that applause was clearly for Sarah, [inaudible 00:49:47] for me. Any questions, please yeah?
Marcel:
Question. Stephen, thank you so much for a really inspiring talk.
Dr. Stephen Hoge:
You might have to get a little closer.
You're good.
Marcel:
I don't know if this is on.
Dr. Stephen Hoge:
I think it's on.
Marcel:
Is this on? Okay.
Thank you so much. My name is Marcel [inaudible 00:50:05] I'm from the class of '89. And I really would like to thank you, first of all, for just a really inspiring talk, and sharing with us the excitement of science and the ups and downs of what you went through.
In my regular life, a husband and a dad. So that's job number one, but also an infectious disease physician. And I do research on vaccines and immune responses vaccines. So I found this very fascinating.
I'd love to geek out about some questions that I'd like to ask you, just probably spend a long time. But for the sake of this group and for our conversation, I wanted to ask a more difficult societal question, which is, I was writing something recently and needed to look up a little bit of data about vaccine coverage.
It turns out that five and a half billion people in the world have now received a COVID vaccine, which is really incredible.
Dr. Stephen Hoge:
It's amazing, yeah.
Marcel:
So congratulations. When you look at the map of who got vaccinated, Canada looks great. Almost everyone's gotten two doses. The United States has gotten many, Western Europe has done very well. But then you look in the center of the map and there's places, the whole continent of Africa.
Dr. Stephen Hoge:
Particularly Africa, yeah.
Marcel:
And many other places where coverage is very, very low. That's probably true for other medical innovations that we have as well. How do we break down this problem and how do we extend the benefits of our innovations to places like that around the world?
Dr. Stephen Hoge:
Yeah, that's a great question. Thank you for it.
It was one of the hardest things about 2021 for us was witnessing the health inequity that we were a part of. And I'm not going to pretend that I'm not a politician, I'm not a public health official. I'm a scientist who runs R and D at an mRNA company. So let's start by saying I'm probably the least qualified, less qualified than you to have an opinion. But you've asked me the question, I'm on stage.
So I think a few things that I learned that we have to fix so that we don't have that problem again, and you pointed to it. There were countries in the world that did not get equitable access to vaccines, did not get access to vaccines until six, nine months later. Now, eventually they did. At the end of 2022, or sorry, in the first quarter of 2022, the African Union started canceling the orders because they didn't need anymore. Which is good news, but it took two years to get doses to them.
And the reality is that was about six, nine months later than everybody else in the Northern Hemisphere had really had their full fair share. A couple of things that I would say. The first is that political groups, countries really do exist to serve themselves at some level. And what we forget about 2021 is that actually there was a tremendous amount of nationalism.
It wasn't even by the way between let's say Northern hemisphere countries and Southern hemisphere countries, or richer and poorer countries, actually, between the United States and Europe. You may not remember this, but at that time, in the first half of two years ago today, Europe was facing waves after waves. And they did not have enough vaccines.
And they were accusing the United States of hoarding those doses. There were lawsuits and threats between the United Kingdom and Europe. It wasn't just a Northern Southern hemisphere problem.
And I think we have to recognize that if we're going to solve the problem of making sure that that doesn't happen, there's not an opportunity for nationalism. We have to distribute access to technology to places where people can't drop barriers at their border. And that's really what was happening.
The United States was making sure that Americans were cared for, and that's the right answer for the United States. And similarly Europe and other countries are doing that. But we need to make sure that there are places that you can manufacture a vaccine, in our case, that are free of those legal limitations.
And so point one is we are actually building a factory in Kenya right now, which will in the future, and unfortunately will probably be needed, be able to produce about 500 million doses of vaccine on the continent of Africa using our technology of whatever's needed. And we're actually putting all the technology there to do that.
It's a multi-year process. It's not a matter of pouring concrete, no matter what somebody reads, or sending a recipe, actually you have to set up a regulatory regime. They need their version of the FDA to be able to make sure that every dose you make is at the right quality and test it and verify that.
And so there's an entire social purpose that has to get put in place so that can work. But we've started that work with the country of Kenya with a specific purpose of trying to put the technology in places where it won't be subject to vaccine or scientific nationalism in the future.
So that's I think point one. But I think the second point and final point I put out is, and we need to figure out a way to sustain those things once established. It's fine for us to go take our lessons from COVID and build a factory there, but you do need to develop some system multinationally that tries to sustain all that infrastructure once it's in place and access more broadly.
And I think on that point, I'm a little bit less optimistic, at least for us. Because humans are pretty good at forgetting what happened a couple of years ago. And I think we've already moved on to other topics, and so we have to do our part as a company. I think that broader part, it really is a societal question for us about whether we can sustain equitable access to healthcare. We should always do that, but it's not always clear that we have the political will to do that.
Michelle Barmazel:
I have so many questions. My name is Michelle Barmazel, I'm actually the President of the Massachusetts Association for Gifted Education. We're based in Newton, which is pretty close to...
Dr. Stephen Hoge:
Brooklyn.
Michelle Barmazel:
Yeah, very close.
The question I'm choosing to go with is are you guys going to be looking at Crohn's? And if so, how can we get into any clinical trials you are doing for Crohn's and other things?
Dr. Stephen Hoge:
Great question. So Crohn's. It's an autoimmune disease for those who don't know it, inflammatory disease of the bowel. And the short answer is yes. We have a whole program in autoimmunity, but there's a couple of pieces to that that are really exciting. Some are making medicines that actually will try and turn down that inflammation. But actually one of the things we're learning a lot is that a lot of chronic disease is related to diet and infection.
And so it's related to viruses. They're actually the passenger virus or stuff that we don't think is always there, but chronic infection with certain types of viruses. And actually in the inflammatory bowel disease space, there's some very interesting science that's being done pre-clinically is starting to show that actually there are parts of that syndrome that might be, yes, they're diet related, but might be related to the acquisition of viruses that certain people don't clear for some reason.
Which will be a fascinating vaccine study if we can get that one. So we are still trying to figure out how we're going to get involved in Crohns, and so I don't have any near-term clinical studies to offer, but it is an area of active research. We actually have a whole team in the autoimmune space led by a woman in Cambridge.
Michelle Barmazel:
Thank you.
Dr. Stephen Hoge:
Of course.
Yeah, or you could yell it up at me. People yell at me all the time.
John:
Hi, John [inaudible 00:57:35].
First of all, thank you for you and your colleagues for the amazing science and work that you've done on behalf of humanity. That's fantastic.
Dr. Stephen Hoge:
Very kind.
John:
Just the science question of the messenger RNA and how it works, even for folks who are folks I talk to who are very talented in the medical field are still have some hesitation around it. Not that you're putting microchips in people.
Dr. Stephen Hoge:
That we admit to.
John:
Hopefully not, there's probably some of those. But just like that mechanism is a very novel mechanism that is not similar in vaccines or in the other things that you're trying to solve. How would you address the concerns about this is if you have the ability to program anything into DNA and RNA structures, does that open some weird Pandora's box from a health perspective or just speak to the health?
Dr. Stephen Hoge:
Yeah, so thank you for the question, and it is an opportunity to take the kinds of things that we heard. This is where I'll start by saying actually scientists do not always make good, actually they make terrible politicians and they don't always make good public health officials. Because those groups are really focused on communicating and explaining things.
And whenever I go into explaining why mRNA is totally fine and safe and you have nothing to worry about it, I end up sounding like a textbook. And people go like, "Oh, he must be lying to me." I don't understand it. So I'm trying to get better at answering these questions without going into the basic science of it, but messenger RNA as a molecule, it can only be used to make a protein. And your body has messenger RNAs in every cell. In fact, you have hundreds of thousands in every cell.
And so when we put a messenger RNA, and we're just falling into that soup of hundreds of thousands. And those hundreds of thousands, all of them get broken down continuously throughout the day. In fact, the half-life, how long a messenger RNA can live in a cell is usually about 12 hours. It's constantly being wiped away clean.
So as a medicine, that's a little bit annoying sometimes, we wish it would last a little bit longer. But from a safety perspective, it's actually fantastic. Because the body just takes these things apart. It's literally food every day. And as soon as you pull the pieces of the messenger RNA into the individual pieces, the individual nucleotides and get recycled as food, literally you take far more messenger RNA in a single bite of a cheeseburger than I will give you in your whole life. You don't think about that, but it's there.
And your body just constantly break those things down, pulls into pieces, and as soon as it pulls the messenger RNA apart, 12 hours later, all the information's lost, the software program's gone. It's just Lego blocks get reassembled into something else by the body that go [inaudible 01:00:13].
And there's no chemical difference between the messenger RNA we give you and what you already have as components in your body. So a lot of things that we didn't even think were possible, people saying, "Well, it's going to get into your genes and change your DNA."
I'm like, well, that just technically can't happen. It's a one-way valve. It goes this way, it gets broken down. But we obviously looked at that in early clinical research with the FDA and others, and we confirmed that that was just never going to be possible. And we published that and shared it. And the scientific community could say, "Okay, that makes sense, but that doesn't make it the easiest thing to communicate."
And so we still have to figure out a way to address some of those things, because when something new comes into the world scientifically and it has the kind of effect that we just all experienced, which is four or 5 billion people have interacted with that medicine, and we have not always done a good job explaining to every one of them what it means and how it works. And it happens so fast. There's a joke, Moderna's an overnight success, and I usually add that 11 years in the making. We ground this thing out for 11 years to get to a point where we could prove that this stuff could work.
We could do the one and it would work, but nobody knew of us that 11 years, they just assume it sprung into the world, and that's a little suspicious. And so they lost that this is a relay race, frankly, a relay race that started more than 11 years ago, hundreds of years ago.
Central dogma, molecular biology saying what mRNA can and cannot do is from the 1950s. We all built on that foundation. But people don't see that, and I think we've not done a great job during the pandemic of explaining that.
In fact, one of the things that I often did not like when I was giving television interviews or others, is that people would ask a question that sounds like, well, messenger RNA, it's this new molecule. It's this new thing, new science. It's new is dangerous. It was the subtext. And I kept wanting to say, "This is the oldest molecule in biology. It is not new, just nobody's ever tried to use it."
But it's one of those things that we just need to do a better job explaining about our platform. If we're going to have the impact that I hope we're going to have in cancer or rare diseases across other medicines, and you're going to keep taking it, I need to find a way to help people understand that when you bite a cheeseburger, you're getting more.
But for sure we need to keep following that and studying it. Now, there are other things that we'll still learn about our [inaudible 01:02:34] medicines. We put them in lipid envelopes, so we coat them in it's like milkshake fat. It's kind of like that. And that's how we deliver them. We're learning about the tolerability of those things and how they work.
That's still cholesterol, that's nothing foreign, something people have had for years, people have in their blood every day. But for the most part, we've just got to do a better job communicating about science. And I don't think we always do that well as scientists.
Yeah, please go ahead.
Speaker 7:
Can you talk a little bit about the growth of your... When you talk about the platform and the product, research [inaudible 01:03:17]. Can you talk a little bit about the growth of Moderna as an organization? And as the leader of Moderna, what are some of the failures? Just bring us inside a little bit. What are some of the things, how did you manage that growth? What were the trials and tribulations of that and just contextually give us a sense for that?
Dr. Stephen Hoge:
So what I'll say is that we obsess about the pace of growth. We describe it as a triangle problem, meaning if you think of a triangle as an organizational structure, if it doubles in size and get a bigger triangle, that actually you create a whole bunch of problems. Which is you have to create a layer above in terms of how you lead and you have to create a layer to the side, and you double the amount of the gene pool, if you will, the number of people in there culturally.
And in fact, for Moderna, we have doubled in size every year for 11 years in a row. Two to the 11th is actually about our size right now. And we've always obsessed and worried about that from a cultural dilution perspective. We, Stefan and I, Stefan's my partner, he's the CEO of the company. I'm the president, I run R and D. We often talk about the fact that every time we do this, it's like a reverse merger of a bunch of people who have no idea who we are and how we operate.
And we're constantly trying to figure out how to onboard people and not dilute ourselves out, keep that view that negative information is good, that our mindsets are about that creativity. I will tell you that it is constantly a work in progress.
During the pandemic, when we grew from about 800 to about three, 4,000, it wasn't so complicated because the purpose was so clear, everybody knew what we were doing.
But we have really struggled in the last year as we've settled back in and looked around, and be like, wow, a lot of you are really new. And how do we adapt? One of the things that we've been trying to do is actually just we think culture is everything.
The way we approach things, culture will make it work. And so we built entire curricula. We built a university, it's called Moderna University, but most of that curricula is actually trying to teach everybody down to shop floor operators about our culture and how we operate.
There's a bunch of mindsets training, it can sound like indoctrination. It's really not. It's actually trying to give everybody a common language for what do we value, how do we work together? I think it's a constant though work in progress. We have not gotten it right yet. We have definitely gone off, and we're in a moment right now where we're struggling with the scale at which we operate because we've actually added layers of leadership that don't know us.
People who have been with us for six months have hired leaders underneath them. And we're right now trying to figure out, do we need to change the way we operate as a company so that we can prevent those people who just got here from becoming the management of the company and changing our culture?
And so not that we don't want them to be a part of our company, so let me get that right. We need to grow that way, but we've got to make sure that we grow in a way that keeps what's special about us. So the growth of Moderna, we were terrified when we went from 20 to 40. We were terrified when we went from 200 to 402 sites. Oh my gosh, we're two sites. How's that going to work?
I'm actually very deeply scared about the state at which we're in right now with 5,000, 6,000 people, because culturally it feels like you're at risk of diluting something. The answer may be that we don't grow very much more. The answer may be to preserve what makes us special culturally, that we very carefully think about growing from here, but we don't know that yet. We're working on it.
Please.
Speaker 8:
I'm super interested [inaudible 01:07:00] cancer vaccines and [inaudible 01:07:05]. And one of the things you said was a big barrier [inaudible 01:07:12]. Do you see that as a big barrier [inaudible 01:07:15] vaccines? [inaudible 01:07:21].
Dr. Stephen Hoge:
So I'll do very quickly, what is the time? I just want to be sensitive.
Sarah Turgeon:
This is probably the last question.
Dr. Stephen Hoge:
Okay. There's one more question I think I saw and that we'll cover real quickly. So barrier. So vaccines, here's the good news about personalized cancer vaccines. The hard part there is making it, and what we've been able to show over the course of the pandemic delivering billions of doses of vaccine into the world is that we actually have been able to solve the delivery. It's still an intramuscular injection.
In fact, our cancer therapy, it has exactly the same composition as your COVID booster, only it happens to prevent the recurrence and relapse of in the study that we've run melanoma, and we hope all cancers in the future.
So the delivery piece we think we solved over the last 11 years for that technology, but for other approaches, including some of the rare disease stuff, we're working in cystic fibrosis in the lungs right now, and that's something where we're still working to prove that we can get delivery to work. Delivery is the big challenge in messenger RNA therapies for sure.
Was there another question or are we... Okay, good. All right. Well, I want to thank everybody for staying and proving my kids wrong.
